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dc.contributor.authorDryden-Peterson, Scotten_US
dc.contributor.authorMedhin, Helufen_US
dc.contributor.authorKebabonye-Pusoentsi, Malebogoen_US
dc.contributor.authorSeage, George R.en_US
dc.contributor.authorSuneja, Gitaen_US
dc.contributor.authorKayembe, Mukendi K. A.en_US
dc.contributor.authorMmalane, Mompatien_US
dc.contributor.authorRebbeck, Timothyen_US
dc.contributor.authorRider, Jennifer R.en_US
dc.contributor.authorEssex, Myronen_US
dc.contributor.authorLockman, Shahinen_US
dc.date.accessioned2015-09-01T13:26:41Z
dc.date.issued2015en_US
dc.identifier.citationDryden-Peterson, S., H. Medhin, M. Kebabonye-Pusoentsi, G. R. Seage, G. Suneja, M. K. A. Kayembe, M. Mmalane, et al. 2015. “Cancer Incidence following Expansion of HIV Treatment in Botswana.” PLoS ONE 10 (8): e0135602. doi:10.1371/journal.pone.0135602. http://dx.doi.org/10.1371/journal.pone.0135602.en
dc.identifier.issn1932-6203en
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:21459015
dc.description.abstractBackground: The expansion of combination antiretroviral treatment (ART) in southern Africa has dramatically reduced mortality due to AIDS-related infections, but the impact of ART on cancer incidence in the region is unknown. We sought to describe trends in cancer incidence in Botswana during implementation of the first public ART program in Africa. Methods: We included 8479 incident cases from the Botswana National Cancer Registry during a period of significant ART expansion in Botswana, 2003–2008, when ART coverage increased from 7.3% to 82.3%. We fit Poisson models of age-adjusted cancer incidence and counts in the total population, and in an inverse probability weighted population with known HIV status, over time and estimated ART coverage. Findings: During this period 61.6% of cancers were diagnosed in HIV-infected individuals and 45.4% of all cancers in men and 36.4% of all cancers in women were attributable to HIV. Age-adjusted cancer incidence decreased in the HIV infected population by 8.3% per year (95% CI -14.1 to -2.1%). However, with a progressively larger and older HIV population the annual number of cancers diagnosed remained constant (0.0% annually, 95% CI -4.3 to +4.6%). In the overall population, incidence of Kaposi’s sarcoma decreased (4.6% annually, 95% CI -6.9 to -2.2), but incidence of non-Hodgkin lymphoma (+11.5% annually, 95% CI +6.3 to +17.0%) and HPV-associated cancers increased (+3.9% annually, 95% CI +1.4 to +6.5%). Age-adjusted cancer incidence among individuals without HIV increased 7.5% per year (95% CI +1.4 to +15.2%). Interpretation Expansion of ART in Botswana was associated with decreased age-specific cancer risk. However, an expanding and aging population contributed to continued high numbers of incident cancers in the HIV population. Increased capacity for early detection and treatment of HIV-associated cancer needs to be a new priority for programs in Africa.en
dc.language.isoen_USen
dc.publisherPublic Library of Scienceen
dc.relation.isversionofdoi:10.1371/journal.pone.0135602en
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC4534370/pdf/en
dash.licenseLAAen_US
dc.titleCancer Incidence following Expansion of HIV Treatment in Botswanaen
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden
dc.relation.journalPLoS ONEen
dash.depositing.authorDryden-Peterson, Scotten_US
dc.date.available2015-09-01T13:26:41Z
dc.identifier.doi10.1371/journal.pone.0135602*
dash.authorsorderedfalse
dash.contributor.affiliatedRider, Jennifer
dash.contributor.affiliatedEssex, Myron
dash.contributor.affiliatedDryden-Peterson, Scott
dash.contributor.affiliatedLockman, Shahin
dash.contributor.affiliatedSeage, George


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