Lung cancer is the most frequently diagnosed type of cancer representing 11.6% of the 18.1 million new global cancer cases in 2018 (Bray et al., 2018)
- In the US, deaths from lung cancer represent 25% of the cancer mortalities (Groot et al., 2018).
- The prevalence of lung cancer is higher among HIV patients and is estimated at 2 to 4 times the incidence in the general population (Pakalla & Ramalingam, 2010).
The rapid decrease in the incidence of lung cancer witnessed between 1990 and the early 2000s, achieved through tobacco control initiatives has leveled off with little gains made in reducing the lung cancer incidence and improving the disease survival rate in recent years (Groot et al., 2018). In 2018, lung cancer was the most prevalent type of cancer accounting for 11.6% of the 18.1 million new global cancer cases (Bray et al., 2018). In the US, deaths from lung cancer represented 25% of all 2018 cancer mortalities. Additionally, lung cancer had the lowest survival rate with an 18% survival rate for all new cases reported between 2003 and 2009 (Groot et al., 2018). The incidence of lung-cancer among HIV positive patients is disproportionately higher than in the general population, estimated at 2 to 4 times the incidence in the general population incidence (Pakalla & Ramalingam, 2010).
While some researchers have attributed the higher lung cancer rate in HIV positive patients to the higher smoking rate in this population, other studies indicate higher incidence of lung cancer in the subpopulation, even with lower proportion of smokers compared to the general population (Kirk et al., 2007; Reddy et al., 2017; Sigel, Mackinson & Thaler, 2018). Research has indicated that immunosuppression and inflammatory processes linked to antiretroviral processes are involved in the high rate of lung cancer among HIV patients (Pakalla & Ramalingam, 2010). In the post-highly active antiretroviral therapy (HAART) era, the incidence of lung cancer and other non-AIDS defining cancers (NADCs) increased from 20% to 71%, implicating HAART in the unexpectedly high lung cancer rates in the HIV positive population. Furthermore, HIV patients exhibit higher lung-cancer specific mortality rates with an estimated hazard ratio of 1.25 when compared to the general population (Suneja et al., 2013)