Adults with HIV and cancer are less likely to receive cancer treatment than patients who are solely suffering from cancer, according to a recent study published in the journal Cancer
In addition to insurance and comorbidities, there are several factors that play a role in the treatment. They include demographics, psychosocial and economic challenges, access to clinical trials and physician concern.
Researchers observed the treatment for cancer of 10,265 HIV-infected people compared with more than two million without HIV. The study focused on the 10 most common cancers among HIV patients: cancers of the head and neck (oral cavity, pharynx, and larynx), upper gastrointestinal tract (pancreas, stomach, and esophagus), colorectal, anal, lung, female breast, cervical, and prostate; Hodgkin lymphoma; and diffuse large B-cell lymphoma (DLBCL).
Demographics differed between the HIV-infected group and the HIV-uninfected group. HIV-infected patients were often younger, male, non-Hispanic black and Hispanic. Most HIV-infected patients had Medicaid, Medicare or no insurance at all as opposed to private insurance, which was held by a majority of the HIV-uninfected group. Additionally, more HIV-infected patients were diagnosed with stage 4 cancer than HIV-uninfected patients (37.2 vs 18.9%). HIV-uninfected patients, on the other hand, were often diagnosed with stage 1 or 2 cancers (57.2 vs 33.2%).
Two of the biggest finds were that black patients and with Medicaid, Medicare, or no insurance were more likely to be untreated for cancer, regardless of tumor type; and that older age was associated with a lack of treatment for both lymphomas and solid tumors.
The treatment of the upper gastrointestinal tract, colorectal, lung, breast, prostate, Hodgkin lymphoma, and DLBCL cancers was significantly less for HIV-infected patients with private insurance compared with HIV-uninfected also privately insured. The only cancer treatment where rates did not differ significantly was for HIV-infected and HIV-uninfected patients with anal cancer.