Cancer in older adults living with HIV

Key take-home messages

• Evidence shows that cancer risk among older people living with HIV is increased for some cancers (e.g., anal, lung, liver).

• Earlier initiation of antiretroviral therapy (ART) following HIV acquisition reduces non-AIDS-defining cancer risk (NADC).

• Due to the longer life expectancy of people living with HIV achieved with antiretroviral therapy , the burden from aging-related cancers (e.g., breast, colon, prostate cancers) can be expected to increase. By 2030, prostate and lung cancers are expected to emerge as the most common types of cancer among people living with HIV.

• Cancer prevention in older people living with HIV requires a comprehensive and multifaceted approach; prevention strategies include cancer screening, vaccinations against oncogenic viruses, management of co-infections, sustained ART adherence, and lifestyle changes (e.g., diet, exercise, smoking cessation). However, uptake of preventive services (e.g., anal cancer screening) remains suboptimal.

• Older adults living with HIV who develop NADCs exhibit a distinct immunological profile characterized by preserved immune function alongside chronic inflammation, immune activation, and accelerated aging. This suggests that cancer risk in this population is driven more by immune dysregulation and inflammaging rather than by immunosuppression.

• Epidemiology and Determinants of Health
  • Epidemiology
• Population(s)
  • Older adults (>50 years)
  • General HIV+ population
• Co-morbidities
  • Cancer
• Health Systems
  • Governance arrangements
  • Financial arrangements
  • Delivery arrangements