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Breast and uterine cancer reduced in women with AIDS
  By Megan Rauscher
ANAHEIM, California (Reuters Health) - Women with AIDS have a lower risk of developing cancer of the breast and uterine corpus (endometrial), perhaps because of alterations in body fat and hormone imbalance, a researcher from the National Cancer Institute told participants at the 96th annual meeting of the American Association for Cancer Research.
"Naively, you'd think that all cancers would be increased in the setting of AIDS," Dr. James J. Goedert noted in an interview with Reuters Health. "In this study, we matched women with AIDS to several million cancer records and looked for differences in the incidence of cancer of the breast, ovarian, and uterine corpus."
Of 77,369 women with AIDS followed for 592,578 person-years from 5 years before to 10 years after diagnosis of AIDS, 274 developed breast cancer, 31 developed ovarian cancer, and 29 developed cancer of the uterine corpus.
The incidence of breast cancer in both pre- and postmenopausal women was reduced by 32% in women with AIDS, with a standardized incidence ratio (SIR) of 0.68. Even after adjusting for childbearing, breast cancer risk was reduced by roughly 27% in women with AIDS.
According to Dr. Goedert, "the deficit in breast cancer among women with AIDS was largest in the early years of the HIV epidemic, intermediate in the early 1990s and in the HAART era is actually approaching what you'd expect in the general population. We don't have a ready explanation for this," he admitted, but the data do support the hypothesis that breast cancer risk is associated with HIV treatment.
The researchers also observed a 40% reduction in the incidence of uterine corpus cancer among postmenopausal women with AIDS (SIR 0.60), while ovarian cancer incidence was not markedly reduced or increased in women with AIDS (SIR 0.85).
"A biological explanation for the deficits in postmenopausal endometrial cancer as well as breast cancer may be hypoestrogenemia and hypoandrogenemia with AIDS and tied into that may be reduced body fat," Dr. Goedert said.
"Particularly in the postmenopausal era, body fat actually accounts for a lot of the circulating estrogens, and women with AIDS relatively speaking are skinnier and have a different body fat distribution than women in the general population," he explained.
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