Cancer care in people living with HIV in Nevada

Abstract Background: Prior national registry and hospital data have demonstrated that people with HIV and cancer are less likely to receive cancer treatment compared with HIV-uninfected patients with the same cancer types. We sought to characterize demographic, clinical, and treatment patterns among people living with HIV and newly diagnosed with cancer in Nevada, an area of high HIV incidence and limited cancer treatment infrastructure. As Nevada data is not included in national registries, previously published national registry studies may overestimate rates of cancer care in PLWHIV and minimize disparities Methods: We obtained data through a linkage from the Nevada Cancer Registry and the Nevada HIV registry in the years 1985 to 2017. Cases were matched using unique identifiers, including medical record number and date of birth, then a de-identified dataset was shared with investigators and used for analysis[GS1] [CC2] . Descriptive statistics were used to examine the cohort of patients living with HIV and newly diagnosed with cancer. Multivariate logistic regression was used to identify predictors of receipt of cancer treatment. The model covariates were age at HIV diagnosis, year of HIV diagnosis, sex, race, insurance status, year of cancer diagnosis, primary cancer site, and tumor stage. Results: The cohort included a total of 984 patients, of whom 847 (86.1%) patients identified as male, 135 (13.7%) as female, and 2 (0.2%) as transgender. For race/ethnicity, 583 (54.9%) reported non-Hispanic White race, 203 (20.6%) non-Hispanic Black race, 151 (15.3%) Hispanic ethnicity, and 47 (4.8%) other races/ethnicities. Among all patients in the cohort, 445 (45.2%) patients received no cancer-directed therapy. Of those receiving treatment, 333 (37.9%) underwent surgery, 118 (15.1%) had radiotherapy, and 232 (42.8%) received chemotherapy. Overall rates of any cancer treatment varied year to year, but increased over time from 40% to 60% during the study period. On multivariate analysis, Black patients (adjusted odds ratio [aOR], 0.44; 95% confidence interval [95% CI], 0.20-0.96; reference group White patients), patients with lung cancer (aOR 0.17, 95% 0.049-0.61; reference group head and neck cancer) and patients with stage IV cancers (aOR 0.27, 95% 0.12-0.64; reference group stage I cancers) were significantly less likely to receive any cancer treatment. Conclusion: Cancer treatment rates among people living with HIV in Nevada is lower than expected based on previously published national data. The data suggest a unique opportunity for collaboration to improve cancer care delivery to people living with HIV in Nevada. Several initiatives are underway to improve access to cancer treatment for people living with HIV in the Mountain West. Citation Format: Valencia T. Henry, Ryan Hutten, Chad Cross, David W. Wetter, Angie Fagerlin, Gita Suneja. Cancer care in people living with HIV in Nevada [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B048.