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Introduction to HIV and cancer Simon Collins HIV i-Base

Introduction to HIV and cancer Simon Collins HIV i-Base. Introduction. • Area of expert care – referrals and networks • BHIVA guidelines • Personal aims for the day? • HIV and cancer – general points • HIV and cancer – scientific concepts • Activist agenda? • Personal comments.

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Introduction to HIV and cancer Simon Collins HIV i-Base

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  1. Introduction to HIV and cancer Simon Collins HIV i-Base

  2. Introduction • Area of expert care – referrals and networks • BHIVA guidelines • Personal aims for the day? • HIV and cancer – general points • HIV and cancer – scientific concepts • Activist agenda? • Personal comments

  3. HIV and cancer • We are lucky to be ageing… • But cancer is often an age-related disease - highest risk comes with age • >75% of people have a lifetime cancer risk - is this a natural ageing process? • Over 200 cancers – each very specific • Many are treatable, with high (>90%) remission rates if detected early (screening / surveillance / self monitoring etc) • Some are not - make the most of life.

  4. HIV and cancer • Expert care essential • Cancer treatment is very different to ART - less data for modified combinations, best guess approach. • Extended timelines for progression, treatment and treatment outcomes. • Risks are multi-factorial and often related to modifiable lifestyle factors. • Personal perspective - prioritise your health.

  5. HIV and cancer: scientific issues • Difficulty of knowing any independent risk from HIV – impact of ART/non- ART and viral suppression. • Difficultly of not having an appropriate matched control group. • Higher rates reported for some and at earlier age – but adjusting for cohort ages of reduced the differences in both incidence and age at diagnosis.

  6. HIV and cancer: scientific issues • Relative vs absolute risks • Issues of screen and risk/benefit balance with screening. • Common sense approach for broad screening programmes is not always supported by evidence. • Difficulty of separating earlier diagnosis and mortality. • Activist role/agenda

  7. Thanks Further info • Macmillan http://www.macmillan.org.uk • BHIVA malignancy guidelines http://www.bhiva.org/Guidelines.aspx UK-CAB reading for April 2013 meeting, including: • Do cancer patients with HIV die sooner? – Mark Bower.
http://www.bhiva.org/121004MarkBower.aspx

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