Trends in Cancer Incidence among People with Human Immunodeficiency Virus in South Korea: A Nationwide National Health Insurance Service Data-based Study

Background:The application of antiretroviral therapy (ART) in people with human immunodeficiency virus (HIV) (PWH) has led to a shift in cancer epidemiology. Methods: PWH were selected from the National Health Insurance Service database from 2002 to 2018.Cancers were identified using the Korean Classification of Disease cancer codes from 2004 to 2019.For incidence analyses, only the first recorded cancer diagnosis per individual was considered.The trends in cancer epidemiology were analyzed according to the duration since HIV diagnosis, categorized as 0-3 years (duration 1), 4-7 years (duration 2), 8-11 years (duration 3), and 12-15 years (duration 4).Analyses were also stratified by the period before and after the implementation of expanded cancer screening programs in Korea: 2004-2011 (period 1) and 2012-2019 (period 2).Results: Among 15,110 PLWHA, 774 developed cancer during follow-up.Of these, 241 were ADCs (234.26 per 100,000 person-years) and 533 were NADCs (523.08 per 100,000 person-years).The proportion of ADCs among all cancers was 37.1%, 21.1%, 20.0%, and 13.5% across increasing durations since HIV diagnosis. Conclusions:In the ART era, NADCs represent an increasing disease burden in PWH, underscoring the importance of cancer screening following HIV diagnosis.