People with HIV are at a higher risk of being diagnosed with nonmelanoma skin cancer, which is already one of the most prevalent forms of cancer in the U.S. A 12-year Kaiser Permanente study indicates that people with HIV are twice as likely as people who are HIV-negative to contract some form of nonmelanoma skin cancer. Squamous cell carcinoma, which forms on the outermost part of the epidermis (the top layer of the skin), is related to a person’s immunodeficiency and associated with lower CD4-cell counts, according to the study, published in the Journal of the National Cancer Institute. The other major type of skin cancer that HIVers are more prone to is basal cell carcinoma, which grows within the deepest part of the epidermis.
More than 3.5 million new cases of nonmelanoma skin cancer are diagnosed each year, according to the journal Archives of Dermatology. While this form of cancer can be easily treated, some cases become locally invasive and medically dangerous.
Because people with HIV are living longer, says lead study author Michael J. Silverberg, Ph.D., MPH, of the Kaiser Permanente Division of Research, the burden of these age-related (rather than AIDS-related) cancers “will only continue to increase. Based on our studies, nonmelanoma skin cancers are by far the most common cancer this population experiences.”
Among the general population, there is typically one case of squamous cell carcinoma for every four cases of basal cell carcinoma. For HIVers, though, the ratio is different, says Maryam M. Asgari, MD, MPH, a senior author on the study and an investigator at Kaiser Permanente’s Division of Research. “For HIV-positive subjects with low CD4 counts,” she says, “there was one case of squamous cell carcinoma for every two cases of basal cell carcinoma.”
Previous studies have indicated that people with HIV are more prone to cancer due to their immunodeficiency. However, there has been very little information about the prevalence of nonmelanoma skin cancer among the HIV-positive population.
What can you do to stay healthy? Asgari says you should be vigilant about skin-cancer screening, “especially for squamous cell carcinomas and particularly for those who are not on antiretroviral therapy or who were diagnosed late and have more advanced HIV/AIDS.”
She adds that HIV-positive individuals should “reduce behaviors that may further increase nonmelanoma skin cancer incidence, such as excessive sun exposure.” And since there appears to be a link between immunodeficiency and squamous cell carcinoma, starting antiretroviral therapy as early as possible to maintain higher CD4 counts “may also help reduce the burden of this cancer.”