Cancer Prevalence in Male Medicaid Beneficiaries With HIV

Siran M Koroukian, PhD, professor, Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, reviews findings from a cross-sectional study of national Medicaid data aimed at determining the prevalence of several types of cancer in men with HIV.

What existing data led you to conduct your research into cancer prevalence in men with HIV?

We were interested in the conditions people with HIV present with, to get a better idea of their morbidity. Cancer is highly prevalent in people living with HIV. A high percentage of people with HIV are represented in Medicaid, so we wanted to understand the prevalence of different cancers within this patient population.

Can you describe your study and findings? Did you find any outcomes particularly surprising?

We used national Medicaid data. This was a massive undertaking because we had to gather and compile data from the Centers for Medicare and Medicaid Services for all 50 states and the District of Columbia. We looked at 13 different types of cancer using the diagnosis codes documented in claims data.

We found a higher prevalence of cancer in men with HIV. Certain cancers were more common than others, including anal cancer, rectal cancer, and lymphoma. This has been reported before, but the magnitude was higher than previously reported. I think the magnitude was surprising, but a lot of it fell within what we expected to see.

How can these findings be applied in real-world clinical practice?

This study highlighted the importance of prevention, particularly with anal cancer, which is closely associated with human papillomavirus. Vaccination should be actively promoted to younger people enrolled in Medicaid. We should focus on prevention and awareness.

Do you plan to expand upon this research?

In this study, we stratified patients based on their symptomatic status—whether they had any opportunistic infections, AIDS-defining cancer, etc. But I think we can go beyond this. I would like to understand the different chronic conditions that people with HIV present with in addition to cancer, and what we can do to prevent and better manage their care. We will be doing a follow-up study with women as well.

Is there anything else you would like to add?

Both cancer and HIV were fatal diseases once, and now they are chronic conditions people can live with, as noted in the accompanying editorial. But we do need to research what we can do to reduce morbidity and mortality in patients with these conditions. Prevention and good management are key strategies.

About Dr Koroukian

Siran Koroukian, PhD, is a professor in the Department of Population and Quantitative Health Sciences at Case Western Reserve University in Cleveland, Ohio. She is also the director of the Population Cancer Analytics Shared Source at Case Comprehensive Cancer Center.

Dr Koroukian’s work is focused on cancer disparities as well as people with multiple chronic conditions who have high burdens of morbidity and mortality, including people living with HIV.

Reference:
Koroukian SM, Zhou G, Navale SM, et al. Excess cancer prevalence in men with HIV: A nationwide analysis of Medicaid data. Cancer. Published online ahead of print March 14, 2022. doi:10.1002/cncr.34166