RT Journal Article
T1 Impact of an enhanced screening program on the detection of non-AIDS neoplasias in patients with human immunodeficiency virus infection
A1 Masia, M.
A1 Padilla, S.
A1 Estan, G.
A1 Portu, J.
A1 Silva, A.
A1 Rivero, A.
A1 Gonzalez-Cordon, A.
A1 Garcia-Fraile, L.
A1 Martinez, O.
A1 Bernal, E.
A1 Galera, C.
A1 Martinez, V. Boix
A1 Macias, J.
A1 Montero, M.
A1 Garcia-Rosado, D.
A1 Vivancos-Gallego, M. J.
A1 Llenas-Garcia, J.
A1 Torralba, M.
A1 Garcia, J. A.
A1 Agullo, V
A1 Gonzalez-Fernandez, M.
A1 Gutierrez, F.
A1 Martinez, E.
A1 IMPAC-NEO Study Grp, 
K1 HIV infection
K1 Neoplasms
K1 Cancer
K1 Non-AIDS-defining cancers
K1 Screening
K1 Early detection of cancer
K1 General-population
K1 Hepatocellular-carcinoma
K1 Hiv
K1 Cancers
K1 People
K1 Mortality
K1 Hiv/aids
K1 Death
K1 Risk
K1 Epidemiology
AB Background: The incidence of non-AIDS defining cancer (NADC) is higher in people living with HIV (PLWH) than in the general population, and it is already one of the leading causes of death in the HIV-infected population. It is estimated that the situation will be aggravated by the progressive aging of PLWH. Early diagnosis through intensive cancer screening may improve the ability for therapeutic interventions and could be critical in reducing mortality, but it might also increase expenditure and harms associated with adverse events. The aim of this study is to evaluate an enhanced screening program for early diagnosis of cancer in PLWH compared to standard practice. The specific objectives are (1) to compare the frequency of cancer diagnosed at an early stage, (2) to analyze safety of the enhanced program: adverse events and unnecessary interventions, (3) to analyze the cost-utility of the program, and (4) to estimate the overall and site-specific incidence of NADC in PLWH.Methods: We will conduct a multicenter, non-blinded, randomized, controlled trial, comparing two parallel arms: conventional vs enhanced screening. Data will be recorded in an electronic data collection notebook. Conventional intervention group will follow the standard of care screening in the participating centers, according to the European AIDS Clinical Society recommendations, and the enhanced intervention group will follow an expanded screening aimed to early detection of lung, liver, anal, cervical, breast, prostate, colorectal, and skin cancer. The trial will be conducted within the framework of the Spanish AIDS Research Network Cohort (CoRIS).Discussion: The trial will evaluate the efficacy, safety, and efficiency of an enhanced screening program for the early diagnosis of cancer in HIV patients compared to standard of care practice. The information provided will be relevant since there are currently no studies on expanded cancer screening strategies in patients with HIV, and available data estimating cost effectiveness or cost-utility of such as programs are scarce. An enhanced program for NADC screening in patients with HIV could lead to early diagnosis and improve the prognosis of these patients, with an acceptable rate of unnecessary interventions, but it is critical to demonstrate that the benefits clearly outweigh the harms, before the strategy could be implemented.
PB Bmc
YR 2021
FD 2021-11-27
LK https://hdl.handle.net/10668/25596
UL https://hdl.handle.net/10668/25596
LA en
DS RISalud
RD Apr 6, 2025