According to a recent article published in the American Journal of Gastroenterology, patients infected with the human immunodeficiency virus (HIV) are not adequately screened for colorectal cancer when compared to the general population.
Colorectal cancer is the second leading cause of cancer-related deaths in the United States. If caught early, colorectal cancer has high cure rates following standard therapies. The current screening recommendations for colorectal cancer in the general population include a colonoscopy (a procedure in which a lighted tube is inserted into the rectum and entire large intestine), sigmoidoscopy (a procedure in which a lighted tube is inserted into the rectum and lower large intestine), or fecal occult blood test (FOBT) (a test for blood in the stool). The recommended age to begin screening is 50 years. Unfortunately, a large portion of individuals within this age bracket does not undergo any of these screening methods due to their inherent invasive nature.
Patients infected with HIV may be at a higher risk of developing some types of cancer such as non-Hodgkin’s lymphoma and possibly colorectal cancer. Researchers continue to evaluate possible associations between the development of cancers and the role of HIV. Now that highly active anti-viral therapy (HAART) is available for the treatment of HIV, patients infected with the virus are able to tolerate therapies for cancers such as chemotherapy, and are thus achieving survival benefits from cancer treatment. With these positive treatment outcomes, it makes sense to provide optimal screening measures for cancer in HIV-infected individuals.
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Researchers from NYU School of Medicine recently conducted a clinical study comparing the rate of screening for colorectal cancer in HIV-infected patients to screening in the general population (control group). Overall, about 20% more of the normal population underwent colorectal cancer screening than HIV-infected individuals: 78% of the control group was screened versus 56% of the HIV group. A sigmoidoscopy had been performed in 17.5% of the control group, compared with only approximately 5% of HIV-infected individuals, and a colonoscopy had been performed in only approximately 8% of patients in the control group, compared with less than 3% of HIV-infected individuals.
The researchers concluded that screening rates for colorectal cancer in HIV-infected individuals appears to be lower than that of the general population, adding that this trend needs to be improved upon. Patients who are infected with HIV should speak with their physician regarding an individualized screening schedule for prevention or early detection of colorectal cancer.
Reference: Reinhold J-P, Moon M, Tenner CT, et al. Colorectal cancer screening in HIV-infected patients 50 years of age and older: Missed opportunities for prevention. *American Journal of Gastroenterology.*2005;100:1805-1812.