Colorectal cancer risk in the HIV-positive population: A comprehensive analysis

Background Due to advancements in highly active antiretroviral therapy (HAART), the overall mortality rate among individuals living with Human Immunodeficiency Virus (HIV) has decreased. HIV infection is associated with an increased risk of various cancers, both AIDS-defining and non-AIDS-defining. However, evidence regarding colorectal cancer (CRC) incidence and risk in the HIV population remains inconclusive. Through extensive analysis of a comprehensive database, this study aims to investigate the prevalence of CRC in the HIV population. Methods We conducted a search within Explorys Inc, a commercial database consisting of electronic medical records data from 26 prominent integrated US healthcare systems, encompassing 36 US hospitals, spanning from 2015 to 2020. Using Systematized Nomenclature of Medicine – Clinical Terms (SNOMED–CT) the codes for “Human immunodeficiency virus infection” were identified. The prevalence of CRC was calculated. To account for confounding variables, a multivariate analysis model was employed. Results The database included records of 217,570 HIV-positive individuals. Utilizing univariate analysis, we calculated the prevalence of CRC among HIV-positive patients in various age groups. The prevalence of CRC among HIV-positive patients was 0.16%, which is shows a twofold increase compared to HIV-negative patients, whose prevalence was 0.08% with a statistically significant difference (P < 0.0001). When adjusting for confounding factors, our analysis showed that HIV-positive patients were more likely to develop CRC with OR 1.796 (95% CI 1.7-1.8, P < 0.0001) compared to HIV-negative individuals. Conclusion Our study shows a markedly elevated prevalence of CRC in HIV-positive individuals when compared to patients without HIV. Additionally, we identified predictors associated with CRC in this population. Further studies are warranted to comprehensively assess this association, thereby facilitating refinement of screening and treatment guidelines.