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Risk of prostate cancer in men with HIV/AIDS: a systematic review and meta-analysis

Abstract

Background

Although previous studies have shown a decreased incidence of prostate cancer in men with HIV/AIDS, the consensus has not been reached. Our aim is to conduct a systematic review and meta-analysis to assess the risk of prostate cancer among people with HIV/AIDS.

Methods

We systematically searched PubMed, Web of Science, Embase, and Cochrane Library until March 2020. Cohort studies were included if they compared the prostate cancer risk between people with HIV/AIDS and uninfected controls or the general population. The summary standardized incidence ratio (SIR) and 95% confidence interval (CI) were calculated using a random-effects model.

Results

A total of 27 studies were included for analysis, with more than 2780 males with HIV/AIDS developing prostate cancer. The results showed that HIV infection was associated with a decreased risk of prostate cancer incidence (SIR, 0.76; 95% CI, 0.64–0.91; P = 0.003), with significant heterogeneity (P < 0.001; I2 = 91.6%). A range of sensitivity analyzes did not significantly change the results.

Conclusions

Our study shows that people with HIV/AIDS have a lower incidence of prostate cancer compared with the general population. However, significant heterogeneity exists among the included studies. Further prospective studies with better designs are needed to elucidate the association between HIV infection and prostate cancer.

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Fig. 1: Flow-chart of study selection.
Fig. 2: Incidence of prostate cancer in men with HIV/AIDS.
Fig. 3: Summary of subgroup analyzes in the original articles.
Fig. 4: Potential explanations for lower prostate cancer incidence in men living with HIV/ADS.

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Acknowledgements

This work was supported by Sanming Project of Medicine in Shenzhen (grant number: SZSM201911015); Innovation Fund for Medical Sciences (CIFMS; grant number: 2016-I2M-2-004). The funders had no role in the study design, data collection, analysis and interpretation, or writing of the paper.

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Sun, D., Cao, M., Li, H. et al. Risk of prostate cancer in men with HIV/AIDS: a systematic review and meta-analysis. Prostate Cancer Prostatic Dis 24, 24–34 (2021). https://doi.org/10.1038/s41391-020-00268-2

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