Retrospective cohort study of survival by sex and HIV status in patients with anal cancer in the USA between 2001 and 2019

The risk of anal cancer is increased among people with HIV. Estimating survival by HIV status and sex and identifying groups at high risk is important. A retrospective study using data from 13 population-based HIV and cancer registries throughout the USA included 24,486 patients with a diagnosis anal cancer between 2001 and 2019. Among these patients 2662 also had HIV infection. HIV was associated with a 1.35 times (95% CI 1.24-1.47) increased all-cause mortality (ACM) in males and 2.47 times (2.10-2.90) increased ACM in females. Among patients with anal cancer and HIV, ACM was increased among non-Hispanic Blacks, people with AIDS, people who inject drugs, patients with adenocarcinoma, and those with no or unknown surgical treatment. HIV was associated with anal cancer-specific mortality among female patients only (HR 1.52; 95% CI 1.18-1.97).