What can people with HIV or AIDS do to try to lower their risk of cancer or find it early?
People with HIV infection or AIDS are at higher risk for certain types of cancer than those who are not infected. They also share the same risks for many other types of cancer. People with HIV or AIDS may be able to lower their risk of some cancers or find them early, when they are more likely to be treated effectively.
Lowering cancer risk
Certain cancers are more common in people with HIV, but even among different people with HIV, the risk of developing many types of cancer is higher if the infection is not well controlled – that is, if the CD4 (helper-T cell) count is low. This is one reason why it is important for people with HIV to stay on their medicines to help keep the infection under control.
The risk of some of types of cancer that are more common in people with HIV may be lowered by avoiding certain cancer risk factors. For example, not smoking or using injection drugs and limiting alcohol may help lower the risk of some cancers. Some types of cancer linked with HIV and AIDS are caused by viruses that can be spread through sex, so using safer sex practices may also help protect against those cancers.
Vaccines against the hepatitis B virus may help protect against one possible cause of liver cancer. Vaccines are also available to help protect against certain human papilloma virus (HPV) infections, which may help prevent some cervical, anal, and other cancers. But the HPV vaccines are only effective if they are given before a person becomes infected with HPV, so they are typically recommended before a person becomes sexually active. Some screening tests that find pre-cancerous changes caused by HPV (see below) may actually help prevent some cancers if these pre-cancers are removed.
People with HIV are also at risk for other cancers, just like people who are not infected. There are some things all people can do that can help lower their overall cancer risk. For example, staying at a healthy weight, getting regular physical activity, and eating a healthy diet rich in plant-based foods may all help lower a person’s risk of cancer.
Finding cancer early
Screening is the process of looking for cancer in people who do not have any symptoms. While people with HIV are at higher risk for certain cancers, for most of these cancers there are no screening tests proven to help lower the risk of dying from them. For example, there are no tests commonly used to screen for either Kaposi sarcoma or non-Hodgkin lymphoma. Still, careful, regular medical checkups are important to look for possible signs or symptoms of these cancers in people with HIV.
In women, invasive cervical cancer can often be found early or even prevented by getting regular Pap tests, but the tests must be done more often than they are in women without HIV. Many HIV experts recommend that women with HIV have 2 Pap tests (Pap smears) 6 months apart during the first year they find out they have HIV. If both Pap tests are normal, they can then have the tests every year.
Other special screening tests for cancer in people with HIV are being studied. For instance, because people with HIV are also at high risk of anal cancer, some experts recommend they get a screening test very much like the Pap smear (sometimes called an anal Pap test). This test is now being looked at to find out if it is a good way to find anal cancer in its early stages. If the test improves survival or other outcomes, it may become a standard cancer screening test for people with HIV infection.
In the meantime, the same cancer early detection tests that are recommended for people without HIV, such as screening tests for breast or colorectal cancer, can also help detect cancers in people with HIV. (For a list of current recommended tests, see American Cancer Society Guidelines for the Early Detection of Cancer.) Your doctor and dentist should also take extra care during your regular checkups to keep a close watch for any early signs of cancer. If you are interested in more cancer screening options, ask your doctor about clinical trials for cancer detection in people with HIV.
Last Medical Review: July 25, 2014 Last Revised: July 25, 2014