Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review
  • Published:

HIV and prostate cancer: a systematic review of the literature

Abstract

Malignancy occurs with increased frequency in the HIV-positive population. The true incidence of prostate cancer in this population is unknown. In the few cases that have been presented in the literature, prostate cancer in HIV-positive men appears to behave much like it does in HIV-negative men. Prostate cancer is the most common malignancy in men and the second leading cause of cancer death. Approximately 800 000 men in the United States are HIV positive, and innovative therapies have dramatically improved survival. HIV disproportionately impacts ethnic groups with increased risk of prostate cancer and has been associated with increases in the incidence of certain malignancies. Despite the high prevalence of both diseases, there is relatively little literature about prostate cancer in HIV-positive patients. There is no consensus on how to screen or treat this patient population. We review the literature with regards to incidence, screening, treatment, and outcomes of this poorly characterized population. We briefly discuss the impact of highly active antiretroviral therapy and testosterone supplementation in the development of prostate cancer. A systematic review of the literature was conducted using MEDLINE key words ‘HIV,’ ‘prostate,’ ‘prostate cancer’ and ‘AIDS.’ Manual bibliographic review of cross-referenced items was also performed. A total of 176 unique abstracts and publications were reviewed; many authors provided data on the incidence of HIV and various malignancies including prostate cancer. Twelve unique publications providing detailed information on 60 patients with HIV and prostate cancer were identified. Prostate cancer is a common malignancy in HIV-positive men. With improved therapies for HIV and increasing survival, the importance for screening and treating prostate cancer is increasing. Acute outcomes of treatment do not demonstrate increased acute morbidity; however long-term outcomes have not been reported.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Engels EA, Pfeiffer RM, Goedert JJ, Virgo P, McNeel TS, Scoppa SM et al. Trends in cancer risk among people with AIDS in the United States 1980–2002. AIDS 2006; 20: 1645.

    Article  PubMed  Google Scholar 

  2. Goedert JJ, Purdue MP, McNeel TS, McGlynn KA, Engels EA . Risk of germ cell tumors among men with HIV/acquired immunodeficiency syndrome. Cancer Epidemiol Biomarkers Prev 2007; 16: 1266.

    Article  CAS  PubMed  Google Scholar 

  3. Goedert JJ, Schairer C, McNeel TS, Hessol NA, Rabkin CS, Engels EA . Risk of breast, ovary, and uterine corpus cancers among 85 268 women with AIDS. Br J Cancer 2006; 95: 642.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Glynn M, Rhodes P . Estimated HIV prevalence in the United States at the end of 2003. National HIV Prevention Conference. Atlanta, GA, 2005.

    Google Scholar 

  5. Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report, 2006. US Department of Health and Human Services, Centers for Disease Control and Prevention: Atlanta, GA, vol. 18, 2008. http://www.cdc.gov/hiv/topics/surveillance/resources/reports/2006report/default.htm

  6. Centers for Disease Control and Prevention. Trends in HIV/AIDS diagnoses—33 states, 2001–2004. MMWR Morb Mortal Wkly Rep 2005; 54: 1149.

    Google Scholar 

  7. Hessol NA, Pipkin S, Schwarcz S, Cress RD, Bacchetti P, Scheer S . The impact of highly active antiretroviral therapy on non-AIDS-defining cancers among adults with AIDS. Am J Epidemiol 2007; 165: 1143.

    Article  PubMed  Google Scholar 

  8. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Murray T et al. Cancer statistics, 2008. CA Cancer J Clin 2008; 58: 71.

    Article  PubMed  Google Scholar 

  9. Ng T, Stein NF, Kaminetsky J, Berman S, Marans HY, McDermott B et al. Preliminary results of radiation therapy for prostate cancer in human immunodeficiency virus-positive patients. Urology 2008. [E-pub ahead of print]

  10. Pantanowitz L, Bohac G, Cooley TP, Aboulafia D, Dezube BJ . Human immunodeficiency virus-associated prostate cancer: clinicopathological findings and outcome in a multi-institutional study. BJU Int 2008; 101: 1519–1523.

    Article  PubMed  Google Scholar 

  11. Walters Z, Shamash J, Powles T . Prostate cancer in HIV-positive individuals: what we know and what we don't. J HIV Ther 2007; 12: 66.

    PubMed  Google Scholar 

  12. Manfredi R, Fulgaro C, Sabbatani S, Dentale N, Legnani G . Disseminated, lethal prostate cancer during human immunodeficiency virus infection presenting with non-specific features. Open questions for urologists, oncologists, and infectious disease specialists. Cancer Detect Prev 2006; 30: 20.

    Article  PubMed  Google Scholar 

  13. Huang WC, Kwon EO, Scardino PT, Eastham JA . Radical prostatectomy in patients infected with human immunodeficiency virus. BJU Int 2006; 98: 303.

    Article  PubMed  PubMed Central  Google Scholar 

  14. O'Connor JK, Nedzi LA, Zakris EL . Prostate adenocarcinoma and human immunodeficiency virus: report of three cases and review of the literature. Clin Genitourin Cancer 2006; 5: 85.

    Article  PubMed  Google Scholar 

  15. Quatan N, Nair S, Harrowes F, Hay P . Should HIV patients be considered a high risk group for the development of prostate cancer? Ann R Coll Surg Engl 2005; 87: 437.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Levinson A, Nagler EA, Lowe FC . Approach to management of clinically localized prostate cancer in patients with human immunodeficiency virus. Urology 2005; 65: 91.

    Article  PubMed  Google Scholar 

  17. Crum NF, Spencer CR, Amling CL . Prostate carcinoma among men with human immunodeficiency virus infection. Cancer 2004; 101: 294.

    Article  PubMed  Google Scholar 

  18. Furco A, Bani-Sadr F, Guymar S, Molina JM . [Metastatic cancer of the prostate in a young 40 year-old HIV-infected male patient]. Presse Med 2003; 32: 930.

    CAS  PubMed  Google Scholar 

  19. Staiman V, Lowe FC . Prostatic disease in HIV-infected patients. Infections in Urology 1996; 42.

  20. Schwartz JD, Prince D . Prostate cancer in HIV infection. AIDS 1996; 10: 797–798.

    Article  CAS  PubMed  Google Scholar 

  21. Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun MJ . Cancer statistics, 2007. CA Cancer J Clin 2007; 57: 43.

    Article  PubMed  Google Scholar 

  22. Ries LAG, Melbert D, Krapcho M, Mariotto A, Miller BA, Feuer EJ, Clegg L, Horner MJ, Howlader N, Eisner MP, Reichman M, Edwards BK (eds). SEER Cancer Statistics Review, 1975–2004. National Cancer Institute: Bethesda, MD. http://seer.cancer.gov/esr/1975_2004/

  23. Biggar RJ, Kirby KA, Atkinson J, McNeel TS, Engels E . Cancer risk in elderly persons with HIV/AIDS. J Acquir Immune Defic Syndr 2004; 36: 861.

    Article  PubMed  Google Scholar 

  24. Frisch M, Biggar RJ, Engels EA, Goedert JJ, AIDS-Cancer Match Registry Study Group. Association of cancer with AIDS-related immunosuppression in adults. JAMA 2001; 285: 1736.

    Article  CAS  PubMed  Google Scholar 

  25. Gallagher B, Wang Z, Schymura MJ, Kahn A, Fordyce EJ . Cancer incidence in New York State acquired immunodeficiency syndrome patients. Am J Epidemiol 2001; 154: 544.

    Article  CAS  PubMed  Google Scholar 

  26. Burgi A, Brodine S, Wegner S, Milazzo M, Wallace MR, Spooner K et al. Incidence and risk factors for the occurrence of non-AIDS-defining cancers among human immunodeficiency virus-infected individuals. Cancer 2005; 104: 1505.

    Article  PubMed  Google Scholar 

  27. Brenner H, Arndt V . Long-term survival rates of patients with prostate cancer in the prostate-specific antigen screening era: population-based estimates for the year 2000 by period analysis. J Clin Oncol 2005; 23: 441.

    Article  PubMed  Google Scholar 

  28. de Koning HJ, Liem MK, Baan CA, Boer R, Schroder FH, Alexander FE . Prostate cancer mortality reduction by screening: power and time frame with complete enrollment in the European Randomised Screening for Prostate Cancer (ERSPC) trial. Int J Cancer 2002; 98: 268.

    Article  CAS  PubMed  Google Scholar 

  29. Gohagan JK, Prorok PC, Hayes RB, Kramer BS . The prostate, lung, colorectal and ovarian (PLCO) cancer screening trial of the National Cancer Institute: history, organization, and status. Control Clin Trials 2000; 21: 251S.

    Article  CAS  PubMed  Google Scholar 

  30. Jensen AR, Garne JP, Storm HH, Ewertz M, Cold S, Alvegaard T et al. Stage and survival in breast cancer patients in screened and non-screened Danish and Swedish populations. Acta Oncol 2003; 42: 701.

    Article  PubMed  Google Scholar 

  31. Prostate-specific antigen (PSA) best practice policy. American Urological Association (AUA). Oncology (Williston Park) 2000; 14: 267.

  32. Lohse N, Hansen AB, Gerstoft J, Obel N . Improved survival in HIV-infected persons: consequences and perspectives. J Antimicrob Chemother 2007; 60: 461.

    Article  CAS  PubMed  Google Scholar 

  33. Schackman BR, Gebo KA, Walensky RP, Losina E, Muccio T, Sax PE et al. The lifetime cost of current human immunodeficiency virus care in the United States. Med Care 2006; 44: 990.

    Article  PubMed  Google Scholar 

  34. Wammack R, Djavan B, Remzi M, Susani M, Marberger M . Morbidity of transrectal ultrasound-guided prostate needle biopsy in patients receiving immunosuppression. Urology 2001; 58: 1004.

    Article  CAS  PubMed  Google Scholar 

  35. Vianna LE, Lo Y, Klein RS . Serum prostate-specific antigen levels in older men with or at risk of HIV infection. HIV Med 2006; 7: 471.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Kwan DJ, Lowe FC . Genitourinary manifestations of the acquired immunodeficiency syndrome. Urology 1995; 45: 13.

    Article  CAS  PubMed  Google Scholar 

  37. Crum NF, Furtek KJ, Olson PE, Amling CL, Wallace MR . A review of hypogonadism and erectile dysfunction among HIV-infected men during the pre- and post-HAART eras: diagnosis, pathogenesis, and management. AIDS Patient Care STDS 2005; 19: 655.

    Article  PubMed  Google Scholar 

  38. Rhoden EL, Morgentaler A . Risks of testosterone-replacement therapy and recommendations for monitoring. N Engl J Med 2004; 350: 482.

    Article  CAS  PubMed  Google Scholar 

  39. Simon V, Ho DD, Abdool KQ . HIV/AIDS epidemiology, pathogenesis, prevention, and treatment. Lancet 2006; 368: 489.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Engels EA, Biggar RJ, Hall HI, Cross H, Crutchfield A, Finch JL et al. Cancer risk in people infected with human immunodeficiency virus in the United States. Int J Cancer 2008; 123: 187.

    Article  CAS  PubMed  Google Scholar 

  41. Klein EA, Silverman R . Inflammation, infection, and prostate cancer. Curr Opin Urol 2008; 18: 315.

    Article  PubMed  Google Scholar 

  42. Pajonk F, Himmelsbach J, Riess K, Sommer A, McBride WH . The human immunodeficiency virus (HIV)-1 protease inhibitor saquinavir inhibits proteasome function and causes apoptosis and radiosensitization in non-HIV-associated human cancer cells. Cancer Res 2002; 62: 5230.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to J Silberstein.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Silberstein, J., Downs, T., Lakin, C. et al. HIV and prostate cancer: a systematic review of the literature. Prostate Cancer Prostatic Dis 12, 6–12 (2009). https://doi.org/10.1038/pcan.2008.44

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/pcan.2008.44

Keywords

This article is cited by

Search

Quick links