Conference Coverage

Cancer Survival Differences Persist Across Treatment Modalities for Early-Stage Tumors Among People With HIV

Edited by:
Ashton L. Stahl

Key Highlights

  • An analysis of 2.7 million cancer cases in the National Cancer Database found lower 5-year survival for people with HIV across most treatment modalities for early-stage lung, prostate, and breast cancer.
  • No significant 5-year survival difference was observed for early-stage anal cancer.
  • Survival disparities persisted despite similar treatment categories, including surgery, radiation, systemic therapy, or combinations.
  • Findings suggest an HIV-associated survival difference independent of treatment modality.

The presence of HIV infection at the time of cancer diagnosis has been associated with increased cancer-related mortality compared with cancer patients without HIV. In a new analysis presented at the 2026 Conference on Retroviruses and Opportunistic Infections in Denver, CO, and based on the National Cancer Database (NCDB) data from 2004 to 2020, investigators found that survival differences persist across specific treatment modalities for patients with stage I–II lung, prostate, and breast cancers.

The researchers sought to move beyond prior aggregate analyses that adjusted for treatment receipt overall and instead examine whether survival differences between people with HIV (PWH) and people without HIV (PWoH) persisted within individual treatment modalities for earlier-stage disease.

Using the NCDB from 2004 to 2020, investigators identified individuals with incident stage I–II lung, prostate, anal, or breast cancer, stratified by HIV status. Survival was defined as the proportion of patients alive 5 years after cancer diagnosis and was evaluated within treatment modalities, including surgery, radiation, systemic therapy, or combinations of these approaches.

Study Findings

Among 2,749,178 PWoH and 7,022 PWH with early-stage cancers, 5-year survival rates were lower for PWH across most treatment modalities at each cancer site examined. At 5 years, survival was 29.6% for PWH versus 39.9% for PWoH with lung cancer, 72.0% versus 76.9% for prostate cancer, and 57.6% versus 74.2% for breast cancer.

For anal cancer, 5-year survival was similar between groups, at 59.4% for PWH and 59.5% for PWoH. The difference in 5-year survival was statistically significant across multiple treatment approaches.

Clinical Implications

According to the study authors, these results provide preliminary evidence of an HIV-associated survival difference in patients with newly diagnosed early-stage tumors receiving comparable cancer treatments. The authors noted that while a cancer-modulating impact of HIV infection could directly contribute to poorer outcomes, additional factors may also play a role.

Expert Commentary

“These results provide preliminary evidence of an HIV-associated survival difference in cancer patients with newly diagnosed early-stage tumors receiving comparable treatments. While a cancer modulating impact of HIV infection could directly contribute to these poorer outcomes, non-HIV medical comorbidities, performance status, and health-related social needs,” the researchers concluded.

Reference

Schneider DJ, Lin J, Islam JY, Coghill AE, Suneja G. Cancer survival differences persist across cancer treatment modalities among people with HIV. Presented at: 2026 Conference on Retroviruses and Opportunistic Infections; February 22-25, 2026; Denver, CO.