Cancer and women living with HIV: results from D:A:D and RESPOND support including screening in routine HIV care

Results from a large international observational study provide important data that should help prioritise early diagnosis and care for different cancers in women living with HIV.

The study included more than 17,500 cisgender women living with HIV and more than 141,000 participant years of follow-up (PYFU).

The median age was 39 (IQR: 32 to 46) years and 48%, 23%, and 5% were white, Black and other race/ethnicity, respectively (~25% unknown). Participants were from cohorts from Western European (43%), Southern Europe (26%) and Northern Europe (17%). The median baseline and pre-ART nadir CD4 counts were 458 (IQR: 306 to 654) and 223 (IQR: 110 to 363) cells/mm3, respectively. Approximately 30% of women were current smokers.

After a median 9.2 (5.5-10.1) years, 832 women were diagnosed with any cancer: an incidence rate of 5.9/1000 PY (95% CI 5.5-6.4) overall, with highest rates of breast, lung and Non-Hodgkin Lymphoma (IR: 1.1, 0.7 and 0.5, respectively).

Higher associations to overall cancer risk were reported with older age (≥45 vs <45 years), geographic location (Southern Europe vs Western Europe) and for current smokers. Lower CD4 nadir and a prior AIDS diagnosis were associated with higher rates of lung- and HPV-related cancer.

The researchers conclude that cancer prevention should be routinely included in HIV care for women and that their data reinforces the importance of early HIV diagnosis, sustained viral suppression and smoking cessation efforts in reducing cancer.

Han MW et al on behalf of the D:A:D and RESPOND collaborations. Cancer burden and risk factors among women with HIV: a multi-regional study from the D:A:D and RESPOND cohort collaborations. eClinical Medicine, January 2026. DOI: 10.1016/j.eclinm.2025.103739.
https://www.sciencedirect.com/science/article/pii/S2589537025006741