However, the incidence of certain cancers not traditionally associated with HIV has increased more than threefold in this population over the same period, such that these non-AIDS-defining cancers now account for an increasing proportion of deaths among persons with HIV. Rates of AIDS-defining cancers such as Kaposi’s sarcoma and non-Hodgkin’s lymphoma have declined markedly among persons with HIV infection in the years following the introduction of combination antiretroviral therapy (cART). These data will inform the development of guidelines for colorectal cancer screening in persons with HIV. Random effects meta-analysis methods will be employed to estimate standardized incidence ratios. We will examine clinical, methodological, and statistical heterogeneity among studies prior to conducting meta-analysis. Two investigators will independently screen citations and full-text articles, conduct data abstraction, and appraise study quality. We will search electronic bibliographic databases from their inception date, as well as conference proceedings and reference lists of included articles. Our secondary objectives are to summarize the evidence for differences with respect to stage at diagnosis, site of disease, and mortality due to colorectal cancer. Our primary outcome is the standardized incidence ratio of colorectal cancer among persons with HIV relative to rates in persons not living with HIV. The purpose of this systematic review and meta-analysis is to synthesize evidence regarding the incidence of colorectal cancer in persons with HIV. As persons with HIV live longer, data regarding the epidemiology of colorectal cancer are required to optimize the long-term management of these patients.
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