BI12 The incidence and survival of Kaposi sarcoma using national cancer registry data

• Published in: British journal of dermatology (1951) Vol. 188; no. Supplement_4
• Main Authors: Quaresma, Catarina, Lapin, Agnieszka, Vernon, Sally, Tan, Agnieszka, Venables, Zoe C
• Format: Journal Article
• Language: English
• Published: 26-06-2023
• ISSN: 0007-0963; 1365-2133
• DOI: 10.1093/bjd/ljad113.180

Abstract
Kaposi sarcoma (KS) is a rare soft tissue endothelial neoplasm associated with human herpesvirus (HHV)-8 infection. Four types of KS are recognized, with the majority of cases in the West attributed to HIV-associated KS or, less frequently, to iatrogenic KS caused by systemic immunosuppression. Population-based data on KS epidemiology in England are lacking, with the last published evaluation dating back to the 1980s. More recently, data on KS epidemiology have been included in the National Cancer Registration and Analysis Service’s (NCRAS) ‘Get Data Out’ annual reports, with details published from 2013 to 2019. A nonsignificant reduction in the incidence rate of KS in England was observed from 2013 [0.271; 95% confidence interval (CI) 0.229–0.319] to 2019 (0.222, 95% CI 0.185–0.265; www.cancerdata.nhs.uk/getdataout/kaposi_sarcoma). This figure is slightly lower than the most recent reported crude incidence rates of KS in Europe from 2000 to 2007 (0.28) and significantly lower than that of the USA in 2017 (0.45) and globally in 2020 (0.439) (https://gco.iarc.fr/today/data/factsheets/cancers/19-Kaposi-sarcoma-fact-sheet.pdf). Data from NCRAS show that most cases of KS in England were diagnosed following a general practitioner referral (32.8%), outside the 2-week wait route (15.6%). A noteworthy proportion of cases (17.2%) were diagnosed following an emergency presentation to the emergency department, emergency clinician referrals or acute admissions. The 5-year net survival after the diagnosis of KS was stable at 81.3% (95% CI 73–89.5), 86.8% (95% CI 79.5–94.1) and 79.7% (95% CI 67.2–92.2) for 2013, 2014 and 2015, respectively (www.cancerdata.nhs.uk/getdataout/kaposi_sarcoma). These data provide a useful insight into the epidemiology of this rare cancer; however, it is probable that the true incidence of KS is under-reported, particularly in cases where there is no histological confirmation or reporting of KS on the death certificate, which may be more likely in patients who were HIV positive. Lack of knowledge of the underlying cause for KS is a major limitation. In conclusion, there is a paucity of published data on KS epidemiology in England. Further evaluation of KS subsets, patient demographics and comorbidity at diagnosis is needed to allow a better understanding of differences in the KS incidence in England in comparison with global figures.