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Comment & Response
October 2017

Exclusion of Kaposi Sarcoma From Analysis of Cancer Burden—Reply

Author Affiliations
  • 1Division of Hematology, Department of Medicine, University of Washington, Seattle
  • 2Institute for Health Metrics and Evaluation, University of Washington, Seattle
JAMA Oncol. 2017;3(10):1429-1430. doi:10.1001/jamaoncol.2017.1747

In Reply In their Letter, Dittmer et al criticize the lack of Kaposi sarcoma (KS) burden estimates in the Global Burden of Disease (GBD) Study. We agree that KS is an important cause of morbidity as well as mortality in locations with high human immunodeficiency virus (HIV) prevalence and that this burden should ideally be captured in the GBD study. However, producing accurate estimates of both mortality and morbidity of KS is challenging as a result of deficiencies in coding deaths due to KS correctly as International Statistical Classification of Diseases and Related Health Problems, Tenth Revision code B21.0 (HIV disease resulting in Kaposi sarcoma) and more importantly in coding deaths due to HIV correctly as HIV.1 Multiple corrections are used in the GBD Study to account for miscoding of HIV deaths. However, these corrections do not (yet) account for more detailed causes of death due to HIV/AIDS other than “HIV/AIDS and tuberculosis” and a combined group of “HIV/AIDS resulting in other diseases.”2