Epidemiology

In the US, the KS incidence rate was approximately 0.23 cases per 100,000 population in 2022. WHO: cancer today - data visualization tools for exploring the global cancer burden in 2022 Opens in new window

KS is more common in black Americans than white Americans (age-adjusted incidence rate 1.19 vs. 0.49 per 100,000, respectively; 2008-2012 data).[6]​ Black Americans are more likely to be diagnosed at a younger age and experience higher mortality rates.[6][7]​ Data from 1998 to 2012 indicate decreasing incidence of KS in the white American population; however, increasing incidence is seen in the black American population from the mid-2000s.[7] Certain sub-populations have been identified with significant increases (e.g., young, non-Hispanic black men in southern US regions).[8]

Globally, the estimated age-standardised incidence rate of KS was 0.41 per 100,000 population in 2022, with an estimated 35,813 diagnosed new cases.[9] Incidence and mortality is highest in Africa (74% of new cases; 86.1% of deaths).[9]

All epidemiological subtypes of KS can affect patients of any age, but there is usually a predilection for males. In 2022, the age-standardised incidence rates of KS were estimated to be 0.6 cases per 100,000 population in men and 0.3 cases per 100,000 in women.[10]

HIV-associated KS (formerly known as epidemic or AIDS-related KS) is one of the most common cancers arising in people living with HIV. In the US, people with HIV are approximately 500 times more likely to be diagnosed with KS than the general population.[11][12]​​ A marked reduction in the incidence of KS is temporally related to increased use of antiretroviral therapy (ART).[11][12]​[13]​​​​​​​ However, in sub-Saharan Africa (where in 2018 ART coverage varied between 9% and 92%), there is limited evidence of declining KS incidence (e.g., in countries such as Uganda, Kenya, South Africa, and Zimbabwe).​[7][14]

Classic (sporadic) KS has the highest incidence rates in Mediterranean countries.[4] Prior to the AIDS era, the incidence of KS in Italy was up to 10 times higher than in other Western countries.[15] Older men of Jewish descent are at risk of developing classic KS.[16]

The incidence of iatrogenic (transplant-related) KS varies with different ethnic and geographical regions.[17][18][19] In the US, the incidence of KS among transplant recipients is reported to be between 8.8 and 12.4 per 100,000 recipients.[19][20]

Prior to the AIDS epidemic, incidence rates for endemic KS were greater for the Democratic Republic of Congo, Uganda, Tanzania, and Cameroon (>6 per 1000 person-years) than for southern or north Africa (≤2 per 1000 person-years).[21]

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