Cancer incidence in people with AIDS in Italy.

Abstract

People with HIV/AIDS (PWHA) have increased risk of some cancers. The introduction of highly active antiretroviral therapies (HAART) has improved their life expectancy, exposing them to the combined consequences of aging and of a prolonged exposure to cancer risk factors. The aim of this study was to estimate incidence rates (IR) in PWHA in Italy, before and after the introduction of HAART, after adjusting for sex and age through direct standardization. An anonymous record linkage between Italian AIDS Registry (21,951 cases) and Cancer Registries (17.3 million, 30% of Italian population) was performed. In PWHA, crude IR, sex- and age-standardized IR and age-specific IR were estimated. The standardized IR for Kaposi sarcoma and non-Hodgkin lymphoma greatly declined in the HAART period. Although the crude IR for all non-AIDS-defining cancers increased in the HAART period, standardized IR did not significantly differ in the 2 periods (352 and 379/100,000, respectively). Increases were seen only for cancer of the liver (IR ratio = 4.6, 95% CI: 1.3-17.0) and lung (IR ratio = 1.8, 95% CI: 1.0-3.2). Age-specific IRs for liver and lung cancers, however, largely overlapped in the 2 periods pointing to the strong influence of the shift in the age distribution of PWHA on the observed upward trends. In conclusion, standardized IRs for non-AIDS-defining cancers have not risen in the HAART period, even if crude IRs of these cancers increased. This scenario calls, however, for the intensification of cancer-prevention strategies, notably smoking cessation and screening programs, in middle-aged HIV-patients.

• Authors: Jerry Polesel, Silvia Franceschi, Barbara Suligoi, Emanuele Crocetti, Fabio Falcini, Stefano Guzzinati, Marina Vercelli, Roberto Zanetti, Giovanna Tagliabue, Antonio Russo, Stefano Luminari, Fabrizio Stracci, Vincenzo De Lisi, Stefano Ferretti, Lucia Mangone, Mario Budroni, Rosa Maria Limina, Silvano Piffer, Diego Serraino, Francesco Bellù, Adriano Giacomin, Andrea Donato, Anselmo Madeddu, Susanna Vitarelli, Mario Fusco, Roberto Tessandori, Rosario Tumino, Pierluca Piselli, Luigino Dal Maso, Cancer and AIDS Registries Linkage Study Cancer, AIDS Registries Linkage Study, Mauro Lise, Antonella Zucchetto, Angela De Paoli, Teresa Intrieri, Rosa Vattiato, Paola Zambon, Antonella Puppo, Silvia Patriarca, Andrea Tittarelli, Mariangela Autelitano, Claudia Cirilli, Francesco La Rosa, Paolo Sgargi, Enza Di Felice, Rosaria Cesaraccio, Francesco Donato, Silva Franchini, Loris Zanier, Fabio Vittadello, Pier Carlo Vercellino, Gennaro Senatore, Maria Lia Contrino, Silvia Antonini, Raffaele Palombino, Sergio Maspero, Maria Guglielmina La Rosa, Laura Camoni, Vincenza Regine
• Journal: International journal of cancer (Int J Cancer) Vol. 127 Issue 6 Pg. 1437-45 (Sep 01 2010) ISSN: 1097-0215 [Electronic] United States
• PMID: 20049835 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Acquired Immunodeficiency Syndrome (complications)
• Humans
• Incidence
• Italy (epidemiology)
• Neoplasms (complications, epidemiology)