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.
| Original language | English |
|---|---|
| Pages (from-to) | 1437-1445 |
| Number of pages | 9 |
| Journal | International Journal of Cancer |
| Volume | 127 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - Sep 1 2010 |
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Keywords
- AIDS
- Cancer incidence
- HAART
- Liver cancer
- Lung cancer
ASJC Scopus subject areas
- Cancer Research
- Oncology
Cite this
Cancer incidence in people with AIDS in Italy. / Polesel, Jerry; Franceschi, Silvia; Suligoi, Barbara; Crocetti, Emanuele; Falcini, Fabio; Guzzinati, Stefano; Vercelli, Marina; Zanetti, Roberto; Tagliabue, Giovanna; Russo, Antonio; Luminari, Stefano; Stracci, Fabrizio; De Lisi, Vincenzo; Ferretti, Stefano; Mangone, Lucia; Budroni, Mario; Limina, Rosa Maria; Piffer, Silvano; Serraino, Diego; Bellù, Francesco; Giacomin, Adriano; Donato, Andrea; Madeddu, Anselmo; Vitarelli, Susanna; Fusco, Mario; Tessandori, Roberto; Tumino, Rosario; Piselli, Pierluca; Dal Maso, Luigino.
In: International Journal of Cancer, Vol. 127, No. 6, 01.09.2010, p. 1437-1445.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Cancer incidence in people with AIDS in Italy
AU - Polesel, Jerry
AU - Franceschi, Silvia
AU - Suligoi, Barbara
AU - Crocetti, Emanuele
AU - Falcini, Fabio
AU - Guzzinati, Stefano
AU - Vercelli, Marina
AU - Zanetti, Roberto
AU - Tagliabue, Giovanna
AU - Russo, Antonio
AU - Luminari, Stefano
AU - Stracci, Fabrizio
AU - De Lisi, Vincenzo
AU - Ferretti, Stefano
AU - Mangone, Lucia
AU - Budroni, Mario
AU - Limina, Rosa Maria
AU - Piffer, Silvano
AU - Serraino, Diego
AU - Bellù, Francesco
AU - Giacomin, Adriano
AU - Donato, Andrea
AU - Madeddu, Anselmo
AU - Vitarelli, Susanna
AU - Fusco, Mario
AU - Tessandori, Roberto
AU - Tumino, Rosario
AU - Piselli, Pierluca
AU - Dal Maso, Luigino
PY - 2010/9/1
Y1 - 2010/9/1
N2 - 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.
AB - 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.
KW - AIDS
KW - Cancer incidence
KW - HAART
KW - Liver cancer
KW - Lung cancer
UR - http://www.scopus.com/inward/record.url?scp=77955056771&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77955056771&partnerID=8YFLogxK
U2 - 10.1002/ijc.25153
DO - 10.1002/ijc.25153
M3 - Article
C2 - 20049835
AN - SCOPUS:77955056771
VL - 127
SP - 1437
EP - 1445
JO - International Journal of Cancer
JF - International Journal of Cancer
SN - 0020-7136
IS - 6
ER -