Cancer incidence in people with AIDS in Italy

被引:55
作者
Polesel, Jerry [1 ]
Franceschi, Silvia [2 ]
Suligoi, Barbara [3 ]
Crocetti, Emanuele [4 ]
Falcini, Fabio [5 ]
Guzzinati, Stefano [6 ]
Vercelli, Marina [7 ,8 ]
Zanetti, Roberto [9 ]
Tagliabue, Giovanna [10 ]
Russo, Antonio [11 ]
Luminari, Stefano [12 ]
Stracci, Fabrizio [13 ]
De Lisi, Vincenzo [14 ]
Ferretti, Stefano [15 ]
Mangone, Lucia [16 ]
Budroni, Mario [17 ]
Limina, Rosa Maria [18 ]
Piffer, Silvano [19 ]
Serraino, Diego [1 ,20 ]
Bellu, Francesco [21 ]
Giacomin, Adriano [22 ]
Donato, Andrea [23 ]
Madeddu, Anselmo [24 ]
Vitarelli, Susanna [25 ]
Fusco, Mario [26 ]
Tessandori, Roberto [27 ]
Tumino, Rosario [28 ,29 ]
Piselli, Pierluca [30 ]
Dal Maso, Luigino [1 ,31 ]
机构
[1] Ctr Riferimento Oncol, Epidemiol & Biostat Unit, IRCCS, I-33081 Aviano, PN, Italy
[2] Int Agcy Res Canc, F-69372 Lyon, France
[3] Natl Inst Hlth, Epidemiol Unit, Dept Infect Dis, Rome, Italy
[4] ISPO, Tuscany Canc Registry, Epidemiol Unit, Canc Prevent & Res Inst, Florence, Italy
[5] Romagna Canc Inst IRST, Dept Med Oncol, Romagna Canc Registry, Meldola, Italy
[6] Ist Oncol Veneto IRCCS, Registro Tumori Veneto, Padua, Italy
[7] Univ Genoa, Ist Nazl Ric Cancro IRCCS, Genoa, Italy
[8] Liguria Canc Registry, Genoa, Italy
[9] Ctr Prevenz Oncol, Piedmont Canc Registry, Turin, Italy
[10] Ist Nazl Tumori, Registro Tumori Lombardia, I-20133 Milan, Italy
[11] Canc Registry Milan, Epidemiol Unit, Local Hlth Author Milan, Milan, Italy
[12] Univ Modena & Reggio Emilia, Dept Hematol & Oncol, Modena Canc Registry, Modena, Italy
[13] Univ Perugia, Dept Surg Med & Publ Hlth, Umbria Canc Registry, I-06100 Perugia, Italy
[14] Parma Prov Canc Registry, Parma, Italy
[15] Univ Ferrara, Ferrara Canc Registry, Sez Anat Patol, Dip Med Sperimentale & Diagnost, I-44100 Ferrara, Italy
[16] Reggio Emilia Canc Registry, Dept Publ Hlth, Reggio Emilia, Italy
[17] Canc Registry Sassari ASLi, Sassari, Italy
[18] Brescia Hlth Unit Canc Registry, Brescia, Italy
[19] Trento Canc Registry, Osservatorio Epidemiol, Trento, Italy
[20] Agenzia Reg Sanita, Friuli Venezia Giulia Canc Registry, Udine, Italy
[21] Alto Adige Sudtirol Canc Registry, Bolzano, Italy
[22] Piedmont Canc Registry, Prevent Dept ASL BI, Epidemiol Unit, Biella, Italy
[23] Salerno Canc Registry, Salerno, Italy
[24] Syracuse Prov Registry Pathol RTP, Syracuse, Italy
[25] Univ Camerino, Macerata Prov Canc & Mortal Registry, Dip Med Sperimentale & Sanita Pubbl, I-62032 Camerino, MC, Italy
[26] Campania Canc Registry, Brusciano, NA, Italy
[27] Sondrio Canc Registry, Sondrio, Italy
[28] Azienda Osped Civile MP Arezzo, Ragusa Canc Registry, Dept Oncol, Ragusa, Italy
[29] Azienda Osped Civile MP Arezzo, Histopathol Unit, Dept Oncol, Ragusa, Italy
[30] INMI L Spallanzani IRCCS, Dept Epidemiol, Rome, Italy
[31] Univ Milan, Inst Med Stat & Biometry GA Maccacaro, Milan, Italy
关键词
AIDS; HAART; cancer incidence; lung cancer; liver cancer; HUMAN-IMMUNODEFICIENCY-VIRUS; SWISS HIV COHORT; HODGKIN-LYMPHOMA; LUNG-CANCER; ANTIRETROVIRAL THERAPY; TRANSPLANT RECIPIENTS; RISK; ERA; SARCOMA; TRENDS;
D O I
10.1002/ijc.25153
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
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.
引用
收藏
页码:1437 / 1445
页数:9
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