Non-Hodgkin lymphoma among young adults with and without AIDS in Italy.
To compare the presentation and prognosis of non-Hodgkin lymphoma (NHL) in people with AIDS (PWA) and in the general Italian population, a record linkage study was carried out. The fraction of NHLs attributable to HIV/AIDS was also estimated. Information from the National AIDS Registry (RAIDS) was linked with records from 13 cancer registries (CR), covering about 15% of the Italian population. During the period 1985--94, among PWA ages 15--49, 136 NHLs were identified (8% of all NHLs) and were compared with 1,481 concurrent incident NHL cases of the same age group among non-PWA. Percentages above 13% of all NHLs were registered in the northern areas of Genoa and Varese, i.e., the most heavily affected by the AIDS epidemic. Between 1 year prior to and 3.5 years after AIDS diagnosis, PWA showed an overall standardised incidence ratio (SIR) for NHL of 302. SIR was particularly high (394) within 3 months after AIDS diagnosis and subsequently declined to 170. SIR was somewhat higher in females (428) than in males (280) but similar among intravenous-drug users (299) and other HIV-transmission groups (309). High-grade NHL, particularly immunoblastic and Burkitt's lymphoma, were twice as frequent among PWA than non-PWA. Conversely, low-grade NHL were less frequent. Except for the high proportion of brain localisation, no clear difference emerged in the pattern of NHL presentation site in PWA compared with non-PWA. At variance with NHL in the general population, among PWA histological grade had little impact on survival, which overall appeared to be very poor (2-year survival: 10%; 95% confidence interval: 3%--17%). Our present linkage of RAIDS and CRs represents an efficient tool for the surveillance of trends in incidence and survival of NHL among PWA in Italy.
Dal Maso
L
L
Servizio di Epidemiologia, Centro di Riferimento Oncologico, Aviano (PN), Italy. epidemiology@cro.it
Rezza
G
G
Zambon
P
P
Tagliabue
G
G
Crocetti
E
E
Vercelli
M
M
Zanetti
R
R
Falcini
F
F
Tonini
G
G
Mangone
L
L
De Lisi
V
V
Ferretti
S
S
Tumino
R
R
Stanta
G
G
Vitarelli
S
S
Serraino
D
D
Franceschi
S
S
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D016483:Lymphoma, AIDS-Related / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011634:Public Health / Q000706:statistics & numerical data*; D012042:Registries; D012307:Risk Factors; D015996:Survival Rate