Risk of cancer following immunosuppression in organ transplant recipients and in HIV-positive individuals in southern Europe.
This investigation highlighted the risk of cancer in 8074 HIV-infected people and in 2875 transplant recipients in Italy and France. Observed and expected numbers of cancer were compared through sex- and age-standardised incidence ratios (SIRs) and 95% confidence intervals (CIs). After 15 years of follow-up, the cumulative probability of cancer was 14.7% in transplant recipients and 13.3% in HIV-positives. The SIRs for all cancers were 9.8 in HIV-positives and 2.2 in transplants. Kaposi's sarcoma (SIR=451 in HIV-positives, 125 in transplants) and non-Hodgkin lymphoma (SIR=62 and 11.1, respectively) were the most common cancers. A significantly increased SIR for liver cancer also emerged in both groups. The risk of lung cancer was significantly elevated in heart transplant recipients (SIR=2.8), and of borderline statistical significance in HIV-positive people (95% CI:0.9-2.8). Immune depression entails a two-fold increased overall risk of cancers, mainly related to cancers associated with a viral aetiology.
Serraino
Diego
D
Unità di Epidemiologia e Biostatistica, Centro di Riferimento Oncologico, via F Gallini, 2, 33081 Aviano (PN), Italy. serrainod@cro.it
Piselli
Pierluca
P
Busnach
Ghil
G
Burra
Patrizia
P
Citterio
Franco
F
Arbustini
Eloisa
E
Baccarani
Umberto
U
De Juli
Emanuela
E
Pozzetto
Ubaldo
U
Bellelli
Stefania
S
Polesel
Jerry
J
Pradier
Christian
C
Dal Maso
Luigino
L
Angeletti
Claudio
C
Carrieri
Maria Patrizia
MP
Rezza
Giovanni
G
Franceschi
Silvia
S
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors; D014180:Transplantation / Q000009:adverse effects*