title: Pattern of cancer risk in persons with AIDS in Italy in the HAART era.
abstract: A record-linkage study was carried out between the Italian AIDS Registry and 24 Italian cancer registries to compare cancer excess among persons with HIV/AIDS (PWHA) before and after the introduction of highly active antiretroviral therapy (HAART) in 1996. Standardised incidence ratios (SIR) were computed in 21951 AIDS cases aged 16-69 years reported between 1986 and 2005. Of 101 669 person-years available, 45 026 were after 1996. SIR for Kaposi sarcoma (KS) and non-Hodgkin lymphoma greatly decreased in 1997-2004 compared with 1986-1996, but high SIRs for KS persisted in the increasingly large fraction of PWHA who had an interval of <1 year between first HIV-positive test and AIDS diagnosis. A significant excess of liver cancer (SIR=6.4) emerged in 1997-2004, whereas the SIRs for cancer of the cervix (41.5), anus (44.0), lung (4.1), brain (3.2), skin (non-melanoma, 1.8), Hodgkin lymphoma (20.7), myeloma (3.9), and non-AIDS-defining cancers (2.2) were similarly elevated in the two periods. The excess of some potentially preventable cancers in PWHA suggests that HAART use must be accompanied by cancer-prevention strategies, notably antismoking and cervical cancer screening programmes. Improvements in the timely identification of HIV-positive individuals are also a priority in Italy to avoid the adverse consequences of delayed HAART use.
authors.affiliation: Epidemiology and Biostatistics Unit, Centro di Riferimento Oncologico IRCCS, Aviano, Italy. epidemiology@cro.it
authors.forename: L
authors.initials: L
authors.lastname: Dal Maso
authors.forename: J
authors.initials: J
authors.lastname: Polesel
authors.forename: D
authors.initials: D
authors.lastname: Serraino
authors.forename: M
authors.initials: M
authors.lastname: Lise
authors.forename: P
authors.initials: P
authors.lastname: Piselli
authors.forename: F
authors.initials: F
authors.lastname: Falcini
authors.forename: A
authors.initials: A
authors.lastname: Russo
authors.forename: T
authors.initials: T
authors.lastname: Intrieri
authors.forename: M
authors.initials: M
authors.lastname: Vercelli
authors.forename: P
authors.initials: P
authors.lastname: Zambon
authors.forename: G
authors.initials: G
authors.lastname: Tagliabue
authors.forename: R
authors.initials: R
authors.lastname: Zanetti
authors.forename: M
authors.initials: M
authors.lastname: Federico
authors.forename: R M
authors.initials: RM
authors.lastname: Limina
authors.forename: L
authors.initials: L
authors.lastname: Mangone
authors.forename: V
authors.initials: V
authors.lastname: De Lisi
authors.forename: F
authors.initials: F
authors.lastname: Stracci
authors.forename: S
authors.initials: S
authors.lastname: Ferretti
authors.forename: S
authors.initials: S
authors.lastname: Piffer
authors.forename: M
authors.initials: M
authors.lastname: Budroni
authors.forename: A
authors.initials: A
authors.lastname: Donato
authors.forename: A
authors.initials: A
authors.lastname: Giacomin
authors.forename: F
authors.initials: F
authors.lastname: Bellù
authors.forename: M
authors.initials: M
authors.lastname: Fusco
authors.forename: A
authors.initials: A
authors.lastname: Madeddu
authors.forename: S
authors.initials: S
authors.lastname: Vitarelli
authors.forename: R
authors.initials: R
authors.lastname: Tessandori
authors.forename: R
authors.initials: R
authors.lastname: Tumino
authors.forename: B
authors.initials: B
authors.lastname: Suligoi
authors.forename: S
authors.initials: S
authors.lastname: Franceschi
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active; D005260:Female; D015497:HIV-1; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D012042:Registries; D012307:Risk Factors; D055815:Young Adult