title: Cancer incidence in people with AIDS in Italy.
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.
authors.affiliation: Epidemiology and Biostatistics Unit, Centro di Riferimento Oncologico IRCCS, Aviano, Pordenone, Italy. polesel@cro.it
authors.forename: Jerry
authors.initials: J
authors.lastname: Polesel
authors.forename: Silvia
authors.initials: S
authors.lastname: Franceschi
authors.forename: Barbara
authors.initials: B
authors.lastname: Suligoi
authors.forename: Emanuele
authors.initials: E
authors.lastname: Crocetti
authors.forename: Fabio
authors.initials: F
authors.lastname: Falcini
authors.forename: Stefano
authors.initials: S
authors.lastname: Guzzinati
authors.forename: Marina
authors.initials: M
authors.lastname: Vercelli
authors.forename: Roberto
authors.initials: R
authors.lastname: Zanetti
authors.forename: Giovanna
authors.initials: G
authors.lastname: Tagliabue
authors.forename: Antonio
authors.initials: A
authors.lastname: Russo
authors.forename: Stefano
authors.initials: S
authors.lastname: Luminari
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Stracci
authors.forename: Vincenzo
authors.initials: V
authors.lastname: De Lisi
authors.forename: Stefano
authors.initials: S
authors.lastname: Ferretti
authors.forename: Lucia
authors.initials: L
authors.lastname: Mangone
authors.forename: Mario
authors.initials: M
authors.lastname: Budroni
authors.forename: Rosa Maria
authors.initials: RM
authors.lastname: Limina
authors.forename: Silvano
authors.initials: S
authors.lastname: Piffer
authors.forename: Diego
authors.initials: D
authors.lastname: Serraino
authors.forename: Francesco
authors.initials: F
authors.lastname: Bellù
authors.forename: Adriano
authors.initials: A
authors.lastname: Giacomin
authors.forename: Andrea
authors.initials: A
authors.lastname: Donato
authors.forename: Anselmo
authors.initials: A
authors.lastname: Madeddu
authors.forename: Susanna
authors.initials: S
authors.lastname: Vitarelli
authors.forename: Mario
authors.initials: M
authors.lastname: Fusco
authors.forename: Roberto
authors.initials: R
authors.lastname: Tessandori
authors.forename: Rosario
authors.initials: R
authors.lastname: Tumino
authors.forename: Pierluca
authors.initials: P
authors.lastname: Piselli
authors.forename: Luigino
authors.initials: L
authors.lastname: Dal Maso
authors.forename: Mauro
authors.initials: M
authors.lastname: Lise
authors.forename: Antonella
authors.initials: A
authors.lastname: Zucchetto
authors.forename: Angela
authors.initials: A
authors.lastname: De Paoli
authors.forename: Teresa
authors.initials: T
authors.lastname: Intrieri
authors.forename: Rosa
authors.initials: R
authors.lastname: Vattiato
authors.forename: Paola
authors.initials: P
authors.lastname: Zambon
authors.forename: Antonella
authors.initials: A
authors.lastname: Puppo
authors.forename: Silvia
authors.initials: S
authors.lastname: Patriarca
authors.forename: Andrea
authors.initials: A
authors.lastname: Tittarelli
authors.forename: Mariangela
authors.initials: M
authors.lastname: Autelitano
authors.forename: Claudia
authors.initials: C
authors.lastname: Cirilli
authors.forename: Francesco
authors.initials: F
authors.lastname: La Rosa
authors.forename: Paolo
authors.initials: P
authors.lastname: Sgargi
authors.forename: Enza
authors.initials: E
authors.lastname: Di Felice
authors.forename: Rosaria
authors.initials: R
authors.lastname: Cesaraccio
authors.forename: Francesco
authors.initials: F
authors.lastname: Donato
authors.forename: Silva
authors.initials: S
authors.lastname: Franchini
authors.forename: Loris
authors.initials: L
authors.lastname: Zanier
authors.forename: Fabio
authors.initials: F
authors.lastname: Vittadello
authors.forename: Pier Carlo
authors.initials: PC
authors.lastname: Vercellino
authors.forename: Gennaro
authors.initials: G
authors.lastname: Senatore
authors.forename: Maria Lia
authors.initials: ML
authors.lastname: Contrino
authors.forename: Silvia
authors.initials: S
authors.lastname: Antonini
authors.forename: Raffaele
authors.initials: R
authors.lastname: Palombino
authors.forename: Sergio
authors.initials: S
authors.lastname: Maspero
authors.forename: Maria Guglielmina
authors.initials: MG
authors.lastname: La Rosa
authors.forename: Laura
authors.initials: L
authors.lastname: Camoni
authors.forename: Vincenza
authors.initials: V
authors.lastname: Regine
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D009369:Neoplasms / Q000150:complications / Q000453:epidemiology*