title: Survival after cancer in Italian persons with AIDS, 1986-2005: a population-based estimation.
abstract: Cancer survival in persons with AIDS (PWA) after introduction of antiretroviral therapies remains poorly characterized. The aim is to provide population-based estimates of cancer survival, overall and for the most important cancer types in PWA, and a comparison with persons without AIDS (non-PWA) affected by the same cancer.
  
  
  
  PWA with cancer at AIDS diagnosis or thereafter were individually matched with non-PWA by type of cancer, sex, age, year of diagnosis, area of living, and, for lymphomas, histological subtype. Five-year observed survival and hazard ratios (HRs) of death in PWA versus non-PWA with 95% confidence intervals (CIs) were estimated.
  
  
  
  We included 2262 Italian PWA and 4602 non-PWA with cancer diagnosed during 1986-2005. Between 1986 and 1995, and 1996 and 2005, 5-year survival for all cancers in PWA improved from 12% to 41% and the corresponding HR versus non-PWA decreased from 5.1 (95% CI: 4.3 to 6.1) to 2.9 (95% CI: 2.6 to 3.3). During 1996-2005, HRs were 2.0 (95% CI: 1.4 to 2.9) for Kaposi sarcoma, 3.4 (95% CI: 2.9 to 4.1) for non-Hodgkin lymphoma, and 2.4 (95% CI: 1.4 to 4.0) for cervical cancer. HRs were 2.5 (95% CI: 2.1 to 3.1) for all non-AIDS-defining cancers, 5.9 (95% CI: 3.1 to 11.2) for Hodgkin lymphoma, and 7.3 (95% CI: 2.8 to 19.2) for nonmelanoma skin cancer. A ≤3-fold survival difference was found for cancers of the stomach, liver, anus, lung, brain, and the most aggressive lymphoma subtypes.
  
  
  
  The persisting, although narrowing, gap in cancer survival between PWA and non-PWA indicates the necessity of enhancing therapeutic approaches, so that PWA can be provided the same chances of survival observed in the general population, and improving cancer prevention and screening.
authors.affiliation: *Epidemiology and Biostatistics Unit, CRO Aviano National Cancer Institute, Italy; †Istituto Superiore di Sanità, Rome, Italy; ‡International Agency for Research on Cancer, Lyon, France; §AIRTUM database, Florence, Italy; ‖Tuscany Cancer Registry, UO di epidemiologia clinica e descrittiva, Istituto per lo studio e la prevenzione oncologica, Florence, Italy; ¶Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; #Department of Epidemiology, INMI "L Spallanzani" IRCCS, Rome, Italy; **Romagna Cancer Registry, Cancer Institute of Romagna IRCCS, Meldola, Italy; ††Piedmont Cancer Registry, Oncology Prevention Center (CPO), Torino, Italy; ‡‡Registro Tumori Regione Liguria, IRCSS Azienda Università Ospedale San Martino-IST Istituto nazionale ricerca sul cancro e Dipartimento di scienze della salute, Genoa University, Genoa, Italy; §§Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS, Padua, Italy; ‖‖Milan Cancer Registry, Milan Health Authority, Epidemiology Unit, Milan, Italy; ¶¶Lombardia Cancer Registry, Varese Province, National Cancer Institute, Milan, Italy; ##Modena Cancer Registry, Department of Oncology, Hematology, and Respiratory Diseases, University of Modena and Reggio Emilia, Modena, Italy; ***Ferrara Cancer Registry, Ferrara University, Ferrara, Italy; †††Brescia Health Unit, Cancer Registry, Brescia, Italy; ‡‡‡S.C. Statistica, qualità e studi clinici IRCCS, Arcispedale S. Maria Nuova, Reggio Emilia, Italy; §§§Parma Province Cancer Registry, University Hospital Parma, Parma, Italy; ‖‖‖Umbria Cancer Registry, Department of Medical and Surgical Specialties, and Public Health, Section of Public Health, Perugia University, Perugia, Italy; ¶¶¶Cancer Registry of Sassari, Sassari, Italy; ###Registro Tumori della Provincia di Trento, Servizio di Epidemiologia Clinica e Valutativa, Trento, Italy; ****Registro Tumori Piemonte, Provincia di Biella CPO, Biella, Italy; †††
authors.forename: Luigino
authors.initials: L
authors.lastname: Dal Maso
authors.forename: Barbara
authors.initials: B
authors.lastname: Suligoi
authors.forename: Silvia
authors.initials: S
authors.lastname: Franceschi
authors.forename: Claudia
authors.initials: C
authors.lastname: Braga
authors.forename: Carlotta
authors.initials: C
authors.lastname: Buzzoni
authors.forename: Jerry
authors.initials: J
authors.lastname: Polesel
authors.forename: Antonella
authors.initials: A
authors.lastname: Zucchetto
authors.forename: Pierluca
authors.initials: P
authors.lastname: Piselli
authors.forename: Fabio
authors.initials: F
authors.lastname: Falcini
authors.forename: Adele
authors.initials: A
authors.lastname: Caldarella
authors.forename: Roberto
authors.initials: R
authors.lastname: Zanetti
authors.forename: Marina
authors.initials: M
authors.lastname: Vercelli
authors.forename: Stefano
authors.initials: S
authors.lastname: Guzzinati
authors.forename: Antonio
authors.initials: A
authors.lastname: Russo
authors.forename: Giovanna
authors.initials: G
authors.lastname: Tagliabue
authors.forename: Francesco
authors.initials: F
authors.lastname: Iachetta
authors.forename: Stefano
authors.initials: S
authors.lastname: Ferretti
authors.forename: Rosa M
authors.initials: RM
authors.lastname: Limina
authors.forename: Lucia
authors.initials: L
authors.lastname: Mangone
authors.forename: Maria
authors.initials: M
authors.lastname: Michiara
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Stracci
authors.forename: Daniela R
authors.initials: DR
authors.lastname: Pirino
authors.forename: Silvano
authors.initials: S
authors.lastname: Piffer
authors.forename: Adriano
authors.initials: A
authors.lastname: Giacomin
authors.forename: Susanna
authors.initials: S
authors.lastname: Vitarelli
authors.forename: Guido
authors.initials: G
authors.lastname: Mazzoleni
authors.forename: Arturo
authors.initials: A
authors.lastname: Iannelli
authors.forename: Maria L
authors.initials: ML
authors.lastname: Contrino
authors.forename: Mario
authors.initials: M
authors.lastname: Fusco
authors.forename: Rosario
authors.initials: R
authors.lastname: Tumino
authors.forename: Anna C
authors.initials: AC
authors.lastname: Fanetti
authors.forename: Paolo
authors.initials: P
authors.lastname: De Paoli
authors.forename: Adriano
authors.initials: A
authors.lastname: Decarli
authors.forename: Diego
authors.initials: D
authors.lastname: Serraino
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000453:epidemiology / Q000401:mortality; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016483:Lymphoma, AIDS-Related / Q000401:mortality*; D008228:Lymphoma, Non-Hodgkin / Q000150:complications / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000401:mortality; D012042:Registries; D012514:Sarcoma, Kaposi / Q000401:mortality*; D016019:Survival Analysis; D055815:Young Adult