Polesel, Jerry and Franceschi, Silvia and Suligoi, Barbara and Crocetti, Emanuele and Falcini, Fabio and Guzzinati, Stefano and Vercelli, Marina and Zanetti, Roberto and Tagliabue, Giovanna and Russo, Antonio and Luminari, Stefano and Stracci, Fabrizio and De Lisi, Vincenzo and Ferretti, Stefano and Mangone, Lucia and Budroni, Mario and Limina, Rosa Maria and Piffer, Silvano and Serraino, Diego and Bellù, Francesco and Giacomin, Adriano and Donato, Andrea and Madeddu, Anselmo and Vitarelli, Susanna and Fusco, Mario and Tessandori, Roberto and Tumino, Rosario and Piselli, Pierluca and Dal Maso, Luigino (2010) Cancer incidence in people with AIDS in Italy. International Journal of Cancer, Vol. 127 (6), p. 1437-1445. eISSN 1097-0215. Article.
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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.
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