Survival after cancer in Italian persons with AIDS, 1986-2005: a population-based estimation.

Abstract

BACKGROUND:

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.

METHODS:

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.

RESULTS:

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.

CONCLUSIONS:

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: Luigino Dal Maso, Barbara Suligoi, Silvia Franceschi, Claudia Braga, Carlotta Buzzoni, Jerry Polesel, Antonella Zucchetto, Pierluca Piselli, Fabio Falcini, Adele Caldarella, Roberto Zanetti, Marina Vercelli, Stefano Guzzinati, Antonio Russo, Giovanna Tagliabue, Francesco Iachetta, Stefano Ferretti, Rosa M Limina, Lucia Mangone, Maria Michiara, Fabrizio Stracci, Daniela R Pirino, Silvano Piffer, Adriano Giacomin, Susanna Vitarelli, Guido Mazzoleni, Arturo Iannelli, Maria L Contrino, Mario Fusco, Rosario Tumino, Anna C Fanetti, Paolo De Paoli, Adriano Decarli, Diego Serraino, Cancer and AIDS Registries Linkage Study
• Journal: Journal of acquired immune deficiency syndromes (1999) (J Acquir Immune Defic Syndr) Vol. 66 Issue 4 Pg. 428-35 (08 01 2014) ISSN: 1944-7884 [Electronic] United States
• PMID: 24798769 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Acquired Immunodeficiency Syndrome (complications, epidemiology, mortality)
• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Female
• Humans
• Italy (epidemiology)
• Lymphoma, AIDS-Related (mortality)
• Lymphoma, Non-Hodgkin (complications, mortality)
• Male
• Middle Aged
• Neoplasms (complications, epidemiology, mortality)
• Registries
• Sarcoma, Kaposi (mortality)
• Survival Analysis
• Young Adult