Survival After Cancer in Italian Persons With AIDS, 1986-2005: A Population-Based Estimation

被引:19
作者
Dal Maso, Luigino [1 ]
Suligoi, Barbara [2 ]
Franceschi, Silvia [3 ]
Braga, Claudia [1 ]
Buzzoni, Carlotta [4 ,5 ]
Polesel, Jerry [1 ]
Zucchetto, Antonella [1 ,6 ]
Piselli, Pierluca [7 ]
Falcini, Fabio [8 ]
Caldarella, Adele
Zanetti, Roberto [9 ]
Vercelli, Marina [10 ,11 ]
Guzzinati, Stefano [12 ]
Russo, Antonio [13 ]
Tagliabue, Giovanna [14 ]
Iachetta, Francesco [15 ]
Ferretti, Stefano [16 ]
Limina, Rosa M. [17 ]
Mangone, Lucia [18 ]
Michiara, Maria [19 ]
Stracci, Fabrizio [20 ,21 ]
Pirino, Daniela R. [22 ]
Piffer, Silvano [23 ]
Giacomin, Adriano [24 ]
Vitarelli, Susanna [25 ]
Mazzoleni, Guido [26 ]
Iannelli, Arturo [27 ]
Contrino, Maria L. [28 ]
Fusco, Mario [29 ]
Tumino, Rosario [30 ]
Fanetti, Anna C. [31 ]
De Paoli, Paolo [32 ]
Decarli, Adriano [6 ]
Serraino, Diego [1 ,33 ]
机构
[1] CRO Aviano Natl Canc Inst, Epidemiol & Biostat Unit, I-33081 Aviano, Pordenone, Italy
[2] Ist Super Sanita, I-00161 Rome, Italy
[3] Int Agcy Res Canc, F-69372 Lyon, France
[4] AIRTUM Database, Florence, Italy
[5] Ist Studio & Prevenz Oncol, UO Epidemiol Clin & Descritt, Tuscany Canc Registry, Florence, Italy
[6] Univ Milan, Dept Clin Sci & Community Hlth, Milan, Italy
[7] INMI L Spallanzani IRCCS, Dept Epidemiol, Rome, Italy
[8] Canc Inst Romagna IRCCS, Romagna Canc Registry, Meldola, Italy
[9] Oncol Prevent Ctr CPO, Piedmont Canc Registry, Turin, Italy
[10] Univ Genoa, Ist Nazl Ric Canc, IRCSS Azienda Univ Osped San Martino IST, Registro Tumori Reg Liguria, Genoa, Italy
[11] Univ Genoa, Dipartimento Sci Salute, Genoa, Italy
[12] Ist Oncol Veneto IRCCS, Registro Tumori Veneto, Padua, Italy
[13] Milan Hlth Author, Milan Canc Registry, Epidemiol Unit, Milan, Italy
[14] Natl Canc Inst, Lombardia Canc Registry, I-20133 Milan, Varese Province, Italy
[15] Univ Modena & Reggio Emilia, Dept Oncol Hematol & Resp Dis, Modena Canc Registry, Modena, Italy
[16] Univ Ferrara, Ferrara Canc Registry, I-44100 Ferrara, Italy
[17] Canc Registry, Brescia Hlth Unit, Brescia, Italy
[18] Arcispedale S Maria Nuova, SC Stat Qualita & Studi Clin IRCCS, Reggio Emilia, Italy
[19] Univ Hosp Parma, Parma Prov Canc Registry, Parma, Italy
[20] Univ Perugia, Dept Med & Surg Specialties, Umbria Canc Registry, I-06100 Perugia, Italy
[21] Univ Perugia, Sect Publ Hlth, I-06100 Perugia, Italy
[22] Canc Registry Sassari, Sassari, Italy
[23] Registro Tumori Prov Trento, Serv Epidemiol Clin & Valutat, Trento, Italy
[24] Prov Biella CPO, Registro Tumori Piemonte, Biella, Italy
[25] Univ Camerino, Dipartimento Med Sperimentale & Sanita Pubbl, Macerata Prov Canc & Mortal Registry, I-62032 Camerino, Italy
[26] Alto Adige Sudtirol Canc Registry, Bolzano, Italy
[27] Salerno Canc Registry, Salerno, Italy
[28] ASP Siracusa, Siracusa Canc Registry, Siracusa, Italy
[29] ASL Napoli 3 Sud, Campania Reg Canc Registry, Naples, Italy
[30] ASP Ragusa, Civ MP Arezzo Hosp, Canc Registry & Histopathol Unit, Ragusa, Italy
[31] Local Hlth Agcy, Sondrio Canc Registry, Sondrio, Italy
[32] CRO Aviano Natl Canc Inst, Sci Directorate, Aviano, Italy
[33] Cent Hlth Direct, Friuli Venezia Giulia Canc Registry, Udine, Italy
关键词
survival; AIDS patients; cancer; hazard ratio; ACTIVE ANTIRETROVIRAL THERAPY; HIV-INFECTED PATIENTS; NON-HODGKIN-LYMPHOMA; HEPATOCELLULAR-CARCINOMA; EXCESS MORTALITY; KAPOSIS-SARCOMA; LUNG-CANCER; IMMUNODEFICIENCY; DEATH; RISK;
D O I
10.1097/QAI.0000000000000184
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
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.
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收藏
页码:428 / 435
页数:8
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