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Incidence of AIDS-Defining Cancers After AIDS Diagnosis Among People with AIDS in Italy, 1986–1998

Franceschi, Silvia; Dal Maso, Luigino; Pezzotti, Patrizio; Polesel, Jerry; Braga, Claudia; Piselli, Pierluca; Serraino, Diego; Tagliabue, Giovanna; Federico, Massimo; Ferretti, Stefano; De Lisi, Vincenzo; La Rosa, Francesco; Conti, Ettore; Budroni, Mario; Vicario, Gianni; Piffer, Silvano; Pannelli, Franco; Giacomin, Adriano; Bellù, Francesco; Tumino, Rosario; Fusco, Mario; Rezza, GiovanniCancer and AIDS Registry Linkage Study

JAIDS Journal of Acquired Immune Deficiency Syndromes: September 1st, 2003 - Volume 34 - Issue 1 - p 84-90
Epidemiology & Social Science

A record linkage was carried out between the Italian National Registry of AIDS and 19 cancer registries. The aim was to evaluate the 1986 through 1998 trends in incidence rate (IR) of AIDS-defining cancers (ADCs) among persons with AIDS (PWA) in Italy overall and according to various characteristics. A steady decrease in IRs was found for Kaposi sarcoma (KS) in men between 1986–1992 (2.5 per 100 person-years [py]) and 1997–1998 (1.0 per 100 py). Conversely, the first decrease in IRs of KS in women (from 0.9 to 0.6 per 100 py) and of non-Hodgkin lymphoma in both genders (from 1.7 to 0.7 per 100 py) was seen between 1993–1996 and 1997–1998, thus pointing to a favorable impact of highly active antiretroviral therapies. The decline was consistent across different age and HIV transmission groups, but it was more marked in PWA with a CD4 count >50 cells/μL than in PWA with more severe immune suppression. As a proportion of AIDS cases, invasive cervical cancer increased from 1.5% in 1993–1996 to 2.4% in 1997–1998, but IRs after AIDS could not be evaluated. On account of the marked decline of KS in men in 1997–1998, the overall burden of ADCs in Italy became similar in both genders.

From the International Agency for Research on Cancer, Lyon, France (Drs Franceschi and Braga); Servizio di Epidemiologia e Biostatistica, Centro di Riferimento Oncologico, Aviano, Italy (Drs Dal Maso, Polesel, and Vicario); Centro Operativo AIDS, Istituto Superiore di Sanità, Rome, Italy (Drs Pezzotti and Rezza); IRCCS “L. Spallanzani”, Rome, Italy (Drs Piselli and Serraino); Registro Tumori Lombardia - Provincia di Varese, Milan, Italy (Dr Tagliabue); Registro Tumori della Provincia di Modena, Modena, Italy (Dr Federico); Registro Tumori della Provincia di Ferrara, Ferrara, Italy (Dr Feretti); Registro Tumori della Provincia di Parma, Parma, Italy (Dr De Lisi); Registro Tumori Umbro, Perugia, Italy (Dr La Rosa); Registro Tumori di Popolazione della Provincia di Latina, Rome, Italy (Dr Conti); Registro Tumori della Provincia di Sassari, Sassari, Italy (Dr Budroni); Registro dei Tumori del Friuli-Venezia Giulia, Aviano, Italy (Dr Vicario); Registro Tumori della Provincia di Trento, Trento, Italy (Dr Piffer); Registro Tumori Provincia di Macerata, Camerino, Italy (Dr Pannelli); Registro Tumori della Provincia di Biella, Biella, Italy (Dr Giacomin); Registro Tumori dell'Alto Adige, Bolzano, Italy (Dr Bellù); Azienda Ospedaliera Civile “MP Arezzo”, Registro Tumori Ragusa, Ragusa, Italy (Dr Tumino); Registro Tumori Regione Campania, Napoli, Italy (Dr Fusco). The other participants of the Cancer and AIDS Registry Linkage Study are listed in the appendix.

Received for publication February 21, 2003; accepted June 9, 2003.

This work was supported by Ministry of Health F.S.N. 2000 contract ICS 060.2/RF 00-55 and by grant 20D/1.1 from the Istituto Superiore di Sanità, Rome, Italy.

Reprints: Luigino Dal Maso, Servizio di Epidemiologia, Centro di Riferimento Oncologico Via Pedemontana Occ. 12–33081 Aviano (PN), Italy (e-mail: epidemiology@cro.it).

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