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 cancers. METHODS: PWA with cancer at AIDS 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 (CI) were estimated. RESULTS: We included 2262 Italian PWA and 4602 non-PWA with cancer diagnosed during 1986-2005. Between 1986-1995 and 1996-2005, 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: 4.3-6.1) to 2.9 (95% CI: 2.6-3.3). In 1996-2005, HRs were 2.0 (95% CI: 1.4-2.9) for Kaposi sarcoma; 3.4 (2.9-4.1) for non-Hodgkin lymphoma; 2.4 (1.4-4.0) for cervical cancer. HRs were 2.5 (2.1-3.1) for all non-AIDS-defining cancers; 5.9 (3.1-11.2) for Hodgkin lymphoma; and 7.3 (2.8-19.2) for non-melanoma skin. A ≤3-fold survival difference was found for cancer of the stomach, liver, anus, lung, brain and the most aggressive lymphoma subtypes. CONCLUSION(S): The persisting, although narrowing, gap in cancer survival between PWA and non-PWA indicates the necessity of enhancing therapeutic approaches, so that PWA will be provided the same chances of survival observed in the general population, and improving cancer prevention and screening.
Survival after cancer in Italian persons with AIDS, 1986-2005: A population-based estimation.
LIMINA, Rosa Maria;
2014-01-01
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 cancers. METHODS: PWA with cancer at AIDS 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 (CI) were estimated. RESULTS: We included 2262 Italian PWA and 4602 non-PWA with cancer diagnosed during 1986-2005. Between 1986-1995 and 1996-2005, 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: 4.3-6.1) to 2.9 (95% CI: 2.6-3.3). In 1996-2005, HRs were 2.0 (95% CI: 1.4-2.9) for Kaposi sarcoma; 3.4 (2.9-4.1) for non-Hodgkin lymphoma; 2.4 (1.4-4.0) for cervical cancer. HRs were 2.5 (2.1-3.1) for all non-AIDS-defining cancers; 5.9 (3.1-11.2) for Hodgkin lymphoma; and 7.3 (2.8-19.2) for non-melanoma skin. A ≤3-fold survival difference was found for cancer of the stomach, liver, anus, lung, brain and the most aggressive lymphoma subtypes. CONCLUSION(S): The persisting, although narrowing, gap in cancer survival between PWA and non-PWA indicates the necessity of enhancing therapeutic approaches, so that PWA will be provided the same chances of survival observed in the general population, and improving cancer prevention and screening.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
