Survival After Cancer in Italian Persons With AIDS, 1986–2005

Maso, Luigino Dal; Suligoi, Barbara; Franceschi, Silvia; Braga, Cláudia; Buzzoni, Carlotta; Polesel, Jerry; Zucchetto, Antonella; Piselli, Pierluca; Falcini, Fabio; Caldarella, Adele; Zanetti, Roberto; Vercelli, Marina; Guzzinati, Stefano; Russo, Antonio; Tagliabue, Giovanna; Iachetta, Francesco; Ferretti, Stefano; Limina, Rosa Maria; Mangone, Lucìa; Michiara, Maria; Stracci, Fabrizio; Pirino, D; Piffer, Silvano; Giacomin, Adriano; Vitarelli, Susanna; Mazzoleni, Guido; Iannelli, A.; Contrino, Maria Lia; Fusco, Mario; Tumino, Rosario; Fanetti, Anna Clara; Paoli, Paolo De; Decarli, Adriano; Serraino, Diego

doi:10.1097/qai.0000000000000184

Cited by 22 publications

(20 citation statements)

References 44 publications

(58 reference statements)

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“…Our study is consistent with prior studies finding reduced survival among HIV-infected individuals diagnosed with lung and prostate cancers, (13,14,16,17) with several finding increased mortality independent of disease stage at diagnosis. (16,17) Among injection drug users, Shiels et al found a nearly four-fold higher risk of death after diagnosis with lung cancer among HIV-infected compared with HIV-uninfected individuals after adjustment for SEER summary stage and smoking, although with 29 cases this did not reach statistical significance.…”

Section: Discussionsupporting

confidence: 93%

“…Of studies comparing cancer prognosis by HIV status, HIV infection has been associated with increased mortality from multiple NADCs, including HL (13–15) and lung, (13,14,16,17) colorectal, (13,14) anal, (14,18) and prostate (14) cancers. However, while mortality from AIDS and other causes may result in reduced survival for HIV-infected individuals, few studies have examined cancer-specific mortality (16); furthermore, several were conducted among individuals living with AIDS, (13,14) who are at particularly high risk of death from non-cancer causes.…”

Section: Introductionmentioning

confidence: 99%

“…However, while mortality from AIDS and other causes may result in reduced survival for HIV-infected individuals, few studies have examined cancer-specific mortality (16); furthermore, several were conducted among individuals living with AIDS, (13,14) who are at particularly high risk of death from non-cancer causes. Despite differences by HIV status in mortality risk factors, such as smoking (19,20) and cancer treatment (21,22), few studies have had available data or adequate sample size to adjust for these factors in analyses of individual cancers.…”

Section: Introductionmentioning

confidence: 99%

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Survival among HIV-Infected and HIV-Uninfected Individuals with Common Non–AIDS-Defining Cancers

Marcus

Chao

Leyden

et al. 2015

Cancer Epidemiology, Biomarkers &Amp; Prevention

101

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Background Non-AIDS-defining cancers increasingly contribute to mortality among human immunodeficiency virus (HIV)-infected individuals. However, few studies have compared cancer prognosis by HIV status with adjustment for risk factors. Methods We conducted a cohort study of HIV-infected and HIV-uninfected adults in Kaiser Permanente California during 1996–2011, following subjects diagnosed with Hodgkin lymphoma (HL) or anal, prostate, colorectal, or lung cancers. We used Kaplan-Meier curves and Cox regression to assess cancer-related mortality within five years, comparing HIV-infected with HIV-uninfected subjects. Adjusted models included age, race/ethnicity, sex, cancer stage, cancer treatment, and smoking. Results Among HIV-infected and HIV-uninfected subjects, there were 68 and 51 cases of HL, 120 and 28 of anal cancer, 150 and 2050 of prostate cancer, 53 and 646 of colorectal cancer, and 80 and 507 of lung cancer, respectively. Five-year cancer-related survival was reduced for HIV-infected compared with HIV-uninfected subjects, reaching statistical significance for lung cancer (10% vs. 19%, P=0.002) but not HL (83% vs. 89%, P=0.40) or anal (64% vs. 74%, P=0.38), prostate (86% vs. 92%, P=0.074), or colorectal cancers (49% vs. 58%, P=0.55). Adjusted results were similar, with lung cancer (hazard ratio [HR] 1.3, 95% confidence interval [CI]: 1.0–1.7) and prostate cancer (HR 2.1, 95% CI: 1.1–4.1) reaching significance. Conclusions Cancer-related mortality was higher among HIV-infected compared with HIV-uninfected individuals for prostate and lung cancers, but not HL, anal cancer, or colorectal cancer. Impact Our findings emphasize the need for a focus on prevention, early detection, and adequate treatment of cancer among HIV-infected individuals.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Survival among HIV-Infected and HIV-Uninfected Individuals with Common Non–AIDS-Defining Cancers

Marcus

Chao

Leyden

et al. 2015

Cancer Epidemiology, Biomarkers &Amp; Prevention

101

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“…The improved survival observed here after diagnosis of hematological malignancies was not explained by changes in the characteristics of HIV‐infected individuals over time but rather by a calendar‐period effect, likely related to more often use of the same cancer treatment protocols as in HIV‐uninfected individuals and to a better adherence to these protocols because of better tolerability. Despite the clear trend towards improved survival after hematological malignancies, we observed a marked difference between the HIV‐infected and general populations for cases diagnosed in 2001–2004 even when restricting to DLBCL, confirming the results of previous studies . Although the improvement in survival could be related to better access to cancer treatment over time, suboptimal management of HIV‐infected individuals with cancer likely persists in 2001–2004; indeed, HIV‐seropositive cancer patients do not receive the same number of cycles or the same doses of chemotherapy as patients not infected by HIV .…”

Section: Discussionsupporting

confidence: 84%

Trends in survival after cancer diagnosis among HIV‐infected individuals between 1992 and 2009. Results from the FHDH‐ANRSCO4 cohort

Hleyhel

Belot

Bouvier

et al. 2015

Intl Journal of Cancer

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Although the decline in cancer mortality rates with the advent of combination antiretroviral therapy (cART) in HIV‐infected individuals can be mostly explained by a decrease in cancers incidence, we looked here if improved survival after cancer diagnosis could also contribute to this decline. Survival trends were analyzed for most frequent cancers in the HIV‐infected population followed in the French Hospital Database on HIV: 979 and 2,760 cases of visceral and non‐visceral Kaposi's sarcoma (KS), 2,339 and 461 cases of non‐Hodgkin lymphoma (NHL) and Hodgkin's lymphoma (HL), 446 lung, 312 liver and 257 anal cancers. Five‐year Kaplan–Meier survival rates were estimated for four periods: 1992–1996, 1997–2000, 2001–2004 and 2005–2009. Cox proportional hazard models were used to compare survival across the periods, after adjustment for confounding factors. For 2001–2004, survival was compared to the general population after standardization on age and sex. Between the pre‐cART (1992–1996) and early‐cART (1997–2000) periods, survival improved after KS, NHL, HL and anal cancer and remained stable after lung and liver cancers. During the cART era, 5‐year survival improved after visceral and non‐visceral KS, NHL, HL and liver cancer, being 83, 92, 65, 87 and 19% in 2005–2009, respectively, and remained stable after lung and anal cancers, being 16 and 65%, respectively. Compared with the general population, survival in HIV‐infected individuals in 2001–2004 was poorer for hematological malignancies and similar for solid tumors. For hematological malignancies, survival continues to improve after 2004, suggesting that the gap between the HIV‐infected and general populations will close in the future.

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“…The Italian Cancer and AIDS registries linkage study found much lower 5‐year survival probabilities than ART‐CC after several specific cancers, for example, liver cancer 8% vs . 26%, but our study was during the early ART period and included PLHIV not on ART who had an AIDS diagnosis . Another Italian study which included PLHIV not on ART found similar 5‐year survival to ART‐CC after a diagnosis of Hodgkin's lymphoma .…”

Section: Discussionmentioning

confidence: 82%

Cause‐specific mortality after diagnosis of cancer among HIV‐positive patients: A collaborative analysis of cohort studies

Trickey

May

Gill

et al. 2020

Intl Journal of Cancer

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People living with HIV (PLHIV) are more likely than the general population to develop AIDS‐defining malignancies (ADMs) and several non‐ADMs (NADMs). Information is lacking on survival outcomes and cause‐specific mortality after cancer diagnosis among PLHIV. We investigated causes of death within 5 years of cancer diagnosis in PLHIV enrolled in European and North American HIV cohorts starting antiretroviral therapy (ART) 1996–2015, aged ≥16 years, and subsequently diagnosed with cancer. Cancers were grouped: ADMs, viral NADMs and nonviral NADMs. We calculated cause‐specific mortality rates (MR) after diagnosis of specific cancers and compared 5‐year survival with the UK and France general populations. Among 83,856 PLHIV there were 4,436 cancer diagnoses. Of 603 deaths after ADM diagnosis, 292 (48%) were due to an ADM. There were 467/847 (55%) and 74/189 (39%) deaths that were due to an NADM after nonviral and viral NADM diagnoses, respectively. MR were higher for diagnoses between 1996 and 2005 versus 2006–2015: ADMs 102 (95% CI 92–113) per 1,000 years versus 88 (78–100), viral NADMs 134 (106–169) versus 111 (93–133) and nonviral NADMs 264 (232–300) versus 226 (206–248). Estimated 5‐year survival for PLHIV diagnosed with liver (29% [19–39%]), lung (18% [13–23%]) and cervical (75% [63–84%]) cancer was similar to general populations. Survival after Hodgkin's lymphoma diagnosis was lower in PLHIV (75% [67–81%]). Among ART‐treated PLHIV diagnosed with cancer, MR and causes of death varied by cancer type, with mortality highest for liver and lung cancers. Deaths within 5 years of NADM diagnoses were more likely to be from cancer than AIDS.

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Survival After Cancer in Italian Persons With AIDS, 1986–2005

Abstract: 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.

Cited by 22 publications

References 44 publications

Survival among HIV-Infected and HIV-Uninfected Individuals with Common Non–AIDS-Defining Cancers

Survival among HIV-Infected and HIV-Uninfected Individuals with Common Non–AIDS-Defining Cancers

Trends in survival after cancer diagnosis among HIV‐infected individuals between 1992 and 2009. Results from the FHDH‐ANRSCO4 cohort

Cause‐specific mortality after diagnosis of cancer among HIV‐positive patients: A collaborative analysis of cohort studies

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