Risk of cancer following immunosuppression in organ transplant recipients and in HIV-positive individuals in southern Europe

• Published in: European journal of cancer (1990) Vol. 43; no. 14; pp. 2117 - 2123
• Main Authors: Serraino, Diego, Piselli, Pierluca, Busnach, Ghil, Burra, Patrizia, Citterio, Franco, Arbustini, Eloisa, Baccarani, Umberto, De Juli, Emanuela, Pozzetto, Ubaldo, Bellelli, Stefania, Polesel, Jerry, Pradier, Christian, Maso, Luigino Dal, Angeletti, Claudio, Carrieri, Maria Patrizia, Rezza, Giovanni, Franceschi, Silvia
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.09.2007; Elsevier
• Subjects: Acquired immunodeficiency; Adult; Aged; Biological and medical sciences; Cancer; Cohort Studies; Female; France; France - epidemiology; Hematology, Oncology and Palliative Medicine; HIV Infections - complications; HIV Infections - epidemiology; HIV-infection; Humans; Immunosuppression - adverse effects; Italy; Italy - epidemiology; Male; Medical sciences; Middle Aged; Neoplasms - epidemiology; Neoplasms - etiology; Organ transplantation; Pharmacology. Drug treatments; Risk Factors; SIR; Transplantation - adverse effects; Tumors; Southern Europe; Italy; France; Europe; Acquired immunodeficiency; Italy; HIV-infection; Organ transplantation; France; SIR; Cancer; Human; Immunopathology; Acquired immunodeficiency,Cancer,France,HIV-infection,Italy,Organ transplantation,SIR; Acquired; AIDS; Pharmacology; Recipient; Transplantation; Malignant tumor; Epidemiology; Immune deficiency; Infection; Immunosuppression; Cancerology; Treatment; Surgery; Viral disease; Risk factor; Graft; Organ
• ISSN: 0959-8049; 1879-0852
• DOI: 10.1016/j.ejca.2007.07.015

Abstract This investigation highlighted the risk of cancer in 8074 HIV-infected people and in 2875 transplant recipients in Italy and France. Observed and expected numbers of cancer were compared through sex- and age-standardised incidence ratios (SIRs) and 95% confidence intervals (CIs). After 15 years of follow-up, the cumulative probability of cancer was 14.7% in transplant recipients and 13.3% in HIV-positives. The SIRs for all cancers were 9.8 in HIV-positives and 2.2 in transplants. Kaposi’s sarcoma (SIR = 451 in HIV-positives, 125 in transplants) and non-Hodgkin lymphoma (SIR = 62 and 11.1, respectively) were the most common cancers. A significantly increased SIR for liver cancer also emerged in both groups. The risk of lung cancer was significantly elevated in heart transplant recipients (SIR = 2.8), and of borderline statistical significance in HIV-positive people (95% CI:0.9–2.8). Immune depression entails a two-fold increased overall risk of cancers, mainly related to cancers associated with a viral aetiology.