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Sant M, Vener C, Lillini R, Rossi S, Bonfarnuzzo S, Marcos-Gragera R, Maynadié M, Innos K, Paapsi K, Visser O, Bernasconi A, Demuru E, Di Benedetto C, Mousavi SM, Blum M, Went P, Serraino D, Bennett D, Sánchez MJ, De Angelis R. Long-term survival for lymphoid neoplasms and national health expenditure (EUROCARE-6): a retrospective, population-based study. Lancet Oncol 2024; 25:731-743. [PMID: 38703784 DOI: 10.1016/s1470-2045(24)00141-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 03/04/2024] [Accepted: 03/06/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Management of lymphoid malignancies requires substantial health system resources. Total national health expenditure might influence population-based lymphoid malignancy survival. We studied the long-term survival of patients with 12 lymphoid malignancy types and examined whether different levels of national health expenditure might explain differences in lymphoid malignancy prognosis between European countries and regions. METHODS For this observational, retrospective, population-based study, we analysed the EUROCARE-6 dataset of patients aged 15 or older diagnosed between 2001 and 2013 with one of 12 lymphoid malignancies defined according to International Classification of Disease for Oncology (third edition) and WHO classification, and followed up to 2014 (Jan 1, 2001-Dec 31, 2014). Countries were classified according to their mean total national health expenditure quartile in 2001-13. For each lymphoid malignancy, 5-year and 10-year age-standardised relative survival (ASRS) was calculated using the period approach. Generalised linear models indicated the effects of age at diagnosis, gender, and total national health expenditure on the relative excess risk of death (RER). FINDINGS 82 cancer registries (61 regional and 21 national) from 27 European countries provided data eligible for 10-year survival estimates comprising 890 730 lymphoid malignancy cases diagnosed in 2001-13. Median follow-up time was 13 years (IQR 13-14). Of the 12 lymphoid malignancies, the 10-year ASRS in Europe was highest for hairy cell leukaemia (82·6% [95% CI 78·9-86·5) and Hodgkin lymphoma (79·3% [78·6-79·9]) and lowest for plasma cell neoplasms (29·5% [28·9-30·0]). RER increased with age at diagnosis, particularly from 55-64 years to 75 years or older, for all lymphoid malignancies. Women had higher ASRS than men for all lymphoid malignancies, except for precursor B, T, or natural killer cell, or not-otherwise specified lymphoblastic lymphoma or leukaemia. 10-year ASRS for each lymphoid malignancy was higher (and the RER lower) in countries in the highest national health expenditure quartile than in countries in the lowest quartile, with a decreasing pattern through quartiles for many lymphoid malignancies. 10-year ASRS for non-Hodgkin lymphoma, the most representative class for lymphoid malignancies based on the number of incident cases, was 59·3% (95% CI 58·7-60·0) in the first quartile, 57·6% (55·2-58·7) in the second quartile, 55·4% (54·3-56·5) in the third quartile, and 44·7% (43·6-45·8) in the fourth quartile; with reference to the European mean, the RER was 0·80 (95% CI 0·79-0·82) in the first, 0·91 (0·90-0·93) in the second, 0·94 (0·92-0·96) in the third, and 1·45 (1·42-1·48) in the fourth quartiles. INTERPRETATION Total national health expenditure is associated with geographical inequalities in lymphoid malignancy prognosis. Policy decisions on allocating economic resources and implementing evidence-based models of care are needed to reduce these differences. FUNDING Italian Ministry of Health, European Commission, Estonian Research Council.
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Affiliation(s)
- Milena Sant
- Analytical Epidemiology and Health Impact Unit, Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Claudia Vener
- Analytical Epidemiology and Health Impact Unit, Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Epidemiology and Prevention Unit, Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Roberto Lillini
- Analytical Epidemiology and Health Impact Unit, Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Silvia Rossi
- Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - Simone Bonfarnuzzo
- Analytical Epidemiology and Health Impact Unit, Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Rafael Marcos-Gragera
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health Government of Catalonia, Catalan Institute of Oncology, Girona, Spain
| | - Marc Maynadié
- Registre des Hémopathies Malignes de Côte d'Or, University of Burgundy and Dijon University Hospital, Dijon, France
| | - Kaire Innos
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | - Keiu Paapsi
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | - Otto Visser
- Department of Registration, Netherlands Comprehensive Cancer Organization, Utrecht, Netherlands
| | - Alice Bernasconi
- Evaluative Epidemiology Unit, Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Elena Demuru
- Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - Corrado Di Benedetto
- Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
| | | | - Marcel Blum
- East Switzerland Cancer Registry and Cancer Registry Liechtenstein, St Gallen, Switzerland
| | - Philip Went
- Institut für Pathologie, Kantonsspital Graubünden, Chur, Switzerland
| | | | - Damien Bennett
- Northern Ireland Cancer Registry (NICR), Belfast, UK; Queens University Belfast (QUB), Centre for Public Health, Institute of Clinical Sciences, Royal Victoria Hospital, Belfast, UK
| | - Maria-Jose Sánchez
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain; Instituto de Investigación Biosanitaria ibs Granada, Granada, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Roberta De Angelis
- Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
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Vercelli M, Lillini R, Quaglia A, Capocaccia R, Vercelli M, Lillini L, Quaglia A, Capocaccia R, De Angelis R, Gatta G, Tagliabue G, Pannozzo F, Ramazzotti V, Fusco M, Cilia S, De Felice E, Vattiato R, Senatore R, Zucchetto A, Buzzoni C, Tognazzo S, Bellù F, Piffer S, Cusimano R, Zarcone M, Cirilli C, Stracci F, Ferretti S, Cesaraccio R, Rosso S, Giacomin A, Cuccaro F, Michiara M. Italian Regional Health System Structure and Expected Cancer Survival. TUMORI JOURNAL 2018. [DOI: 10.1177/1636.17892] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Marina Vercelli
- Liguria Region Cancer Registry, Descriptive Epidemiology Unit, IRCCS Azienda Ospedaliera Universitaria San Martino – IST Istituto Nazionale per la Ricerca sul Cancro, Genoa
- Department of Health Sciences, University of Genoa, Genoa
| | - Roberto Lillini
- Liguria Region Cancer Registry, Descriptive Epidemiology Unit, IRCCS Azienda Ospedaliera Universitaria San Martino – IST Istituto Nazionale per la Ricerca sul Cancro, Genoa
- National Center of Epidemiology, Surveillance and Promotion of Health, National Institute of Health, Rome
- “Vita & Salute” San Raffaele University, Milan, Italy
| | - Alberto Quaglia
- Liguria Region Cancer Registry, Descriptive Epidemiology Unit, IRCCS Azienda Ospedaliera Universitaria San Martino – IST Istituto Nazionale per la Ricerca sul Cancro, Genoa
| | - Riccardo Capocaccia
- Liguria Region Cancer Registry, Descriptive Epidemiology Unit, IRCCS Azienda Ospedaliera Universitaria San Martino – IST Istituto Nazionale per la Ricerca sul Cancro, Genoa
- National Center of Epidemiology, Surveillance and Promotion of Health, National Institute of Health, Rome
| | - M Vercelli
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - L Lillini
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - A Quaglia
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - R Capocaccia
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - R De Angelis
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - G Gatta
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - G Tagliabue
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - F Pannozzo
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - V Ramazzotti
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - M Fusco
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - S Cilia
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - E De Felice
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - R Vattiato
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - R Senatore
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - A Zucchetto
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - C Buzzoni
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - S Tognazzo
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - F Bellù
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - S Piffer
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - R Cusimano
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - M Zarcone
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - C Cirilli
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - F Stracci
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - S Ferretti
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - R Cesaraccio
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - S Rosso
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - A Giacomin
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - F Cuccaro
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - M Michiara
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
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Medenwald D, Vordermark D, Dietzel CT. Cancer mortality in former East and West Germany: a story of unification? BMC Cancer 2017; 17:94. [PMID: 28148231 PMCID: PMC5288858 DOI: 10.1186/s12885-017-3086-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 01/24/2017] [Indexed: 01/04/2023] Open
Abstract
Background Health and social conditions vary between West and East Germany. Methods We analyzed annual mortality data of all recorded deaths caused by lung, colorectal, breast and prostate cancer in Germany as they are published by the Federal Bureau of Statistics (FBS) encompassing the period 1980–2014 for former West Germany (WG) and 1990–2014 for former East Germany (EG). To compare East and West Germany we computed the ratio of the mortality rates in both parts (mortality rate ratio, MRR, <1 indicates a lower mortality in EG). Forecasting methods of time series analyses were applied (model selection based on the Box/Jenkins approach) to predict 5-year trends until 2019. Results Lung cancer: In women mortality rose in both regions (WG: +2.8%, 1991–2014, EG: +2.2%, 1990–2014). In men mortality in WG declined between −2.1% and −1.2%, and by −2.7% (1993–2009) in EG which was followed by a plateau. Colorectal cancer: A decline was found in both WG (−3.1%, 1993–2014) and EG women (−3.8%, 1993–2008 and −2.0%, 2008–2014). A decline in EG men since 1992 (−0.9%, 1992–1997 and −2.3%, 1997–2014) mirrors the development in WG (−2.6%, 1995–2014). Breast cancer: Constant mortality decline in WG after 1996. In EG a decline (−2.4%, 1992–2007) was followed by a plateau with an MRR <1 (1990–2014). Prostate cancer: In WG a decline (−3.4%) came to a hold after 2007, while there was a constant decline of 1.5% in EG. The forecast indicated that mortality of colorectal/lung cancer in men and breast cancer reaches a plateau in future years. Conclusion Courses of mortality were similar between East and West, while existing differences are likely to remain in the near future. Electronic supplementary material The online version of this article (doi:10.1186/s12885-017-3086-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Daniel Medenwald
- Department of Radiation Oncology, University Hospital Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany. .,Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Germany.
| | - Dirk Vordermark
- Department of Radiation Oncology, University Hospital Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
| | - Christian T Dietzel
- Department of Radiation Oncology, University Hospital Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
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Baili P, Di Salvo F, Marcos-Gragera R, Siesling S, Mallone S, Santaquilani M, Micheli A, Lillini R, Francisci S. Age and case mix-standardised survival for all cancer patients in Europe 1999-2007: Results of EUROCARE-5, a population-based study. Eur J Cancer 2015; 51:2120-2129. [PMID: 26421816 DOI: 10.1016/j.ejca.2015.07.025] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 07/08/2015] [Accepted: 07/17/2015] [Indexed: 02/03/2023]
Abstract
BACKGROUND Overall survival after cancer is frequently used when assessing a health care service's performance as a whole. It is mainly used by the public, politicians and the media, and is often dismissed by clinicians because of the heterogeneous mix of different cancers, risk factors and treatment modalities. Here we give survival details for all cancers combined in Europe, correlating it with economic variables to suggest reasons for differences. METHODS We computed age and cancer site case-mix standardised relative survival for all cancers combined (ACRS) for 29 countries participating in the EUROCARE-5 project with data on more than 7.5million cancer cases from 87 population-based cancer registries, using complete and period approach. RESULTS Denmark, United Kingdom (UK) and Eastern European countries had lower survival than neighbouring countries. Five-year ACRS has been increasing throughout Europe, and substantial increases, between 1999-2001 and 2005-2007, have been achieved in countries where survival was lower in the past. Five-year ACRS for men and women are positively correlated with macro-economic variables like the Gross Domestic Product (GDP) and Total National Expenditure on Health (TNEH) (R2 about 70%). Countries with recent larger increases in GDP and TNEH had greater increases in cancer survival. CONCLUSIONS ACRS serves to compare all cancer survival in Europe taking account of the geographical variability in case-mixes. The EUROCARE-5 data on ACRS confirm previous EUROCARE findings. Survival appears to correlate with macro-economic determinants, particularly with investments in the health care system.
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Affiliation(s)
- Paolo Baili
- Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS "Istituto Nazionale dei Tumori", via Venezian 1, 20133 Milan, Italy
| | - Francesca Di Salvo
- Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS "Istituto Nazionale dei Tumori", via Venezian 1, 20133 Milan, Italy.
| | - Rafael Marcos-Gragera
- Epidemiology Unit and Girona Cancer Registry (Oncology Coordination Plan). Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Girona Biomedical Research Institute, Girona, Spain
| | - Sabine Siesling
- Netherlands Comprehensive Cancer Organisation (Department of Research), PO Box 19079, 3501 DB Utrecht, The Netherlands; MIRA Institute of Biomedical Technology and Technical Medicine, University of Twente (Department of Health Technology and Services Research), Enschede, The Netherlands
| | - Sandra Mallone
- National Centre for Epidemiology Surveillance and Health Promotion (CNESPS), National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | - Mariano Santaquilani
- Informatics service, National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | - Andrea Micheli
- Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS "Istituto Nazionale dei Tumori", via Venezian 1, 20133 Milan, Italy; Department of Health Sciences (DISS), University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy
| | - Roberto Lillini
- PhD School in Applied Sociology and Methodology of Research, Department of Sociology, University of Milan-Bicocca, Milan, Italy; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Silvia Francisci
- National Centre for Epidemiology Surveillance and Health Promotion (CNESPS), National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
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Forsea A, del Marmol V, Stratigos A, Geller A. Melanoma prognosis in Europe: far from equal. Br J Dermatol 2014; 171:179-82. [DOI: 10.1111/bjd.12923] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2014] [Indexed: 12/21/2022]
Affiliation(s)
- A.M. Forsea
- Dermatology Department; Elias University Hospital; Carol Davila University of Medicine and Pharmacy Bucharest; 17, Marasti Blvd Sector 1 Bucharest Romania
| | - V. del Marmol
- Department of Dermatology; Erasme Hospital; Université Libre de Bruxelles; 1070 Bruxelles Belgium
| | - A. Stratigos
- Department of Dermatology; University of Athens Medical School; Andreas Sygros Hospital; Dragoumi 5 161 21 Athens Greece
| | - A.C. Geller
- Department of Social and Behavioral Sciences; Harvard School of Public Health; Kresge Building, 677 Huntington Ave. Boston MA 02115 U.S.A
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Pizzi C, Arpino G, Acampora G, Aiello N, DE Rosa A, Diaferia I, DI Nunzio A, Fragna G, Franco A, Russo M, Sansone F, Scarpati C, Spinuso A, Arpino G, Luce A, Tommasielli G, Caraglia M, DE Placido S. Cancer prevalence in the city of Naples: Contribution of the GP database analyses to the cancer registries network. Mol Clin Oncol 2013; 1:726-732. [PMID: 24649236 PMCID: PMC3915682 DOI: 10.3892/mco.2013.101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Accepted: 03/25/2013] [Indexed: 11/06/2022] Open
Abstract
The Italian cancer registries network has not been sufficiently developed in the Southern regions. General practitioners (GPs) are knowledgeable about the prevalence, incidence and mortality for different types of cancer in their patient populations. The aim of this pilot study was to verify the feasibility and reliability of the characterization of cancer populations using GP databases in order to evaluate the impact of cancer in the general population of Naples. The characteristics of the cases studied have been collected by interview or electronic health record and recorded on paper or magnetic supports, appropriately conforming to the current privacy law. Databases are centralized, stored and codified on electronic data-sheets and periodically elaborated by the 'Consorzio Nazionale delle Cooperative Mediche' and 'Federico II' University. The present study was initiated on September 15, 2004. The analysed geographical area included the suburbs of 'Stella' and 'San Carlo all'Arena', situated in the historical center of Naples and corresponding to Health Care District 29 of the local health service. The analysis included 16,927 men and women (age range, 6-97 years) from the outpatient offices of 12 GPs who agreed to participate in the study. Results showed that the analysed population represents 16.3% of the general population residing in the area under study. We identified 342 (2%) patients with cancer, 143 (0.8%) of whom were men and 199 (1.2%) women (M/F ratio of 0.7). Of the 342 patients, 10 (5 men and 5 women) had a double cancer; thus, a total of 352 malignancies was characterized. Cancer prevalence was 2,020/100,000 inhabitants. This estimate is lower compared to the national prevalence (2,683/100,000 inhabitants) but higher compared to that in other southern Italian areas. Results, stratified by International Classification of Disease, ninth revision (ICD-IX), based on factors including gender and age, demonstrated that breast cancer, urogenital tumours and colorectal cancer are the most frequently occurring types of cancer identified among the inhabitants of Naples. Cancer prevalence in the historical center of Naples is in concordance with national estimates and projections and National Cancer Registries may be easily and accurately supported by GP medical databases.
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Affiliation(s)
- Claudia Pizzi
- Consorzio Nazionale delle Cooperative Mediche - Italian Society of General Medicine (SIMG), 'Federico II' University, 80131 Naples
| | - Grazia Arpino
- Department of Clinical Medicine and Surgery, Faculty of Medicine, 'Federico II' University, 80131 Naples
| | - Giuseppe Acampora
- Consorzio Nazionale delle Cooperative Mediche - Italian Society of General Medicine (SIMG), 'Federico II' University, 80131 Naples
| | - Nadia Aiello
- Consorzio Nazionale delle Cooperative Mediche - Italian Society of General Medicine (SIMG), 'Federico II' University, 80131 Naples
| | - Augusto DE Rosa
- Consorzio Nazionale delle Cooperative Mediche - Italian Society of General Medicine (SIMG), 'Federico II' University, 80131 Naples
| | - Immacolata Diaferia
- Consorzio Nazionale delle Cooperative Mediche - Italian Society of General Medicine (SIMG), 'Federico II' University, 80131 Naples
| | - Alessandro DI Nunzio
- Consorzio Nazionale delle Cooperative Mediche - Italian Society of General Medicine (SIMG), 'Federico II' University, 80131 Naples
| | - Giuseppe Fragna
- Consorzio Nazionale delle Cooperative Mediche - Italian Society of General Medicine (SIMG), 'Federico II' University, 80131 Naples
| | - Amedeo Franco
- Consorzio Nazionale delle Cooperative Mediche - Italian Society of General Medicine (SIMG), 'Federico II' University, 80131 Naples
| | - Maria Russo
- Consorzio Nazionale delle Cooperative Mediche - Italian Society of General Medicine (SIMG), 'Federico II' University, 80131 Naples
| | - Fulvia Sansone
- Consorzio Nazionale delle Cooperative Mediche - Italian Society of General Medicine (SIMG), 'Federico II' University, 80131 Naples
| | - Carmela Scarpati
- Consorzio Nazionale delle Cooperative Mediche - Italian Society of General Medicine (SIMG), 'Federico II' University, 80131 Naples
| | - Antonio Spinuso
- Consorzio Nazionale delle Cooperative Mediche - Italian Society of General Medicine (SIMG), 'Federico II' University, 80131 Naples
| | - Giovanni Arpino
- Consorzio Nazionale delle Cooperative Mediche - Italian Society of General Medicine (SIMG), 'Federico II' University, 80131 Naples
| | - Amalia Luce
- Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, 80138 Naples, Italy
| | - Giuseppina Tommasielli
- Consorzio Nazionale delle Cooperative Mediche - Italian Society of General Medicine (SIMG), 'Federico II' University, 80131 Naples
| | - Michele Caraglia
- Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, 80138 Naples, Italy
| | - Sabino DE Placido
- Department of Clinical Medicine and Surgery, Faculty of Medicine, 'Federico II' University, 80131 Naples
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Quaglia A, Lillini R, Mamo C, Ivaldi E, Vercelli M. Socio-economic inequalities: a review of methodological issues and the relationships with cancer survival. Crit Rev Oncol Hematol 2012; 85:266-77. [PMID: 22999326 DOI: 10.1016/j.critrevonc.2012.08.007] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2010] [Revised: 11/08/2011] [Accepted: 08/29/2012] [Indexed: 02/07/2023] Open
Abstract
During the past few decades, many studies on socio-economic factors and health outcomes have been developed using various methodologies with differing approaches. A bibliographic research in MEDLINE/PubMed and SCOPUS was carried out for the period 2000-2011 to describe the influence of socio-economic status (SES) on cancer survival, in particular with reference to the outcome of European research results and the results of some cases of other Western studies. This review is divided into two sections: the first describing the different approaches of the study on individuals and populations of the concept of "social class" as well as methods used to measure the association between deprivation and health (i.e. ecological level studies, deprivation indexes, etc.); and the second discussing the association between socio-economic factors and cancer survival, describing the roles of various determinants of differences in survival, such as clinical and pathological prognostic factors, together with consideration of diagnosis and treatment and some patients' characteristics.
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Affiliation(s)
- Alberto Quaglia
- U.O.S. Epidemiologia Descrittiva (Registro Tumori), IRCCS Azienda Ospedaliera Universitaria San Martino-IST Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy.
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Vercelli M, Lillini R, Capocaccia R, Quaglia A. Use of SERTS (Socio-Economic, health Resources and Technologic Supplies) models to estimate cancer survival at provincial geographical level. Cancer Epidemiol 2012; 36:566-74. [PMID: 22906484 DOI: 10.1016/j.canep.2012.07.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Revised: 07/24/2012] [Accepted: 07/25/2012] [Indexed: 11/24/2022]
Abstract
AIM The main aim of this work is to compute expected cancer survival for Italian provinces by Socio-Economic and health Resources and Technologic Supplies (SERTS) models, based on demographic, socioeconomic variables and information describing the health care system (SEH). METHODS Five-year age-standardised relative survival rates by gender for 11 cancer sites and all cancers combined of patients diagnosed in 1995-1999, were obtained from the Italian Association of Cancer Registries (CRs) database. The SEH variables describe at provincial level macro-economy, demography, labour market, health resources in 1995-2005. A principal components factor analysis was applied to the SEH variables to control their strong mutual correlation. For every considered cancer site, linear regression models were estimated considering the 5-RS% as dependent variable and the principal components factors of the SEH variables as independent variables. RESULTS The model composition was correlated to the characteristics of take in charge of patients. SEH factors were correlated with the observed survival for all cancer combined and colon-rectum in both sexes, prostate, kidney and non Hodgkin's lymphomas in men, breast, corpus uteri and melanoma in women (R(2) from 40% to 85%). In the provinces without any CR the survival was very similar with that of neighbouring provinces with analogous social, economic and health characteristics. CONCLUSIONS The SERTS models allowed us to interpret the survival outcome of oncologic patients with respect to the role of the socio-economic and health related system characteristics, stressing how the peculiarities of the take in charge at the province level could address the decisions regarding the allocation of resources.
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Affiliation(s)
- Marina Vercelli
- Liguria Region Cancer Registry, Descriptive Epidemiology Unit, IRCCS Azienda Ospedaliera Universitaria San Martino - IST Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy.
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Verma M, Patel P, Verma M. Biomarkers in prostate cancer epidemiology. Cancers (Basel) 2011; 3:3773-98. [PMID: 24213111 PMCID: PMC3763396 DOI: 10.3390/cancers3043773] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2011] [Revised: 09/26/2011] [Accepted: 09/26/2011] [Indexed: 01/09/2023] Open
Abstract
Understanding the etiology of a disease such as prostate cancer may help in identifying populations at high risk, timely intervention of the disease, and proper treatment. Biomarkers, along with exposure history and clinical data, are useful tools to achieve these goals. Individual risk and population incidence of prostate cancer result from the intervention of genetic susceptibility and exposure. Biochemical, epigenetic, genetic, and imaging biomarkers are used to identify people at high risk for developing prostate cancer. In cancer epidemiology, epigenetic biomarkers offer advantages over other types of biomarkers because they are expressed against a person's genetic background and environmental exposure, and because abnormal events occur early in cancer development, which includes several epigenetic alterations in cancer cells. This article describes different biomarkers that have potential use in studying the epidemiology of prostate cancer. We also discuss the characteristics of an ideal biomarker for prostate cancer, and technologies utilized for biomarker assays. Among epigenetic biomarkers, most reports indicate GSTP1 hypermethylation as the diagnostic marker for prostate cancer; however, NKX2-5, CLSTN1, SPOCK2, SLC16A12, DPYS, and NSE1 also have been reported to be regulated by methylation mechanisms in prostate cancer. Current challenges in utilization of biomarkers in prostate cancer diagnosis and epidemiologic studies and potential solutions also are discussed.
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Affiliation(s)
- Mukesh Verma
- Epidemiology and Genetics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institues of Health (NIH), 6130 Executive Blvd., Rockville, MD 20852, USA; E-Mail:
| | - Payal Patel
- Epidemiology and Genetics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institues of Health (NIH), 6130 Executive Blvd., Rockville, MD 20852, USA; E-Mail:
| | - Mudit Verma
- Laboratory of Cancer Biology and Genetics, Clinical Research Center, National Cancer Institute, National Institues of Health (NIH), 9000 Rockville Pike, Bethesda, MD 20892, USA; E-Mail:
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