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Bisanti L, La Corte C, Dara M, Bertini F, Parisi MG, Chemello R, Cammarata M, Parrinello D. Global warming-related response after bacterial challenge in Astroides calycularis, a Mediterranean thermophilic coral. Sci Rep 2024; 14:8495. [PMID: 38605161 PMCID: PMC11009343 DOI: 10.1038/s41598-024-58652-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 04/02/2024] [Indexed: 04/13/2024] Open
Abstract
A worldwide increase in the prevalence of coral diseases and mortality has been linked to ocean warming due to changes in coral-associated bacterial communities, pathogen virulence, and immune system function. In the Mediterranean basin, the worrying upward temperature trend has already caused recurrent mass mortality events in recent decades. To evaluate how elevated seawater temperatures affect the immune response of a thermophilic coral species, colonies of Astroides calycularis were exposed to environmental (23 °C) or elevated (28 °C) temperatures, and subsequently challenged with bacterial lipopolysaccharides (LPS). Using immunolabeling with specific antibodies, we detected the production of Toll-like receptor 4 (TLR4) and nuclear factor kappa B (NF-kB), molecules involved in coral immune responses, and heat shock protein 70 (HSP70) activity, involved in general responses to thermal stress. A histological approach allowed us to characterize the tissue sites of activation (epithelium and/or gastroderm) under different experimental conditions. The activity patterns of the examined markers after 6 h of LPS stimulation revealed an up-modulation at environmental temperature. Under warmer conditions plus LPS-challenge, TLR4-NF-kB activation was almost completely suppressed, while constituent elevated values were recorded under thermal stress only. An HSP70 up-regulation appeared in both treatments at elevated temperature, with a significantly higher activation in LPS-challenge colonies. Such an approach is useful for further understanding the molecular pathogen-defense mechanisms in corals in order to disentangle the complex interactive effects on the health of these ecologically relevant organisms related to global climate change.
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Affiliation(s)
- L Bisanti
- Department of Earth and Marine Sciences, University of Palermo, 90128, Palermo, Italy
- NBFC, National Biodiversity Future Center, 90133, Palermo, Italy
| | - C La Corte
- Department of Earth and Marine Sciences, University of Palermo, 90128, Palermo, Italy
- NBFC, National Biodiversity Future Center, 90133, Palermo, Italy
| | - M Dara
- Department of Earth and Marine Sciences, University of Palermo, 90128, Palermo, Italy
- NBFC, National Biodiversity Future Center, 90133, Palermo, Italy
| | - F Bertini
- Department of Earth and Marine Sciences, University of Palermo, 90128, Palermo, Italy
- NBFC, National Biodiversity Future Center, 90133, Palermo, Italy
| | - M G Parisi
- Department of Earth and Marine Sciences, University of Palermo, 90128, Palermo, Italy
- NBFC, National Biodiversity Future Center, 90133, Palermo, Italy
| | - R Chemello
- Department of Earth and Marine Sciences, University of Palermo, 90128, Palermo, Italy
- NBFC, National Biodiversity Future Center, 90133, Palermo, Italy
| | - M Cammarata
- Department of Earth and Marine Sciences, University of Palermo, 90128, Palermo, Italy.
- NBFC, National Biodiversity Future Center, 90133, Palermo, Italy.
| | - D Parrinello
- Department of Earth and Marine Sciences, University of Palermo, 90128, Palermo, Italy
- NBFC, National Biodiversity Future Center, 90133, Palermo, Italy
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La Corte C, Dara M, Bertini F, Bisanti L, Cammarata M, Parisi MG. Sea anemones, methylmercury, and bacterial infection: A closer look at multiple stressors. Mar Pollut Bull 2024; 201:116287. [PMID: 38547612 DOI: 10.1016/j.marpolbul.2024.116287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 03/17/2024] [Accepted: 03/20/2024] [Indexed: 04/07/2024]
Abstract
Specimens of the Mediterranean sea anemone Anemonia viridis were exposed to methylmercury (MeHg) and bacterial infection to study their immune responses to a well-known toxic pollutant. Anemones were housed in laboratory conditions and divided into five experimental groups: 1. control (no microinjection); 2. filtered seawater + buffer injection; 3. filtered seawater + Escherichia coli injection; 4. MeHg + buffer injection; 5. MeHg + E. coli injection. Data showed an increase in antioxidant enzyme production compared to the constitutive condition, while methylmercury inhibited lysozyme production. The buffer inoculation had no statistically significant effects on the animals. In addition, electrophoretic and protease analyses revealed differences in the type of proteins produced, as well as a modulation of proteases depending on the treatment. The study demonstrated the immunomodulatory effect of the organic pollutant on A. viridis, validating its use as a model organism for marine coastal biomonitoring programmes and multiple stress studies.
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Affiliation(s)
- C La Corte
- Marine Immunobiology Laboratory, Department of Earth and Marine Sciences (DiSTeM), University of Palermo, Viale delle Scienze, Ed. 16, 90128 Palermo, Italy; NBFC, National Biodiversity Future Center, Piazza Marina 61, Palermo 90133, Italy.
| | - M Dara
- Marine Immunobiology Laboratory, Department of Earth and Marine Sciences (DiSTeM), University of Palermo, Viale delle Scienze, Ed. 16, 90128 Palermo, Italy; NBFC, National Biodiversity Future Center, Piazza Marina 61, Palermo 90133, Italy.
| | - F Bertini
- Marine Immunobiology Laboratory, Department of Earth and Marine Sciences (DiSTeM), University of Palermo, Viale delle Scienze, Ed. 16, 90128 Palermo, Italy; NBFC, National Biodiversity Future Center, Piazza Marina 61, Palermo 90133, Italy.
| | - L Bisanti
- Marine Immunobiology Laboratory, Department of Earth and Marine Sciences (DiSTeM), University of Palermo, Viale delle Scienze, Ed. 16, 90128 Palermo, Italy; NBFC, National Biodiversity Future Center, Piazza Marina 61, Palermo 90133, Italy.
| | - M Cammarata
- Marine Immunobiology Laboratory, Department of Earth and Marine Sciences (DiSTeM), University of Palermo, Viale delle Scienze, Ed. 16, 90128 Palermo, Italy; NBFC, National Biodiversity Future Center, Piazza Marina 61, Palermo 90133, Italy.
| | - M G Parisi
- Marine Immunobiology Laboratory, Department of Earth and Marine Sciences (DiSTeM), University of Palermo, Viale delle Scienze, Ed. 16, 90128 Palermo, Italy; NBFC, National Biodiversity Future Center, Piazza Marina 61, Palermo 90133, Italy.
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Candela S, Bisanti L, Canova C, Caranci N, Petrelli A. Editorial: Immigrant's health in different migration contexts. Front Public Health 2023; 11:1188061. [PMID: 37521987 PMCID: PMC10374296 DOI: 10.3389/fpubh.2023.1188061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 03/27/2023] [Indexed: 08/01/2023] Open
Affiliation(s)
- Silvia Candela
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Local Health Authority of Reggio Emilia, Reggio Emilia, Italy
| | | | - Cristina Canova
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padova, Padua, Italy
| | - Nicola Caranci
- Department of Innovation in Health and Social Care, General Directorate of Health and Welfare, Bologna, Italy
| | - Alessio Petrelli
- Epidemiology Unit, National Institute for Health, Migration and Poverty (INMP), Rome, Italy
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Paci E, Bisanti L. [The COVID-19 epidemic and total mortality: missed data and the incoming epidemiology]. Epidemiol Prev 2023; 47:67-72. [PMID: 37078199 DOI: 10.19191/ep23.1-2.a571.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
The generation of rapid information has been an important novelty in the COVID-19 pandemic and a challenge for epidemiology. The methodological frailty and uncertainty of rapid data use has been a consequence. We are talking about an 'intermezzo' epidemiology between the event and the production of consolidated data that opens up great opportunities to the use epidemiology for rapid public health decisions, provided a careful work to be done before emergencies. In Italy, an ad hoc national COVID-19 information system producing daily data that quickly became essential for public decision-making. Total and all-cause mortality data are derived from the traditional information system of the Italian National Institute of Statistics (Istat), which, at the onset of the pandemic, was unable to provide rapid total and all-causes mortality data at the national level and still produces them with a one- to two-month delay. National cause and place mortality data referred to the first epidemic wave (March and April 2020) was in May 2021 and recently updated (October 2022) for the whole year 2020. Nearly three years after the onset of the epidemic, we have no nationwide rapid information on the distribution of deaths by place of death (hospitals, nursing homes and other care facilities, home) neither on their breakdown in 'by COVID-19', 'with COVID-19', and 'non-COVID-19' deaths. The pandemic being still in progress, new problems arise (the long-term impact of COVID-19, the impact of lockdown policies, etcetera), whose solution cannot be postponed until peer reviewed papers are available. A fine-tuning of the rapid processing of interim data certainly requires the development of national and regional information systems, but first of all a methodologically robust 'intermezzo' epidemiology.
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Bisanti L, Candela S, Dansero L, Destefanis C, Mondo L, Ricceri F. [Hazards and damages of migration. Work in progress in Susa Valley]. Epidemiol Prev 2022; 46:310-311. [PMID: 36628640 DOI: 10.19191/ep22.5-6.a558.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Luigi Bisanti
- Sottogruppo "Nocività del processo migratorio" del Gruppo di lavoro AIE-migranti;
| | - Silvia Candela
- Sottogruppo "Nocività del processo migratorio" del Gruppo di lavoro AIE-migranti
| | - Lucia Dansero
- Sottogruppo "Nocività del processo migratorio" del Gruppo di lavoro AIE-migranti
| | - Cinzia Destefanis
- Sottogruppo "Nocività del processo migratorio" del Gruppo di lavoro AIE-migranti
| | - Luisa Mondo
- Sottogruppo "Nocività del processo migratorio" del Gruppo di lavoro AIE-migranti
| | - Fulvio Ricceri
- Sottogruppo "Nocività del processo migratorio" del Gruppo di lavoro AIE-migranti
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Bisanti L. [New research tools are needed to contribute to the protection of migrants' health]. Epidemiol Prev 2019; 43:213-214. [PMID: 31650773 DOI: 10.19191/ep19.4.p213.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Luigi Bisanti
- Direzione scientifica di Epidemiologia e Prevenzione
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Zanutto S, Ciniselli CM, Belfiore A, Lecchi M, Masci E, Delconte G, Primignani M, Tosetti G, Dal Fante M, Fazzini L, Airoldi A, Vangeli M, Turpini F, Rubis Passoni GG, Viaggi P, Arena M, Motta RIO, Cantù AM, Crosta C, De Roberto G, Iannuzzi F, Cassinotti A, Dall'Olio V, Tizzoni L, Sozzi G, Meroni E, Bisanti L, Pierotti MA, Verderio P, Gariboldi M. Plasma miRNA-based signatures in CRC screening programs. Int J Cancer 2019; 146:1164-1173. [PMID: 31304978 DOI: 10.1002/ijc.32573] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 06/12/2019] [Accepted: 06/26/2019] [Indexed: 02/06/2023]
Abstract
Colorectal cancer (CRC) screening programs help diagnose cancer precursors and early cancers and help reduce CRC mortality. However, currently recommended tests, the fecal immunochemical test (FIT) and colonoscopy, have low uptake. There is therefore a pressing need for screening strategies that are minimally invasive and consequently more acceptable to patients, most likely blood based, to increase early CRC identification. MicroRNAs (miRNAs) released from cancer cells are detectable in plasma in a remarkably stable form, making them ideal cancer biomarkers. Using plasma samples from FIT-positive (FIT+) subjects in an Italian CRC screening program, we aimed to identify plasma circulating miRNAs that detect early CRC. miRNAs were initially investigated by quantitative real-time PCR in plasma from 60 FIT+ subjects undergoing colonoscopy at Fondazione IRCCS Istituto Nazionale dei Tumori, then tested on an internal validation cohort (IVC, 201 cases) and finally in a large multicenter prospective series (external validation cohort [EVC], 1121 cases). For each endoscopic lesion (low-grade adenoma [LgA], high-grade adenoma [HgA], cancer lesion [CL]), specific signatures were identified in the IVC and confirmed on the EVC. A two-miRNA-based signature for CL and six-miRNA signatures for LgA and HgA were selected. In a multivariate analysis including sex and age at blood collection, the areas under the receiver operating characteristic curve (95% confidence interval) of the signatures were 0.644 (0.607-0.682), 0.670 (0.626-0.714) and 0.682 (0.580-0.785) for LgA, HgA and CL, respectively. A miRNA-based test could be introduced into the FIT+ workflow of CRC screening programs so as to schedule colonoscopies only for subjects likely to benefit most.
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Affiliation(s)
- Susanna Zanutto
- Tumor Genomics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,Molecular Genetics of Cancer Unit, Fondazione Istituto FIRC Oncologia Molecolare (IFOM), Milan, Italy
| | - Chiara Maura Ciniselli
- Bioinformatics and Biostatistics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Antonino Belfiore
- Tumor Genomics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Mara Lecchi
- Bioinformatics and Biostatistics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Enzo Masci
- Diagnostic and Therapeutic Endoscopy Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Gabriele Delconte
- Diagnostic and Therapeutic Endoscopy Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Massimo Primignani
- CRC "A. M. e A. Migliavacca" Center for Liver Disease, Division of Gastroenterology and Hepatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Giulia Tosetti
- CRC "A. M. e A. Migliavacca" Center for Liver Disease, Division of Gastroenterology and Hepatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Marco Dal Fante
- Gastroenterology and Endoscopy Unit, Humanitas San Pio X, Milan, Italy
| | - Linda Fazzini
- Gastroenterology and Endoscopy Unit, Humanitas San Pio X, Milan, Italy
| | - Aldo Airoldi
- Hepatology and Gastroenterology Unit, Niguarda Ca' Granda Hospital, Milan, Italy
| | - Marcello Vangeli
- Hepatology and Gastroenterology Unit, Niguarda Ca' Granda Hospital, Milan, Italy
| | - Francesca Turpini
- Digestive Endoscopy Unit, Department of Gastro Hepatology, ASST Santi Paolo e Carlo, San Carlo Borromeo Hospital, Milan, Italy
| | - Giovanni Giuseppe Rubis Passoni
- Digestive Endoscopy Unit, Department of Gastro Hepatology, ASST Santi Paolo e Carlo, San Carlo Borromeo Hospital, Milan, Italy
| | - Paolo Viaggi
- Digestive Endoscopy Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy
| | - Monica Arena
- Digestive Endoscopy Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy
| | | | | | - Cristiano Crosta
- Division of Endoscopy, European Institute of Oncology IRCCS, Milan, Italy
| | | | | | | | | | | | - Gabriella Sozzi
- Tumor Genomics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Emanuele Meroni
- Diagnostic and Therapeutic Endoscopy Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Luigi Bisanti
- Scientific Directorate, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Marco Alessandro Pierotti
- Molecular Genetics of Cancer Unit, Fondazione Istituto FIRC Oncologia Molecolare (IFOM), Milan, Italy.,Scientific Directorate, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Paolo Verderio
- Bioinformatics and Biostatistics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Manuela Gariboldi
- Tumor Genomics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,Molecular Genetics of Cancer Unit, Fondazione Istituto FIRC Oncologia Molecolare (IFOM), Milan, Italy
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Deandrea S, Tidone E, Bellini A, Bisanti L, Leonardo NG, Silvestri AR, Consonni D. Implementation of Failure Mode and Effects Analysis to the specimens flow in a population-based colorectal cancer screening programme using immunochemical faecal occult blood tests: a quality improvement project in the Milan colorectal cancer screening programme. BMJ Open Qual 2018; 7:e000299. [PMID: 29610774 PMCID: PMC5878255 DOI: 10.1136/bmjoq-2017-000299] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 02/12/2018] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND A multidisciplinary working group applied the Healthcare Failure Mode and Effects Analysis (HFMEA) approach to the flow of kits and specimens for the first-level test of a colorectal cancer screening programme using immunochemical faecal occult blood tests. METHODS HFMEA comprised four steps: (1) identification and mapping of the process steps (subprocesses); (2) analysis of failure modes and calculation of the risk priority numbers (RPNs); (3) identification of corrective actions; and (4) follow-up and evaluation of corrective actions. RESULTS The team identified 9 main failure modes, 12 effects and 34 associated causes. RPN scores ranged from 2 to 96. Failure modes within the first five positions in the ranking list ordered by RPN concerned: 'degraded haemoglobin in the specimen', 'mixed-up kits' and 'anonymous specimen'. All of these could lead to false-negative results and/or subjects with positive tests not being recalled for assessment. The team planned corrective actions for those failure modes. As a result, the follow-up of corrective actions showed a significant decrease in the proportion of anonymous kits from 11.6 to 4.8 per 1000 (relative reduction of 59%). The HFMEA exercise led to a reduction in: missed positive tests; missed cancer and high-risk adenomas; complaints about the communication of test results to a person who never did the test; and false-negative results due either to haemoglobin degradation or an expired sampling tube. CONCLUSIONS HFMEA is a useful tool for reducing errors in colorectal cancer screening programmes using faecal occult blood tests and is characterised by a straightforward interpretation of results and ease of communication to healthcare managers and decision makers.
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Affiliation(s)
- Silvia Deandrea
- European Commission, Directorate-General Joint Research Centre (JRC), Ispra VA, Italy
- Agenzia di Tutela della Salute della Citta Metropolitana di Milano, Milano, Italy
| | - Enrica Tidone
- Agenzia di Tutela della Salute della Citta Metropolitana di Milano, Milano, Italy
| | - Aldo Bellini
- Agenzia di Tutela della Salute della Citta Metropolitana di Milano, Milano, Italy
| | - Luigi Bisanti
- Agenzia di Tutela della Salute della Citta Metropolitana di Milano, Milano, Italy
| | | | - Anna Rita Silvestri
- Agenzia di Tutela della Salute della Citta Metropolitana di Milano, Milano, Italy
| | - Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italy
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Micheli A, Sanz N, Mwangi-Powell F, Coleman MP, Neal C, Ullrich A, Travado L, Santini LA, Grassi L, De Lorenzo F, Costa A, Dangou JM, Bisanti L, Costantini AS, Abu-Rmeileh N, Kamal M, Federico M, Saracci R, Rennert G, Stefanini A, Cavalli F, Cazap E, Redmond K, O?Reilly S, Muti P, Casali P, Gatta G, Ferrari A, Koifman S, Bah E, Pastore G, Barr R, Lombardo C, Frazzingaro C, Ciampichini R, Baili P. International collaborations in cancer control and the Third International Cancer Control Congress. Tumori 2018; 95:579-96. [DOI: 10.1177/030089160909500502] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Over the past few decades, there has been growing support for the idea that cancer needs an interdisciplinary approach. Therefore, the international cancer community has developed several strategies as outlined in the WHO non-communicable diseases Action Plan (which includes cancer control) as the World Health Assembly and the UICC World Cancer Declaration, which both include primary prevention, early diagnosis, treatment, and palliative care. This paper highlights experiences/ideas in cancer control for international collaborations between low, middle, and high income countries, including collaborations between the European Union (EU) and African Union (AU) Member States, the Latin-American and Caribbean countries, and the Eastern Mediterranean countries. These proposals are presented within the context of the global vision on cancer control set forth by WHO in partnership with the International Union Against Cancer (UICC), in addition to issues that should be considered for collaborations at the global level: cancer survival (similar to the project CONCORD), cancer control for youth and adaptation of Clinical Practice Guidelines. Since cancer control is given lower priority on the health agenda of low and middle income countries and is less represented in global health efforts in those countries, EU and AU cancer stakeholders are working to put cancer control on the agenda of the EU-AU treaty for collaborations, and are proposing to consider palliative care, population-based cancer registration, and training and education focusing on primary prevention as core tools. A Community of Practice, such as the Third International Cancer Control Congress (ICCC-3), is an ideal place to share new proposals, learn from other experiences, and formulate new ideas. The aim of the ICCC-3 is to foster new international collaborations to promote cancer control actions in low and middle income countries. The development of supranational collaborations has been hindered by the fact that cancer control is not part of the objectives of the Millennium Development Goals (MGGs). As a consequence, less resources of development aids are allocated to control NCDs including cancer.
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Affiliation(s)
- Andrea Micheli
- Descriptive studies and health planning unit, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
| | - Natalia Sanz
- Descriptive studies and health planning unit, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
| | | | - Michel P Coleman
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Andreas Ullrich
- Diseases and Health Promotion, World Health Organization (WHO), Geneva, Switzerland
| | - Luzia Travado
- National Coordination for Oncology Diseases, High Commission for Health, Lisbon, Portugal
| | | | - Luigi Grassi
- Section of Psychiatry, University of Ferrara, Italy
| | | | | | | | - Luigi Bisanti
- Epidemiology Unit, Local Health Authority of Milan, Milan, Italy
| | - Adele Seniori Costantini
- Occupational and Environmental Epidemiology Unit, ISPO Cancer Prevention and Research Institute, Florence, Italy
| | - Niveen Abu-Rmeileh
- Institute of Community and Public Health, Birzeit University West Bank, Palestinian Authority
| | - Mostafa Kamal
- Egyptian Smoking Prevention Research Institute, Cairo, Egypt
| | | | | | - Gad Rennert
- National Israeli Breast and Colorectal Cancer Detection Programs Ministry of Health and Israel Cancer Association, Department of Community Medicine and Epidemiology Carmel Medical Center and B. Rappaport Faculty of Medicine, Technion, Israel
| | - Angelo Stefanini
- Office of Development Cooperation, Consulate General of Italy, Jerusalem (on leave from the University of Bologna, Italy), Jerusalem, Israel
| | - Franco Cavalli
- International Union Against Cancer (UICC), Geneva, Switzerland
| | - Eduardo Cazap
- Latino American and Caribbean Society of Medical Oncology (SLACOM), Buenos Aires, Argentina
| | - Kathy Redmond
- Cancer World Magazine and Media Program, European School of Oncology, Milan, Italy
| | - Susan O?Reilly
- British Columbia Cancer Agency, Division of Medical Oncology Department of Medicine at the University of British Columbia, Vancouver, Canada
| | - Paola Muti
- Italian National Cancer Institute “Regina Elena”, Rome, Italy
| | - Paolo Casali
- Oncology Medicine Unit, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
| | - Gemma Gatta
- Evaluation Epidemiology Unit, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
| | - Andrea Ferrari
- Paedriatic Oncology Unit, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
| | | | - Ebrima Bah
- International Agency for Cancer Research (IARC), Banjul, Gambia
| | | | | | - Claudio Lombardo
- National Institute for Cancer Research of Genoa, Genoa, and Alleanza Contro il Cancro, Rome
| | - Cristina Frazzingaro
- Descriptive studies and health planning unit, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
| | - Roberta Ciampichini
- Descriptive studies and health planning unit, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
| | - Paolo Baili
- Descriptive studies and health planning unit, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
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Rossi S, Crocetti E, Capocaccia R, Gatta G, Buzzoni C, Giacomin A, Zanetti R, Bisanti L, Tessandori R, Crosignani P, Vercelli M, Mazzoleni G, Piffer S, Zambon P, Serraino D, Ferretti S, Michiara M, Federico M, de Leon MP, Mangone L, Falcini F, Crocetti E, La Rosa F, Vitarelli S, Pannozzo F, Fusco M, Donato A, Traina A, Tumino R, Madeddu A, Contrino M, Budroni M. Estimates of cancer burden in Italy. Tumori 2018; 99:416-24. [DOI: 10.1177/030089161309900318] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims and background This paper presents updated estimates of the incidence, prevalence and mortality of stomach, colorectal, lung, breast, uterine cervix and prostate cancer and skin melanoma in the Italian population. In particular, point estimates for 2012 and time trends from 1970 to 2015 will be provided. Methods The presented figures were obtained by summing up the regional epidemiological indicator estimates presented in the other papers of this monographic issue, which were derived by applying the MIAMOD statistical back-calculation method to cancer registries survival data and official mortality rates. Results Our findings indicate that breast, colon-rectum and prostate will be the cancer sites with the highest incidence rates in the forthcoming years. The incidence rates still tend to increase for breast, male colorectal cancer and female lung cancer as well as for skin melanoma. By contrast, the incidence of stomach cancer, cervical cancer and male lung cancer, by far the most common tumor sites up to the early 1990s, will continue to decrease. The mortality estimates showed a decreasing trend for all considered cancers with the only exception of lung cancer in women. Conclusion These results point to the need to reinforce prevention activities by developing more effective preventive measures for population groups at risk. There is also a need to support timely and continuous cancer surveillance in the Italian population through cancer registries in order to monitor the spread of the cancer risk and to evaluate the impact of prevention policies and therapeutic advances.
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Affiliation(s)
- Silvia Rossi
- National Center of Epidemiology, Italian National Institute of Health, Rome
| | - Emanuele Crocetti
- Tuscany Cancer Registry, Cancer Prevention and Research Institute (ISPO), Florence
- AIRTUM National Secretary
| | | | - Gemma Gatta
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | | | - R. Zanetti
- Registro tumori Piemonte, città di Torino
| | | | | | | | - M. Vercelli
- Registro tumori Liguria, Provincia di Genova, UOS Epidemiologia descrittiva, IRCSS AOU SMIST/UNIGE
| | - G. Mazzoleni
- Registro tumori dell'Alto Adige-Tumorregister SüdTirol
| | - S. Piffer
- Registro tumori della Provincia di Trento
| | | | | | | | | | | | | | | | | | - E. Crocetti
- AIRTUM National Secretary, Registro tumori Regione Toscana
| | | | | | | | - M. Fusco
- Registro tumori di popolazione Regione Campania
| | - A. Donato
- Registro tumori della Provincia di Salerno
| | - A. Traina
- Registro tumori della Mammella di Palermo
| | - R. Tumino
- Registro tumori della Provincia di Ragusa
| | | | | | - M. Budroni
- Registro tumori della Provincia di Sassari
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Cazzaniga G, Bisanti L, Randi G, Deandrea S, Bungaro S, Pregliasco F, Perotti D, Spreafico F, Masera G, Valsecchi MG, Biondi A, Greaves M. Possible role of pandemic AH1N1 swine flu virus in a childhood leukemia cluster. Leukemia 2017; 31:1819-1821. [PMID: 28446785 PMCID: PMC5542028 DOI: 10.1038/leu.2017.127] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Giovanni Cazzaniga
- Centro Ricerca Tettamanti, Clinica Pediatrica Università di Milano Bicocca, Fondazione MBBM/Ospedale San Gerardo, Monza, Italy
| | - Luigi Bisanti
- Servizio di Epidemiologia, Azienda Sanitaria Locale di Milano, Milano, Italy
| | - Giorgia Randi
- Servizio di Epidemiologia, Azienda Sanitaria Locale di Milano, Milano, Italy
| | - Silvia Deandrea
- Servizio di Epidemiologia, Azienda Sanitaria Locale di Milano, Milano, Italy
| | - Silvia Bungaro
- Centro Ricerca Tettamanti, Clinica Pediatrica Università di Milano Bicocca, Fondazione MBBM/Ospedale San Gerardo, Monza, Italy
| | - Fabrizio Pregliasco
- Dipartimento di Scienze Biomediche per la Salute - Università degli Studi di Milano, Milano, Italy
| | - Daniela Perotti
- Department of Preventive and Predictive Medicine, Unit of Molecular Bases of Genetic Risk and Genetic Testing, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano
| | - Filippo Spreafico
- Pediatric Oncology Unit, Hematology and Pediatric Onco-Hematology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Giuseppe Masera
- Clinica Pediatrica Università di Milano Bicocca, Fondazione MBBM/Ospedale San Gerardo, Monza, Italy
| | - Maria Grazia Valsecchi
- Center of Biostatistics for Clinical Epidemiology, Department of Health Sciences, University of Milano-Bicocca, Monza, Italy
| | - Andrea Biondi
- Clinica Pediatrica Università di Milano Bicocca, Fondazione MBBM/Ospedale San Gerardo, Monza, Italy
| | - Mel Greaves
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK
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Magnani C, Ranucci A, Badaloni C, Cesaroni G, Ferrante D, Miligi L, Mattioli S, Rondelli R, Bisanti L, Zambon P, Cannizzaro S, Michelozzi P, Cocco P, Celentano E, Assennato G, Merlo DF, Mosciatti P, Minelli L, Cuttini M, Torregrossa MV, Lagorio S, Haupt R, Forastiere F. Road Traffic Pollution and Childhood Leukemia: A Nationwide Case-control Study in Italy. Arch Med Res 2017; 47:694-705. [PMID: 28476197 DOI: 10.1016/j.arcmed.2017.02.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Accepted: 02/23/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND The association of childhood leukemia with traffic pollution was considered in a number of studies from 1989 onwards, with results not entirely consistent and little information regarding subtypes. AIM OF THE STUDY We used the data of the Italian SETIL case-control on childhood leukemia to explore the risk by leukemia subtypes associated to exposure to vehicular traffic. METHODS We included in the analyses 648 cases of childhood leukemia (565 Acute lymphoblastic-ALL and 80 Acute non lymphoblastic-AnLL) and 980 controls. Information on traffic exposure was collected from questionnaire interviews and from the geocoding of house addresses, for all periods of life of the children. RESULTS We observed an increase in risk for AnLL, and at a lower extent for ALL, with indicators of exposure to traffic pollutants. In particular, the risk was associated to the report of closeness of the house to traffic lights and to the passage of trucks (OR: 1.76; 95% CI 1.03-3.01 for ALL and 6.35; 95% CI 2.59-15.6 for AnLL). The association was shown also in the analyses limited to AML and in the stratified analyses and in respect to the house in different period of life. CONCLUSIONS Results from the SETIL study provide some support to the association of traffic related exposure and risk for AnLL, but at a lesser extent for ALL. Our conclusion highlights the need for leukemia type specific analyses in future studies. Results support the need of controlling exposure from traffic pollution, even if knowledge is not complete.
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Affiliation(s)
- Corrado Magnani
- Cancer Epidemiology Unit, Department of Translational Medicine, CPO Piedmont and University of Eastern Piedmont, Novara, Italy.
| | - Alessandra Ranucci
- Cancer Epidemiology Unit, Department of Translational Medicine, CPO Piedmont and University of Eastern Piedmont, Novara, Italy
| | - Chiara Badaloni
- Department of Epidemiology, Lazio Regional Health Service, Roma, Italy
| | - Giulia Cesaroni
- Department of Epidemiology, Lazio Regional Health Service, Roma, Italy
| | - Daniela Ferrante
- Cancer Epidemiology Unit, Department of Translational Medicine, CPO Piedmont and University of Eastern Piedmont, Novara, Italy
| | - Lucia Miligi
- Occupational and Environmental Epidemiology Unit, ISPO Cancer Prevention and Research Institute, Florence, Italy
| | - Stefano Mattioli
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Roberto Rondelli
- Paediatric Oncology-Haematology Lalla Seràgnoli, Policlinico S.Orsola-Malpighi, Bologna, Italy
| | | | | | - Santina Cannizzaro
- Lega Italiana per la Lotta contro i Tumori Onlus Sez. Provinciale di Ragusa, Ragusa Ibla, Italy
| | - Paola Michelozzi
- Department of Epidemiology, Lazio Regional Health Service, Roma, Italy
| | - Pierluigi Cocco
- Department of Medical Sciences and Public Health, Occupational Health Section, University of Cagliari, Cagliari, Italy
| | - Egidio Celentano
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione G.Pascale, IRCCS, Napoli, Italy
| | | | - Domenico Franco Merlo
- Clinical Epidemiology, IRCCS Azienda Ospedaliera Universitaria San Martino-IST Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - Paola Mosciatti
- Università di Camerino, Dipartimento di Medicina Sperimentale e di Sanità Pubblica, Camerino, Italy
| | - Liliana Minelli
- Dipartimento di Medicina Sperimentale-Sezione di Sanità Pubblica, Università degli Studi di Perugia, Perugia, Italy
| | - Marina Cuttini
- Unità di Ricerca di Epidemiologia Perinatale, Ospedale Pediatrico Bambino Gesù, Roma, Italy
| | - Maria Valeria Torregrossa
- Dipartimento di Scienze per la Promozione della Salute Sez.Igiene, Università degli Studi di Palermo, Palermo, Italy
| | - Susanna Lagorio
- National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health, Roma, Italy
| | - Riccardo Haupt
- Epidemiology and Biostatistics Unit, Istituto Giannina Gaslini, Genova, Italy
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Michelozzi P, De Sario M, Miligi L, Piro S, Schifano P, Bisanti L. [Investigative model for the evaluation of spatio-temporal clusters of childhood cancers]. Epidemiol Prev 2016; 40:42-54. [PMID: 27807961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This paper describes the conceptual framework and the critical issues of investigations of clusters of childhood cancers and defines an investigative model for the health authorities responsible for assessing a suspected cluster, taking into account the guidelines available and considering the most recent advances of the Geographical Information System and of the specific statistical methodology. Three main investigation phases are identified: the first consists in the preliminary study on the health of population living in the area where the cases are defined and aetiological hypotheses are formulated; the second is the cluster evaluation study using statistical methods assessing the spatial heterogeneity and collecting information about potential risk factors; the third is the analytical epidemiological study to test aetiological hypotheses suggested by the previous phases. The residential cohort approach is the most valid to date to assess long-term effects, and allows to reconstruct the lifetime residential history from the population registry. The researchers' decision on how detailed about a suspected cluster the investigation has to be needs to take into account both the level of alarm in the population and the limited resources available. The concern about a suspected cluster of cancer cases should always be addressed, even if this implies to acknowledge limits of research and uncertainty in results interpretation.
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Affiliation(s)
- Paola Michelozzi
- Dipartimento di epidemiologia del Servizio sanitario regionale, ASL Roma 1, Regione Lazio, Roma.
| | - Manuela De Sario
- Dipartimento di epidemiologia del Servizio sanitario regionale, ASL Roma 1, Regione Lazio, Roma
| | - Lucia Miligi
- Istituto per lo studio e la prevenzione oncologica (ISPO), Firenze
| | - Sara Piro
- Istituto per lo studio e la prevenzione oncologica (ISPO), Firenze
| | - Patrizia Schifano
- Dipartimento di epidemiologia del Servizio sanitario regionale, ASL Roma 1, Regione Lazio, Roma
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Terracini B, Bisanti L, Fabiani L, Valenti M, Paci E. [Planning research and surveillance after natural disasters: outcome of the scientific publications about L'Aquila (Central Italy) and other places struck by an earthquake]. Epidemiol Prev 2016; 40:106-8. [PMID: 27291218 DOI: 10.19191/ep16.2s1.p106.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | | | - Leila Fabiani
- Dipartimento di medicina clinica, sanità pubblica, scienze della vita e dell'ambiente, Università degli Studi dell'Aquila
| | - Marco Valenti
- Dipartimento di scienze cliniche applicate e biotecnologie, Università degli Studi dell'Aquila
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Giordano L, Bisanti L, Salamina G, Ancelle Park R, Sancho-Garnier H, Espinas J, Berling C, Rennert G, Castagno R, Dotti M, Jaramillo L, Segnan N. The EUROMED CANCER network: state-of-art of cancer screening programmes in non-EU Mediterranean countries. Eur J Public Health 2015; 26:83-9. [PMID: 26072520 DOI: 10.1093/eurpub/ckv107] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The EUROMED CANCER Network project aims to support non-EU Mediterranean countries in the development of cancer early detection and screening policies. METHODS Through a structured questionnaire information from 15 countries (Albania, Algeria, Bosnia and Herzegovina (BiH), Croatia, Egypt, Jordan, UN Interim Administration Mission in Kosovo, Lebanon, Montenegro, Morocco, Palestinian National Authority, Serbia, Syria, Tunisia and Turkey) were collected on cancer epidemiology and control. RESULTS Large differences between countries are evident. Breast cancer (BC) is the commonest cancer among women, though the incidence rate is much lower in non-EU than in EU Mediterranean countries. Conversely, cervical cancer (CC) is much more common in the former than in the latter countries. Colorectal cancer (CRC) is more frequent in Northern than in Eastern and Southern Mediterranean shores. Population-based cancer registries are available in few countries but most of them lack information on disease staging. Opportunistic screening for CC and BC is unevenly spread across and within countries; organised screening programmes are rare and do not meet international recommendations. BC and CC early detection is extensively considered a priority, while a few countries included CRC into their agenda. CONCLUSIONS Collected data witnesses inadequacy of health information system and, in general, of the strategies for cancer control in the involved countries. A uniform approach for strengthening cancer control is not realistic neither feasible. Tailored preventive actions for cancer early detection have to be started concurrently with the development of a reliable health information system and, specifically, with cancer registration.
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Affiliation(s)
| | - Luigi Bisanti
- 1 Cancer Prevention Center of Piedmont, Turin, Italy
| | | | | | | | | | | | - Gad Rennert
- 7 National Cancer Control Centre, Haifa, Israel
| | | | - Marta Dotti
- 1 Cancer Prevention Center of Piedmont, Turin, Italy
| | | | - Nereo Segnan
- 1 Cancer Prevention Center of Piedmont, Turin, Italy
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Senore C, Ederle A, DePretis G, Magnani C, Canuti D, Deandrea S, Zorzi M, Barca A, Bestagini P, Faitini K, Bisanti L, Casale C, Ferro A, GiorgiRossi P, Quadrino F, Fiorina G, Capuano A, Segnan N, Fantin A. Invitation strategies for colorectal cancer screening programmes: The impact of an advance notification letter. Prev Med 2015; 73:106-11. [PMID: 25602908 DOI: 10.1016/j.ypmed.2015.01.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 01/09/2015] [Accepted: 01/11/2015] [Indexed: 11/27/2022]
Abstract
AIM To estimate the impact of an advance notification letter on participation in sigmoidoscopy (FS) and fecal immunochemical test (FIT) screening. METHODS Eligible subjects, invited in 3 Italian population based programmes using FS and in 5 using FIT, were randomised (1:1:1), within GP, to: A) standard invitation letter; B) advance notification followed after 1month by the standard invitation; and C) B+indication to contact the general practitioner (GP) to get advice about the decision to be screened. We calculated the 9-month attendance and the incremental cost of each strategy. We conducted a phone survey to assess GP's utilization and predictors of participation. RESULTS The advance notification was associated with a 20% increase in the attendance among 15,655 people invited for FS (B vs A - RR: 1.17, 95% CI: 1.10-1.25; C vs A - RR: 1.19, 95% CI: 1.12-1.27); the incremental cost ranged between 10 and 9 Euros. Participation in FIT screening (N=23,543) was increased only with simple pre-notification (B vs A - RR: 1.06, 95% CI: 1.02-1.10); the incremental cost was 22.5 Euros. GP consultation rate was not increased in group C. CONCLUSIONS An advance notification represents a cost-effective strategy to increase participation in FS screening; its impact on the response to FIT screening was limited.
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Affiliation(s)
- Carlo Senore
- AOU Città della Salute e della Scienza, CPO Piemonte, Via San Francesco da Paola 31, Torino, Italy.
| | - Andrea Ederle
- Ospedale Fracastoro, UO Gastroenterologia, Via Circonvallazione 1, S Bonifacio, VE, Italy
| | - Giovanni DePretis
- UO Gastroenterologia, Ospedale S Chiara, Largo Medaglie d'Oro 9, Trento, Italy
| | - Corrado Magnani
- Unversità del Piemonte Orientale, CPO Piemonte, Via Solaroli 1, Novara, Italy
| | - Debora Canuti
- SS Programma di Screening Oncologici AUSL Rimini, Via Coriano 38, Rimini, Italy
| | - Silvia Deandrea
- ASL Città di Milano, Servizio di Epidemiologia, Corso Italia 19, Milano, Italy
| | - Manuel Zorzi
- Registro Tumori del Veneto, Passaggio Gaudenzio 1, Padova, Italy
| | - Alessandra Barca
- Regione Lazio, Direzione Regionale Salute e Integrazione Sociosanitaria, Via Rosa Raimondi Garibaldi 7, Rome, Italy
| | | | - Katia Faitini
- UO Gastroenterologia, Ospedale S Chiara, Largo Medaglie d'Oro 9, Trento, Italy
| | - Luigi Bisanti
- ASL Città di Milano, Servizio di Epidemiologia, Corso Italia 19, Milano, Italy
| | - Coralba Casale
- SS Programma di Screening Oncologici AUSL Rimini, Via Coriano 38, Rimini, Italy
| | - Antonio Ferro
- Dipartimento di Prevenzione, ASL 17 di Este Monselice, Via Francesconi 2, Este, PD, Italy
| | - Paolo GiorgiRossi
- Servizio Interaziendale Epidemiologia, AUSL Reggio Emilia, Via Amendola 2, Reggio Emilia, Italy
| | - Francesco Quadrino
- Regione Lazio, Direzione Regionale Salute e Integrazione Sociosanitaria, Via Rosa Raimondi Garibaldi 7, Rome, Italy
| | - Giorgia Fiorina
- AOU Città della Salute e della Scienza, CPO Piemonte, Via San Francesco da Paola 31, Torino, Italy
| | - Arianna Capuano
- AOU Città della Salute e della Scienza, CPO Piemonte, Via San Francesco da Paola 31, Torino, Italy
| | - Nereo Segnan
- AOU Città della Salute e della Scienza, CPO Piemonte, Via San Francesco da Paola 31, Torino, Italy
| | - Alberto Fantin
- Ospedale Fracastoro, UO Gastroenterologia, Via Circonvallazione 1, S Bonifacio, VE, Italy
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Paci E, Bisanti L, Faggiano F. [Epidemiologia e Prevenzione, a tool for the Italian Public HealthManifesto for a tobacco endgame strategy in Italy]. Epidemiol Prev 2015; 39:10. [PMID: 25855540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Magnani C, Mattioli S, Miligi L, Ranucci A, Rondelli R, Salvan A, Bisanti L, Masera G, Rizzari C, Zambon P, Cannizzaro S, Gafà L, Luzzatto LL, Benvenuti A, Michelozzi P, Kirchmayer U, Cocco P, Biddau P, Galassi C, Celentano E, Guarino E, Assennato G, de Nichilo G, Merlo DF, Bocchini V, Pannelli F, Mosciatti P, Minelli L, Chiavarini M, Cuttini M, Casotto V, Torregrossa MV, Valenti RM, Forastiere F, Haupt R, Lagorio S, Risica S, Polichetti A. SETIL: Italian multicentric epidemiological case-control study on risk factors for childhood leukaemia, non hodgkin lymphoma and neuroblastoma: study population and prevalence of risk factors in Italy. Ital J Pediatr 2014; 40:103. [PMID: 25539823 PMCID: PMC4310183 DOI: 10.1186/s13052-014-0103-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 12/04/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Aetiology of childhood leukaemia and childhood neoplasm is poorly understood. Information on the prevalence of risk factors in the childhood population is limited. SETIL is a population based case-control study on childhood leukaemia, conducted with two companion studies on non-Hodgkin Lymphoma (NHL) and neuroblastoma. The study relies on questionnaire interviews and 50 Hz magnetic field (ELF-MF) indoor measurements. This paper discusses the SETIL study design and includes descriptive information. METHODS The study was carried out in 14 Italian regions (78.3% of Italian population aged 0-10). It included leukaemia, NHL and neuroblastoma cases incident in 0-10 year olds in 1998-2001, registered by the Italian Association of Paediatric Haematology and Oncology (AIEOP) (accrual over 95% of estimated incidence). Two controls for each leukaemia case were randomly sampled from the Local Health Authorities rolls, matched by gender, birthdate and residence. The same controls were used in NHL and neuroblastoma studies. Parents were interviewed at home on: physical agents (ELF-MF and ionizing radiation), chemicals (smoking, solvents, traffic, insecticides), occupation, medical and personal history of children and parents, infectious diseases, immunizations and associated factors. Occupational exposure was collected using job specific modules. ELF-MF was measured in the main rooms (spot measurement) and close to child's bed (48 hours measurement). RESULTS The study included: 683 leukaemia cases (87% ALL, 13% AnLL), 97 NHL, 155 neuroblastomas, and 1044 controls. CONCLUSIONS SETIL represents a data source on exposure of Italian children to a broad array of potential carcinogenic factors.
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Affiliation(s)
- Corrado Magnani
- />Medical Statistics & Cancer Epidemiology Unit - Department of Translational Medicine, CPO Piemonte and University of Eastern Piedmont, V. Solaroli 17, Novara, 28100 Italy
| | - Stefano Mattioli
- />Section of Occupational Medicine, Department of Internal Medicine, Geriatrics and Nephrology, University of Bologna, Bologna, Italy
| | - Lucia Miligi
- />Occupational and Environmental Epidemiology Unit, ISPO Cancer Prevention and Research Institute, Florence, Italy
| | | | - Roberto Rondelli
- />Paediatric Oncology-Haematology “Lalla Seràgnoli”, Policlinico S.Orsola-Malpighi, Bologna, Italy
| | | | | | - Giuseppe Masera
- />Clinica Pediatrica, Università Milano Bicocca, Monza, Italy
| | | | - Paola Zambon
- />Registro Tumori del Veneto, Università di Padova, Padova, Italy
| | - Santina Cannizzaro
- />Lega Italiana per la Lotta contro i Tumori Onlus Sez, Provinciale di Ragusa, Ragusa Ibla, Italy
| | - Lorenzo Gafà
- />Lega Italiana per la Lotta contro i Tumori Onlus Sez, Provinciale di Ragusa, Ragusa Ibla, Italy
| | | | - Alessandra Benvenuti
- />Occupational and Environmental Epidemiology Unit, ISPO Cancer Prevention and Research Institute Firenze, Firenze, Italy
| | - Paola Michelozzi
- />UOC Epidemiologia Ambientale, Dipartimento Epidemiologia Regione Lazio, Roma, Italy
| | | | - Pierluigi Cocco
- />Dipartimento di Sanità Pubblica, Sezione di Medicina del Lavoro, Università di Cagliari, Cagliari, Italy
| | - Pierfranco Biddau
- />Servizio di Oncoematologia Pediatrica, Ospedale Microcitemico Cagliari, Cagliari, Italy
| | | | - Egidio Celentano
- />S. O. Analisi e Monitoraggio, ARSAN - Agenzia Regionale Sanitaria della Campania, Napoli, Italy
| | | | | | | | - Domenico Franco Merlo
- />Epidemiology, Biostatistics and Clinical Trials, IRCCS Azienda Ospedaliera Universitaria San Martino- IST Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - Vittorio Bocchini
- />Epidemiology, Biostatistics and Clinical Trials, IRCCS AOU San Martino- IST Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - Franco Pannelli
- />Registro Tumori di Macerata e Università di Camerino, Camerino, Italy
| | - Paola Mosciatti
- />Università di Camerino, Dipartimento di Medicina Sperimentale e di Sanità Pubblica, Camerino, Italy
| | - Liliana Minelli
- />Dipartimento di Medicina Sperimentale - Sezione di Sanità Pubblica Università degli Studi di Perugia, Perugia, Italy
| | - Manuela Chiavarini
- />Dipartimento di Medicina Sperimentale - Sezione di Sanità Pubblica, Università degli Studi di Perugia, Perugia, Italy
| | - Marina Cuttini
- />Unità di Unità di Ricerca di Epidemiologia Perinatale, Ospedale Pediatrico Bambino Gesù, Roma, Italy
| | | | - Maria Valeria Torregrossa
- />Dipartimento di Scienze per la Promozione della Salute Sez.Igiene, Università degli Studi di Palermo, Palermo, Italy
| | - Rosalia Maria Valenti
- />Dipartimento di Scienze per la Promozione della Salute Sez.Igiene, Università degli Studi di Palermo, Palermo, Italy
| | - Francesco Forastiere
- />UOC Epidemiologia Ambientale, Dipartimento Epidemiologia Regione Lazio, Roma, Italy
| | | | - Susanna Lagorio
- />National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health, Rome, Italy
| | - Serena Risica
- />Retired, formerly: Department of Technology and Health, National Institute of Health, Rome, Italy
| | - Alessandro Polichetti
- />Retired, formerly: Department of Technology and Health, National Institute of Health, Rome, Italy
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DeCensi A, Bonanni B, Maisonneuve P, Serrano D, Omodei U, Varricchio C, Cazzaniga M, Lazzeroni M, Rotmensz N, Santillo B, Sideri M, Cassano E, Belloni C, Muraca M, Segnan N, Masullo P, Costa A, Monti N, Vella A, Bisanti L, D'Aiuto G, Veronesi U. A phase-III prevention trial of low-dose tamoxifen in postmenopausal hormone replacement therapy users: the HOT study. Ann Oncol 2013; 24:2753-60. [DOI: 10.1093/annonc/mdt244] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Gatta G, Ciampichini R, Bisanti L, Contiero P, Tessandori R, Baili P, Rossi S. Estimates of cancer burden in Lombardy. Tumori 2013. [PMID: 24158056 DOI: 10.1700/1334.14791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS AND BACKGROUND Cancer registration in Lombardy covers almost half of the regional population and started in 1976 in the Varese province. The aim of this paper is to provide estimates of the incidence, mortality and prevalence of seven major cancers for the entire Lombardy region in the period 1970-2015. METHODS The estimates were obtained by applying the MIAMOD method, a statistical back-calculation approach to derive incidence and prevalence figures starting from mortality and relative survival data. Published data from the Italian cancer registries were modeled in order to estimate the regional cancer survival. RESULTS In Lombardy, about 9,000 new cases of breast cancer, 8,500 of colorectal cancer, 7,200 of prostate cancer and 6,700 of lung cancer were expected to be diagnosed in the year 2012. Incidence rates are still rising for female breast cancer, skin melanoma in both sexes, and lung cancer in women. By contrast, the rates have been declining for cervix and stomach cancer. For lung cancer in men, prostate cancer and colorectal cancer the rates increased, reaching a peak in different periods, and then decreased. Prevalence increased for all cancers considered except cervix cancer. The rise was less pronounced in stomach cancer due to the impressive reduction of its incidence and was striking for breast and prostate cancer, with 116,000 and 58,900 prevalent cases in 2012. Mortality dropped for all considered cancers with the only exception of lung cancer in women. CONCLUSION This up-to-date picture of the cancer risk and burden in Lombardy shows the increasing demand for oncology services as one of the major challenges for the region. However, primary prevention is still the only way to simultaneously reduce incidence, prevalence and mortality rates, thus saving further lives and preserving health resources.
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Miligi L, Benvenuti A, Mattioli S, Salvan A, Tozzi GA, Ranucci A, Legittimo P, Rondelli R, Bisanti L, Zambon P, Cannizzaro S, Kirchmayer U, Cocco P, Celentano E, Assennato G, Merlo DF, Mosciatti P, Minelli L, Cuttini M, Torregrossa V, Lagorio S, Haupt R, Risica S, Polichetti A, Magnani C. Risk of childhood leukaemia and non-Hodgkin's lymphoma after parental occupational exposure to solvents and other agents: the SETIL Study. Occup Environ Med 2013; 70:648-55. [DOI: 10.1136/oemed-2012-100951] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Abstract
Aims and background Cancer registration in Lombardy covers almost half of the regional population and started in 1976 in the Varese province. The aim of this paper is to provide estimates of the incidence, mortality and prevalence of seven major cancers for the entire Lombardy region in the period 1970—2015. Methods The estimates were obtained by applying the MIAMOD method, a statistical back-calculation approach to derive incidence and prevalence figures starting from mortality and relative survival data. Published data from the Italian cancer registries were modeled in order to estimate the regional cancer survival. Results In Lombardy, about 9,000 new cases of breast cancer, 8,500 of colorectal cancer, 7,200 of prostate cancer and 6,700 of lung cancer were expected to be diagnosed in the year 2012. Incidence rates are still rising for female breast cancer, skin melanoma in both sexes, and lung cancer in women. By contrast, the rates have been declining for cervix and stomach cancer. For lung cancer in men, prostate cancer and colorectal cancer the rates increased, reaching a peak in different periods, and then decreased. Prevalence increased for all cancers considered except cervix cancer. The rise was less pronounced in stomach cancer due to the impressive reduction of its incidence and was striking for breast and prostate cancer, with 116,000 and 58,900 prevalent cases in 2012. Mortality dropped for all considered cancers with the only exception of lung cancer in women. Conclusion This up-to-date picture of the cancer risk and burden in Lombardy shows the increasing demand for oncology services as one of the major challenges for the region. However, primary prevention is still the only way to simultaneously reduce incidence, prevalence and mortality rates, thus saving further lives and preserving health resources.
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Affiliation(s)
- Gemma Gatta
- Evaluative epidemiology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - Roberta Ciampichini
- Evaluative epidemiology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | | | - Paolo Contiero
- Registro Tumori Provincia di Varese, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | | | - Paolo Baili
- Evaluative epidemiology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - Silvia Rossi
- Centro Nazionale di Epidemiologia, Istituto Superiore di Sanità, Rome, Italy
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Faustini A, Stafoggia M, Colais P, Berti G, Bisanti L, Cadum E, Cernigliaro A, Mallone S, Scarnato C, Forastiere F. Air pollution and multiple acute respiratory outcomes. Eur Respir J 2013; 42:304-13. [PMID: 23314899 DOI: 10.1183/09031936.00128712] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Short-term effects of air pollutants on respiratory mortality and morbidity have been consistently reported but usually studied separately. To more completely assess air pollution effects, we studied hospitalisations for respiratory diseases together with out-of-hospital respiratory deaths. A time-stratified case-crossover study was carried out in six Italian cities from 2001 to 2005. Daily particulate matter (particles with a 50% cut-off aerodynamic diameter of 10 μm (PM10)) and nitrogen dioxide (NO2) associations with hospitalisations for respiratory diseases (n = 100 690), chronic obstructive pulmonary disease (COPD) (n = 38 577), lower respiratory tract infections (LRTI) among COPD patients (n = 9886) and out-of-hospital respiratory deaths (n = 5490) were estimated for residents aged ≥35 years. For an increase of 10 μg·m(-3) in PM10, we found an immediate 0.59% (lag 0-1 days) increase in hospitalisations for respiratory diseases and a 0.67% increase for COPD; the 1.91% increase in LRTI hospitalisations lasted longer (lag 0-3 days) and the 3.95% increase in respiratory mortality lasted 6 days. Effects of NO2 were stronger and lasted longer (lag 0-5 days). Age, sex and previous ischaemic heart disease acted as effect modifiers for different outcomes. Analysing multiple rather than single respiratory events shows stronger air pollution effects. The temporal relationship between the pollutant increases and hospitalisations or mortality for respiratory diseases differs.
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Lagorio S, Ferrante D, Ranucci A, Negri S, Sacco P, Rondelli R, Cannizzaro S, Torregrossa MV, Cocco P, Forastiere F, Miligi L, Bisanti L, Magnani C. Exposure to benzene and childhood leukaemia: a pilot case-control study. BMJ Open 2013; 3:bmjopen-2012-002275. [PMID: 23444447 PMCID: PMC3586103 DOI: 10.1136/bmjopen-2012-002275] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES Main purpose To evaluate the feasibility of a measurement-based assessment of benzene exposure in case-control studies of paediatric cancer; Additional aims To identify the sources of exposure variability; to assess the performance of two benzene biomarkers; to verify the occurrence of participation bias; to check whether exposures to benzene and to 50 Hz magnetic fields were correlated, and might exert reciprocal confounding effects. DESIGN Pilot case-control study of childhood leukaemia and exposure to benzene assessed by repeated seasonal weekly measurements in breathing zone air samples and outside the children's dwellings, with concurrent determinations of cotinine, t-t-muconic acid (MA) and sulfo-phenylmercapturic acid (S-PMA) in urine. PARTICIPANTS 108 cases and 194 controls were eligible for inclusion. RESULTS Full-participation was obtained from 46 cases and 60 controls, with low dropout rates before four repeats (11% and 17%); an additional 23 cases and 80 controls allowed the collection of outdoor air samples only. The average benzene concentration in personal and outdoor air samples was 3 μg/m(3) (SD 1.45) and 2.7 μg/m(3) (SD 1.41), respectively. Personal exposure was strongly influenced by outdoor benzene concentrations, higher in the cold seasons than in warm seasons, and not affected by gender, age, area of residence or caseness. Urinary excretion of S-PMA and personal benzene exposure were well correlated. Outdoor benzene levels were lower among participant controls compared with non-participants, but did not differ between participant and non-participant cases; the direction of the bias was found to depend on the cut-point chosen to distinguish exposed and unexposed. Exposures to benzene and extremely low-frequency magnetic fields were positively correlated. CONCLUSIONS Repeated individual measurements are needed to account for the seasonal variability in benzene exposure, and they have the additional advantage of increasing the study power. Measurement-based assessment of benzene exposure in studies of childhood leukaemia appears feasible, although it is financially and logistically demanding.
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Affiliation(s)
- Susanna Lagorio
- National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health, Rome, Italy
| | - Daniela Ferrante
- Unit of Medical Statistics and Epidemiology, CPO Piemonte and University “Amedeo Avogadro” of Piemonte Orientale, Novara, Italy
| | - Alessandra Ranucci
- Unit of Medical Statistics and Epidemiology, CPO Piemonte and University “Amedeo Avogadro” of Piemonte Orientale, Novara, Italy
| | - Sara Negri
- Centro Ricerche Ambientali, Fondazione Salvatore Maugeri, Padova and Pavia, Italy
| | - Paolo Sacco
- Centro Ricerche Ambientali, Fondazione Salvatore Maugeri, Padova and Pavia, Italy
| | - Roberto Rondelli
- Operation Office, Italian Association of Paediatric Haematology and Oncology (AIEOP), Sant'Orsola Malpighi Hospital, Bologna, Italy
| | | | | | - Pierluigi Cocco
- Department of Public Health, Occupational Health Section, University of Cagliari, Cagliari, Italy
| | | | - Lucia Miligi
- Occupational and Environmental Epidemiology Unit, ISPO Cancer Prevention and Research Institute, Florence, Italy
| | - Luigi Bisanti
- Epidemiology Unit, Milan Local Health Agency, Milan, Italy
| | - Corrado Magnani
- Unit of Medical Statistics and Epidemiology, CPO Piemonte and University “Amedeo Avogadro” of Piemonte Orientale, Novara, Italy
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Giordano A, Ferrari G, Radice D, Randi G, Bisanti L, Solari A. Self-assessed health status changes in a community cohort of people with multiple sclerosis: 11 years of follow-up. Eur J Neurol 2012; 20:681-8. [DOI: 10.1111/ene.12028] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Accepted: 10/04/2012] [Indexed: 11/28/2022]
Affiliation(s)
- A. Giordano
- Unit of Neuroepidemiology; Foundation IRCCS Neurological Institute C. Besta; Milan Italy
| | - G. Ferrari
- Unit of Neuroepidemiology; Foundation IRCCS Neurological Institute C. Besta; Milan Italy
| | - D. Radice
- Division of Epidemiology and Biostatistics; European Institute of Oncology; Milan Italy
| | - G. Randi
- Unit of Epidemiology; Local Health Authority; Milan Italy
| | - L. Bisanti
- Unit of Epidemiology; Local Health Authority; Milan Italy
| | - A. Solari
- Unit of Neuroepidemiology; Foundation IRCCS Neurological Institute C. Besta; Milan Italy
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Ponti A, Mano MP, Tomatis M, Baiocchi D, Barca A, Berti R, Bisanti L, Casella D, Deandrea S, Delrio D, Donati G, Falcini F, Frammartino B, Frigerio A, Mantellini P, Naldoni C, Orzalesi L, Pagano G, Pietribiasi F, Ravaioli A, Sedda ML, Taffurelli M, Cataliotti L, Segnan N. [Audit system on quality of breast cancer diagnosis and treatment: results of quality indicators on screen-detected lesions in Italy, 2010]. Epidemiol Prev 2012; 36:87-95. [PMID: 23293273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This survey, conducted by the Italian breast screening network (GISMa), collects yearly individual data on diagnosis and treatment on about 50% of all screen-detected, operated lesions in Italy. The 2010 results show good overall quality and an improving trend over time. Critical issues were identified, including waiting times and compliance with the recommendations on not performing frozen section examination on small lesions. Preoperative diagnosis improved constantly over the years, but there is still a large variation between regions and programmes. For almost 90% of screen-detected invasive cancers the sentinel lymph node technique (SLN) was performed on the axilla, avoiding a large number of potentially harmful dissections. On the other hand, potential overuse of SLN for ductal carcinoma in situ deserves further investigation. The detailed results have been distributed, also by means of a web data warehouse, to regional and local screening programmes in order to allow multidisciplinary discussion and identification of the appropriate solutions to any issues documented by the data. It should be assigned priority to the problem of waiting times. Specialist Breast Units with adequate case volume and enough resources would provide the best setting for making monitoring effective in producing quality improvements with shorter waiting times.
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MESH Headings
- Aged
- Breast Neoplasms/diagnosis
- Breast Neoplasms/diagnostic imaging
- Breast Neoplasms/epidemiology
- Breast Neoplasms/pathology
- Breast Neoplasms/therapy
- Carcinoma, Ductal, Breast/diagnosis
- Carcinoma, Ductal, Breast/diagnostic imaging
- Carcinoma, Ductal, Breast/epidemiology
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/therapy
- Carcinoma, Intraductal, Noninfiltrating/diagnosis
- Carcinoma, Intraductal, Noninfiltrating/diagnostic imaging
- Carcinoma, Intraductal, Noninfiltrating/epidemiology
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Carcinoma, Intraductal, Noninfiltrating/therapy
- Early Detection of Cancer/standards
- Female
- Humans
- Italy/epidemiology
- Mammography
- Mass Screening/standards
- Medical Audit
- Middle Aged
- Neoplasm Grading
- Neoplasm Staging
- Quality Indicators, Health Care
- Sentinel Lymph Node Biopsy
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Senore C, Ederle A, Fantin A, Andreoni B, Bisanti L, Grazzini G, Zappa M, Ferrero F, Marutti A, Giuliani O, Armaroli P, Segnan N. Acceptability and side-effects of colonoscopy and sigmoidoscopy in a screening setting. J Med Screen 2012; 18:128-34. [PMID: 22045821 DOI: 10.1258/jms.2011.010135] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Quantitative information on adverse reactions associated with colorectal cancer (CRC) screening tests is useful to estimate the balance between benefit and risk in different strategies. SETTING Six Italian screening centres. METHODS Thirty-day active follow-up (interview about side-effects and acceptability of the screening procedure and review of hospital admissions) among average-risk people undergoing flexible sigmoidoscopy (FS), total colonoscopy (TC), fecal immunochemical test (FIT) in a multicentre randomized trial of CRC screening. Multivariable logistic models were used to assess determinants of completion rate and self-reported pain. RESULTS The attendance rate following the first invitation and mail reminder was 28.2% (1696/6018) in the FS and 23.0% (1382/6021) in the TC arm. Response rate to the 30-day follow-up questionnaire was 88.6% (1502/1696) among people undergoing FS, and 86.7% (1198/1382) among those undergoing TC. The proportion of people complaining of serious reactions following bowel preparation (odds ratio [OR], 5.17; 95% confidence interval [CI] 3.70-7.24) or reporting severe pain immediately after the exam (OR, 1.86; 95% CI 1.47-2.34) was higher for TC than for FS. The most common post-procedural complaints were abdominal distension and pain. People mentioning pain or bowel distension following preparation were more likely to report severe pain both after FS (OR, 2.13; 95% CI 1.52-2.97) and TC (OR: 2.03; 95% CI 1.41-2.90). The 30-day hospitalization rate was similar after FS, TC and FIT. CONCLUSIONS Screenees reported higher pain levels after TC than FS. The proportion of people complaining of severe side effects after discharge was similar. Bowel preparation was poorly tolerated by people undergoing TC. Subjects' reactions to the bowel preparation was predictive of post-procedural discomfort. A commitment of at least 48 hours was required of people undergoing TC, compared with 3-4 for FS.
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Affiliation(s)
- Carlo Senore
- Centro Prevenzione Oncologica Regione Piemonte and Azienda Ospedaliero-Universitaria S. Giovanni Battista di Torino, V. San Francesco da Paola 31, 10123 Torino, Italy.
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Giordano A, Ferrari G, Radice D, Randi G, Bisanti L, Solari A. Health-related quality of life and depressive symptoms in significant others of people with multiple sclerosis: a community study. Eur J Neurol 2012; 19:847-54. [PMID: 22233289 DOI: 10.1111/j.1468-1331.2011.03638.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND PURPOSE Uncertain prognosis and modest treatment efficacy make multiple sclerosis (MS) a particularly difficult disease to adjust to for both patients and their significant others (SOs). Few studies have assessed health-related quality of life (HRQOL) and depressive symptoms in SOs of people with MS in the community. We assessed, and identified predictors of, HRQOL and depression in SOs of adults with MS. METHODS POSMOS (postal survey of self-assessed health in MS adults and SOs) is a longitudinal survey on a random sample of 251 people with MS in the Milan area. In 2010, SOs and contemporaneous controls completed the SF-36 and Chicago Multiscale Depression Inventory (CMDI). RESULTS Overall, 142 SOs (mean age 53.1 years; 50% women, 65% partners) and 120 controls (similar to SOs for sex and education, but older) participated. By multivariable modeling of the SO plus control population, SF-36 vitality was lower in SOs (proportional odds ratio 0.45; 95% confidence interval 0.28-0.70), women (0.41; 0.27-0.64), and older subjects (0.98; 0.97-0.99). SF-36 mental health was also lower in SOs (0.62; 0.40-0.96) and women (0.43; 0.28-0.67). Regarding MS characteristics associated with HRQOL and depression in SOs, severe disability [Expanded Disability Status Scale (EDSS > 6.5)] had no effect, whilst depressive symptoms (pathologic CMDI) negatively influenced most SF-36 and all CMDI scores in SOs. CONCLUSIONS SOs had significantly lower vitality and psychological well-being than controls, identifying a burden in being the companion of a person with MS. This burden was unrelated to physical compromise but associated with depressive symptoms in MS.
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Affiliation(s)
- A Giordano
- Unit of Neuroepidemiology, Foundation IRCCS Neurological Institute C. Besta, Milan, Italy
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Lise M, Franceschi S, Buzzoni C, Zambon P, Falcini F, Crocetti E, Serraino D, Iachetta F, Zanetti R, Vercelli M, Ferretti S, La Rosa F, Donato A, De Lisi V, Mangone L, Busco S, Tagliabue G, Budroni M, Bisanti L, Fusco M, Limina RM, Tumino R, Piffer S, Madeddu A, Bellù F, Giacomin A, Candela G, Anulli ML, Dal Maso L. Changes in the incidence of thyroid cancer between 1991 and 2005 in Italy: a geographical analysis. Thyroid 2012; 22:27-34. [PMID: 22216985 DOI: 10.1089/thy.2011.0038] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The incidence of thyroid cancer (TC) has been increasing over the last 30 years in several countries, with some of the worldwide highest TC incidence rates (IRs) reported in Italy. The objectives of this study were to evaluate by histological subtypes the geographical heterogeneity of the incidence of TC in Italy and to analyze recent time trends for papillary thyroid carcinoma (PTC) in different cancer registries (CRs). METHODS The study included cases of TC (<85 years of age) reported to 25 Italian CRs between 1991 and 2005. Age-standardized IRs were computed for all histological subtypes of TC according to CRs. Estimated annual percent change and joinpoint regression analysis were used for analysis of PTC. RESULTS In women, IRs of PTC ranged between 3.5/100,000 in Latina and 8.5/100,000 in Sassari for the period 1991-1995 (a 2.4-fold difference) and between 7.3/100,000 in Alto Adige and 37.5/100,000 in Ferrara for 2001-2005 (a 5.1-fold difference). In men, IRs ranged between 0.7/100,000 in Latina and 3.4/100,000 in Sassari for the period 1991-1995 (a 4.9-fold difference) and between 2.0/100,000 (Alto Adige, Trento) and 10.6/100,000 in Ferrara for 2001-2005 (a 5.3-fold difference). In both sexes, IRs significantly higher than the pooled estimates emerged for the most recent period in the majority of CRs located within the Po River plain and in Latina, but they were lower in the Alpine belt. For women, CRs reported higher IRs than pool estimates showed, between 1991 to 2005, a significantly more marked annual percent change (+12%) than other CRs (+7%). For men the corresponding estimates were +11% and +8%. CONCLUSIONS The distribution of PTC does not lend support to a role of environmental radiation exposure due to the Chernobyl fallout, iodine deficiency, or (volcanic) soils. Between 1991 and 2005, wide geographic variations in the incidence of PTC and heterogeneous upward trends emerged, suggesting that the heterogeneity was a relatively recent phenomenon; this appeared to be mainly explained by variations, at a local level, in medical surveillance.
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Affiliation(s)
- Mauro Lise
- Epidemiology and Biostatistics Unit, Aviano Cancer Center, IRCCS, Aviano, Italy
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Musicco M, Palmer K, Russo A, Caltagirone C, Adorni F, Pettenati C, Bisanti L. Association between prescription of conventional or atypical antipsychotic drugs and mortality in older persons with Alzheimer's disease. Dement Geriatr Cogn Disord 2011; 31:218-24. [PMID: 21474930 DOI: 10.1159/000326213] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/17/2011] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND/AIMS To evaluate whether dementia patients prescribed antipsychotic drugs have a higher mortality compared to unexposed patients, and to investigate whether there are differences in mortality associated with exposure to conventional versus atypical antipsychotic drugs. METHODS Retrospective population cohort study with information gathered from the Italian Health Information System. All 4,369 residents of Milan (Italy) aged 60 years or older who were newly prescribed an antidementia drug (donepezil, rivastigmine or galantamine) from January 2002 to June 2008 were included. All new users of antipsychotic drugs in this cohort were categorized according to conventional (n = 156) or atypical (n = 806) drug exposure. The mortality risks of users of conventional or atypical antipsychotics compared to nonusers were evaluated with survival analysis, considering exposure to antipsychotic drugs as a time-dependent variable. RESULTS Mortality was increased two- and fivefold in users of atypical and conventional antipsychotics, respectively, with respect to nonusers. CONCLUSIONS Dementia patients prescribed antipsychotic drugs had a higher risk of death. This risk was highest for those prescribed conventional antipsychotics. At least part of the excess mortality may be due to the underlying neuropsychiatric symptoms that prompted the use of antipsychotics rather than a direct medication effect.
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Affiliation(s)
- Massimo Musicco
- Institute of Biomedical Technologies, National Research Council, Via Fratelli Cervi 93, Segrate, Italy.
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Chiusolo M, Cadum E, Stafoggia M, Galassi C, Berti G, Faustini A, Bisanti L, Vigotti MA, Dessì MP, Cernigliaro A, Mallone S, Pacelli B, Minerba S, Simonato L, Forastiere F. Short-Term Effects of Nitrogen Dioxide on Mortality and Susceptibility Factors in 10 Italian Cities: The EpiAir Study. Environ Health Perspect 2011; 119:1233-8. [PMID: 21586369 PMCID: PMC3230391 DOI: 10.1289/ehp.1002904] [Citation(s) in RCA: 114] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2010] [Accepted: 05/17/2011] [Indexed: 05/03/2023]
Abstract
BACKGROUND Several studies have shown an association between nitrogen dioxide (NO2) and mortality. In Italy, the EpiAir multicentric study, "Air Pollution and Health: Epidemiological Surveillance and Primary Prevention," investigated short-term health effects of air pollution, including NO2. OBJECTIVES To study the individual susceptibility, we evaluated the association between NO2 and cause-specific mortality, investigating individual sociodemographic features and chronic/acute medical conditions as potential effect modifiers. METHODS We considered 276,205 natural deaths of persons > 35 years of age, resident in 10 Italian cities, and deceased between 2001 and 2005. We chose a time-stratified case-crossover analysis to evaluate the short-term effects of NO2 on natural, cardiac, cerebrovascular, and respiratory mortality. For each subject, we collected information on sociodemographic features and hospital admissions in the previous 2 years. Fixed monitors provided daily concentrations of NO2, particulate matter ≤ 10 μm in aerodynamic diameter (PM10) and ozone (O3). RESULTS We found statistically significant associations with a 10-μg/m3 increase of NO2 for natural mortality [2.09% for lag 0-5; 95% confidence interval (CI), 0.96-3.24], for cardiac mortality (2.63% for lag 0-5; 95% CI, 1.53-3.75), and for respiratory mortality (3.48% for lag 1-5; 95% CI, 0.75-6.29). These associations were independent from those of PM10 and O3. Stronger associations were estimated for subjects with at least one hospital admission in the 2 previous years and for subjects with three or more specific chronic conditions. Some cardiovascular conditions (i.e., ischemic heart disease, pulmonary circulation impairment, heart conduction disorders, heart failure) and diabetes appeared to confer a strong susceptibility to air pollution. CONCLUSIONS Our results suggest significant and likely independent effects of NO2 on natural, cardiac, and respiratory mortality, particularly among subjects with specific cardiovascular preexisting chronic conditions and diabetes.
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Affiliation(s)
- Monica Chiusolo
- Environmental Epidemiological Unit, Regional Environmental Protection Agency, Piedmont, Turin, Italy
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Ponti A, Tomatis M, Baiocchi D, Barca A, Berti R, Bisanti L, Bordon R, Casella D, Cogo C, Deandrea S, Delrio D, Donati G, Falcini F, Frigerio A, Leonardo N, Mancini S, Mantellini P, Naldoni C, Pagano G, Ravaioli A, Pietribiasi F, Sedda ML, Taffurelli M, Zorzi M, Cataliotti L, Segnan N, Mano MP. Audit on quality of breast cancer diagnosis and treatment in Italy, 2008-2009. Epidemiol Prev 2011; 35:87-95. [PMID: 22166352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This survey, conducted by the Italian breast screening network (GISMa), collects individual data yearly on about 50% of all screen-detected, operated lesions in Italy. The 2008-2009 results show good overall quality of diagnosis and treatment and an improving trend over time. Critical issues were identified, including waiting times and compliance with the recommendations on not performing frozen section examination on small lesions. Pre-operative diagnosis reached the acceptable target, but there is a large variation between regions and programmes. For almost 90% of screen-detected invasive cancers the sentinel lymph node technique (SLN) was performed on the axilla, avoiding a large number of potentially harmful dissections. On the other hand, potential overuse of SLN deserves further investigation. The detailed results have been distributed, also by means of a web-based data warehouse, to regional and local screening programmes in order to allow multidisciplinary discussion and identification of the appropriate solutions to any problem documented by the data. Specialist breast units with adequate case volume and enough resources would provide the best setting for making audits effective in producing quality improvements with shorter waiting times.
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Segnan N, Armaroli P, Bonelli L, Risio M, Sciallero S, Zappa M, Andreoni B, Arrigoni A, Bisanti L, Casella C, Crosta C, Falcini F, Ferrero F, Giacomin A, Giuliani O, Santarelli A, Visioli CB, Zanetti R, Atkin WS, Senore C. Once-only sigmoidoscopy in colorectal cancer screening: follow-up findings of the Italian Randomized Controlled Trial--SCORE. J Natl Cancer Inst 2011; 103:1310-22. [PMID: 21852264 DOI: 10.1093/jnci/djr284] [Citation(s) in RCA: 427] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND A single flexible sigmoidoscopy at around the age of 60 years has been proposed as an effective strategy for colorectal cancer (CRC) screening. METHODS We conducted a randomized controlled trial to evaluate the effect of flexible sigmoidoscopy screening on CRC incidence and mortality. A questionnaire to assess the eligibility and interest in screening was mailed to 236,568 men and women, aged 55-64 years, who were randomly selected from six trial centers in Italy. Of the 56,532 respondents, interested and eligible subjects were randomly assigned to the intervention group (invitation for flexible sigmoidoscopy; n = 17,148) or the control group (no further contact; n = 17,144), between June 14, 1995, and May 10, 1999. Flexible sigmoidoscopy was performed on 9911 subjects. Intention-to-treat and per-protocol analyses were performed to compare the CRC incidence and mortality rates in the intervention and control groups. Per-protocol analysis was adjusted for noncompliance. RESULTS A total of 34,272 subjects (17,136 in each group) were included in the follow-up analysis. The median follow-up period was 10.5 years for incidence and 11.4 years for mortality; 251 subjects were diagnosed with CRC in the intervention group and 306 in the control group. Overall incidence rates in the intervention and control groups were 144.11 and 176.43, respectively, per 100,000 person-years. CRC-related death was noted in 65 subjects in the intervention group and 83 subjects in the control group. Mortality rates in the intervention and control groups were 34.66 and 44.45, respectively, per 100,000 person-years. In the intention-to-treat analysis, the rate of CRC incidence was statistically significantly reduced in the intervention group by 18% (rate ratio [RR] = 0.82, 95% confidence interval [CI] = 0.69 to 0.96), and the mortality rate was non-statistically significantly reduced by 22% (RR = 0.78; 95% CI = 0.56 to 1.08) compared with the control group. In the per-protocol analysis, both CRC incidence and mortality rates were statistically significantly reduced among the screened subjects; CRC incidence was reduced by 31% (RR = 0.69; 95% CI = 0.56 to 0.86) and mortality was reduced by 38% (RR = 0.62; 95% CI = 0.40 to 0.96) compared with the control group. CONCLUSION A single flexible sigmoidoscopy screening between ages 55 and 64 years was associated with a substantial reduction of CRC incidence and mortality.
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Affiliation(s)
- Nereo Segnan
- Centro di Prevenzione Oncologica Piemonte and S. Giovanni University Hospital, Turin, Italy.
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Faustini A, Stafoggia M, Berti G, Bisanti L, Chiusolo M, Cernigliaro A, Mallone S, Primerano R, Scarnato C, Simonato L, Vigotti MA, Forastiere F. The relationship between ambient particulate matter and respiratory mortality: a multi-city study in Italy. Eur Respir J 2011; 38:538-47. [PMID: 21233266 DOI: 10.1183/09031936.00093710] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The association of air pollutants with natural and respiratory mortality has been consistently reported. However, several aspects of the relationship between particulate matter with a 50% cut-off aerodynamic diameter of 10 μm (PM(10)) and respiratory mortality require further investigation. The aim of the present study was to assess the PM(10)-respiratory mortality association in Italy and examine potentially susceptible groups. All deaths from natural (n=276,205) and respiratory (n=19,629) causes among subjects aged ≥ 35 yrs in 10 northern, central and southern Italian cities in 2001-2005 were included in the study. Pollution data for PM(10), nitrogen dioxide and ozone were also obtained. A time-stratified case-crossover analysis was carried out. Different cumulative lags were selected to analyse immediate, delayed, prolonged and best-time effects of air pollution. The shape of the exposure-response curve was analysed. Age, sex, chronic conditions and death site were investigated as potential effect modifiers. We found a 2.29% (95% CI 1.03-3.58%) increase in respiratory mortality at 0-3 days lag. The increase in respiratory mortality was higher in summer (7.57%). The exposure-response curve had a linear shape without any threshold. Sex and chronic diseases modified the relationship between particular matter (PM) and respiratory mortality. The effect of PM on respiratory mortality was stronger and more persistent than that on natural mortality. Females and chronic disease sufferers were more likely to die of a respiratory disease caused by air pollution than males and healthy people.
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Affiliation(s)
- A Faustini
- Epidemiology Dept, Regional Health Service of Lazio, Rome, Italy.
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Stafoggia M, Forastiere F, Faustini A, Biggeri A, Bisanti L, Cadum E, Cernigliaro A, Mallone S, Pandolfi P, Serinelli M, Tessari R, Vigotti MA, Perucci CA. Susceptibility Factors to Ozone-related Mortality. Am J Respir Crit Care Med 2010; 182:376-84. [DOI: 10.1164/rccm.200908-1269oc] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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D'Ippoliti D, Michelozzi P, Marino C, de'Donato F, Menne B, Katsouyanni K, Kirchmayer U, Analitis A, Medina-Ramón M, Paldy A, Atkinson R, Kovats S, Bisanti L, Schneider A, Lefranc A, Iñiguez C, Perucci CA. The impact of heat waves on mortality in 9 European cities: results from the EuroHEAT project. Environ Health 2010; 9:37. [PMID: 20637065 DOI: 10.1186/1476-069x-9-37-45] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2010] [Accepted: 07/16/2010] [Indexed: 05/20/2023]
Abstract
BACKGROUND The present study aimed at developing a standardized heat wave definition to estimate and compare the impact on mortality by gender, age and death causes in Europe during summers 1990-2004 and 2003, separately, accounting for heat wave duration and intensity. METHODS Heat waves were defined considering both maximum apparent temperature and minimum temperature and classified by intensity, duration and timing during summer. The effect was estimated as percent increase in daily mortality during heat wave days compared to non heat wave days in people over 65 years. City specific and pooled estimates by gender, age and cause of death were calculated. RESULTS The effect of heat waves showed great geographical heterogeneity among cities. Considering all years, except 2003, the increase in mortality during heat wave days ranged from + 7.6% in Munich to + 33.6% in Milan. The increase was up to 3-times greater during episodes of long duration and high intensity. Pooled results showed a greater impact in Mediterranean (+ 21.8% for total mortality) than in North Continental (+ 12.4%) cities. The highest effect was observed for respiratory diseases and among women aged 75-84 years. In 2003 the highest impact was observed in cities where heat wave episode was characterized by unusual meteorological conditions. CONCLUSIONS Climate change scenarios indicate that extreme events are expected to increase in the future even in regions where heat waves are not frequent. Considering our results prevention programs should specifically target the elderly, women and those suffering from chronic respiratory disorders, thus reducing the impact on mortality.
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D'Ippoliti D, Michelozzi P, Marino C, de'Donato F, Menne B, Katsouyanni K, Kirchmayer U, Analitis A, Medina-Ramón M, Paldy A, Atkinson R, Kovats S, Bisanti L, Schneider A, Lefranc A, Iñiguez C, Perucci CA. The impact of heat waves on mortality in 9 European cities: results from the EuroHEAT project. Environ Health 2010; 9:37. [PMID: 20637065 PMCID: PMC2914717 DOI: 10.1186/1476-069x-9-37] [Citation(s) in RCA: 280] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2010] [Accepted: 07/16/2010] [Indexed: 05/17/2023]
Abstract
BACKGROUND The present study aimed at developing a standardized heat wave definition to estimate and compare the impact on mortality by gender, age and death causes in Europe during summers 1990-2004 and 2003, separately, accounting for heat wave duration and intensity. METHODS Heat waves were defined considering both maximum apparent temperature and minimum temperature and classified by intensity, duration and timing during summer. The effect was estimated as percent increase in daily mortality during heat wave days compared to non heat wave days in people over 65 years. City specific and pooled estimates by gender, age and cause of death were calculated. RESULTS The effect of heat waves showed great geographical heterogeneity among cities. Considering all years, except 2003, the increase in mortality during heat wave days ranged from + 7.6% in Munich to + 33.6% in Milan. The increase was up to 3-times greater during episodes of long duration and high intensity. Pooled results showed a greater impact in Mediterranean (+ 21.8% for total mortality) than in North Continental (+ 12.4%) cities. The highest effect was observed for respiratory diseases and among women aged 75-84 years. In 2003 the highest impact was observed in cities where heat wave episode was characterized by unusual meteorological conditions. CONCLUSIONS Climate change scenarios indicate that extreme events are expected to increase in the future even in regions where heat waves are not frequent. Considering our results prevention programs should specifically target the elderly, women and those suffering from chronic respiratory disorders, thus reducing the impact on mortality.
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Affiliation(s)
| | - Paola Michelozzi
- Department of Epidemiology, Regional Health Authority, Rome, Italy
| | - Claudia Marino
- Department of Epidemiology, Regional Health Authority, Rome, Italy
| | | | | | - Klea Katsouyanni
- Department of Hygiene and Epidemiology, Medical School, University of Athens, Greece
| | | | - Antonis Analitis
- Department of Hygiene and Epidemiology, Medical School, University of Athens, Greece
| | | | - Anna Paldy
- National Institute of Environmental Health, Budapest, Hungary
| | - Richard Atkinson
- Division of Community Health Sciences, St. George's University, London, UK
| | - Sari Kovats
- Public and Environmental Health Research Unit, London School of Hygiene and Tropical Medicine, London, UK
| | - Luigi Bisanti
- Department of Epidemiology, Health Authority Milan, Milan, Italy
| | - Alexandra Schneider
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Neuherberg, Germany
| | - Agnès Lefranc
- Department of Environmental Health, French Institute for Public Health Surveillance, Saint Maurice, Cedex France
| | - Carmen Iñiguez
- Epidemiology and Statistics Unit, Valencian School of Health Studies, Valencia, Spain
| | - Carlo A Perucci
- Department of Epidemiology, Regional Health Authority, Rome, Italy
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Lombardi E, Simoni M, La Grutta S, Viegi G, Bisanti L, Chellini E, Dell'Orco V, Migliore E, Petronio MG, Pistelli R, Rusconi F, Sestini P, Forastiere F, Galassi C. Effects of pet exposure in the first year of life on respiratory and allergic symptoms in 7-yr-old children. The SIDRIA-2 study. Pediatr Allergy Immunol 2010; 21:268-76. [PMID: 20444167 DOI: 10.1111/j.1399-3038.2009.00910.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The effects of pet exposure on the development of respiratory symptoms have recently been the matter of vivid discussion. Our objective was to determine the effects of exposure to cat or dog in the first year of life on subsequent respiratory/allergic symptoms in children in a large Italian multicentre study. As part of the SIDRIA-2 Study (Studi Italiani sui Disturbi Respiratori dell'Infanzia e l'Ambiente 2002), the parents of 20016 children (median age 7 yr) provided information on indoor exposures at different times in life and respiratory/allergic symptoms through questionnaires. Logistic regression analyses were performed taking into account cat or dog exposure at different times in life and adjusting for the presence of the other pet, mould exposure, gender, age, parental education, maternal smoking during the first year of life, current passive smoking, family history of asthma/rhinitis/eczema and other potential confounders. Neither significant effects of dog exposure in the first year of life nor in other periods were found on respiratory/allergic symptoms after adjusting for the other covariates. Cat exposure in the first year of life was significantly and independently associated with current wheezing [OR (95% CI) 1.88 (1.33-2.68), p < 0.001] and current asthma [1.74 (1.10-2.78), p < 0.05] and border-line associated with current rhinoconjunctivitis [1.43 (0.97-2.11), p = 0.07]. No other effects of cat exposure were found on respiratory/allergic symptoms. Cat, but not dog, exposure in the first year of life is an independent risk factor for current wheezing, current asthma and current rhinoconjunctivitis at the age of 7.
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Affiliation(s)
- Enrico Lombardi
- Section of Respiratory Medicine, Department of Paediatrics, University of Florence, Anna Meyer Children's University Hospital, Florence, Italy.
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Senore C, Armaroli P, Silvani M, Andreoni B, Bisanti L, Marai L, Castiglione G, Grazzini G, Taddei S, Gasperoni S, Giuliani O, Malfitana G, Marutti A, Genta G, Segnan N. Comparing different strategies for colorectal cancer screening in Italy: predictors of patients' participation. Am J Gastroenterol 2010; 105:188-98. [PMID: 19826409 DOI: 10.1038/ajg.2009.583] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The objective of this study was to study predictors of patients' participation in colorectal cancer (CRC) screening. METHODS Men and women, aged 55-64 years, were randomized to the following: (i) biennial fecal occult blood test (FOBT) delivered by mail (n=2,266); (ii) FOBT delivered by a general practitioner (GP)/screening facility (n=5,893); (iii) "once-only" sigmoidoscopy (FS) (n=3,650); (iv) FS followed by FOBT for screenees with negative FS (n=10,867); and (v) patient's choice between FS and FOBT (n=3,579). A stratified (by screening arm) random sample of attenders and nonattenders was contacted by trained interviewers 4 months after the initial invitation. Subjects giving their consent were administered a questionnaire (available online) investigating perceptions of individual CRC risk, attitudes toward prevention, adoption of health protective behaviors, and reasons for attendance/nonattendance. Adjusted prevalence odds ratios (ORs) were computed by multivariable logistic regression. RESULTS The response rate was 71.9% (701 of 975) among nonattenders and 88.9% (773 of 870) among attenders. Adjusting for screening arm, center, gender, age, and education, participation was significantly higher among people who consulted their GP before undergoing screening (OR: 4.24; 95% confidence interval (CI): 3.11-5.78), who mentioned one first-degree relative with CRC (OR: 3.62; 95% CI: 2.02-6.49), who reported regular physical activity (OR: 1.85; 95% CI: 1.33-2.55), and who read the mailed information (letter only: OR: 1.85; 95% CI: 1.23-2.78; letter+leaflet: OR: 3.18; 95% CI: 2.12-4.76). People who considered screening to be ineffective (OR: 0.12; 95% CI: 0.08-0.19), those who considered it to be effective but reported even moderate levels of anxiety (OR: 0.32; 95% CI: 0.23-0.45), and those who mentioned previous knowledge of CRC screening tests were less likely to accept the invitation (OR: 0.49; 95% CI: 0.34-0.70). CONCLUSIONS Adoption of health protective behaviors is associated with a higher attendance rate, whereas anxiety represents a strong barrier, even among people who deemed screening to be effective. Increasing the proportion of people who consult their GP when making a decision regarding screening might enhance participation.
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Affiliation(s)
- Carlo Senore
- Centro Prevenzione Oncologica Regione Piemonte and Azienda Ospedaliero-Universitaria S. Giovanni Battista di Torino, Turin, Italy.
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Agabiti N, Pirani M, Schifano P, Cesaroni G, Davoli M, Bisanti L, Caranci N, Costa G, Forastiere F, Marinacci C, Russo A, Spadea T, Perucci CA. Income level and chronic ambulatory care sensitive conditions in adults: a multicity population-based study in Italy. BMC Public Health 2009; 9:457. [PMID: 20003336 PMCID: PMC2804615 DOI: 10.1186/1471-2458-9-457] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2009] [Accepted: 12/11/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A relationship between quality of primary health care and preventable hospitalizations has been described in the US, especially among the elderly. In Europe, there has been a recent increase in the evaluation of Ambulatory Care Sensitive Conditions (ACSC) as an indicator of health care quality, but evidence is still limited. The aim of this study was to determine whether income level is associated with higher hospitalization rates for ACSC in adults in a country with universal health care coverage. METHODS From the hospital registries in four Italian cities (Turin, Milan, Bologna, Rome), we identified 9384 hospital admissions for six chronic conditions (diabetes, hypertension, congestive heart failure, angina pectoris, chronic obstructive pulmonary disease, and asthma) among 20-64 year-olds in 2000. Case definition was based on the ICD-9-CM coding algorithm suggested by the Agency for Health Research and Quality - Prevention Quality Indicators. An area-based (census block) income index was used for each individual. All hospitalization rates were directly standardised for gender and age using the Italian population. Poisson regression analysis was performed to assess the relationship between income level (quintiles) and hospitalization rates (RR, 95% CI) separately for the selected conditions controlling for age, gender and city of residence. RESULTS Overall, the ACSC age-standardized rate was 26.1 per 10.000 inhabitants. All conditions showed a statistically significant socioeconomic gradient, with low income people being more likely to be hospitalized than their well off counterparts. The association was particularly strong for chronic obstructive pulmonary disease (level V low income vs. level I high income RR = 4.23 95%CI 3.37-5.31) and for congestive heart failure (RR = 3.78, 95% CI = 3.09-4.62). With the exception of asthma, males were more vulnerable to ACSC hospitalizations than females. The risks were higher among 45-64 year olds than in younger people. CONCLUSIONS The socioeconomic gradient in ACSC hospitalization rates confirms the gap in health status between social groups in our country. Insufficient or ineffective primary care is suggested as a plausible additional factor aggravating inequality. This finding highlights the need for improving outpatient care programmes to reduce the excess of unnecessary hospitalizations among poor people.
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Affiliation(s)
- Nera Agabiti
- Epidemiology Department, Local Health Authority RM/E, Rome, Italy.
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Galassi C, Faustini A, Colais P, Stafoggia M, Berti G, Biggeri A, Bisanti L, Cernigliaro A, Chiusolo M, Mallone S, Pandolfi P, Serinelli M, Tessari R, Vigotti MA, Forastiere F. [EpiAir health data]. Epidemiol Prev 2009; 33:43-51. [PMID: 20418585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
INTRODUCTION the EpiAir (Air pollution and health: epidemiological surveillance and prevention) Project has been conducted in 10 Italian cities. In this paper we describe the health data used to detect adverse health effects associated with air pollution exposure (mortality and hospital discharge databases) and to identify comorbidities (based on hospital discharge databases) as susceptibility factors to the effects of air pollution. MATERIAL AND METHODS for each city, we performed descriptive analyses of mortality data included in the study.We considered subjects aged 35+ years old, resident and deceased within the cities in the study period (2001-2005) for non-accidental causes. For each deceased subject, information were collected on hospital discharge diagnoses in the previous 2-year period. Urgent hospital admissions of subjects resident in nine cities and hospitalized within the city for specific diseases (including cardiac, cerebrovascular and respiratory conditions) were also included as endpoints. Annual mean raw death and hospitalization rates were calculated for each city. RESULTS 276,205 deaths and 701,902 urgent hospital admissions have been included in the study. Annual mean crude death rates for non accidental causes in the population aged +35 yrs resident and deceased in the municipalities ranged from 12.1 and 15.7 per 1,000 residents.The percentage of deceased subjects with at least one of the selected comorbidities ranged from 32 to 48%. Annual mean crude urgent hospitalization rates in the resident population ranged from 5.5 to 11.7 per 1,000 residents for cardiac diseases; 1.7 to 3.7 per 1,000 residents for cerebrovascular diseases and 3.3 to 10.7 per 1,000 residents for respiratory diseases. Several factors can explain the between-cities differences observed, especially in the hospitalization rates, including availability and variability in the health care services utilization. CONCLUSION an epidemiological surveillance system based on health databases has to take into account the observed differences.
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Affiliation(s)
- Claudia Galassi
- Azienda ospedaliero-universitaria S. Giovanni Battist e CPO Piemonte, Torino.
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Baldacci S, Maio S, Viegi G, Forastiere F, Bisanti L, Randi G, Rognoni M, Simonato L, Tessari R, Berti G, Cadum E, Chiusolo M, Grosa MM, Ivaldi C, Pelosini R, Poncino S, Galassi C, Pacelli B, Pandolfi P, Scarnato C, Miglio R, Caranci N, Pace G, Zanini G, Grechi D, Chellini E, Mallone S, Accetta G, Barchielli A, Nuvolone D, Baccini M, Biggeri A, Baldacci S, Viegi G, Vigotti M, Colais P, Faustini A, Forastiere F, Perucci CA, Stafoggia M, Vigotti M, Minerba S, Serinelli M, Dessì PM, Cernigliaro A, Scondotto S. [Atmospheric pollution and human health.in the literature and interpretation of environmental. toxicological and epidemiologic studies]. Epidemiol Prev 2009; 33:1-72. [PMID: 20839608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- Sandra Baldacci
- Unità di epidemiologia ambientale polmonare Istituto di fisiologia clinica, CNR, Via Trieste 41, 56126 Pisa.
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Cadum E, Berti G, Biggeri A, Bisanti L, Faustini A, Forastiere F. [The results of EpiAir and the national and international literature]. Epidemiol Prev 2009; 33:113-143. [PMID: 20418591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The EpiAir Project evaluated the short term effects of air pollution on mortality and morbidity in 10 Italian cities (Milano, Mestre-Venezia, Torino, Bologna, Firenze, Pisa, Roma, Taranto, Cagliari e Palermo) during the period 2001-2005. A time-stratified case-crossover design was adopted, with results equivalent to those found using the traditional time series approach. The levels of PM10, NO2 and ozone measured in the Italian cities during the study period were higher than the reference European standards and the World Health Organization guidelines indicating a persistent exposure of Italian people to toxic air pollutants. The results of the EpiAir study showed higher effect estimates for mortality related to PM10 and NO2 than those reported in international studies and in previous Italian analyses. The percentage increase of natural mortality associated with a 10 microg/m3 increase in PM10 concentration was 0.69%, while it was 0.33% in Europe (APHEA study), 0.29% in North America (NNMAPS study) and 0.31% in the previous Italian meta-analysis of data collected in the nineties (MISA study). An important effect of PM10 and NO2 has been observed on hospitalizations for acute cardiac diseases, in particular myocardial infarction and heart failure, while NO2 increased the frequency of hospital admissions for respiratory diseases, especially asthma. The lag time between exposure and health effects was immediate for cardiovascular diseases and delayed for respiratory diseases. The study considered several susceptibility factors and elderly subjects were found to be more vulnerable to PM10 effects. The findings suggest the need for continuous epidemiologic surveillance of the health effects of air pollutants in Italy together with immediate national and local preventive programmes.
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Affiliation(s)
- Ennio Cadum
- Epidemiologia ambientale, ARPA Piemonte, Torino.
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Serinelli M, Vigotti MA, Stafoggia M, Berti G, Bisanti L, Mallone S, Pacelli B, Tessari R, Forastiere F. Particulate matter and out-of-hospital coronary deaths in eight Italian cities. Occup Environ Med 2009; 67:301-6. [DOI: 10.1136/oem.2009.046359] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Migliore E, Berti G, Galassi C, Pearce N, Forastiere F, Calabrese R, Armenio L, Biggeri A, Bisanti L, Bugiani M, Cadum E, Chellini E, Dell'Orco V, Giannella G, Sestini P, Corbo G, Pistelli R, Viegi G, Ciccone G. Respiratory symptoms in children living near busy roads and their relationship to vehicular traffic: results of an Italian multicenter study (SIDRIA 2). Environ Health 2009; 8:27. [PMID: 19534827 PMCID: PMC2708149 DOI: 10.1186/1476-069x-8-27] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2008] [Accepted: 06/18/2009] [Indexed: 05/21/2023]
Abstract
BACKGROUND Epidemiological studies have provided evidence that exposure to vehicular traffic increases the prevalence of respiratory symptoms and may exacerbate pre-existing asthma in children. Self-reported exposure to road traffic has been questioned as a reliable measurement of exposure to air pollutants. The aim of this study was to investigate whether there were specific effects of cars and trucks traffic on current asthma symptoms (i.e. wheezing) and cough or phlegm, and to examine the validity of self-reported traffic exposure. METHODS The survey was conducted in 2002 in 12 centers in Northern, Center and Southern Italy, different in size, climate, latitude and level of urbanization. Standardized questionnaires filled in by parents were used to collect information on health outcomes and exposure to traffic among 33,632 6-7 and 13-14 years old children and adolescents. Three questions on traffic exposure were asked: the traffic in the zone of residence, the frequency of truck and of car traffic in the street of residence. The presence of a possible response bias for the self-reported traffic was evaluated using external validation (comparison with measurements of traffic flow in the city of Turin) and internal validations (matching by census block, in the cities of Turin, Milan and Rome). RESULTS Overall traffic density was weakly associated with asthma symptoms but there was a stronger association with cough or phlegm (high traffic density OR = 1.24; 95% CI: 1.04, 1.49). Car and truck traffic were independently associated with cough or phlegm. The results of the external validation did not support the existence of a reporting bias for the observed associations, for all the self-reported traffic indicators examined. The internal validations showed that the observed association between traffic density in the zone of residence and respiratory symptoms did not appear to be explained by an over reporting of traffic by parents of symptomatic subjects. CONCLUSION Children living in zones with intense traffic are at higher risk for respiratory effects. Since population characteristics are specific, the results of validation of studies on self-reported traffic exposure can not be generalized.
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Affiliation(s)
- Enrica Migliore
- Cancer Epidemiology Unit, AOU San Giovanni Battista Hospital – Center for Cancer Prevention (CPO Piedmont) and University of Turin, Via Santena 7, 10126 Turin, Italy
| | - Giovanna Berti
- Regional Environmental Protection Agency, Piedmont Region, Via Sabaudia 164, 10095 Grugliasco (Turin), Italy
| | - Claudia Galassi
- Cancer Epidemiology Unit, AOU San Giovanni Battista Hospital – Center for Cancer Prevention (CPO Piedmont) and University of Turin, Via Santena 7, 10126 Turin, Italy
| | - Neil Pearce
- Centre for Public Health Research, Massey University Wellington Campus, PO Box 756 Wellington 6140 NZ
- Department of Biomedical Sciences and Human Oncology, University of Turin, Via Santena 7, 10126 Turin, Italy
| | - Francesco Forastiere
- Department of Epidemiology, Rome/E Local Health Authority, Via di S. Costanza 53, 00198 Rome, Italy
| | - Roberto Calabrese
- Cancer Epidemiology Unit, AOU San Giovanni Battista Hospital – Center for Cancer Prevention (CPO Piedmont) and University of Turin, Via Santena 7, 10126 Turin, Italy
- Department of Pediatrics, "Regina Margherita" Children's Hospital, University of Turin, P.zza Polonia 94, 10126 Turin, Italy
| | - Lucio Armenio
- I Pediatric Clinic, University of Bari, Piazza G. Cesare 11,70124 Bari, Italy
| | - Annibale Biggeri
- Department of Statistics, University of Florence, Viale Morgagni 59, 50134 Florence, Italy
- Unit of Biostatistics, Istituto per lo Studio e la Prevenzione Oncologica (ISPO), Via San Salvi 12, 50135 Florence, Italy
| | - Luigi Bisanti
- Epidemiology Unit, Local Health Authority, Corso Italia 19, 20122 Milan, Italy
| | - Massimiliano Bugiani
- Unit of Pneumology and Allergology, Local Health Authority TO-2, Lungo Dora Savona 26, 10152 Turin, Italy
| | - Ennio Cadum
- Regional Environmental Protection Agency, Piedmont Region, Via Sabaudia 164, 10095 Grugliasco (Turin), Italy
| | - Elisabetta Chellini
- Unit of Environmental and Occupational Epidemiology, Istituto per lo Studio e la Prevenzione Oncologica (ISPO), Via San Salvi 12, 50135 Florence, Italy
| | - Valerio Dell'Orco
- Department of Prevention, Rome/G Local Health Authority – Tivoli Corso Garibaldi 7, 00034 Colleferro (Rome), Italy
| | - Gabriele Giannella
- Unit of Preventive Medicine, Local Health Authority, Via Trento 6, 46100 Mantova, Italy
| | - Piersante Sestini
- Institute of Respiratory Diseases, University of Siena, Viale Bracci 3, 53100 Siena, Italy
| | - Giuseppe Corbo
- Department of Respiratory Physiology, Catholic University of Rome, Largo F.Vito 1, 00168 Rome, Italy
| | - Riccardo Pistelli
- Department of Respiratory Physiology, Catholic University of Rome, Largo F.Vito 1, 00168 Rome, Italy
| | - Giovanni Viegi
- CNR Institutes of Biomedicine and Molecular Immunology, Palermo, and of Clinical Physiology, Pisa. Via Ugo La Malfa 153, 90146 Palermo, Italy
| | - Giovannino Ciccone
- Cancer Epidemiology Unit, AOU San Giovanni Battista Hospital – Center for Cancer Prevention (CPO Piedmont) and University of Turin, Via Santena 7, 10126 Turin, Italy
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47
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Andreoni B, Crosta C, Sonzogni A, Pirola M, Pavan A, Bisanti L, Senore C, Sassatelli R, Sguinzi R, Bertani E, Bianchi P, Chiappa A. Comparison between endoscopic and surgical treatment of screen-detected versus non-screen-detected colorectal cancers. Ecancermedicalscience 2009; 3:142. [PMID: 22276007 PMCID: PMC3224002 DOI: 10.3332/ecancer.2009.142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2009] [Indexed: 11/08/2022] Open
Affiliation(s)
- B Andreoni
- Division of General-Laparoscopic Surgery, European Institute of Oncology, Milan 20141, Italy
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48
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Agabiti N, Cesaroni G, Picciotto S, Bisanti L, Caranci N, Costa G, Forastiere F, Marinacci C, Pandolfi P, Russo A, Perucci CA. The association of socioeconomic disadvantage with postoperative complications after major elective cardiovascular surgery. J Epidemiol Community Health 2009; 62:882-9. [PMID: 18791046 PMCID: PMC2602741 DOI: 10.1136/jech.2007.067470] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background: Understanding the mechanism by which both patient- and hospital level factors act in generating disparities has important implications for clinicians and policy-makers. Objective: To measure the association between socioeconomic position (SEP) and postoperative complications after major elective cardiovascular procedures. Design: Multicity hospital-based study. Subjects: Using Hospital Discharge Registries (ICD-9-CM codes), 19 310 patients were identified undergoing five cardiovascular operations (coronary artery bypass grafting (CABG), valve replacement, carotid endarterectomy, major vascular bypass, repair of unruptured abdominal aorta aneurysm (AAA repair)) in four Italian cities, 1997–2000. Measures: For each patient, a five-level median income index by census block of residence was calculated. In-hospital 30-day mortality, cardiovascular complications (CCs) and non-cardiovascular complications (NCCs) were the outcomes. Odds ratios (ORs) were estimated with multilevel logistic regression adjusting for city of residence, gender, age and comorbidities taking into account hospital and individual dependencies. Main results: In-hospital 30-day mortality varied by type of surgery (CABG 3.7%, valve replacement 5.7%, carotid endarterectomy 0.9%, major vascular bypass 8.8%, AAA repair 4.0%). Disadvantaged people were more likely to die after CABG (lowest vs highest income OR 1.93, p trend 0.023). For other surgeries, the relationship between SEP and mortality was less clear. For cardiac surgery, SEP differences in mortality were higher for publicly funded patients in low-volume hospitals (lowest vs highest income OR 3.90, p trend 0.039) than for privately funded patients (OR 1.46, p trend 0.444); however, the difference in the SEP gradients was not statistically significant. Conclusions: Disadvantaged people seem particularly vulnerable to mortality after cardiovascular surgery. Efforts are needed to identify structural factors that may enlarge SEP disparities within hospitals.
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Affiliation(s)
- N Agabiti
- Department of Epidemiology, Local Health Authority Rome E, Via di S Costanza 53, 00198 Rome, Italy.
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49
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Michelozzi P, Accetta G, De Sario M, D'Ippoliti D, Marino C, Baccini M, Biggeri A, Anderson HR, Katsouyanni K, Ballester F, Bisanti L, Cadum E, Forsberg B, Forastiere F, Goodman PG, Hojs A, Kirchmayer U, Medina S, Paldy A, Schindler C, Sunyer J, Perucci CA. High Temperature and Hospitalizations for Cardiovascular and Respiratory Causes in 12 European Cities. Am J Respir Crit Care Med 2009; 179:383-9. [DOI: 10.1164/rccm.200802-217oc] [Citation(s) in RCA: 364] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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50
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Analitis A, Katsouyanni K, Biggeri A, Baccini M, Forsberg B, Bisanti L, Kirchmayer U, Ballester F, Cadum E, Goodman PG, Hojs A, Sunyer J, Tiittanen P, Michelozzi P. Effects of cold weather on mortality: results from 15 European cities within the PHEWE project. Am J Epidemiol 2008; 168:1397-408. [PMID: 18952849 DOI: 10.1093/aje/kwn266] [Citation(s) in RCA: 349] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Weather-related health effects have attracted renewed interest because of the observed and predicted climate change. The authors studied the short-term effects of cold weather on mortality in 15 European cities. The effects of minimum apparent temperature on cause- and age-specific daily mortality were assessed for the cold season (October-March) by using data from 1990-2000. For city-specific analysis, the authors used Poisson regression and distributed lag models, controlling for potential confounders. Meta-regression models summarized the results and explored heterogeneity. A 1 degrees C decrease in temperature was associated with a 1.35% (95% confidence interval (CI): 1.16, 1.53) increase in the daily number of total natural deaths and a 1.72% (95% CI: 1.44, 2.01), 3.30% (95% CI: 2.61, 3.99), and 1.25% (95% CI: 0.77, 1.73) increase in cardiovascular, respiratory, and cerebrovascular deaths, respectively. The increase was greater for the older age groups. The cold effect was found to be greater in warmer (southern) cities and persisted up to 23 days, with no evidence of mortality displacement. Cold-related mortality is an important public health problem across Europe. It should not be underestimated by public health authorities because of the recent focus on heat-wave episodes.
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Affiliation(s)
- A Analitis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, University of Athens, Athens, Greece
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