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Dal Maso L, Panato C, De Paoli A, Mattioli V, Serraino D, Elisei R, Zoppini G, Gobitti C, Borsatti E, Di Felice E, Falcini F, Ferretti S, Francisci S, Giorgi Rossi P, Guzzinati S, Mazzoleni G, Pierannunzio D, Piffer S, Vaccarella S, Vicentini M, Zorzi M, Franceschi S, Fedeli U. Trends in thyroid function testing, neck ultrasound, thyroid fine needle aspiration, and thyroidectomies in North-eastern Italy. J Endocrinol Invest 2021; 44:1679-1688. [PMID: 33460012 PMCID: PMC8285305 DOI: 10.1007/s40618-020-01475-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 11/24/2020] [Indexed: 11/04/2022]
Abstract
PURPOSE Evidence of an increased diagnostic pressure on thyroid has emerged over the past decades. This study aimed to provide estimates of a wide spectrum of surveillance indicators for thyroid dysfunctions and diseases in Italy. METHODS A population-based study was conducted in North-eastern Italy, including 11.7 million residents (20% of the total Italian population). Prescriptions for TSH testing, neck ultrasound or thyroid fine needle aspiration (FNA), surgical procedures, and drugs for hypo- or hyperthyroidism were extracted from regional health databases. Proportions and rates of selected examinations were calculated from 2010 to 2017, overall and by sex, calendar years, age, and region. RESULTS Between 2010 and 2017 in North-eastern Italy, 24.5% of women and 9.8% of men received at least one TSH test yearly. In 2017, 7.1% of women and 1.5% of men were prescribed drugs for thyroid dysfunction, 94.6% of whom for hypothyroidism. Neck ultrasound examinations were performed yearly in 6.9% of women and 4.6% of men, with a nearly two-fold variation between areas. Thyroid FNA and thyroidectomies were three-fold more frequent in women (394 and 85 per 100,000) than in men (128 and 29 per 100,000) with a marked variation between areas. Both procedures decreased consistently after 2013. CONCLUSIONS The results of this population-based study describe recent variations over time and between surrounding areas of indicators of 'diagnostic pressure' on thyroid in North-eastern Italy. These results emphasize the need to harmonize practices and to reduce some procedures (e.g., neck ultrasound and total thyroidectomies) in certain areas.
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Affiliation(s)
- L Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Via Franco Gallini 2, 33081, Aviano, PN, Italy.
| | - C Panato
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Via Franco Gallini 2, 33081, Aviano, PN, Italy
| | - A De Paoli
- Epidemiological Department, Azienda Zero, Via J. Avanzo, 35, 35132, Padua, Italy
| | - V Mattioli
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Via Franco Gallini 2, 33081, Aviano, PN, Italy
| | - D Serraino
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Via Franco Gallini 2, 33081, Aviano, PN, Italy
| | - R Elisei
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy
| | - G Zoppini
- Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Hospital Trust of Verona, Verona, Italy
| | - C Gobitti
- Radiation Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081, Aviano, Italy
| | - E Borsatti
- Nuclear Medicine Unit, CRO Aviano National Cancer Institute, Via Franco Gallini, 2, 33081, Aviano, Italy
| | - E Di Felice
- Authority for Healthcare and Welfare, Emilia Romagna Regional Health Service, Bologna, Italy
| | - F Falcini
- Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, Italy
- Azienda Usl della Romagna, Forlì, Italy
| | - S Ferretti
- Ferrara Cancer Registry, University of Ferrara, Azienda USL Ferrara, Ferrara, Italy
| | - S Francisci
- National Centre for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - P Giorgi Rossi
- Reggio Emilia Cancer Registry, Epidemiology Unit, AUSL ASMN-IRCCS, Azienda USL di Reggio Emilia, Reggio Emilia, Italy
| | - S Guzzinati
- Epidemiological Department, Azienda Zero, Via J. Avanzo, 35, 35132, Padua, Italy
| | | | - D Pierannunzio
- National Centre for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - S Piffer
- Trento Province Cancer Registry, Unit of Clinical Epidemiology, Trento, Italy
| | - S Vaccarella
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - M Vicentini
- Reggio Emilia Cancer Registry, Epidemiology Unit, AUSL ASMN-IRCCS, Azienda USL di Reggio Emilia, Reggio Emilia, Italy
| | - M Zorzi
- Epidemiological Department, Azienda Zero, Via J. Avanzo, 35, 35132, Padua, Italy
| | - S Franceschi
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Via Franco Gallini 2, 33081, Aviano, PN, Italy
| | - U Fedeli
- Epidemiological Department, Azienda Zero, Via J. Avanzo, 35, 35132, Padua, Italy.
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Dal Maso L, Panato C, Tavilla A, Guzzinati S, Serraino D, Mallone S, Botta L, Boussari O, Capocaccia R, Colonna M, Crocetti E, Dumas A, Dyba T, Franceschi S, Gatta G, Gigli A, Giusti F, Jooste V, Minicozzi P, Neamtiu L, Romain G, Zorzi M, De Angelis R, Francisci S. Cancer cure for 32 cancer types: results from the EUROCARE-5 study. Int J Epidemiol 2021; 49:1517-1525. [PMID: 32984907 DOI: 10.1093/ije/dyaa128] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Few studies have estimated the probability of being cured for cancer patients. This study aims to estimate population-based indicators of cancer cure in Europe by type, sex, age and period. METHODS 7.2 million cancer patients (42 population-based cancer registries in 17 European countries) diagnosed at ages 15-74 years in 1990-2007 with follow-up to 2008 were selected from the EUROCARE-5 dataset. Mixture-cure models were used to estimate: (i) life expectancy of fatal cases (LEF); (ii) cure fraction (CF) as proportion of patients with same death rates as the general population; (iii) time to cure (TTC) as time to reach 5-year conditional relative survival (CRS) >95%. RESULTS LEF ranged from 10 years for chronic lymphocytic leukaemia patients to <6 months for those with liver, pancreas, brain, gallbladder and lung cancers. It was 7.7 years for patients with prostate cancer at age 65-74 years and >5 years for women with breast cancer. The CF was 94% for testis, 87% for thyroid cancer in women and 70% in men, 86% for skin melanoma in women and 76% in men, 66% for breast, 63% for prostate and <10% for liver, lung and pancreatic cancers. TTC was <5 years for testis and thyroid cancer patients diagnosed below age 55 years, and <10 years for stomach, colorectal, corpus uteri and melanoma patients of all ages. For breast and prostate cancers, a small excess (CRS < 95%) remained for at least 15 years. CONCLUSIONS Estimates from this analysis should help to reduce unneeded medicalization and costs. They represent an opportunity to improve patients' quality of life.
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Affiliation(s)
- Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano, Italy
| | - Chiara Panato
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano, Italy
| | - Andrea Tavilla
- National Center for Prevention and Health Promotion, Italian National Institute of Health (ISS), Rome, Italy
| | | | - Diego Serraino
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano, Italy
| | - Sandra Mallone
- National Center for Prevention and Health Promotion, Italian National Institute of Health (ISS), Rome, Italy
| | - Laura Botta
- Evaluative Epidemiology Unit, Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Olayidé Boussari
- Registre Bourguignon des Cancers Digestifs, INSERM UMR 1231, CHU de Dijon, Université de Bourgogne, Dijon, France
| | | | | | - Emanuele Crocetti
- Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, ItalyAzienda Usl della Romagna, Forlì, Italy
| | - Agnes Dumas
- National Institute for Health and Medical Research (INSERM), Paris, France
| | - Tadek Dyba
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Silvia Franceschi
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano, Italy
| | - Gemma Gatta
- Evaluative Epidemiology Unit, Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Anna Gigli
- Institute for Research on Population and Social Policies, National Research Council, Rome, Italy
| | | | - Valerie Jooste
- Registre Bourguignon des Cancers Digestifs, INSERM UMR 1231, CHU de Dijon, Université de Bourgogne, Dijon, France
| | - Pamela Minicozzi
- Analytical Epidemiology and Health Impact Unit, Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Luciana Neamtiu
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Gaëlle Romain
- Registre Bourguignon des Cancers Digestifs, INSERM UMR 1231, CHU de Dijon, Université de Bourgogne, Dijon, France
| | - Manuel Zorzi
- Veneto Tumour Registry, Azienda Zero, Padua, Italy
| | - Roberta De Angelis
- Department of Oncology and Molecular Medicine, Italian National Institute of Health (ISS), Rome, Italy
| | - Silvia Francisci
- National Center for Prevention and Health Promotion, Italian National Institute of Health (ISS), Rome, Italy
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Dal Maso L, Panato C, Tavilla A, Guzzinati S, Serraino D, De Angelis R, Francisci S. When is a cancer patient cured? (Results from the EUROCARE-5 study). Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.1263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Although heterogenous risks of recurrence or late effects according to cancer type and host factors exist, increasing evidence of cure has emerged for some cancers. This leads, among other important topics, to the so-called “right to be forgotten” law, adopted in France and Belgium to help cancer survivors access loans and insurance. The aim of the study was to estimate population-based indicators of cancer cure in Europe by type, sex, age, and period.
Methods
Data from 7.2 million cancer patients, aged 15-74 years, from 42 population-based cancer registries in 17 countries were extracted from the EUROCARE-5 dataset. Mixture-cure models were used to estimate: a) median life expectancy of fatal cases (LEF); b) cure fraction (CF) as a proportion of patients with death rates similar to the general population; and c) time to cure (TTC) as the time to reach five-year conditional relative survival (CRS)>95%.
Results
LEF ranged from 10 years for patients with chronic lymphocytic leukemia to < 6 months for those with liver, pancreas, brain, gallbladder, and lung cancers. The CF was 94% for testis, 87% for thyroid cancer in women (70% in men), 86% for skin melanoma in women (76% in men), 66% for breast, 63% for prostate, and <10% for liver, lung, and pancreatic cancers. TTC was <5 years for testis and thyroid cancer patients diagnosed below age 55 years, and <10 years for stomach, colorectal, corpus uteri, and melanoma patients of all ages. For breast and prostate cancers, a small excess remained for at least 15 years.
Conclusions
In a context of increasing number of people living after a cancer diagnosis, these results may help to reduce unneeded medicalization (e.g., follow-up) and resources needed for their care, and they further document that there is already a cure for some cancers.
Fundings
This work was supported by the Italian Association of Cancer Research (AIRC) and the European Commission (IPAAC).
Key messages
Cancer cure indicators are provided for European patients and 32 cancer type. Recognizing cancer patients as cured has relevant clinical and social implications.
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Affiliation(s)
- L Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano IRCCS, Aviano, Italy
| | - C Panato
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano IRCCS, Aviano, Italy
| | - A Tavilla
- National Center for Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy
| | - S Guzzinati
- Veneto Tumor Reigstry, Azienda Zero, Padua, Italy
| | - D Serraino
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano IRCCS, Aviano, Italy
| | - R De Angelis
- Department Oncology and Molecular Medicine, Italian National Institute of Health, Rome, Italy
| | - S Francisci
- National Center for Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy
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Franceschi S, Gallo T, Panato C, Gongolo F, Franzo A. Coverage of HPV vaccination programme in Friuli Venezia Giulia Region (Northern Italy). Epidemiol Prev 2020; 44:378-384. [PMID: 33706490 DOI: 10.19191/ep20.5-6.p378.013] [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] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVES to assess the completeness and timeliness of Human papillomavirus (HPV) vaccination programme in Friuli Venezia Giulia (FVG) Region (Northern Italy), notably by monitoring 2-dose coverage among girls before they turn 15 years old (referred to as "at 15") in each year between 2009 and 2018 and making a preliminary evaluation of coverage among boys at 13 years in 2016-2018. DESIGN retrospective study. SETTING AND PARTICIPANTS for each vaccine recipient, demographic information and history of HPV vaccine uptake from the digital FVG Vaccination Registry updated as of 31.12.2018 were extracted. Numerator data comprised all doses allocated to FVG residents. Age-specific denominators were derived from the FVG census in each examined year. Coverage estimates for the year 2018 were also provided by number of doses. MAIN OUTCOME MEASURES coverage for a full course of HPV vaccine, defined as 2 doses in girls and boys younger than age 15 years but 3 doses in less young women. RESULTS In FVG 52,217 females had received >=1 dose since 2008 and 12,152 males since 2015. >=2-dose coverage in girls at 15 increased from 42% in 2009 to 76% in 2015 and slightly declined afterwards (69% in 2018). In 2008, 3-dose coverage was 65%, 74%, and 59% in females aged 16-17, 18-19, and 20-26 years, respectively. In the same year, 2-dose coverage in boys at 13 years was 54%, similar to the coverage in girls at 13 years (57%). CONCLUSIONS this paper shows the achievements of routine and catch-up HPV vaccination in FVG. While coverage in girls at 15 years of age peaked in 2015 and slightly diminished in subsequent years, the coverage in boys at 13 in 2018 had already approached the coverage in same-age girls (57%). On account of the signs of weakening in girls' coverage, campaigns in support to HPV vaccination must be repeated, especially in favour of the most cost-effective group, i.e., girls before 15 years of age. The heavy burden posed by the COVID-19 emergency on other prevention-related activities makes a better targeted use of HPV vaccination even more necessary.
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Affiliation(s)
- Silvia Franceschi
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano (PN) (Italy)
- Joint last authors
| | - Tolinda Gallo
- Servizio Prevenzione, sicurezza alimentare e sanità pubblica veterinaria, Direzione centrale salute, politiche sociali e disabilità, Regione autonoma Friuli Venezia Giulia, Udine (Italy)
- Joint last authors
| | - Chiara Panato
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano (PN) (Italy)
| | - Francesco Gongolo
- Servizio Prevenzione, sicurezza alimentare e sanità pubblica veterinaria, Direzione centrale salute, politiche sociali e disabilità, Regione autonoma Friuli Venezia Giulia, Udine (Italy)
| | - Antonella Franzo
- Servizio Prevenzione, sicurezza alimentare e sanità pubblica veterinaria, Direzione centrale salute, politiche sociali e disabilità, Regione autonoma Friuli Venezia Giulia, Udine (Italy)
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Bucchi L, Mancini S, Crocetti E, Dal Maso L, Baldacchini F, Vattiato R, Giuliani O, Ravaioli A, Caldarella A, Carrozzi G, Ferretti S, Filiberti RA, Fusco M, Gatti L, Gili A, Magoni M, Mangone L, Mazzoleni G, Michiara M, Panato C, Piffer S, Piras D, Rosso S, Rugge M, Scala U, Tagliabue G, Tumino R, Stanganelli I, Falcini F. Mid-term trends and recent birth-cohort-dependent changes in incidence rates of cutaneous malignant melanoma in Italy. Int J Cancer 2020; 148:835-844. [PMID: 33405292 DOI: 10.1002/ijc.33259] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 04/21/2020] [Revised: 07/21/2020] [Accepted: 07/28/2020] [Indexed: 01/12/2023]
Abstract
In Oceania, North America and north-western Europe, after decades of increase, cutaneous malignant melanoma (CMM) rates began to stabilise or decline before 2000. Anecdotal evidence suggests that the reversal of the incidence trend is extending to southern Europe. To obtain a formal confirmation, this nationwide study from Italy investigated the incidence trends by birth cohort. Twenty-one local cancer registries covering a population of 15 814 455 provided incidence data for primary CMM registered between 1994 and 2013. Trends in age-standardised rates were analysed using joinpoint regression models and age-period-cohort models. Age-standardised incidence showed a consistent increase throughout the period (estimated annual percent change, 3.6 [95% confidence interval, 3.2-4.0] among men and 2.5 [2.0-3.1] among women). This pattern was confirmed by a sensitivity analysis with removal of low-risk populations of southern Italy. The rates, however, showed a stabilisation or a decrease in men and women aged below 35. Using the cohort of 1949-the median cohort with respect to the number of cases for both genders-as a reference, the incidence rate ratio increased for successive cohorts born until 1973 (women) and 1975 (men), and subsequently tended to decline. For the most recent cohorts in both genders, the risk of disease returned to the level of the cohort of 1949. The changes observed in the latest generations can be interpreted as the earliest manifestations of a birth-cohort-dependent incidence decrease. Our study adds to previous data indicating that the reversal of the long-term upward incidence trend of CMM is extending to southern Europe.
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Affiliation(s)
- Lauro Bucchi
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Silvia Mancini
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Emanuele Crocetti
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Flavia Baldacchini
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Rosa Vattiato
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Orietta Giuliani
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Alessandra Ravaioli
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Adele Caldarella
- Tuscany Cancer Registry, Clinical and Descriptive Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Giuliano Carrozzi
- Modena Cancer Registry, Public Health Department, Local Health Authority, Modena, Italy
| | - Stefano Ferretti
- Romagna Cancer Registry, section of Ferrara, Local Health Authority, and University of Ferrara, Ferrara, Italy
| | | | | | - Luciana Gatti
- Mantova Cancer Registry, Epidemiology Unit, Agenzia di Tutela della Salute (ATS) della Val Padana, Mantova, Italy
| | - Alessio Gili
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - Michele Magoni
- Registry of Brescia Province, Epidemiology Unit, Brescia Health Protection Agency, Brescia, Italy
| | - Lucia Mangone
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Maria Michiara
- Parma Cancer Registry, Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Chiara Panato
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Silvano Piffer
- Trento Province Cancer Registry, Unit of Clinical Epidemiology, Trento, Italy
| | - Daniela Piras
- Sassari Cancer Registry, Azienda Regionale per la Tutela della Salute - ATS, Sassari, Italy
| | - Stefano Rosso
- Piedmont Cancer Registry, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | | | | | - Giovanna Tagliabue
- Lombardy Cancer Registry-Varese Province, Cancer Registry Unit, Department of Research, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, Provincial Health Authority (ASP), Ragusa, Italy
| | - Ignazio Stanganelli
- Skin Cancer Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy.,Department of Dermatology, University of Parma, Parma, Italy
| | - Fabio Falcini
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy.,Cancer Prevention Unit, Local Health Authority, Forlì, Italy
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Panato C, Vaccarella S, Dal Maso L, Basu P, Franceschi S, Serraino D, Wang K, Lei F, Chen Q, Huang B, Mathew A. Thyroid Cancer Incidence in India Between 2006 and 2014 and Impact of Overdiagnosis. J Clin Endocrinol Metab 2020; 105:dgaa192. [PMID: 32297630 PMCID: PMC7947989 DOI: 10.1210/clinem/dgaa192] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 04/14/2020] [Indexed: 12/19/2022]
Abstract
CONTEXT/OBJECTIVE Increases of thyroid cancer (TC) incidence emerged in the past several decades in several countries. This study aimed to estimate time trends of TC incidence in India and the proportion of TC cases potentially attributable to overdiagnosis by sex, age, and area. DESIGN TC cases aged 0 to 74 years reported to Indian cancer registries during 2006 through 2014 were included. Age-standardized incidence rates (ASR) and TC overdiagnosis were estimated by sex, period, age, and area. RESULTS Between 2006 to 2008 and 2012 to 2014, the ASRs for TC in India increased from 2.5 to 3.5/100,000 women (+37%) and from 1.0 to 1.3/100,000 men (+27%). However, up to a 10-fold difference was found among regions in both sexes. Highest ASRs emerged in Thiruvananthapuram (14.6/100,000 women and 4.1/100,000 men in 2012-2014), with 93% increase in women and 64% in men compared with 2006 to 2008. No evidence of overdiagnosis was found in Indian men. Conversely, overdiagnosis accounted for 51% of TC in Indian women: 74% in those aged < 35 years, 50% at ages 35 to 54 years, and 30% at ages 55 to 64 years. In particular, 80% of TC overdiagnosis in women emerged in Thiruvananthapuram, whereas none or limited evidence of overdiagnosis emerged in Kamrup, Dibrugarh, Bhopal, or Sikkim. CONCLUSIONS Relatively high and increasing TC ASRs emerged in Indian regions where better access to health care was reported. In India, as elsewhere, new strategies are needed to discourage opportunistic screening practice, particularly in young women, and to avoid unnecessary and expensive treatments. Present results may serve as a warning also for other transitioning countries.
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Affiliation(s)
- Chiara Panato
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | | | - Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Partha Basu
- International Agency for Research on Cancer, Lyon, France
| | - Silvia Franceschi
- Scientific Directorate, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Diego Serraino
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Kevin Wang
- Department of Internal Medicine, Division of Medical Oncology, University of Kentucky, Lexington, KY, USA
| | - Feitong Lei
- Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, USA
| | - Quan Chen
- Biostatistics and Bioinformatics Shared Facility, Markey Cancer Center, University of Kentucky, Lexington, KY, USA
| | - Bin Huang
- Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, USA
- Biostatistics and Bioinformatics Shared Facility, Markey Cancer Center, University of Kentucky, Lexington, KY, USA
| | - Aju Mathew
- Department of Internal Medicine, Division of Medical Oncology, University of Kentucky, Lexington, KY, USA
- MOSC Medical College Kolenchery, Kerala, India
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Mathew A, Maso LD, Panato C, Serraino D, Franceschi S, Basu P, Wang K, Lei F, Chen Q, Huang B, Vaccarella S. Thyroid cancer incidence in India between 2006 and 2014 and impact of overdiagnosis. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e18574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e18574 Background: Increases of thyroid cancer (TC) incidence emerged in the last decades in several countries. This study aimed to estimate time trends of TC incidence in India and the proportion of TC cases potentially attributable to overdiagnosis by sex, age, and area. Methods: TC cases aged 0-74 years reported to Indian cancer registries during 2006- 2014 were included. Age-standardized incidence rates (ASR) and TC overdiagnosis were estimated by sex, period, age, and area. Results: Between 2006-2008 and 2012-2014, the ASRs for TC in India increased from 2.5 to 3.5/100,000 women (+37%) and from 1.0 to 1.3/100.000 men (+27%). However, up to a 10-fold difference was found among regions in both sexes. Highest ASRs emerged in Thiruvananthapuram (14.6/100,000 women and 4.1/100,000 men in 2012- 2014), with 93% increase in women and 64% in men compared to 2006-2008. No evidence of overdiagnosis was found in Indian men. Conversely, overdiagnosis accounted for 51% of TC in Indian women: 74% in those aged < 35 years, 50% at ages 35-54 years, and 30% at ages 55-64 years. In particular, 80% of TC overdiagnosis in women emerged in Thiruvananthapuram, while none or limited evidence of overdiagnosis emerged in Kamrup, Dibrugarh, Bhopal, and Sikkim. Conclusions: Relatively high and increasing TC ASRs emerged in Indian regions where better access to healthcare was reported. In India, as elsewhere, new strategies are needed to discourage opportunistic screening practice, particularly in young women, and to avoid unnecessary and expensive treatments. Present results may serve as a warning also for other transitioning countries.
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Affiliation(s)
- Aju Mathew
- University of Kentucky Markey Cancer Center, Lexington, KY
| | - Luigino Dal Maso
- Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, Via F. Gallini 2, 33081, Aviano (PN), Italy
| | - Chiara Panato
- Centro di Riferimento Oncologico (CRO) Aviano, IRCCS, Aviano, Italy
| | | | | | - Partha Basu
- Chittaranjan National Cancer Institute, Kolkata, India
| | | | - Feitong Lei
- University of Kentucky College of Public Health, Lexington, KY
| | - Quan Chen
- University of Kentucky, Lexington, KY
| | - Bin Huang
- Kentucky Cancer Registry, Lexington, KY
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8
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Hamdi-Cherif M, Serraino D, Bouad S, Dib A, Boudaoud K, Atoui S, Mergherm I, Toffolutti F, Bidoli E, Kara L, Ayat A, Habia G, Makhloufi K, Bouchaibi I, Kettaf S, Chenafi S, Dilmi D, Bouhafs K, Ablaoui B, Chaouche H, Belbedj L, Nadjem A, Lakab N, Virdone S, Panato C. Sociodemographic and Reproductive Risk Factors for Breast Cancer: A Case-Control Study in the Setif Province, Northern Algeria. Asian Pac J Cancer Prev 2020; 21:457-464. [PMID: 32102524 PMCID: PMC7332138 DOI: 10.31557/apjcp.2020.21.2.457] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Indexed: 12/03/2022] Open
Abstract
Background: The age-standardized rate of breast cancer (BC) increased nearly nine-fold in the last 30 years in Setif, Algeria. A case-control study was carried out to investigate the role of sociodemographic characteristics and reproductive factors in the etiology of BC in this young Arab/Berber population of Setif. Methods: Cases were 612 women with incident BC admitted to major teaching and general hospitals of Setif during 2012–2017. Controls were 615 women admitted for acute, non-neoplastic conditions to the same hospital network of cases. Information was elicited using a standardized questionnaire. Odds ratios (ORs) and 95% confidence intervals (CIs) were computed after allowance for age and education. Results: Significant associations with BC risk emerged for family history of BC (OR= 4.15 for yes vs. no; 95%CI: 2.22-7.77), for the generation of oral contraceptive used (OR=1.57 for II-generation vs. III-generation; 95%CI:1.01-2.44), and education (OR=0.63 for >11 years vs. no schooling; 95%CI: 0.46-0.86). Conversely, parity and body mass index were not associated with BC risk, whereas a late age at menarche was linked with a non statistically significant BC risk (OR=1.20 for >15 vs. <13 years; 95%CI:0.86-1.66). These results were consistent in strata of menopausal status. Conclusion(s): Some of the expected risk factors (e.g., low education levels and type of oral contraceptives) were associated with elevated BC risks also in Setif, and these findings offer further support to primary preventive efforts already carried on in Algeria. Conversely, no association emerged for other well established risk factors (e.g., body mass index).
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Affiliation(s)
| | - Diego Serraino
- Cancer Epidemiology Unit, Oncological Reference Center (CRO), IRCCS, Aviano, Italy.,Friuli Venezia Giulia Cancer Registry, IRCCS Oncological Reference Center, Aviano, Italy
| | - Souad Bouad
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Adlane Dib
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Khadidja Boudaoud
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Saida Atoui
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Imene Mergherm
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Federica Toffolutti
- Cancer Epidemiology Unit, Oncological Reference Center (CRO), IRCCS, Aviano, Italy
| | - Ettore Bidoli
- Cancer Epidemiology Unit, Oncological Reference Center (CRO), IRCCS, Aviano, Italy
| | - Lamia Kara
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Asma Ayat
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Ghania Habia
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Kenza Makhloufi
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Imane Bouchaibi
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Sabah Kettaf
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Samiha Chenafi
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Douniazad Dilmi
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Karima Bouhafs
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Bahadinne Ablaoui
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Hadjira Chaouche
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Loubna Belbedj
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Asma Nadjem
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Nawel Lakab
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Saverio Virdone
- Cancer Epidemiology Unit, Oncological Reference Center (CRO), IRCCS, Aviano, Italy
| | - Chiara Panato
- Cancer Epidemiology Unit, Oncological Reference Center (CRO), IRCCS, Aviano, Italy
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9
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Panato C, Serraino D, De Santis E, Forgiarini O, Angelin T, Bidoli E, Zanier L, Del Zotto S, Vaccarella S, Franceschi S, Dal Maso L. Thyroid cancer in Friuli Venezia Giulia, northeastern Italy: incidence, overdiagnosis, and impact of type of surgery on survival. Tumori 2019; 105:296-303. [PMID: 30917766 DOI: 10.1177/0300891619839307] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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] [Indexed: 02/06/2023]
Abstract
BACKGROUND Incidence rates of thyroid cancer (TC) increased in the last decades worldwide. This study aimed to describe TC incidence in the Friuli Venezia Giulia (FVG) region, to estimate the quota of overdiagnosis, and to investigate the impact of surgery on long-term survival after TC diagnosis. METHODS TC cases reported to the FVG population-based cancer registry during 2002-2013, aged <85 years, were included. Age standardized rates (ASR) on the European population were computed, while proportion of TC overdiagnosis was estimated in comparison with expected age-specific incidence rates from published time series. Adjusted hazard ratios of death, with 95% confidence intervals, were also estimated. RESULTS During 2002-2013, 1701 TC cases were reported to the FVG cancer registry, with papillary TC (78.2%) as the most frequent histologic type. ASR increased from 12.4 to 16.5 in women and from 4.3 to 6.2 in men (+33.1% and +44.2%, respectively). Overdiagnosis was estimated as 79% of TC cases in women and 64% in men. Almost all TC cases (97.1%) underwent surgery, including 84.6% of women and 78.9% of men who underwent total thyroidectomy. Up to 10 years after TC diagnosis, the type of surgery did not appear to influence survival. CONCLUSIONS This study documented an increase in TC incidence in FVG in the last decade, with overdiagnosis accounting for a large proportion of TC diagnoses and total thyroidectomy in more than 80% of cases. These findings suggest reconsidering thyroid screening practice and aggressive therapeutic strategies, as recommended by new TC guidelines.
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Affiliation(s)
- Chiara Panato
- 1 Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Diego Serraino
- 1 Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Emilia De Santis
- 2 Friuli Venezia Giulia Cancer Registry, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Ornella Forgiarini
- 2 Friuli Venezia Giulia Cancer Registry, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Tiziana Angelin
- 1 Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Ettore Bidoli
- 1 Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Loris Zanier
- 3 Epidemiological Service, Azienda Regionale di Coordinamento per la Salute (ARCS), Udine, Italy
| | - Stefania Del Zotto
- 3 Epidemiological Service, Azienda Regionale di Coordinamento per la Salute (ARCS), Udine, Italy
| | | | - Silvia Franceschi
- 5 Scientific Directorate, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Luigino Dal Maso
- 1 Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
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10
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Botta L, Dal Maso L, Guzzinati S, Panato C, Gatta G, Trama A, Rugge M, Tagliabue G, Casella C, Caruso B, Michiara M, Ferretti S, Sensi F, Tumino R, Toffolutti F, Russo AG, Caiazzo AL, Mangone L, Mazzucco W, Iacovacci S, Ricci P, Gola G, Candela G, Sardo AS, De Angelis R, Buzzoni C, Capocaccia R. Changes in life expectancy for cancer patients over time since diagnosis. J Adv Res 2019; 20:153-159. [PMID: 31467707 PMCID: PMC6710558 DOI: 10.1016/j.jare.2019.07.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 04/16/2019] [Revised: 07/12/2019] [Accepted: 07/12/2019] [Indexed: 11/16/2022] Open
Abstract
Research question: how cancer impacts on LE changes during patients’ entire life LE increased in patients surviving the first years and decreasing thereafter. Patients’ LE in the long-term approached but seldom reached the general population’s LE. This method describes when cancer survivors’ excess risk of death became negligible. Life expectancy indicator is easy to be understood and interpreted by patients.
The aims of this study were to provide life expectancy (LE) estimates of cancer patients at diagnosis and LE changes over time since diagnosis to describe the impact of cancer during patients' entire lives. Cancer patients' LE was calculated by standard period life table methodology using the relative survival of Italian patients diagnosed in population-based cancer registries in 1985–2011 with follow-up to 2013. Data were smoothed using a polynomial model and years of life lost (YLL) were calculated as the difference between patients' LE and that of the age- and sex-matched general population. The YLL at diagnosis was highest at the youngest age at diagnosis, steadily decreasing thereafter. For patients diagnosed at age 45 years, the YLL was above 20 for lung and ovarian cancers and below 6 for thyroid cancer in women and melanoma in men. LE progressively increased in patients surviving the first years, decreasing thereafter, to approach that of the general population. YLL in the long run mainly depends on attained age. Providing quantitative data is essential to better define clinical follow-up and plan health care resource allocation. These results help assess when the excess risk of death from tumour becomes negligible in cancer survivors.
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Affiliation(s)
- Laura Botta
- Evaluative Epidemiology Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | - Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, PN, Italy
| | | | - Chiara Panato
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, PN, Italy
| | - Gemma Gatta
- Evaluative Epidemiology Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | - Annalisa Trama
- Evaluative Epidemiology Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | - Massimo Rugge
- Veneto Tumor Registry, Azienda Zero, 35131 Padua, Italy
| | - Giovanna Tagliabue
- Lombardy Cancer Registry, Varese Province, Cancer Registry Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | - Claudia Casella
- Liguria Cancer Registry, Clinical Epidemiology, Ospedale Policlinico San Martino IRCCS, 16132 Genova, Italy
| | - Bianca Caruso
- Modena Cancer Registry, Public Health Department, AUSL di Modena, 41126 Modena, Italy
| | - Maria Michiara
- Parma Cancer Registry, Oncology Unit, Azienda Ospedaliera Universitaria di Parma, 43100 Parma, Italy
| | - Stefano Ferretti
- Ferrara Cancer Registry, University of Ferrara, Local Health Authority Ferrara, 44121 Ferrara, Italy
| | - Flavio Sensi
- North Sardinia Cancer Registry, Azienda Regionale per la Tutela della Salute, 07100 Sassari, Italy
| | - Rosario Tumino
- Cancer Registry for the Provinces of Caltanisetta and Ragusa, Dipartimento di Prevenzione Medica, Azienda Sanitaria Provinciale (ASP) Ragusa, 97100 Ragusa, Italy
| | - Federica Toffolutti
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, PN, Italy
| | - Antonio Giampiero Russo
- Cancer Registry of Milan, Epidemiology Unit, Agency for Health Protection of Milan, 20122 Milan, Italy
| | - Anna Luisa Caiazzo
- Cancer Registry of Salerno Province, Azienda Sanitaria Provinciale (ASP) Salerno, 84014 Nocera Inferiore, Italy
| | - Lucia Mangone
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42100 Reggio Emilia, Italy
| | - Walter Mazzucco
- Sciences for Health Promotion (PROSAMI) Department, University of Palermo, and Clinical Epidemiology and Cancer Registry Unit, Palermo University Hospital "P. Giaccone", 90127 Palermo, Italy
| | - Silvia Iacovacci
- Cancer Registry of Latina Province, Direzione Azienda AUSL, Centro Direzionale Latina Fiori, 04100 Latina, Italy
| | - Paolo Ricci
- Mantova Cancer Registry, Epidemiology Unit, Agenzia di Tutela della Salute (ATS) della Val Padana, 46100 Mantova, Italy
| | - Gemma Gola
- Como Cancer Registry, UOC Epidemiologia-ATS Insubria, 21100 Varese, Italy
| | - Giuseppa Candela
- Trapani Cancer Registry, Dipartimento di Prevenzione della Salute, Servizio Sanitario Regionale Sicilia, Azienda Sanitaria Provinciale (ASP), 91100 Trapani, Italy
| | - Antonella Sutera Sardo
- Catanzaro Cancer Registry, Servizio di Epidemiologia e Statistica Sanitaria, Azienda Sanitaria Provinciale (ASP) Catanzaro, 88100 Catanzaro, Italy
| | - Roberta De Angelis
- Unit of Cancer Epidemiology and Genetics, Department of Oncology and Molecular Medicine, ISTITUTO SUPERIORE DI SANITA' (Italian National Institute of Health), 00161 Rome, Italy
| | - Carlotta Buzzoni
- Tuscany Cancer Registry, Clinical and Descriptive Epidemiology Unit, Cancer Prevention and Research Institute (ISPRO), 50139 Florence, Italy.,AIRTUM Database, Registro Tumori Toscano, Istituto per lo Studio e la Prevenzione Oncologica, SC Epidemiologia Clinica, 50139 Florence, Italy
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11
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Dal Maso L, Panato C, Guzzinati S, Serraino D, Francisci S, Botta L, Capocaccia R, Tavilla A, Gigli A, Crocetti E, Rugge M, Tagliabue G, Filiberti RA, Carrozzi G, Michiara M, Ferretti S, Cesaraccio R, Tumino R, Falcini F, Stracci F, Torrisi A, Mazzoleni G, Fusco M, Rosso S, Tisano F, Fanetti AC, Sini GM, Buzzoni C, De Angelis R. Prognosis and cure of long-term cancer survivors: A population-based estimation. Cancer Med 2019; 8:4497-4507. [PMID: 31207165 PMCID: PMC6675712 DOI: 10.1002/cam4.2276] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [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: 04/11/2019] [Accepted: 05/06/2019] [Indexed: 12/30/2022] Open
Abstract
Background Increasing evidence of cure for some neoplasms has emerged in recent years. The study aimed to estimate population‐based indicators of cancer cure. Methods Information on more than half a million cancer patients aged 15‐74 years collected by population‐based Italian cancer registries and mixture cure models were used to estimate the life expectancy of fatal tumors (LEFT), proportions of patients with similar death rates of the general population (cure fraction), and time to reach 5‐year conditional relative survival (CRS) >90% or 95% (time to cure). Results Between 1990 and 2000, the median LEFT increased >1 year for breast (from 8.1 to 9.4 years) and prostate cancers (from 5.2 to 7.4 years). Median LEFT in 1990 was >5 years for testicular cancers (5.8) and Hodgkin lymphoma (6.3) below 45 years of age. In both sexes, it was ≤0.5 years for pancreatic cancers and NHL in 1990 and in 2000. The cure fraction showed a 10% increase between 1990 and 2000. It was 95% for thyroid cancer in women, 94% for testis, 75% for prostate, 67% for breast cancers, and <20% for liver, lung, and pancreatic cancers. Time to 5‐year CRS >95% was <10 years for testis, thyroid, colon cancers, and melanoma. For breast and prostate cancers, the 5‐year CRS >90% was reached in <10 years but a small excess remained for >15 years. Conclusions The study findings confirmed that several cancer types are curable. Became aware of the possibility of cancer cure has relevant clinical and social impacts.
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Affiliation(s)
- Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Chiara Panato
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | | | - Diego Serraino
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Silvia Francisci
- National Center for Prevention and Health Promotion, Italian National Institute of Health (ISS), Rome, Italy
| | - Laura Botta
- Evaluative Epidemiology Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Riccardo Capocaccia
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Andrea Tavilla
- National Center for Prevention and Health Promotion, Italian National Institute of Health (ISS), Rome, Italy
| | - Anna Gigli
- Institute for Research on Population and Social Policies, National Research Council, Rome, Italy
| | - Emanuele Crocetti
- Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS and Azienda Usl della Romagna, Meldola (Forlì), Italy
| | - Massimo Rugge
- Veneto Tumour Registry, Azienda Zero, Padua, Italy.,Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Giovanna Tagliabue
- Lombardy Cancer Registry-Varese Province, Cancer Registry Unit, Department of Research, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Rosa Angela Filiberti
- Liguria Cancer Registry, Clinical Epidemiology, IRCCS Policlinico San Martino, Genova, Italy
| | - Giuliano Carrozzi
- Modena Cancer Registry, Public Health Department, AUSL Modena, Modena, Italy
| | - Maria Michiara
- Parma Cancer Registry, Oncology Unit, Azienda Ospedaliera Universitaria di Parma, Parma, Italy
| | - Stefano Ferretti
- Romagna Cancer Registry - Section of Ferrara. Local Health Unit, University of Ferrara, Ferrara, Italy
| | - Rosaria Cesaraccio
- North Sardinia Cancer Registry, Azienda Regionale per la Tutela della Salute, Sassari, Italy
| | | | - Fabio Falcini
- Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS and Azienda Usl della Romagna, Meldola (Forlì), Italy
| | - Fabrizio Stracci
- Public Health Section, Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | | | | | - Mario Fusco
- Cancer Registry of ASL Napoli 3 Sud, Napoli, Italy
| | - Stefano Rosso
- Registro Tumori Piemonte, Provincia di Biella CPO, Biella, Italy
| | - Francesco Tisano
- Cancer Registry of the Province of Siracusa, Local Health Unit of Siracusa, Siracusa, Italy
| | - Anna Clara Fanetti
- Sondrio Cancer Registry, Epidemiology unit, ATS della Montagna, Sondrio, Italy
| | | | - Carlotta Buzzoni
- Tuscany Cancer Registry, Clinical and Descriptive Epidemiology Unit, Cancer Prevention and Research Institute (ISPO), Florence, Italy.,AIRTUM Database, Florence, Italy
| | - Roberta De Angelis
- Department of Oncology and Molecular Medicine, Italian National Institute of Health (ISS), Rome, Italy
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12
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Riccò M, Razio B, Panato C, Poletti L, Signorelli C. Knowledge, Attitudes and Practices of Agricultural Workers towards Tetanus Vaccine: a Field Report. Ann Ig 2018; 29:239-255. [PMID: 28569334 DOI: 10.7416/ai.2017.2156] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Agricultural Workers are both more exposed to tetanus and at higher risk to be inadequately immunized than other usual recipients of the same vaccine. STUDY DESIGN Our cross-sectional questionnaire-based study aimed to evaluate tetanus vaccination status, knowledge, attitudes and practices in Agricultural Workers in North-Eastern Italy. METHODS Bivariate and multivariate logistic regression analyses were used to identify, from individual and work-related characteristics, factors significantly associated with appropriate vaccination status. RESULTS Among 707 participants, 58.4% had an up-to-date immunization status. In 33.1%, last booster was performed by an Emergency Department. The main reason for inadequate immunization was having forgotten the recommended periodic booster (146/707; 20.7%). Attitude towards tetanus vaccination was somehow favourable in 79.5% of participants, and 72.7% correctly identified tetanus vaccination as mandatory for Agricultural Workers. A lower degree of false beliefs and better knowledge of official recommendations were significant predictors of vaccine propensity. The main predictor for an appropriate vaccination status was interaction with a healthcare provider, in general (adjusted Odds Ratio, adjOR 2.516 95%CI 1.707-3.710), and specifically regarding vaccine counseling, (adjOR 6.275 3.184-12.367 and adjOR 9.739 95%CI 3.933-24.111 for general practitioners and occupational physicians, respectively). CONCLUSIONS Our study enlightens the key role of healthcare providers in recalling and promoting vaccination policies, as well in increasing the general awareness of Agricultural Workers regarding vaccines and official recommendations.
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Affiliation(s)
- M Riccò
- Occupational Health and Safety Unit, Department of Prevention, Provincial Agency for Health Services of the Autonomous Province of Trento, Italy
| | - B Razio
- First cycle degree in Environment and Workplace Prevention Techniques, University of Trento, Italy
| | - C Panato
- First cycle degree in Environment and Workplace Prevention Techniques, University of Trento, Italy
| | - L Poletti
- First cycle degree in Environment and Workplace Prevention Techniques, University of Trento, Italy
| | - C Signorelli
- Department of Biomedical, Biotechnological and Translational Sciences, University of Parma, Italy - School of Medicine, University Vita-Salute San Raffaele IRCCS, Milan, Italy
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13
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Panato C, Abusamaan K, Bidoli E, Hamdi-Cherif M, Pierannunzio D, Ferretti S, Daher M, Elissawi F, Serraino D. Survival after the diagnosis of breast or colorectal cancer in the GAZA Strip from 2005 to 2014. BMC Cancer 2018; 18:632. [PMID: 29866055 PMCID: PMC5987449 DOI: 10.1186/s12885-018-4552-x] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 05/24/2018] [Indexed: 02/03/2023] Open
Abstract
Background Within a dramatic socio-political context, cancer represents a growing health burden in the Gaza Strip. We investigated the survival experience of people diagnosed with breast (BC) or colorectal (CRC) cancer from 2005 to 2014. Methods Data included 1360 BC cases (median age 55.1 years) and 722 CRC cases (median age: 59.5 years; 52.5% men) recorded by the Gaza Cancer Registry according to a standard protocol. Clinical information was available for cases diagnosed in 2005–2006 only. Survival probabilities were estimated by Kaplan-Meyer method, while hazard ratios (HRs) and 95% confidence intervals (CI), adjusted for age and sex, were computed to assess factors associated with the risk of death. Results Five-year survival was 65.1% for women with BC and 50.2% for patients with CRC. Advanced age (> 65 years), stage, and grade increased the death risk. Full access to therapies was associated with a reduced risk of death as compared with patients who had limited access (HR = 0.26, 95% CI:0.13–0.51 for BC; and HR = 0.11, 95% CI:0.04–0.31 for CRC). Conclusion(s) The 5-year survival after BC or CRC in the Gaza Strip was in line with estimates from surrounding Arab countries, but it was much lower than in developed Mediterranean countries (e.g., in Italy or in Jewish people in Israel).
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Affiliation(s)
- Chiara Panato
- Cancer Epidemiology Unit, IRCCS Centro di Riferimento Oncologico, Aviano, Italy
| | - Khaled Abusamaan
- Ministry of Health, PHC, Training and Education Department, Gaza, Palestine
| | - Ettore Bidoli
- Cancer Epidemiology Unit, IRCCS Centro di Riferimento Oncologico, Aviano, Italy
| | | | - Daniela Pierannunzio
- Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, Rome, Italy
| | - Stefano Ferretti
- Dipartment Morfologia, Chirurgia e Medicina Sperimentale, Università di Ferrara - Registro Tumori Area Vasta Emilia Centrale, Azienda USL Ferrara, - Servizio Prevenzione collettiva e Sanità pubblica, Ferrara, Regione Emilia-Romagna, Italy
| | - Mahmoud Daher
- WHO Office. Occupied Palestinian Territory, UNDP Building, Elnasr Street, Gaza, Palestine
| | - Fouad Elissawi
- Ministry of Health, Primary Health Care directorate, Gaza, Palestine
| | - Diego Serraino
- Cancer Epidemiology Unit, IRCCS Centro di Riferimento Oncologico, Aviano, Italy. .,Friuli Venezia Giulia Cancer Registry, IRCCS Centro di Riferimento Oncologico, Aviano, Italy.
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14
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Dal Maso L, Panato C, Franceschi S, Serraino D, Buzzoni C, Busco S, Ferretti S, Torrisi A, Falcini F, Zorzi M, Cirilli C, Mazzucco W, Magoni M, Collarile P, Pannozzo F, Caiazzo AL, Russo AG, Gili A, Caldarella A, Zanetti R, Michiara M, Mangone L, Filiberti RA, Fusco M, Gasparini F, Tagliabue G, Cesaraccio R, Tumino R, Gatti L, Tisano F, Piffer S, Sini GM, Mazzoleni G, Rosso S, Fanetti AC, Vaccarella S. The impact of overdiagnosis on thyroid cancer epidemic in Italy,1998-2012. Eur J Cancer 2018; 94:6-15. [PMID: 29502036 DOI: 10.1016/j.ejca.2018.01.083] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [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: 12/12/2017] [Revised: 01/16/2018] [Accepted: 01/20/2018] [Indexed: 01/08/2023]
Abstract
AIMS In Italy, incidence rates of thyroid cancer (TC) are among the highest worldwide with substantial intracountry heterogeneity. The aim of the study was to examine time trends of TC incidence in Italy and to estimate the proportion of TC cases potentially attributable to overdiagnosis. METHODS Data on TC cases reported to Italian cancer registries during 1998-2012 aged <85 years were included. Age-standardised incidence rates (ASR) were computed by sex, period, and histology. TC overdiagnosis was estimated by sex, period, age, and Italian region. RESULTS In Italy between 1998-2002 and 2008-2012, TC ASR increased of 74% in women (from 16.2 to 28.2/100,000) and of 90% in men (from 5.3 to 10.1/100,000). ASR increases were nearly exclusively due to papillary TC (+91% in women, +120% in men). In both sexes, more than three-fold differences emerged between regions with highest and lowest ASR. Among TC cases diagnosed in 1998-2012 in Italy, we estimated that overdiagnosis accounted for 75% of cases in women and 63% in men and increased over the study period leading to overdiagnosis of 79% in women and 67% in men in 2008-2012. Notably, overdiagnosis was over 80% among women aged <55 years, and substantial variations were documented across Italian regions, in both genders. CONCLUSION(S) Incidence rates of TC are steadily increasing in Italy and largely due to overdiagnosis. These findings call for an update of thyroid gland examination practices in the asymptomatic general population, at national and regional levels.
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Affiliation(s)
- Luigino Dal Maso
- Cancer Epidemiology Unit, CRO Aviano National Cancer Institute IRCCS, Aviano, Italy.
| | - Chiara Panato
- Cancer Epidemiology Unit, CRO Aviano National Cancer Institute IRCCS, Aviano, Italy
| | | | - Diego Serraino
- Cancer Epidemiology Unit, CRO Aviano National Cancer Institute IRCCS, Aviano, Italy
| | - Carlotta Buzzoni
- Tuscany Cancer Registry, Clinical and Descriptive Epidemiology Unit, Cancer Prevention and Research Institute (ISPO), Florence, Italy; AIRTUM Database, Florence, Italy
| | - Susanna Busco
- Cancer Registry of Latina Province, ASL Latina, Italy
| | - Stefano Ferretti
- Ferrara Cancer Registry, University of Ferrara, Azienda USL Ferrara, Italy
| | - Antonietta Torrisi
- Registro Tumori Integrato Catania-Messina-Siracusa-Enna, Università Degli Studi di Catania, Italy
| | - Fabio Falcini
- Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (Forlì), Italy-Azienda Usl della Romagna, Forlì, Italy
| | - Manuel Zorzi
- Veneto Tumor Registry, Veneto Region, Padua, Italy
| | - Claudia Cirilli
- Modena Cancer Registry, Public Health Department, AUSL Modena, Italy
| | - Walter Mazzucco
- Palermo and Province Cancer Registry, Clinical Epidemiology Unit with Cancer Registry, Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone", University of Palermo, Italy
| | - Michele Magoni
- Brescia Cancer Registry, Epidemiology Unit, Brescia Health Protection Agency, Italy
| | - Paolo Collarile
- Cancer Epidemiology Unit, CRO Aviano National Cancer Institute IRCCS, Aviano, Italy
| | | | | | | | - Alessio Gili
- Public Health Section, Dept. of Experimental Medicine, University of Perugia, Italy
| | - Adele Caldarella
- Tuscany Cancer Registry, Clinical and Descriptive Epidemiology Unit, Cancer Prevention and Research Institute (ISPO), Florence, Italy
| | - Roberto Zanetti
- Piedmont Cancer Registry, City of Torino, Ospedale S. Giovanni Battista-CPO, Torino, Italy
| | - Maria Michiara
- Parma Cancer Registry, Oncology Unit, Azienda Ospedaliera Universitaria di Parma, Italy
| | - Lucia Mangone
- Reggio Emilia Cancer Registry, Epidemiology Unit, AUSL ASMN-IRCCS, Azienda USL di Reggio Emilia, Italy
| | - Rosa Angela Filiberti
- Liguria Region Cancer Registry, Epidemiologia Clinica, Ospedale Policlinico San Martino IRCCS, Genova, Italy
| | - Mario Fusco
- Cancer Registry of ASL Napoli 3 Sud, Napoli, Italy
| | | | - Giovanna Tagliabue
- Lombardy Cancer Registry, Varese Province, Cancer Registry Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Rosaria Cesaraccio
- North Sardinia Cancer Registry, Azienda Regionale per la Tutela della Salute, Sassari, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, "Civic - M.P. Arezzo" Hospital, ASP Ragusa, Italy
| | - Luciana Gatti
- Mantova Cancer Registry, Epidemilogy Unit, Agenzia di Tutela Della Salute (ATS) Della Val Padana, Mantova, Italy
| | - Francesco Tisano
- Cancer Registry of the Province of Siracusa, Local Health Unit of Siracusa, Italy
| | - Silvano Piffer
- Trento Province Cancer Registry, Unit of Clinical Epidemiology, Trento, Italy
| | | | | | - Stefano Rosso
- Piedmont Cancer Registry, Biella Province, Biella, Italy
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15
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Guzzinati S, Virdone S, De Angelis R, Panato C, Buzzoni C, Capocaccia R, Francisci S, Gigli A, Zorzi M, Tagliabue G, Serraino D, Falcini F, Casella C, Russo AG, Stracci F, Caruso B, Michiara M, Caiazzo AL, Castaing M, Ferretti S, Mangone L, Rudisi G, Sensi F, Mazzoleni G, Pannozzo F, Tumino R, Fusco M, Ricci P, Gola G, Giacomin A, Tisano F, Candela G, Fanetti AC, Pala F, Sardo AS, Rugge M, Botta L, Dal Maso L. Characteristics of people living in Italy after a cancer diagnosis in 2010 and projections to 2020. BMC Cancer 2018; 18:169. [PMID: 29426306 PMCID: PMC5807846 DOI: 10.1186/s12885-018-4053-y] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 01/25/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Estimates of cancer prevalence are widely based on limited duration, often including patients living after a cancer diagnosis made in the previous 5 years and less frequently on complete prevalence (i.e., including all patients regardless of the time elapsed since diagnosis). This study aims to provide estimates of complete cancer prevalence in Italy by sex, age, and time since diagnosis for all cancers combined, and for selected cancer types. Projections were made up to 2020, overall and by time since diagnosis. METHODS Data were from 27 Italian population-based cancer registries, covering 32% of the Italian population, able to provide at least 7 years of registration as of December 2009 and follow-up of vital status as of December 2013. The data were used to compute the limited-duration prevalence, in order to estimate the complete prevalence by means of the COMPREV software. RESULTS In 2010, 2,637,975 persons were estimated to live in Italy after a cancer diagnosis, 1.2 million men and 1.4 million women, or 4.6% of the Italian population. A quarter of male prevalent cases had prostate cancer (n = 305,044), while 42% of prevalent women had breast cancer (n = 604,841). More than 1.5 million people (2.7% of Italians) were alive since 5 or more years after diagnosis and 20% since ≥15 years. It is projected that, in 2020 in Italy, there will be 3.6 million prevalent cancer cases (+ 37% vs 2010). The largest 10-year increases are foreseen for prostate (+ 85%) and for thyroid cancers (+ 79%), and for long-term survivors diagnosed since 20 or more years (+ 45%). Among the population aged ≥75 years, 22% will have had a previous cancer diagnosis. CONCLUSIONS The number of persons living after a cancer diagnosis is estimated to rise of approximately 3% per year in Italy. The availability of detailed estimates and projections of the complete prevalence are intended to help the implementation of guidelines aimed to enhance the long-term follow-up of cancer survivors and to contribute their rehabilitation needs.
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Affiliation(s)
- Stefano Guzzinati
- Veneto Tumor Registry, Veneto Region, Padova, Passaggio Gaudenzio 1, 35131 Padova, Italy
| | - Saverio Virdone
- Cancer Epidemiology Unit, CRO Aviano National Cancer Institute IRCCS, Via Franco Gallini 2, 33081 Aviano, PN Italy
| | | | - Chiara Panato
- Cancer Epidemiology Unit, CRO Aviano National Cancer Institute IRCCS, Via Franco Gallini 2, 33081 Aviano, PN Italy
| | - Carlotta Buzzoni
- Tuscany Cancer Registry, Clinical and Descriptive Epidemiology Unit, Cancer Prevention and Research Institute (ISPO), Florence, Italy
- AIRTUM Database, Florence, Italy
| | - Riccardo Capocaccia
- Dipartimento di Ricerca Epidemiologica e Medicina Molecolare (DREaMM), Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Anna Gigli
- Institute for Research on Population and Social Policies, National Research Council, Rome, Italy
| | - Manuel Zorzi
- Veneto Tumor Registry, Veneto Region, Padova, Passaggio Gaudenzio 1, 35131 Padova, Italy
| | - Giovanna Tagliabue
- Lombardy Cancer Registry, Varese Province, Cancer Registry Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Diego Serraino
- Cancer Epidemiology Unit, CRO Aviano National Cancer Institute IRCCS, Via Franco Gallini 2, 33081 Aviano, PN Italy
| | - Fabio Falcini
- Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (Forlì), Italy-Azienda Usl della Romagna, Forlì, Italy
| | - Claudia Casella
- Registro Tumori Ligure, Epidemiologia Clinica, Ospedale Policlinico San Martino IRCCS, Genova, Italy
| | - Antonio Giampiero Russo
- Cancer Registry of Milan, Epidemiology Unit, Agency for Health Protection of Milan, Milan, Italy
| | - Fabrizio Stracci
- Public Health Section, Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - Bianca Caruso
- Modena Cancer Registry, Public Health Department, AUSL Modena, Modena, Italy
| | - Maria Michiara
- Parma Cancer Registry, Oncology Unit, Azienda Ospedaliera Universitaria di Parma, Parma, Italy
| | | | - Marine Castaing
- Registro Tumori Integrato Catania-Messina-Siracusa-Enna, Università degli Studi di Catania, Catania, Italy
| | - Stefano Ferretti
- Ferrara Cancer Registry, Ferrara Local Health Board, University of Ferrara, USL Ferrara, Ferrara, Italy
| | - Lucia Mangone
- Reggio Emilia Cancer Registry, Epidemiology unit, AUSL ASMN-IRCCS, Azienda USL di Reggio Emilia, Reggio Emilia, Italy
| | - Giuseppa Rudisi
- Palermo and Province Cancer Registry, Clinical Epidemiology Unit, Azienda Ospedaliera Universitaria Policlinico “Paolo Giaccone”, Palermo, Italy
| | - Flavio Sensi
- North Sardinia Cancer Registry, Azienda Regionale per la Tutela della Salute, Sassari, Italy
| | | | - Fabio Pannozzo
- Cancer Registry of Latina Province, AUSL Latina, Latina, Italy
| | | | - Mario Fusco
- Cancer Registry of ASL Napoli 3 Sud, Napoli, Italy
| | - Paolo Ricci
- Mantova Cancer Registry, Epidemilogy Unit, Agenzia di Tutela della Salute (ATS) della Val Padana, Mantova, Italy
| | - Gemma Gola
- Como Cancer Registry, ATS Insubria, Varese, Italy
| | - Adriano Giacomin
- Registro Tumori Piemonte, Provincia di Biella CPO, Biella, Italy
| | - Francesco Tisano
- Cancer Registry of of the Province of Siracusa, Local Health Unit of Siracusa, Siracusa, Italy
| | - Giuseppa Candela
- Trapani Cancer Registry, Dipartimento di Prevenzione della Salute, Trapani, Italy
| | | | - Filomena Pala
- Nuoro Cancer Registry, RT Nuoro, ASSL Nuoro/ATS Sardegna, Nuoro, Italy
| | | | - Massimo Rugge
- Veneto Tumor Registry, Veneto Region, Padova, Passaggio Gaudenzio 1, 35131 Padova, Italy
- Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Laura Botta
- Dipartimento di Ricerca Epidemiologica e Medicina Molecolare (DREaMM), Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Luigino Dal Maso
- Cancer Epidemiology Unit, CRO Aviano National Cancer Institute IRCCS, Via Franco Gallini 2, 33081 Aviano, PN Italy
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16
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Riccò M, Razio B, Poletti L, Panato C, Vezzosi L, Odone A, Signorelli C. Sun protective behaviors in Agricultural Workers from North-Eastern Italy (2016). Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx189.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- M Riccò
- Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | - B Razio
- University of Trento/Verona, Trento, Italy
| | - L Poletti
- University of Trento/Verona, Trento, Italy
| | - C Panato
- University of Trento/Verona, Trento, Italy
| | | | - A Odone
- University of Parma, Parma, Italy
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17
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Razio B, Panato C, Poletti L, Vezzosi L, Riccò M. Climate changes and Workplace Heath Exposure: knowledge and perceptions of Safety Representatives. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- B Razio
- Provincial Agency for Health Services of the Autonomous Province of Trento, Trento, Italy
| | - C Panato
- University of Verona/Trento, Trento, Italy
| | - L Poletti
- University of Verona/Trento, Trento, Italy
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18
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Spessotto P, Fornasarig M, Pivetta E, Maiero S, Magris R, Mongiat M, Canzonieri V, De Paoli P, De Paoli A, Buonadonna A, Serraino D, Panato C, Belluco C, Cannizzaro R. Probe-based confocal laser endomicroscopy for in vivo evaluation of the tumor vasculature in gastric and rectal carcinomas. Sci Rep 2017; 7:9819. [PMID: 28852161 PMCID: PMC5575283 DOI: 10.1038/s41598-017-10963-1] [Citation(s) in RCA: 17] [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] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 08/17/2017] [Indexed: 12/17/2022] Open
Abstract
Probe-based Confocal Laser Endomicroscopy (pCLE) is a powerful imaging technique that allows to perform gastrointestinal endomicroscopy at subcellular resolution. The aim of this study was to assess the use of pCLE to evaluate tumor angiogenesis in rectal and gastric cancers. A total of 35 consecutive patients with gastric and 91 with rectal carcinomas underwent endoscopy and pCLE during the same examination. Vascular assessment was based on vessel shape and size, vessel permeability and blood flow, and allowed the creation of an angiogenic score ranging from 0, for normal vasculature, to 4, for aberrant vasculature. A significant difference for the presence of vessels with large diameter and defective blood flow was found between rectal and gastric cancers. Overall, rectal cancers displayed a higher angiogenic score compared to gastric cancers. Conventional therapy induced a striking reduction in the angiogenic score only in rectal cancer patients. Taken together, our findings suggest that the pCLE technology is suitable for the evaluation of the tumor microvasculature abnormalities. Therefore, the real-time assessment of the vasculature status may represent a promising approach to predict the efficacy of the treatments and improve the clinical management of patients with gastric or rectal carcinomas.
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Affiliation(s)
- Paola Spessotto
- Molecular Oncology, Department of Translational Research, CRO-IRCCS, National Cancer Institute, Aviano, Italy
| | - Mara Fornasarig
- Gastroenterology, CRO-IRCCS, National Cancer Institute, Aviano, Italy
| | - Eliana Pivetta
- Molecular Oncology, Department of Translational Research, CRO-IRCCS, National Cancer Institute, Aviano, Italy
| | - Stefania Maiero
- Gastroenterology, CRO-IRCCS, National Cancer Institute, Aviano, Italy
| | - Raffaella Magris
- Gastroenterology, CRO-IRCCS, National Cancer Institute, Aviano, Italy
| | - Maurizio Mongiat
- Molecular Oncology, Department of Translational Research, CRO-IRCCS, National Cancer Institute, Aviano, Italy
| | | | - Paolo De Paoli
- Scientific Directorate, CRO-IRCCS, National Cancer Institute, Aviano, Italy
| | - Antonino De Paoli
- Radiation Oncology, CRO-IRCCS, National Cancer Institute, Aviano, Italy
| | - Angela Buonadonna
- Medical Oncology, CRO-IRCCS, National Cancer Institute, Aviano, Italy
| | - Diego Serraino
- Epidemiology and Biostatistics, CRO-IRCCS, National Cancer Institute, Aviano, Italy
| | - Chiara Panato
- Epidemiology and Biostatistics, CRO-IRCCS, National Cancer Institute, Aviano, Italy
| | - Claudio Belluco
- Surgical Oncology, CRO-IRCCS, National Cancer Institute, Aviano, Italy
| | - Renato Cannizzaro
- Gastroenterology, CRO-IRCCS, National Cancer Institute, Aviano, Italy.
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19
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Collarile P, Bidoli E, Barbone F, Zanier L, Del Zotto S, Fuser S, Stel F, Panato C, Gallai I, Serraino D. Residence in Proximity of a Coal-Oil-Fired Thermal Power Plant and Risk of Lung and Bladder Cancer in North-Eastern Italy. A Population-Based Study: 1995-2009. Int J Environ Res Public Health 2017; 14:ijerph14080860. [PMID: 28788106 PMCID: PMC5580564 DOI: 10.3390/ijerph14080860] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 07/24/2017] [Accepted: 07/28/2017] [Indexed: 01/26/2023]
Abstract
This study investigated the risk of lung and bladder cancers in people residing in proximity of a coal-oil-fired thermal power plant in an area of north-eastern Italy, covered by a population-based cancer registry. Incidence rate ratios (IRR) by sex, age, and histology were computed according to tertiles of residential exposure to benzene, nitrogen dioxide (NO2), particular matter, and sulfur dioxide (SO2) among 1076 incident cases of lung and 650 cases of bladder cancers. In men of all ages and in women under 75 years of age, no significant associations were observed. Conversely, in women aged ≥75 years significantly increased risks of lung and bladder cancers were related to high exposure to benzene (IRR for highest vs. lowest tertile: 2.00 for lung cancer and 1.94 for bladder cancer) and NO2 (IRR: 1.72 for lung cancer; and 1.94 for bladder cancer). In these women, a 1.71-fold higher risk of lung cancer was also related to a high exposure to SO2. Acknowledging the limitations of our study, in particular that we did not have information regarding cigarette smoking habits, the findings of this study indicate that air pollution exposure may have had a role with regard to the risk of lung and bladder cancers limited to women aged ≥75 years. Such increased risk warrants further analytical investigations.
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Affiliation(s)
- Paolo Collarile
- Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, 33081 Aviano (PN), Italy.
| | - Ettore Bidoli
- Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, 33081 Aviano (PN), Italy.
| | - Fabio Barbone
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, 34137 Trieste, Italy.
- Department of Medical and Biological Sciences, University of Udine, 33100 Udine, Italy.
| | - Loris Zanier
- Epidemiologic Service, Regional Health Directorate of Friuli Venezia Giulia, 33100 Udine, Italy.
| | - Stefania Del Zotto
- Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, 33081 Aviano (PN), Italy.
| | - Simonetta Fuser
- Regional Environmental Protection Agency of Friuli Venezia Giulia, 33057 Palmanova (UD), Italy.
| | - Fulvio Stel
- Regional Environmental Protection Agency of Friuli Venezia Giulia, 33057 Palmanova (UD), Italy.
| | - Chiara Panato
- Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, 33081 Aviano (PN), Italy.
| | - Irene Gallai
- Regional Environmental Protection Agency of Friuli Venezia Giulia, 33057 Palmanova (UD), Italy.
| | - Diego Serraino
- Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, 33081 Aviano (PN), Italy.
- Friuli Venezia Giulia Cancer Registry, 33081 Aviano (PN), Italy.
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20
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Merler E, Girardi P, Panato C, Bressan V. [Increased risk of mesothelioma and lung cancer among workers exposed to asbestos who could require an anticipated retirement]. Epidemiol Prev 2016; 40:26-34. [PMID: 26951730 DOI: 10.19191/ep16.1s1.p026.027] [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: 06/05/2023]
Abstract
OBJECTIVES to assess the association among malignant pleural mesothelioma (MPM) and lung cancer (LC) among workers who have been exposed to asbestos and have or not have required an anticipated leave from work, a possibility offered by the 1992 law banning asbestos in Italy, in the framework of the health surveillance programmes on going in the Veneto Region (Northern Italy). SETTING AND PARTICIPANTS a cohort of asbestos workers derived from the rosters of selected factories and alive in 1992, followed from 1992 to 2012.MPM cases have been identified through the Regional Mesothelioma Registry, while LC cases through a link with the Regional Cancer Registry, hospital discharges, and death certificates. Risks related to asbestos exposure were calculated by mixed effects Poisson regression model. RESULTS the risk of MPM and LC increases at any additional duration of work, up to very high values for long term durations of work for MPM, and up to a three fold increase for LC. Early retirements have been requested by a fraction only in the position of submitting it. CONCLUSION subjects who have been exposed to asbestos should be the target of a post-occupational surveillance, and further work is suggested to identify subjects at high risk of LC because of smoking habits and more heavy exposure to asbestos, in order to develop programmes for primary and secondary cancer prevention.
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Affiliation(s)
- Enzo Merler
- Registro regionale veneto dei casi di mesotelioma, Servizio prevenzione igiene e sicurezza nei luoghi di lavoro (SPISAL), Azienda ULSS 16, Padova.
| | - Paolo Girardi
- Registro regionale veneto dei casi di mesotelioma, Servizio prevenzione igiene e sicurezza nei luoghi di lavoro (SPISAL), Azienda ULSS 16, Padova
- Sistema epidemiologico regionale, Regione Veneto, Padova
| | - Chiara Panato
- Registro regionale veneto dei casi di mesotelioma, Servizio prevenzione igiene e sicurezza nei luoghi di lavoro (SPISAL), Azienda ULSS 16, Padova
| | - Vittoria Bressan
- Registro regionale veneto dei casi di mesotelioma, Servizio prevenzione igiene e sicurezza nei luoghi di lavoro (SPISAL), Azienda ULSS 16, Padova
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