Lung cancer epidemiology in North Sardinia, Italy

Background The aim of this study was to analyze and describe the epidemiological characteristics and trends of lung cancer in North Sardinia, Italy, in the period 1992–2010. Methods Data were obtained from the tumor registry of Sassari province which is a part of a wider registry web, coordinated today by the Italian Association for Tumor Registries. Results The overall number of lung cancer cases registered was 4,325. The male-to-female ratio was 4.6:1 and the mean age 68.1 years for males and 67 years for females. The standardized incidence rates were 73.1/100,000 and 13.5/100,000 and the standardized mortality rates 55.7/100,000 and 9.9/100,000 for males and females, respectively. An increasing trend in incidence of lung cancer in women was evidenced. Conversely, incidence was found to decrease in males. Relative survival at 5 years from diagnosis was low (8.8% for males and 14.9% for females). Furthermore, an increase in mortality rates was observed in both sexes in the period under investigation. Conclusions Our data show an increasing trend of lung cancer incidence in women in North Sardinia in the last decades. Conversely, a reduction of incidence rates was observed in males. Furthermore, a slightly increasing trend in mortality rates was observed in both sexes, suggesting the need to enhance smoking control strategies, consider adoption of effective surveillance policies, and improve diagnosis and treatment methods

Effects of warmer and drier climate conditions on plant composition and biomass production in a Mediterranean shrubland community

The last IPCC report predicts warmer and drier conditions for the future European climate and the Mediterranean basin could be highly sensible to future climatic change. In order to investigate how the forecast more stressing factors could affect Mediterranean shrubland ecosystems, an appropriate manipulation of the microclimate was carried out in an area covered by Mediterranean maquis aimed at extending the drought period and increasing the night-time temperature. Soil cover, plant growth, litterfall, leaf water status, and leaf nutritional status were monitored over three growing seasons. The manipulation altered the microclimate according to common scenarios, increasing mean annual night-time air temperature by about 1 °C and mean annual temperature by about 0.5 °C, and decreasing precipitation between 6-46% of the total rainfall during the growing seasons. A general increase of vegetation cover was observed in the whole community during the three years of experimentation. This positive temporal pattern was mainly observed in control and warming treatment, whereas in the drought treatment it was less evident. At species-specific level, a clear negative effect of drought treatment was observed for C. monspeliensis percentage cover. Shoot elongation was not significantly affected by the warming treatment. A significant negative effect of drought treatment was noticed in the 2001-2002 and 2002-2003 growing seasons. An increase of N and P concentrations in the drought treatment in Cistus was observed and it can be explained by the reduced shoot growth induced by the water shortage that we had observed in the same treatment. The absence of a concentration effect on the other two species could be the signal of the different behaviour with regard to a drier climate, and therefore could be a symptom of future change in species composition. We underline the need of longterm observation, because of the different responses of plants in the short and long- term conditions

Una Nuova area sperimentale di lungo termine, per lo studio degli effetti dell'incremento della temperatura e del periodo di aridità in formazioni di sclerofille mediterranee

A new long-term experimental area for studying the effects of climate warming and seasonal drought on a Mediterranean shrubland community. Global changes, such as land use changes, altered atmosphere composition, and climate changes, have been altering the functioning of ecosystems with possible impacts on the degree of biodiversity. Temperature and water availability are the two main determinants of the functional processes of terrestrial ecosystems. Climatic changes could have strong effects on vulnerable ecosystems as Mediterranean shrublands/garrigue/maquis, where the growth and survival of the plants are strictly dependent on the drought and to the high summer temperature. Furthermore, other pressures, such as grazing and wildfires, occur frequently in the Mediterranean area. In order to assess the impacts of the temperature increase and precipitation reduction on Mediterranean shrublands, a new experimental area was established in Sardinia at the Porto Conte forest, Alghero (SS). A system of automatic roofs covers 6 experimental plots (20 m2), in order to simulate an increase of temperature during the night (3 plots) or to intercept the precipitations during a 2-3 months period (3 plots). Three additional plots are used as control. All the observations were conducted in other five European shrubland ecosystems, according to common protocols developed in the context of the European project VULCAN (www.vulcanproject.com). The studies of the different ecological and physiological processes are organised in working packages (Plant, Soil, Fauna, Water) and integrated in a risk assessments evaluation. The aim of this paper is to analyse the first two years of data, to demonstrate the microclimatic modifications induced by the experimental system

Progettazione di un sistema CAD per le colonscopie virtuali

Il lavoro di tesi &egrave consistito nella progettazione e nell'implementazione di un sistema di computer assisted diagnosis per l'ispezione e la manipolazione di dataset volumetrici di tipo biomedico. Il sistema &egrave stato inoltre specializzato e sperimentato su colonscopie virtuali

Using long-term data and crop modelling to assess climate change impacts on durum wheat production in the Mediterranean

Future projections of climate for the Mediterranean area indicate an increasing trend for temperature and a reduction in annual rainfall amounts during the next decades (lPCC, 2007). Different crop models were recently used to predict responses of crops to climate changes, to analyse the most appropriate actions to mitigate potential effects, and to propose guidelines for adaptation (Ludwig and Asseng, 2006; Tubiello 2000). In this study, 30-year climate and durum wheat yield datasets from two experimental sites located in southern Sardinia, Italy, were used for CERES-Wheat model calibration and validation, with the purpose of determining the impact of climate change on production

Global surveillance of cancer survival 1995-2009: analysis of individual data for 25,676,887 patients from 279 population-based registries in 67 countries (CONCORD-2)

BACKGROUND: Worldwide data for cancer survival are scarce. We aimed to initiate worldwide surveillance of cancer survival by central analysis of population-based registry data, as a metric of the effectiveness of health systems, and to inform global policy on cancer control. METHODS: Individual tumour records were submitted by 279 population-based cancer registries in 67 countries for 25·7 million adults (age 15-99 years) and 75,000 children (age 0-14 years) diagnosed with cancer during 1995-2009 and followed up to Dec 31, 2009, or later. We looked at cancers of the stomach, colon, rectum, liver, lung, breast (women), cervix, ovary, and prostate in adults, and adult and childhood leukaemia. Standardised quality control procedures were applied; errors were corrected by the registry concerned. We estimated 5-year net survival, adjusted for background mortality in every country or region by age (single year), sex, and calendar year, and by race or ethnic origin in some countries. Estimates were age-standardised with the International Cancer Survival Standard weights. FINDINGS: 5-year survival from colon, rectal, and breast cancers has increased steadily in most developed countries. For patients diagnosed during 2005-09, survival for colon and rectal cancer reached 60% or more in 22 countries around the world; for breast cancer, 5-year survival rose to 85% or higher in 17 countries worldwide. Liver and lung cancer remain lethal in all nations: for both cancers, 5-year survival is below 20% everywhere in Europe, in the range 15-19% in North America, and as low as 7-9% in Mongolia and Thailand. Striking rises in 5-year survival from prostate cancer have occurred in many countries: survival rose by 10-20% between 1995-99 and 2005-09 in 22 countries in South America, Asia, and Europe, but survival still varies widely around the world, from less than 60% in Bulgaria and Thailand to 95% or more in Brazil, Puerto Rico, and the USA. For cervical cancer, national estimates of 5-year survival range from less than 50% to more than 70%; regional variations are much wider, and improvements between 1995-99 and 2005-09 have generally been slight. For women diagnosed with ovarian cancer in 2005-09, 5-year survival was 40% or higher only in Ecuador, the USA, and 17 countries in Asia and Europe. 5-year survival for stomach cancer in 2005-09 was high (54-58%) in Japan and South Korea, compared with less than 40% in other countries. By contrast, 5-year survival from adult leukaemia in Japan and South Korea (18-23%) is lower than in most other countries. 5-year survival from childhood acute lymphoblastic leukaemia is less than 60% in several countries, but as high as 90% in Canada and four European countries, which suggests major deficiencies in the management of a largely curable disease. INTERPRETATION: International comparison of survival trends reveals very wide differences that are likely to be attributable to differences in access to early diagnosis and optimum treatment. Continuous worldwide surveillance of cancer survival should become an indispensable source of information for cancer patients and researchers and a stimulus for politicians to improve health policy and health-care systems

Characteristics of the colorectal cancers diagnosed in the early 2000s in Italy. Figures from the IMPATTO study on colorectal cancer screening

The impact of organized screening programmes on colorectal cancer (CRC) can be observed at a population level only several years after the implementation of screening. We compared CRC characteristics by diagnostic modality (screen-detected, non-screen-detected) as an early outcome to monitor screening programme effectiveness. Data on CRCs diagnosed in Italy from 2000 to 2008 were collected by several cancer registries. Linkage with screening datasets made it possible to divide the cases by geographic area, implementation of screening, and modality of diagnosis (screen-detected, non-screen-detected).We compared the main characteristics of the different subgroups of CRCs through multivariate logistic regression models. The study included 23,668 CRCs diagnosed in subjects aged 50-69 years, of which 11.9%were screendetected (N=2,806), all from the North-Centre of Italy. Among screen-detected CRCs, we observed a higher proportion of males, of cases in the distal colon, and a higher mean age of the patients. Compared with pre-screening cases, screen-detected CRCs showed a better distribution by stage at diagnosis (OR for stage III or IV: 0.40, 95%CI: 0.36-0.44) and grading (OR for poorly differentiated CRCs was 0.86, 95%CI: 0.75-1.00). Screen-detected CRCs have more favourable prognostic characteristics than non-screen-detected cases. A renewed effort to implement screening programmes throughout the entire country is recommended

Colorectal cancer epidemiology in an area with a spontaneous screening program

The aim of this study was to analyze and describe the epidemiological characteristics and trends of colorectal cancer in Sassari province (Sardinia, Italy), an area with a spontaneous surveillance program for colorectal malignancies, in the period 1992–2010. Data were obtained from the local tumor registry which makes part of a wider registry web, coordinated, today, by the Italian Association for Tumor Registries. The overall number of colorectal cancer cases registered was 4.284. The male-to-female ratio was 1:0.7 and the mean age 68.3 years for males and 69.4 years for females. The standardized incidence rates were 49.3/100,000 and 31.1/100,000 and the standardized mortality rates 20.4/100,000 and 12.4/100,000 for males and females respectively. An increasing trend in the incidence of colorectal cancer in Sassari province was evidenced. Relative survival at 5 years from diagnosis was 48.6% (52.3% for males and 44.7% for females). A slight increase in mortality rates was observed, as opposed to national figures, probably attributable to the lacking of organized screening strategies in the area

Incidence trends of colorectal cancer in the early 2000s in Italy. Figures from the IMPATTO study on colorectal cancer screening

We utilised the IMPATTO study's archives to describe the 2000-2008 colorectal cancer (CRC) incidence rate trends in Italy, once screening programmes based on the faecal immunochemical test were implemented in different areas. Data on CRCs diagnosed in Italy from 2000 to 2008 in subjects aged 40-79 years were collected by 23 cancer registries. Incidence rate trends were evaluated as a whole and by macro-area (North-Centre and South-Islands), presence of a screening programme, sex, ten-year age class, anatomic site, stage at diagnosis, and pattern of diagnosis (screen-detected, non-screen-detected). The annual percent change (APC) of incidence rate trends, with 95% confidence intervals (95%CI), were computed. The study included 46,857 CRCs diagnosed in subjects aged 40-79 years, of which 2,806 were screendetected. The incidence rates in the North-Centre were higher than in the South and on the Islands. During the study period, screening programmes had been implemented only in the North-Centre and had a significant effect on incidence rates, with an initial sharp increase in incidence, followed by a decrease that started in the 3rd-4th years of screening. These incidence rate trends were exclusively due to modifications in the rates of stage I cases. After screening programmes started, incidence increased in all anatomic sites, particularly in the distal colon. The differential figures introduced by the implementation of screening programmes warrant a continuous surveillance of CRC incidence and mortality trends to monitor the impact of screening at a national level

Role of BRCA2 mutation status on overall survival among breast cancer patients from Sardinia

Background: Germline mutations in BRCA1 or BRCA2 genes have been demonstrated to increase the risk of developing breast cancer. Conversely, the impact of BRCA mutations on prognosis and survival of breast cancer patients is still debated. In this study, we investigated the role of such mutations on breast cancer-specific survival among patients from North Sardinia. Methods: Among incident cases during the period 1997–2002, a total of 512 breast cancer patients gave their consent to undergo BRCA mutation screening by DHPLC analysis and automated DNA sequencing. The Hakulinen, Kaplan-Meier, and Cox regression methods were used for both relative survival assessment and statistical analysis. Results: In our series, patients carrying a germline mutation in coding regions and splice boundaries of BRCA1 and BRCA2 genes were 48/512 (9%). Effect on overall survival was evaluated taking into consideration BRCA2 carriers, who represented the vast majority (44/48; 92%) of mutation-positive patients. A lower breast cancer-specific overall survival rate was observed in BRCA2 mutation carriers after the first two years from diagnosis. However, survival rates were similar in both groups after five years from diagnosis. No significant difference was found for age of onset, disease stage, and primary tumour histopathology between the two subsets. Conclusion: In Sardinian breast cancer population, BRCA2 was the most affected gene and the effects of BRCA2 germline mutations on patients' survival were demonstrated to vary within the first two years from diagnosis. After a longer follow-up observation, breast cancer-specific rates of death were instead similar for BRCA2 mutation carriers and non-carriers