What if cancer survival in Britain were the same as in Europe: how many deaths are avoidable?

OBJECTIVE: To estimate the number of deaths among cancer patients diagnosed in Great Britain that would be avoidable within 5 years of diagnosis if the mean (or highest) survival in Europe for patients diagnosed during 1985-1989, 1990-1994 and 1995-1999 were achieved. DESIGN: Five-year relative survival for cancers in Great Britain compared with that from other countries in the EUROCARE-2, -3 and -4 studies. Calculation of excess deaths (those more than expected from mortality in the general population) that would be avoidable among cancer patients in Britain if relative survival were the same as in Europe. SETTING: Great Britain (England, Wales, Scotland) and 13 other European countries. SUBJECTS: 2.8 million adults diagnosed in Britain with 1 of 39 cancers during 1985-1989 (followed up to 1994), 1990-1994 (followed up to 1999) and 1995-1999 (followed up to 2003). MAIN OUTCOME MEASURE: Annual number of avoidable deaths within 5 years of diagnosis. Percentage of the excess (cancer-related) deaths among cancer patients that would be avoidable. RESULTS: Compared with the mean European 5-year relative survival, the largest numbers of avoidable deaths for patients diagnosed during 1985-1989 were for cancers of the breast (about 18% of the excess mortality from this cancer, 7541 deaths), prostate (14%, 4285), colon (9%, 4090), stomach (8%, 3483) and lung (2%, 3548). For 1990-1994, the largest numbers of avoidable deaths were for cancers of the prostate (20%, 7335), breast (15%, 6165), colon (9%, 4376), stomach (9%, 3672), lung (2%, 3735) and kidney (22%, 2644). For 1995-1999, most of the avoidable deaths were for cancers of the prostate (17%, 5758), breast (15%, 5475), lung (3%, 4923), colon (10%, 4295), stomach (9%, 3137) and kidney (21%, 2686).Overall, some 6600-7500 premature deaths would have been avoided each year among cancer patients diagnosed in Britain during 1985-1999 if the mean survival in Europe had been achieved. This represents 6-7% of cancer-related mortality. Compared with the highest European survival, avoidable premature mortality among cancer patients fell from about 12 800 deaths a year (12.2% of cancer-related mortality) to about 11 400 deaths a year (10.6%) over the same period.A large component of the avoidable mortality is due to prostate cancer: excluding this cancer from comparison with the European mean survival reduces the annual number of avoidable deaths by 1000-1500, and the percentage of excess mortality by up to 1%. Compared with the highest survival, the annual number of avoidable deaths would be 1500-2000 fewer, and 1-2% lower as a percentage of excess mortality, but the overall trend in avoidable premature mortality among cancer patients would be similar, falling from 11.4% (1985-1989) to 10.3% (1990-1994) and 9.7% for those diagnosed during 1995-1999.For several cancers, survival in Britain was slightly higher than the mean survival in Europe; this represented some 110-180 premature deaths avoided each year during the period 1985-2003. CONCLUSIONS: Avoidable premature mortality among cancer patients diagnosed in Britain during 1985-1999 has represented 6-7% of cancer-related mortality compared with the mean survival in Europe. Compared with the highest levels of survival in Europe, the reduction from 12.2% to 10.6% of cancer-related mortality reflects small but steady progress over the period 1985-2003

Indoor height determination of the new absolute gravimetric station of L'Aquila

In this paper we describe all the field operations and the robust post-processing proceduresto determine the height of the new absolute gravimetric station purposely selected to belong to a new absolute gravimetric network and located in the Science Faculty of the L’Aquila University. This site has been realized indoor in the Geomagnetism laboratory, so that the height cannot be measured directly, but linking it to the GNSS antenna of AQUI benchmark located on the roof of the same building, by a classical topographic survey. After the topographic survey, the estimated height difference between AQUI and the absolute gravimetric site AQUIgis 14.970±0.003 m. At the epoch of the 2018 gravimetric measures, the height of AQUI GNSS station was 712.974±0.003 m, therefore the estimated ellipsoidalheight of the gravimetric site at the epoch of gravity measurements is 698.004±0.005 m. Absolute gravity measurements are referred to the equipotential surface of gravity field, so that the knowledge of the geoidal undulation at AQUIg allows us to infer the orthometric height as 649.32 m

Role of hormonal risk factors in HER2-positive breast carcinomas

Examination of parity, age at menarche and at menopause by HER2 status in a large series of breast carcinomas showed a statistically significant increased-frequency of HER2-positive tumours in lower risk subgroups. The findings suggest a difference in the protective role of hormone-related risk factors between HER2-positive and -negative tumour

Population-based monitoring of cancer patient survival in situations with imperfect completeness of cancer registration

Selective underascertainment of cases may bias estimates of cancer patient survival. We show that the magnitude of potential bias strongly depends on the time periods affected by underascertainment and on the type of survival analysis (cohort analysis vs period analysis). We outline strategies on how to minimise or overcome potential biases

Aggiornamento tecnologico e test funzionali del gravimetro da fondo LaCoste&Romberg modello U-HG24

Nel presente lavoro viene descritto l’aggiornamento tecnologico, effettuato in collaborazione con la società Tecnomare SpA, di un gravimetro da fondo LaCoste & Romberg modello U, serie H (numero HG24), di proprietà dell'Istituto Nazionale di Geofisica e Vulcanologia. Sono inoltre descritti e brevemente discussi i primi test in laboratorio ed i risultati di misure gravimetriche di fondo mare effettuate dal 19 al 22 Luglio 2010 nell'Area Marina Protetta del Parco Nazionale delle Cinque Terre. L'acquisizione di dati gravimetrici rientrava nelle attività specifiche del progetto di ricerca InSAS promosso e finanziato da eni Spa. La campagna a mare InSAS si è svolta in collaborazione con il NURC (NATO Undersea Research Centre) utilizzando come vettore marino il Coastal Research Vessel (CRV) ‘Leonardo’. Contestualmente all'attività di misure di gravità di fondo, sono stati acquisiti ed elaborati dal Politecnico di Milano diversi set di dati interferometrici Synthetic Aperture Sonar (SAS) su alcuni riflettori attivi e passivi localizzati nell'area di indagine. La campagna di misure a mare è stata preceduta da una serie di test in laboratorio al fine di valutare la piena funzionalità dello strumento in esame. In questa fase sono state acquisite diverse serie temporali allo scopo di valutare la qualità della misura e la sua ripetibilità

The New Paradigms in Clinical Research: From Early Access Programs to the Novel Therapeutic Approaches for Unmet Medical Needs.

Despite several innovative medicines gaining worldwide approval in recent years, there are still therapeutic areas for which unsatisfied therapeutic needs persist. For example, high unmet clinical need was observed in patients diagnosed with type 2 diabetes mellitus and hemophilia, as well as in specific age groups, such as the pediatric population. Given the urgent need to improve the therapy of clinical conditions for which unmet clinical need is established, clinical testing, and approval of new medicines are increasingly being carried out through accelerated authorization procedures. Starting from 1992, the Food and Drug Administration and the European Medicines Agency have supported the so-called Early Access Programs (EAPs). Such procedures, which can be based on incomplete clinical data, allow an accelerated marketing authorization for innovative medicines. The growth in pharmaceutical research has also resulted in the development of novel therapeutic approaches, such as biotech drugs and advanced therapy medicinal products, including new monoclonal antibodies for the treatment of asthma, antisense oligonucleotides for the treatment of Duchenne muscular dystrophy and spinal muscular atrophy, and new anticancer drugs that act on genetic biomarkers rather than any specific type of cancer. Even though EAPs and novel therapeutic approaches have brought huge benefits for public health, their implementation is limited by several challenges, including the high risk of safety-related label changes for medicines authorized through the accelerated procedure, the high costs, and the reimbursement and access concerns. In this context, regulatory agencies should provide the best conditions for the implementation of the described new tools