Characteristics of people living in Italy after a cancer diagnosis in 2010 and projections to 2020

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\u2009=\u2009305,044), while 42% of prevalent women had breast cancer (n\u2009=\u2009604,841). More than 1.5 million people (2.7% of Italians) were alive since 5 or more years after diagnosis and 20% since 6515 years. It is projected that, in 2020 in Italy, there will be 3.6 million prevalent cancer cases (+\u200937% vs 2010). The largest 10-year increases are foreseen for prostate (+\u200985%) and for thyroid cancers (+\u200979%), and for long-term survivors diagnosed since 20 or more years (+\u200945%). Among the population aged 6575 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 need

Worldwide trends in population-based survival for children, adolescents, and young adults diagnosed with leukaemia, by subtype, during 2000–14 (CONCORD-3) : analysis of individual data from 258 cancer registries in 61 countries

Background Leukaemias comprise a heterogenous group of haematological malignancies. In CONCORD-3, we analysed data for children (aged 0–14 years) and adults (aged 15–99 years) diagnosed with a haematological malignancy during 2000–14 in 61 countries. Here, we aimed to examine worldwide trends in survival from leukaemia, by age and morphology, in young patients (aged 0–24 years). Methods We analysed data from 258 population-based cancer registries in 61 countries participating in CONCORD-3 that submitted data on patients diagnosed with leukaemia. We grouped patients by age as children (0–14 years), adolescents (15–19 years), and young adults (20–24 years). We categorised leukaemia subtypes according to the International Classification of Childhood Cancer (ICCC-3), updated with International Classification of Diseases for Oncology, third edition (ICD-O-3) codes. We estimated 5-year net survival by age and morphology, with 95% CIs, using the non-parametric Pohar-Perme estimator. To control for background mortality, we used life tables by country or region, single year of age, single calendar year and sex, and, where possible, by race or ethnicity. All-age survival estimates were standardised to the marginal distribution of young people with leukaemia included in the analysis. Findings 164563 young people were included in this analysis: 121328 (73·7%) children, 22963 (14·0%) adolescents, and 20272 (12·3%) young adults. In 2010–14, the most common subtypes were lymphoid leukaemia (28205 [68·2%] patients) and acute myeloid leukaemia (7863 [19·0%] patients). Age-standardised 5-year net survival in children, adolescents, and young adults for all leukaemias combined during 2010–14 varied widely, ranging from 46% in Mexico to more than 85% in Canada, Cyprus, Belgium, Denmark, Finland, and Australia. Individuals with lymphoid leukaemia had better age-standardised survival (from 43% in Ecuador to ≥80% in parts of Europe, North America, Oceania, and Asia) than those with acute myeloid leukaemia (from 32% in Peru to ≥70% in most high-income countries in Europe, North America, and Oceania). Throughout 2000–14, survival from all leukaemias combined remained consistently higher for children than adolescents and young adults, and minimal improvement was seen for adolescents and young adults in most countries. Interpretation This study offers the first worldwide picture of population-based survival from leukaemia in children, adolescents, and young adults. Adolescents and young adults diagnosed with leukaemia continue to have lower survival than children. Trends in survival from leukaemia for adolescents and young adults are important indicators of the quality of cancer management in this age group.peer-reviewe

Global survival trends for brain tumors, by histology: analysis of individual records for 556,237 adults diagnosed in 59 countries during 2000–2014 (CONCORD-3)

Background: Survival is a key metric of the effectiveness of a health system in managing cancer. We set out to provide a comprehensive examination of worldwide variation and trends in survival from brain tumors in adults, by histology. Methods: We analyzed individual data for adults (15–99 years) diagnosed with a brain tumor (ICD-O-3 topography code C71) during 2000–2014, regardless of tumor behavior. Data underwent a 3-phase quality control as part of CONCORD-3. We estimated net survival for 11 histology groups, using the unbiased nonparametric Pohar Perme estimator. Results: The study included 556,237 adults. In 2010–2014, the global range in age-standardized 5-year net survival for the most common sub-types was broad: in the range 20%–38% for diffuse and anaplastic astrocytoma, from 4% to 17% for glioblastoma, and between 32% and 69% for oligodendroglioma. For patients with glioblastoma, the largest gains in survival occurred between 2000–2004 and 2005–2009. These improvements were more noticeable among adults diagnosed aged 40–70 years than among younger adults. Conclusions: To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumors by histology in adults. We have highlighted remarkable gains in 5-year survival from glioblastoma since 2005, providing large-scale empirical evidence on the uptake of chemoradiation at population level. Worldwide, survival improvements have been extensive, but some countries still lag behind. Our findings may help clinicians involved in national and international tumor pathway boards to promote initiatives aimed at more extensive implementation of clinical guidelines

A Research Study on Crowding in Correctional Centers during the Covid-19 Epidemic in Italy

The effects of the spread of Covid-19 have had important consequences on everybody’s life but also had a dramatic impact for the population inside correctional centers in Italy; these issuses have finally received great attention over the last few months. This paper is primarily focused on the analysis of the critical aspects of overcrowding in Italian correctional centers, a cyclical issue which has become even more critical during the current pandemic emergency. Our research aims at describing the development of the number of prisoners before and after government legislative actions taken in early 2020 to reduce overcrowding of prisoners; furthermore we study these effects in combination with the main features of some Italian correctional centers. There is some evidence that the number of prisoners first decreased but then started increasing again, as it had always happened after similar governative decrees adopted in other cases in the past; moreover, it is also clear that the available capacity of jails is not homogeneous in Italy and that the situation is different between the different regions. The main difficulty encountered in preparing the research analysis for this contribution has been the access to data related to the dissemination of the pandemic inside correctional centers; in fact, in some frameworks such as prisons, this kind of information is not often available or completely updated.Gli effetti della diffusione del Covid-19 hanno avuto importanti conseguenze sulla vita di tutti noi e in particolare un impatto drammatico per le persone detenute nelle case circondariali in Italia; questi temi hanno ricevuto grande attenzione negli ultimi mesi. Il presente lavoro è principalmente rivolto all’analisi degli aspetti di rischio del sovraffollamento carcerario italiano, un problema che si ripresenta periodica-mente e che è diventato ancor di maggior criticità nell’attuale situazione di pandemia. Il contributo intende analizza la situazione carceraria prima e dopo le misure legislative adottate all’inizio del 2020 per attenuare il problema del sovraffollamento; inoltre vengono studiati gli effetti di tali provvedimenti alla luce di alcuni dati strutturali degli istituti penitenziari in Italia. Dai risultati emersi vi è evidenza di una diminuzione del numero di detenuti a cui tuttavia sta seguendo una fase di tendenziale risalita, in maniera analoga a quanto si è verificato a seguito di alcuni provvedimenti adottati in passato per fronteggiare il sovraffollamento carcerario. Emerge inoltre una situazione carceraria non omogenea con differenze anche notevoli nei diversi provveditorati. La principale difficoltà riscontrata durante la stesura di questo contributo è relativa all’accesso ai dati sulla diffusione della pandemia che, in determinati contesti (come ad esempio nelle carceri), risulta notevolmente complesso e le informazioni sono spesso non aggiornate

Estimated glomerular filtration rate, all-cause mortality and cardiovascular diseases incidence in a low risk population: the MATISS study.

BACKGROUND:Chronic kidney disease (CKD) independently increases the risk of death and cardiovascular disease (CVD) in the general population. However, the relationship between estimated glomerular filtration rate (eGFR) and CVD/death risk in a general population at low risk of CVD has not been explored so far. DESIGN:Baseline and longitudinal data of 1465 men and 1459 women aged 35-74 years participating to the MATISS study, an Italian general population cohort, were used to evaluate the role of eGFR in the prediction of all-cause mortality and incident CVD. METHODS:Bio-bank stored sera were used to evaluate eGFR at baseline. Serum creatinine was measured on thawed samples by means of an IDMS-calibrated enzymatic method. eGFR was calculated by the CKD-EPI formula. RESULTS:At baseline, less than 2% of enrolled persons had eGFR < 60 mL/min/1.73 m(2) and more than 70% had a 10-year cardiovascular risk score < 10%. In people 60 or more years old, the first and the last eGFR quintiles (<90 and ≥109 mL/min/1.73 m(2), respectively) were associated to an increased risk for both all-cause mortality (hazard ratio 1.6, 95% confidence interval 1.2-2.1 and 4.3, 1.6-11.7, respectively) and incident CVD (1.6, 1.0-2.4 and 7.0, 2.2-22.9, respectively), even if adjusted for classical risk factors. CONCLUSIONS:These findings strongly suggest that in an elderly, general population at low risk of CVD and low prevalence of reduced renal filtration, even a modest eGFR reduction is related to all-cause mortality and CVD incidence, underlying the potential benefit to this population of considering eGFR for their risk prediction

The CINDI Health Monitor Survey. Health behaviour among the Italian adult population, 2001-2002

&lt;p&gt;In accordance to the WHO-CINDI (Countrywide Integrated Non-communicable Diseases Intervention) Programme, in 2001-2002 Italy participated in the Health Monitor Survey (HMS) along with all the other CINDI member countries.&lt;/p&gt;&lt;p&gt;The survey aimed to investigate, by the use of a standard questionnaire, the self-reported health status, life-habits, social and health conditions, use of health services and other features of the study population.&lt;/p&gt;&lt;p&gt;Following the international CINDI protocol, the adult population (25-64 years of age) from six Italian demonstration areas were chosen: Bassiano-Lenola (LT), Brisighella (RA), Rovescala (PV), Sardinia (CA, SS), Udine (UD); Valle dell’Irno (SA). A total number of 4095 subjects, including both males and females were enrolled, with a participation rate of 53%, equal to 2202 subjects [45.7% males (M) and 54.3% females (F)]. All age groups were equally represented. From the analysis of the age-standardised rates, the following results were obtained. Self-reported “good state of health”: M 71%, F 56.9%; Hypertension: M 15.6%, F 17.5%; Diabetes: M 6.1%, F 4.2%; Back-illness: M 18%, F 22%; Gastritis: M 12.8%, F 12.6%; Headache: M 31.7%, F 54.6%; Insomnia: M 15.9%, F 28.5%; Daily smokers: M 35.7%, F 23.5%; Daily consumption of wine: M 40.2%, F 15.7%; BMI ≥ 30: M 12.3%, F 13.5%; Regular leisure physical activity: M 27.6%, F 23.1%; Hard physical activity: M 40.5%, F 24%. The results demonstrate how rural areas (Rovescala and Valle dell’Irno) experience worse health conditions. Thanks to the HMS, the population’s health needs have been focused and compared to those of other CINDI countries, in order to plan specific interventions aimed at the improvement of lifestyle and health conditions.&lt;/p&gt