20 research outputs found
Assessment of the INLA approach on gerarchic bayesian models for the spatial disease distribution: a real data application
The use of approximate methods as the INLA (Integrated Nested Laplace Approximation) approach is being widely used in Bayesian inference, especially in spatial risk model estimation where the Besag-York-Mollie (BYM) model `
has found a proper use. INLA appears time saving compared to Monte Carlo simulations based on Markov Chains (MCMC), but it produces some differences in
estimates [1, 2]. Data from the Veneto Cancer Registry has been considered with
the scope to compare cancer incidence estimates with INLA method and with two
other procedures based on MCMC simulation, WinBUGS and CARBayes, under
R environment. It is noteworthy that INLA returns estimates comparable to both
MCMC procedures, but it appears sensitive to the a-priori distribution. INLA is fast
and efficient in particular with samples of moderate-high size. However, care must
to be paid to the choice of the parameter relating to the a-priori distribution
Cancer incidence in immigrants by geographical area of origin: data from the Veneto Tumour Registry, Northeastern Italy
ObjectiveWe investigated whether there are differences in cancer incidence by geographical area of origin in North-eastern Italy.MethodsWe selected all incident cases recorded in the Veneto Tumour Registry in the period 2015-2019. Subjects were classified, based on the country of birth, in six geographical areas of origin (Italy, Highly Developed Countries-HDC, Eastern Europe, Asia, Africa, South-central America). Age-standardized incidence rates and incidence rate ratio (IRR) were calculated, for all cancer sites and for colorectal, liver, breast and cervical cancer separately.ResultsWe recorded 159,486 all-site cancer cases; 5.2% cases occurred in subjects born outside Italy, the majority from High Migratory Pressure Countries (HMPC) (74.3%). Incidence rates were significantly lower in subjects born in HMPC in both sexes. Immigrants, in particular born in Asia and Africa, showed lower rates of all site cancer incidence. The lowest IRR for colorectal cancer was observed in males from South-Central America (IRR 0.19, 95%CI 0.09-0.44) and in females from Asia (IRR 0.32, 95%CI 0.18-0.70). The IRR of breast cancer appeared significantly lower than Italian natives in all female populations, except for those coming from HDC. Females from Eastern Europe showed a higher IRR for cervical cancer (IRR 2.02, 95%CI 1.57-2.61).ConclusionCancer incidence was found lower in subjects born outside Italy, with differences in incidence patterns depending on geographical area of origin and the cancer type in question. Further studies, focused on the country of birth of the immigrant population, would help to identify specific risk factors influencing cancer incidence
ITALIAN CANCER FIGURES - REPORT 2015: The burden of rare cancers in Italy = I TUMORI IN ITALIA - RAPPORTO 2015: I tumori rari in Italia
OBJECTIVES:
This collaborative study, based on data collected by the network of Italian Cancer Registries (AIRTUM), describes the burden of rare cancers in Italy. Estimated number of new rare cancer cases yearly diagnosed (incidence), proportion of patients alive after diagnosis (survival), and estimated number of people still alive after a new cancer diagnosis (prevalence) are provided for about 200 different cancer entities.
MATERIALS AND METHODS:
Data herein presented were provided by AIRTUM population- based cancer registries (CRs), covering nowadays 52% of the Italian population. This monograph uses the AIRTUM database (January 2015), which includes all malignant cancer cases diagnosed between 1976 and 2010. All cases are coded according to the International Classification of Diseases for Oncology (ICD-O-3). Data underwent standard quality checks (described in the AIRTUM data management protocol) and were checked against rare-cancer specific quality indicators proposed and published by RARECARE and HAEMACARE (www.rarecarenet.eu; www.haemacare.eu). The definition and list of rare cancers proposed by the RARECAREnet "Information Network on Rare Cancers" project were adopted: rare cancers are entities (defined as a combination of topographical and morphological codes of the ICD-O-3) having an incidence rate of less than 6 per 100,000 per year in the European population. This monograph presents 198 rare cancers grouped in 14 major groups. Crude incidence rates were estimated as the number of all new cancers occurring in 2000-2010 divided by the overall population at risk, for males and females (also for gender-specific tumours).The proportion of rare cancers out of the total cancers (rare and common) by site was also calculated. Incidence rates by sex and age are reported. The expected number of new cases in 2015 in Italy was estimated assuming the incidence in Italy to be the same as in the AIRTUM area. One- and 5-year relative survival estimates of cases aged 0-99 years diagnosed between 2000 and 2008 in the AIRTUM database, and followed up to 31 December 2009, were calculated using complete cohort survival analysis. To estimate the observed prevalence in Italy, incidence and follow-up data from 11 CRs for the period 1992-2006 were used, with a prevalence index date of 1 January 2007. Observed prevalence in the general population was disentangled by time prior to the reference date (≤2 years, 2-5 years, ≤15 years). To calculate the complete prevalence proportion at 1 January 2007 in Italy, the 15-year observed prevalence was corrected by the completeness index, in order to account for those cancer survivors diagnosed before the cancer registry activity started. The completeness index by cancer and age was obtained by means of statistical regression models, using incidence and survival data available in the European RARECAREnet data.
RESULTS:
In total, 339,403 tumours were included in the incidence analysis. The annual incidence rate (IR) of all 198 rare cancers in the period 2000-2010 was 147 per 100,000 per year, corresponding to about 89,000 new diagnoses in Italy each year, accounting for 25% of all cancer. Five cancers, rare at European level, were not rare in Italy because their IR was higher than 6 per 100,000; these tumours were: diffuse large B-cell lymphoma and squamous cell carcinoma of larynx (whose IRs in Italy were 7 per 100,000), multiple myeloma (IR: 8 per 100,000), hepatocellular carcinoma (IR: 9 per 100,000) and carcinoma of thyroid gland (IR: 14 per 100,000). Among the remaining 193 rare cancers, more than two thirds (No. 139) had an annual IR <0.5 per 100,000, accounting for about 7,100 new cancers cases; for 25 cancer types, the IR ranged between 0.5 and 1 per 100,000, accounting for about 10,000 new diagnoses; while for 29 cancer types the IR was between 1 and 6 per 100,000, accounting for about 41,000 new cancer cases. Among all rare cancers diagnosed in Italy, 7% were rare haematological diseases (IR: 41 per 100,000), 18% were solid rare cancers. Among the latter, the rare epithelial tumours of the digestive system were the most common (23%, IR: 26 per 100,000), followed by epithelial tumours of head and neck (17%, IR: 19) and rare cancers of the female genital system (17%, IR: 17), endocrine tumours (13% including thyroid carcinomas and less than 1% with an IR of 0.4 excluding thyroid carcinomas), sarcomas (8%, IR: 9 per 100,000), central nervous system tumours and rare epithelial tumours of the thoracic cavity (5%with an IR equal to 6 and 5 per 100,000, respectively). The remaining (rare male genital tumours, IR: 4 per 100,000; tumours of eye, IR: 0.7 per 100,000; neuroendocrine tumours, IR: 4 per 100,000; embryonal tumours, IR: 0.4 per 100,000; rare skin tumours and malignant melanoma of mucosae, IR: 0.8 per 100,000) each constituted <4% of all solid rare cancers. Patients with rare cancers were on average younger than those with common cancers. Essentially, all childhood cancers were rare, while after age 40 years, the common cancers (breast, prostate, colon, rectum, and lung) became increasingly more frequent. For 254,821 rare cancers diagnosed in 2000-2008, 5-year RS was on average 55%, lower than the corresponding figures for patients with common cancers (68%). RS was lower for rare cancers than for common cancers at 1 year and continued to diverge up to 3 years, while the gap remained constant from 3 to 5 years after diagnosis. For rare and common cancers, survival decreased with increasing age. Five-year RS was similar and high for both rare and common cancers up to 54 years; it decreased with age, especially after 54 years, with the elderly (75+ years) having a 37% and 20% lower survival than those aged 55-64 years for rare and common cancers, respectively. We estimated that about 900,000 people were alive in Italy with a previous diagnosis of a rare cancer in 2010 (prevalence). The highest prevalence was observed for rare haematological diseases (278 per 100,000) and rare tumours of the female genital system (265 per 100,000). Very low prevalence (<10 prt 100,000) was observed for rare epithelial skin cancers, for rare epithelial tumours of the digestive system and rare epithelial tumours of the thoracic cavity.
COMMENTS:
One in four cancers cases diagnosed in Italy is a rare cancer, in agreement with estimates of 24% calculated in Europe overall. In Italy, the group of all rare cancers combined, include 5 cancer types with an IR>6 per 100,000 in Italy, in particular thyroid cancer (IR: 14 per 100,000).The exclusion of thyroid carcinoma from rare cancers reduces the proportion of them in Italy in 2010 to 22%. Differences in incidence across population can be due to the different distribution of risk factors (whether environmental, lifestyle, occupational, or genetic), heterogeneous diagnostic intensity activity, as well as different diagnostic capacity; moreover heterogeneity in accuracy of registration may determine some minor differences in the account of rare cancers. Rare cancers had worse prognosis than common cancers at 1, 3, and 5 years from diagnosis. Differences between rare and common cancers were small 1 year after diagnosis, but survival for rare cancers declined more markedly thereafter, consistent with the idea that treatments for rare cancers are less effective than those for common cancers. However, differences in stage at diagnosis could not be excluded, as 1- and 3-year RS for rare cancers was lower than the corresponding figures for common cancers. Moreover, rare cancers include many cancer entities with a bad prognosis (5-year RS <50%): cancer of head and neck, oesophagus, small intestine, ovary, brain, biliary tract, liver, pleura, multiple myeloma, acute myeloid and lymphatic leukaemia; in contrast, most common cancer cases are breast, prostate, and colorectal cancers, which have a good prognosis. The high prevalence observed for rare haematological diseases and rare tumours of the female genital system is due to their high incidence (the majority of haematological diseases are rare and gynaecological cancers added up to fairly high incidence rates) and relatively good prognosis. The low prevalence of rare epithelial tumours of the digestive system was due to the low survival rates of the majority of tumours included in this group (oesophagus, stomach, small intestine, pancreas, and liver), regardless of the high incidence rate of rare epithelial cancers of these sites. This AIRTUM study confirms that rare cancers are a major public health problem in Italy and provides quantitative estimations, for the first time in Italy, to a problem long known to exist. This monograph provides detailed epidemiologic indicators for almost 200 rare cancers, the majority of which (72%) are very rare (IR<0.5 per 100,000). These data are of major interest for different stakeholders. Health care planners can find useful information herein to properly plan and think of how to reorganise health care services. Researchers now have numbers to design clinical trials considering alternative study designs and statistical approaches. Population-based cancer registries with good quality data are the best source of information to describe the rare cancer burden in a population
A contribution to the history of religious guidebooks: birth and fruition of the italian guides of the twentieth century Jubilee
The survey analyses and compares the most successful guides published on occasion of the Jubilees of the years 1900, 1950, 2000
Assessing the impact of individual nutrition on biodiversity : a conceptual framework for the selection of indicators targeted at the out-of-home catering sector
Agriculture is an economic sector with massive impact on biodiversity and agrobiodiversity. Sustainable diets represent a critical policy leverage and a realistic opportunity to reduce the environmental impact of the agro-food sector while improving human health at the same time. Eating out is an increasingly common habit for many consumers and, by offering sustainable dishes, catering companies can play a central role. To do this, they need to understand and correctly assess the sustainability of their food portfolio, but assessment tools are not well established yet. The NAHGAST project, of which this study was part, developed and tested a sustainability assessment tool for catering companies based on concrete targets defined per meal. This study addresses the lack of methods to evaluate the impact of food on biodiversity, with a particular focus on agrobiodiversity. The work illustrates a context-specific application of an enhanced DPSIR model to structure information and select indicators, and proposes a transdisciplinary use of existing metrics. Further research is needed in order to define scientifically sound target values or sustainability ranges for each indicator per meal, in order to calculate them. Strengths and limits of the study are discussed
Who are the consumers? : The need for a sustainability-integrated consumer research agenda
In order to make our lifestyles sustainable, changing our consumption patterns is fundamental. Hence, we need to better understand who the "consumers" are and to consider them as an active actor to directly engage for ensuring effective policies. In order to support a resource-light society, production and consumption need to be considered through an integrated system view; within this, consumers play an important role as co-acting subjects. Almost every activity in private life involves a form of consumption aimed at satisfying the subject's needs and often regarded through an economic lens. Sustainable development is not about abolishing private consumption, but rather about making it environmentally, socially and individually sustainable in its design, organization and realization, also involving ideas of simplicity or renunciation. In this paper, we will assess the status quo of the German and European debates on Consumer Research Policies and discuss the idea to link sustainability research and consumer research - where a strategic relation is currently missing. Within that discussion, an evidence-based and obligatory consumer research strategy in Germany and Europe would represent a significant improvement. A system view perspective is necessary to take into consideration the impressive amount of diversity, and to elaborate realistic economic and consumer policies. Therefore, we propose nine steps for understanding the role of the consumer in implementing sustainable development from a scientific and political perspective. The limitations of this paper are thus a result of the very diverse and often unclear policies and agendas produced by governments. The implementation of the proposed innovative research agenda for a future-orientated and sustainability-based consumer research is not free from challenges. Still, the paper suggests the first steps towards this direction. After a critical discussion of the current EU and German consumer and sustainability policies, nine differentiated and substantial ways to integrate and ameliorate them are proposed
Knowledge Creation between Integrated Assessment Models and Initiative-Based Learning - An Interdisciplinary Approach
This paper explores the opportunities for integrating Initiative Based Learning (IBL) and Integrated Assessment Models (IAMs) in order to improve our understanding of learning in the context of societal transition pathways, and more specifically by focusing on solar PV as an energy transition technology. Our analysis shows that IAMs and IBL conceptualize learning in a very different way, and the two approaches have major structural differences with respect to the geographical as well as the temporal scale of analysis. This is also due to the different goals of the two methodologies. The aim of IAM is to develop long-term energy and technology scenarios for the next thirty to eighty years, and to describe learning processes mostly to account for future potential improvements in technologies, while IBL focuses on understanding the configuration of actors in specific institutional settings that legitimize and support specific technologies and ultimately lead to dynamics of social learning. Although ambitious forms of integration between IAMs and IBL are not feasible today, the two approaches can be used in parallel and lead to mutual enrichment via a process that we label a two-way recursive collaboration
Sexually transmitted infections in oral cavity lesions. Human Papillomavirus y Chlamydia trachomatis
Fil: Mossman, Jessica. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas; Argentina.Fil: Mossman, Jessica. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Virología Dr. José María Vanella; Argentina.Fil: Talavera, Angel Daniel. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Estomatología A; Argentina.Fil: Monetti, Marina Soledad. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas; Argentina.Fil: Monetti, Marina Soledad. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Virología Dr. José María Vanella; Argentina.Fil: Criscuolo, María Inés. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Estomatología B; Argentina.Fil: Venezuela, Raul Fernando. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas; Argentina.Fil: Kiguen, Ana Ximena. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas; Argentina.Fil: Ferreyra de Prato, Ruth. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Anatomía Patológica A; Argentina.Fil: López de Blanc, Silvia. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Estomatología B; Argentina.Fil: Cuffini, Cecilia Gabriela . Universidad Nacional de Córdoba. Facultad de Ciencias Médicas; Argentina.Fil: Cuffini, Cecilia Gabriela . Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Virología Dr. José María Vanella; Argentina.The aim of this study was to evaluate the presence of Human Papillomavirus (HPV) and Chlamydia trachomatis (C. trachomatis) in oral cavity lesions and rate the association between this co-infection, in Córdoba- Argentina.Fil: Mossman, Jessica. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas; Argentina.Fil: Mossman, Jessica. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Virología Dr. José María Vanella; Argentina.Fil: Talavera, Angel Daniel. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Estomatología A; Argentina.Fil: Monetti, Marina Soledad. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas; Argentina.Fil: Monetti, Marina Soledad. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Virología Dr. José María Vanella; Argentina.Fil: Criscuolo, María Inés. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Estomatología B; Argentina.Fil: Venezuela, Raul Fernando. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas; Argentina.Fil: Kiguen, Ana Ximena. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas; Argentina.Fil: Ferreyra de Prato, Ruth. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Anatomía Patológica A; Argentina.Fil: López de Blanc, Silvia. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Estomatología B; Argentina.Fil: Cuffini, Cecilia Gabriela . Universidad Nacional de Córdoba. Facultad de Ciencias Médicas; Argentina.Fil: Cuffini, Cecilia Gabriela . Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Virología Dr. José María Vanella; Argentina.Salud Pública y Medioambienta