Biomedical subjects

F Stracci

Publications and source records attributed to F Stracci.

14 recordsLinked to original sources

PubMed2006

Evaluation of goiter using ultrasound criteria: a survey in a middle schoolchildren population of a mountain area in Central Italy.

Iodine deficiency is still an important health care problem in the world. In Italy, as in most European countries, it is responsible for the development of mild to moderate endemic goiter. In 1995 we conducted a goiter survey in the Gubbio township, an area of Umbria region in Italy, close to the Appenine mountain chain. This study demonstrated a high prevalence of goiter in the middle schoolchildren population, indicating the presence of moderate endemic goiter. Soon after, a goiter prevention campaign aimed at implementing the consumption of iodinated salt was started. In 2001, a second survey was conducted in the middle schoolchildren (age 11-14 yr old) of Gubbio and neighbour townships. Eight hundred thirteen subjects were studied. Data obtained in 240 age-matched children, studied in the same area in 1995, were used for comparison to monitor changes 5 yr after the beginning of iodine prophylaxis. Thyroid volume was measured by ultrasonography. Gland volume was expressed in ml. A large population living in a iodine-sufficient area, previously reported by others, was used as control. Urinary iodine excretion was measured randomly in 20% of the children. The overall prevalence of goiter decreased between 1995 and 2001 from 29 to 8%. Goiter odds ratio (OR), corrected for age, was 4.0 (95% CI 2.8-5.9) for 1995 compared to 2001 (p<0.000). Mean thyroid volume in the matched populations was 7.6+/-2.5 ml in 1995 and 5.7+/-2.1 ml in 2001. Median iodine urinary excretion increased from 72.6 to 93.5 mug/l, at the limit of statistical significance. Living in a rural area, no consumption of iodized salt and familiarity for goiter represented independent risk factors for goiter development. This study was the first conducted in Umbria region and confirmed that an implementation campaign for iodized salt consumption is a simple and useful instrument to prevent endemic goiter and related diseases. A new survey to evaluate goiter prevalence in the same area 10 yr after the beginning of iodine prophylaxis is already planned.

Adolescent↗

PubMed2005

Classic Kaposi's sarcoma in Italy, 1985-1998.

To evaluate incidence rates (IRs) of classic Kaposi's sarcoma (CKS) in Italy after the spread of AIDS, we distinguished CKS from AIDS-related KS (AKS) using an 'ad hoc' record linkage procedure between 15 Cancer Registries (CRs) (21% of the Italian population) and the national AIDS Registry. Between 1985 and 1998, 874 cases of CKS and 634 cases of AKS were diagnosed in the study areas. CKS accounted for 16 and 27% of KS cases below 55 years of age in men and women, respectively, but for 91 and 100% of those above age 55. The IRs for CKS were 1.0/ in men and 0.4/100,000 in women, but they varied between 0.3 in Umbria and 4.7 in Sassari in men, and between 0.1 in Parma and 1.7 in Sassari in women. IRs of CKS in both genders were stable between 1985-1987 and 1993-1998. In Northern and Central CRs the IR (adjusted for age and gender) for CKS was 0.5 in individuals born in the same area, but 1.6 in individuals born in Southern Italy or in the Islands (rate ratio = 3.2) suggesting that KS-associated herpesvirus, the cause of KS, is acquired early in life.

Acquired Immunodeficiency Syndrome↗

PubMed2005

A population survival model for breast cancer.

Breast cancer is a major health problem, and disease control depends on an effective healthcare system. A registry-based tool to monitor the quality of breast cancer care could be useful. The aim of this study was to develop a population survival model for breast cancer based on the Nottingham Prognostic Model (NPM). To this end, 1452 cases of breast cancer diagnosed in the Umbria Region, Italy, during the period 1994-1996 were studied. An extensive search for routinely available variants in prognosis and treatment was performed. In about 80% of cases complete information on factors included in the NPM was available. The Cox model was used to assess the prognostic value of study factors. Nodal stage was the most important prognostic factor. In women who did not undergo axillary dissection (17%) the risk of death was twice that in women with no affected nodes, but they received chemotherapy with the same frequency. Radiotherapy was also less frequently used in this group. Grading was a significant prognostic factor only when women over 80 were excluded. Population survival models based on data from cancer registries may provide a tool that can be used to evaluate healthcare systems and the effectiveness of interventions. The inclusion of older women in our models decreased the significance of many established prognostic factors because of the frequency of incomplete evaluation and less aggressive treatment in these patients. Not undergoing surgical axillary dissection was associated with a worse prognosis and with less aggressive treatment.

Aged↗

PubMed2004

Breast cancer incidence, mortality and survival in the Umbria region of Italy (1978-1999).

Recent incidence, mortality and survival rates of female invasive breast cancer in the Umbria region were compared with data of 20 years ago and with data from other Italian Registries. Incidence data, derived from an ad hoc survey and from cancer registry records, were analysed for the periods 1978-1982 and 1994-1999; mortality trend rates were calculated based on data from official publications and the variation was assessed by joinpoint analysis. Fifteen-year survival rates, observed, relative and age-adjusted, were also calculated. Compared with the years 1978-1982, the age-adjusted incidence rates rose during 1994-1999, while age-adjusted mortality rates decreased in this latter period. Incidence and mortality rates specific for each age group showed a constant increase with age, in both periods of observation, especially among women from 50 to 75 years of age. The 5-year relative survival rates increased 17%, rising from 0.71 in 1978-1982 to 0.86 in 1994-1998; the survival improvement was evident among women aged 45-54, and 65-74. Age-adjusted incidence and mortality rates in Umbria were lower than in other Italian Registries and survival rates showed a better prognosis for breast cancers diagnosed in Umbria in the period 1994-1998. In conclusion, the 1994-1998 decline in breast cancer mortality and the survival improvement may in part reflect the effectiveness of earlier detection by mammography and the progress in treatments. Genetic and lifestyle factors along with the improvement in diagnosis, and in quality of data collection and classification could have determined the recorded increase in breast cancer incidence.

Aged↗

PubMed2004

Population-based incidence and mortality cancer trends (1986-1997) from the network of Italian cancer registries.

The objective of this study was to analyse incidence and mortality cancer trends in the Italian Network of Cancer Registries (about 8,000,000 inhabitants) during the period 1986-1997. Included were 525,645 newly diagnosed cancers and 269,902 cancer deaths (subjects > 14 years). Joinpoints (points in time where trend significantly changes from linearity) were found and estimated annual percentage changes (EAPC) used to summarize tendencies. Overall cancer incidence increased in both sexes and cancer mortality significantly decreased (since 1991 among men). Lung cancer showed significantly decreasing incidence (EAPC = -1.4%) and mortality (EAPC = -1.6%) among men and increasing trends among women. In women, breast cancer incidence significantly increased (EAPC= +1.7%) and mortality decreased since 1989 (EAPC= -2.0%). Stomach cancer incidence and mortality decreased in both sexes. Prostate incidence sharply increased since 1991 and mortality decreased. Colon cancer incidence increased and rectum mortality decreased significantly in both sexes. Significant increases in incidence were also found for kidney (up to 1991 among men), urinary bladder, skin epithelioma, melanoma, liver (up to 1993 among men), pancreas, mesothelioma, Kaposi's sarcoma (up to 1995 among men), testis, thyroid, non-Hodgkin's lymphomas and multiple myeloma. Mortality significantly decreased for cancers of the oral cavity and pharynx, oesophagus, liver (women), larynx (men), bone, cervix (since 1990), central nervous system, urinary bladder, thyroid, Hodgkin's lymphomas and leukaemias (men). Non-Hodgkin's lymphoma mortality increased in both sexes. In conclusion, most of the changes seen can be explained as the effect of changes in smoking habits and of the extension of secondary prevention activities. The Italian health care system will also have to cope with growing cancer diagnostic and therapeutic needs due to population ageing.

Age Distribution↗

PubMed2001

Comparability issues of survival data.

This study examines the level of homogeneity in cancer registration and follow up techniques adopted by each registry, in order to ensure a correct evaluation of the data and of the geographical differences observed within Italy. A quality check was performed on the registration techniques, assuring that they met the international standards and yielded correct data, and on follow up methods. Difficulties concerning the assessment of certain tumours emerged from international debates. Thus, registries were requested to fill in a questionnaire to thoroughly examine differences in the management of tumour cases with difficult biological and clinical assessment (e.g. in situ and urinary bladder tumours). Some discrepancies in registration methods were observed. The most significant problems concern urinary bladder tumours, especially in coding procedures of in situ and uncertain behaviour tumours and the proportion of short-term survivors proportions for some geographical areas. Good quality and comparability indices were generally observed (microscopic verification, follow up management). In conclusions, quality standards in cancer registration appear good and allow for a correct geographical comparability. Some important problems regard only a small number of cancer sites (namely urinary bladder), whose results should be examined with caution.

Female↗

PubMed2000

Long term survival of upper aerodigestive tract cancer in male patients in the Umbria region (Italy).

The aim of this work was to make a study of the whole population of a central Italian region, the Umbria region--cancer survival rates for the upper aerodigestive tract, which includes cancers of the head and neck (tongue, oral cavity, pharynx), oesophagus and larynx. In Italy cancer survival rates do not cover entire regions but single municipalities or provinces. Cases of incidence were derived from an 'ad hoc' survey carried out during the period 1978-1982. Starting from the nominative data, we studied up to 15 years 245 head and neck, 87 oesophagus and 321 larynx cases of cancer in males. Data for female cases were not considered because of the small number. Cancer cases were followed up mainly by verification at the Registry Office of several municipalities, the Regional Death Registry and the list of persons under the Regional Health Service. Observed survival rates for head and neck cancer were 0.63, 0.29, 0.17 and 0.12 at 1, 5, 10 and 15 years of follow-up respectively; rates for cancers of the oesophagus and larynx were 0.30, 0.08, 0.06, 0.03 and 0.79, 0.54, 0.41, 0.30 respectively. Relative survival rates were 0.65, 0.34, 0.24, 0.23 for cancer of the head and neck, 0.31, 0.10, 0.09, 0.08 for cancer of the oesophagus, and 0.81, 0.63, 0.59, 0.56 for cancer of the larynx, at 1, 5, 10 and 15 years of follow-up. The worst survival rates were observed for oesophagus and hypopharynx. Overall survival values for Umbrian patients were relatively good, being higher than survival data reported for a similar period by Italian Cancer Registries. They were also strikingly similar to survival rates for England and Scotland.

Aged↗

PubMed2000

Incidence, mortality and long-term survival from prostate cancer in Umbria, Italy, 1978-1994.

OBJECTIVES AND METHODS: Incidence, mortality and long-term survival from prostate cancer were examined in the Umbria region of Italy, for the period 1978-1994. Incidence rates were derived from an ad hoc survey carried out over the period 1978-1982 and from 1994 cancer registry records. The mortality over the period derived from data of the official publications and the survival rates, at 15 years, were calculated starting from the ad hoc survey incident cases. RESULTS: In the Umbria region, over the period 1978-1994, crude incidence rates from prostate cancer increased from 31.2 to 81. 9 per 100,000 and mortality rates from 22.7 to 31.9 per 100,000. The rates were from 30.5 to 61.2 for age-adjusted incidence while standardized mortality remained constant (from 22.6 to 22.7 per 100, 000). Survival in Umbria, compared with rates from other European Cancer Registries, is low both at 5- and 10-year follow-up. CONCLUSION: The great incidence increase observed over the study period could depend on a lesser completeness achieved by the 1978-1982 ad hoc survey with respect to the 1994 cancer registry data and/or from the screening campaign carried out in a large part of the region in 1994. Different elements support these hypotheses. However the above hypotheses can be verified over the next years when further incidence and survival data from the cancer registry will be available.

Aged↗

PubMed1998

Urinary organ cancer survival in the Umbria region (Italy): follow-up at ten years.

OBJECTIVES AND METHODS: Survival of 687 urinary bladder and 217 kidney cancer patients was investigated using incident cases registered in an ad hoc survey in the Umbria region for the period 1978-1982. Death certificate only cases were excluded. The follow-up was carried out through the General Nominative Register of Causes of Death and verified at the Registrar's Offices of the various towns of the Region. RESULTS: At 10 years about one third of all bladder cancer patients were still alive while for kidney cancer the rate was 0.41 for females and 0.26 for males. Observed survival rates, at 1 year time intervals, never differed significantly in the two sexes even if, for kidney cancer, both observed and relative survival rates were somewhat higher in females than in males and, for bladder cancer, higher in males than in females. From survival rates by age groups both observed and relative rates decreased with age in males. In females the trend was unsteady due to the low survival in the first age group (15-44 years) for the two sites and a lower rate for kidney cancers in the 55-64 years age group compared to the next age groups. This trend was also probably due to the small number of cases. CONCLUSIONS: Comparison of survivals in Umbria with those of European registries shows higher rates for bladder cancer in both sexes and for kidney cancer in females in Umbria, while the value for kidney cancer survival in males was intermediate.

Adolescent↗

PubMedDate not supplied

[Trends of colorectal cancer incidence, mortality and survival in the Umbria, region of Italy. 1978-82 and 1994-99].

The aim of the study is to show the colorectal cancer trend in Umbria, a central Italian region, from 1978 to 1999. Data concerning regional incidence, mortality and survival derived from an ad hoc survey carried out in Umbria in the period 1978-1982 and from Umbria Population-based Registry (RTUP) for the years 1994-1999. The incidence of colorectal cancer increases in both sexes, expecially for the age class > 75 years. Mortality rises slightly, without no difference between sexes. Survival of patients with colorectal cancer has improved in the two sexes from 45 to 74 years-age, while the lower survival has registered for age between 75 and 84 years. We concluded that the situation in Umbria is quiet good, but it is affected by aging of Umbrian population. Delaying in diagnosis or inefficacy in therapy can explain shorter survival in older patients.

Adult↗

PubMedDate not supplied

[Trends in gastric cancer incidence, mortality and survival in the Umbria region of Italy. 1978-82 and 1994-99].

Gastric cancer, despite the decrease observed in the last 50 years, is yet the fourth cause of death for malignant tumor in Italy. Data from the Registro Tumori Umbro di Popolazione have been used to assess incidence, mortality and survival rates for this cancer over the period 1994-1999. The results have been compared with the data of an ad hoc study realized in the period 1978-1982 and with the ones of the other population-based cancer registries. Mortality and incidence rates are among the highest in Italy, confirming the existence of a high risk area for gastric cancer in central Italy; anyway, both mortality and incidence decrease during the study period. Also survival rates from gastric cancer recorded in Umbria over the period 94-99 were among the highest respect to other Italian cancer Registries. A case-control study carried out in a neighbouring area, aimed to explain the elevated incidence of gastric cancer, found that the consumption of a "traditional" diet--rich in proteins (particularly from sausages), nitritis and nitrous compound, alcohol, coffee, and fibres--was an important risk factor for gastric cancer. Survival over the period 94-99 is significantly improved, if compared to 1979-82 survival rate. The high survival rate recorded in the Umbria region could be related both to the number of cases treated in Umbria and to the quality of the regional oncologic system; in fact, in Umbria we reported high survival rates for several malignancies.

Adult↗

PubMedDate not supplied

[A monitoring system for occupational cancer].

INTRODUCTION: The Italian Occupation and Safety Act (d.lgs 626/94) provided for the establishment of a nationwide occupational cancer registry, under the National Institute for Occupational Health and Safety (ISPESL), with the aim of detecting cancer cases of occupational origin and estimating the influence of occupation in cancer causation. METHODS: Information on cancer cases, drawn from six Italian population-based cancer registries (CRs of Friuli Venezia Giulia Region, Genoa Town and Genoa Province, Macerata Town, Umbria Region, Varese Town, Veneto Region), and on a random sample of population controls selected in each CRs area were linked with data on subjects employed in private enterprises that have been available in electronic form since 1974 at the National Institute for Social Security (INPS). In this way, both for cases and controls, the occupational histories of past employment were collected. A population-based case-control study covering the period 1990-1998 was carried out with the aim of estimating occupational cancer risk in the private sector by site and economic category in each area. Since one of the major drawbacks of this approach is the difficulty in distinguishing true occupational hazards from incidental findings derived from multiple comparisons, an extensive research of occupational literature was carried out, independently of the study results, to compare our results with existing knowledge on occupational risks. RESULTS: Pooled analysis of the most recent incidence data based on 36,379 cases and 29,572 controls was performed; 34 "statistically significant" associations were found for 11 economic categories. Using our literature review, 10 associations were supported by more than 5 publishedpapers, 14 by a number of papers between 1 and 5, and 10 associations had not been previously reported. CONCLUSIONS: This system appears suitable for assessing existing occupational cancer risks and can eventually lead to detecting occupational hazards in many areas of Italy. The system can also provide a list of cases suitable for in-depth search for past occupational exposures.

Adult↗

PubMedDate not supplied

[Survival of men with upper aerodigestive cancer in Umbria, Italy. 1978-82 and 1994-98].

The aim of this study is to analyze the upper aerodigestive cancer survival in Umbria, a central Italian region, in the periods 1978-82 and 1994-98. The cases' data diagnosed in the period 1978-82 were derived from an ad hoc survey carried out in Umbria and for the years 1994-98 from Umbria Population-based Registry (RTUP). In the period 1994-98 the relative survival has lightly improved compared with the previous one. Comparison among five year relative standardized survival for head and neck, oesophagus and larynx, in Umbria region and in the other Italian registries, shows a quite high survival that could be further improved with an early diagnosis and, consequently, less destroying treatments.

Esophageal Neoplasms↗

PubMedDate not supplied

[Decrease of frequency of male lung cancer in Umbria region. 1978-1982 and 1994-1999].

In Umbria, region of Central Italy, lung cancer is the leading cause of death due to cancer in males. The aim of this work is to highlight decrease of mortality from lung cancer in males in Umbria, in the last 20 years and to describe relationship among incidence, mortality and survival of this cancer. The incidence data derived from an ad hoc survey carried out over the period 1978-1982 and for 1994-1999 from the Umbrian Population Cancer Registry (RTUP). The mortality data were derived from official publications of the Italian Central Institute for Statistics (ISTAT) and covered the entire period 1978-1999. Estimated annual percent change (EAPC) was calculated by joinpoint regression analysis. Decrease of mortality from male lung cancer in Umbria began in the 1990-ies due to reduced quantity of tar in cigarettes, decreasing consumption of tobacco and increasing of survival derived from the quality and the effectiveness of the oncological health care system.

Aged↗