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"Cavallo, Rossella"
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Trends in Survival and Cure Indicators of Thin and Thick Cutaneous Malignant Melanoma in Italy
2026
Background In Italy, cure indicators of cutaneous malignant melanoma according to Breslow tumour thickness have never been assessed. Objectives To evaluate the time trend in 1‐year net survival (NS), 5|1‐year conditional NS (CNS) and cure fraction (CF). Methods Data from 10 cancer registries and 13,377 patients aged 15–74 years were used. Five|1‐year CNS was defined as the probability of surviving 5 years given that the patient has survived 1 year. CF was defined as the proportion of patients with the same life expectancy as the general population. One‐year NS and 5|1‐year CNS were contrasted between 2013–2017 and 2003–2007, and CF between 2015 and 2005. Results For lesions up to 4 mm thick, 1‐year NS reached a level > 98.0%. In 2013–2017, 5|1‐year CNS was above 90% for men and women with lesions up to 2.0 mm thick and increased markedly for men with lesions > 2.0–4.0 mm thick (65.1% to 82.4%) and > 4.0 mm thick (57.6% to 69.4%). The CF of patients with a melanoma ≤ 1.0 mm thick was approximately 100% in both sexes, and nearly doubled from 2005 to 2015 (28% to 54%) for men aged 55–74 years with a melanoma > 4.0 mm thick. Conclusions Patients with a melanoma ≤ 1 mm thick have the same life expectancy as the general population. The increase in the CF of men with thick lesions supports the hypothesis that novel therapies, approved in Italy since 2013, offer the possibility of cure.
Journal Article
Risk of thyroid as a first or second primary cancer. A population‐based study in Italy, 1998–2012
2021
Background The number of patients living after a cancer diagnosis is increasing, especially after thyroid cancer (TC). This study aims at evaluating both the risk of a second primary cancer (SPC) in TC patients and the risk of TC as a SPC. Methods We analyzed two population‐based cohorts of individuals with TC or other neoplasms diagnosed between 1998 and 2012, in 28 Italian areas covered by population‐based cancer registries. Standardized incidence ratios (SIRs) of SPC were stratified by sex, age, and time since first cancer. Results A total of 38,535 TC patients and 1,329,624 patients with other primary cancers were included. The overall SIR was 1.16 (95% CI: 1.12–1.21) for SPC in TC patients, though no increase was shown for people with follicular (1.06) and medullary (0.95) TC. SPC with significantly increased SIRs was bone/soft tissue (2.0), breast (1.2), prostate (1.4), kidney (2.2), and hemolymphopoietic (1.4) cancers. The overall SIR for TC as a SPC was 1.49 (95% CI: 1.42–1.55), similar for all TC subtypes, and it was significantly increased for people diagnosed with head and neck (2.1), colon–rectum (1.4), lung (1.8), melanoma (2.0), bone/soft tissue (2.8), breast (1.3), corpus uteri (1.4), prostate (1.5), kidney (3.2), central nervous system (2.3), and hemolymphopoietic (1.8) cancers. Conclusions The increased risk of TC after many other neoplasms and of few SPC after TC questions the best way to follow‐up cancer patients, avoiding overdiagnosis and overtreatment for TC and, possibly, for other malignancies. This is the first study able to calculate population‐based risk of thyroid cancers as a first or second tumor separately for different thyroid cancer histological types (i.e., follicular, medullary, and poorly differentiated). In a context of a large proportion of thyroid cancer cases due to overdiagnosis, the findings of the present study may help to more focused primary prevention and surveillance for side effects of treatments, thus avoiding overtreatment, particularly among younger women.
Journal Article
Trends in cancer incidence and mortality in Italy, 2013–2017
2025
Cancer incidence and mortality trends represent epidemiological indicators of fundamental importance for public health systems. The study's aim is to present recent (2013–2017) short-term cancer incidence and mortality trends in Italy, including 80 % of the Italian population, for different cancer sites by sex, age group, and areas. Joinpoint Regression models were employed. A significantly decreasing trend in the incidence of all cancers was observed for men in Italy (-1.9 % per year), particularly for cancers of the lung (-2.5 %), liver (-3.9 %), stomach (-2.8 %), colorectal (-2.2 %), prostate (-3.4 %), and leukaemias (-3.2 %). The only significant increase was seen for skin melanoma (+5.2 % per year). Among women, overall cancer incidence remained stable, with a decrease in the North (-0.6 %) and an increase in the South and Islands (+0.9 %). Decreasing trends were observed for colorectal (-1.9 %), stomach (-3.5 %), liver (-4.0 %%), and leukaemias (-2.0 %) cancers, while incidence increased for skin melanoma (+6.0 % per year), and lung cancer (2.3 %). Cancer mortality declined consistently in both sexes (-1.8 % per year in men and −0.6 % in women), across different areas, and age groups. The observed trends in men and women partly reflect the impact of risk factors affecting both sexes at different times, mainly in the case of tobacco and lung cancer. Also, some trends may be linked to organized screening initiatives (e.g. colorectal) or the decrease in opportunistic screening (e.g. prostate). The snapshot of cancer trends in Italy may highlight new opportunities for strengthening prevention activities and advancing research on early detection and target treatments.
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•We observed decreasing incidence and mortality trends in men and stable incidence and decreasing mortality trends in women.•Skin melanoma incidence increased in both sexes, while lung cancer increased in women and decreased in men.•Stomach, colorectal, liver and leukaemias incidence decreased in both sexes.•We highlighted the need to improve cancer prevention initiatives and research in diagnostic and treatments in Italy
Journal Article
Cancer incidence, mortality, and survival estimates in Italy: Methodological approaches
2025
Italy, home to one of the world’s oldest populations, has traditionally shown geographic differences in cancer incidence, with rates decreasing from north to south. The cancer registries that have been accredited by the Italian Cancer Registry Network (AIRTUM), during the last 20 years altogether cover the 90 % of the Italian population, aiming to improve data quality, standardize procedures, and promote research. This study presents the methodological approaches used for data collection, quality control, and analysis to describe current patterns of cancer incidence, mortality, and survival across Italy's three macro-areas (North, Central, South). Estimates of incidence rates and case numbers for 2025 were also produced. Data from 34 accredited cancer registries were analyzed, comprising over 4.6 million cases from 1981 to 2020, with a detailed focus on the 2008–2017 period, which includes over 3 million cases. Cancer incidence and mortality data were collected according to ICD-O-3 and ICD-10 classifications and processed for statistical analysis using tools such as SEERPrep, SEERStat, and the Joinpoint Regression Program. Age-standardized rates were calculated, and incidence and mortality trends from 2013 to 2017 were modeled. Five-year cumulative net survival was estimated using the Pohar-Perme method to adjust for competing risks. Survival trends were analyzed by geographic areas and cancer sites, revealing regional disparities in cancer outcomes.
•Cancer registries provide affordable population-based statistics on cancer epidemiology.•Incidence, mortality and survival are the main indicators used for cancer surveillance.•Appropriate methodologic approaches make comparisons intelligible.•In Italy there are historical differences in cancer figures by macro-areas.•There is a need to provide cancer statistics updated to the pre-Covid-19 era in Italy.
Journal Article
Incidence rates and trends of paediatric cancer in Italy, 2008–2017
by
Sessa, Marcella
,
Maule, Milena
,
Santa, Valenti Clemente
in
Adenomatous polyposis coli
,
Adolescent
,
Adolescents
2025
Paediatric cancers are rare, yet, Italy has previously shown some of the highest incidence rates in Europe as a leading cause of death in children and adolescents. This study updates data from Italy for 2008–2017, analyses trends from 1998, and compares findings with other European regions.
A population-based approach was used, leveraging data from the Italian Association of Cancer Registries (AIRTUM). Thirty-one cancer registries covering 77 % of the Italian paediatric population contributed data on tumour type, age, sex, residence, and diagnosis date. Cancers were classified using the International Classification of Childhood Cancer, Third Edition (ICCC-3). Age-specific (IR) and age-standardized incidence rates (ASR) were computed, while trends were analysed with Joinpoint regression to estimate annual (APC) and average annual percentage change (AAPC).
From 2008–2017, 17,322 malignant paediatric cancer cases were reported in Italy. The age-standardized incidence rate (ASR) was 166.8 per million for ages 0–14 and 294.3 per million for adolescents 15–19. Over the study period, incidence rates were generally stable, but a significant increase was observed for bone tumours in children and thyroid and melanoma in adolescents. Central Italy showed higher incidence rates compared to other Italian regions. Italy still shows one of the highest incidence rates in Europe.
While the study confirms overall stable incidence trends in Italy, it also highlights an increase in specific cancers such as melanoma and thyroid tumours in adolescents. Central Italy exhibited higher incidence rates, potentially due to environmental and/or diagnostic factors. Continuous monitoring and further research are needed to clarify regional variations and evaluate the impact of early diagnosis and environmental exposures.
•17,322 paediatric cancer cases recorded in Italy (2008–2017).•ASR: 166.8/million in children; IR: 294.3/million in adolescents.•Central Italy had highest incidence, esp. melanoma and epithelial tumours.•Italy shows higher paediatric cancer rates than other European regions.•Stable trends; increased bone tumours (children), thyroid and melanoma (adolescents).
Journal Article
Quality of data from cancer registries in Italy: An appraisal
by
Contiero, Paolo
,
Stracci, Fabrizio
,
Usticano, Antonella
in
Accreditation
,
Cancer
,
Cancer epidemiology in Italy
2025
We report the results of the quality assessment on data collected by cancer registries belonging to the Italian network of Cancer Registries (AIRTUM). For all malignant cancers diagnosed in 2013–2017, overall percentages of cases known from the death certificate only (DCO), and those of cases with cyto-histological confirmation (MV), were provided. The overall percentage of DCOs was small (1.2 %). The percentage of microscopic verification was overall high (87.6 %), with some variations among registries. DCO proportion varied from 0.1 % for cutaneous melanoma to 3.8 % for liver and pancreatic tumours. Differences across sites in MV proportion were linked to the different diagnostics. The rate of cases lost to follow-up was on average very low (0.7 %). This quality evaluation confirmed that data provided by the Italian cancer registries were affordable.
•Data from Italian cancer registries have long been included in IARC and ENCR publications.•Data from cancer registries should not be produced only for cancer registries.•Quality indices should also address aspects that are more useful and understandable for other stakeholders.•The Italian network of cancer registries (AIRTUM) has provided updated cancer statistics
Journal Article
Incidence of Thyroid Cancer in Italian Contaminated Sites
2020
Some human literature suggests a possible role of endocrine disruptors (EDs) exposure in thyroid cancer (TC) development. We investigated TC incidence in selected Italian National Priority Contaminated Sites (NPCS) with documented presence of EDs considered thyroid carcinogens. Adjusted Standardized Incidence Ratios (SIRs), with their 90% confidence intervals, were computed by gender, and age-specific groups (aged 15–39 years, and 40 years or over) for each NPCS in the period 2006 to 2013. In the age group of 15–39 years, a significant excess of TC risk was found in two NPCSs in males; non-significant excess risks were observed in four NPCSs in males, and in five in females. In the age group of 40 years and over, significant excess risks were found in six NPCSs in males and in seven NPCSs in females; non-significant excess risks were identified in two NPCSs in males and females. The findings of several excesses in incidence, mainly observed in adults aged 40 years or over, are suggestive of a possible adverse effect associated with residence in NPCSs, even if a role of other factors cannot be excluded, due to the adoption of an ecological study design. Future analytical studies are needed to clarify if EDs are a TC risk factor for individuals living in NPCSs.
Journal Article
Metastatic Recurrence of Breast Cancer by Stage and Molecular Profile: A Population‐Based Study Among Italian Women
by
Seghini, Pietro
,
Ravaioli, Alessandra
,
Capocaccia, Riccardo
in
Adolescent
,
Adult
,
Age Factors
2026
Background This study aims to estimate the long‐term risk of metastatic recurrence (MR) among Italian women with breast cancer (BC) by period, age, stage, and surrogate molecular profile. Methods Data on 59,968 women below age 75 years diagnosed in 1997–2017 with stage I‐III BC from 7 population‐based Italian cancer registries were analyzed. We used a novel modeling method, based on an illness–death process coupled with a mixture cure model, to estimate relative survival and MR risks up to 15 years after BC diagnosis according to calendar period, age, stage, and profile. Results The risk of MR for the entire cohort at 15 years decreased from 20.6% in 1997–2006 to 12.3% in 2007–2017, when MR risk within 15 years was 3.0% for stage I, 16.0% for stage II, and 42.7% for stage III. The conditional risk of MR decreased with time since diagnosis, with stage I–III triple‐negative BC having a higher risk of developing MR in the first 5 years regardless of age (16.0% at age 15–54 years and 18.3% at 55–74 years), but < 1% once they survived for 5 years without recurrence. In contrast, hormone receptor‐positive BC had a lower but persisting risk of MR of about 6% for both age groups in the first 10 years, halving to about 3% in the following 5 years after diagnosis. Conclusions This study provides a population‐based estimate of the long‐term risk of MR for women with BC by major prognostic factors. These findings may help in tailoring follow‐up strategies through informative risk stratification.
Journal Article
Trends in Net Survival from Vulvar Squamous Cell Carcinoma in Italy (1990–2015)
by
Ferretti, Stefano
,
Rosso, Stefano
,
Ballotari, Paola
in
Cancer therapies
,
Chemotherapy
,
Clinical medicine
2023
(1) Objective: In many Western countries, survival from vulvar squamous cell carcinoma (VSCC) has been stagnating for decades or has increased insufficiently from a clinical perspective. In Italy, previous studies on cancer survival have not taken vulvar cancer into consideration or have pooled patients with vulvar and vaginal cancer. To bridge this knowledge gap, we report the trend in survival from vulvar cancer between 1990 and 2015. (2) Methods: Thirty-eight local cancer registries covering 49% of the national female population contributed the records of 6274 patients. Study endpoints included 1- and 2-year net survival (NS) calculated using the Pohar-Perme estimator and 5-year NS conditional on having survived two years (5|2-year CNS). The significance of survival trends was assessed with the Wald test on the coefficient of the period of diagnosis, entered as a continuous regressor in a Poisson regression model. (3) Results: The median patient age was stable at 76 years. One-year NS decreased from 83.9% in 1990–2001 to 81.9% in 2009–2015 and 2-year NS from 72.2% to 70.5%. Five|2-year CNS increased from 85.7% to 86.7%. These trends were not significant. In the age stratum 70–79 years, a weakly significant decrease in 2-year NS from 71.4% to 65.7% occurred. Multivariate analysis adjusting for age group at diagnosis and geographic area showed an excess risk of death at 5|2-years, of borderline significance, in 2003–2015 versus 1990–2002. (4) Conclusions: One- and 2-year NS and 5|2-year CNS showed no improvements. Current strategies for VSCC control need to be revised both in Italy and at the global level.
Journal Article
Sense and Sensibility: The Role of Cognitive Appraisal in Resident Support for Cultural Events
by
Cavallo, Daniela
,
Baratta, Rossella
in
Cognition & reasoning
,
Cognitive Appraisal Theory
,
Community Support
2025
This research delves into the pivotal role of local community support in the success of cultural events, focusing on the Italian Capital of Culture. While Social Exchange Theory has been extensively used to understand residents' support, its limitations have recently prompted the integration of Cognitive Appraisal Theory to explore the emotional and coping aspects. A mixed-method approach is employed, utilizing a survey of 635 residents to assess perceived benefits and costs, alongside 17 interviews exploring residents' emotions and coping potential in relation to the event. Results reveal that perceived costs contribute to the lack of support, whereas perceived benefits show an insignificant impact. In addition, positive emotions towards the event are associated with residents' support, whereas negative emotions and a limited coping potential prompt residents to oppose the event. This integrated approach contributes to the literature on residents' attitudes toward cultural events, offering insights for local administrations and event organizers.
Journal Article