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ObjectiveThe impact of a screening programme on colorectal cancer (CRC) incidence in its target population depends on several variables, including coverage with invitations, participation rate, positivity rate of the screening test, compliance with an invitation to second-level assessment and endoscopists’ sensitivity. We propose a synthetic indicator that may account for all the variables influencing the potential impact of a screening programme on CRC incidence.DesignWe defined the ‘rate of advanced adenoma on the target population’ (AA-TAP) as the rate of patients who received a diagnosis of advanced adenoma within a screening programme, divided by the programme target population. We computed the AA-TAP for the CRC Italian screening programmes (biennial faecal immunochemical test, target population 50–69 year olds) using the data of the Italian National Survey from 2003 to 2016, overall and by region, and assessed the association between AA-TAP and CRC incidence fitting a linear regression between the trend of regional CRC incidence rates in 50–74 year old subjects and the cumulative AA-TAP.ResultsIn 2016, the AA-TAP at a national level was 105×100 000, whereas significant differences were observed between the northern and central regions (respectively 126 and 149×100 000) and the South and Islands (36×100 000). The cumulative AA-TAP from 2004 to 2012 was significantly correlated with the difference between CRC incidence rates in 2013–2014 and those in 2003–2004 (p=0.009).ConclusionThe AA-TAP summarises into a single indicator the potential impact of a screening programme in reducing CRC incidence rates.

Population-based cancer registries are crucial to monitor health system performance, inform policy makers and allocate resources effectively. We updated Italian survival estimates for children and adolescents, analysing temporal and geographical differences to evaluate improvements. Cases were from the Association of Italian Cancer Registries and codified according to the International Classification of Childhood Cancer, 3rd edition. Thirty-one cancer registries provided 9142 incident cases (2013–2017) and 15 cancer registries contributed data for 12,447 incident cases (1998–2017) for trend analysis. We used the period approach to estimate survival in children (0–14 years) and adolescents (15–19 years) during the period 2013–2017. Survival was estimated by age, sex and geographical area of residence. Survival improved over time in both children and adolescents. Among children, significant progress was observed for acute myeloid leukaemia, non-Hodgkin lymphomas, ependymomas, Ewing sarcoma, and acute lymphoid leukaemia. For adolescents, notable improvements were found in non-Hodgkin lymphomas and skin melanomas. However, disparities emerged across Italy, with major differences observed for central nervous system neoplasms and osteosarcoma in children, as well as for acute lymphatic leukaemia and soft tissue sarcomas in adolescents. Increased survival was observed in many Italian children and adolescents with tumours and differences emerged across Italian regions. We will investigate the reasons for these discrepancies in collaboration with clinicians. •In Italy, 5-year survival reached 85 % in children, 89 % in adolescents.•Progress has been observed in leukaemia, lymphomas, and certain solid tumours.•Survival improved in children with acute myeloid leukaemia and non-Hodgkin lymphomas.•In adolescents, survival increased mainly for lymphomas.•Cancer registries are essential to monitor trends and guide health policies.

The demographic transition, together with changes in lifestyles and the exposure to other risk factors, contributed to a rising burden of chronic degenerative diseases, including cancer, in Italy. We provided updated figures on cancer incidence and mortality in Italy during the period 2013–2017, using data provided by 34 population-based cancer registries from the AIRTUM network. Age-standardized incidence rates (ASRs) and age-standardized mortality rates (ASMRs) per 100,000 were estimated, stratified by sex, cancer site or type, and macroarea. The cumulative risk (number of individuals who need to be followed over a lifetime for one to develop cancer), stratified by cancer site and sex, was estimated. Overall, 1,359,053 incident cancer cases (52.8 % in men) were registered during the surveillance period. The ASR for all malignant tumours was 657.1 per 100,000 among men and 475.5 per 100,000 among women. We documented the highest ASRs for all cancer sites in both sexes (males: 685.7 per 100,000, females: 496.1 per 100,000) in the North, followed by the Center (males: 646.6 per 100,000, females: 488.1 per 100,000), and the South and Islands (males: 626.7 per 100,000, females: 435.4 per 100,000). Mortality rates are less than half that of incidence rates (SMR was 331.8 per 100,000 men and 188.8 per 100,000 women), with negligible differences among Italian areas. One man out of two and 1 women out of three may develop a cancer in their lifetime. Despite incidence and mortality figures in Italy were almost aligned with the ones documented in Europe, our findings recalled the importance for policy-makers to implement national policies and community-based prevention strategies aimed at reducing the cancer burden. •The study, covering 80 % of Italian population, analyzes data from 34 Cancer Registries of the AIRTUM network for the period 2013–2017 (1359053 cases).•Incidence rates (ASR): men 657.1/100,000, women 475.5/100,000. Mortality rates (ASMR): men 331.8/100,000, women 188.8/100,000.•The cumulative risk of developing cancer is 1 in 2 men and 1 in 3 women.•Most frequent cancers: Men: Prostate (18 %), Lung (15 %), Colorectal (13 %). Women: Breast (31 %), Colorectal (12 %), Lung (7 %).•Geographic Differences in incidence and mortality were present and their ranking depended on cancer site.

Background Recent genome-wide studies of many species reveal the existence of a myriad of RNAs differing in size, coding potential and function. Among these are the long non-coding RNAs, some of them producing functional small peptides via the translation of short ORFs. It now appears that any kind of RNA presumably has a potential to encode small peptides. Accordingly, our team recently discovered that plant primary transcripts of microRNAs ( pri-miRs ) produce small regulatory peptides (miPEPs) involved in auto-regulatory feedback loops enhancing their cognate microRNA expression which in turn controls plant development. Here we investigate whether this regulatory feedback loop is present in Drosophila melanogaster . Results We perform a survey of ribosome profiling data and reveal that many pri-miRNAs exhibit ribosome translation marks. Focusing on miR-8, we show that pri-miR-8 can produce a miPEP-8. Functional assays performed in Drosophila reveal that miPEP-8 affects development when overexpressed or knocked down. Combining genetic and molecular approaches as well as genome-wide transcriptomic analyses, we show that miR-8 expression is independent of miPEP-8 activity and that miPEP-8 acts in parallel to miR-8 to regulate the expression of hundreds of genes. Conclusion Taken together, these results reveal that several Drosophila pri-miRs exhibit translation potential. Contrasting with the mechanism described in plants, these data shed light on the function of yet undescribed primary-microRNA -encoded peptides in Drosophila and their regulatory potential on genome expression.

Background According to international guidelines, Human Papillomavirus (HPV) DNA tests represent a valid alternative to Pap Test for primary cervical cancer screening, provided that they guarantee balanced clinical sensitivity and specificity for cervical intraepithelial neoplasia grade 2 or more (CIN2+) lesions. The study aimed to assess whether HPV Selfy (Ulisse BioMed – Trieste, Italy), a full-genotyping HPV DNA test that detects and differentiates 14 high-risk HPV (HR-HPV) types, meets the criteria for primary cervical cancer screening described in the international guidelines, on clinician-collected as well as on self-collected samples. Methods For each participant woman, consecutively referring to Azienda Sanitaria Universitaria Giuliano Isontina (Trieste, Italy) and CRO—National Cancer Institute (Aviano, Italy) for the cervical cancer screening program, the following samples were tested: (a) a clinician-collected cervical specimen, analyzed with the reference test (Hybrid Capture®2 test, HC2) and HPV Selfy; and (b) a self-collected vaginal sample, analyzed with HPV Selfy. Enrolled women were also asked to fulfill a questionnaire about self-sampling acceptability. As required by guidelines, a non-inferiority test was conducted to compare the clinical performance of the test under evaluation with its reference test. Results HPV Selfy clinical sensitivity and specificity resulted non-inferior to those of HC2. By analysis of a total of 889 cervical liquid-based cytology samples from a screening population, of which 98 were from women with CIN2+, HPV Selfy showed relative sensitivity and specificity for CIN2+ of 0.98 and 1.00 respectively (non-inferiority score test: P  = 0.01747 and P  = 0.00414, respectively); the test reached adequate intra- and inter-laboratory reproducibility. Moreover, we demonstrated that the performance of HPV Selfy on self-collected vaginal samples was non-inferior to the performance obtained on clinician-collected cervical specimen (0.92 relative sensitivity and 0.97 relative specificity). Finally, through HPV Selfy genotyping, we were able to describe HPV types prevalence in the study population. Conclusions HPV Selfy fulfills all the requirements of the international Meijer’s guidelines and has been clinically validated for primary cervical cancer screening purposes. Moreover, HPV Selfy has also been validated for self-sampling according to VALHUDES guidelines. Therefore, at date, HPV Selfy is the only full-genotyping test validated both for screening purposes and for self-sampling. Trial registration ASUGI Trieste n. 16008/2018; CRO Aviano n.17149/2018

Depressive and manic episodes within bipolar disorder (BD) and major depressive disorder (MDD) involve altered mood, sleep, and activity, alongside physiological alterations wearables can capture. Firstly, we explored whether physiological wearable data could predict (aim 1) the severity of an acute affective episode at the intra-individual level and (aim 2) the polarity of an acute affective episode and euthymia among different individuals. Secondarily, we explored which physiological data were related to prior predictions, generalization across patients, and associations between affective symptoms and physiological data. We conducted a prospective exploratory observational study including patients with BD and MDD on acute affective episodes (manic, depressed, and mixed) whose physiological data were recorded using a research-grade wearable (Empatica E4) across 3 consecutive time points (acute, response, and remission of episode). Euthymic patients and healthy controls were recorded during a single session (approximately 48 h). Manic and depressive symptoms were assessed using standardized psychometric scales. Physiological wearable data included the following channels: acceleration (ACC), skin temperature, blood volume pulse, heart rate (HR), and electrodermal activity (EDA). Invalid physiological data were removed using a rule-based filter, and channels were time aligned at 1-second time units and segmented at window lengths of 32 seconds, as best-performing parameters. We developed deep learning predictive models, assessed the channels' individual contribution using permutation feature importance analysis, and computed physiological data to psychometric scales' items normalized mutual information (NMI). We present a novel, fully automated method for the preprocessing and analysis of physiological data from a research-grade wearable device, including a viable supervised learning pipeline for time-series analyses. Overall, 35 sessions (1512 hours) from 12 patients (manic, depressed, mixed, and euthymic) and 7 healthy controls (mean age 39.7, SD 12.6 years; 6/19, 32% female) were analyzed. The severity of mood episodes was predicted with moderate (62%-85%) accuracies (aim 1), and their polarity with moderate (70%) accuracy (aim 2). The most relevant features for the former tasks were ACC, EDA, and HR. There was a fair agreement in feature importance across classification tasks (Kendall W=0.383). Generalization of the former models on unseen patients was of overall low accuracy, except for the intra-individual models. ACC was associated with \"increased motor activity\" (NMI>0.55), \"insomnia\" (NMI=0.6), and \"motor inhibition\" (NMI=0.75). EDA was associated with \"aggressive behavior\" (NMI=1.0) and \"psychic anxiety\" (NMI=0.52). Physiological data from wearables show potential to identify mood episodes and specific symptoms of mania and depression quantitatively, both in BD and MDD. Motor activity and stress-related physiological data (EDA and HR) stand out as potential digital biomarkers for predicting mania and depression, respectively. These findings represent a promising pathway toward personalized psychiatry, in which physiological wearable data could allow the early identification and intervention of mood episodes.

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. [Display omitted] •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

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.