1,721,294 research outputs found
Sopravvivenza relativa (SR) per tumore maligno nei pazienti anziani europei rispetto agli adulti di mezza età: SR a 1 e 5 anni dalla diagnosi dei casi incidenti 1990-94 e analisi del trend 1983-94.
No full textcancer survival - elderly - middle age
TRENDS IN LUNG-CANCER MORTALITY IN 3 BROAD ITALIAN GEOGRAPHICAL AREAS BETWEEN 1969 AND 1987
No full textTrends in death certification rates from lung cancer in broad Italian geographical areas (north/centre/south) were analysed over the period 1969-1987. In northern Italy, lung cancer rates in young and middle-aged males reached a peak between the mid and late 1970s, and tended to decline afterwards; only above age 60 was mortality still rising in the 1980s. A similar pattern of age-specific rates was observed in central areas, while in the South rates tended to level off in the early 1980s only below age 55, but were still upwards in subsequent age groups. Consequently, the north/south ratio for the overall age-standard rate increased slightly between the late 1960s and mid 1970s, from 1.68 (corresponding to a world standardised rate of 47.1/100 000 in the north vs. 28.1 in the south) to 1.73, but declined to 1.55 between 1985 and 1987 (for a rate of 69.1/100 000 males in the north vs. 44.6 in south). In the younger age groups a diverging pattern was observed: at ages of 25-34 rates in 1985 and 1987 were apparently higher in the south (1.0 vs. 0.9/100 000 in the north), and in the 35-44 age group the north/south ratio decreased from 1.7 to 1.2 (with rates of 12.9 and 10.7, respectively, in 1985 and 1987). Among females, lung cancer rates increased in all geographical areas and age groups except the youngest (25-34 years). Under the age of 50, the rises were proportionally similar in various geographical areas, thus widening the north/south difference in absolute terms. Above the age of 50, the north/south difference tended to be wider in relative terms too, reaching a factor of 2 in the 65-74 age group. The overall age-standardised north/south ratio for females increased from 1.51 in 1969-1974 (5.6 vs. 3.7/100 000) to 1.87 in 1985-1987 (8.4 vs. 4.5/100 000). These trends reflect changes in smoking habits in subsequent generations of Italian males and females from different areas of the country, and confirm the central role of cigarette smoking in lung cancer rates in various populations, although this does not exclude some influence by other, mainly occupational, lung carcinogens on the substantial differences in lung cancer rates in various Italian geographical areas
Epidemiology of rare cancers and inequalities in oncologic outcomes
No full textRare cancers epidemiology is better known compared to the other rare diseases. Thanks to the long history of the European population-based cancer registries and to the EUROCARE huge database, the burden of rare cancers has been estimated the European (EU28) population. A considerable fraction of all cancers is represented by rare cancers (24%). They are a heterogeneous group of diseases, but they share similar problems: uncertainty of diagnosis, lack of therapies, poor research opportunities, difficulties in clinical trials, lack of expertise and of centres of reference. This paper analyses the major epidemiological indicators of frequency (incidence and prevalence) and outcome (5-year survival) of all rare cancers combined and of selected rare cancers that will be in depth treated in this monographic issue. Source of the results is the RARECAREnet search tool, a database publicly available. Disparities both in incidence and survival, and consequently in prevalence of rare cancers were reported across European countries. Major differences were shown in outcome: 5-year relative survival for all rare cancers together, adjusted by age and case-mix, varied from 55% or more (Italy, Germany, Belgium and Iceland) and less than 40% (Bulgaria, Lithuania and Slovakia). Similarly, for all the analyzed rare cancers, a large survival gap was observed between the Eastern and the Nordic and Central European regions. Dramatic geographical variations were assessed for curable cancers like testicular and non epithelial ovarian cancers. Geographical difference in the annual age-adjusted incidence rates for all rare cancers together varied between >140 per 100,000 (Italy, Scotland, France, Germany, and Switzerland) and <100 (Finland, Portugal, Malta, and Poland). Prevalence, the major indicator of public health resources needs, was about 7-8 times larger than incidence. Most of rare cancers require complex surgical treatment, thus a multidisciplinary approach is essential and treatment should be provided in centres of expertise and/or in networks including expert centres. Networking is the most appropriate answer to the issues pertaining to rare cancers. Actually, in Europe, an opportunity to improve outcome and reduce disparities is provided by the creation of the European Reference Networks for rare diseases (ERNs). The Joint Action of rare cancers (JARC) is a major European initiative aimed to support the mission of the ERNs. The role of population based cancer registries still remains crucial to describe rare cancers management and outcome in the real word and to evaluate progresses made at the country and at the European level
A wide difference in cancer survival between middle aged and elderly patients in Europe.
No full textAbstract
Nowadays the burden of cancer in elderly people has reached an alarming extent. The purpose of this study is comparing cumulative and conditional relative survival in elderly patients between 65 and 84 years and younger adults aged from 55 to 64. Fifty-three cancer registries of 22 European countries, participating in the EUROCARE-3 programme, collected information on the cases diagnosed over the period 1990-1994. We computed cumulative and conditional relative survival for 16 cancer sites. Middle aged patients experienced a better prognosis than the elderly for all cancer sites, in both sexes and the differences were more marked at 1 than 5 years since diagnosis. The very large differences noted in the first period after cancer detection declined in the subsequent years and, when 5-years conditional survival was considered, for several cancers the elderly and younger adults had the same probabilities of surviving. The death relative excess risks (RERs) in the elderly with respect younger individuals were really very high and markedly larger at 1 than 5 years, and in women than men. Genitourinary and gynaecological cancers showed the highest RERs, around 2.0 and between 1.5 and 2.5 respectively. This very high early mortality could be due not only to clinical aspects: the barriers to health care access and a consequent late diagnosis might represent for elderly patients the main determinant of this very large prognostic disadvantage. In conclusion, clinical management of cancer in the elderly remains a major issue to be faced with complex social and health care policies
Metodi di stima della sopravvivenza nazionale per tumore in nazioni parzialmente coperte da registrazione.
No full textcancer survival - estimate method
Models for estimating cancer survival rates in the italian regions by mean sod socio-economic and health-related ecological variables.
No full textModels for estimating cancer survival rate
Use of socio-economic factors and healthcare resources to estimate cancer survival in European countries with partial national cancer registration.
No full textAbstract
BACKGROUND AND AIMS: Cancer is a chronic disease whose clinical history has a strong relationship with socio-economic indicators, and it could be defined as a real "social disease". For this reason, socio-economic factors can be used to project survival rates by means of ecological models. The present study had two main aims: to generalize to all adult patients study of the association between survival and socio-economic and healthcare technologies and related medical resources factors; to provide insights on the possible bias in giving national meaning to survival rates based on pools of regional cancer registries where national coverage is not available.
MATERIAL AND METHODS: The EUROCARE 3 Study provided age-standardized survival rates at 5 years from the diagnosis for 10 major cancer sites collected by 52 cancer registries from 21 European countries for the period 1990-1994. For each area and country, socio-economic and health-related variables were collected for the period 1993-1995. Multiple linear regression models were used to compute predicted survival rates in countries totally covered by registration, starting from the correlation between socio-economic and health-related variables and observed survival rates. For those areas not totally covered by cancer registry activity, a correctional parameter coming from the previous linear regression models was computed in order to estimate survival at a national level also in these countries.
RESULTS: Predicted survival rates were very close to the observed rates for countries totally covered by cancer registries. The estimates were also good for nations with partial national cancer registration, with less convergence in results for countries where socio-economic differences between the whole territory and the covered area were relevant.
CONCLUSIONS: In the light of these findings, evaluation of the role of socio-economic and health-related factors and the estimation of survival is of utmost importance in order to evaluate healthcare outcomes and to support planners in allocating resources in a more effective and egalitarian way
Methods to estimate national survival for different cancer sites in nations only partially covered by cancer registration.
No full textMethods to estimate national survival for different cancer sites in nations only partially covered by cancer registratio
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