1,721,026 research outputs found
Useful indicators to interpret the cancer burden in Italy.
No full textIntroduction. In the last decades the demographics of most Western countries have undergone a deep transformation, which has caused a steady increase in degenerative chronic diseases and has made maintaining health and social support by the welfare system difficult. This paper aims to present a set of indicators pertaining to the health status of the Italian population and to the national economic and social systems, as an aid to a better interpretation of the cancer burden impact and of its future tendencies. Material and methods. All indicators were derived from the ISTAT Health for All database. They were presented by region or macro area, globally or by gender, considering the most recent regional distribution and their time trends. The following features of the Italian population were chosen: percent of people aged over 65 years; life expectancy at birth; birth rate; crude and age-standardized overall mortality rates; dependency ratio; percent of single persons; percent of people with no more than a junior high school diploma; percent of people attaining at least the short first university degree; percent of people employed in the service and tertiary sectors; unemployment rate; incidence of poverty; total health expenditure (THE) as an absolute value and as percent of GDP; percent of public THE; percent of out-of-pocket THE of households; percent of smokers; proportion of overweight and obese people aged ≥18 years. Results. Italy presented an unbalanced demographic situation with an increasingly old population, a decreasing middle-aged age group, a low birth rate, high crude overall mortality rates, and decreasing standardized overall mortality rates. The Italian population is characterized by a constant increase in the dependency ratio and in the percentage of people living alone, together with increasing expenses for health care, both at the public and households levels. Smoking has reduced its impact in men but not yet in women. The increasing proportion of overweight and obese people may explain the convergence in time of the mortality rates of the different Italian macro areas. Discussion and conclusion. The Italian situation seems to be not well fitted to face the expected growing cancer burden. Along with the aging of the population, the corresponding lowering of the national GDP due to the persisting global economic crisis will lead the public sector and families to reduce health expenditure, while the number of people affected by cancer is bound to increase. Moreover, the social support provided by family members and the advantages of the Mediterranean dietary habits are declining. The strategies for facing the challenging evolution of the future should focus on successful primary prevention and a wider application of evidence-based medicine to optimize the choice of diagnostic and therapeutic procedures offered to citizens
Capitolo III. Stato di salute e indici di deprivazione in Liguria.
No full textdeprivation index & healt
Procedura di validazione per confronto dell’Indice di Deprivazione Regionale ligure rispetto all’Indice di Deprivazione Nazionale italiano tramite l’analisi della sopravvivenza delle pazienti affette da tumore della mammella nel comune di Genova.
No full textIndici di deprivazione a confronto sulla sopravvivenza per cancr
Metodi di stima della sopravvivenza nazionale per tumore in nazioni parzialmente coperte da registrazione.
No full textcancer survival - estimate method
Stato di salute e deprivazione socio-economica per la provincia di Savona.
No full textStato di salute e deprivazione socio-economic
[Building of a local deprivation index to measure the health status in the Liguria Region].
No full textAbstract
AIMS: during the last twenty years, in the most of the European nations, studies on how measuring socioeconomic differences related to inequities in take in charge of patients, health care and outcomes have been developed. The aim of this paper is the computation of a Liguria Region Deprivation Index (IDR), able to describe the peculiar health characteristics of the Liguria population, economically and socially quite homogeneous, on the basis of the socioeconomic (SE) differences related to health outcomes according to the differences in general mortality.
DESIGN: all the population and households variables from the 2001 Italian Census have been considered at municipal level and, for Genoa and Savona, at lower administrative area level, selecting only the ones significantly correlated to the general mortality by Pearson correlation. The Standard Mortality Ratios (SMR on 2001 standard Liguria population) for Overall Mortality by gender and age groups (0-64 years and 65+ years) have been used as dependent variables. In order to build the RDI and classify the areas on the basis of increasing socioeconomic deprivation, a multivariate methodology have been used by means of principal component factor analysis of the previous selected variables and k-means clustering of the geographical areas; then these results have been compared with the SMR by analysis of variance. Finally, the RDI has been applied to the SMR of some groups of principal causes of death (all tumours and cardiovascular, respiratory and digestive system diseases), in order to differentiate the population by health outcomes.
RESULTS: two factors have been identified: an economic-educational factor and a socio-familiar one. The first factor describes the educational level and occupation, while the second one the marital status, the family dimension and the house peculiarities. The clustering procedure has allowed to identify five groups of geographical areas, distributed by the increasing of the SE deprivation. The most problematic areas are located in the countryside or in some spot places of the seaside, far from the health care centres and with difficult access by travel connection. The association between RDI and overall mortality SMRs confirms the relationship between deprivation and mortality increases, according to a statistically significant linear trend. Similar relationships have been observed for cardiovascular and digestive system diseases, while no associations have been found for respiratory illness and overall cancers.
CONCLUSIONS: the RDI is able to give information on the health differences in the population, by differentiating the mortality trend on the basis of specific situations of richness and social hardship. It is useful not only for disentangling by economic condition, but also by the resources of the social and familiar support to cope with the illness situations. So, the relationship between deprivation and mortality, according to a statistically significant linear trend, shows how groups of Liguria people suffer by a lack of familiar resources, which strongly reduces the possibility of a quick take in charge and the adhesion to the more adequate therapeutic procedure, till to fatal results. In this way, areas of aimed actions can be defined by the local decision-makers, in order to optimize the health resources allocation and to reduce inequities
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
Deprivation and cancer incidence in a de-industrialised and highly ageing area. [Deprivazione e incidenza di cancro in un’area ex-industriale a forte invecchiamento].
No full textAbstract
Aims: The analysis by tumor site, age groups and gender of the 1999-2003 cancer incidence in Genoa province population clusters in relationships with the socio-economic (SE) deprivation, evaluating if the observed associations confirmed the literature.
Methods: The SIR of all malignant cancers (but not melanoma skin cancers) and 35 sites were computed by deprivation cluster, gender and age groups (all ages, 0-64, 65+ years), evaluating the variance in SIR among groups. The SE clusters were individuated by the Genoa Deprivation Index
(GDI), derived from the re-parameterisation of the LRDI (Liguria Region Deprivation Index) inside the territorial limits of Genoa province.
Results: All malignant cancers combined showed no association with deprivation in both sexes due to a balance of positive and negative observed associations. Increasing trend at decreasing deprivation (linear negative associations) regarded colon, melanoma, skin carcinomas, breast, prostate, meningioma and myelodysplastic syndromes, while the opposite (linear positive associations) were observed for oropharynx, oesophagus, stomach, rectum, liver, lung, mesothelioma, uterine corpus, testis, kidney, brain, Hodgkin’s and non-Hodgkin’s lymphomas and myeloma.
Conclusions: The combined effects of population ageing, de-industrialisation and increasing role of touristic activities in Liguria induced a situation forerunner of the possible post-industrial Western countries development outcomes. Our study confirmed some known associations between deprivation and cancer incidence occurrence: both the positive with smoke- and alcohol-consumption (oropharynx, oesophagus, lung) and infectious risks (rectum, liver) and the negative ones with diet, obesity and sedentariness (colon, breast, prostate) and sun recreational exposure (skin carcinomas, melanoma). Also the controversial evidences regarding brain and haematological tumours seemed confirmed. From the
future experiences of re-allocation of resources on the Genoa territory could derive input on readjustment policies on social and health resources redistribution at national level
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
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