10,147 research outputs found
[A comparative analysis between regional mesothelioma registries and cancer registries: results of the ReNaM-AIRTUM project].
No full textOBJECTIVES:
to assess the agreement on row data and incidence rates between regional mesothelioma registries (CORs) and population cancer registries (CRs) in Italy, and to contribute in harmonizing the procedures used in identifying the date of incidence and the morphology of mesothelioma cases.
SETTING E PARTICIPANTS:
the mesothelioma cases registered by 19 CRs and by 9 out of 19 CORs were included in the study. Some CORs were not able to participate in the study, because there were no active CRs in their areas.
MAIN OUTCOME MEASURES:
agreement on cases defined as mesotheliomas by the two types of registries; Cohen's k was used for the evaluation of the agreement on morphology on specific mesothelioma (ICD-O-3 90513-90533) and mesothelioma not otherwise specified (NOS) (ICD-O-3 90503); instead, Odds Ratio was calculated to evaluate the direction of the discrepancy. Difference among incidence rates were calculated using data collected by the two types of registries. It was also made a comparison between dates of incidence.
RESULTS:
the comparison among the registered data by the two different types of registry showed a high concordance (>80%), especially in the areas where there is a continuous exchange of data. Only in a few areas a lower concordance was observed. The agreement between specific and non-specific morphology showed a fairly wide range and lower values than the calculation of the positive agreement. CORs used the specific morphology (ICD-O-3 90503-90533) with higher frequency compared to CRs. The CRs incidence standardized rates are higher when only cases defined as «certain » by ReNaM are considered; on the opposite the CORs rates are higher when all cases defined as «certain, probable and possible» are considered.
CONCLUSIONS:
the study permitted to compare and bring out the different procedures used in identifying the date of incidence of cases and morphology definition. This represents a first step of a cooperative discussion process among the involved registries: the working group hope it will end with the implementation of shared guidelines
Confronto fra registri specializzati e registri tumori di popolazione: i risultati del progetto ReNaM-AIRTUM [A comparative analysis between regional mesothelioma registries and cancer registries: results of the ReNaM-AIRTUM project].
No full textAbstract
OBJECTIVES: to assess the agreement on row data and incidence rates between regional mesothelioma registries (CORs) and population cancer registries (CRs) in Italy, and to contribute in harmonizing the procedures used in identifying the date of incidence and the morphology of mesothelioma cases.
SETTING E PARTICIPANTS: the mesothelioma cases registered by 19 CRs and by 9 out of 19 CORs were included in the study. Some CORs were not able to participate in the study, because there were no active CRs in their areas.
MAIN OUTCOME MEASURES: agreement on cases defined as mesotheliomas by the two types of registries; Cohen's k was used for the evaluation of the agreement on morphology on specific mesothelioma (ICD-O-3 90513-90533) and mesothelioma not otherwise specified (NOS) (ICD-O-3 90503); instead, Odds Ratio was calculated to evaluate the direction of the discrepancy. Difference among incidence rates were calculated using data collected by the two types of registries. It was also made a comparison between dates of incidence.
RESULTS: the comparison among the registered data by the two different types of registry showed a high concordance (>80%), especially in the areas where there is a continuous exchange of data. Only in a few areas a lower concordance was observed. The agreement between specific and non-specific morphology showed a fairly wide range and lower values than the calculation of the positive agreement. CORs used the specific morphology (ICD-O-3 90503-90533) with higher frequency compared to CRs. The CRs incidence standardized rates are higher when only cases defined as «certain » by ReNaM are considered; on the opposite the CORs rates are higher when all cases defined as «certain, probable and possible» are considered.
CONCLUSIONS: the study permitted to compare and bring out the different procedures used in identifying the date of incidence of cases and morphology definition. This represents a first step of a cooperative discussion process among the involved registries: the working group hope it will end with the implementation of shared guidelines
Confronto fra registri specializzati e registri tumori di popolazione: i risultati del progetto ReNaM-AIRTUM = A comparative analysis between regional mesothelioma registries and cancer registries: results of the ReNaM-AIRTUM project
No full textOBIETTIVI: stimare il livello di concordanza e le stime di incidenza dei casi di mesotelioma, rilevati da registri indipendenti, i registri regionali dei mesoteliomi (COR) e i registri tumori di popolazione (RT), al fine di contribuire all’armonizzazione delle modalità di identificazione e codifica dei casi.
SETTING E PARTECIPANTI: i casi di mesotelioma registrati da 19 RT italiani e da 9 su 19 COR. Alcuni COR non hanno potuto aderire per l’assenza di RT accreditati nell’area oggetto dello studio.
PRiNCIPALI MISURE DI OUTCOME: si è proceduto al calcolo della concordanza sui positivi per i casi codificati come mesotelioma. La statistica k di Cohen è stata utilizzata per stimare il grado di concordanza fra morfologia di mesotelioma maligno con istotipo specificato (ICD-O-3 da 90513 a 90533) e con istotipo non altrimenti specificato (NAS) (ICD-O-3 90503); inoltre è stato calcolato l’Odds Ratio per valutare la direzione della discordanza di questa codifica. La stima dell’incidenza per entrambi i registri è stata effettuata calcolando tassi di incidenza standardizzati utilizzando come standard la popolazione europea e si è valutata l’eventuale differenza dei tassi. E’ stato effettuato anche un confronto fra le date di incidenza.
RISULTATI: il risultato della concordanza sui positivi ha mostrato in generale valori di concordanza alti (>80%), specialmente nelle aree dove lo scambio di dati è prassi periodica. Solo per poche aree sono emersi risultati di concordanza più bassi. La concordanza fra morfologia di mesotelioma con istotipo, specificato e non, ha mostrato un range abbastanza ampio (k da -0,06 a 0,65) e un valore più basso rispetto al calcolo della concordanza sui positivi. Lo studio ha fatto emergere differenti modalità nell’individuazione della data di incidenza e nella codifica della morfologia, mostrando che i COR sono in grado di attribuire più frequentemente una morfologia con istotipo specificato rispetto ai RT. I tassi standardizzati sono risultati maggiori per i RT quando calcolati per i soli casi definiti «certi» dal ReNaM, considerando, invece, l’insieme di casi ReNaM «certi, probabili e possibili» il valore dei tassi è risultato superiore per i COR.
CONCLUSIONE: questo progetto di collaborazione tra AIRTUM e ReNaM ha permesso di individuare differenze nelle stime di incidenza del mesotelioma maligno prodotte da registri tumori diversi. Tali differenze erano riconducibili, per alcune aree, a una difficoltà nel reperire informazioni utili alla definizione dei casi di mesotelioma. Lo studio ha permesso, inoltre, di consolidare i confronti esistenti e di creare, a livello locale, un’attività di scambio dati tra RT e COR. E’ stato possibile, infine, approntare una prima riflessione comune tra i registri coinvolti per individuare un percorso che si auspica possa portare alla realizzazione di linee guida comuni e alla formazione degli operatori deputati alla codifica.
Parole chiave: mesotelioma, registri tumori, concordanz
Malignant mesothelioma due to non-occupational asbestos exposure from the Italian national surveillance system (ReNaM): epidemiology and public health issues
No full textItaly produced and imported a large amount of raw asbestos, up to the ban in 1992, with a peak in the period between 1976 and 1980 at about 160 000 tons/year. The National Register of Mesotheliomas (ReNaM, "Registro Nazionale dei Mesoteliomi" in Italian), a surveillance system of mesothelioma incidence, has been active since 2002, operating through a regional structure
Asbestos Exposure and Malignant Mesothelioma in Construction Workers—Epidemiological Remarks by the Italian National Mesothelioma Registry (ReNaM)
No full textNotwithstanding the ban in 1992, asbestos exposure for workers in the construction sector in Italy remains a concern. The purpose of this study is to describe the characteristics of malignant mesothelioma (MM) cases recorded by the Italian registry (ReNaM) among construction workers. Incident mesothelioma cases with a definite asbestos exposure have been analyzed. Characteristics of cases and territorial clusters of crude rates of MM in construction workers have been described, as well as the relation between asbestos use before the ban and the historical trend of workforce in the construction sector in Italy. ReNaM has collected 31,572 incident MM cases in the period from 1993 to 2018 and asbestos exposure has been assessed for 24,864 (78.2%) cases. An occupational exposure has been reported for 17,191 MM cases (69.1% of subjects with a definite asbestos exposure). Among them, 3574 had worked in the construction sector, with an increasing trend from 15.8% in the 1993–98 period to 23.9% in 2014–2018 and a ubiquitous territorial distribution. The large use of asbestos in construction sector before the ban makes probability of exposure for workers a real concern still today, particularly for those working in maintenance and removal of old buildings. There is a clear need to assess, inform, and prevent asbestos exposure in this sector
Epidemiological Surveillance for primari prevention of malignant mesothelioma: the Italian Experience,
No full textMagnetic resonance imaging of pelvic floor dysfunction - joint recommendations of the ESUR and ESGAR Pelvic Floor Working Group
No full textObjective: To develop recommendations that can be used as guidance for standardized approach regarding indications, patient preparation, sequences acquisition, interpretation and reporting of magnetic resonance imaging (MRI) for diagnosis and grading of pelvic floor dysfunction (PFD). Methods: The technique included critical literature between 1993 and 2013 and expert consensus about MRI protocols by the pelvic floor-imaging working group of the European Society of Urogenital Radiology (ESUR) and the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) from one Egyptian and seven European institutions. Data collection and analysis were achieved in 5 consecutive steps. Eighty-two items were scored to be eligible for further analysis and scaling. Agreement of at least 80 % was defined as consensus finding. Results: Consensus was reached for 88 % of 82 items. Recommended reporting template should include two main sections for measurements and grading. The pubococcygeal line (PCL) is recommended as the reference line to measure pelvic organ prolapse. The recommended grading scheme is the “Rule of three” for Pelvic Organ Prolapse (POP), while a rectocele and ARJ descent each has its specific grading system. Conclusion: This literature review and expert consensus recommendations can be used as guidance for MR imaging and reporting of PFD. Key points: • These recommendations highlight the most important prerequisites to obtain a diagnostic PFD-MRI.• Static, dynamic and evacuation sequences should be generally performed for PFD evaluation.• The recommendations were constructed through consensus among 13 radiologists from 8 institutions. © 2016 The Author(s
Comment on 'The latency period of mesothelioma among a cohort of British asbestos workers (1978-2005)': methodological problems with case-only survival analysis.
No full textPleural malignant mesothelioma epidemic: incidence, modalities of asbestos exposure and occupations involved from the Italian National Register.
No full textDue to the large scale use of asbestos (more than 3.5 million tons produced or imported until its definitive banning in 1992), a specific national surveillance system of mesothelioma incident cases is active in Italy, with direct and individual anamnestic etiological investigation. In the period between 1993 and 2004, a case-list of 8,868 pleural MM was recorded by the Italian National Register (ReNaM) and the modalities of exposure to asbestos fibres have been investigated for 6,603 of them. Standardized incidence rates are 3.49 (per 100,000 inhabitants) for men and 1.25 for women, with a wide regional variability. Occupational asbestos exposure was in 69.3% of interviewed subjects (N = 4,577 cases), while 4.4% was due to cohabitation with someone (generally, the husband) occupationally exposed, 4.7% by environmental exposure from living near a contamination source and 1.6% during a leisure activity. In the male group, 81.5% of interviewed subjects exhibit an occupational exposure. In the exposed workers, the median year of first exposure was 1957, and mean latency was 43.7 years. The analysis of exposures by industrial sector focuses on a decreasing trend for those traditionally signaled as "at risk" (asbestos-cement industry, shipbuilding and repair and railway carriages maintenance) and an increasing trend for the building construction sector. The systematic mesothelioma surveillance system is relevant for the prevention of the disease and for supporting an efficient compensation system. The existing experience on all-too-predictable asbestos effects should be transferred to developing countries where asbestos use is spreadin
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