Abstract：
BACKGROUND: the description of the geographical distribution and temporal trends of cancer is relevant for prevention and improving the quality of care. This is primarily achieved through the incidence measures derived from population cancer registries (CRs). In recent years, in Italy there has been a prevalence of \'real-time\' estimates and projections, although based on rather dated data. Given the significant increase in registration activity and still in absence of a national cancer registry network, the recent publication of Volume 12 of Cancer Incidence in Five Continents (CI5) provides a valuable opportunity to update cancer incidence estimates in Italy and to provide national and macroarea reference estimates.
OBJECTIVE: to explore the pattern of cancer in Italy by reviewing and reorganizing the most recent data from cancer registries.
METHODS: data from Italian cancer registries included in CI5 for the years 2013-2017 were obtained. Populations were verified, corrected for errors, and normalized to Italian National census reconstruction. The completeness of CR data was assessed using the mortality/incidence ratio applied to potential outlier data. Age-specific rates, Age standardized rates (ASRs), and truncated rates for adults (35-64 years) were calculated for 79 different neoplasms. Analyses were performed for individual CRs and macroareas. Temporal comparisons were made for 23 CRs with data from 2008-2012.
RESULTS: the observed incidence rates show extreme heterogeneity. Among males, the overall ASR ranges from 584 per 100,000 in the province of Reggio Calabria to 809.9 per 100,000 in the province of Sondrio. Among women, ASR is highest in Emilia-Romagna (540.5) and lowest in the province of Avellino (409.9). The gradient with decreasing rates from North to South is clearly visible only for female breast cancer. Higher rates of lung cancer are observed for the city of Naples in both genders. In adult males (35-64 years), ASRs of lung cancer are maximum in the provinces of Caserta and Naples, where they are more than double the ASRs observed in the Veneto Region. In general, a significant decline in male ASRs is observed in Northern Italy compared to the previous five-year period. A significant part of this trend is influenced by lung cancer that is significantly decreasing throughout the Centre-North among men and substantially increasing among women. The database and tables with details of all calculated indicators are provided as supplementary material.
CONCLUSIONS: the analysis has shown the importance of a review of real CR data and, in general, working with real data to not only develop specific estimates of cancers in Italy, but also to share reference rates and basic data for further analysis. The present review has also revealed critical issues with data submitted to the IARC. The comparison and verification of data quality through control and audit processes must represent a concrete operational perspective of the national cancer registry network. From the perspective of cancer epidemiology, important indications emerge regarding the distribution of cancers that can fuel aetiological research, as well as the planning of prevention and care activities. The data also show that it is advisable to separate the provinces of Caserta and Naples from the South in estimation and projection models. The comparison and verification of data quality through control and audit processes must represent a concrete operational perspective of the national cancer registry network.
OBJECTIVE: to explore the pattern of cancer in Italy by reviewing and reorganizing the most recent data from cancer registries.
METHODS: data from Italian cancer registries included in CI5 for the years 2013-2017 were obtained. Populations were verified, corrected for errors, and normalized to Italian National census reconstruction. The completeness of CR data was assessed using the mortality/incidence ratio applied to potential outlier data. Age-specific rates, Age standardized rates (ASRs), and truncated rates for adults (35-64 years) were calculated for 79 different neoplasms. Analyses were performed for individual CRs and macroareas. Temporal comparisons were made for 23 CRs with data from 2008-2012.
RESULTS: the observed incidence rates show extreme heterogeneity. Among males, the overall ASR ranges from 584 per 100,000 in the province of Reggio Calabria to 809.9 per 100,000 in the province of Sondrio. Among women, ASR is highest in Emilia-Romagna (540.5) and lowest in the province of Avellino (409.9). The gradient with decreasing rates from North to South is clearly visible only for female breast cancer. Higher rates of lung cancer are observed for the city of Naples in both genders. In adult males (35-64 years), ASRs of lung cancer are maximum in the provinces of Caserta and Naples, where they are more than double the ASRs observed in the Veneto Region. In general, a significant decline in male ASRs is observed in Northern Italy compared to the previous five-year period. A significant part of this trend is influenced by lung cancer that is significantly decreasing throughout the Centre-North among men and substantially increasing among women. The database and tables with details of all calculated indicators are provided as supplementary material.
CONCLUSIONS: the analysis has shown the importance of a review of real CR data and, in general, working with real data to not only develop specific estimates of cancers in Italy, but also to share reference rates and basic data for further analysis. The present review has also revealed critical issues with data submitted to the IARC. The comparison and verification of data quality through control and audit processes must represent a concrete operational perspective of the national cancer registry network. From the perspective of cancer epidemiology, important indications emerge regarding the distribution of cancers that can fuel aetiological research, as well as the planning of prevention and care activities. The data also show that it is advisable to separate the provinces of Caserta and Naples from the South in estimation and projection models. The comparison and verification of data quality through control and audit processes must represent a concrete operational perspective of the national cancer registry network.
摘要：
背景：对癌症地理分布和时间趋势的描述与预防和提高护理质量有关。这主要是通过从人群癌症登记处（CR）得出的发病率指标来实现的。近年来,在意大利，“实时”估计和预测普遍存在，尽管基于相当过时的数据。鉴于登记活动显著增加，而且仍然没有国家癌症登记网络，最近出版的《五大洲癌症发病率》(CI5)第12卷提供了一个宝贵的机会来更新意大利的癌症发病率估计值,并提供国家和宏观地区的参考估计值.
目的：通过审查和重组癌症登记处的最新数据来探索意大利的癌症模式。
方法：获得了2013-2017年意大利癌症登记处纳入CI5的数据。人口被核实，纠正错误，并使意大利全国人口普查重建正常化。使用应用于潜在异常数据的死亡率/发病率比评估CR数据的完整性。特定年龄的比率，年龄标准化率(ASR)，并计算了79种不同肿瘤的成人（35-64岁）截短率。对单个CR和宏观区域进行了分析。对23个CR与2008-2012年的数据进行了时间比较。
结果：观察到的发病率显示出极端的异质性。在男性中，总体ASR范围从雷焦卡拉布里亚省的每100,000人中的584人到Sondrio省的每100,000人中的809.9人。在女性中,ASR在艾米利亚-罗马涅（540.5）最高，在阿韦利诺省（409.9）最低。从北方到南方，发病率下降的梯度仅在女性乳腺癌中清晰可见。在两种性别中，那不勒斯市的肺癌发病率都较高。成年男性（35-64岁），肺癌的ASR在卡塞塔和那不勒斯省是最大的，它们是威尼托地区观察到的ASR的两倍以上。总的来说,与前五年相比,意大利北部男性ASR显著下降.这种趋势的很大一部分受到肺癌的影响，肺癌在整个中北部地区的男性显着减少，而在女性中却大大增加。提供了包含所有计算指标细节的数据库和表格作为补充材料。
结论：分析显示了审查真实CR数据的重要性，总的来说,使用真实数据不仅可以得出意大利癌症的具体估计，还可以分享参考利率和基础数据，以便进一步分析。本审查还揭示了提交给IARC的数据的关键问题。通过控制和审核过程对数据质量进行比较和验证必须代表国家癌症注册网络的具体操作观点。从癌症流行病学的角度来看，关于癌症的分布出现了重要的迹象，可以促进病因研究，以及预防和护理活动的规划。数据还表明，建议在估计和预测模型中将卡塞塔省和那不勒斯省与南方分开。通过控制和审核过程对数据质量进行比较和验证必须代表国家癌症注册网络的具体操作观点。
目的：通过审查和重组癌症登记处的最新数据来探索意大利的癌症模式。
方法：获得了2013-2017年意大利癌症登记处纳入CI5的数据。人口被核实，纠正错误，并使意大利全国人口普查重建正常化。使用应用于潜在异常数据的死亡率/发病率比评估CR数据的完整性。特定年龄的比率，年龄标准化率(ASR)，并计算了79种不同肿瘤的成人（35-64岁）截短率。对单个CR和宏观区域进行了分析。对23个CR与2008-2012年的数据进行了时间比较。
结果：观察到的发病率显示出极端的异质性。在男性中，总体ASR范围从雷焦卡拉布里亚省的每100,000人中的584人到Sondrio省的每100,000人中的809.9人。在女性中,ASR在艾米利亚-罗马涅（540.5）最高，在阿韦利诺省（409.9）最低。从北方到南方，发病率下降的梯度仅在女性乳腺癌中清晰可见。在两种性别中，那不勒斯市的肺癌发病率都较高。成年男性（35-64岁），肺癌的ASR在卡塞塔和那不勒斯省是最大的，它们是威尼托地区观察到的ASR的两倍以上。总的来说,与前五年相比,意大利北部男性ASR显著下降.这种趋势的很大一部分受到肺癌的影响，肺癌在整个中北部地区的男性显着减少，而在女性中却大大增加。提供了包含所有计算指标细节的数据库和表格作为补充材料。
结论：分析显示了审查真实CR数据的重要性，总的来说,使用真实数据不仅可以得出意大利癌症的具体估计，还可以分享参考利率和基础数据，以便进一步分析。本审查还揭示了提交给IARC的数据的关键问题。通过控制和审核过程对数据质量进行比较和验证必须代表国家癌症注册网络的具体操作观点。从癌症流行病学的角度来看，关于癌症的分布出现了重要的迹象，可以促进病因研究，以及预防和护理活动的规划。数据还表明，建议在估计和预测模型中将卡塞塔省和那不勒斯省与南方分开。通过控制和审核过程对数据质量进行比较和验证必须代表国家癌症注册网络的具体操作观点。
