Italian cancer figures, report 2009: Cancer trend (1998-2005).

OBJECTIVE: the aim of this collaborative project of the Italian Network of Cancer Registries (Airtum; www.registri-tumori.it) was to analyse cancer incidence and mortality trends in Italy with special reference to the period 1998-2005.

METHOD: the study was based on the Airtum database, which collects and checks data from all the Airtum registries. The present study was based on 20 general and 2 specific populationbased cancer registries. Overall, we analysed 818,017 incident cases and 342,444 cancer deaths for the time period 1998-2005. Seventy percent of the analysed population was from the North of Italy, 17% from the Centre, and 13% from the South. A joinpoint analysis was carried out to detect the point in time where the trend changed; trends are described by means of the estimated annual percent change (APC), with appropriate 95% confidence intervals. Crude and standardized incidence and mortality rates were computed for 36 cancer sites, for both sexes, three age-classes (0-49, 50-69 and 70+ years), and three geographic areas (North, Centre, and South of Italy). Specific chapters are devoted to long-term trends (1986-2005), differences among age-groups, and international comparisons.

RESULTS: In 1998-2005, cancer mortality for all sites showed a statistically significant decrease among men (APC - 1.7) and women (- 0.8). Mortality significantly decreased in both sexes for stomach cancer, rectum cancer, liver cancer, and Hodgkin lymphoma. Mortality also decreased among men for cancers of the upper aerodigestive tract, oesophagus, lung, prostate, urinary bladder, and leukaemia. Among women mortality decreased for cancers of the colon, bone, breast, and uterus not otherwise specified. An increase in mortality was recorded for lung cancer among women (+1.5) and melanoma among men (+2.6). Incidence for all cancers together (except non-melanoma skin cancers) increased among men (APC +0.3) and remained stable among women. Cancer sites which showed increasing incidence were thyroid and melanoma in both sexes, colon, testis, soft tissue among men, and lung and Hodgkin lymphoma among women. For several cancer sites incidence decreased, e.g., stomach and Kaposi sarcoma (men and women), upper aerodigestive tract, oesophagus, lung, urinary bladder, myeloma and leukaemia (men), gallbladder, cervix uteri and ovary (women).

CONCLUSIONS: this monograph presents a detailed description of cancer incidence and mortality trends in Italy. It is based on the Italian Network of Cancer Registries which presently covers about one-third of the whole Italian population. This monograph is a useful scientific tool for all those, be they researchers or public health administrators, who are involved in the fields of cancer prevention and care.