Search

Objectives: to investigate, for the first time, the incidence of cancer (years 2009-2015) and geographical distribution among children and adolescents with cancer diagnosis in Lazio Region (Central Italy)., Design: to compute incidence rates of childhood cancers from Lazio Region Childhood Cancer Registry (LRCCR) database, established in 2015, and to compare results with national figures for 2012 provided by the Italian cancer registries network (AIRTUM)., Setting and Participants: all new cases of malignant tumours (behaviour: /3 of ICD-O-3 classification) and all central nervous system tumours were selected, regardless of behaviour (/0, /1, /3) in children and adolescents (0-19 years) registered in the LRCCR data base., Main Outcome Measures: it was computed: • the raw and the direct standardised rates for the 0-14-year and the 15-19-year age groups for total malignant tumours of the ICCC-3 classification by area (province level and municipality of Rome); • Relative Risks (RR) for area-specific rate compared with that of the Lazio Region and 95% Confidence Intervals (95%CI)., Results: a total of 1,782 incident cases were recorded in 2009-2015; of these, 91.4% were confirmed by a pathology report. Standardized Incidence Rate for all malignant tumours is 207.2×1,000,000 (95%CI 195.5-219.5) in children and 335.1×1,000,000 (95%CI 308.9-361.2) in adolescents. Compared to the Lazio Region, a higher incidence of tumours is observed in Rome municipality (RR 1.09; 95%CI 0.98-1.20) and in the Frosinone province (RR 1.07; 95%CI 0.91-1.25) for the whole 0-19-year age group., Conclusions: compared to the pooled AIRTUM figures for 2003-2008, Lazio Region showed a higher incidence for all cancers, both in children and adolescents, and for specific tumours, such as leukaemia in children and thyroid carcinoma in adolescents. Apart from the diverse observation period, these differences may be due to a higher registry sensitivity of the childhood specialized registry compared to general population registries. The observed incidence excesses for specific geographical areas and tumours deserve further investigations. Overall, in its first seven years of activity, the Lazio childhood cancer registry was able to provide reliable epidemiological figures of cancer incidence in children and adolescents in the Italian context.

Objective: To examine the relationship between air pollution and coronary events in Rome in the period 1998-2000, considering both out-of-hospital deaths and hospitalisations., Design: Time-series of daily counts of out-of-hospital deaths and hospitalised events, implementation of Generalised Additive Models., Setting: The air pollutants taken into account were PNC (Particle Number Concentration--a measure of ultrafine particles), PM10, CO, NO2, SO2 and O3. The association was studied with respect to either single days or the cumulative effect on more consecutive days; furthermore, effect modification by age was tested (for the age groups 0-64, 65-74 and 75+)., Participants: People resident of Rome and died/hospitalised for coronary causes into the city in the period 1998-2000., Main Outcome Measure: Association between pollutants and out-of-hospital deaths/hospitalised events. Distinction between fatal events (out-of-hospital deaths + hospitalisations with death within 28 days of admission) and non fatal events (hospitalisations with survival longer than 28 days)., Results: Significant association between PNC, PM10, and CO with out-of-hospital deaths, smaller effect on hospitalised events. For a variation of PNC of 28000 particles per cm3 (interquartile range of the distribution) the increase in the risk of out-of-hospital coronary death at lag 0 was 8.1%; for hospital admissions, the risk increased by 4%. The association was stronger in subjects older than 65, and was more evident for total fatal events than for non-fatal hospitalisations., Conclusion: The study showed increased risks of coronary events associated with air pollution in Rome: ultrafine particles, directly generated by vehicular traffic, are the environmental indicator which best characterizes the health risk.

Background: Malignant mesothelioma is indicative of past exposure to asbestos. In recent years an increase of incidence and mortality from malignant mesothelioma has been observed. Recent legislation in Italy requires nation-wide registration of asbestos-related pathologies. We conducted a preparatory study for systematic recording of cases of malignant pleural mesothelioma in the Lazio region., Objectives: To register new diagnoses of malignant mesothelioma, to estimate the incidence in the Lazio region, and to evaluate possible survey instruments., Methods: We conducted a systematic study of hospital admissions in the region with diagnosis of cancer of the pleura (ICD-IX 163) in the period 1997-2000. Clinical information and results of diagnostic tests were requested for 530 patients from the hospitals involved. Using the capture-recapture method, it was possible to estimate the accuracy of the data we compiled using hospital admissions as the data source (76.8%, 95% C.I.=76.4-77.3)., Results: After careful review of clinical documentation, the diagnosis of malignant mesothelioma of the pleura was confirmed in 31.6% of cases (156 cases diagnosed). The percentage of confirmed cases has risen over the years (from 21% in 1997 to 45.1% in 2000) and it was higher in large public hospitals than in other types of health care facilities. On the basis of 156 confirmed cases of mesothelioma (116 males and 40 females), we estimated the annual incidence of the disease in the Lazio region as 1.73 new cases per 100,000 inhabitants among men and 0.47 new cases per 100,000 inhabitants among women., Conclusions: The results show that the incidence of mesothelioma in the region is consistent with national data, falling in the middle of the range for all Italian regions. However, some areas emerge (for example, Colleferro, Civitavecchia, Tarquinia, Ferentino, Gaeta, Aprilia, Pomezia) that have particularly high rates, probably in relation to past occupational asbestos exposure. The role of diffuse environmental exposure in Rome may warrant further investigation.

One of the most important aspect of any surveillance system is completeness. We conducted an evaluation of the completeness of the AIDS surveillance system (SSAIDS) of Lazio region. We estimated the underreporting of AIDS cases in SSAIDS of Lazio in the period 1996-1998 through a linkage with the regional Hospital Information System (HIS) for the same years. A logistic regression model was used to estimate the relative risk (Odds Ratios--OR) of being unreported by demographic and clinical characteristics. A total of 56 cases had not been reported in the period 1996-1998, corresponding to 3.6% of underreporting. The risk of not being reported was associated with undetermined value of CD4 at diagnosis of AIDS (OR 15.40), unknown modality of exposure (OR 3.15) and with AIDS defining illness at diagnosis (ADI) as mycobacteriosis (OR 11.65), encephalopaties (OR 4.47) and toxoplasmosis (OR 8.67). Differences were also observed by clinical centre of diagnosis. In conclusion, the degree of underreporting is lower in our region than in other countries and the SSAIDS has a high completeness in Lazio. In agreement with other studies, underreporting is more frequent for cases with undermined value of CD4 at diagnosis of AIDS and unknown modality of exposure. The results regarding ADI need further investigation.

In 1991 the Lazio Region set up a surveillance system which collects individual data on each drug user attending Public Treatment Centres (PTCs). The analysis of surveillance system data allows not only to describe the characteristics of treatments but also to analyse determinants of treatment outcomes. In this study the outcome of treatment was evaluated in 5.646 drug users who attended public centres in 1992. The outcome was defined in two categories: positive (subjects who completed the therapeutic program, were referred to different service or were still in treatment) negative (subjects who refused or dropped out treatment, arrested or dead). Drug users usually receive more than one treatment in one year, 60% of them successfully completed. Methadone treatment shows the highest level of compliance while naltrexone the lowest. The negative outcome is highly associated with sex, type of treatment, length of treatment and outcome of previous treatment. Males are more likely to experience a negative outcome than females. Those offered naltrexone are more likely to refuse and drop out than those offered psychosocial treatment. Long term treatments are more successful than shorter ones. Furthermore, drop out is higher among those who have dropped out in the past. Although this observational study might not permit conclusions on the efficacy of each type of treatment, it allows an evaluation of the selection procedures at the treatment centres. Treatment centres for drug users in Lazio tend to select clients according to standard therapeutic treatment protocols instead of making treatments more accessible to drug users.