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The aim of the study was to evaluate the roles of screening activation and hormone replacement therapy discontinuation on the recent declining breast cancer incidence trends in Italy. We analyzed 41,358 invasive female breast cancers incident during 1991–2004 in six Italian population-based cancer registries. Overall and age-specific incidence trends were evaluated using Joinpoint analysis. In addition to calendar years, data were analyzed on a years-since-screening-activation basis. Annual percentage change of standardized rates was computed. There were statistically significant increasing trends for women 40–44 and 45–49 years that did not change after screening activation. On the contrary, for women 50–69 years old and for those 70+ years, the increasing trends flattened around 2 years after screening activation. The prevalence of hormone replacement therapy use in Italy is and was rather low. In conclusion, the recent tendency toward stabilization observed in Italy for female breast cancer incidence rates in women aged 50 years or more follows the introduction of mammographic screening.

Recent advances in the cancer treatment and the resulting increase in patient survival have led to greater scientific interest in multiple primary malignancies (MPM). It is now recognized that longer survival combined with the administration of active but toxic therapeutic regimens has made patients more prone to develop a “second primary cancer,” as a consequence of therapy (e.g., thyroid cancer in lymphoma patients treated with radiotherapy) or of longer exposure to risk factors [1].

Objectives To investigate the correlation between maternal, obstetric and sample characteristics and the quality (i.e. yield of trophoblastic cells) of intrauterine lavage (IUL) samples. Methods We collected 202 IUL samples from women scheduled for first trimester termination of pregnancy (TOP). Trophoblastic cells were isolated from IUL samples and used for DNA analysis by a multiplex quantitative fluorescent polymerase chain reaction (QF-PCR) assay. A multivariate logistic regression analysis was performed, and a p < 0.05 was considered statistically significant. Results The presence of trophoblastic cells in IUL samples was documented in 151/202 cases (74.7%). Blood contamination of IULs was the only characteristic to positively correlate with the presence of trophoblasts (p = 0.039; OR: 1.99; 95% CI: 1.03–3.82). Conclusions The correlation between the presence of contaminating blood and trophoblastic cells would indirectly confirm the hypothesis that IUL might act as a mini-CVS. The high yield rate of trophoblasts irrespective of maternal characteristics and past obstetric history would support the clinical use of this sampling technique, provided that its safety is clearly defined. Copyright © 2008 John Wiley & Sons, Ltd.

We analyzed colorectal cancer incidence data from the Tuscany Cancer Registry, central Italy, for the period 1985-2005. We carried out a trend analysis through a Joinpoint regression analysis, and summarized trends as annual percent change (APC) of the standardized (European standard) rates. Colorectal incidence rates increased until 1996 (APC= + 1.4, 95% CI: 0.8 -1.9), then decreased significantly (APC=-1.1, 95% CI: -0.8 to - 0.4). The change was detected as statistically significant in the age group of 54 + years. Among younger individuals, we observed an increasing incidence until 2003. In the same geographical area, a colorectal screening programme has been active from 1982; it was initially based on guaiac faecal occult blood testing (GFOBT) and on immunological testing (IFOBT) since the mid 1990s. The decline in colorectal cancer incidence since 1996, in the whole population and especially among individuals older than 54 years, may suggest the effect of FOBT screening in terms of precancerous polyps removal.

In this article, we illustrate the command distrate, which calculates age-standardized rates with efficient interval estimation by using formulas developed by Tiwari, Clegg, and Zou (2006, Statistical Methods in Medical Research 15: 547–569) as a modification of the method proposed by Fay and Feuer (1997, Statistics in Medicine 16: 791–801). This method is currently used in the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute in Bethesda, Maryland; the Italian Association of Cancer Registries (Associazione Italiana Registro Tumori, AIRTUM); and the Lombardy Mesothelioma and Sinonasal Cancer Registry in Northern Italy. The command produces a compact output and allows for the possibility of specifying a rate multiplier, for instance, x100,000 or x1,000,000. Furthermore, rates and confidence limits can be easily exported to an external dataset for further processing (for example, for making graphs). The command distrate is a useful addition to the official Stata command dstdize.