Presented today at the Ministry of Health the new volume on cancer numbers, the result of the collaboration between AIOM, AIRTUM, AIOM Foundation, PASSI, Silver PASSI and SIAPEC-IAP. Three and a half million Italians live after the discovery of the disease and at least one in four patients, or almost one million people, has returned to have the same life expectancy as the general population and can be considered cured. Stefania Gori, PRESIDENT of AIOM: "It also tends to decrease mortality, thanks to prevention programs and improvement of therapies". But among women, in addition to breast cancer, also increases lung cancer, and in the two growing genera pancreas, thyroid and melanomas.
The five most frequent diagnoses are breast cancer (53,500 cases in 2019), colorectal (49,000), lung (42,500), prostate (37,000) and bladder (29,700). In particular, colorectal, stomach, liver and prostate cancers are on the decline, and lung cancers are on the rise, increasing among women (2.2% per year), due to the spread of cigarette smoking habit.
Breast cancer and, in both genders, pancreatic, thyroid and melanomas (especially in the South) are also on the rise.
All numbers included in the ninth edition of the official census of the Italian Association of Medical Oncology (AIOM), the Italian Association of Tumor Registers (AIRTUM), the AIOM Foundation, PASSI (Progress of Health Companies in Italy), Silver PASSI and the Italian Society of Pathological Anatomy and Cytology Diagnostics (SIAPEC-IAP), and collected in the volume "Cancer numbers in Italy 2019" – published in a version for operators and one for patients – presented today at the Auditorium of the Ministry of Health at a conference National.
At the regional level, the highest incidence of diagnosis is in Friuli-Venezia Giulia (716 cases per 100,000 inhabitants), the lowest in Calabria (559 cases per 100,000 inhabitants).
Almost 3 and a half million Italians (3,460,025, 5.3% of the entire population) live after the diagnosis of cancer, a growing figure (there were 2 million and 244 thousand in 2006, 2 million and 587 thousand in 2010, about 3 million in 2015), thanks to increasingly effective treatments and increased adherence to screening programs.
Survival is also on the rise: 63% of women and 54% of men are alive 5 years after diagnosis. At least one in four patients, or nearly one million people, has returned to the same life expectancy as the general population and can be considered cured. "The data, relating to time trends in the period 2003-2014, indicate that the incidence of cancers is decreasing in both genders. Breast cancer is the most frequent in the population, growing especially in the areas of the Central-North for the extension of screening programs and the target population: the latter, however, is not a negative phenomenon, because many cancers that, without screening, would have been discovered at an advanced stage are detected at an early stage and with a high probability of healing.
"The incidence of malignant tumours retains significant geographical differences: it gradually decreases from Northern Italy to southern-island. In the male, the standardized incidence rate for all cancers is lower in the Centre (minus 4%, compared to the North) and even lower in the South (minus 14%); the same trend is confirmed in the female gender (minus 5% in central Italy and less 17% in south-island Italy, compared to the North). It is likely to attribute this situation to factors acting in a 'protective' sense (eating habits, reproductive life, lower exposure to environmental risk factors). In the South, however, the lower adherence to cancer screenings did not point to the beneficial effects of early diagnosis, which are seen in the Sept.
"In the male, the best survivals are recorded for testicular, prostate and thyroid cancers; thyroid, breast and melanoma cancers. In the female gender, survival for all cancers is higher than that of the male population: this gender advantage is also maintained in individual locations and may be associated with the different spread of specific screenings (breast and uterus) and the greater propensity of the female gender to adhere to prevention/screening programs". Survival at 5 years higher is recorded, for men, in Valle D'Aosta (61%), Emilia-Romagna and Tuscany (56%) and, for women, in Emilia-Romagna and Tuscany (65%).
In 2016 (the last year available), in our country, there were 179,502 deaths attributable to cancer (100,003 men and 79,499 women).
One study estimated the attributable risks of cancer-related death related to lifestyle (smoking, alcohol, excess weight, diet and physical inactivity) specific to the Italian population, showing an overall risk from 37.9% to 43.8%, with a higher percentage in men (46.7%) women (26.8%).
"The book also contains an analysis of the lifestyles of over-65s who have been diagnosed with cancer. The results are worrying. Older people who have been diagnosed with cancer maintain habits, such as smoking, alcohol abuse, sedentary lifestyle or low consumption of fruits and vegetables that are risk factors for cancer recurrence or aggravating the disease itself. Among the over-65s who have been diagnosed with cancer, the proportion of people who remain habitual smokers remains significant. 18% still consume alcohol that is risky for health and 40% say they are sedentary."
The leading cause of cancer death in Italy is lung cancer (33,838 deaths in 2016), followed by colorectal (19,575), breast (12,760), pancreas (12,049) and liver (9,702). Lung cancer (in 2003-2014) remains the first big killer and shows a downward trend in men (-1.6%) and increasing in the female population (2.2%).
"In particular, in the last decade for all big killers oncology, but not only, morphological diagnosis is associated with molecular profiles. One example is breast cancer, which is now recognized as a heterogeneous disease that includes at least 21 (histo)different invasive types and which has distinct molecular subtypes. Based on these precise morphological and molecular diagnoses, the oncologist is able to adopt and modulate specific therapies more suitable for the individual patient."
"The steady increase in people living after diagnosis requires careful assessment of the health and social impact in terms of follow-up planning and rehabilitation. Important investments are needed in terms of primary prevention, in order to reduce the risk of getting cancer: cancer is the potentially most preventable and, today, even more treatable chronic disease".