Piscitelli Prisco, Marino Immacolata, Falco Andrea, Rivezzi Matteo, Romano Roberto, Mazzella Restituta, Neglia Cosimo, Della Rosa Giulia, Pellerano Giuseppe, Militerno Giuseppe, Bonifacino Adriana, Rivezzi Gaetano, Romizi Roberto, Miserotti Giuseppe, Montella Maurizio, Bianchi Fabrizio, Marinelli Alessandra, De Donno Antonella, De Filippis Giovanni, Serravezza Giuseppe, Di Tanna Gianluca, Black Dennis, Gennaro Valerio, Ascolese Mario, Distante Alessandro, Burgio Ernesto, Crespi Massimo, Colao Annamaria
Medicina Futura Research, Southern Italy Hospital Institute (IOS), Centro Direzionale, Isola E3, Palazzo Avalon, 80143 Naples, Italy.
Department of Economics and Statistics and CSEF, University Federico II, 80131 Naples, Italy.
Int J Environ Res Public Health. 2017 May 9;14(5):495. doi: 10.3390/ijerph14050495.
: Cancer Registries (CRs) remain the gold standard for providing official epidemiological estimations. However, due to CRs' partial population coverage, hospitalization records might represent a valuable tool to provide additional information on cancer occurrence and expenditures at national/regional level for research purposes. The Epidemiology of Cancer in Italy (EPIKIT) study group has been built up, within the framework of the Civic Observers for Health and Environment: Initiative of Responsibility and Sustainability (COHEIRS) project under the auspices of the Europe for Citizens Program, to assess population health indicators. : To assess the burden of all cancers in Italian children and adults. : We analyzed National Hospitalization Records from 2001 to 2011. Based on social security numbers (anonymously treated), we have excluded from our analyses all re-hospitalizations of the same patients ( = 1,878,109) over the entire 11-year period in order to minimize the overlap between prevalent and incident cancer cases. To be more conservative, only data concerning the last five years (2007-2011) have been taken into account for final analyses. The absolute number of hospitalizations and standardized hospitalization rates (SHR) were computed for each Italian province by sex and age-groups (0-19 and 20-49). : The EPIKIT database included a total of 4,113,169 first hospital admissions due to main diagnoses of all tumors. The annual average number of hospital admissions due to cancer in Italy has been computed in 2362 and 43,141 hospitalizations in pediatric patients (0-19 years old) and adults (20-49 years old), respectively. Women accounted for the majority of cancer cases in adults aged 20-49. As expected, the big city of Rome presented the highest average annual number of pediatric cancers ( = 392, SHR = 9.9), followed by Naples ( = 378; SHR = 9.9) and Milan ( = 212; SHR = 7.3). However, when we look at SHR, minor cities (i.e., Imperia, Isernia and others) presented values >10 per 100,000, with only 10 or 20 cases per year. Similar figures are shown also for young adults aged 20-49. : In addition to SHR, the absolute number of incident cancer cases represents a crucial piece of information for planning adequate healthcare services and assessing social alarm phenomena. Our findings call for specific risk assessment programs at local level (involving CRs) to search for causal relations with environmental exposures.
癌症登记处（CRs）仍然是提供官方流行病学估计的金标准。然而，由于癌症登记处覆盖的人群不完整，住院记录可能是一种有价值的工具，可用于在国家/地区层面提供有关癌症发生情况和支出的额外信息，以用于研究目的。意大利癌症流行病学（EPIKIT）研究小组是在欧洲公民计划的支持下，在公民健康与环境观察组织：责任与可持续性倡议（COHEIRS）项目的框架内组建的，旨在评估人群健康指标。
评估意大利儿童和成人中所有癌症的负担。
我们分析了2001年至2011年的国家住院记录。基于社会保险号码（进行匿名处理），我们在整个11年期间从分析中排除了同一患者的所有再次住院情况（= 1,878,109），以尽量减少现患癌症病例和新发病例之间的重叠。为了更加保守，最终分析仅考虑了最近五年（2007 - 2011年）的数据。按性别和年龄组（0 - 19岁和20 - 49岁）计算了每个意大利省份的住院绝对数和标准化住院率（SHR）。
EPIKIT数据库总共包含4,113,169例因所有肿瘤的主要诊断而首次住院的病例。意大利因癌症住院的年平均数量在儿科患者（0 - 19岁）和成人（20 - 49岁）中分别计算为2362例和43,141例。在20 - 49岁的成年人中，女性占癌症病例的大多数。正如预期的那样，大城市罗马的儿科癌症年平均数量最高（= 392，SHR = 9.9），其次是那不勒斯（= 378；SHR = 9.9）和米兰（= 212；SHR = 7.3）。然而，当我们查看标准化住院率时，小城市（即因佩里亚、伊塞尔尼亚等）的数值>每10万人10例，每年仅有10例或20例病例。20 - 49岁的年轻人也呈现出类似的数据。
除了标准化住院率外，新发病例的绝对数对于规划适当的医疗服务和评估社会警报现象是至关重要的信息。我们的研究结果呼吁在地方层面开展特定的风险评估项目（包括癌症登记处参与），以寻找与环境暴露的因果关系。
