Servizio di Epidemiologia, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, 42122 Reggio Emilia, Italy.
Center for Environmental, Nutritional and Genetic Epidemiology (CREAGEN), Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Università 4, 41121 Modena, Italy.
Int J Environ Res Public Health. 2020 Jun 11;17(11):4165. doi: 10.3390/ijerph17114165.
We calculated time trends of standardised mortality rates and risk factors for breast cancer (BC) from 1990 to 2016 for all women resident in Italy. The age-standardised mortality rate in Italy decreased from 4.2 in 1990 to 3.2 (×100,000) in 2016. While participation in organised screening programmes and age-standardised fertility rates decreased in Italy, screening invitation coverage and mammography uptake, the prevalence of women who breastfed and mean age at birth increased. Although southern regions had favourable prevalence of protective risk factors in the 1990s, fertility rates decreased in southern regions and increased in northern regions, which in 2016 had a higher rate (1.28 vs. 1.32 child per woman) and a smaller increase in women who breastfed (+4% vs. +30%). In 2000, mammography screening uptake was lower in southern than in northern and central regions (28% vs. 52%). However, the increase in mammography uptake was higher in southern (203%) than in northern and central Italy (80%), reducing the gap. Participation in mammographic screening programmes decreased in southern Italy (-10%) but increased in the North (6.6%). Geographic differences in mortality and risk factor prevalence is diminishing, with the South losing all of its historical advantage in breast cancer mortality.
我们计算了 1990 年至 2016 年所有居住在意大利的女性的乳腺癌死亡率和危险因素的标准化趋势。意大利的标准化死亡率从 1990 年的 4.2 下降到 2016 年的 3.2（每 10 万人）。虽然意大利参与有组织的筛查计划和标准化生育率下降，但筛查邀请覆盖率和乳房 X 光检查率上升，母乳喂养的女性比例和出生时的平均年龄增加。尽管南部地区在 20 世纪 90 年代具有有利的保护因素，但南部地区的生育率下降，北部地区的生育率上升，2016 年北部地区的生育率更高（每个妇女 1.28 比 1.32 个孩子），母乳喂养的女性比例增加幅度更大（4%比 30%）。2000 年，南部地区的乳房 X 光筛查率低于北部和中部地区（28%比 52%）。然而，南部地区的乳房 X 光检查率增幅更高（203%），高于意大利北部和中部（80%），缩小了差距。南部意大利的乳房 X 光筛查参与率下降（-10%），但北部地区（6.6%）有所增加。死亡率和危险因素流行率的地域差异正在缩小，南部地区在乳腺癌死亡率方面失去了所有历史优势。
