Decline of childhood cancer mortality in Italy, 1955-1980.

The decline in childhood cancer mortality in Italy from 1955 to 1980 has been evaluated through (1) comparison of age-specific and age-standardized (0-14 years) rates for the periods 1955-1960 and 1979-1980 and (2) computation of expected numbers of deaths by application of the age-specific rates for the period 1955-1960 to the population structure of subsequent periods. Certified mortality fell by 35% for leukaemias, 90% for Hodgkin's disease, 30% for non-Hodgkin's lymphomas, 40% for bone sarcomas, 30% for kidney (Wilms') tumours, 65% for retinoblastoma. No clear trend was reported for other neoplasms, including neuroblastoma. About 300 cancer deaths per year were avoided in the period 1979-1980 compared with the expected number based on the 1955-1960 rates (170 for leukaemias alone). Although clearly encouraging, these trends are substantially less favourable than those from several other developed countries. It is therefore likely that several dozen other deaths from childhood cancer could be avoided each year through earlier (or more accurate) application of effective therapies, particularly for neoplasms requiring radiotherapy or surgical treatment.