Incidence of Non-Melanoma Skin Cancers in Salento (Southern Italy): A 15-Year Retrospective Analysis from the Cancer Registry of Lecce.

BACKGROUND AND OBJECTIVES: Non-melanoma skin cancers (NMSCs) include basal cell carcinoma (BCC) and squamous-cell carcinoma (SCC), as well as a wide range of rare skin tumors. NMSCs is the most frequently diagnosed type of tumor among Caucasians. We aimed at estimating the incidence and mortality of NMSCs in the Salento area (Lecce province, Southern Italy), whose population is assumed to experience heavy and frequent sun exposure due to climatic/environmental factors, both for working and leisure activities. MATERIALS AND METHODS: We computed the incidence of NMSCs in the Province of Lecce by examining the comprehensive real-world data collected by the local cancer registry, which covers all the 830,000 inhabitants, over a period of fifteen years (from 2003 to 2017), with a focus on the latest 5 years (2013-2017) for the analysis of the different histologic morphologies of these tumors. The incidence of NMSCs has been described in terms of absolute frequencies, crude rates and age-adjusted direct standardized rates (DSR). Joinpoint analysis was used to examine temporal trends in the incidence of NMSCs and estimate annual percent changes (APCs). RESULTS: During the period of 2003-2017, the incidence of NMSCs reached a direct standardized rate (DSR) of 162.62 per 100,000 in men (mortality 1.57 per 100,000) and 89.36 per 100,000 in women (mortality 0.52 per 100,000), respectively. The incidence significantly increased among both men and women across the entire period. Basal cell carcinoma (BCC), with its different morphologies, represented about 67.6% of the NMSCs in men (n = 2139 out of a total of 3161 tumors observed between 2013 and 2017) and about 75.8% of the NMSCs in women (n = 1718 out of a total of 2264 tumors from 2013 to 2017), thus accounting for the vast majority of NMSCs. The results are consistent with the literature data carried out both at national and international level. CONCLUSIONS: Proper monitoring of this phenomenon through timely reporting and recording of all new NMSC cases is necessary to develop new preventive strategies.

Risk Factors for Lung Cancer in the Province of Lecce: Results from the PROTOS Case-Control Study in Salento (Southern Italy).

In the province of Lecce (southern Italy), a higher incidence of lung cancer (LC) among men compared to regional and national data was reported. In a sub-area in the center of the province (cluster area), the incidence and mortality for LC was even higher. PROTOS is a case-control study aimed at investigating possible risk factors for LC in the province area. A total of 442 patients with LC and 1326 controls matched by sex and age living in the province of Lecce for at least 10 years were enrolled and georeferenced; they filled in a questionnaire with their personal information and exposures. For each risk factor, an Odds Ratio adjusted for all the other variables was calculated. The risk of LC increased with excessive use of alcohol in women, for those subjects with a family cancer history, for each increase in pack/year of cigarettes, for men more exposed considering the industrial district in the cluster area, and for those using pesticides in agriculture without wearing personal protective equipment. The higher incidence of adenocarcinoma in both sexes suggests that, in addition to cigarette smoking, concurrent exposures to other environmental, occupational, and life-style factors may play a role in increased cancer risk and should be more deeply explored.

Retrospective Analysis of the Pharmaco-Utilization of VEGF Inhibitors and Health Care Costs among Patients with Wet Age-Related Macular Degeneration and Other Ocular Diseases in Italy.

This Italian retrospective study aimed to analyze the pharmaco-utilization of anti-VEGF drugs and health care costs among patients with wet age-related macular degeneration (wAMD) or other ocular diseases. A retrospective analysis was performed on administrative databases of Italian entities covering approximately six million individuals. Across January 2010-December 2017, patients aged ≥50 years with a prescription of intravitreal anti-VEGFs were included as "wAMD" patients [by wAMD hospitalization or intravitreal injections] or as "other ocular diseases" patients [by hospitalization for other ocular disorders or intravitreal injections, with concomitant diabetes diagnosis or dexamethasone treatment]. The date of first matching of inclusion criteria was index-date. wAMD-cohort. Overall, 3879 patients were included; at index-date, 82.2% were treated with Ranibizumab, 15.8% with Aflibercept, and 2% with Pegaptanib. During the follow-up, the mean/annual anti-VEGF prescription [3.6 (first-year)-0.8 (third-year)] and the total expenditure [5799.84 € (first-year)-3212.84 € (third-year)] decreased. Other ocular diseases-cohort. Overall, 2646 patients were enclosed; 85.9% were treated with Ranibizumab, 13.5% with Aflibercept, and 0.6% with Pegaptanib. During the follow-up, the mean/annual anti-VEGF prescription [3.3 (first-year)-0.5 (third-year)] and the total cost [7196.83 € (first-year)-5162.68 € (third-year)] decreased. This observational study highlighted a decline in anti-VEGF prescriptions over time in both cohorts, suggesting a trend of under-treatment that could worsen the patients' clinical outcomes and increase health care resource consumption.

[Childhood cancer incidence in Apulia Region (Southern Italy), 2003-2008]. / Incidenza dei tumori maligni infantili in Puglia, 2003-2008.

OBJECTIVES: to investigate, for the first time, the incidence rates of malignant childhood cancers (children aged 0-14 years) in Apulia Region (Southern Italy) in the period 2003-2008. DESIGN: to compute incidence rates of childhood cancers from Apulia Region Cancer Registry database compared with the corresponding results published in 2012 by the Italian cancer registries network (AIRTUM),where data from the Apulia population were not included, because not available. SETTING AND PARTICIPANTS: we selected all incident cases of malignant tumours (behaviour: /3 of ICD-O-3 classification) in children aged 0-14 registered in the Apulia cancer registry. Local health unit (LHU) of Lecce (section of the Apulia cancer registry) collected data from 2003 to 2006; LHU of Taranto, BT, and Brindisi collected data from 2006 to 2008. MAIN OUTCOME MEASURES: we computed crude, age specific, and directly standardised rates (DSR), with 95% confidence intervals, of all malignant tumours, all categories and 5 subgroups of the ICCC-3 classification; standardised incidence ratios (SIR) for all childhood malignant tumours using the rates of the AIRTUM Pool 2003-2008 as reference . RESULTS: incident cases were 183. DSR (x106) of all childhood malignant tumours are: Apulia Region 169.7 (95%CI 145.9- 196.4); Brindisi 160.4 (95%CI 106.2-232.9); BT 177.7 (95%CI 122.7-248.7); Lecce 144.3 (95%CI 111.1-184.2); Taranto 216.2 (95%CI 163.0-281.4). SIR estimates are: Apulia Region 102.9 (95%CI 88.5-119.0); Brindisi 100.2 (95%CI 66.6-144.9); BT 105.4 (95%CI 73.0-147.2); Lecce 85.5 (95%CI 66.0-109.0); Taranto 134.6 (95%CI 101.7-174.8). Main incidence measures for all ICCC-3 categories and five subgroups of childhood cancers in Apulia are also reported. CONCLUSIONS: in Apulia Region, we estimated a DSR for all childhood malignant tumours very close to that of the AIRTUM Pool. DSRs for each ICCC-3 category look comparable with the data from the national survey too. When data of each LHU were analysed, the SIR estimate makes it evident an excess of all malignant childhood cancers in the LHU of Taranto. Other results of particular cancers and specific age groups also provide suggestions for further investigations.