Gender differences, environmental pressures, tumor characteristics, and death rate in a lung cancer cohort: a seven-years Bayesian survival analysis using cancer registry data from a contaminated area in Italy.

Introduction: In Taranto, Southern Italy, adverse impacts on the environment and human health due to industrial installations have been studied. In the literature, associations have been reported between gender, environmental factors, and lung cancer mortality in women and men. The aim of this study was to investigate the relationships between gender, residence in areas with high environmental pressures, bronchus/lung cancer characteristics, and death rate. Methods: Data from the Taranto Cancer Registry were used, including all women and men with invasive bronchus/lung cancer diagnosed between 1 January 2016 and 31 December 2020 and with follow-up to 31 December 2022. Bayesian mixed effects logistic and Cox regression models were fitted with the approach of integrated nested Laplace approximation, adjusting for patients and disease characteristics. Results: A total of 2,535 person-years were observed. Male gender was associated with a higher prevalence of histological grade 3 (OR 2.45, 95% CrI 1.35-4.43) and lung squamous-cell carcinoma (OR 3.04, 95% CrI 1.97-4.69). Variables associated with higher death rate were male gender (HR 1.24, 95% CrI 1.07-1.43), pathological/clinical stage II (HR 2.49, 95% CrI 1.63-3.79), III (HR 3.40, 95% CrI 2.33-4.97), and IV (HR 8.21, 95% CrI 5.95-11.34), histological grade 3 (HR 1.80, 95% CrI 1.25-2.59), lung squamous-cell carcinoma (HR 1.18, 95% CrI 1.00-1.39), and small-cell lung cancer (HR 1.62, 95% CrI 1.31-1.99). Variables associated with lower death rate were other-type lung cancer (HR 0.65, 95% CrI 0.44-0.95), high immune checkpoint ligand expression (HR 0.75, 95% CrI 0.59-0.95), lung localization (HR 0.73, 95% CrI 0.62-0.86), and left localization (HR 0.85, 95% CrI 0.75-0.95). Discussion: The results among patients with lung cancer did not show an association between residence in the contaminated site of national interest (SIN) and the prevalence of the above mentioned prognostic factors, nor between residence in SIN and death rate. The findings confirmed the independent prognostic values of different lung cancer characteristics. Even after adjusting for patients and disease characteristics, male gender appeared to be associated with a higher prevalence of poorly differentiated cancer and squamous-cell carcinoma, and with an increased death rate.

Environmental pressures, tumor characteristics, and death rate in a female breast cancer cohort: a seven-years Bayesian survival analysis using cancer registry data from a contaminated area in Italy.

Introduction: In Taranto, Southern Italy, adverse impacts on the environment and human health due to industrial installations have been studied. In the literature, few associations have been reported between environmental factors and breast cancer mortality in women. The aim of this study was to investigate the relationships between residence in areas with high environmental pressures, female breast cancer characteristics, and death rate. Methods: Data from the Taranto Cancer Registry were used, including all women with invasive breast cancer diagnosed between 01 January 2015 and 31 December 2020 and with follow-up to 31 December 2021. Bayesian mixed effects logistic and Cox regression models were fitted with the approach of integrated nested Laplace approximation, adjusting for patients and disease characteristics. Results: A total of 10,445 person-years were observed. Variables associated with higher death rate were residence in the contaminated site of national interest (SIN) (HR 1.22, 95% CrI 1.01-1.48), pathological/clinical stage III (HR 2.77, 95% CrI 1.93-3.97) and IV (HR 17.05, 95% CrI 11.94-24.34), histological grade 3 (HR 2.50, 95% CrI 1.20-5.23), Ki-67 proliferation index of 21-50% (HR 1.42, 95% CrI 1.10-1.83) and > 50% (HR 1.81, 95% CrI 1.29-2.55), and bilateral localization (HR 1.65, 95% CrI 1.01-2.68). Variables associated with lower death rate were estrogen and/or progesterone receptor positivity (HR 0.61, 95% CrI 0.45-0.81) and HER2/neu oncogene positivity (HR 0.59, 95% CrI 0.44-0.79). Discussion: The findings confirmed the independent prognostic values of different female breast cancer characteristics. Even after adjusting for patients and disease characteristics, residence in the SIN of Taranto appeared to be associated with an increased death rate.

Population-based incidence of gastrointestinal stromal tumors in Puglia.

INTRODUCTION: This study presents the incidence of gastrointestinal stromal tumors (GISTs) in an Italian region of over 4 million inhabitants monitored for 10 years and is the largest incidence study of this type of cancer conducted so far in Italy. METHODS: In order to ensure the registration of all GISTs, including those with nonmalignant behavior, a cancer list was integrated with the cases found through an ad hoc data mining process that covered all the pathologic reports of Puglia. Case distributions by sex, age groups, site, and prognostic groups according to Miettinem and Lasota classification and crude and age-standardized incidence rates were produced. RESULTS: In the 10-year period 2006 to 2015, 708 cases of GIST were recorded in Puglia. The average crude incidence rate was 1.7 per 100,000 person-years and the age-standardized incidence rate, using 2013 European standard population, was 1.8 per 100,000 person-years (95% confidence interval [CI], 1.6-1.9). Incidence was higher in men than in women: crude incidence rate was 2.0 per 100,000 person-years and age-standardized incidence rate 2.2 per 100,000 person-years (95% CI, 2.0-2.4) in men and 1.5 per 100,000 person-years and 1.4 per 100,000 person-years (95% CI, 1.2-1.6) in women. DISCUSSION: Our incidence rates are comparable with those of other international studies and they are located in the medium to high end of the range. The comparisons are affected by a different capacity of the cancer registries to intercept and record GISTs with nonmalignant behavior. Distribution of cases for sex, age groups, sites, and prognostic risk groups are consistent with previous results.

[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.