Estimates of cancer burden in Emilia-Romagna

AIMS AND BACKGROUND: This paper aims to provide a comprehensive overview of mid-term epidemiological trends for the major cancer sites in the Emilia-Romagna region of northern Italy (population 4,400,000). METHODS: The MIAMOD method, a back-calculation approach to estimate and project the incidence of chronic diseases from mortality and patient survival, was used for the estimation of incidence and prevalence by calendar year (from 1970 to 2015) and age (from 0 to 99). Survival estimates were taken from cancer registries of northeastern Italy. RESULTS: The estimated incidence of stomach cancer decreased by approximately 75% for both sexes. Trends in incidence of colorectal cancer differed between males and females. For females, the rate increased moderately until the year 2000 with a slow decrease thereafter, whereas the male colorectal cancer incidence showed a regular increase until 2010 followed by a substantial leveling off. Among males the lung cancer incidence and mortality rates showed a steep increase until the late 1980s and a rapid decrease thereafter. Among females, the trends were increasing over the entire study period. The estimated incidence of female breast cancer rose sharply between 1970 and 2001, but from that year onwards a slightly decreasing trend was observed. Mortality peaked in 1988 and has fallen since. The incidence of prostate cancer showed a 3-fold increase. After 2005, the rate is expected to stabilize. Among females, the estimated prevalence increased for breast cancer (52,700 cases expected in 2015), colorectal cancer, lung cancer and melanoma, while decreasing for stomach cancer and cervical cancer. Among males, the estimates showed an upward trend for prostate cancer (32,100 cases expected in 2015) and colorectal cancer, and a leveling off for lung cancer after 2010. CONCLUSION: The estimates were fairly consistent with previous data from several epidemiological sources. The MIAMOD method provided a picture of the impressive increase in the prevalence of breast cancer and prostate cancer over the 45-year period studied.