Alessandra Spitale

University of Padova, Padova, Veneto, Italy

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Publications (7)9.64 Total impact

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    ABSTRACT: The objective of this study was to analyse incidence and mortality cancer trends in the Italian Network of Cancer Registries (about 8,000,000 inhabitants) during the period 1986-1997. Included were 525,645 newly diagnosed cancers and 269,902 cancer deaths (subjects > 14 years). Joinpoints (points in time where trend significantly changes from linearity) were found and estimated annual percentage changes (EAPC) used to summarize tendencies. Overall cancer incidence increased in both sexes and cancer mortality significantly decreased (since 1991 among men). Lung cancer showed significantly decreasing incidence (EAPC = -1.4%) and mortality (EAPC = -1.6%) among men and increasing trends among women. In women, breast cancer incidence significantly increased (EAPC= +1.7%) and mortality decreased since 1989 (EAPC= -2.0%). Stomach cancer incidence and mortality decreased in both sexes. Prostate incidence sharply increased since 1991 and mortality decreased. Colon cancer incidence increased and rectum mortality decreased significantly in both sexes. Significant increases in incidence were also found for kidney (up to 1991 among men), urinary bladder, skin epithelioma, melanoma, liver (up to 1993 among men), pancreas, mesothelioma, Kaposi's sarcoma (up to 1995 among men), testis, thyroid, non-Hodgkin's lymphomas and multiple myeloma. Mortality significantly decreased for cancers of the oral cavity and pharynx, oesophagus, liver (women), larynx (men), bone, cervix (since 1990), central nervous system, urinary bladder, thyroid, Hodgkin's lymphomas and leukaemias (men). Non-Hodgkin's lymphoma mortality increased in both sexes. In conclusion, most of the changes seen can be explained as the effect of changes in smoking habits and of the extension of secondary prevention activities. The Italian health care system will also have to cope with growing cancer diagnostic and therapeutic needs due to population ageing.
    European Journal of Cancer Prevention 08/2004; 13(4):287-95. · 2.97 Impact Factor
  • European Journal of Cancer Prevention - EUR J CANCER PREV. 01/2004; 13(4):287-295.
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    ABSTRACT: Building a database with the estimates of the observed populations of the Italian Cancer Registries (CR), subdivided into sex, annual age classes and calendar year; making this population database available in the AIRT website; making available an Excel file that allows the input of a population by 5-year age classes in order to obtain an esteem of the annual classes. Employment of different interpolation methods, namely annual age classes starting from 5-year classes, an esteem of the final open class of 85 years and over. 17 CRs that take part to the incidence and mortality trend study promoted by AIRT in 2003. AIRT. A database of the estimated populations observed by the CRs by sex and annual age classes on 31 December of each incidence year. Only for 6 on 17 CRs taking part in the AIRT trend terpolation methods have been used. The performance of these methods, tested with an empirical measure of error called WMISE, have given good results, even if in the elderly classes the fit is poor and sometimes not sufficient. Different interpolation methods have been used to build and make available a database containing reliable data of population, in order to use them as denominators for the incidence and mortality trend analysis. It is also available an Excel file that allows the input of a population by 5-year age classes in order to obtain an esteem of the annual classes.
    Epidemiologia e prevenzione 01/2004; 28(4-5):231-8. · 0.92 Impact Factor
  • Stefano Guzzinati, Alessandra Spitale
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    ABSTRACT: The Italian Network of Cancer Registries (AIRT) built three databases for the study of cancer trends in Italy during 1986-1997: incident cases, deaths and populations observed by the eighteen Italian Cancer Registries active on about 23% of the Italian resident population. The incidence data have been validated through ad hoc programmes and CHECK-IARC. A pool of nine Cancer Registries, that had an almost complete coverage for the study period 1986-1997, has been chosen for the trend analysis (pool AIRT). 525,645 cases and 269,902 deaths have been analysed on a total of 8 million residents.
    Epidemiologia e prevenzione 01/2004; 28(2 Suppl):7-11. · 0.92 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The Italian Network of Cancer Registries analyzed incidence and mortality cancer trends during the period 1986-1997 Overall, 525,645 incident cancers and 269,902 cancer deaths (in subjects 15 years and older) were included. Age-adjusted rates, joinpoints (points in time where trend significantly changes from linearity) and estimated annual percent changes in rates (EAPC) were computed. Overall cancer incidence was significantly increasing in both sexes and cancer mortality was significantly decreasing (since 1991 among males). Incidence and mortality trends are summarised for single cancer sites. Crude rates are also showed to evaluate the effect of population ageing in terms of diagnostic and therapeutic burden for the National Health System.
    Epidemiologia e prevenzione 01/2004; 28(2 Suppl):1-6. · 0.92 Impact Factor
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    ABSTRACT: The purpose of the present paper is to calculate cancer incidence estimates in the italian regions for the year 2001. Estimates are computed according to the mortality/incidence (M/I) ratio method. Observed data were from Italian areas covered by cancer registration and recently published by Cancer Registries Network (1993-1998), by the Italian National Institute of Health (ISS), that published mortality statistics for the year 1998, and by the National Institute of Statistics (Istat) that provided population figures for the year 2001. Regression coefficients of the M/I ratios specific by cancer site, age class, sex and geographical area were computed and then applied to the observed mortality in the Italian regions in the year 1998. The estimated number of new cancer cases was then computed multiplying the estimated rates for the regional populations in the year 2001, as published by Istat. The total number of estimated new cancers (with the exclusion of skin cancers) in Italy was approximately 160,000 in men and 130,000 in women. The population of the Liguria region, older than other Italian regional populations, showed the highest crude rates, while its risk is similar compared to other Northern regions, as indicated by age-standardised rates. The most frequent tumour sites are the lung cancer (29,500 cases), the colon-rectum cancer (19,900 cases) and the prostate cancer (19,600 cases) in men; the breast cancer (35,000 cases), the colon-rectum cancer (19,500 cases) and the stomach cancer (6,800 cases) in women. The invasive cervical cancer, largely preventable with early diagnosis, is still responsible for approximately 3,000 new cases yearly. Incidence estimates are a useful tool for a better management of health resources. Treatment costs for tumour patients are generally high in the first period for diagnosis and principal treatment, while they fade during follow-up and remission. Costs increase during the terminal phase of disease. In the first period, costs can be predicted thanks to incidence estimates, while in the last period mortality data are more useful.
    Epidemiologia e prevenzione 01/2004; 28(4-5):247-57. · 0.92 Impact Factor
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    ABSTRACT: Immunosuppressive treatment has changed the prognosis of Lupus nephritis over time, but improvement in prognosis is difficult to analyze in different historical periods, and should be better demonstrated in comparison with life expectancy of sex-and age-matched people. Long-term patient and renal survival of 90 patients diagnosed with Lupus nephritis at our center from 1968 to 2001 with a follow-up time of 14+/-8 years was retrospectively evaluated. Patient and kidney survival significantly increased over time. Multivariate analyses show that risks of patient and renal death decreased by 8% at each year of follow-up, and increased by more than 5 time in patients aged > 30 years at diagnosis. As only 14 patients were men, relative survival as compared to that of the sex- and age-matched general population of the Piedmont Region was calculated for the 76 women. Improvement in the survival of the cohort of women was seen at any time of follow-up: in particular, it was sharply lower in the first period (relative survival at 5, 10 and 15 years = 0.784, 0.665, and 0.620, respectively) and increased in the second (relative survival at 5, 10 and 15 years = 0.939, 0.921, and 0.850, respectively) nearly approaching that expected for the general population, i.e. 0.993, 0.983 and 0.967, respectively. Taken together, our data allow us to draw the conclusion that life expectancy in women with Lupus nephritis has improved over time, paralleling an improved awareness of the disease and a significant increase in steroid pulse therapy as induction/remission phase. Improvement in survival is for the first time demonstrated to cover the gap with life expectancy of the general population for women with Lupus nephritis.
    International journal of immunopathology and pharmacology 22(4):1135-41. · 2.99 Impact Factor