Emanuele Crocetti

• www.emanuelecrocetti.com, MD, PhD (Epidemiology&Public Health)
• Consultant at www.emanuelecrocetti.com

Background: The objectives of this study were to quantitatively assess the geographic heterogeneity of cancer prevalence in selected Western Countries and to explore the associations between its determinants. Methods: For 20 cancer sites, 5-year cancer prevalence, incidence, and survival were observed and age standardised for the mid 2000s in the...

Due to changes in cancer-related risk factors, improvements in diagnostic procedures and treatments, and the aging of the population, in most developed countries cancer accounts for an increasing proportion of health care expenditures. The analysis of cancer-related costs is a topic of several economic and epidemiological studies and represents a r...

Formal indicators for the evaluation of the quality of melanoma care are needed. We identified 13 process indicators, which encompassed early diagnosis, pathology reporting and surgical treatment. We evaluated the adherence to these indicators using a population-based series on incident skin melanomas (only primary melanomas) for the year 2004 (687...

Purpose: Diabetes is associated with increased risk of developing colorectal cancer (CRC), but its effect on overall and cancer-specific mortality in CRC patients has been little investigated. The aim of this study was to assess the influence of diabetes on overall and cancer-specific mortality in Italian CRC patients. Methods: Cases of adult (≥...

Objective The epidemiologic scenario of prostate cancer (PC) is changing rapidly. The present study updates to 2024 the estimates of PC in Italy, including incident and prevalent cases, deaths, and metastatic PC (mPC), which is further subdivided into de novo mPC (metastasis detected at diagnosis) and recurrent mPC (metachronous metastasis). Metho...

BaCKgrouND: the epidemiology of skin melanoma (Sm) is rapidly changing. therefore, we aimed at updating up to 2024 the Italian estimates on Sm providing the number of incident and prevalent cases, the deaths and the distribution by stage at diagnosis. METHODS: Incidence was extrapolated from age- and sex-specific International Agency for Research o...

Abstract Objective Five-year net survival and conditional survival from vulvar squamous cell carcinoma (VSCC) in Italy have shown no progress during the past three decades. This study aims to estimate the complete prevalence and multiple indicators of cure for VSCC patients. Methods Observed prevalence was estimated using 31 Italian cancer registri...

Background The number and projections of cancer survivors are necessary to meet the healthcare needs of patients, while data on cure prevalence, that is, the percentage of patients who will not die of cancer by time since diagnosis, are lacking. Materials and methods Data from Italian cancer registries (duration of registration ranged from 9 to 40...

Background In Italy, the incidence of cutaneous malignant melanoma is two-fold higher in the north than in the south. This gradient might be associated with differences in incidence trends and disease surveillance. We compared the time trends in incidence rates, mortality rates, dermatologic office visit rates and skin biopsy rates between the Emil...

Lettura magistrale

People alive many years after breast (BC) or colorectal cancer (CRC) diagnoses are increasing. This paper aimed to estimate the indicators of cancer cure and complete prevalence for Italian patients with BC and CRC by stage and age. A total of 31 Italian Cancer Registries (47% of the population) data until 2017 were included. Mixture cure models al...

Introduction This cross-sectional study was aimed at estimating the number of Italian incident cancer patients in 2020 eligible for, and respondent to, immune checkpoint inhibitors (ICI). Methods The study is based on publicly available data: the ICI approved until August 2022 by the Italian Medicines Agency (AIFA) with their specific indications...

Introduction. According to the National Oncological Plan 2023-2027 on the importance of multidisciplinary and interactive e-learning training, the Italian Melanoma Intergroup (IMI) has developed MelaMEd (Melanoma Multimedia Education), a national project for general practitioners (GPs) on the prevention and detection of cutaneous melanoma through a...

The text discusses the role of general practitioners (GPs) in the prevention and early diagnosis of melanoma, a type of skin cancer. It highlights the need for GPs to be able to recognize suspicious skin lesions and refer patients to specialist dermatology centers. However, many GPs lack comprehensive training in diagnosing melanoma. The text menti...

Background The geothermal power plants for electricity production currently active in Italy are all located in Mt. Amiata area in the Tuscany region. A cross-sectional survey was conducted in the framework of the regional project “InVETTA—Biomonitoring Survey and Epidemiological Evaluations for the Protection of Health in the Amiata Territories”, u...

A recent research project using data from 38 cancer registries has provided new epidemiologic insights into the results of efforts for melanoma control in Italy between the 1990s and the last decade. In this article, the authors present a summary and a commentary of their findings. Incidence increased significantly throughout the study period in bo...

Objectives To describe the procedures to derive complete prevalence and several indicators of cancer cure from population-based cancer registries. Materials and methods Cancer registry data (47% of the Italian population) were used to calculate limited duration prevalence for 62 cancer types by sex and registry. The incidence and survival models,...

Purpose The aim of this study was to estimate the Italian burden of incident breast cancer (BC) by subtypes, according to the distribution of hormonal receptor (HR) status and expression of human epidermal growth factor 2 (HER2). Methods Female breast cancers incidence in the Romagna Unit of the Emilia-Romagna registry (n. 10,711) were grouped int...

(1) Objective: In many Western countries, survival from vulvar squamous cell carcinoma (VSCC) has been stagnating for decades or has increased insufficiently from a clinical perspective. In Italy, previous studies on cancer survival have not taken vulvar cancer into consideration or have pooled patients with vulvar and vaginal cancer. To bridge thi...

cro

Natural sources and anthropogenic activities are responsible for the widespread presence of heavy metals in the environment in the volcanic and geothermal area of Mt. Amiata (Tuscany, Italy). This study evaluates the extent of the population exposure to metals and describes the major individual and environmental determinants. A human biomonitoring...

The 8th Edition of the American Joint Committee on Cancer (AJCC) Staging Manual removed the mitotic rate (MR) as a staging criterion for T1 melanomas, thus leading to a debate on sentinel lymph node biopsy (SLNB) in thin melanomas. This study investigates whether MR plays a role in selecting patients with T1 melanoma for SLNB. We analyzed clinical...

Background: The global increase in incidence of cutaneous malignant melanoma (CMM) occurring in the past decades has been partly attributed to increased diagnostic scrutiny of early lesions, with a potential phenomenon of overdiagnosis. The reported positive linear relation between skin biopsy rate and incidence of early CMM is compatible with thi...

Sommario Il rischio di un secondo tumore, valutato in 38.535 pazienti con tumori tiroidei (TT) diagnosticati tra il 1998 e il 2012 in Italia, era 1,16 (+16%, rispetto alla popolazione generale) per tutti i tumori, per secondi tumori delle ossa/connettivo 2,0, mammella 1,2, prostata 1,4, reni 2,2 e emolinfopoietici 1,4 mentre non si è evidenziato al...

Objectives Revision of the priority list for incidence date to incorporate modern diagnostic methods, including but not limited to flow cytometry, molecular testing, screening tests and new radiological/imaging techniques. The revision should not preclude comparison of survival estimates with tumours registered using the existing priority list, to...

Background: We determined the relative contribution of decreased tumour thickness to the favourable trend in survival from cutaneous malignant melanoma (CMM) in Italy. Methods: Eleven local cancer registries covering a population of 8 056 608 (13.4% of the Italian population in 2010) provided the records of primary CMM cases registered between 2...

https://www.ars.toscana.it/2-articoli/4707-geotermia-e-salute-in-toscana-presentato-il-rapporto-2021-di-ars.html In Italia la produzione di energia elettrica da fonte geotermica è interamente concentrata in Toscana, dove si raggiunge una capacità installata globale di più di 900 MW, pari a circa il 34% del fabbisogno elettrico regionale. Fu propri...

Objectives: to update the Italian estimates of survival for patients with a paediatric cancer, tobacco smoke-associated cancers, and cancers targeted by screening; to assess geographical differences. Design: population-based descriptive study. Setting and participants: incident cancer cases diagnosed in 2010-2014, with follow-up to 2018, from...

Variation in cancer incidence between countries and groups of countries has been well studied. However cancer incidence is linked to risk factors that may vary within countries, and may subsist in localized geographic areas. In this study we investigated between- and withincountry variation in the incidence of all cancers combined for countries bel...

With over one million new cases (n = 1,033,701) and 782,685 deaths in 2018, gastric cancer (GC) ranks fifth for incidence and third for mortality among cancers worldwide. Most cancers have sporadic origin (90%) while a small proportion (10%) show a family component or hereditary syndromes. GC arises, in most cases, from the interaction of genetic a...

interpretation of the effect of multiple variables is not straightforward. Classification and Regression Trees Analysis (CART), which allows a more friendly data evaluation, could be a valid integration of the message from Cox model. METHODS: The CART algorithm splits up data, creating a “tree” of groups of patients with different profiles for the...

Background: New oral anticoagulant agents (NOACs) are valid alternatives for vitamin K antagonists (VKA) in patients with non-valvular atrial fibrillation (NVAF) for stroke prevention. In clinical practice, NOACs users may differ from patients enrolled in clinical trials in age or comorbidities, and thus it is a critical issue to evaluate the effe...

Background The number of patients living after a cancer diagnosis is increasing, especially after thyroid cancer (TC). This study aims at evaluating both the risk of a second primary cancer (SPC) in TC patients and the risk of TC as a SPC. Methods We analyzed two population-based cohorts of individuals with TC or other neoplasms diagnosed between...

Abstract: Variation in cancer incidence between countries and groups of countries has been well studied. However cancer incidence is linked to risk factors that may vary within ountries, and may subsist in localized geographic areas. In this study we investigated between- and within country variation in the incidence of all cancers combined for cou...

The study presented in this article aims at investigating the clinical usefulness of a novel test, called T-PEC, for the diagnosis of Developmental Language Disorder in Italian preschool children. The instrument exploits the production of clitic pronouns, in particular third person direct object clitics (3PDO-CL), as a clinical marker for the disor...

Abstract: Aims: The number of patients living after a cancer diagnosis is increasing, especially after thyroid cancer (TC). This study aims at evaluating both the risk of a second primary cancer (SPC) in TC patients and the risk of TC as a SPC. Methods: Two population-based cohorts of cancer patients aged up to 84 years were identified from 28 Ita...

Abstract: Objectives: Survival from cutaneous malignant melanoma (CMM) has increased for years in most western countries. So far, this has commonly been attributed to a trend towards lower Breslow tumour thickness. This study aimed to determine the relative role that the improvement in tumour thickness has played in the favourable trend in survival...

Objective: A reliable measure of the burden of inflammatory bowel diseases (IBDs), including ulcerative colitis and Crohn's disease, are essential to monitor their epidemiology and plan appropriate health services. Methods: This is a population-based study carried out in the Milan Agency for Health Protection. Incident and prevalent cases were i...

This corrects the article DOI: 10.23736/S0392-0488.17.05584-5.

Background: Few studies have estimated the probability of being cured for cancer patients. This study aims to estimate population-based indicators of cancer cure in Europe by type, sex, age and period. Methods: 7.2 million cancer patients (42 population-based cancer registries in 17 European countries) diagnosed at ages 15-74 years in 1990-2007 wi...

Background: Few studies have estimated the probability of being cured for cancer patients. This study aims to estimate population-based indicators of cancer cure in Europe by type, sex, age and period. Methods: 7.2 million cancer patients (42 population-based cancer registries in 17 European countries) diagnosed at ages 15-74 years in 1990-2007 wit...

In Oceania, North America and north‐western Europe, after decades of increase, cutaneous malignant melanoma (CMM) rates began to stabilise or decline before 2000. Anecdotal evidence suggests that the reversal of the incidence trend is extending to southern Europe. To obtain a formal confirmation, this nationwide study from Italy investigated the in...

Introduction The activity of cancer registries represents a multistep process that starts by gathering information from a variety of sources. Such information is checked, linked, enriched and handled to produce high-quality original data capable of being informative enough to prove useful in answering specific epidemiological and clinical questions...

Introduction: Chronic infections and infestations represent one of the leading causes of cancer. Eleven agents have been categorized by the International Agency for Research on Cancer (IARC) in Group 1, 3 in Group 2A and 4 in Group 2B. We previously estimated that the incidence of cancers associated with infectious agents accounted for the 8.5% of...

Background: An increased risk of death by suicide in cancer patients has been documented since decades. We evaluated the risk of death by suicide in an Italian population-based cancer case series and added the results to a systematic review and meta-analysis of the literature. Methods: The Italian series, including 127,042 primary cancer patient...

Cancer registries (CRs) produce original and reliable data on cancer frequency and prognosis, document individual clinical paths, and represent a privileged real-world setting for quality of care and effectiveness evaluation. To reach their aim, CRs use many sources of information (hospital discharge notes, pathology reports, death certificates, an...

Epidemiologia del melanoma: stato dell'arte e prospettive

Background The basic scope of population-based cancer registries (CRs) is to collect data that enable computation of cancer incidence. In addition to this, nowadays most registries can provide more extensive information such as data on stage and treatment, which could be used to assess and compare different care pathways. The current analysis repor...

EVIDENCE REVIEW We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fer...

The prolonged use of drugs such as beta-blockers, acetylsalicylic acid, omeprazole, statins, oral contraceptives and hormone replacement therapy might have some role in melanocytic nevi development and be ultimately linked to melanoma risk. Aims of the study were to evaluate a possible association between the above-mentioned drugs and features such...

Nel 2008 è pervenuta alla direzione aziendale (DA) della ASL 11 di Empoli (oggi Azienda Usl Toscana Centro) la segnalazione da parte di alcuni MMG di una inusuale mortalità per leucemie tra i loro assistiti in un comune. La Direzione aziendale della ASL ha quindi deciso di effettuare un approfondimento epidemiologico formalizzando la costituzione d...

In the past two decades, the treatment landscape for patients with metastatic renal cell carcinoma has significantly changed thanks to the approval of several targeted molecular therapies (VEGF and mTOR inhibitors) and recently immune-checkpoint inhibitors. The Italian Association of Medical Oncology (AIOM) Renal Cell Cancer (RCC) Guidelines Panel...

In 2008, some general practitioners (GPs) in the area of Empoli (Tuscany Region, Central Italy), reported to the Local Health Authority (LHA), an unusually high frequency of leukemia deaths among their patients residing in a one of the municipalities of the area. The LHA decided to carry out an epidemiological investigation. An interdepartmental wo...

Background: Increasing evidence of cure for some neoplasms has emerged in recent years. The study aimed to estimate population-based indicators of cancer cure. Methods: Information on more than half a million cancer patients aged 15-74 years collected by population-based Italian cancer registries and mixture cure models were used to estimate the...

BACKGROUND: Prognostic factors in cutaneous melanoma are commonly evaluated by the Cox proportional hazard model. However, the interpretation of the effect of multiple variables is not straightforward. Classification and Regression Trees Analysis (CART), which allows a more friendly data evaluation, could be a valid integration of the message from...

Recent evidence in melanoma and trends

Objectives: Prognostic definition and treatment of breast cancer are supported by multigene testing. A recent trial (TAILORx) provided evidence against the use of adjuvant chemotherapy in early breast cancer (HR+ HER2-) with an intermediate result (11-25) in a multigene test (Oncotype DX). These results consequently fueled great discussion among o...

http://www.toscanamedica.org/87-toscana-medica/qualita-e-professione/836-i-numeri-del-cancro-in-toscana-2018

Background: Breast cancer is the most common cancer and the leading cause of cancer-related death in females, with a large societal and economic impact. Decisions regarding its treatment are largely affected by the categorization into different subtypes with hormone receptor status and HER2 status being the most important predictive factors. Other...

Background: the employment relationship with a public health service foresees a remuneration that in many cases is the main income, it takes place within a hierarchical structure, whose top management is nominated by politics. Therefore, objectives and priorities can change according to the prevailing policy. Objectives: to verify the existence...

Objective To evaluate short-term (2003–2014) cancer incidence and mortality trends in Italy. Methods Italian Cancer Registries data, available in the AIRTUM database, from 17 out of 20 regions were used. The number of incident cases and deaths were estimated for those registries and those years with incomplete information. Age-standardized rates,...

The development and diffusion of automation puts at risk traditional cancer registries but it also offers the opportunity to exploit their potentialities. It seems necessary to redefine some cornerstones of our activity to be part of the ongoing change and to sharing our wealth of knowledge on data and their interpretation.

Il Disturbo del Linguaggio (DL) è il disturbo del neurosviluppo più frequente in età evolutiva: colpisce circa 5-7% dei bambini in età prescolare, riducendo la sua incidenza all’1-2% in età scolare [Lindsay & Strand, 2016]; può ledere aspetti diversi dell’elaborazione del linguaggio (fonologia, morfosintassi, sintassi, semantica lessicale e frasale...

https://www.aiom.it/wp-content/uploads/0208/11/2018_carcinoma_mammella.pdf

After a long-term increase, the incidence of cutaneous malignant melanoma has stabilized recently or even decreased in several populations of North-western Europe, USA, Canada, Australia and New Zealand, but not in southern Europe. The incidence trends of primary invasive cutaneous malignant melanoma (International Classification of Diseases, 10th...

The aim was to evaluate changes in skin melanoma incidence and mortality at a population level in central Italy over the past two decades. Skin melanoma incidence rate from 1994 to 2014, were retrieved from the Umbrian Cancer Registry (about 900 000 inhabitants). Changes from 1994–1999 to 2010–2014 in tumour and patient characteristics– sex, age (0...

Background The 8th edition of TNM has introduced new rules for staging cutaneous melanoma. Objective To compare TNM 7th and 8th editions in defining pathological stages of melanoma. Methods A population‐based series of 1847 skin melanoma from Romagna cancer registry (Italy) incident during 2003‐2012 has been used to measure the agreement (with Co...

Effects of automation on cancer registries's future

https://www.aiom.it/wp-content/uploads/2018/10/2018_NumeriCancro-operatori.pdf

Una sessione del recente Convegno dell’Associazione italiana di epidemiologia tenutosi a Mantova ha affrontato la questione del conflitto d’interesse. Nella discussione ho fatto notare come nessuno dei relatori delle molte relazioni presentate in precedenza avesse dichiarato di avere conflitti d’interesse, pur lavorando (come dipendenti o precari)...

Purpose: Breast is the leading site of cancer onset and death in Italy. Cases diagnosed in stage IV or that progress in metastatic phase represent a specific and challenging task for oncologists. Estimates on the burden of breast cancer (BC) in stage IV in Italy are not available. Methods: We applied mortality-incidence age-specific ratios measure...

Il ruolo del disegno dello studio nella ricerca scientifica