Abstract Background Global variations in survival for brain tumors are very wide when all histological types are considered together. Appraisal of international differences should be informed by the distribution of histology, but little is known beyond Europe and North America. Methods The source for the analysis was the CONCORD database, a program of global surveillance of cancer survival trends, which includes the tumor records of individual patients from more than 300 population-based cancer registries. We considered all patients aged 0-99 years who were diagnosed with a primary brain tumor during 2000-2014, whether malignant or nonmalignant. We presented the histology distribution of these tumors, for patients diagnosed during 2000-2004, 2005-2009, and 2010-2014. Results Records were submitted from 60 countries on 5 continents, 67 331 for children and 671 085 for adults. After exclusion of irrelevant morphology codes, the final study population comprised 60 783 children and 602 112 adults. Only 59 of 60 countries covered in CONCORD-3 were included because none of the Mexican records were eligible. We defined 12 histology groups for children, and 11 for adults. In children (0-14 years), the proportion of low-grade astrocytomas ranged between 6% and 50%. Medulloblastoma was the most common subtype in countries where low-grade astrocytoma was less commonly reported. In adults (15-99 years), the proportion of glioblastomas varied between 9% and 69%. International comparisons were made difficult by wide differences in the proportion of tumors with unspecified histology, which accounted for up to 52% of diagnoses in children and up to 65% in adults. Conclusions To our knowledge, this is the first account of the global histology distribution of brain tumors, in children and adults. Our findings provide insights into the practices and the quality of cancer registration worldwide.

Histology

Brain tumor

10.1093/neuonc/noab067

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Treatment patterns among patients with malignant pleural mesothelioma: An Italian, population‐based nationwide study

Thoracic Cancer (2020)

Annalisa Trama Claudia Proto Diego Signorelli Marina Chiara Garassino Giuseppe Lo Russo

Abstract Background Malignant pleural mesothelioma (MPM) is a rare cancer with a poor prognosis. Centralization of rare cancer in dedicated centers is recommended to ensure expertise, multidisciplinarity and access to innovation. In Italy, expert centers for MPM have not been identified in all regions. We aimed to describe the treatment patterns among MPM patients across different Italian regions and to identify factors associated with the treatment patterns across the regions. Methods We performed an observational study on a random sample of 2026 MPM patients diagnosed in 2003–2008. We included 26 population‐based registries covering 70% of the Italian population. To identify factors associated with treatment patterns, across the different regions, we fitted a multinomial logistic regression model adjusted by age, sex, stage, histology and hospital with thoracic surgical department. Results MPM patients mostly received chemotherapy alone (41%) or no cancer‐directed therapy (36%) especially the older patients. The first course of treatment for MPM patients differed across regions. Patients from Piedmont, Liguria and Campania were more likely to receive no cancer‐directed therapy; those living in Tuscany and Sicily were more likely to get surgery; patients from Marche and Lazio were more likely to receive chemotherapy. These differences were not explained by age, sex, stage, histology and availability of a thoracic surgery department. Conclusions There is limited expertise available and lack of a network able to maximize the expertise available may contribute to explaining the results of our study. Our findings support the need to ensure the appropriate care of all MPM patients in reorganizing the health care services. Key points Significant findings of the study: MPM patients mostly received chemotherapy alone or no cancer‐directed therapy especially the older patients. The first course of treatment for MPM patients differed across Italian regions. What this study adds: Differences in MPM clinical management are not explained by the age, stage, histology nor by the availability of a thoracic surgery department. Limited expertise for MPM contribute to explaining the unequal access to appropriate care for MPM patients in Italy.

10.1111/1759-7714.13456

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Molecular Subtypes, Metastatic Pattern and Patient Age in Breast Cancer: An Analysis of Italian Network of Cancer Registries (AIRTUM) Data

Journal of Clinical Medicine (2021)

Giovanna Tagliabue Sabrina Fabiano Paolo Contiero Giulio Barigelletti Maurizio Castelli

Breast cancer stage at diagnosis, patient age and molecular tumor subtype influence disease progression. The aim of this study was to analyze the relationships between these factors and survival in breast cancer patients among the Italian population using data from the AIRTUM national database. We enrolled women with primary breast cancer from 17 population-based cancer registries. Patients were subdivided into older (>69 years), middle (50-69 years) and younger age groups (<50 years) and their primary tumors categorized into four molecular subtypes based on hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status. There were 8831 patients diagnosed between 2010 and 2012 included. The most represented age group was 50-69 years (41.7%). In 5735 cases the molecular subtype was identified: HER2-/HR+ was the most frequent (66.2%) and HER2+/HR- the least (6.2%). Of the 390 women with metastases at diagnosis, 38% had simultaneous involvement of multiple sites, independent of age and molecular profile. In women with a single metastatic site, bone (20% of cases), liver (11%), lung (7%) and brain (3%) were the most frequent. In the studied age groups with different receptor expression profiles, the tumor metastasized to target organs with differing frequencies, affecting survival. Five-year survival was lowest in women with triple-negative (HER2-/HR-) tumors and women with brain metastases at diagnosis.

Primary tumor

10.3390/jcm10245873

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Airborne particulate matter in school classrooms of Northern Italy

ISEE Conference Abstracts (2013)

Sabrina Rovelli Andrea Cattaneo Camilla Paola Nuzzi Andrea Spinazzè Silvia Piazza

Background - Indoor air quality in schools is a significant concern because children spend at least 30% of their week-days inside school buildings, where air pollutants can achieve high concentrations, and they are much more vulnerable than adults to the effects of air pollution. Aims - The primary aim of this study was to investigate PM mass concentrations in classrooms, evaluating the impact of indoor activities, outdoor sources and air exchange rates on indoor PM levels. Methods - PM2,5 and PM10 measurements were carried out in 9 schools of Northern Italy. Sampling was done from Monday morning to Friday afternoon in three classrooms of each school and was repeated in winter 2011-12 and 2012-13. At the same time, PM2.5 samples were also collected outdoors. Two different photometers were used to collect PM2.5 and PM10 -continuous data, corrected a-posteriori using simultaneous gravimetric PM2.5 measurements. Results - Indoor PM2.5 levels appeared to be correlated with corresponding outdoor concentrations, with mean I/O PM2.5 ratios generally < 1. It was estimated that most of the PM2.5 in classrooms was originated from outdoor sources. Children's movement, clothing and crowding of classrooms led to the resuspension of coarse particles and greatly contributed to increase indoor PM10 levels. Indeed, a statistically significant difference for PM10 was found between periods of school occupation - when PM10 was mainly composed by coarse particles and reached very high levels - and when rooms were empty. Cleaning activities also affected PM mass concentrations, especially for particles > 10 µm. No significant correlation was found between PM mass concentrations and air change rates. Conclusions - This study found high indoor PM levels in school classrooms - especially for PM10 - and indoor average PM concentrations often exceeded the recommended guideline values. This study was carried out in the framework of the "Sinphonie" and "CCM-Indoor school" projects.

10.1289/isee.2013.p-1-01-05

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RISK OF HEMOLYMPHOPOIETIC NEOPLASM BEFORE AND AFTER THYROID CANCER. A POPULATION‐BASED STUDY IN ITALY, 1998‐2012

Hematological Oncology (2021)

V. Mattioli Emanuele Crocetti Luigino Dal Maso Carlotta Buzzoni Silvia Franceschi

Introduction: The number of patients living after a cancer diagnosis is increasing, especially after hemolymphopoietic and thyroid cancer (TC). This study aims at evaluating both the risk of a second hemolymphopoietic cancer in TC patients and the risk of TC as a second cancer. Methods: Two population-based cohorts of cancer patients aged up to 84 years were identified from 28 Italian cancer registries in the 1998–2012. The first included TC patients and the second hemolymphopoietic cancers patients with cancers. Standardized incidence ratios (SIR) of SPC were stratified by sex, age, and time since first cancer. SPC diagnosed within 2 months since first are not included in the computation of cancer-specific SIRs. Results: 38,535 TC patients and 154,820 patients with hemolymphopoietic cancers were included. Overall SIR for hemolymphopoietic cancer in TC patients was significantly increased (SIR=1.5 in women and 1.3 in men), as well as for most of the hemolymphopoietic subtypes (SIR=2.7 for acute lymphoid leukemia, 1.6 for follicular non-Hodgkin lymphomas, 1.5 for chronic lymphoid leukemia, and 1.4 for myelomas for both sexes). The overall SIR for hemolymphopoietic cancer in TC patients was significantly higher in all three age groups (0-34 years: 2.0, 35-54: 1.4 and 55+: 1.4 for both sexes). The risk of TC cancer was significantly increased after Acute Lymphoid Leukemia (10 cases, SIR=6.1), Hodgkin lymphomas (38, 2.8), and all hemolymphopoietic neoplasms (183, 1.8). The risk of TC after any hemolymphopoietic cancer was particularly higher for the age groups 0-34 and 35-54 (SIR 4.3 and 1.8 respectively). Conclusions: TC patients have both an increased risk of developing a second hemolymphopoietic cancer as TC to be a second cancer. An elevated risk of second primary tumors from the use of radioactive iodine (RAI) therapy in TC patients, in particular in pediatric and young adult patients, may explain the elevated incidence of acute lymphoid leukaemias and hemolymphoiectic neoplasms overall. The present finding may help in designing surveillance programs for hemolymphopoietic cancers in TC patients and vice versa keeping into consideration the possibility of overdiagnosis of TC. Keywords: Prevention and Cancer Interception No conflicts of interests pertinent to the abstract.

Follicular thyroid cancer

10.1002/hon.104_2881

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