[Cancer mortality in Southern Italy, 1999-2003].

INTRODUCTION: Official statistics on mortality represent one of the most important indicators on the health status of a population. Cancer mortality time trends show that southern Italy is progressively losing its lower mortality gap as compared to the North of the country. The mortality contribution of this pattern at a fine geographical scale (provinces) has not been extensively studied in southern Italy. OBJECTIVE: To provide a cancer mortality profile in the 23 provinces of South Italy. DESIGN: Descriptive geographical study at population level. SETTING: Cancer mortality analysis by main causes of death and gender, conducted between 1999 and 2003. We computed age-standardized rates (reference World population) (ASR) as well as standardized mortality ratios (South Italy as reference population) (SMR) to compare mortality between geographical areas. MAIN OUTCOME MEASURES: Mortality from all cancer causes and from major neoplasms. RESULTS: In southern Italy, ASRs for all cancer causes (benign and malignant) were 149.3/105 in males and 81.0/105 in females. In both genders, these rates were lower than rates in Italy as a whole (-8% in males and -9% in females). Cancer mortality ASRs for liver, prostate, urinary organs, melanoma and skin, and neoplasms of lymphatic and haematopoietic tissues displayed weak, or barely any, differences between the South and Italy as a whole. Statistically significant (p<0.01) mortality excesses were observed in 7 out of 23 examined provinces, with highest frequency excesses in Naples and Caserta provinces. In males liver cancer mortality showed a SMR excess of 30- 50% in 4/23 provinces. Female breast cancer mortality displayed a 10% excess in 3/23 provinces. CONCLUSIONS: Although this analysis highlighted a lower mortality in southern Italy, as compared to Italy as a whole, seven provinces showed excesses mainly for liver and breast cancers. Current knowledge on cancer etiology explains the vast majority of such observed excesses. Further analyses will help in designing and monitoring cancer prevention and early diagnosis interventions also in South Italy.