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A FIRST OF WHICH there is little to be happy about. It is the number of new cancer diagnoses, that will grow in 2020 only in the female population. In particular due to the lung cancer, which is also the leading cause of cancer death. Translated: women get sick more, + 3.4% compared to the previous year the same disease from which one dies the most. The data arise from the photograph taken as every year by Cancer numbers, a volume rich in data and indications fruit of the collaboration of the leading Italian experts in oncology and epidemiology (Aiom – Italian Association of Medical Oncology, Aortim – Italian Association of Cancer Registries, Siapec-Iap – Italian Society of Pathological Anatomy and Diagnostic Cytology, Aiom Foundation, Steps – Progress of the Sanitary Authorities for health in Italy and PASSI d’Argento), presented at the Istituto Superiore di Sanità.
The increase in the diagnosis of lung cancer that alarms oncologists is observed especially among those over 70 years of age and is linked to the habit of cigarette smoke, which since the 1970s has increasingly spread to the female population. In general, 377,000 new cancer diagnoses are expected this year in our country, 195,000 in men and 182,000 in women. The most frequently diagnosed cancer in 2020 will be breast cancer, followed by colorectal, lung, prostate and bladder cancer.
“Pancreatic cancer and melanoma diagnoses are increasing in both genders,” he says. Giordano Beretta, National President of Aiom and Director of Humanitas Gavazzeni Medical Oncology of Bergamo. “Breast cancer is also increasing, especially in those under 50 years of age, also as a consequence of the extension of the age group examined in some Regions. On the other hand, prostate neoplasms are decreasing in men, due to less use of PSA as test And, in both sexes, the rates of incidence of stomach and liver cancers are diminishing, in which we can suppose an effect of the vaccination against the hepatitis B and the treatments against the hepatitis C “.
Screening jobs
The second important figure that emerges from the Report is the sharp decrease in colorectal diagnoses in both sexes, demonstrating the effectiveness of put on screen. In 2020, the incidence rates of this neoplasm will be reduced by 20% compared to the 2013 peak. More. Early detection of the disease thanks to screening combined with the effectiveness of therapies in the most advanced stages has produced a improvement in 5-year survival, which has gone from 52% in the 1990s to 65% today. Considering all neoplasms, theeffectiveness of prevention campaigns and innovative therapies determines an overall increase in the number of people alive after diagnosis: there are about 3.6 million, an increase of 37% compared to 10 years ago. Almost a million people have returned to the same life expectancy as the general population and can be considered cured.
“Much has been done but there is still work to be done to improve the offer of screening programs, especially in the South and especially for some cancers that are also very widespread, such as colorectal, the data tells us that even less than 5 of each 10 people over 50 are tested, ”says Silvio Brusaferro, president of the Istituto Superiore di Sanità.
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You die less
Another important piece of information is that of Overall reduction in estimated mortality rates in 2020 compared to 2015: they are decreasing in both men (-6%) and women (-4.2%), thanks to advances in diagnosis and treatments. However, compared to men, women diagnosed with cancer live longer. In the first, the 5-year survival is 54% while in the second it reaches 63%; The difference is largely explained by the fact that the most common cancer in women is breast cancer, which has a better prognosis than other neoplasms, but also by the delay with which men on average reach the diagnosis. “Although the time limit from diagnosis to indicate cure is variable in relation to different types of cancer and sex, it has been estimated that more than half of women diagnosed with cancer are cured or destined to recover,” he explains. Massimo Rugge, President Airtum – Among men, this percentage is lower due to the higher frequency of cancers with a more severe prognosis. In fact, there remains a group of pathologies that are often already in an advanced stage at the time of diagnosis and with high lethality (central nervous system, liver, lung, esophagus, mesothelioma, pancreas), with an unsatisfactory 5-year survival . More research efforts are needed to address precisely these diseases, which are still difficult to cure. “
Good news on the one hand, as the Minister of Health points out Roberto Speranza in the preface to the volume, but also great challenges to face, especially in terms of research. “The role of translational research in improving the prognostic outlook is confirmed”, highlights Franco Locatelli, president of the Superior Council of Health. “It is now well established that it is best cared for where it is researched and this concept should lead to the investment of increasing resources in the field of oncology.”
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Possible prevention
Cancers cause more than 25% of all deaths each year. “In 2020, it is estimated that, in our country, cancers will be the cause of death of 183,200 people, a slightly higher absolute figure, due to the aging of the population, compared to what was documented in 2017,” he explains. Anna Sapino, President of SIAPEC-IAP. Today, however, we know that a good part of the deaths, some 65 thousand, can be avoided because the appearance of the neoplasms that caused them is due to behavioral risk, therefore editable. “In Europe, the United States and other western countries, About 40% of new cancer cases are potentially preventable.”, He comments Stefania gori, president of the Aiom Foundation. “In both sexes, smoking is the risk factor with the greatest impact, to which at least 43 thousand annual deaths from cancer are attributable.
In fact, tobacco smoke is associated with the appearance of approximately one in three cancers and 17 types of cancer, in addition to lung cancer ”. Compared with past decades, in Italy today people smoke less: one in four does, but the reduction is less marked among people with economic difficulties and low educational level, as is the case with excess weight and sedentary lifestyle. So here are other factors to consider. “17% of Italians consume alcohol in amounts that put health at risk, 32% are overweight (11% obese) and up to 35% are sedentary,” he underlines Maria Masocco, Scientific coordinator of PASSI and PASSI d’Argento. Habits that are not lost with age: the data collected by PASSI d’Argento shows that, among those over 65 years diagnosed with cancer, 11% continue to smoke, 18% consume alcohol in excess, 15% are obese and 40 % sedentary, as seen among people free of chronicity ”. In short, on the front of the promoting healthy lifestyles much more can be done.
