Trends in cancer mortality: perspectives from Italy and the United States.
Cancer continues to be a major public health problem in Italy, as it is throughout the world. We analyzed age-adjusted mortality rates for all cancers combined and for specific cancer sites in Italy for five year periods from 1950 to 1989. We compared trends in Italian cancer mortality to those observed in the United States during the same time period. We also considered some ancillary data including age-specific mortality rates, as well as incidence and five year relative survival data from the Modena Province. Age-adjusted cancer mortality rates in Italy are increasing in males and, to a lesser extent, females. This finding is in contrast to a recent plateau in age-adjusted cancer mortality rates in the United States. In Italy, stomach cancer mortality has declined substantially, counteracting marked increases in lung cancer mortality, particularly in males, and breast and lung cancer in females. Changes in cancer mortality in Italy, as in the US, have been driven primarily by changes in disease incidence rather than advances in therapeutics. These data suggest a need for realignment of cancer control resources toward prevention, particularly with regard to lung cancer and tobacco usage.
Bailar
J C
JC
Department of Health Studies, University of Chicago, IL 60637-1470, USA.
Gornik
H L
HL
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D009369:Neoplasms / Q000401:mortality*; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology