title: Looking at differences in stage and treatment of colorectal cancers across Italy: a EUROCARE-5 high resolution study.
abstract: OBJECTIVE
  The high incidence and the estimate of a five-year relative survival of 59% for colorectal cancer in Italy were the main reasons to investigate the management of Italian patients with colorectal cancer diagnosed in the early 2000s.
  
  
  METHODS
  Samples of adult (≥15 years) patients diagnosed in 2003-2005 with a colorectal cancer were randomly selected in 8 Italian population-based cancer registries. The z test was used to evaluate differences in proportions of Dukes stage, patients with at least 12 examined lymph nodes, and of cases treated with curative surgery plus chemotherapy or plus radiotherapy and diagnosed with colon or rectal tumors, respectively. Logistic regression models were used to estimate odds ratios of receiving the selected treatment in each cancer registry, age group and stage category, by anatomical subsite.
  
  
  RESULTS
  A total of 3,938 colorectal cancer patients were analyzed. About 40% of the cases were over 75 years of age at diagnosis and at Dukes A + B stages. Higher proportions of early stages were found in the northern cancer registries. High percentages of resection with a curative intent were observed in Reggio Emilia (northern Italy), in 15 to 74-year-old patients, and at Dukes B stage. At least 12 lymph nodes were more frequently examined in the north of the country. After adjusting for age and stage, no significant differences were seen in the odds ratios of receiving surgery plus chemotherapy between cancer registries, whereas surgery plus radiotherapy was more frequent in Napoli (southern Italy) and less frequent in Biella (northern Italy).
  
  
  CONCLUSIONS
  Some disparities in staging and treatment of colorectal cancer patients persist across Italy. National oncological plans still need to reduce inequalities in provision and access to proper care.
authors: Department of Preventive and Predictive Medicine, Descriptive Studies and Health Planning Unit, Fondazione IRCSS Istituto Nazionale dei Tumori, Via Venezian 1, Milan, Italy. pamela.minicozzi@istitutotumori.mi.it
authors: Pamela
authors: P
authors: Minicozzi
authors: Adele
authors: A
authors: Caldarella
authors: Adriano
authors: A
authors: Giacomin
authors: Maurizio
authors: M
authors: Ponz de Leon
authors: Rosaria
authors: R
authors: Cesaraccio
authors: Fabio
authors: F
authors: Falcini
authors: Mario
authors: M
authors: Fusco
authors: Francesco
authors: F
authors: Iachetta
authors: Carlotta
authors: C
authors: Pellegri
authors: Rosario
authors: R
authors: Tumino
authors: Riccardo
authors: R
authors: Capocaccia
authors: Milena
authors: M
authors: Sant
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D003110:Colonic Neoplasms / Q000473:pathology / Q000628:therapy; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy*; D013505:Digestive System Surgical Procedures; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016017:Odds Ratio; D018714:Radiotherapy, Adjuvant; D012004:Rectal Neoplasms / Q000473:pathology / Q000628:therapy; D012042:Registries; D012189:Retrospective Studies; D012494:Sampling Studies; D016896:Treatment Outcome