Time trends of cancer incidence in childhood in Campania region: 25 years of observation.
BACKGROUND
Childhood cancer is relatively uncommon and the European age-standardized rate was 164 new case per million per year among children 0 to 14 years of age (95 % CI 158-170). Aims of our study are to evaluate the cases of these malignant diseases observed between 0 and 15 years of age in the Campania region between 1990 and 2014, the ration between observed and expected cases by disease and province of residence. Also we studied the percentage of extra-regional migration over the time by disease and province of residence.


METHODS
In this study we reported the patients with malignant disease observed in 25 years (1990-2014) based on the specialized registry, the Mod. 1.01 of the AIEOP (Association Italian Pediatric Hematology-Oncology). The size of the monitored population also allowed us to systematically examine five time trends: 1990-94: 1995-99; 2000-04; 2005-09; and 2010-14.


RESULTS
Between 1990 and 2014 a total of 3655 malignant neoplasms were reported: Napoli province (2059 cases), Salerno province (625), Caserta province (589), Avellino province (229), and Benevento province (153). Epidemiological data suggested that about 4100 cases could be expected in Campania region during the same period. The overall ratio between observed (O) and expected (E) numbers of cases in the five periods considered rose gradually from 0.69 in the first period to 0.76, then 0.82, 0.91, and 0.94, in the other periods considered. The extra-regional migration involved 1029 cases (28.1 %), showing a reduction from 33.7 % of the first period to 20.3 % of the last period considered. Considering single province of residence we observed the lowest rate of migration in Napoli and Caserta province, whereas higher levels were observed in the other provinces. For all provinces, except Salerno, the extra-regional migration declined significantly over time.


CONCLUSIONS
The present findings showed an increase over time of O/E ratio, probably due to improvement in the organization of centers and greater trust of families in local centers. It is possible to further improve the efficiency of healthcare system of Campania region and migration can be reduced with a more rational use of hospitals throughout region.
Servizio di Oncologia Pediatrica, Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica- Seconda Università degli Studi di Napoli, Naples, Italy. paolo.indolfi@unina2.it.|AIL Sezione "Valentina Picazio", Caserta, Italy. paolo.indolfi@unina2.it.
Paolo
P
Indolfi
AIL Sezione "Valentina Picazio", Caserta, Italy.
Serena
S
Picazio
Servizio di Oncologia Pediatrica, Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica- Seconda Università degli Studi di Napoli, Naples, Italy.
Silverio
S
Perrotta
Servizio di Oncologia Pediatrica, Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica- Seconda Università degli Studi di Napoli, Naples, Italy.
Francesca
F
Rossi
Unità di Oncologia ed Ematologia Pediatrica "Lalla Seràgnoli", Università di Bologna, Bologna, Italy.
Andrea
A
Pession
Servizio di Oncologia Pediatrica, Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica- Seconda Università degli Studi di Napoli, Naples, Italy.
Martina
M
Di Martino
Servizio di Oncologia Pediatrica, Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica- Seconda Università degli Studi di Napoli, Naples, Italy.
Elvira
E
Pota
Servizio di Oncologia Pediatrica, Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica- Seconda Università degli Studi di Napoli, Naples, Italy.
Daniela
D
Di Pinto
Servizio di Oncologia Pediatrica, Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica- Seconda Università degli Studi di Napoli, Naples, Italy.
Cristiana
C
Indolfi
Unità di Oncologia ed Ematologia Pediatrica "Lalla Seràgnoli", Università di Bologna, Bologna, Italy.
Roberto
R
Rondelli
Responsabile Registro Tumori Infantili Regione Campania, Naples, Italy.
Francesco
F
Vetrano
Servizio di Oncologia Pediatrica, Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica- Seconda Università degli Studi di Napoli, Naples, Italy.
Fiorina
F
Casale
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D008297:Male; D009369:Neoplasms / Q000453:epidemiology*; D012307:Risk Factors
Cancer; Children; Epidemiology