title: Cancer time trend in a population following a socio-economic transition: results of age-period-cohort analysis.
abstract: OBJECTIVE
  To examine cancer trend using age-period-cohort analysis with a cohort of patients in Sardinia, Italy, where epidemiological transition occurred between 1950 and 1960.
  
  
  METHODS
  Poisson log-linear regression models were used to analyze time trend in patients undergoing upper endoscopy between 1995 and 2013.
  
  
  RESULTS
  A total of 10,546 clinical records (62.2% women) were retrieved. In 541 patients (5.1%), a diagnosis of cancer was reported, more often in men (5.5%) than in women (4.9%). Age and birth cohort were significantly associated with cancer rate according to age-period-cohort analysis (p < 0.0001), whereas the effect of time period was negligible (p = 0.875). An upward trend for all cancers was observed in the younger generations (7.15% before 1950, 8.85% between 1950 and 1960, and 10.7% after 1960).
  
  
  CONCLUSIONS
  Population aging and increased exposure to cancer risk factors after epidemiological transition were the major determinants associated with cancer in this Sardinian cohort, whereas time period had no effect, ruling out any variation in diagnostic accuracy. These results may facilitate the provision of preventive measures by the health care system, and improve population-tailored cancer screening strategies.
authors.affiliation: Dipartimento di Medicina Clinica e Sperimentale, University of Sassari, Viale San Pietro n 8, Sassari, 07100, Italy. gmpes@uniss.it.|National Institute of Biostructures and Biosystems (INBB), University of Sassari, Sassari, Italy. gmpes@uniss.it.
authors.forename: Giovanni Mario
authors.identifier: http://orcid.org/0000-0003-3265-2823
authors.initials: GM
authors.lastname: Pes
authors.affiliation: Dipartimento di Medicina Clinica e Sperimentale, University of Sassari, Viale San Pietro n 8, Sassari, 07100, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Cocco
authors.affiliation: Dipartimento di Medicina Clinica e Sperimentale, University of Sassari, Viale San Pietro n 8, Sassari, 07100, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Bibbò
authors.affiliation: Dipartimento di Medicina Clinica e Sperimentale, University of Sassari, Viale San Pietro n 8, Sassari, 07100, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Marras
authors.affiliation: Dipartimento di Medicina Clinica e Sperimentale, University of Sassari, Viale San Pietro n 8, Sassari, 07100, Italy.|Baylor College of Medicine, Michael E. DeBakey VAMC, 2002 Holcombe Blvd, Houston, TX, USA.
authors.forename: Maria Pina
authors.initials: MP
authors.lastname: Dore
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D013997:Time Factors; D055815:Young Adult
keywords: Age-period-cohort analysis; Cancer prevalence; Epidemiological transition; Sardinia