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Reggio nell'Emilia, Italy

Busco S.,Epidemiology Unit | Giorgi Rossi P.,Servizio Interaziendale di Epidemiologia | Sperduti I.,Regina Elena Cancer Institute | Pezzotti P.,Laziosanita Agency for Public Health | And 2 more authors.
Cancer Epidemiology

Objective: To describe the thyroid cancer incidence trends and geographical patterns in the Latina Province of Lazio, Italy using the population-based cancer registry. Methods: We extracted from the Latina cancer registry all cases of thyroid cancer from 1997 to 2006. Cases were classified according to morphological type and diameter. Data for diagnostic procedures for Latina Province residents from 2001 to 2006 were extracted from the regional outpatient procedures information system. Results: A total of 982 cases were diagnosed, for a standardized incidence of 8.3 and of 27.9 per 100,000 in males (. n, 220) and in females (. n, 762), respectively. The annual percent change (APC) was +16.7% (95% CI +7.2, +27.2) and +10.5% (95% CI +6.5, +14.6) in males and females, respectively. The increase was mostly due to papillary (. n, 759) and small (≤20. mm) cancers (. n, 617), with no difference by age (<45 years; n, 431). The APC of neck ultrasound performed was +8.7% (95% CI +0.1, +18.1) and +9.0% (95% CI +1.1, +17.4) and that of biopsy/cytology was +17.0% (95% CI +13.0, +21.3) and +16.6% (95% CI +6.2, +28.1) in men and women, respectively. The geographic pattern of biopsy/cytology was similar to that of cancer incidence but not to that of neck ultrasound. Conclusions: In Latina, the increase in thyroid cancer incidence was more rapid than in the rest of Italy, particularly for types with a good prognosis. While tumor size and histotype suggest an increase in detection instead of an increase in disease occurrence, data on diagnostic procedure reimbursements cannot provide an explanation. © 2013 Elsevier Ltd. Source

Pacchiarotti A.,Servizio Interaziendale di Epidemiologia
American journal of clinical pathology

This study aimed to compare the interobserver Cohen κ on H&E staining and on H&E plus p16(INK4a) staining of all cervical biopsy specimens in a population-based screening program. All the colposcopy-guided biopsies generated by the routine screening of 23,258 women aged 25 to 64 years were stained with H&E and H&E plus p16. Biopsy specimens were reviewed by six external experts. The four diagnoses were available in 441 cases. The interobserver κ values were 0.52 (95% confidence interval [CI], 0.45-0.58) and 0.48 (95% CI, 0.42-0.56) with H&E and H&E + p16, respectively, when using a five-group classification (normal, CIN 1, CIN 2, CIN 3, and cancer); adopting a two-group classification (≤CIN 1 and ≥CIN 2), the values were 0.75 (95% CI, 0.66-0.82) and 0.70 (95% CI, 0.61-0.79), respectively. The use of p16 on all cervical biopsy specimens in a screening program showed virtually no effect on reproducibility of the histologic diagnosis. Source

Tornesello M.L.,Italian National Cancer Institute | Buonaguro L.,Italian National Cancer Institute | Giorgi-Rossi P.,Servizio Interaziendale di Epidemiologia | Buonaguro F.M.,Italian National Cancer Institute
BioMed Research International

Cervical cancer arises from cells localized in the ectoendocervical squamocolumnar junction of the cervix persistently infected with one of about 13 human papillomavirus (HPV) genotypes. The majority of HPV infections induces low grade squamous epithelial lesions that in more than 90% of cases spontaneously regress and in about 10% eventually progress to high grade lesions and even less frequently evolve to invasive cancer. Tumor progression is characterized by (1) increased expression of E6 and E7 genes of high risk HPVs, known to bind to and inactivate p53 and pRb oncosuppressors, respectively; (2) integration of viral DNA into host genome, with disruption of E2 viral genes and host chromosomal loci; and (3) molecular alterations of key regulators of cell cycle. Molecular markers with high sensitivity and specificity in differentiating viral infections associated with cellular abnormalities with high risk of progression are strongly needed for cervical cancer screening and triage. This review will focus on the analysis of clinical validated or candidate biomarkers, such as HPV DNA, HPV E6/E7 mRNA, HPV proteins, p16(INK4a) and Ki67, TOP2A and MCM2 cellular factors, and DNA methylation profiles, which will likely improve the identification of premalignant lesions that have a high risk to evolve into invasive cervical cancer. © 2013 Maria Lina Tornesello et al. Source

Dalla Palma P.,Anatomia Patologica | Moresco L.,Anatomia Patologica | Giorgi Rossi P.,Servizio Interaziendale di Epidemiologia
Acta Cytologica

Objective: To assess the introduction of computer-assisted Pap test screening in cervical cancer screening. Various scenarios are considered: conventional and liquid-based cytology (LBC) slides, fully automatic instrumentation (Becton Dickinson FocalPoint™ Slide Profiler and Hologic ThinPrep® Imaging System), and semiautomatic scanner (Hologic Integrated Imager I-Squared). Methods: A working group was formed that included researchers from the largest centers already using instrumentation. A questionnaire on laboratory management and on socialethical issues and annual workload was proposed. Prices for the technology were obtained directly from the producers; costs were calculated from observed and literature data. The scope of the report and final draft were submitted to a consulting committee of stakeholders. Results: The break-even point was found to be 49,000 casesyear, if conventional slides were used, while it was near the theoretical maximum capacity, 70,000 casesyear, with LBC slides. Efficiency increased with the volume of slides. Screening time decreased by two thirds for conventional slides and by less than half for LBC slides. Acceptance of the instrumentation by the users was good. Conclusions: Computer-assisted screening may increase productivity even if in most situations it will mean additional costs. Furthermore, primary screening with human papillomavirus tests will drastically reduce the need for Pap test reading. Copyright © 2013 S. Karger AG, Basel. Source

Hassan C.,Laziosanita Agenzia di Sanita Pubblica | Rossi P.G.,Servizio Interaziendale di Epidemiologia | Camilloni L.,Laziosanita Agenzia di Sanita Pubblica | Rex D.K.,Indiana University | And 5 more authors.
Alimentary Pharmacology and Therapeutics

Background A variety of tests have been proposed for colorectal cancer (CRC), giving rise to uncertainty regarding the optimal approach. The efficacy and effectiveness of different tests are related to both screenee participation and the detection rate. Aim To perform a meta-analysis on adherence and detection rates of CRC screening tests. Methods Relevant publications were identified by MEDLINE/EMBASE and other databases for the period 1999-2012. A previous systematic review was used for the period before 1966-1999. RCTs and controlled studies including a direct comparison of the uptake rates among different options for CRC screening were included. Adherence and detection rates for advanced neoplasia and cancer were extracted. Risk for bias was ascertained according to CONSORT guidelines. Forrest plots were produced based on random-effect models. Results Fourteen studies provided data on 197 910 subjects. Endoscopic strategies were associated with a lower participation (RR: 0.67, 95% CI: 0.56, 0.80) rate, but a higher detection rate of advanced neoplasia (RR: 3.21, 95% CI: 2.38, 4.32) compared with faecal tests. FIT was superior to g-FOBT with regard to both adherence (RR: 1.16, 95% CI 1.03, 1.30) and detection of advanced neoplasia (RR: 2.28, 95% CI 1.68, 3.10) and cancer (RR: 1.96, 95% CI: 1.2, 3.2). Conclusion The superior accuracy of endoscopy compared with faecal tests minimised any impact of the participation rate in determining the detection rate of advanced neoplasia in a screening setting. © 2012 Blackwell Publishing Ltd. Source

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