A FIRST OF which there is little to be happy about. It is that of the number of new cancer diagnoses, which will grow in 2020 only in the female population. In particular because of the lung cancer, which is also the leading cause of cancer death. Translated: women get sick more, + 3.4% compared to the previous year the very disease of which one dies the most. The data emerges from the photograph taken as every year by The numbers of cancer, a volume rich in data and indications resulting from the collaboration of the leading Italian experts in oncology and epidemiology (Aiom – Italian Association of Medical Oncology, Aortim – Italian Association of Cancer Registers, Siapec-Iap – Italian Society of Pathological Anatomy and Diagnostic Cytology, Aiom Foundation, Steps – Progress of the Health Authorities for health in Italy and PASSI d’Argento), presented at the Istituto Superiore di Sanità.
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The increase in the diagnosis of lung cancer that alarms oncologists is observed especially among the over 70s and is linked to the habit of cigarette smoke, which since the 1970s has increasingly spread to the female population. In general, 377,000 new cancer diagnoses are expected this year in our country, 195,000 in men and 182,000 in women. The most frequently diagnosed cancer in 2020 will be breast cancer, followed by colorectal, lung, prostate and bladder.
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“Diagnoses of melanoma and pancreatic cancer are increasing in both sexes,” he says Giordano Beretta, national president of Aiom and head of Medical Oncology Humanitas Gavazzeni of Bergamo. “Breast cancer is also on the rise, especially in the under 50s, also as a consequence of the extension of the age group screened in some Regions. On the other hand, prostate neoplasms are decreasing in men, due to the lower use of PSA as a test And, in both sexes, the incidence rates for stomach and liver cancers are decreasing, in which we can hypothesize an effect of hepatitis B vaccination and hepatitis C treatments “.
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Screening works
The second important figure that emerges from the Report is the sharp decline in colorectal diagnoses in both sexes, demonstrating the effectiveness of the screening. In 2020, the incidence rates of this neoplasm will be down by 20% compared to the peak of 2013. More. The early detection of the disease thanks to screening combined with the effectiveness of therapies in the most advanced stages have produced an improvement in 5-year survival, which has increased from 52% in the 1990s to 65% today. Considering all the neoplasms, theeffectiveness of prevention campaigns and innovative therapies determines an overall increase in the number of people alive after diagnosis: there are about 3.6 million, an increase of 37% compared to 10 years ago. Nearly one million people have returned to the same life expectancy as the general population and can be considered cured.
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“Much has been done but work still needs to be done to enhance the offer of screening programs, especially in the South and especially for some cancers that are also very widespread, such as colorectal, the data tell us that even less than 5 out of 10 people over 50 they undergo the test “, says Silvio Brusaferro, President of the Istituto Superiore di Sanità.
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You die less
Another important data is that relating to overall reduction in mortality rates estimated in 2020 compared to 2015: they are decreasing in both men (-6%) and women (-4.2%), thanks to the progress made in diagnosis and treatments. Compared to men, however, women diagnosed with cancer live longer. In the former, 5-year survival is 54% while the latter reach 63%; the difference largely explained by the fact that in women the most frequent cancer is that of the breast, which has a better prognosis than other neoplasms, but also by the delay with which men on average arrive at the diagnosis. “Although the time limit from diagnosis to indicate healing is variable in relation to different cancers and sex, it has been estimated that over half of women diagnosed with cancer are cured or destined to recover – he explains Massimo Rugge, President Airtum – Among men, this percentage is lower due to the higher frequency of cancers with a more severe prognosis. There remains, in fact, a group of pathologies that are often already in an advanced stage at the time of diagnosis and of high lethality (central nervous system, liver, lung, esophagus, mesothelioma, pancreas), with unsatisfactory 5-year survival. More research efforts are needed to address precisely these diseases, which are still difficult to cure “.
Good news on the one hand, as the Minister of Health points out Roberto Speranza in the preface to the volume, but also great challenges still to be faced, especially in terms of research. “The role of translational research in improving the prognostic perspective is confirmed,” he stresses Franco Locatelli, president of the Superior Health Council. “It is now well established that better care is taken where research is done and this concept must lead to the investment of more and more resources in the oncology field”.
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Prevention possible
Cancers cause more than 25% of total deaths each year. “In 2020, it is estimated that, in our country, cancers will be the cause of death for 183,200 people, a slightly higher absolute number, due to the aging of the population, compared to that documented in 2017”, he explains Anna Sapino, president of SIAPEC-IAP. Today, however, we know that a good portion of deaths, about 65 thousand, can be avoided because the onset of the neoplasms that caused them is due to behavioral risk, therefore editable. “In Europe, the United States and other Western countries, about 40% of new cancer cases are potentially avoidable”, He comments Stefania Gori, president of the Aiom Foundation. “In both sexes, smoking is the risk factor with the greatest impact, to which at least 43 thousand annual deaths from cancer are attributable.
In fact, tobacco smoke is associated with the onset of about one in three cancers and as many as 17 types of cancer, in addition to that of the lung ”. Compared to past decades, in Italy today people smoke less: one in four does, but the reduction is less marked among people with economic difficulties and low education, as is also the case for excess weight and sedentary lifestyle. So here are other factors to watch out for. “17% of Italians consume alcohol in quantities at risk to health, 32% are overweight (11% obese) and as many as 35% are sedentary”, underlines Maria Masocco, Scientific coordinator of PASSI and PASSI d’Argento. “Habits that are not lost with age: the data collected by PASSI d’Argento show that, among the over 65s diagnosed with cancer, 11% still smoke, 18% consume excessive alcohol, 15 % are obese and 40% sedentary, as can be seen among people free from chronicity ”. In short, on the front of the promotion of healthy lifestyles much more can be done.
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