According to estimates by the International Agency for Cancer Research and the European Network of Cancer Registries (ENCR), in 2023 in Italy there were 395 thousand new cases of cancer (excluding skin cancers other than melanoma), of which 187 thousand in women. Which therefore represents about half of the cases. Judging by the growth forecasts of new diagnoses – which in women is 0.6% per year while in men it is 1.3% -, patients are destined to remain the minority of cancer patients. But there are some pathologies that are of particular concern: if in fact the most frequent cancer in women remains breast cancer (30% of all female cancers), also colorectal-anal cancer (12.7%) and lung cancer (7.4%) %) hit hard. And without the female population paying the same level of attention to these tumors as they do to breast cancer. This is followed by specifically female tumors, such as that of the endometrium (5.5%), the cervix (1.3%) and the ovary (3%). Here is the situation in Italy case by case.
“If it’s not gender, it’s not medicine”
by Noemi Penna
Breast cancer
According to the latest Aiom-Airtum report in 2022, in Italy, there were 55,700 new cases of breast cancer and 15,500 estimated deaths. Survival five years after diagnosis, however, is very good (88%), and translates into over 834 thousand women living after diagnosis. Part of the credit goes to the mammography screening service for early diagnosis. According to data from the National Screening Observatory, it has a national extension of 85.9% (close to the objective established at European level for 2025) and over 56% of the population to whom it is offered participates, i.e. women between 50 and 69 years old. However, it should be underlined that both in terms of extension and adherence there is a strong North-South gradient, with the southern regions bringing up the rear in early diagnosis.
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by Tiziana Moriconi
Colorectal-anal cancer
The second most frequent female cancer, colorectal-anal cancer affected approximately 23,700 women in 2023. The chances of survival five years after diagnosis are 66%, which rise to 79% if the first year post-diagnosis is exceeded. In Italy today there are approximately 233,200 women who have had colorectal-anal cancer and mortality has decreased by almost 9% compared to the period 2003-2009. Even for these tumors, early diagnosis can make the difference. However, participation in the screening program for fecal occult blood is decidedly not optimal: the national value (which includes both sexes, between 50 and 69 years) is 38.7%, with values higher than in the North (47.6%) compared to the Center (31.5%) and the South and Islands (23.7%).
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Lung cancer
The third place of lung cancer in the sad ranking of the most frequent tumors in women, correlated to the increase in tobacco consumption, should not be surprising. Although in absolute terms the primacy remains with men, in 2023 an estimated 14 thousand new diagnoses were made in women, with a five-year survival rate of 23% (higher than that of men, equal to 16%). Lung cancer deaths in 2022 are estimated to total 35,700, of which 12,100 are women. The trend of female cancer deaths, with equal opportunities and care with men, is clearly rising (+16%) compared to the period 2003-2006 and in contrast to the male one (-18.7%). “The high incidence of lung cancer, both in men and women, and the mortality statistics linked to this cancer require us to never forget the importance of primary prevention, and in particular the fight against smoking, the main risk factor ” – write in the Aiom-Airtum report Giuseppe Altavilla, professor of medical oncology at the University of Messina, and Massimo Di Maio, of the oncology department of the University of Turin, who recall that the vast majority of lung tumors are diagnosed in an advanced stage. Screening to identify lung cancer early in those most at risk (heavy smokers) exists and in studies “has demonstrated a reduction in tumor-specific mortality and a significant increase in the chances of diagnosis at an early stage. However, to date in Italy it is not included in public programs, despite the strong positive recommendation in the Aiom 2021 guidelines.
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Endometrial cancer
Endometrial cancer is the only gynecological neoplasm with an increasing incidence and mortality: 10,200 new cases were estimated in 2023, while overall deaths from uterine cancers (endometrium, cervix, sarcomas) in 2022 were 2,500. “The onset symptom of the disease is represented by abnormal uterine bleeding – we read in Cancer numbers 2023 – The precociousness of the symptom means that 80% of endometrial tumors are diagnosed when the lesion is still confined to the uterus ”. The five-year net survival figure is 79%, which translates into 122,600 women living in Italy after being diagnosed with cancer.
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by Mara Magistroni
Cervical cancer
Cervical cancer represents 1.3% of all tumors in women and is the fifth most frequent neoplasm in the young female population. In 2022 there will be around 2,500 new diagnoses, with five-year survival standing at 68%. Cervical screening (Pap test offered every three years between the ages of 25 and 30/35 and HPV test offered every five years to women aged between 30/35 and 64 years) is widely extended throughout the national territory ( 88.3%), with membership remaining just under 40% (the range varies from 47.8% in the North to 33.4% in the Center and 32.6% in the South and Islands).
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by Letizia Gabaglio
Ovarian cancer
In tenth place in the ranking of the most frequent tumors in women in Italy, 6,000 new cases of ovarian cancer and 3,600 related deaths were estimated in 2022. These are aggressive neoplasms, in most cases detected in an advanced stage. “In fact, approximately 75-80% of patients present an advanced disease at the time of diagnosis; much rarer (10%) is the finding of a neoplasm limited to the ovaries or pelvis, most often discovered occasionally during routine gynecological checks – write Sabrina Chiara Cecere and Sandro Pignata, of the Complex Operational Unit of experimental uro-gynecological clinical oncology of the National Cancer Institute Irccs “G. Foundation” Pascale” Napoli in the Aiom-Airtum report – The high mortality associated with this tumor (the five-year survival rate from diagnosis is 43%, ed.) is attributable to many factors including: a non-specific and late symptomatology and the absence of validated screening strategies that allow for early diagnosis, except for women with alterations of the BReast CAncer genes 1 and 2 (BRCA1 and BRCA2)”. The trend of oncological deaths due to ovarian cancer is slightly decreasing compared to the 2003-2006 values (-3.6%) and today there are approximately 49,800 women alive after a diagnosis.
