Abstract: The present study evaluates the application of an automatic system for variables coding by means of strings reading in the text of the pathology reports, in the database of the Tuscany Cancer Registry. Incidence data for the years 2000 (n. 6297) and 2001 (n. 6291) for subjects for whom computerised pathology reports were available were included. The system is based on Queries (SQL language) linked to Functions (Visual Basic for Applications) that work on Windows Access. The agreement between original data inputted by the registrars and variables coded by means of automatic reading has been evaluated by means of Cohen's kappa. The following variables were analysed: cancer site (kappa = 0.87 between "manual" and automatic coding, for cases incident in the year 2001), morphology (kappa=0.75), Berg's morphology groups (kappa=0.87), behaviour (kappa=0.70), grading (kappa=0.90), Gleason (kappa=0.90), focality (kappa=0.86), lateralily (kappa=0.36), pT (kappa=0.92), pN (kappa=0.76), pM (kappa=0.28), number of lymph nodes (kappa=0.69), number of positive lymph nodes (kappa=0.70), Breslow thickness (kappa=0.94), Clark level (kappa=0.91), Dukes (kappa=0.74). The system of automatic reading of strings allows to collect a very huge amount of reliable information and its use should be implemented by the Registries.

Abstract: The Italian Network of Cancer Registries analyzed incidence and mortality cancer trends during the period 1986-1997 Overall, 525,645 incident cancers and 269,902 cancer deaths (in subjects 15 years and older) were included. Age-adjusted rates, joinpoints (points in time where trend significantly changes from linearity) and estimated annual percent changes in rates (EAPC) were computed. Overall cancer incidence was significantly increasing in both sexes and cancer mortality was significantly decreasing (since 1991 among males). Incidence and mortality trends are summarised for single cancer sites. Crude rates are also showed to evaluate the effect of population ageing in terms of diagnostic and therapeutic burden for the National Health System.

Abstract: The objective of this study was to analyse incidence and mortality cancer trends in the Italian Network of Cancer Registries (about 8,000,000 inhabitants) during the period 1986-1997. Included were 525,645 newly diagnosed cancers and 269,902 cancer deaths (subjects > 14 years). Joinpoints (points in time where trend significantly changes from linearity) were found and estimated annual percentage changes (EAPC) used to summarize tendencies. Overall cancer incidence increased in both sexes and cancer mortality significantly decreased (since 1991 among men). Lung cancer showed significantly decreasing incidence (EAPC = -1.4%) and mortality (EAPC = -1.6%) among men and increasing trends among women. In women, breast cancer incidence significantly increased (EAPC= +1.7%) and mortality decreased since 1989 (EAPC= -2.0%). Stomach cancer incidence and mortality decreased in both sexes. Prostate incidence sharply increased since 1991 and mortality decreased. Colon cancer incidence increased and rectum mortality decreased significantly in both sexes. Significant increases in incidence were also found for kidney (up to 1991 among men), urinary bladder, skin epithelioma, melanoma, liver (up to 1993 among men), pancreas, mesothelioma, Kaposi's sarcoma (up to 1995 among men), testis, thyroid, non-Hodgkin's lymphomas and multiple myeloma. Mortality significantly decreased for cancers of the oral cavity and pharynx, oesophagus, liver (women), larynx (men), bone, cervix (since 1990), central nervous system, urinary bladder, thyroid, Hodgkin's lymphomas and leukaemias (men). Non-Hodgkin's lymphoma mortality increased in both sexes. In conclusion, most of the changes seen can be explained as the effect of changes in smoking habits and of the extension of secondary prevention activities. The Italian health care system will also have to cope with growing cancer diagnostic and therapeutic needs due to population ageing.

Abstract: The trend analysis of the data base of the Italian Network of Cancer Registries has had a descriptive approach. The period of study has been from 1986 to 1997. Within this period we have included only nine Registries that were active for at least ten years (pool AIRT). For three Registries few lacking incidence years have been estimated according to their observed data. For the pool of Registries standardised (standard = European population) incidence and mortality rates have been computed with the direct method. The so called joinpoint analysis has been used to detect temporal points of trend change. Trends have been summarised by means of estimated annual percent change (EAPC) of the rate. Age-specific and birth cohort-specific rates have been also computed.