Crocetti E, Ravaioli A, Serraino D, Guzzinati S, Bucchi L, Ferretti S, Toffolutti F, Zamagni F, Dal Maso L, Italian Cancer Registries WG  

46th Annual Meeting of the Group for Cancer Epidemiology and Registration in Latin Language Countries (GRELL).

Pamplona, 18-20 may 2022

Abstract 

Objectives. A disadvantage in cancer survival in patients living in southern Italy was observed in the last decades. The aim of this study was to update internal comparisons of cancer survival in Italy.
Methods. Data from seventeen population-based cancer registries, representing 31% of the Italian resident population were included. 479144 cases diagnosed in subjects 15+ years old between 2010 and 2014 with active follow-up up to the end of 2018 were analysed. Observed, net age-standardized survival at 1, 5 years and at 5 years since diagnosis conditioned to having survived the first year were computed.
Results. Overall, for men 5-year net survival was 58.7% (IC 57.9-59.5) in the North-Centre and 55.1% (52.1-57.8) in the South and for women 70.1% (69.3-70.9) and 66.2 (63.2-68.9), respectively. The disadvantage for the South was substantially present for all the cancer sites regardless of gender, age and prognosis. For example, among men for prostate (91.4% vs 87.3%), or non-Hodgkin lymphoma (67.6% vs 60.2%) or among women for breast (88.0% vs 84.7%) or leukaemia (47.7% vs 39.9%). Most of the differences were present also in observed survival, as well as in the other computed survival estimates.
Conclusion. The study confirmed a cancer survival gap in Italy with a worse prognosis for citizens residing in the South. The difference does not seem lessened from the past. Many factors related to cancer diagnosis and treatment may contribute to survival, and therefore their geographical unfair distribution explain the evidenced difference. However, in Italy there is a public universalistic health system. Results of the present study suggested that there is no equal access in the country to preventive-diagnostic-therapeutic oncological pathways of equivalent quality. Among the possible determinants it should be considered that socio-economic inequality is more common in the South than in the other Italian areas.