Angelis R, Zarcone M, Fabiano S, Perotti V, Pesce MT, Serraino D, Stracci F, Mazzucco W, Maso LD, Gatta G, Fusco M; AIRTUM Working Group.
Cancer Epidemiol. 2026 Oct;104:103142. doi: 10.1016/j.canep.2026.103142. Epub 2026 Jul 23.
Abstract
In the last five decades, the epidemiology of cancer in Italy has been characterised by a north-south gradient in cancer incidence, mortality, and survival. Recently, this pattern has been changing, making it important to analyse the three indicators together to understand the underlying dynamics and to identify successes and failures in cancer control. Herein, data from 20 accredited Italian population-based cancer registries were used to examine age-standardised trends in incidence, five-year net survival, and mortality rates, for all cancers and 18 major cancer types, between 2008 and 2017. Data from the national pool were compared with macro-areas ones from north-centre and south-islands. We classified trends according to a 5-category model, ranging from ‘Optimal Progress’ (decreasing incidence and mortality, increasing survival) to ‘Worsening’ (increase of both incidence and mortality). At the national level we found progress in all indicators for all cancers combined: incidence and mortality rates declined, on average, by 2.5% and 5.5% annually, while survival increased by 2.5 % points. Similar optimal progress was shown, in men, by all cancers and lung cancer and, in both sexes, by liver cancer, and non-Hodgkin lymphoma. Conversely, evidence of worsening emerged for lung cancer in women, with incidence and mortality rates increasing, on average, by 6.5% and 4% annually. Contrasting trends emerged from north to south for colorectal, pancreatic, and kidney cancers. Trends were homogeneous, but improvements were stronger in the north-centre for all cancers, all cancers in men, male lung, prostate and bladder cancers, non-Hodgkin lymphoma, and for breast cancer mortality. For female lung cancer and breast cancer incidence, we documented a stronger burden increase in the south-islands. The advantage in cancer incidence and mortality risk shown decades ago by the south-islands macro area is being lost, and, if these trends remain stable, in near future the north-south gradient is expected to be reversed for many cancers.