Cancer mortality in Italy, 1979

The values registered in 1979 for total cancer age-standardized mortality rates appear somehow less reassuring than those of previous years. In fact, a moderate increase was observed not only for males (275.82 vs 271.71/100,000 in 1978 for the truncated 35-64 death certification rate), but also for females (161.82 vs 160.02/100,000 women aged 35-64), after six years of steady declines in total cancer mortality rates for young and middle-aged women. This rather unfavorable pattern of trends appears largely attributable to a reduction in the downward trends for the neoplasms which had been steadily declining over the last two or three decades. In particular, death certification rates from cancer of the (cervix) uteri remained totally stable in young and middle-aged women (17.30/100,000 females aged 35-64) after over 15 years of continuous decline, and mortality from gastric cancer in females aged 35-64 indeed showed a slight increase. Likewise, moderate increases were registered in mortality from leukemias at younger ages in both sexes. However, in part potentially attributable to minor changes in classification, these trends nonetheless indicate that major changes in prognosis from leukemias are unlikely to have occurred at the end of the 1970's. Among << highly curable>> neoplasms, the only one showing consistent declines in 1979 was Hodgkin's disease. In contrast, steady increases have continued in 1979 in mortality from lung and other tobacco-related neoplasms (mouth or pharynx, larynx, esophagus, pancreas, kidney and bladder) for middle-aged and older males and, to a lesser extent, for females. Furthermore, there is no indication of decreasing mortality from lung cancer, even in younger (35 to 44) males, which is in sharp contrast with recent trends from Britain, Scandinavia and North America. Upward trends were also observed for cancers of the liver, intestines and pleura (however, hardly interpretable owing to the Revision of the ICD) and for skin cancer (melanoma) at younger ages in females, whereas 1979 mortality rates were practically stable for neoplasms of the breast, ovary and prostate, at least below age 65, when death certification is more accurate.