Trends in cancer mortality in Italy, 1955-1978

Trends in age-specific and age-standardized cancer death certification rates in Italy from 1955 to 1978 were analyzed. In males total cancer mortality rates increased in all age groups. However, when respiratory and other tobacco-related neoplasms were excluded, death certification rates were roughly stable up to age 64. Moderate decreases in overall cancer mortality have been apparent at younger ages (35-44) since the early 1970's. In females, all the age-specific and the age standardized, under-65 death certification rates decreased; the downward trends were more pronounced (-18.5%) in the younger age group considered (35-44 years). Respiratory cancer mortality increased sharply in males: lung cancer death rates reached a plateau in the early 1970's in the 35-44-year age group, but increased at all subsequent ages. In females, the increase in lung cancer mortality was about 50% in the 45-54 and 55-64-year age groups, but no upward trend was evident in younger women. Other tobacco-related cancers (mouth or pharynx, larynx, esophagus, pancreas, kidney and bladder) also rose considerably. In both sexes, gastric cancer mortality dropped about 50% below age 65, but mortality rates from cancer of the stomach were still considerably higher than in other Western countries. Likewise, mortality from cancer of the (cervix) uteri decreased markedly, mostly in younger age groups. Upward trends in death certification rates were evident for cancers of the bowel (colon and rectum, about 50% in males, and 35% in females below age 65), and of the breast in females. However, these trends have levelled off since the late 1960's, at least in the younger age groups. Certified death rates from cancer of the skin (melanoma) increased over all the periods considered in the young of both sexes. Cancer mortality rates showed marked increases in older (greater than or equal to 65) males, but this can be partially explained in terms of better case ascertainment and more accurate death certification.