Cancer mortality in broad Italian geographical areas, 1975-1977

Death certification rates from various cancers or groups of cancers in broad Italian geographical areas (North/Center/South) over the period 1975-1977 were analyzed. In both sexes, there was a clear North/South gradient, with considerably higher rates in the North for total cancer mortality as well as for most common neoplasms. The geographical variation was more marked in males (North/South ratio for total cancer mortality = 1.75 at all ages and 1.70 truncated 35-64 years) than in females (ratio = 1.48 at all ages and 1.28 truncated 35-64). Although, in general terms, the present results confirm previous analyses of cancer mortality in Italy, a few interesting tendencies should be noted. First, the geographical differences in the mid-late 1970's were much more marked for tobacco-related cancers (a factor of over two in males in the North/South ratio) than for other chiefly epithelial carcinomas or nonepithelial cancers. In general, variations for nontobacco-related cancers tended to level off over more recent calendar periods. However, there was little tendency towards decreasing differences in gastric cancer mortality (which was markedly elevated in the North and Center), at least in males. During the 1970's death certification rates from cancer of the (cervix) uteri decreased in northern and central more than in southern Italy. This pattern of trends may have been influenced by a different impact of cervical screening in various areas of the country.