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Introduction The epidemiology of lung cancer is changing worldwide, with smoking being the key driver of lung cancer incidence and mortality. Our aim is to analyze the incidence, survival and mortality trends in Italy in the framework of the 2017 survey on smoking behavior in Italy.Methods AIRTUM 2017 reports on cancer survival and incidence; 2017 survey on smoking behavior in Italy.Results Men achieved progress in lung cancer control characterized by a decrease in incidence and mortality and an increase in survival. The decreasing use of tobacco in men (from 60% in the 1960s to 24% in 2017) was most likely responsible for the decreasing incidence and mortality. Women showed no progress: although survival improved slightly, the incidence and mortality were both on the rise. This was most likely due to the increasing smoking rates in women in the 1970s and 80s. Of major concern is the accelerated rise in the number of smoking women from 4.6 million in 2016 to 5.7 million in 2017 compared to the decrease observed in men (from 6.9 to 6 million).Conclusions The incidence and mortality trends in males clearly demonstrate that primary prevention is the most effective way to reduce lung cancer mortality. By contrast, a 24% increase in the prevalence of smoking among women in just 1 year is extremely worrying for the future, and calls for immediate action by targeted strategies to reduce tobacco consumption in women and avert the dreadful prospect of a lung cancer epidemic in Italy.

To evaluate, through the investigation of an administrative database, the cost of patients affected by diabetes. Our dataset allows to map the progress of the disease so as to evaluate the impact on costs of co-pathologies.The Local Health Authority (ASL) of Brescia, which covers a population of about 1 million, has linked several databases (administrative, demographic) so that for each resident a profile of cost, detailed for hospitalisation, drugs, specialists visits etc, has been obtained. Such link allows to determine whether patients are affected by one or more of 13 chronic diseases.We estimated the total cost of the diseases, the costs per patient and the costs of each item (hospitalisation, drugs etc) for 2003. Diabetes accounts for about 12% of the total costs; its cost depends on the number of co-pathologies and can vary from € 892 (only diabetes) to € 5,330 for the most severe cases. The mean age of the diabetic patient is about the same for men and women (62 years), but men develop co-pathologies earlier (about 5 years before). This is especially true for cardiovascular co-morbidities, that represent about 20% of the total expenditure for diabetes.Administrative and demographic databases can be a very important source for the analysis at local level, whose utility goes far beyond simple expenditure control.

In this retrospective historical study, we compared the incidences of malignancies observed among 854 renal transplant recipients (RT) with at least 1 yr of follow‐up, with the incidences of neoplasias among patients under regular dialytic treatment (RDT) and a control population from Northern Italy. Cox's proportional hazard model was used in RT recipients in order to evaluate the prognostic factors related to the development of neoplasia. Seventy six out of 854 RT patients (8.9%) developed some malignant neoplasia: 46% of these 76 were cutaneous neoplasias including melanomas, and the remaining 54% non cutaneous cancers: 33% miscellaneous tumors (MT), mostly adenocarcinomas, 17% Kaposi's sarcomas (KS), 4% non‐Hodgkin's lymphomas (NHL). Malignancies had a higher incidence (p<0.01) among RT recipients than among control and RDT patients. However, MT were equally frequent among the three groups. RDT patients on the contrary, had similar incidence of neoplasias when compared to the control population, but showed at lower incidence of squamous cell carcinomas (SCC). The risk ratios (RR) for the most frequent neoplasias among RT recipients vs. control population were: 224.7 for KS, 7.4 for NHL, 6.2 for SCC, 5.7 for basal cell carcinomas (BCC), 4.0 for MT. The risk of developing a de novoneoplasia was of about 13% at 10 yr and of 34% at 20 yr. In RT recipients, Cox's proportional analysis showed that age >40 at transplantation and male sex were the only risk factors associated with an increased incidence of neoplasias, while no difference was observed between conventional (azathioprine+methylprednisolone: Aza+MP) and CSA therapy or in CSA monotherapy vs. double or triple therapy. However, KS occurrence correlated both with CSA dose (RR 15.2 for monotherapy; 12.5 for double therapy; 2.98 for triple therapy) and with 10 or more i.v. methylprednisolone pulses for treatment of rejection (RR 5.2). We conclude that in our series CSA does not increase the risk for development of neoplasias, when compared to conventional immunosuppression.