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1. Cancer data quality and harmonization in Europe: the experience of the BENCHISTA Project – international benchmarking of childhood cancer survival by stage

Author

Angela Lopez-Cortes, Fabio Didonè, Laura Botta, Lisa L. Hjalgrim, Zsuzsanna Jakab, Adela Cañete Nieto, Charles Stiller, Bernward Zeller, Gemma Gatta, Kathy Pritchard-Jones, The BENCHISTA Project Working Group, Joanne Aitken, Leisa O’Neil, Monika Hack, Ruth Ladenstein, Elizabeth Van Eycken, Nancy Van Damme, Lindsay Frazier, Beatriz De Camargo, Marceli de Oliveira Santos, Zdravka Valerianova, Dobrin Konstantinov, Sumit Gupta, Jason D Pole, Mario Sekerija, Jan Stary, Jaroslav Sterba, Jeanette F Winther, Keiu Paapsi, Brigitte Lacour, Emmanuel Desandes, Jacqueline Clavel, Claire Poulalhon, Friederike Erdmann, Eleni T Petridou, Evdoxia Bouka, Michael Mian, Rocco Galasso, Giuseppe Sampietro, Francesco Vetrano, Milena M Maule, Carlotta Sacerdote, Paola Ballotari, Emilia De Santis, Margherita Ferrante, Rosalia Ragusa, Luca Boni, Magda Rognoni, Rosalba Amodio, Lorenza Boschetti, Francesco Cuccaro, Danila Bruno, Antonio G Russo, Federico Gervasi, Maria L Gambino, Elisabetta Borciani, Maria Michiara, Lucia Mangone, Gianbattista Spagnoli, Stefano Ferretti, Fabio Falcini, Eugenia Spata, Sonia Manasse, Paola Coccia, Francesca Bella, Adele Caldarella, Teresa Intrieri, Tiziana Scuderi, Roberto V Rizzello, Massimo Rugge, Stefano Guzzinati, Deirdre Murray, Tomohiro Matsuda, Kayo Nakata, Miriam J Azzopardi, Aina H Dahlen, Johannesen Tom Børge, Jerzy Kowalczyk, Monika Jedrzejczyk, Gabriela Caldas, Mihaela Bucurenci, Dana Coza, Vesna Zadnik, Arantza Lopez de Munain, Fernando Almela-Vich, Nieves Fuster-Camarena, Ra f a e l Marcos-Gragera, Maria José Sanchez, Nuria Aragones, Raquel Lopez, Maria Dolores Chirlaque, Marcela Guevara, Elena Pardo, Rafael Peris-Bonet, Marià Carulla, Päivi Lähteenmäki, Claudia E Kuehni, Shelagh M Redmond, Henrike Karim-Kos, Paul Stacey, Lucy Irvine, Anna Gavin, Deirdre Fitzpatrick, David S Morrison, Karen Smith, Dyfed Wyn Huws, Janet Warlow, Sandra Strauss, Simon Bailey, Adela Canete Nieto, Nathalie Gaspar, Filippo Spreafico, Angela Polanco, Riccardo Capocaccia, Andrea Di Cataldo, and Meric Klein

Subjects
childhood cancer, population-based, cancer registry, Toronto staging, diagnosis, survival, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

IntroductionVariation in stage at diagnosis of childhood cancers (CC) may explain differences in survival rates observed across geographical regions. The BENCHISTA project aims to understand these differences and to encourage the application of the Toronto Staging Guidelines (TG) by Population-Based Cancer Registries (PBCRs) to the most common solid paediatric cancers.MethodsPBCRs within and outside Europe were invited to participate and identify all cases of Neuroblastoma, Wilms Tumour, Medulloblastoma, Ewing Sarcoma, Rhabdomyosarcoma and Osteosarcoma diagnosed in a consecutive three-year period (2014-2017) and apply TG at diagnosis. Other non-stage prognostic factors, treatment, progression/recurrence, and cause of death information were collected as optional variables. A minimum of three-year follow-up was required. To standardise TG application by PBCRs, on-line workshops led by six tumour-specific clinical experts were held. To understand the role of data availability and quality, a survey focused on data collection/sharing processes and a quality assurance exercise were generated. To support data harmonization and query resolution a dedicated email and a question-and-answers bank were created.Results67 PBCRs from 28 countries participated and provided a maximally de-personalized, patient-level dataset. For 26 PBCRs, data format and ethical approval obtained by the two sponsoring institutions (UCL and INT) was sufficient for data sharing. 41 participating PBCRs required a Data Transfer Agreement (DTA) to comply with data protection regulations. Due to heterogeneity found in legal aspects, 18 months were spent on finalizing the DTA. The data collection survey was answered by 68 respondents from 63 PBCRs; 44% of them confirmed the ability to re-consult a clinician in cases where stage ascertainment was difficult/uncertain. Of the total participating PBCRs, 75% completed the staging quality assurance exercise, with a median correct answer proportion of 92% [range: 70% (rhabdomyosarcoma) to 100% (Wilms tumour)].ConclusionDifferences in interpretation and processes required to harmonize general data protection regulations across countries were encountered causing delays in data transfer. Despite challenges, the BENCHISTA Project has established a large collaboration between PBCRs and clinicians to collect detailed and standardised TG at a population-level enhancing the understanding of the reasons for variation in overall survival rates for CC, stimulate research and improve national/regional child health plans.

Published
2023
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2. The impact of overdiagnosis on thyroid cancer epidemic in Italy,1998-2012

Author

Giuseppe Sampietro, Alessio Gili, Anselmo Madeddu, Cinzia Gasparotti, Chiara Panato, Ivan Cometti, Salvatore Vaccarella, Silvano Piffer, Martina Taborelli, Luigino Dal Maso, Fabio Falcini, Maria Michiara, Diego Serraino, Eugenia Spata, Walter Mazzucco, Stefano Ferretti, Alessandra Ravaioli, Antonietta Torrisi, Rosanna Cusimano, D Pirino, Mario Fusco, Giulio Barigelletti, Santo Scalzi, Luca Cavalieri D'Oro, Susanna Busco, Michele Magoni, Massimo Varvarà, Paolo Ricci, GianMaria Pennelli, S Patriarca, Luciana Gatti, Massimo Vicentini, Claudia Cirilli, Giorgia Stoppa, Anna Luisa Caiazzo, Andreas Bulatko, M Usala, Manuel Zorzi, Antonio Russo, Stefano Rosso, Giuseppina Candela, Lucia Mangone, Roberto Rizzello, Silvia Leite, Rosario Tumino, Rosaria Cesaraccio, A.C. Fanetti, Giovanna Tagliabue, Adele Caldarella, Guido Mazzoleni, A. Puppo, Pier Carlo Vercellino, Carlotta Buzzoni, F Tisano, Francesco Cuccaro, Linda Guarda, Maria Francesca Vitale, Gianfranco Manneschi, Fabio Pannozzo, Roberto Zanetti, Francesca Gasparini, Anna Melcarne, Giovanna Maria Sini, Paolo Sgargi, Ugo Fedeli, Rosa Filiberti, Paolo Collarile, Arturo Iannelli, Simona Carone, Katia Valla, Elisabetta Borciani, G Gola, Silvia Franceschi, and Luigino Dal Maso, Chiara Panato, Silvia Franceschi, Diego Serraino, Carlotta Buzzoni, Susanna Busco, Stefano Ferretti, Antonietta Torrisi, Fabio Falcini, Manuel Zorzi, Claudia Cirilli, Walter Mazzucco, Michele Magoni, Paolo Collarile, Fabio Pannozzo, Anna Luisa Caiazzo, Antonio Giampiero Russo, Alessio Gili, Adele Caldarella, Roberto Zanetti, Maria Michiara, Lucia Mangone, Rosa Angela Filiberti, Mario Fusco, Francesca Gasparini, Giovanna Tagliabue, Rosaria Cesaraccio, Rosario Tumino, Luciana Gatti, Francesco Tisano, Silvano Piffer, Giovanna Maria Sini, Guido Mazzoleni, Stefano Rosso, Anna Clara Fanetti, Salvatore Vaccarella

Subjects
Male, Cancer Research, Medical Overuse, Settore MED/42 - Igiene Generale E Applicata, 0302 clinical medicine, Registries, Young adult, Overdiagnosis, Child, Thyroid cancer, Aged, 80 and over, education.field_of_study, Incidence (epidemiology), Incidence, Thyroid, Time trends, Middle Aged, medicine.anatomical_structure, Oncology, Italy, 030220 oncology & carcinogenesis, Child, Preschool, Female, medicine.symptom, Adult, Mortality, Adolescent, Population, Socio-culturale, 030209 endocrinology & metabolism, Asymptomatic, 03 medical and health sciences, Young Adult, medicine, Humans, Thyroid Neoplasms, education, Epidemics, Aged, business.industry, Infant, Newborn, Cancer, Infant, medicine.disease, Overdiagnosi, business, Demography
Abstract

Aims: In Italy, incidence rates of thyroid cancer (TC) are among the highest world- wide with substantial intracountry heterogeneity. The aim of the study was to examine time trends of TC incidence in Italy and to estimate the proportion of TC cases potentially attribut- able to overdiagnosis. Methods: Data on TC cases reported to Italian cancer registries during 1998e2012 aged

Published
2018

3. Screening for colorectal cancer in Italy: 2011-2012 survey

Author

Manuel, Zorzi, Lucia, Mangone, Emanuela, Anghinoni, Susanna, Baracco, Elisabetta, Borciani, Adele, Caldarella, Fabio, Falcini, Anna Clara, Fanetti, Stefano, Ferretti, Paolo, Giorgi Rossi, Maria, Michiara, Giorgia, Randi, Fabrizio, Stracci, Massimo, Vicentini, Antonella, Zucchetto, Marco, Zappa, and C, Fedato

Subjects
Male, Incidence, Colonoscopy, Middle Aged, Italy, Occult Blood, Surveys and Questionnaires, Humans, Mass Screening, Female, Colorectal Neoplasms, Early Detection of Cancer, Aged, Neoplasm Staging
Abstract

The impact of organized screening programmes on colorectal cancer (CRC) can be observed at a population level only several years after the implementation of screening. We compared CRC characteristics by diagnostic modality (screen-detected, non-screen-detected) as an early outcome to monitor screening programme effectiveness. Data on CRCs diagnosed in Italy from 2000 to 2008 were collected by several cancer registries. Linkage with screening datasets made it possible to divide the cases by geographic area, implementation of screening, and modality of diagnosis (screen-detected, non-screen-detected).We compared the main characteristics of the different subgroups of CRCs through multivariate logistic regression models. The study included 23,668 CRCs diagnosed in subjects aged 50-69 years, of which 11.9% were screen-detected (N=2,806), all from the North-Centre of Italy. Among screen-detected CRCs, we observed a higher proportion of males, of cases in the distal colon, and a higher mean age of the patients. Compared with pre-screening cases, screen-detected CRCs showed a better distribution by stage at diagnosis (OR for stage III or IV: 0.40, 95%CI: 0.36-0.44) and grading (OR for poorly differentiated CRCs was 0.86, 95%CI: 0.75-1.00). Screen-detected CRCs have more favourable prognostic characteristics than non-screen-detected cases. A renewed effort to implement screening programmes throughout the entire country is recommended.

Published
2015

4. Colonoscopic surveillance of first-degree relatives of colorectal cancer patients in a faecal occult blood screening programme

Author

Laura Briganti, Fabio Falcini, Marella Zatelli, Silvia Mancini, Luisa Paterlini, Patrizia Landi, A C Finarelli, Americo Colamartini, Cinzia Campari, Romano Sassatelli, Federica Rossi, Paola Baldazzi, Rossella Olivetti, Orietta Giuliani, Stefano Zanarini, Mauro Palazzi, Fabio Fornari, Roberto Nannini, Marilena Manfredi, Rosa Vattiato, M. Giovanardi, Carlo Naldoni, C. Palmonari, Maurizio Ponz de Leon, Rossella Corradini, Corrado Zurlini, V.G. Matarese, Sonia Gordini, Lauro Bucchi, Giorgio Gatti, Mirna Severi, Coralba Casale, Elisabetta Borciani, Omero Triossi, and Priscilla Sassoli de Bianchi

Subjects
Adenoma, Adult, Male, Cancer Research, medicine.medical_specialty, Epidemiology, Colorectal cancer, Population, Colonoscopy, Kaplan-Meier Estimate, Gastroenterology, Internal medicine, Aged, Colorectal Neoplasms, Family Health, Feasibility Studies, Female, Humans, Italy, Likelihood Functions, Mass Screening, Middle Aged, Occult Blood, Prevalence, medicine, Family history, First-degree relatives, education, Mass screening, education.field_of_study, medicine.diagnostic_test, business.industry, medicine.disease, digestive system diseases, Confidence interval, Oncology, business
Abstract

Background: In some Italian areas, colonoscopic surveillance of first-degree relatives (FDRs) of colorectal cancer (CRC) patients is provided as a part of local population-based faecal occult blood test (FOBT) screening programmes. The objective of the present study was to assess the feasibility and early results of this surveillance model. Methods: Data from district screening centres were used to evaluate the process of identification and selection of eligible FDRs (residence in the Emilia-Romagna Region, age 40–75 years, no recent colonoscopy) of screen-detected CRC patients and the detected prevalence of disease. The probability for an FDR to undergo colonoscopy and to be diagnosed with CRC and advanced adenoma was estimated using the Kaplan–Meier method. The sex- and age-standardised ratio of detected prevalence to that expected based on results from a colonoscopy screening study of the Italian general population was estimated. Results: Between 2005 and 2011, 9319 FDRs of 2437 screen-detected CRC patients (3.8 per patient) were identified and contacted. Their likelihood of being eligible for, and accepting, colonoscopy was 0.11 (95% confidence interval: 0.11–0.12). Among the 926 subjects undergoing colonoscopy, the prevalence of previous negative screening FOBT was 63%. Eleven CRCs (1.2%) and 100 advanced adenomas (10.8%) were detected. The standardised ratio of detected prevalence to that expected was 0.91 (95% confidence interval: 0.19–2.66) for CRC and 1.48 (1.04–2.05) for advanced adenoma. Conclusions: The procedure of selection of FDRs was extremely ineffective. Due to previous negative screening tests, the prevalence of disease was less than expected. A population-based FOBT screening programme is a highly unsuitable setting for the provision of surveillance to FDRs of CRC patients.

Published
2013

5. Cardiopulmonary Bypass: ‘A Low T4 and T3 Syndrome’ with Blunted Thyrotropin (TSH) Response to Thyrotropin-Releasing Hormone (TRH)

Author

Giuseppe Robuschi, Dante Medici, Francesco Fesani, Guglielmo Barboso, Mara Montermini, Lorenzo d’Amato, Eliana Gardini, Elisabetta Borciani, Elisabetta DallundefinedAglio, Mario Salvi, Angelo Gnudi, and Elio Roti

Subjects
endocrine system, medicine.medical_specialty, Triiodothyronine, endocrine system diseases, business.industry, Endocrinology, Diabetes and Metabolism, Thyrotropin-releasing hormone, Low T3 Syndrome, Hypothermia, Prolactin, law.invention, Endocrinology, TRH stimulation test, law, Internal medicine, medicine, Cardiopulmonary bypass, medicine.symptom, business, hormones, hormone substitutes, and hormone antagonists, Hormone
Abstract

Thyroid hormone serum concentrations, the thyrotropin (TSH) and prolactin (PRL) response to thyrotropin-releasing hormone (TRH) were evaluated in patients undergoing cardiopulmonary bypass (CPB) conducted in hypothermia. During CPB a marked decrease of thyroxine (T4) and triiodothyronine (T3) concentration with a concomitant increase of reverse T3 (rT3) were observed similarly to other clinical states associated with the 'low T3 syndrome'. Furthermore, in the present study elevated FT4 and FT3 concentrations were observed. In a group of patients, TRH administered during CPB at 26 degrees C elicited a markedly blunted TSH response. In these patients, PRL concentration was elevated but did not significantly increase after TRH. The increased concentrations of FT4 and FT3 were probably due to the large doses of heparin administered to these patients. Thus, the blunted response of TSH to TRH might be the consequence of the elevation of FT4 and FT3 in serum, however, other factors might play a role since also the PRL response to TRH was blocked.

Published
1986

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