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Roviello F, Marano L, Ambrosio MR, Resca L, D'Ignazio A, Petrelli F, Petrioli R, Costantini M, Polom K, Macchiarelli R, Biviano I, Marrelli D. Signet ring cell percentage in poorly cohesive gastric cancer patients: A potential novel predictor of survival. Eur J Surg Oncol 2021; 48:561-569. [PMID: 34511269 DOI: 10.1016/j.ejso.2021.09.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 08/06/2021] [Accepted: 09/02/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Signet ring cells (SRC) are widely acknowledged as a prognostically unfavorable histotype amongst poorly cohesive gastric cancer. In this study we evaluated the impact of SRC percentage on the clinical, pathological and prognostic features of these tumors according to the classification by the European Chapter of the IGCA. METHODS We retrospectively reviewed records of patients with poorly cohesive gastric cancer that underwent surgery between 1995 and 2016, whose tissue specimens were available in a biological bank. All slides were put under revision, patients were reclassified into three groups according to the proportion of signet ring cells: "pure" SRC (containing ≥90% of SRCs), Poorly Cohesive-Not Otherwise Specified (PC-NOS) (containing ≤10% of SRCs), and PC-NOS/SRC (containing <90% but >10% of SRCs). The clinicopathological factors between different types were analyzed and prognostic differences were compared. RESULTS Among 143 enrolled patients, 51% were male and 49% were female. The mean (±SD) age at diagnosis was 61 ± 13.9 years. Eighty-seven patients (60.8%) were reclassified as PC-NOS, 56 (39.2%) as PC-NOS/SRC and none as "pure" SRC. Five-years overall survival was significantly higher in PC-NOS/SRC group (63.3%) compared with PC-NOS group (12.7%). The increase in mortality risk was more than four-fold in patients with PC-NOS pattern compared to those with PC-NOS/SRC (HR 4.32 [95% CI 2.5-7.4]. After adjustment for potential confounding factors, SRC pattern was still an independent predictor of survival. CONCLUSIONS The percentage of SRCs is inversely related to tumor aggressiveness, confirming the role of SRC pattern as an independent predictor of survival.
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Affiliation(s)
- Franco Roviello
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Siena, Italy
| | - Luigi Marano
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Siena, Italy.
| | - Maria Raffaella Ambrosio
- Pathology Unit, University of Siena, Siena, Italy; Pathology Unit, Azienda USL Toscana Nord-Ovest, Pisa, Italy
| | - Luca Resca
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Siena, Italy
| | - Alessia D'Ignazio
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Siena, Italy
| | - Federica Petrelli
- Pathology Unit, University of Siena, Siena, Italy; Pathology Unit, Azienda USL Toscana Nord-Ovest, Pisa, Italy
| | - Roberto Petrioli
- Department of Medicine, Surgery and Neurosciences, Unit of Medical Oncology, University of Siena, Siena, Italy
| | | | - Karol Polom
- Department of Surgical Oncology, Medical University of Gdansk, Gdansk, Poland
| | | | - Ivano Biviano
- Gastroenterology and Operative Endoscopy Unit, AOU Senese, Siena, Italy
| | - Daniele Marrelli
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Siena, Italy
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Berton G, Cordiano R, Cavuto F, Bagato F, Segafredo B, Pasquinucci M. Neoplastic disease after acute coronary syndrome: incidence, duration, and features: the ABC-4* Study on Heart Disease. J Cardiovasc Med (Hagerstown) 2019; 19:546-553. [PMID: 30119096 DOI: 10.2459/jcm.0000000000000701] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
AIM To investigate the clinical features and incidence of malignant neoplasia during 17 years of follow-up in an unselected sample of patients with acute coronary syndrome (ACS). METHODS The Adria, Bassano, Conegliano, and Padova Hospital-4 Study on Heart Disease is an ongoing, prospective study of an unbiased population of patients with ACS. Baseline clinical and laboratory data were obtained during the first 7 days of hospitalization at three different intensive coronary care units. The current study included data from 589 patients with ACS. RESULTS At enrollment, 19 patients had confirmed neoplasia. During follow-up, 99 additional patients developed malignant neoplastic disease. The incidence rate was 17.8 cases per 1000 person-years, which was about three times higher than that observed in the general population. Patients had a shorter duration of neoplasia when they developed it after enrollment compared with those with preexisting neoplasia [hazard ratio = 2.0 (1.5-2.6), P = 0.001]. Patients with neoplasia who died during follow-up had an earlier onset of neoplasia [hazard ratio = 1.8 (1.1-2.9), P = 0.01] and shorter duration than survivors [hazard ratio = 4.1 (2.4-7.0), P < 0.0001]. The estimated time to diagnosis of neoplasia indicated elderly patients had a significantly higher risk than younger people during the 17 years of follow-up. After the onset of neoplasia, survival time declined more sharply in the elderly than younger people. CONCLUSION The long-term prospective study showed that patients with ACS have a higher incidence of malignancy than the general population. Those who develop neoplasm after being diagnosed with ACS have a worse prognosis than patients with a preexisting neoplasia.
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Affiliation(s)
- Giuseppe Berton
- Department of Cardiology, Conegliano General Hospital, Conegliano
| | - Rocco Cordiano
- Department of Internal Medicine and Cardiology, Adria General Hospital, Adria
| | - Fiorella Cavuto
- Department of Cardiology, Bassano del Grappa General Hospital, Bassano del Grappa, Italy
| | - Francesco Bagato
- Department of Internal Medicine and Cardiology, Adria General Hospital, Adria
| | - Beatrice Segafredo
- Department of Cardiology, Bassano del Grappa General Hospital, Bassano del Grappa, Italy
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Baili P, De Angelis R, Casella I, Grande E, Inghelmann R, Francisci S, Verdecchia A, Capocaccia R, Meneghini E, Micheli A. Italian Cancer Burden by Broad Geographical Area. TUMORI JOURNAL 2018; 93:398-407. [PMID: 17899872 DOI: 10.1177/030089160709300412] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims and background Cancer burden estimates in Italian regions are available for the period 1970-2010 as a result of the project “I TUMORI IN ITALIA” connected with EUROCHIP, the European project on cancer control. The Italian health-care system is organized at a regional level, so regional estimates of cancer indicators are useful to identify priorities for cancer plans. We compared cancer site-specific epidemiological estimates by 3 macro-areas (obtained by grouping regions) to suggest priorities for Italian cancer control plans, both at national and regional levels. Methods Mortality and incidence estimates for all cancers combined and for stomach, colorectal, lung, breast and prostate cancers were downloaded from the website www.tumori.net and aggregated in broad age classes (0-54, 55-74 and 75-84 years) and macro-areas (northern, central and southern Italy). Results Historically, Southern Italy had a lower cancer risk than the Center and North. After 2000 this epidemiological picture disappeared and the incidence and mortality rates in the Center are reaching those of the North. Also the weight of various cancer sites on all cancers has changed in Italy in the last decades. Lung cancer is still the most frequent cancer in the male population in the South, while in the Center-North it has been surpassed by prostate cancer and colorectal cancer. The lung cancer weight on all cancer deaths is increasing in women. Prostate cancer has become the most frequent male cancer in the Center-North in the age class 55-84. Breast cancer is the most frequent cancer in the female population and its incidence rates in the North are higher than those in the Center-South for all age classes. Colorectal cancer incidence rates have dramatically increased in men and colorectal cancer is nowadays the second cancer diagnosed in women in all age classes and macro-areas. Discussion From the epidemiological data here presented we derived the following suggestions and observations for cancer control plans: a) tobacco prevention should focus on the male population in the South, and on female populations in the country as a whole; b) prevention concerning diet and physical activity (risk factors for colorectal cancer) should be considered mainly for men at a national level; c) the coverage of breast cancer screening programs should be increased in the Center-South; d) colorectal cancer screening should be promoted at a national level; e) PSA testing (that is not actually included among the screening programs recommended) for prostate cancer is probably more widespread in the Center-North, resulting in an increased incidence without any evident decline in mortality as yet.
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Affiliation(s)
- Paolo Baili
- Unità di Epidemiologia Descrittiva e Programmazione Sanitaria, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
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4
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Verdecchia A, De Angelis R, Francisci S, Grande E. Methodology for Estimation of Cancer Incidence, Survival and Prevalence in Italian Regions. TUMORI JOURNAL 2018; 93:337-44. [PMID: 17899863 DOI: 10.1177/030089160709300403] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background The Italian health care system is based on a regional responsibility and organization. Incidence, survival and prevalence of cancer patients were estimated for major cancer sites by single regions in Italy within a collaborative project “I TUMORI IN ITALIA” aimed at providing epidemiological information in a web site, www.tumori.net , for health operators, health programmers, epidemiologists and the general public. The aim of this paper is to present the methodology used to derive regional estimates of cancer burden indicators in Italy for major cancer sites. Methods Estimates require a complex methodology to be used. We present herein the methodology to provide regional estimates that involves a combined use of multiple methods to model and extrapolate patient survival to derive incidence and prevalence estimates and future projections. Results Regional patient survival estimates in Italy are presented and discussed. Cancer survival has greatly improved over the years and differences between northern-central and southern regions have persisted. The fraction of patients cured from cancer is today over 50% for young men and women aged 15-44 and declines to 15%-25% at older ages (75-99). Discussion We integrated different methods to derive estimates of cancer burden in Italy, at a regional level, in order to take advantage of all information available and to obtain the most reliable estimates. The value of producing regional estimates of cancer burden indicators was motivated by the lack of such information systematically on the Italian national territory.
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Affiliation(s)
- Arduino Verdecchia
- Reparto di Epidemiologia dei Tumori, Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, Rome, Italy.
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Capocaccia R, Buzzoni C, Grande E, Inghelmann R, Bellù F, Cassetti T, de Dottori M, Donato A, De Lisi V, Falcini F, Federico M, Ferretti S, Fusco M, Giacomin A, Guzzinati S, Mangone L, Piffer S, Rosso S, Sechi O, Tagliabue G, Tumino R, Vercelli M, Vitarelli S. Estimated and Observed Cancer Incidence in Italy: A Validation Study. TUMORI JOURNAL 2018; 93:387-91. [PMID: 17899870 DOI: 10.1177/030089160709300410] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims and background The study aimed to validate model-based incidence estimates by means of observed incidence rates provided by Italian cancer registries, for five major cancer sites (stomach, colon and rectum, lung, breast and prostate cancers) and for all cancers together. Methods Recent incidence rates observed by Italian population-based cancer registries were extracted from the data base of the Italian Association of Cancer Registries. Regional estimates of incidence rates for the same cancers were obtained by the MIAMOD method. Observed and estimated crude incidence rates and incidence trends were compared for the period of diagnosis 1985-2000. Eight Italian cancer registries and seven regions were selected for the analysis since they had incidence data available during the entire selected period. Results and conclusions An excellent agreement between estimated and observed crude incidence rates was found for all single cancer sites, regarding absolute incidence levels and time trends. A partial exception was breast, where empirical data showed a sudden increase in the last three years of observation, perhaps due to organized screenings in some Italian regions, and not captured by statistical models. Substantial underestimation of model-based incidence rates was found for all cancers combined, where the difference tended to increase with calendar year, up to a maximum of 20% in recent years. The greatest part of the discrepancy can be attributed to multiple cancers, which were included in cancer registries statistics but were not accounted for in MIAMOD estimates.
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Affiliation(s)
- Riccardo Capocaccia
- Reparto di Epidemiologia dei Tumori, Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, Rome, Italy.
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Micheli A, Berrino F, Paci E, Verdecchia A, Pierotti MA. Strategies for Cancer Control in Italy. TUMORI JOURNAL 2018. [DOI: 10.1177/030089160709300402] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Andrea Micheli
- Unità di Epidemiologia Descrittiva e
Programmazione Sanitaria, Fondazione IRCCS “Istituto Nazionale dei Tumori”,
Milan
| | - Franco Berrino
- Unità di Epidemiologia Eziologia e
Prevenzione, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan
| | - Eugenio Paci
- Unità di Epidemiologia clinica e
descrittiva, Centro per lo Studio e la Prevenzione Oncologica, CSPO, Florence
| | - Arduino Verdecchia
- Reparto di Epidemiologia dei Tumori,
Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto
Superiore di Sanità, Rome
| | - Marco A Pierotti
- Direzione Scientifica, Fondazione
IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
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7
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Galise I, Rashid I, Cuccaro F, Bisceglia L, Coviello V, Melcarne A, Minerba S, Mincuzzi A, Assennato G, Foschi R, Rossi S, Gatta G. Estimates of cancer burden in Puglia. TUMORI JOURNAL 2018; 99:382-9. [DOI: 10.1177/030089161309900314] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and background A regional population-based cancer registry that provides incidence and survival data has become active only recently. Since it is important to know the time trends of basic epidemiological indicators to understand the cancer burden in the region, this paper will provide incidence, prevalence and mortality estimates in the region for seven major cancers for the period 1970—2015. Methods The estimates were obtained by applying the MIAMOD method, a statistical back-calculation approach to derive incidence and prevalence figures starting from mortality and relative survival data. Survival was modeled on the basis of published data from the Italian cancer registries. Results The incidence rates are estimated to be still increasing for female breast cancer, colorectal cancer in men and skin melanoma in both sexes. By contrast, the incidence rates indicate a decreasing trend for cervix uteri cancer and stomach cancer, the latter both in men and women. For these cancers an analogous trend is observed for mortality, confirming the reduction of the risk factors related to these cancer types. The incidence rates for lung cancer and prostate cancer in men were estimated to rise, reach a peak, and then decrease in the last part of the considered period. Prevalence increased for all the considered cancers except cervix cancer. The increase was striking for breast cancer and less pronounced for stomach cancer in both genders. Conclusion This paper provides a description of the burden of the major cancers until 2015. The results highlight the need to reinforce effective preventive measures to contrast cancers related to an unhealthy lifestyle and to increase the compliance with organized screening programs to reduce the colorectal and breast cancer burden.
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Affiliation(s)
- Ida Galise
- Registro Tumori Puglia, IRCCS Istituto Tumori Giovanni Paolo II, Bari
| | - Ivan Rashid
- Registro Tumori Puglia, IRCCS Istituto Tumori Giovanni Paolo II, Bari
| | - Francesco Cuccaro
- Registro Tumori Puglia, IRCCS Istituto Tumori Giovanni Paolo II, Bari
- ARPA Puglia
| | - Lucia Bisceglia
- Registro Tumori Puglia, IRCCS Istituto Tumori Giovanni Paolo II, Bari
- AReS Puglia
| | - Vincenzo Coviello
- Registro Tumori Puglia, IRCCS Istituto Tumori Giovanni Paolo II, Bari
- ASL BT, Barletta-Andria-Trani
| | - Anna Melcarne
- Registro Tumori Puglia, IRCCS Istituto Tumori Giovanni Paolo II, Bari
- ASL Lecce
| | - Sante Minerba
- Registro Tumori Puglia, IRCCS Istituto Tumori Giovanni Paolo II, Bari
- ASL Taranto
| | - Antonia Mincuzzi
- Registro Tumori Puglia, IRCCS Istituto Tumori Giovanni Paolo II, Bari
- ASL Taranto
| | - Giorgio Assennato
- Registro Tumori Puglia, IRCCS Istituto Tumori Giovanni Paolo II, Bari
- ARPA Puglia
| | - Roberto Foschi
- SS Epidemiologia Valutativa, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - Silvia Rossi
- Centro Nazionale di Epidemiologia, Istituto Superiore di Sanità, Rome, Italy
| | - Gemma Gatta
- SS Epidemiologia Valutativa, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
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Vanalli M, Rio F. Development of a core outcome set based on Case Report Form (CRF) to assess laboratory biomarkers and clinical parameters in Onco-Hematology area. Trials 2015. [PMCID: PMC4460777 DOI: 10.1186/1745-6215-16-s1-p23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Moradpour F, Fatemi Z. Estimation of the Projections of the Incidence Rates, Mortality and Prevalence Due to Common Cancer Site in Isfahan, Iran. Asian Pac J Cancer Prev 2013; 14:3581-5. [DOI: 10.7314/apjcp.2013.14.6.3581] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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10
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Piffer S, Gentilini M, Rizzello R, Mazzoleni G, Bellù F, Rossi S. Estimates of cancer burden in Trentino-Alto Adige. TUMORI JOURNAL 2013; 99:296-307. [DOI: 10.1177/030089161309900304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and background The Trentino-Alto Adige region is composed of two autonomous provinces (Trento and Bolzano), each with its own cancer registry. The registries' total coverage is 100% of the regional population. The main difference between the two provinces in terms of cancer epidemiology is related to the prostate cancer incidence and survival, with higher values in Bolzano. This paper provides an update until 2015 of the basic epidemiological indicators for seven major cancers for the entire region. Methods The indicators were estimated by means of the MIAMOD method, a statistical back-calculation approach to derive incidence and prevalence figures starting from mortality and relative survival data. Mortality data were provided by ISTAT for the period 1970—2002 while survival was modeled on the basis of published data from the Italian cancer registries. Results The estimates for 2012 show that breast cancer was the most common cancer in women and prostate cancer was most common in men. Incidence and mortality were decreasing for cervix cancer and stomach cancer in both genders during the whole study period. The lung cancer incidence and mortality were decreasing in men but increasing in women. The colorectal cancer incidence rose in both genders while the mortality was decreasing in women. The incidence of skin melanoma increased in both sexes, while the mortality remained very low. The breast cancer incidence was increasing up to 2015 while the mortality was declining since 1986. The prostate cancer incidence increased up to 2006, thereafter the rates stabilized while mortality started to decrease in the early 2000s. The highest mortality rates were estimated for lung cancer in men and breast cancer in women. Conclusions Lifestyle plays an important role in cancer trends, as does organized screening for early detection of cervix, breast and colorectal cancer. The provincial data on risk factor distribution and adherence to and coverage of organized screening are satisfactory and their optimization may allow additional benefits in terms of public health.
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Affiliation(s)
- Silvano Piffer
- Servizio Epidemiologia Clinica e Valutativa, Registro Tumori, Azienda Provinciale per i Servizi Sanitari, Trento
| | - Maria Gentilini
- Servizio Epidemiologia Clinica e Valutativa, Registro Tumori, Azienda Provinciale per i Servizi Sanitari, Trento
| | - Roberto Rizzello
- Servizio Epidemiologia Clinica e Valutativa, Registro Tumori, Azienda Provinciale per i Servizi Sanitari, Trento
| | - Guido Mazzoleni
- UO Anatomia Patologica, Registro Tumori, Ospedale S Maurizio, Bolzano
| | - Francesco Bellù
- UO Anatomia Patologica, Registro Tumori, Ospedale S Maurizio, Bolzano
| | - Silvia Rossi
- Centro Nazionale di Epidemiologia, Istituto Superiore di Sanità, Rome, Italy
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Ventura L, Miccinesi G, Buzzoni C, Crocetti E, Paci E, Foschi R, Rossi S. Estimates of cancer burden in Tuscany. TUMORI JOURNAL 2013; 99:334-41. [DOI: 10.1177/030089161309900308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and background The Tuscan cancer registry has been operating since 1985, providing cancer incidence and survival data in Tuscany; it covers about 33% of the regional population. The purpose of this paper is to provide incidence, prevalence and mortality estimates for the major cancers in the whole Tuscany region for the period 1970—2015. Methods The estimated figures were obtained by applying the MIAMOD method. Starting from mortality and survival data, incidence and prevalence were derived using a statistical back-calculation approach. Survival was modeled on the basis of published data from the Italian cancer registries. Results According to the estimates, the most frequent cancer sites were colon-rectum in both genders, prostate in men and breast in women, with 4,188, 3,082 and 3,092 new diagnoses, respectively, in 2012. The incidence rates were steadily increasing for lung cancer in women and melanoma in both sexes, while they were decreasing for uterine cervix cancer in women, lung cancer in men and stomach cancer in both sexes. For colorectal cancer a small reduction in incidence was estimated for both sexes in recent years. The incidence rates for prostate cancer, after a steep increase and subsequent stabilization, were estimated to increase slightly in the last years. The breast cancer incidence was estimated to stabilize in the last 10 years. The mortality trends were decreasing for all considered cancers except female lung cancer. Prevalence increased for most of the studied cancers except stomach cancer in both sexes, lung cancer in men and cervix cancer in women. The highest prevalence was estimated for breast cancer, with over 42,000 cases in 2012. Conclusion This paper provides an updated description of the cancer burden in Tuscany until 2015. These trends will have a significant impact on the regional health services and it is therefore important to enhance both primary prevention, for reducing the cancer incidence, and oncological surveillance, for evaluating the care and assistance of cancer patients.
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Affiliation(s)
- Leonardo Ventura
- Clinical and Descriptive Epidemiology Department, Cancer Prevention and Research Institute (ISPO), Florence
| | - Guido Miccinesi
- Clinical and Descriptive Epidemiology Department, Cancer Prevention and Research Institute (ISPO), Florence
| | - Carlotta Buzzoni
- Tuscany Cancer Registry, Cancer Prevention and Research Institute (ISPO), Florence
| | - Emanuele Crocetti
- Tuscany Cancer Registry, Cancer Prevention and Research Institute (ISPO), Florence
| | - Eugenio Paci
- Clinical and Descriptive Epidemiology Department, Cancer Prevention and Research Institute (ISPO), Florence
| | | | - Silvia Rossi
- National Center of Epidemiology, Italian National Institute of Health, Rome, Italy
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Vercelli M, Quaglia A, Lillini R, Rossi S, Foschi R, Orengo MA, Marani E, Casella C, Puppo A, Celesia MV, Cogno R, Levreri I, Benfatto L, Manenti S, Cappellano D, Garrone E. Estimates of cancer burden in Liguria. TUMORI JOURNAL 2013; 99:285-95. [DOI: 10.1177/030089161309900303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and background The regional health care system of Liguria caters for a resident population which is among the oldest in Europe. One population-based cancer registry is present in the region, providing incidence and survival data for the Genoa province (covering 55% of the regional population). This paper will estimate the incidence, prevalence and mortality in the Liguria region for cancers of the lung, breast, prostate, colon-rectum, stomach and uterine cervix and melanoma of the skin in 1970—2015. Methods The estimated figures were obtained by applying the MIAMOD method. Starting from mortality and survival data, incidence and prevalence were derived using a statistical back-calculation approach. Survival was modeled on the basis of published data from the Italian cancer registries. The MIAMOD method was applied also to estimate the colorectal cancer incidence, mortality and prevalence rates in the Ligurian provinces in the period 1988—2015. Results In 2012 about 1,500 new cases of breast cancer were expected in Ligurian women. The estimates for the other cancer sites were considerably lower, ranging from 839 (colon-rectum) to 54 (cervix). In men about 1,400 new cases were estimated for prostate cancer, while the incidence for the other sites ranged from 1,118 (colon-rectum) to 208 (skin melanoma). The breast cancer prevalence rate was more than 10 times the incidence rate in women, and the lung cancer prevalence rate was more than double the incidence rate in both sexes. Mortality rates were highest for lung cancer in men and breast cancer in women; the lowest rates were estimated for melanoma and cancer of the uterine cervix. Conclusion In Liguria a large portion of the health expenditure has been devoted to diagnostic and therapeutic resources. This may have contributed to the reduction of mortality rates and to the improvement of cancer survival. This phenomenon, added to population aging, will inflate the cancer prevalence. One of the major challenges for the Liguria region is to face the increasing demand for oncology services.
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Affiliation(s)
- Marina Vercelli
- RTRL, Registro Tumori Regione Liguria c/o SS Epidemiologia Descrittiva, Azienda Ospedale Università San Martino, IST, Istituto Nazionale Ricerca sul Cancro, Genoa
- DISSAL, Dipartimento di Scienze della Salute, Università di Genova, Genoa
| | - Alberto Quaglia
- RTRL, Registro Tumori Regione Liguria c/o SS Epidemiologia Descrittiva, Azienda Ospedale Università San Martino, IST, Istituto Nazionale Ricerca sul Cancro, Genoa
| | - Roberto Lillini
- RTRL, Registro Tumori Regione Liguria c/o SS Epidemiologia Descrittiva, Azienda Ospedale Università San Martino, IST, Istituto Nazionale Ricerca sul Cancro, Genoa
- Università “Vita - Salute” San Raffaele, Milan
| | - Silvia Rossi
- CNESPS, Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, Rome
| | - Roberto Foschi
- SS Epidemiologia Valutativa, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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13
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Gatta G, Ciampichini R, Bisanti L, Contiero P, Tessandori R, Baili P, Rossi S. Estimates of cancer burden in Lombardy. TUMORI JOURNAL 2013; 99:277-84. [DOI: 10.1177/030089161309900302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and background Cancer registration in Lombardy covers almost half of the regional population and started in 1976 in the Varese province. The aim of this paper is to provide estimates of the incidence, mortality and prevalence of seven major cancers for the entire Lombardy region in the period 1970—2015. Methods The estimates were obtained by applying the MIAMOD method, a statistical back-calculation approach to derive incidence and prevalence figures starting from mortality and relative survival data. Published data from the Italian cancer registries were modeled in order to estimate the regional cancer survival. Results In Lombardy, about 9,000 new cases of breast cancer, 8,500 of colorectal cancer, 7,200 of prostate cancer and 6,700 of lung cancer were expected to be diagnosed in the year 2012. Incidence rates are still rising for female breast cancer, skin melanoma in both sexes, and lung cancer in women. By contrast, the rates have been declining for cervix and stomach cancer. For lung cancer in men, prostate cancer and colorectal cancer the rates increased, reaching a peak in different periods, and then decreased. Prevalence increased for all cancers considered except cervix cancer. The rise was less pronounced in stomach cancer due to the impressive reduction of its incidence and was striking for breast and prostate cancer, with 116,000 and 58,900 prevalent cases in 2012. Mortality dropped for all considered cancers with the only exception of lung cancer in women. Conclusion This up-to-date picture of the cancer risk and burden in Lombardy shows the increasing demand for oncology services as one of the major challenges for the region. However, primary prevention is still the only way to simultaneously reduce incidence, prevalence and mortality rates, thus saving further lives and preserving health resources.
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Affiliation(s)
- Gemma Gatta
- Evaluative epidemiology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - Roberta Ciampichini
- Evaluative epidemiology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | | | - Paolo Contiero
- Registro Tumori Provincia di Varese, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | | | - Paolo Baili
- Evaluative epidemiology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - Silvia Rossi
- Centro Nazionale di Epidemiologia, Istituto Superiore di Sanità, Rome, Italy
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Tumino R, Capocaccia R, Traina A, Madeddu A, Contrino ML, Zigon G. Estimates of cancer burden in Sicily. TUMORI JOURNAL 2013; 99:399-407. [DOI: 10.1177/030089161309900316] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims and background Estimates are complementary epidemiological measures which allow to present data on cancer burden, especially in geographical areas where measurements of cancer occurrence are not supported by exhaustive statistics on incidence, mortality and survival. The aim of this paper is to provide cancer incidence, mortality and prevalence estimates and projections for the major cancers in the period 1970—2015 for the entire region of Sicily. Methods The estimates were computed by applying the MIAMOD method, a statistical back-calculation approach to derive incidence and prevalence figures starting from mortality and relative survival data. Published data from the Italian cancer registries were modeled in order to estimate the regional cancer survival. Results In 2012 the most common cancers were breast cancer in women, colorectal cancer in both sexes, and prostate cancer in men, with about 4,000, 3,500 and 3,000 estimated new cases, respectively. The highest crude mortality rates were estimated for lung cancer in men (63.6 per 100,000) and breast cancer in women (30.8 per 100,000) and the lowest for skin melanoma (both sexes) and cancer of the cervix uteri. For colorectal, lung and stomach cancer and skin melanoma, all the indicators were higher in men than women. The prevalence figures in women were more than 9 times the incidence figures for breast cancer and more than 10 times the incidence figures for skin melanoma. The prevalence was twice the incidence for lung cancer in both sexes. The prevalence increased for all the considered cancers except cervical cancer. Conclusion According to our analyses in Sicily we expect about 14,000 new diagnoses and 5,500 deaths for the major cancer types in a year, while about 92,000 persons with a diagnosis of the considered cancers were alive in 2012. We expect an increase in cancer survival and contemporary aging of the population: both expectations will inflate the cancer prevalence, causing more demand for oncology facilities.
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Affiliation(s)
- Rosario Tumino
- Registro Tumori della Provincia di Ragusa, Azienda Sanitaria Provinciale Ragusa, Ragusa
| | | | - Adele Traina
- Registro tumori della Mammella di Palermo, Palermo
| | | | | | - Giulia Zigon
- SS di Epidemiologia Valutativa, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
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Abstract
Aims and background Abruzzo and Molise are two regions located in the south of Italy, currently without population-based cancer registries. The aim of this paper is to provide estimates of cancer incidence, mortality and prevalence for the Abruzzo and Molise regions combined. Methods The MIAMOD method, a back-calculation approach to estimate and project the incidence of chronic diseases from mortality and patient survival, was used for the estimation of incidence and prevalence by calendar year (from 1970 to 2015) and age (from 0 to 99). The survival estimates are based on cancer registry data of southern Italy. Results The most frequently diagnosed cancers were those of the colon and rectum, breast and prostate, with 1,394, 1,341 and 698 new diagnosed cases, respectively, estimated in 2012. Incidence rates were estimated to increase constantly for female breast cancer, colorectal cancer in men and melanoma in both sexes. For prostate cancer and male lung cancer, the incidence rates increased, reaching a peak, and then decreased. In women the incidence of colorectal and lung cancer stabilized after an initial increase. For stomach and cervical cancers, the incidence rates showed a constant decrease. Prevalence was increasing for all the considered cancer sites with the exception of the cervix uteri. The highest prevalence values were estimated for breast and colorectal cancer with about 12,300 and over 8,200 cases in 2012, respectively. In the 2000s the mortality rates declined for all cancers except skin melanoma and female lung cancer, for which the mortality was almost stable. Conclusion This paper provides a description of the burden of the major cancers in Abruzzo and Molise until 2015. The increase in cancer survival, added to population aging, will inflate the cancer prevalence. In order to better evaluate the cancer burden in the two regions, it would be important to implement cancer registration.
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Affiliation(s)
- Roberto Foschi
- Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - Lorena Viviano
- Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - Silvia Rossi
- National Center of Epidemiology, Italian National Institute of Health, Rome, Italy
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Pizzi C, Arpino G, Acampora G, Aiello N, DE Rosa A, Diaferia I, DI Nunzio A, Fragna G, Franco A, Russo M, Sansone F, Scarpati C, Spinuso A, Arpino G, Luce A, Tommasielli G, Caraglia M, DE Placido S. Cancer prevalence in the city of Naples: Contribution of the GP database analyses to the cancer registries network. Mol Clin Oncol 2013; 1:726-732. [PMID: 24649236 PMCID: PMC3915682 DOI: 10.3892/mco.2013.101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Accepted: 03/25/2013] [Indexed: 11/06/2022] Open
Abstract
The Italian cancer registries network has not been sufficiently developed in the Southern regions. General practitioners (GPs) are knowledgeable about the prevalence, incidence and mortality for different types of cancer in their patient populations. The aim of this pilot study was to verify the feasibility and reliability of the characterization of cancer populations using GP databases in order to evaluate the impact of cancer in the general population of Naples. The characteristics of the cases studied have been collected by interview or electronic health record and recorded on paper or magnetic supports, appropriately conforming to the current privacy law. Databases are centralized, stored and codified on electronic data-sheets and periodically elaborated by the 'Consorzio Nazionale delle Cooperative Mediche' and 'Federico II' University. The present study was initiated on September 15, 2004. The analysed geographical area included the suburbs of 'Stella' and 'San Carlo all'Arena', situated in the historical center of Naples and corresponding to Health Care District 29 of the local health service. The analysis included 16,927 men and women (age range, 6-97 years) from the outpatient offices of 12 GPs who agreed to participate in the study. Results showed that the analysed population represents 16.3% of the general population residing in the area under study. We identified 342 (2%) patients with cancer, 143 (0.8%) of whom were men and 199 (1.2%) women (M/F ratio of 0.7). Of the 342 patients, 10 (5 men and 5 women) had a double cancer; thus, a total of 352 malignancies was characterized. Cancer prevalence was 2,020/100,000 inhabitants. This estimate is lower compared to the national prevalence (2,683/100,000 inhabitants) but higher compared to that in other southern Italian areas. Results, stratified by International Classification of Disease, ninth revision (ICD-IX), based on factors including gender and age, demonstrated that breast cancer, urogenital tumours and colorectal cancer are the most frequently occurring types of cancer identified among the inhabitants of Naples. Cancer prevalence in the historical center of Naples is in concordance with national estimates and projections and National Cancer Registries may be easily and accurately supported by GP medical databases.
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Affiliation(s)
- Claudia Pizzi
- Consorzio Nazionale delle Cooperative Mediche - Italian Society of General Medicine (SIMG), 'Federico II' University, 80131 Naples
| | - Grazia Arpino
- Department of Clinical Medicine and Surgery, Faculty of Medicine, 'Federico II' University, 80131 Naples
| | - Giuseppe Acampora
- Consorzio Nazionale delle Cooperative Mediche - Italian Society of General Medicine (SIMG), 'Federico II' University, 80131 Naples
| | - Nadia Aiello
- Consorzio Nazionale delle Cooperative Mediche - Italian Society of General Medicine (SIMG), 'Federico II' University, 80131 Naples
| | - Augusto DE Rosa
- Consorzio Nazionale delle Cooperative Mediche - Italian Society of General Medicine (SIMG), 'Federico II' University, 80131 Naples
| | - Immacolata Diaferia
- Consorzio Nazionale delle Cooperative Mediche - Italian Society of General Medicine (SIMG), 'Federico II' University, 80131 Naples
| | - Alessandro DI Nunzio
- Consorzio Nazionale delle Cooperative Mediche - Italian Society of General Medicine (SIMG), 'Federico II' University, 80131 Naples
| | - Giuseppe Fragna
- Consorzio Nazionale delle Cooperative Mediche - Italian Society of General Medicine (SIMG), 'Federico II' University, 80131 Naples
| | - Amedeo Franco
- Consorzio Nazionale delle Cooperative Mediche - Italian Society of General Medicine (SIMG), 'Federico II' University, 80131 Naples
| | - Maria Russo
- Consorzio Nazionale delle Cooperative Mediche - Italian Society of General Medicine (SIMG), 'Federico II' University, 80131 Naples
| | - Fulvia Sansone
- Consorzio Nazionale delle Cooperative Mediche - Italian Society of General Medicine (SIMG), 'Federico II' University, 80131 Naples
| | - Carmela Scarpati
- Consorzio Nazionale delle Cooperative Mediche - Italian Society of General Medicine (SIMG), 'Federico II' University, 80131 Naples
| | - Antonio Spinuso
- Consorzio Nazionale delle Cooperative Mediche - Italian Society of General Medicine (SIMG), 'Federico II' University, 80131 Naples
| | - Giovanni Arpino
- Consorzio Nazionale delle Cooperative Mediche - Italian Society of General Medicine (SIMG), 'Federico II' University, 80131 Naples
| | - Amalia Luce
- Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, 80138 Naples, Italy
| | - Giuseppina Tommasielli
- Consorzio Nazionale delle Cooperative Mediche - Italian Society of General Medicine (SIMG), 'Federico II' University, 80131 Naples
| | - Michele Caraglia
- Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, 80138 Naples, Italy
| | - Sabino DE Placido
- Department of Clinical Medicine and Surgery, Faculty of Medicine, 'Federico II' University, 80131 Naples
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Sánchez MJ, Payer T, De Angelis R, Larrañaga N, Capocaccia R, Martinez C. Cancer incidence and mortality in Spain: estimates and projections for the period 1981-2012. Ann Oncol 2011; 21 Suppl 3:iii30-36. [PMID: 20427358 DOI: 10.1093/annonc/mdq090] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND National indicators of cancer burden are essential information for cancer surveillance and health planning, so that in countries with partial registration coverage and geographically variable risk patterns, such as Spain, this is even more relevant. This article provides estimates of cancer incidence in Spain for all cancers combined, with the single exception of non-melanoma skin cancer, and for major cancer sites over the period 1981-2006, with projections up to 2012. PATIENTS AND METHODS Estimates were obtained by applying the MIAMOD method, a statistical back-calculation approach, to derive incidence from mortality and relative survival data. RESULTS During the period 1981-2012, age-standardised incidence rates for all cancers rose from the beginning of the period and started to decline from 2000 onwards among men, and increased across the whole period among women. Differences in incidence trends between men and women might be attributable to the gender-specific case-mix of sites for all cancers, and to differences in risk factors specific to certain cancer sites in men and women, with smoking being the main factor accounting for these differences between the sexes. CONCLUSIONS Estimates and projections of cancer incidence and mortality show divergent trends in Spain by sex and tumour type. This information is basic for planning and enhancing public health strategies and resources.
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Affiliation(s)
- M J Sánchez
- Granada Cancer Registry, Andalusian School of Public Health, Granada, Spain.
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Iannazzo S, Pradelli L, Carsi M, Perachino M. Cost-effectiveness analysis of LHRH agonists in the treatment of metastatic prostate cancer in Italy. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2011; 14:80-89. [PMID: 21211489 DOI: 10.1016/j.jval.2010.10.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVES Luteinizing hormone-releasing hormone (LHRH) agonists represent one of the main cost factors in the management of patients with metastatic prostate cancer. We compared the cost-effectiveness of the five different 3-month formulations of LHRH agonists currently available for advanced prostate cancer in Italy, because these differ both in their capacity to suppress testosterone and in their acquisition costs. METHODS A probabilistic, patient-level simulation model was developed to compare the cost-effectiveness, from the perspective of the Italian National Health Service (INHS), of leuprorelin 11.25 mg and 22.5 mg, triptorelin 11.25 mg, buserelin 9.9 mg, and goserelin 10.8 mg. The model incorporated testosterone-dependent progression-free and cancer-specific survival functions, LHRH agonist effectiveness data, and national costs and tariffs. Cox's proportional hazard models were used to compute total and progression-free survival functions based on clinical data from 129 patients with metastatic prostate cancer treated in an Italian center. Bayesian random effects models were employed to summarize evidence from published literature on testosterone suppression obtained with the available LHRH agonists. RESULTS Estimated total survival was ≈5 years, with a maximum difference between treatment options of ≈2 months. There was a mean difference of almost €2,500 in lifetime total costs between the least costly option (leuprorelin 22.5 mg) and the most expensive (goserelin). In the incremental cost-effectiveness analysis, leuprorelin 22.5 mg dominated all alternatives except buserelin, which had an incremental cost-effectiveness ratio versus leuprorelin 22.5 mg of ≈€12,000 per life-month gained. CONCLUSIONS Based on modelling with meta-analysis of comparative survival data, leuprorelin 22.5 mg was the most cost-effective treatment of the available depot formulation LHRH agonists.
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Affiliation(s)
- S Iannazzo
- AdRes Health Economics & Outcomes Research, Torino, Italy.
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Amadio P, Bordonaro R, Borsellino N, Butera A, Caruso M, Ferraù F, Russello R, Savio G, Valenza R, Zerilli F, Gebbia V. Scientific Activity and Needs Among Medical Oncology Units in Sicily: A Survey of The Italian Association of Medical Oncology. J Chemother 2010; 22:48-53. [DOI: 10.1179/joc.2010.22.1.48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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