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Role of Occupation in Shaping Cancer Disparities. Cancers (Basel) 2022; 14:cancers14174259. [PMID: 36077790 PMCID: PMC9454748 DOI: 10.3390/cancers14174259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 08/24/2022] [Accepted: 08/29/2022] [Indexed: 11/25/2022] Open
Abstract
Simple Summary The investigation of cancer disparities is of major importance. In this paper, we address this issue through the occupational point of view, trying to capture how work and its related factors impact on cancer inequalities. The data we provide may increase awareness relevant to cancer control, and stimulate further studies aimed at the identification of the occupational determinants of cancer disparities and the quantification of their role. Abstract Cancer occurrence is characterized globally by profound socioeconomic differences. Occupation is a fundamental component of socioeconomic status. In this review, we discuss the role of occupation as a determinant of cancer disparities. First, we address the issue of participation in cancer screening programs based on income, health insurance, occupational status and job title. Second, we review the role of occupation in contributing to disparities by acting as a mediator between cancer and (i) education and (ii) race/ethnicity. Lastly, we analyze data from a multicenter case−control study of lung cancer to calculate the mediating role of occupational exposure to diesel exhaust, silica and welding fumes in the association between education and lung cancer. By addressing the complex paths from occupation to cancer inequalities from multiple points of view, we provide evidence that occupational-related characteristics, such as income, health insurance, unemployment and hazardous exposures impinge on cancer control and outcomes. The increasing awareness of these aspects is fundamental and should lead to public health interventions to avoid inequalities rising from occupational factors.
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Bosetti C, Traini E, Alam T, Allen CA, Carreras G, Compton K, Fitzmaurice C, Force LM, Gallus S, Gorini G, Harvey JD, Kocarnik JM, La Vecchia C, Lugo A, Naghavi M, Pennini A, Piccinelli C, Ronfani L, Xu R, Monasta L. National burden of cancer in Italy, 1990-2017: a systematic analysis for the global burden of disease study 2017. Sci Rep 2020; 10:22099. [PMID: 33328623 PMCID: PMC7744506 DOI: 10.1038/s41598-020-79176-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 11/25/2020] [Indexed: 12/20/2022] Open
Abstract
We monitored the burden of cancer in Italy and its trends over the last three decades, providing estimates of cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs), for cancer overall and 30 cancer sites using data from the Global Burden of Disease study 2017. An overview of mortality trends between 1990 and 2017 was also provided. In 2017, there were 254,336 new cancer cases in men and 214,994 in women, corresponding to an age-standardized incidence rate (ASIR) of 438 and 330/100,000, respectively. Between 1990 and 2017, incident cancer cases, and, to a lesser extent, ASIRs significantly increased overall and for almost all cancer sites, but ASIRs significantly declined for lung and other tobacco-related neoplasms. In 2017, there were 101,659 cancer deaths in men (age-standardized death rate, ASDR, 158.5/100,000) and 78,918 in women (ASDR 93.9/100,000). Cancer deaths significantly increased between 1990 and 2017 (+ 18%), but ASDR significantly decreased (- 28%). Deaths significantly increased for many cancer sites, but decreased for stomach, esophageal, laryngeal, Hodgkin lymphoma, and testicular cancer. ASDRs significantly decreased for most neoplasms, with the main exceptions of cancer of the pancreas and uterus, and multiple myeloma. In 2017, cancer caused 3,204,000 DALYs. Between 1990 and 2017, DALYs and age-standardized DALY rates significantly declined (-3.4% and -33%, respectively). Age-standardized mortality rates in Italy showed favorable patterns over the last few decades. However, the absolute number of cancer cases and, to a lower extent, of cancer deaths increased likely due to the progressive ageing of the population, this calling for a continuous effort in cancer prevention, early diagnosis, and treatment.
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Affiliation(s)
- Cristina Bosetti
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri, 2, 20156, Milan, Italy.
| | - Eugenio Traini
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Tahiya Alam
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Christine A Allen
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Giulia Carreras
- Oncologic Network, Prevention, and Research Institute, Florence, Italy
| | - Kelly Compton
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Christina Fitzmaurice
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Division of Hematology, University of Washington, Seattle, WA, USA
| | - Lisa M Force
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Silvano Gallus
- Department of Environmental Health Sciences, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Giuseppe Gorini
- Oncologic Network, Prevention, and Research Institute, Florence, Italy
| | - James D Harvey
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Jonathan M Kocarnik
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Alessandra Lugo
- Department of Environmental Health Sciences, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Alyssa Pennini
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | | | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Rixing Xu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Lorenzo Monasta
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
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Apostoli P, Boffetta P, Bovenzi M, Cocco PL, Consonni D, Cristaudo A, Discalzi G, Farioli A, Manno M, Mattioli S, Pira E, Soleo L, Taino G, Violante FS, Zocchetti C. Position Paper on Asbestos of the Italian Society of Occupational Medicine. LA MEDICINA DEL LAVORO 2019; 110:459-485. [PMID: 31846450 PMCID: PMC7809933 DOI: 10.23749/mdl.v110i6.9022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Indexed: 12/24/2022]
Abstract
The Position Paper (PP) on asbestos of the Italian Society of Occupational Medicine (SIML) aims at providing a tool to the occupational physician to address current diagnostic criteria and results of epidemiological studies, and their consequences in terms of preventive and evaluation actions for insurance, compensation and litigation. The PP was based on an extensive review of the scientific literature and was compiled by a Working Group comprising researchers who have contributed to the international literature on asbestos-related diseases, as well as occupational physicians with extensive experience in the evaluation of risks and the medical surveillance of workers currently and formerly exposed to asbestos. The PP was drafted and reviewed between 2017 and 2018; its final version was prepared according to the guidelines of AGREE Reporting Checklist. All the members of the Working Group subscribed to the document, which was eventually approved by SIML's Executive Committee. The first section addresses industrial hygiene issues, such as methods for environmental monitoring, advantages and limitations of different microscopy techniques, the potential role of microfibers and approaches for retrospective assessment of exposure, in particular in epidemiological studies. The second section reviews the biological effects of asbestos with particular attention to the diagnostic aspects of asbestosis, pleural changes, mesothelioma and lung cancer. In the following section the criteria of causal attribution are discussed, together with different hypotheses on the form of the risk functions, with a comparison of the opinions prevalent in the literature. In particular, the models of the risk function for mesothelioma were examined, in the light of the hypothesis of an acceleration or anticipation of the events in relation to the dose. The last section discusses topics of immediate relevance for the occupational physician, such as health surveillance of former exposed and of workers currently exposed in remediation activities.
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Affiliation(s)
- Pietro Apostoli
- Dipartimento di Specialità Medico-Chirurgiche, Scienze Radiologiche e Sanità Pubblica, Università degli Studi di Brescia, Brescia, Italia..
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Chirieac LR, Hung YP, Foo WC, Hofer MD, VanderLaan PA, Richards WG, Sugarbaker DJ, Bueno R. Diagnostic value of biopsy sampling in predicting histology in patients with diffuse malignant pleural mesothelioma. Cancer 2019; 125:4164-4171. [PMID: 31390057 DOI: 10.1002/cncr.32416] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 06/19/2019] [Accepted: 06/20/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND The classification of diffuse malignant mesothelioma into epithelioid, biphasic, and sarcomatoid types is based on histologic patterns. The diagnosis is made on biopsies, and because of intratumoral heterogeneity, they may not be representative of the entire tumor. The number and volume of biopsies needed to reach diagnostic accuracy in diffuse malignant mesothelioma and their prognostic value remain unclear. METHODS This study examined 759 consecutive patients with pleural diffuse malignant mesothelioma treated by pleurectomy/decortication or extrapleural pneumonectomy for the presence of epithelioid and/or sarcomatoid histology and classified both the presurgery biopsies (core-needle or thoracoscopic) and surgical resection specimens. The number and volume of biopsies were correlated with pre- and postsurgery histologies and overall survival. RESULTS Diffuse malignant mesothelioma was classified as epithelioid (76%), biphasic (18%), sarcomatoid (5%), or indeterminate (1%) in biopsies and as epithelioid (64%), biphasic (32%), and sarcomatoid (4%) in surgical resection specimens (overall concordance, 80.6%). The positive likelihood ratios were 2.4, 13.6, and 90.1 for biopsies with epithelioid, biphasic, and sarcomatoid histologies, respectively. Concordant histologies between biopsies and resections were associated with a higher number of biopsies (median tissue blocks for concordant histologies vs discordant histologies, 3 vs 2; P < .002) but were less associated with a higher volume (median, 1.2 vs 1.1 cm3 ; P = .06). In a multivariate analysis, overall survival was independently predicted by histology in the resection specimen (P < .0001) but not in the biopsy (P = .09). CONCLUSIONS In contrast to epithelioid histology, sarcomatoid histology in biopsies is highly accurate. Despite intratumoral heterogeneity, the accuracy of histologic classification increases with the number of tissue blocks examined, emphasizing the diagnostic value of extensive sampling by presurgery biopsies.
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Affiliation(s)
- Lucian R Chirieac
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Yin P Hung
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.,Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Wai Chin Foo
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.,Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Matthias D Hofer
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.,Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Paul A VanderLaan
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.,Division of Anatomic Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - William G Richards
- Department of Thoracic Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - David J Sugarbaker
- Department of Thoracic Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Raphael Bueno
- Department of Thoracic Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
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Gogou E, Hatzoglou C, Zarogiannis SG, Malli F, Jagirdar RM, Gourgoulianis KI. Mesothelioma Mortality Rates in Greece for the Period 2005-2015 Is Increased Compared to Previous Decades. ACTA ACUST UNITED AC 2019; 55:medicina55080419. [PMID: 31366157 PMCID: PMC6724054 DOI: 10.3390/medicina55080419] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 07/10/2019] [Accepted: 07/25/2019] [Indexed: 12/13/2022]
Abstract
Background and Objective: To present summary statistics regarding malignant mesothelioma (MM) mortality in Greece during the period 2005–2015 and compare it with previous decades, along with gender, age and geographical area analysis. Materials and Methods: The Hellenic Statistical Authority provided the data, which included all deaths for the period 1983 to 2015 that mentioned MM as the death cause in the corresponding death certificate. MM mortality rates have been calculated with respect to gender, age, and geographical location in Greece. Furthermore, a comparison analysis was made among three eleven consecutive year periods, in order to assess potential changes in the mortality rates. Results: The MM mortality rate has significantly increased during the period 2005–2015 both in males and females compared to earlier decades. The maximum number of MM deaths has shifted to an older age group of 70–80 years during the 2005–2015 period as compared to that of 1983–2004 in both genders. Additionally, MM mortality rates have significantly increased in all geographical areas except for the Epirus Prefecture. Conclusions: Our results demonstrate an increased MM mortality rate in Greece for the decade 2005–2015 as compared to the two previous decades. This increase is possibly due to the fact that the peak in asbestos production and use in Greece was in mid 1990s, while the asbestos ban came in effect in 2005. Based on these findings the MM epidemic in Greece has not yet peaked, therefore it is important to implement screening strategies for early MM detection.
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Affiliation(s)
- Evdoxia Gogou
- Department of Physiology, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41500 Larissa, Greece.
| | - Chrissi Hatzoglou
- Department of Physiology, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41500 Larissa, Greece
| | - Sotirios G Zarogiannis
- Department of Physiology, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41500 Larissa, Greece
| | - Foteini Malli
- Anatomy and Physiology Lab, Nursing Department, University of Thessaly, 41500 Larissa, Greece
| | - Rajesh M Jagirdar
- Department of Physiology, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41500 Larissa, Greece
| | - Konstantinos I Gourgoulianis
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41500 Larissa, Greece
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