Cytological and histological diagnosis of lung cancer in Sardinia and Italy in the 1990s.

BACKGROUND: Up to 30-50% of all lung cancer cases remain without cyto-histological characterisation. The aim of our study was to evaluate retrospectively the proportion of histological and/or cytological diagnosis in patients with lung cancer in Sardinia. METHODS: Data was gathered by consulting the hospital registers and case notes of individual patients released from hospital with a diagnosis of Lung Cancer at all medical centres throughout Sardinia. In gathering patients' data, we focused our attention on cytological and histological procedures through which allowed the lung cancer was diagnosed. Cancer Registries data was utilised to compare our data with national and Sassari province data. RESULTS: From 1991 to 1996 there was a total of 3146 lung cancer patients registered in Sardinia. 1902 patients (60.5%) had a histological diagnosis, 142 patients (4.5%) a cytological diagnosis while in 1102 patients (35%) the diagnosis was performed without any pathological validation. CONCLUSIONS: Our study has shown that lung cancer diagnosis is supported by pathological verification in 65% of cases while in remaining 35% of patients the diagnosis is based only on clinical and radiological reports. In Italy data from Cancer Registries report the percentage of cytohistological diagnosis to be 70% with the percentage of cytological diagnosis being higher than in Sardinia.

Epidemiology of lung cancer in Sardinia, Italy, from 1980 to 1996.

SETTING: Bronchial carcinoma is the most common cause of death among all malignant tumours. Despite a progressive increase, many Italian regions--ours included--do not have a Regional Cancer Registry. OBJECTIVE: To assess lung cancer incidence and mortality rates in Sardinia during the period 1980-1996. METHODS: Data were gathered by consulting hospital registers and the case notes of individual patients released from hospital with a diagnosis of bronchial carcinoma at all Sardinian medical centres between 1980 and 1996. RESULTS: A total of 7734 patients with lung cancer were registered in Sardinia between 1980 and 1996. Data showed a steady increase in lung cancer incidence rates over the years (from 22.3/100000 in 1980 to 34.5 in 1996). The same increase was evident in mortality rates (from 25.7/100000 in 1980 to 42.9 in 1996). The increase in mortality rates was higher in women (+146%) than in men (+59.5%). CONCLUSIONS: Results show a slow but steady increase in lung cancer incidence and mortality rates in Sardinia. The high number of smokers among lung cancer patients seems to indicate that anti-smoking campaigns need to be more effective in Sardinia.

Epidemiology of tuberculosis in Sardinia: a comparison of two data-gathering methods.

SETTING: A complete surveillance system for tuberculosis should be able to guarantee constant updating of incidence and provide useful data on a variety of problems related to tuberculosis such as drug resistance, co-infection with the human immunodeficiency virus (HIV), the geographic origin of patients, and mycobacterial species. OBJECTIVE AND DESIGN: To assess the completeness of the surveillance system currently operating in Sardinia, cases seen by all medical centres between 1987 and 1995 were compared with those notified to Sardinian Public Health Services for the same period. RESULTS: Each year, on average 39% of cases seen in Sardinia are notified; 646 (40%) of the 1591 patients notified during the study period were never seen by regional medical centres. An analysis of the results shows that from 1992 the decline recorded in incidence rates in previous years ceased: 1992 (26/100,000), 1993 (25/100,000), 1994 (28/100,000), and 1995 (24/100,000). CONCLUSIONS: The current surveillance system in Sardinia is inadequate for performing an accurate epidemiological survey of the disease. Epidemiological analysis based solely on notification can provide neither reliable incidence rates nor useful information concerning many aspects of tuberculosis.

Etiology and therapy of community-acquired pneumonia.

The Authors report the data of a retrospective study performed on 520 patients admitted to the Institute of Respiratory Diseases, University of Sassari, Italy, for community acquired pneumonia (CAP) from 1980 to 1995. The aim of this study was to investigate: the frequency of risk factors and their impact on severity of pneumonia; the frequency of pathogens and their correlation with the severity of the illness; antibiotic treatments. One or more risk factors were found in 86% of patients, while 14% had none. In 286 patients (55%) no etiological diagnosis was possible, while in 234 patients (45%) the pathogen was identified. Of the latter, 73% suffered from pneumonia caused by Gram-negative bacilli, 24% by Gram-positive organisms, 0.8% by Mycoplasma pneumoniae and 1.7% by respiratory viruses and endemic fungi. The mortality rate found was 2.69%. In this study, pneumonia caused by Gram-negative bacilli showed a plurilobar and often bilateral involvement, frequent resistance to the most common antibiotics, which required longer hospitalization (> 30 days). The high prevalence of pneumonia caused by Gram-negative bacilli can be explained by the presence in most of the patients, of serious and numerous risk factors.