Evaluation of goiter using ultrasound criteria: a survey in a middle schoolchildren population of a mountain area in Central Italy.

Iodine deficiency is still an important health care problem in the world. In Italy, as in most European countries, it is responsible for the development of mild to moderate endemic goiter. In 1995 we conducted a goiter survey in the Gubbio township, an area of Umbria region in Italy, close to the Appenine mountain chain. This study demonstrated a high prevalence of goiter in the middle schoolchildren population, indicating the presence of moderate endemic goiter. Soon after, a goiter prevention campaign aimed at implementing the consumption of iodinated salt was started. In 2001, a second survey was conducted in the middle schoolchildren (age 11-14 yr old) of Gubbio and neighbour townships. Eight hundred thirteen subjects were studied. Data obtained in 240 age-matched children, studied in the same area in 1995, were used for comparison to monitor changes 5 yr after the beginning of iodine prophylaxis. Thyroid volume was measured by ultrasonography. Gland volume was expressed in ml. A large population living in a iodine-sufficient area, previously reported by others, was used as control. Urinary iodine excretion was measured randomly in 20% of the children. The overall prevalence of goiter decreased between 1995 and 2001 from 29 to 8%. Goiter odds ratio (OR), corrected for age, was 4.0 (95% CI 2.8-5.9) for 1995 compared to 2001 (p<0.000). Mean thyroid volume in the matched populations was 7.6+/-2.5 ml in 1995 and 5.7+/-2.1 ml in 2001. Median iodine urinary excretion increased from 72.6 to 93.5 mug/l, at the limit of statistical significance. Living in a rural area, no consumption of iodized salt and familiarity for goiter represented independent risk factors for goiter development. This study was the first conducted in Umbria region and confirmed that an implementation campaign for iodized salt consumption is a simple and useful instrument to prevent endemic goiter and related diseases. A new survey to evaluate goiter prevalence in the same area 10 yr after the beginning of iodine prophylaxis is already planned.

Survival of children with cancer in Torino, Italy.

During 1967-78, cancer was diagnosed in 870 children living in the Province of Torino. Survival until the end of 1978 is reported separately for cases diagnosed in 1967-70, in 1971-74, and in 1975-78. Comparisons between the three series indicate a statistically significant (p less than 0.05) increase in survival rates for children with leukemia and cancer of the central nervous system as well as a nonstatistically significant increase for children with lymphoma (both Hodgkin's and non-Hodgkin's). No consistent changes in time were noticed for neuroblastomas, nephroblastomas, soft tissue sarcomas, and retinoblastomas. Survival rates for both types of lymphomas and for leukemias (at least for cases diagnosed after 1975) were very similar to corresponding population-derived data from the U.S. and other Western countries. Rates for other cancers were relatively poor in the Province of Torino. It is suggested that relatively high care standards are easier to achieve in the case of childhood cancers requiring chemotherapy than in cancers commonly treated through radiotherapy and/or surgery.