RESUMO
A retrospective observational study utilising cancer incidence data from a population-based registry investigated determinants affecting primary liver cancer survival in a southern Italian region with high hepatitis viral infection rates and obesity prevalence. Among 2687 patients diagnosed between 2006 and 2019 (65.3% male), a flexible hazard-based regression model revealed factors influencing 5-year survival rates. High deprivation levels [HR = 1.41 (95%CI = 1.15-1.76); p < 0.001], poor access to care [HR = 1.99 (95%IC = 1.70-2.35); p < 0.0001], age between 65 and 75 [HR = 1.48 (95%IC = 1.09-2.01); p < 0.05] or >75 [HR = 2.21 (95%CI = 1.62-3.01); p < 0.0001] and residing in non-urban areas [HR = 1.35 (95%CI = 1.08-1.69); p < 0.01] were associated with poorer survival estimates. While deprivation appeared to be a risk factor for primary liver cancer patients residing within the urban area, the geographic distance from specialised treatment centres emerged as a potential determinant of lower survival estimates for residents in the non-urban areas. After balancing the groups of easy and poor access to care using a propensity score approach, poor access to care and a lower socioeconomic status resulted in potentially having a negative impact on primary liver cancer survival, particularly among urban residents. We emphasise the need to interoperate cancer registries with other data sources and to deploy innovative digital solutions to improve cancer prevention.
RESUMO
Ovarian cancer is characterized by a low incidence of disease and a high mortality. To correctly analyze the epidemiology of this disease it is therefore necessary to obtain data from population-based tumor registries. From 2003 to 2005, 251 new cases were registered in the tumor registry of the province of Palermo. Cases were identified from various sources, mainly hospital discharge forms, pathology reports and death certificates.The distribution of incident cases was analysed by age, type of diagnosis, disease stage, and treatment. Survival was calculated at one, three and five years. Morphologically, epithelial tumors were the most common frequent. The disease was more frequent in older age groups, with the highest incidence observed in the age group 55-69 years. Incidence and mortality rates were similar to those reported by the pool of Italian tumor registries. Disease stage was found to be related to patient age. Survival was related to stage of disease, age at diagnosis and type of treatment. Younger patients had a longer survival while advanced staging was the most unfavorable prognostic factor. Regarding the type of treatment, treatment of ovarian cancer is complex and requires close integration and coordination of the various healthcare professionals involved.
