CANCER MORTALITY IN ITALY, 1994, AND AN OVERVIEW OF TRENDS FROM 1955 TO 1994

Background: Data and statistics are presented on cancer death certific ation in Italy, updating previous publications covering the period 195 5-1993. Methods: Data for 1994 and the quinquennium 1990-94 subdivided into 30 cancer sites are presented in 8 tables, including age- and se x-specific absolute and percentage frequencies of cancer deaths, and c rude, age-specific and age-standardized rates, at all ages and truncat ed for the 35-64 year age group. Trends in age-standardized rates for major cancer sites are plotted from 1955 to 1994. Results: The age-sta ndardized (world standard) death certification rates from all neoplasm s steadily declined from the peak of 199.2/100,000 males in 1988 to 18 6.3 in 1994, and in females from 102.5 in 1989 to 98.6 in 1994. Ever l arger was the decline in truncated rates, for males from the peak of 2 75.1/100,000 in 1983 to 223.2 (-19%) in 1994, and for females from 151 .6/100,000 in 1987 to 136.4 (-10%). A major component of the favourabl e cancer mortality trends in males was lung cancer (accounting for 31, 000 deaths in both sexes combined in 1994), whose overall age-standard ized rates declined from 60.3 in 1987-89 to 54.6/100,000 males in 1994 (-9%), and from the peak of 96.7 in 1983 at ages 35 to 64 to 72.7 in 1994 (-25%). In contrast, female lung cancer rates have remained stabl e from 1992 onwards, but have increased from 7.2 to 7.7 at all ages an d from 10.6 to 11.0 at age 35-64 between 1985-89 and 1990-94. These di fferent trends in the two sexes reflect the patterns and trends in smo king among Italian males and females. Conclusions: Cancer mortality tr ends in Italy over the period 1990-94 were relatively favourable, main ly reflecting the decline in lung cancer rates in males, together with the persistent declines in gastric cancer in both sexes and in cervix uteri for women. Continuous advancements were registered for neoplasm s amenable to treatment, essentially testicular cancer, Hodgkin's dise ase and childhood leukaemias. The major unfavourable trends were obser ved for non Hodgkin's lymphomas, and require therefore further monitor ing, besides a clearer understanding of their determinants. Italy main tains an intermediate level of cancer mortality on a European scale, s uggesting that further progress is possible, mostly for tobacco-relate d neoplasms in males.