In the year 1992, 3,392 new cases of cancer, including 1,829 males and 1,563 females, were diagnosed in residents of the Modena Province. The crude incidence rate per 100,000 population was 620 for men and 503 for women. Age-standardized to the World population, incidence rates decreased to 333 and 247 respectively, with a male to female ratio of 1.3:1.
The five most common new cancers were breast (432 cases), lung (401), colon (250), bladder (210) and stomach (194). For the first time, breast cancer turned out to be more frequent than lung cancer. Most cancers showed similar incidence rates in men and women. Exceptions were thyroid cancers, which showed a higher incidence in women (female to male ratio = 2.9:1), and lung (male to female ratio = 6.3:1), bladder (3.4:1), and kidney cancers (1.8:1) which exhibited a higher incidence in men.
The lifetime cumulative risk of developing a cancer was 330 per 1,000 and 237 per 1,000 for men and women, respectively.
In terms of mortality, 1,057 men and 756 women died of cancer in 1992, the crude mortality rate being 358 in men and 243 in women. Age-standardized to the world population these rates become 180 and 97 per 100,000, respectively.
The most frequent causes of death in men were cancers of the lung (366 cases), stomach (91 cases) and prostate (82 cases). In women, the most frequent causes of death were cancers of the breast (139 cases), colon (76 cases) and stomach (70 cases). Breast cancer (18.4%) and lung cancer (34.7%) resulted by far the most frequent causes of death in women and men, respectively.
The mortality/incidence ratio was 0.58 in men and 0.48 in women.
The median age at diagnosis of cancer was 67 years for both sexes.
Stomach cancer, decreasing from 264 cases in 1988 to 194 in 1992 (-26.5%) and breast cancer, increasing from 338 cases in 1988 to 431 in 1992, were the only two cancers which showed significant differences in incident rates.
The proportion of cases with histologic diagnosis was 82% in men and 86% in women, whereas the proportion of cases registered on a "death certificate only" basis was 2.5%.
This volume also publishes the 5-year survival data relative to all cases of cancer (excluding non-melanoma skin cancers) diagnosed in 1988-91. Through the collaboration of the General Registry Offices of the municipalities of the Modena Province, it was possible to complete the follow-up in 99,8% of cases. The relative median survival was 44 months for all sites (37 months in men and 51 months in women).
The higher 5-year survival rate observed in women reflects the different survival rates exhibited by lung (which is predominantly a disease of men) and breast cancer (which affects women in 99% of cases).
Cancers of the pancreas (5-year relative survival rate of 3%), liver (4%), esophagus (5%) and lung (10%) were associated with a very poor prognosis. Cancers showing the highest cure rate were those of the testis (100%), thyroid (89%) and Hodgkin's disease (84%) in men, and those of the thyroid (84%), corpus uteri (82), and breast (78%) in women.
In patients with breast and lung cancer, survival was also calculated according to the disease stage. A significant increase in the percentage of cases diagnosed at stage I was observed in breast cancer, whereas no differences in stage distribution were recorded in the group of patients with lung cancer.
Index