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R Capocaccia

Publications and source records attributed to R Capocaccia.

At least 73 records · Page 4Linked to original sources
PubMed1993

Relationships between incidence and mortality in non-reversible diseases.

The estimation of the incidence of chronic diseases from mortality and survival rates is shown to be attainable, under some simplifying hypotheses, through the solution of a convolution equation. Exact solutions are derived for the cases in which survival times of incident cases are exponential or gamma distributed. Applications to breast cancer, HIV infection and stomach cancer incidence in the Italian population are presented.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Trends in lung cancer mortality in three broad Italian geographical areas between 1969 and 1987.

Trends in death certification rates from lung cancer in broad Italian geographical areas (north/centre/south) were analysed over the period 1969-1987. In northern Italy, lung cancer rates in young and middle-aged males reached a peak between the mid and late 1970s, and tended to decline afterwards; only above age 60 was mortality still rising in the 1980s. A similar pattern of age-specific rates was observed in central areas, while in the South rates tended to level off in the early 1980s only below age 55, but were still upwards in subsequent age groups. Consequently, the north/south ratio for the overall age-standard rate increased slightly between the late 1960s and mid 1970s, from 1.68 (corresponding to a world standardised rate of 47.1/100,000 in the north vs. 28.1 in the south) to 1.73, but declined to 1.55 between 1985 and 1987 (for a rate of 69.1/100,000 males in the north vs. 44.6 in south). In the younger age groups a diverging pattern was observed: at ages of 25-34 rates in 1985 and 1987 were apparently higher in the south (1.0 vs. 0.9/100,000 in the north), and in the 35-44 age group the north/south ratio decreased from 1.7 to 1.2 (with rates of 12.9 and 10.7, respectively, in 1985 and 1987). Among females, lung cancer rates increased in all geographical areas and age groups except the youngest (25-34 years). Under the age of 50, the rises were proportionally similar in various geographical areas, thus widening the north/south difference in absolute terms. Above the age of 50, the north/south difference tended to be wider in relative terms too, reaching a factor of 2 in the 65-74 age group. The overall age-standardised north/south ratio for females increased from 1.51 in 1969-1974 (5.6 vs. 3.7/100,000) to 1.87 in 1985-1987 (8.4 vs. 4.5/100,000). These trends reflect changes in smoking habits in subsequent generations of Italian males and females from different areas of the country, and confirm the central role of cigarette smoking in lung cancer rates in various populations, although this does not exclude some influence by other, mainly occupational, lung carcinogens on the substantial differences in lung cancer rates in various Italian geographical areas.

Adult↗
PubMed1992

Estimated incidence and prevalence of female breast cancer in Italian regions.

Female breast cancer incidence and prevalence in Italy have been estimated by region and vast areas from population-based survival data of breast cancer patients and 1970-1987 specific mortality data using a mathematical model. Italian age-standardized incidence rates (ASR) for 1987 range from 70 to 90 per 100,000 women-year in the Northern regions, 55 to 73 in the Center, and 45 to 72 in the South. Overall, the ASR is about 80 in the North, 70 in the Center and 60 in the South. In the absence of competitive mortality, breast cancer cumulative risk in the 0-74 years life span is about 7 women out of 100 in the North, 6 in the Center and 5 in the South. The decreasing risk pattern from North to Center then South appears less evident when under 45 age-specific rates are considered. Very high levels for young age-groups are present both in the North (Liguria and Emilia Romagna) and South (Sardinia and Apulia). The incidence pattern by age differs from region to region and over the considered period, suggesting that a birth-cohort effect is crossing the whole country. Using to model, it can be estimated that the risk by cohort increases from the generations born at the beginning of the century to those born in the 40s, after which, for subsequent generations, it has been decreasing in all the considered areas and is similar in the North and South. We can infer that for the whole country the incidence will increase up to the years 2000-2010 when those birth-cohorts at higher risk will also be at higher risk for age. In 1987, about 250,000 Italian women had a present or past history of breast cancer: for the 1970-1987 period, prevalence has increased by approximately 5,500 cases per year.

Age Factors↗
PubMed1992

Survival for lung cancer in northern Italy.

From the population covered by the Lombardy Cancer Registry (northern Italy), all 2,259 lung cancer patients diagnosed from 1976 to 1981 were followed through 30 November 1989. The length of follow-up ranged from eight to 13 years. A special investigation on long-term survivors showed that a negligible proportion (0.01 percent) of errors occur in determining life status when an active follow-up is adopted. Age, stage, and histotype were found to be statistically significant, independent, prognostic factors in multivariate analysis both by the Cox model and by a model considering the relative survival. Observed survival was 29 percent at one year after diagnosis, 13 percent at two years, eight percent at three years, five percent at five years and two percent at 10 years. Survival decreased with age, but the youngest patients of both sexes showed lower survival compared with immediately subsequent ages. Among morphologically confirmed tumors, epidermoid carcinomas and adenocarcinomas showed the highest survival (38 percent and 33 percent at one year, respectively); small cell carcinomas showed the poorest prognosis (one-year survival, 23 percent). Beyond the second year after diagnosis, differences between histotypes became slighter. Survival according to stage showed a decreasing pattern from limited to advanced tumors, one-year figures being 41 percent for localized tumors, 27 percent for regional metastasis, and three percent for distant metastasis. Relative survival in Varese was compared with that reported by other cancer registries in Western countries: the variability noted could be related to different modalities of registration and to different distribution of clinical and demographic factors.

Adult↗
PubMed1992

[Trends in mortality from respiratory tract tumors in Italy, 1969-1987].

Trends of Italian death certification for cancers of the lung, larynx, pleura and nasal sinuses were analyzed for both sexes in the period from 1969 to 1987. For lung and laryngeal cancer, the analyses have been conducted for broad geographical areas within Italy (North, Center and South). Mortality rates for males aged 35-44 years consistently decreased in the North; increased until the late 1970's, and then decreased in the Center; and consistently increased in the South. In the 45-54 age group, mortality rates peaked in all areas between the late 1970's and the early 1980's, subsequently decreasing. For ages over 54 years, the rates continued to increase even in the 1980's. Female lung cancer rates increased in all areas and in all age groups over 35 years. In the 25-34 years old age group the rates decreased in the North and tended to increase in the Center and in the South. Below age 50, the increases were proportional in the three areas, while for older ages the increase was greater in the North both in absolute and proportional terms. Cohort effects showed a general increase for the generations born up to 1930, in both sexes and in all geographical areas. Different trends were observed for cohorts born after 1940: decreasing for both sexes in the North, and steady for men and increasing for women in the other areas. From the mid 1970's, laryngeal cancer standardized rates for 35-64 age group decreased, or at most remained constant, in all geographical areas. The decreasing tendency was more marked in men. Larynx cancer cohort effects for men were at a maximum for cohorts born around 1990, decreasing thereafter. In women, cohort effects appeared to consistently decrease. Overall rates of pleural cancer mortality increased during the period 1969-1987, and the sex ratio was stable, from 1980 onwards, at a value of about 2.4. Cohort effects showed, for pleural cancer, a general increase for all the cohorts. The increase was particularly apparent in male cohorts born after 1930. Overall mortality rates for cancer of the nasal sinuses was rather stable in both sexes from 1975 onwards. However, in the 35-64 year age group, mortality rates increase for males and decreased for females.

Adult↗
PubMed1992

[Incidence and prevalence of respiratory tumors in Italy. Estimation from mortality data].

This study estimates the incidence and prevalence of larynx and lung cancers using a mathematical model based on available data on specific mortality and survival. In Italy, larynx and lung cancers account for more than 95% of respiratory cancers. In this paper, estimates of age/sex-specific and age-standardized incidence rates and prevalence are presented for the years 1970 and 1987. Age and birth-cohort effects on incidence are also presented by sex and broad geographical area. The procedure was firstly validated using data from four cancer registries: Varese (Northern Italy), Parma (North-Central Italy), Florence (Central Italy), and Ragusa (Southern Italy). Estimates were then carried out at the national level and for each major geographical area (i.e. North, Center and South). Larynx cancer age-standardized incidence rates increased for men by about 25% from 1970 to 1987. Age-specific rates increased for ages greater than 44 years, but decreased for younger ages. Cohort effects are low for older cohorts; they steeply increase and plateau for the 1900-1905 cohorts, and then peak for the 1930 cohort. The risk for cohorts born after 1930 systematically decreases. We estimated that the 1930 birth cohort has a risk five times higher than the 1890 cohort. For women, the incidence rates increased by about 30% from 1970 to 1987, for all age classes. Cohort effects steadily increase from the 1886 birth cohort to the 1960 cohort. The estimated prevalence between ages 30 and 84 increased from about 24,400 cases in 1970 (23,000 males and 1,400 females) to about 51,400 cases in 1987 (48,600 males and 2,800 females). For men, 42% of the increase can be attributed to an increase in the incidence of the disease; 45% can be attributed to population aging, and only 13% to an increase in the survival probability. Corresponding figures for women are 42%, 48%, and 10%. For lung cancer, we estimated 32,000 incident cases for 1987 (28,000 men and 4,000 women), two times the corresponding figures for 1970 (14,000 men and 2,000 women). Looking at age-adjusted rates, the overall risk of lung cancer increased by about 60% for men and 52% for women during a period of 17 years. Age-specific incidence rates increased proportionally with age for ages greater than 50 years. By contrast, there was a slight but systematic risk reduction in younger age classes.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1991

Survival and age at diagnosis of breast cancer in a population-based cancer registry.

From the population covered by the Lombardy Cancer Registry, Italy, 1991 female breast cancer patients diagnosed from 1976 to 1981 were followed up until May 1987. Relative survival was 69% at 5 years and 58% at 10 years; median survival was 8.8 years. Ages 40-49 showed the best survival; ages 25-34 were 20% lower. From age 50 onwards, survival decreased progressively, with the exception of age group 65-74. We suggest that the best prognosis for ages 40-49, followed by the survival fall in subsequent ages, could be related to an anticipation of diagnosis in ages near menopause. The death hazard function showed a bimodal pattern, with a first peak in the first years after diagnosis, and a second one between the seventh and eighth years. The death hazard rate decreased by about 1% per year at each subsequent calendar year of diagnosis. When such an estimated calendar effect was taken in account, there were no considerable survival differences among Western countries covered by population-based cancer registries.

Adult↗
PubMed1991

[Problems of codification of cause of death: comparison of the mortality data of the ISTAT and the Regional Mortality Registry of Tuscany].

A two-part study was undertaken to assess the comparability of the coding of underlying cause of death between ISTAT (Central Statistics Office providing "national" mortality statistics) and RMR (Mortality Registry of Tuscany Region providing "local" mortality statistics). In Part I was compared mortality data of the Province of Florence (years 1985-1986) from the files of ISTAT with those of RMR. The source of the cause of death is the same for both systems (ISTAT certificate), but the data collection and coding of RMR are different from those of ISTAT. In Part II was compared a set of 219 Tuscany death certificates (year 1988) coded by ISTAT and RMR. The results showed an high degree of completeness of RMR (only--0.65% vs. ISTAT) and a satisfactory level of correspondence in the number of deaths for circulatory diseases, for neoplasms and for cancers of most important sites (lung, stomach, intestine, pancreas, breast). Discrepancies were found for some other diseases; for some of these causes of death, also age-adjusted mortality rates showed discrepancies (for example ischaemic heart disease). The cause of these differences have been analyzed.

Adolescent↗
PubMed1990

Breast cancer incidence and prevalence estimated from survival and mortality.

Survival probability for female breast cancer patients was used to estimate incidence rates from breast cancer mortality data in Italy. The female breast cancer survival curve from the Lombardy Cancer Registry (LCR) was used to test the method on data from four local cancer registries, covering areas in different regions of Italy. In spite of the well known geographic variability of female breast cancer incidence and mortality, the results support the idea that survival probability does not change across the country and that the survival probability from the LCR is a good estimate of that in the country as a whole. Female breast cancer incidence and prevalence rates were then estimated for Italy, making use of a mathematical model specifically developed for chronic diseases. In 1985, crude incidence and prevalence rates of female breast cancer, for ages up to 74 years, were estimated as 71 and 701 per 100,000 women, respectively. Estimated incidence rates show a complex trend with age, increasing to a temporary pronounced peak at the age of 52. A marked cohort effect was found to increase significantly the risk of the disease from the 1886 to the 1930 birth cohorts by a factor of 2.9. After the 1930 cohort, risks have continued at a constant high level.

Adult↗
PubMed1990

Life expectancy in Italian track and field athletes.

Nine hundred eighty-three top Italian track and field athletes (700 males and 283 females) were examined for survival, mortality and causes of death for an average follow-up period of 18.6 years starting from their last year of competition as members of the national team. Overall mortality rates were compared to the rates expected on the basis of the life tables for Italian people of the same age, sex and time period. Thirty-four deaths were observed among males (vs 46.6 expected) with a O/E ratio of 0.73, while 3 deaths were observed among women (vs 6.2 expected) with a O/E ratio of 0.48. Neither of these differences was significant, but the O/E ratio for the group as a whole was quite significant (p = 0.0296). Some of the athletes demonstrated behavioural characteristics developed during their active careers that might have contributed to their low mortality rate.

Adolescent↗
PubMed1990

[Mortality from liver cirrhosis in Italy: a two-component model for estimation of the quota attributable to alcohol].

Liver cirrhosis is considered as a double etiology disease, being its incidence and mortality associated either to alcohol consumption or to a previous viral hepatitis infection of type "B" or "neither A nor B". A two components mathematical model is here used to estimate the proportion of liver cirrhosis mortality attributable to alcohol consumption and the proportion from hepatitis. The model has been fitted to mortality data of the 95 Italian provinces in 5 periods of three years each from 1969 to 1983. In 1981-83, the first-component (interpretable as due to alcohol) is estimated to account for 31% in males and 28% in females of total mortality from liver cirrhosis. Estimates are given also for large geographical areas, regions and provinces.

Adult↗
PubMed1989

A method for the estimation of chronic disease morbidity and trends from mortality data.

Measures of chronic degenerative disease diffusion, such as incidence and prevalence rates, are a basic need for epidemiologists and others working in many fields of human sciences. Equations relating death probabilities to incidence and survival probabilities for chronic degenerative diseases are derived from a cohort point of view. A maximum likelihood approach is adopted for the estimation of incidence as a function of time related covariates. When time series of mortality data are available, the model can be used to describe and analyse levels and dynamics of morbidity. A trial application to lung and breast cancer is given for the province of Varese, Italy, where incidence data are available from the Lombardy Cancer Register.

Adult↗
PubMed1988

Mortality from liver cirrhosis in Italy: proportion associated with consumption of alcohol.

A descriptive analysis of the features of mortality from cirrhosis in Italy suggests that it is made up of two components which are characterized by different age trends. On the basis of this hypothesis, a model has been postulated and applied to the data for the 94 Italian provinces in order to identify the two components. When considering alcoholic drinking data, it appears that only one of these components is associated with the consumption of alcohol, both for men and for women. In this way an estimate can be made of the proportion of mortality in Italy which can be linked to alcohol consumption. For males, this is 40.4% (47.1% for the North, 29.7% for Central Italy, and 33% for the South/Islands). For females, the average is 24.6% (36.6% for the North, 16.2% for Central Italy, and 12.3% for the South/Islands). In absolute terms, these figures represent approx 5000 of the 13,000 deaths per year among males and around 1200 of the 5000 deaths from cirrhosis among females.

Adult↗
PubMed1987

Prediction of surgery for obstruction in Crohn's ileitis. A study of 64 patients.

The charts of 64 patients with Crohn's ileitis were reviewed to determine what characteristics at the time of first observation at a specialized center were predictive of surgery for irreversible obstruction, using Cox's proportional hazard model. Individual variables which proved significant (P less than 0.01) included age at presentation to the clinic, serum albumin, sedimentation rate, and the presence of radiologic strictures. Patients eventually requiring surgery were older than the rest because of a later date of symptom onset; furthermore, patients with strictures on initial x-rays had not been ill for a longer period of time than those who did not have strictures. These data suggest that fibrosis and stenosis are characteristic of a subgroup of Crohn's patients, rather than being inevitable phases of disease evolution. Multivariate analysis revealed that patients with low serum albumin, high sedimentation rate, and roentgenologic stenosis at first observation were ten times as likely to require surgery for obstruction at 10 years than those without any of these three unfavorable parameters.

Adult↗
PubMed1987

Erythrocyte fatty acid composition and gallstone disease: results of an epidemiological survey.

Within a cross-sectional study on the epidemiology of gallstone disease (GD) and its related factors, relation of GD to habitual dietary fat types has been investigated. Gallbladder status was assessed by ultrasound; fatty acid composition of the habitual diet was estimated by GLC of erythrocyte fatty acids. No differences in erythrocyte fatty acid composition were observed between women without gallstones, women with gallstones (aware and unaware of their condition), and women who had cholecystectomies. Multivariate analysis, including other diet-dependent and gallstone-related variables, showed no significant association between erythrocyte fatty acids and risk for gallstones. However, raised erythrocyte linoleic:saturated ratio was associated with increased risk for gallstones only in women with very low serum triglycerides. This latter finding needs further confirmation and is presently unexplainable. Our results suggest that dietary fatty acids do not play a major role in GD.

Adult↗
PubMed1986

Age, period, cohort and geographical area effects on the relationship between risk factors and coronary heart disease mortality. 15-year follow-up of the European cohorts of the Seven Countries study.

The effects of three major risk factors (i.e. serum cholesterol, systolic blood pressure and smoking habits) on prediction of coronary heart disease (CHD) mortality in relation to three nuisance variables--i.e. geographical location, age of subject at examination and period of examination--are analyzed using data from three different 5-year apart examinations of the Seven Countries Study and observations on CHD mortality in the corresponding 15-year follow-up period. First, a cross-classification exploratory analysis including both CHD-free subjects at entry and prevalence subjects, by different geographical areas, age classes and examination times is presented. Secondly, a logistic regression including the three major risk factors and the three nuisance variables, regarded both as confounders and effect modifiers is discussed. The prevalence status of the subjects is also considered as a nuisance variable in this second analysis. Results showed that: (a) there is a highly significant (p less than 0.001) marked decrease in the association between cholesterol level and CHD mortality with increasing age of subject; (b) a decreasing association with coronary heart disease mortality as age increases also holds for smoking habits (p less than 0.05). This association, however, tends to be reinforced with time (p less than 0.05), i.e. the relative risk of heavy smokers vs non-smokers is four times bigger in the period 1970-75, than in the period 1960-65, age and all other factors being equal; (c) a possible dependence of the association between systolic blood pressure and CHD on geographical area is suggested, although this finding could be the result of chance with a 10% probability.

Adult↗
PubMed1985

Estimation of cancer morbidity using mortality data.

Data on the incidence and prevalence of diseases provide an essential basis for several sanitary and epidemiologic purposes. Unfortunately, official routine statistics provide little, if any, reliable information on incidence and prevalence. The estimation of such indexes on the basis of other indirect statistics, such as mortality, can therefore be of great use. A mathematical model for degenerative diseases in a stationary population was applied to cancers occurring in the Varese province of Italy where comparative morbidity data were available from the Lombardy Cancer Register. A very good agreement between estimated and observed incidence rates was found for some cancers such as stomach and lung cancer. The agreement obtained in these cases suggests that model hypotheses may be usefully adopted. This conclusion can probably be extrapolated to the general population of Italy or other Italian areas characterized by a population structure which is similarly stationary.

Adult↗