Tumors: in 2022 there are 390,700 new cases estimated but there is a post-Covid “rebound” on diagnoses. Index focused on lifestyles. Schillaci: «40% of cases and 50% of deaths can be avoided by intervening on risk factors». Even triple risk with Sars-CoV-2: get vaccinated | Healthcare24

In 2022, in Italy, 390,700 new cancer diagnoses are estimated (in 2020 they were 376,600), 205,000 in men and 185,700 in women. In two years, the increase was 14,100 cases. The most frequently diagnosed cancer in 2022 was breast cancer (55,700 cases, +0.5% compared to 2020), followed by colorectal cancer (48,100, +1.5% in men and +1.6% in women). women), lung (43,900, +1.6% in men and +3.6% in women), prostate (40,500, +1.5%) and bladder (29,200, +1.7% in men and +1.5% in women). 0% in women). In 2020, the pandemic led to a drop in new diagnoses, partly linked to the interruption of cancer screening and the slowdown in diagnostic activities, but today we are witnessing a recovery in cancer cases as in other European countries. Which risks getting worse, if a barrier to incorrect lifestyles is not put in place: 33% of adults are overweight and 10% obese, 24% smoke and sedentary people have increased from 23% in 2008 to 31% in 2021. On the other hand, the resumption of screening programs, which returned to pre-pandemic levels in 2021, should be read positively, in particular mammography reaches 46% coverage, 30% for the colorectal and 35% for the cervix. The reactivation of secondary prevention programs corresponds to an increase in the number of surgeries for colorectal and breast cancer, even at an early stage. And in cancer care, the anti-Covid vaccination plays a leading role. The risk of death, among people with a history of cancer and positive for SARS-CoV-2 infection, is 2-3 times higher among those who are not vaccinated than those who are vaccinated.
It is the official census, now in its twelfth edition, which describes the aspects relating to the diagnosis and therapy of neoplasms thanks to the work of the Italian Association of Medical Oncology (AIOM), AIRTUM (Italian Association of Cancer Registries), AIOM Foundation, National Screening Observatory ( ONS), PASSI (Progress of Health Trusts in Italy), PASSI d’Argento and the Italian Society of Pathological Anatomy and Diagnostic Cytology (SIAPeC-IAP), collected in the volume “The numbers of cancer in Italy 2022”, presented at a press conference in Rome, at the Ministry of Health.
«The increase to 390,700 in the absolute number of cases in 2022 raises questions for which there are currently no exhaustive answers – says Saverio Cinieri, President of Aiom -. These estimates for Italy for 2022 seem to indicate an increase in the absolute number of cancers, largely linked to the aging of the population, in apparent contrast with the decreasing trend of incidence rates observed if, hypothetically, we consider unchanged the age of citizens. These updated data invite more and more to strengthen actions to counter diagnostic delay and to promote secondary and above all primary prevention, acting on the control of risk factors starting from tobacco smoke, obesity, physical inactivity, abuse of alcohol and the need to promote vaccinations against infections known to cause cancer, such as HPV”.
Minister Schillaci’s intervention. We are finally overcoming the emergency phase of Covid-19, we can draw a balance of the side effects of the pandemic and among these one of the most harmful is represented by the sharp slowdown and in some cases the suspension of cancer screenings, especially during the first wave. These interruptions have led to missed diagnoses and an increase in the incidence of oncological diseases that we will discount in the years to come», said Health Minister Orazio Schillaci speaking at the presentation of the Report. “The risk of death, among people with a history of cancer and positivity for Sars-CoV-2 infection, is 2-3 times higher among those who are not vaccinated than those who are vaccinated,” Schillaci specified, inviting these fragile patients to get vaccinated. . «The pandemic – he said – has further highlighted the fragility of the health care offer, making the need to intervene by overcoming inequalities even more evident. I reiterate my commitment to rapid approval of the National Oncology Plan as part of actions to strengthen the prevention, diagnosis, treatment and assistance of cancer patients throughout the country. On the occasion of the EU Council, I supported the adoption of a recommendation which, in addition to strengthening screening programmes, extends them to cancers which are not currently included. Strong investments in research are also needed – Schillaci said – with particular attention to omics science, biomedical research and artificial intelligence techniques. For my part, there is a great commitment to supporting any initiative useful for strengthening investments for ever more effective research, diagnosis and treatment approaches, for the protection of all patients and in support of operators, patients and family members».
Raise citizens’ awareness of primary prevention rules. «The Passi data on lifestyles confirm the non-optimal adherence of citizens to a healthy lifestyle – says Maria Masocco, scientific manager of the surveillance systems PASSI and PASSI d’Argento, coordinated by the Istituto Superiore di Sanità -. From the analysis of the historical series of behavioral risk factors, it emerges that there have not been great improvements in the last 15 years and, with the exception of the habit of smoking cigarettes which has continued its slow reduction for over thirty years, the consumption of alcohol at risk, a sedentary lifestyle and excess weight, on the whole, worsen or remain stable. Not only. In the midst of the pandemic, during the two-year period 2020-2021, these trends underwent changes mostly in a pejorative sense. The impact of the pandemic on lifestyles is more visible in 2020 and seems, in part, to return in 2021. But efforts to raise citizens’ awareness of the importance of primary prevention must not stop”.
As emerges from the survey involving 10 pathological anatomies for breast cancer and 12 for colorectal cancer, the number of breast cancers operated on in 2020 was 4.7% lower (-151 cases) compared to 2019, to then go back up in 2021 (+ 441 cases, + 14.5%). In 2020, the number of colorectal cancers operated on was 10.8% lower (-238 cases) compared to 2019, while it increased by 233 cases (+11.9%) in 2021 compared to 2020. «This edition contains the update to 2021 of the survey contained in the last edition on the impact of Sars-CoV-2 infection on breast and colorectal cancer surgery – highlights Guido Mazzoleni, Bolzano Health Authority, Cancer Registry of Bolzano, SIAPeC-IAP contact person -. The updated results show, in general and for both tumors, an increase in cases operated on in 2021 compared to 2020 and an increase in the percentage of pTis tumors, i.e. in the initial stage, in 2021 compared to previous years, both in the breast and in the colorectal, confirming a resumption of cancer screening. Furthermore, an increase in both neoplasms of the N0 and N1a categories should be reported, a likely indicator of an earlier management of diagnosed tumors”.
Screening, Italy at 2 and also at 3 speeds. Indeed, in 2021 a return to pre-pandemic data is observed also with regard to the coverage of secondary prevention programmes. For mammography, the Italian average value, which in 2020 stood at 30%, in 2021 returns in line (46.3%) with the coverage values ​​(i.e. the proportion of women who have had mammography out of the total population having law) for the period 2018-2019. For colorectal screening (search for occult blood in the stool) the overall value was around 30%, to decrease to 17% in 2020 and go back up to 30% in 2021. Cervical screening had pre-pandemic values ​​around 38-39 %, a drop to 23% in 2020 and a level of coverage of 35% in 2021. «These data give us a country with two, if not three speeds, but also with considerable capacity to respond to emergencies – underlines Paola Mantellini, Director of the National Screening Observatory -. Most screening activities did not stop during the pandemic, but Covid-19 has highlighted even more the fragility of these programs, already evident in the pre-pandemic era. The goal is not to make up for the delays induced by the health emergency, but to obtain optimal coverage levels which, in certain areas of the country and for some programmes, were not achieved even before the pandemic. Because the higher the levels of coverage, the greater our ability to diagnose the disease at an early stage. It is in fact important to point out that, within each single macro-area, there are Regions with greater recovery capacity and others in evident difficulty also in 2021″.
The Covid risk for fragile patients. A chapter of the book is dedicated to the impact of Covid on cancer patients. «In Italy, the pandemic has caused an increase in the mortality of cancer patients, especially in males, in old age, with cancer diagnosed less than 2 years ago and in hematological neoplasms – explain Fabrizio Stracci, (AIRTUM President) and Diego Serraino (Director , SOC Oncological Epidemiology and Cancer Registry of Friuli Venezia Giulia, Oncological Reference Center, IRCCS, Aviano) -. It is essential that fragile patients, including cancer patients, get vaccinated. In fact, a study of all residents in Friuli Venezia Giulia and in the province of Reggio Emilia has shown that the risk of death among individuals with a history of cancer and positive for SARS-CoV-2 infection is 2-3 times higher among the unvaccinated compared to the vaccinated”.
The “cohabitants” and the healed. Compared to the 2.5 million citizens living in Italy in 2006 with a previous diagnosis of cancer, this rose to around 3.6 million in 2020, 37% more than observed just 10 years earlier. The increase was particularly marked for those living more than 10 or 15 years after diagnosis. In 2020, approximately 2.4 million people (65% of the total) have been diagnosed for more than 5 years, while 1.4 million (39% of the total) have been diagnosed for more than a decade. More than a quarter (27%) of those living after a cancer diagnosis have recovered.
«In the vast majority of cases, a person free from disease more than 10 years after the end of treatment can, in the absence of a recurrence, be considered cured – concludes Giordano Beretta, President of the Aiom Foundation -. Exceptions to this rule are some tumors in which the healing time is longer and neoplasms arising in childhood and adolescence, in which 5 years may be enough. The fact that a person who has been diagnosed with an oncological pathology can be considered cured represents a radical paradigm shift, which also becomes a motivating element for adherence to screenings, once it is understood that healing is so much the easier the earlier the diagnosis. In Italy, however, recovered cancer patients still risk encountering concrete difficulties when, for example, they try to take out life insurance or apply for a mortgage or bank loan. This is why it is essential to implement, also in Italy, a law on the ‘Right to be Forgotten’, following the example of other European countries».