Abstract
In a previous survey of newly diagnosed haematological malignancies (HMs) in Sardinia from 1974 to 1993, we observed a marked increase in the incidence of many HMs that we chiefly attributed to improvements in case ascertainment. To better define the nature of this increase, we extended the survey by an additional decade (1994–2003), applying the same previously used methods. The incidence of HMs further increased from 1994 to 2003. The incidence rate of total HMs (THMs), standardised to the world population, was 30.15 × 105 person-years vs. 21.58 from 1984 to 1993 and 15.26 from 1974 to 1983. The temporal variations in the incidence differed in different HMs and were correlated with the diseases clinical characteristics and the increased availability of diagnostic tools and skills in Sardinia. These observations support the hypothesis that the temporal differences in the incidence rates observed for many HMs in Sardinia over the 30-year survey period were caused by temporal differences in diagnostic efficiency rather than by disease occurrence. An important exception was the increase in non-Hodgkin’s lymphoma, which represents a true increase in occurrence, similarly to most Western countries. The incidence rates of HMs already having or reaching stable values in the decade 1994–2003 were similar to those of most Western countries. No significant evidence emerged to suggest that Sardinian particularities influenced the occurrence of HMs. This study demonstrates the extent to which diagnostic efficiency can influence incidence evaluations and emphasises the importance of prolonged observation to determine the validity of incidence rates for both temporal and geographic comparisons.
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Bernardinelli L, Maida A, Marinoni A, Clayton DG, Romano G, Montomoli C, Fadda D, Solinas G, Castiglia P, Cocco PI, Ghislandi M, Berzuini C, Pascutto C, Nerini M, Styles B, Capocaccia R, Lispi L, Mallardo E (1994) Atlas of cancer mortality in Sardinia 1983–1987. Direzione Progetto FATMA CNR, Rome
Biggeri A, Lagazio C, Catelan D, Pirastu R, Casson E, Terracini B (2006) Report on health status of residents in areas with industrial, mining or military sites in Sardinia, Italy. Epidemiol Prev 30(1 Suppl 1):5–95
Broccia G, Deplano W, Dessalvi P, Giannico B, Luxi G, Chessa E, Murru A (2004) Haematological malignancies in the island of Sardinia 1974–1993: age and sex distributions and temporal changes in incidence. Hematol Oncol 22:91–109
Centers for Disease Control and Prevention (2003) Epi Info 2002 software, revision 2. Centers for Disease Control and Prevention. Atlanta, GA
Plummer M (1977) Age standardization. In: Parkin DM, Whelan SL, Ferlay J, Raymond L, Young J (eds) Cancer incidence in five continents, vol. 7. IARC, Lyon, pp 66–68
Smith A, Howell D, Patmore R, Jack A, Roman E (2011) Incidence of haematological malignancy by sub-type: a report from the Haematological Malignancy Research Network. Br J Cancer 105:1684–1692
Sant M, Allemani C, Tereanu C, De Angelis R, Capocaccia R, Visser O, Marcos-Gragera R, Maynadié M, Simonetti A, Lutz JM, Berrino F (2010) Incidence of hematologic malignancies in Europe by morphologic subtype: results of the HAEMACARE project. Blood 116:3724–3734
Morton LM, Wang SS, Devesa SS, Hartge P, Weisenburger DD, Linet MS (2006) Lymphoma incidence patterns by WHO subtype in the United States, 1992–2001. Blood 107:265–277
National Cancer Institute (2012) Surveillance, epidemiology, and end results. http://www.seer.cancer.gov/statfacts. Accessed 7 June 2012
Xie Y, Davies SM, Xiang Y, Robinson LL, Ross JA (2003) Trends in leukemia incidence and survival in the United States (1973–1998). Cancer 97:2229–2235
McNally RJ, Roman E, Cartwright RA (1999) Leukemias and lymphomas: time trends in the UK, 1984–93. Cancer Causes Control 10:35–42
Cancer Research UK (2012) CancerStats: cancer statistics for the UK. http://www.canceresearchuk.org/cancer-info/cancerstats. Accessed 7 June 2012
Maynadié M, Girodon F, Manivet-Janoray I, Mounier M, Mugneret F, Bailly F, Favre B, Caillot D, Petrella T, Flesch M, Carli PM (2011) Twenty-five years of epidemiological recording on myeloid malignancies: data from the specialized registry of hematological malignancies of Cote d’Or (Burgundy, France). Haematologica 96:55–61
Associazione Italiana dei Registri Tumori (2012) Tumori in Italia, versione 1. http://www.registri-tumori.it. Accessed 12 September 2012
Devesa SS, Fears T (1992) Non-Hodgkin’s lymphoma time trends: United States and international data. Cancer Res 52:5432s–5440s
Carli PM, Boutron MC, Maynadie M, Bailly F, Caillot D, Petrella T (1994) Increase in the incidence of non-Hodgkin’s lymphomas: evidence for a recent sharp increase in France independent of AIDS. Br J Cancer 70:713–715
Muller AMS, Ihorst G, Mertelsmann R, Engelhardt M (2005) Epidemiology of non-Hodgkin’s lymphoma (NHL): trends, geographic distribution and etiology. Ann Hematol 84:1–12
Alexander DD, Mink PJ, Adami HO, Chang ET, Cole P, Mandel JS, Trichopoulos D (2007) The non-Hodgkin lymphomas: a review of the epidemiological literature. Int J Cancer 120:1–39
Dores GM, Anderson WF, Curtis RE, Landgren O, Ostroumova E, Bluhm EC, Rabkin CS, Devesa SS, Linet MS (2007) Chronic lymphocytic leukaemia and small lymphocytic lymphoma: overview of the descriptive epidemiology. Br J Haematol 139:809–819
van den Broek EC, Kater AP, van de Schans SA, Karim-Kos HE, Janssen-Heijnen ML, Peters WG, Nooijen PT, Coebergh JW, Posthuma EF (2012) Chronic lymphocytic leukaemia in the Netherlands: trends in incidence, treatment and survival. Eur J Cancer 48:889–895
Turesson I, Velez R, Kristinsson SY, Landgren O (2010) Patterns of multiple myeloma during the past 5 decades: stable incidence rates for all age groups in the population but rapidly changing age distribution in the clinic. Mayo Clin Proc 85:225–230
Jensen MK, de Nully BP, Nielsen OJ, Hasselbach HC (2000) Incidence, clinical features and outcome of essential thrombocythaemia in a well-defined geographical area. Eur J Haematol 65:132–139
Rollison DE, Howlader N, Smith MT, Strom SS, Merritt WD, Ries LA, Edwards BK, List AF (2008) Epidemiology of myelodisplastic syndromes and chronic myeloprolipherative disorders in the United States, 2001–2004, using data from the NAACCR and SEER programs. Blood 112:45–52
Acknowledgments
The majority of this research was performed on a voluntary basis and with personal funds.
Several cases from decade 3 were retrieved from hospital archives under the supervision of G. B. by a staff supported by funds from the ASL 8-Cagliari in agreement with the chief investigator, Prof. Cocco PL. Other cases were obtained by the EpiLymph project and kindly communicated by Prof. Cocco PL. We are particularly indebted for their important help to Dr. G. Murgia of Paediatric Oncology in Cagliari, Prof. G. Faa of the University Pathology Dept. in Cagliari, Dr. G. Tolu of the Pathology Dept. in Oristano and Eng. Francesca Frexia of CRS4 (Centro di Ricerca, Sviluppo e Studi Superiori in Sardegna-Pula, Cagliari) for their fundamental help.
Special thanks to Sisar (Sistemi Archiviazione—Sestu, Cagliari) for their professional skills and kindness and for generously making the clinical records in their archives available to us.
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The authors declare that they have no conflicts of interest.
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This paper is dedicated to the memory of Prof. Maurizio Longinotti, to remember his long and passionate work in improving knowledge and sanitary assistance for the Haematologic Malignancies in the island of Sardinia.
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Broccia, G., Longinotti, M., Gabbas, A. et al. A 30-year epidemiologic survey (1974–2003) of haematological malignancies on the island of Sardinia: temporal changes in incidence and a geographic comparison of incidence rates. Ann Hematol 93, 1041–1049 (2014). https://doi.org/10.1007/s00277-013-2002-z
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DOI: https://doi.org/10.1007/s00277-013-2002-z