Epidemiologia & Prevenzione最新文献

{"title":"[Cancer: when oblivion is a right].","authors":"Redazione di Epidemiologia Prevenzione","doi":"10.19191/EP24.2.047","DOIUrl":"https://doi.org/10.19191/EP24.2.047","url":null,"abstract":"","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"48 2","pages":"116-117"},"PeriodicalIF":1.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141072283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in access to breast, colorectal, and cervical cancer screening programmes have intensified during the pandemic period. Findings of a health equity audit conducted by the Pavia Healthcare Protection Agency (Lombardy Region, Northern Italy)","authors":"Daniela Girardi, Riccardo Vecchio, Marina Tanious, Stefano Cacitti, Cinzia Ancarani, Simona Dalle Carbonare, Pietro Perotti, Chiara Bonafede, Roberta Cavallo, Leandro Gentile, Andrea Parrini, Erika Maria Lucente, Alessandro Carlesso, Ennio Cadum, Lorella Cecconami, Anna Odone, Silvia Deandrea","doi":"10.19191/EP24.2.A672.040","DOIUrl":"10.19191/EP24.2.A672.040","url":null,"abstract":"<p><strong>Objectives: </strong>to evaluate the disparities in access to cancer screening programmes in the Province of Pavia (Lombardy Region, Northern Italy), along with identifying the factors influencing these disparities; to assess the impact of the pandemic emergency on invitation and screening coverage in the three organized screening programmes, which are provided free of charge to the target population.</p><p><strong>Design: </strong>observational retrospective study covering both the pre-pandemic and the pandemic periods.</p><p><strong>Setting and participants: </strong>for breast cancer screening, the eligible population comprises women aged 45 to 74; colorectal cancer screening is offered to men and women aged 50 to 74; cervical cancer screening is tailored based on women age. The management of all three screening programmes is overseen by the Health Protection Agency of Pavia, which proactively invites the eligible population through invitation letters.</p><p><strong>Main outcomes measures: </strong>for each screening programme, the examination coverage (the number of screened individuals out of the total eligible population) was analysed considering its influencing factors, with a specific emphasis on equity-related factors such as demographics (sex, age), geographic factors (country and continent of birth, residential district), comorbidities.</p><p><strong>Results: </strong>the SARS-CoV-2 pandemic has led to a reorganization of healthcare services and to a reduction of the offer, resulting in an overall reduction in test coverage for all three programmes (-16.3% for breast and colorectal cancer screening, -8.5% for cervical cancer screening). The disparities in coverage among various population groups, reflecting inequalities in access, further escalated from the pre-pandemic to the pandemic period. Noteworthy, equity-related predictors of reduced screening access were non-Italian nationality and residency in rural or mountainous districts.</p><p><strong>Conclusions: </strong>during periods of healthcare system strain, such as the pandemic, disparities in access can become more pronounced. It is crucial to implement measures for enhancing access to screening in a more equitable manner.</p>","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"48 2","pages":"130-139"},"PeriodicalIF":1.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141072210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[For a more effective health impact assessment (HIA)].","authors":"Fabrizio Bianchi, Carla Ancona, Lucia Bisceglia, Andrea Ranzi","doi":"10.19191/EP24.2.10.19191/EP24.2.A366.033","DOIUrl":"10.19191/EP24.2.10.19191/EP24.2.A366.033","url":null,"abstract":"","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"48 2","pages":"100-101"},"PeriodicalIF":1.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141072287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A top-down path to promote environmental justice in a contaminated area. The experience with the community of Porto Torres (Sardinia, Italy)].","authors":"Roberto Pasetto, Daniela Marsili","doi":"10.19191/EP24.2.A687.030","DOIUrl":"10.19191/EP24.2.A687.030","url":null,"abstract":"<p><p>Nowadays, in Italy, researchers from various disciplines and institutions are referring to environmental justice to promote health equity in relation to environmental risks and benefits. This presents an opportunity for the convergence of bottom-up and top-down perspectives, which differ in nature, to advance environmental justice at the local level. This contribution presents the experience of researchers from the Italian National Institute of Health in the contaminated area of Porto Torres (Sardinia). The experience began with the development of study activities aimed at describing the health profile of the population residing in Porto Torres. These activities embraced the requests of the local community and included interactions with local institutional and social actors. The study activities were designed with a focus on environmental justice, which requires an understanding of the local context and of its history. The contribution describes the various stages that led from the development of the study to the engagement with local institutional and social actors, communication of study results, and participation in local initiatives on environmental justice. Finally, the text proposes some considerations on how researchers from a central institution can develop and conduct study activities to promote environmental justice at the local level.</p>","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"48 2","pages":"165-171"},"PeriodicalIF":1.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stillbirths: results of a pilot population-based surveillance system in Italy (SPItOSS)","authors":"Michele Antonio Salvatore, Silvia Salvi, Paola D'Aloja, Patrizia Vergani, Roberto Bellù, Carlo Dani, Federico Mecacci, Maria Rosa D'Anna, Maria Grazia Privitera, Serena Donati","doi":"10.19191/EP24.2.A630.041","DOIUrl":"10.19191/EP24.2.A630.041","url":null,"abstract":"<p><strong>Objectives: </strong>to describe the results of a pilot population-based perinatal mortality surveillance system, with regards to stillbirths; to study maternal, obstetric, and foetal characteristics, evaluating risk factors and understanding causes.</p><p><strong>Design: </strong>a cross-sectional study was conducted on incident cases of stillbirths collected by the surveillance system from July 2017 to June 2019 in three Italian Regions (Lombardy, Tuscany, and Sicily).</p><p><strong>Setting and participants: </strong>data on stillbirths, resulting from the in-hospital multidisciplinary audits, organised using the Significant Event Audit methodology, were analysed. According to the World Health Organization (WHO) definitions, the project identified stillbirths as foetuses born dead >=28 weeks of gestation. The WHO International Classification of Diseases-Perinatal Mortality was used to categorise the causes of foetal death.</p><p><strong>Main outcomes measures: </strong>maternal characteristics, obstetric and foetal findings were investigated. Unadjusted relative risks and 95% confidence intervals were computed with respect to the background population. Finally, causes of death and contributing maternal conditions have been considered.</p><p><strong>Results: </strong>the maternity and neonatal units of the three participating Regions notified 520 stillbirths, of which 435 cases underwent to the multidisciplinary audit (83.7%); 40.0% of cases occurred in the gestational age range between 36 and 39 weeks. The risk of stillbirth was significantly increased in mothers with foreign citizenship (RR: 1.39; 95%CI: 1.13-1.71), multiple pregnancies (RR: 1.59; 95%CI 1.05-2.42), and pregnancies conceived with assisted reproductive technologies (RR: 2.15; 95%CI 1.45-3.19). The rate of congenital malformations was 6.0%. A diagnosis of foetal growth restriction was reported in 10.3% of cases, although the percentage of dead foetuses weighting <10° centile was at least twice in almost all gestational age periods. Post-mortem and placental histological examinations were carried out in more than 70% and more than 90% of cases, respectively.</p><p><strong>Conclusions: </strong>the implementation of a population-based surveillance system with high participation rate of maternity units and the use of universally accepted definitions could improve the identification of stillbirth avoidable risk factors and potentially modifiable predisposing maternal conditions, highlighting issues of perinatal assistance in need of improvement.</p>","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"48 2","pages":"140-148"},"PeriodicalIF":1.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141072211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Considerations on the Italian NHS].","authors":"Giovannino Ciccone","doi":"10.19191/EP24.2.035","DOIUrl":"https://doi.org/10.19191/EP24.2.035","url":null,"abstract":"","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"48 2","pages":"107-108"},"PeriodicalIF":1.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141072286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The importance of the details in the evaluation of screening programmes].","authors":"Silvia Candela","doi":"10.19191/EP24.2.036","DOIUrl":"https://doi.org/10.19191/EP24.2.036","url":null,"abstract":"","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"48 2","pages":"109-110"},"PeriodicalIF":1.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141072291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Priorities and tools to evaluate the effectiveness of Italian National Health Service interventions: spotlight on the current debate].","authors":"Lucia Bisceglia, Carla Ancona, Luigi Bisanti, Silvia Candela, Elisabetta Listorti, Francesca Mataloni, Lorenzo Richiardi, Giuseppe Traversa, Maria Luisa Clementi, Francesco Forastiere","doi":"10.19191/EP24.2.034","DOIUrl":"https://doi.org/10.19191/EP24.2.034","url":null,"abstract":"","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"48 2","pages":"102-106"},"PeriodicalIF":1.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141072290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Climate crisis and Saharan dust advections in Italy: a relevant issue on the public health agenda].","authors":"Matteo Renzi, Simona Vecchi, Paola Michelozzi","doi":"10.19191/EP24.2.038","DOIUrl":"10.19191/EP24.2.038","url":null,"abstract":"","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"48 2","pages":"113-115"},"PeriodicalIF":1.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Analysis of predictive factors for non-adherence to organized screening for colorectal and breast cancers in the pre-pandemic period (2018-2019) in Lombardy Region (Northern Italy)].","authors":"Antonio Giampiero Russo, Rossella Murtas, Paola Ballotari, Luca Cavalieri d'Oro, Maria Letizia Gambino, Anna Clara Fanetti, Giovanni Maifredi, Federica Manzoni, Giuseppe Sampietro, Olivia Leoni, Corrado Celata, Danilo Cereda, Silvia Deandrea","doi":"10.19191/EP24.2.A720.039","DOIUrl":"https://doi.org/10.19191/EP24.2.A720.039","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;according to the International Agency for Cancer Research on Cancer, in 2022, breast cancer is the most common cancer in the Italian population, followed by colorectal cancer. Oncological screenings represent an effective secondary prevention strategy to counteract colorectal and breast cancers, significantly reducing mortality. In Lombardy Region (Northern Italy), screening programmes have been active since 2007, but adherence, especially in specific population subgroups, remains lower than expected.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;to analyse potential predictors of non-adherence to colorectal and breast cancer screening in the Lombardy Region during the pre-pandemic period of 2018-2019.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;a retrospective cohort study aimed at investigating the role of sociodemographic variables, health status, and access to the healthcare system on non-adherence to colorectal and breast cancer screening. Statistical analyses were conducted separately by each Agency for Health Protection (ATS). The results of the models were synthesized across the Lombardy region through random-effects meta-analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting and participants: &lt;/strong&gt;residents within the territory of each ATS in Lombardy as of 01.01.2018 and aged between 49 and 69 years at the beginning of the follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes measures: &lt;/strong&gt;adherence to colorectal and breast cancer screenings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;during the study period, across the Lombardy Region, 2,820,138 individuals were eligible to participate in colorectal cancer screening, and 1,357,344 women were eligible to participate in breast cancer screening, with an invitation coverage of 87% and 86%, respectively.For breast cancer screening, older age, cardiopathy, chronic obstructive pulmonary disease (COPD), inflammatory bowel diseases (IBD), autoimmune diseases, and presence of a rare disease are associated with a reduced risk of non-adherence. Conversely, foreign citizenship, oncological diagnosis, transplant, chronic kidney disease/dialysis, diabetes, heart failure, arterial or cerebral vasculopathy, and presence of a neurological diagnosis are associated with significant excess risks of non-participation. For colorectal cancer screening, factors favouring adherence include female gender, older age, cardiopathy, COPD, autoimmune diseases, and having access/utilization of primary care. Non-adherence is associated with foreign citizenship, transplant, chronic kidney disease/dialysis, diabetes, heart failure, arterial or cerebral vasculopathy, IBD, neurological diseases, residence in assisted living facilities, use of integrated home care, and presence of disability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;this is the first study conducted in the Lombardy Region which explores the theme of equity of access to organized screenings. This analysis highlights how sociodemographic determinants, chronic conditions, and access to the health","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"48 2","pages":"118-129"},"PeriodicalIF":1.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141072281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}