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Geographic Inequalities in Breast Cancer in Italy: Trend Analysis of Mortality and Risk Factors

Author

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  • Paolo Giorgi Rossi

    (Servizio di Epidemiologia, Azienda Unità Sanitaria Locale—IRCCS di Reggio Emilia, Via Amendola 2, 42122 Reggio Emilia, Italy)

  • Olivera Djuric

    (Servizio di Epidemiologia, Azienda Unità Sanitaria Locale—IRCCS di Reggio Emilia, Via Amendola 2, 42122 Reggio Emilia, Italy
    Center for Environmental, Nutritional and Genetic Epidemiology (CREAGEN), Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Università 4, 41121 Modena, Italy)

  • Simone Navarra

    (National Institute of Statistics (Istat), Viale Liegi 13, 00198 Rome, Italy)

  • Alessandra Rossi

    (National Institute for Health, Migration and Poverty (INMP), Via di San Gallicano, 25/a, 00153 Rome, Italy)

  • Anteo Di Napoli

    (National Institute for Health, Migration and Poverty (INMP), Via di San Gallicano, 25/a, 00153 Rome, Italy)

  • Luisa Frova

    (National Institute of Statistics (Istat), Viale Liegi 13, 00198 Rome, Italy)

  • Alessio Petrelli

    (National Institute for Health, Migration and Poverty (INMP), Via di San Gallicano, 25/a, 00153 Rome, Italy)

Abstract

We calculated time trends of standardised mortality rates and risk factors for breast cancer (BC) from 1990 to 2016 for all women resident in Italy. The age-standardised mortality rate in Italy decreased from 4.2 in 1990 to 3.2 (×100,000) in 2016. While participation in organised screening programmes and age-standardised fertility rates decreased in Italy, screening invitation coverage and mammography uptake, the prevalence of women who breastfed and mean age at birth increased. Although southern regions had favourable prevalence of protective risk factors in the 1990s, fertility rates decreased in southern regions and increased in northern regions, which in 2016 had a higher rate (1.28 vs. 1.32 child per woman) and a smaller increase in women who breastfed (+4% vs. +30%). In 2000, mammography screening uptake was lower in southern than in northern and central regions (28% vs. 52%). However, the increase in mammography uptake was higher in southern (203%) than in northern and central Italy (80%), reducing the gap. Participation in mammographic screening programmes decreased in southern Italy (−10%) but increased in the North (6.6%). Geographic differences in mortality and risk factor prevalence is diminishing, with the South losing all of its historical advantage in breast cancer mortality.

Suggested Citation

  • Paolo Giorgi Rossi & Olivera Djuric & Simone Navarra & Alessandra Rossi & Anteo Di Napoli & Luisa Frova & Alessio Petrelli, 2020. "Geographic Inequalities in Breast Cancer in Italy: Trend Analysis of Mortality and Risk Factors," IJERPH, MDPI, vol. 17(11), pages 1-14, June.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:11:p:4165-:d:370147
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    References listed on IDEAS

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    1. Hastert, Theresa A. & Ruterbusch, Julie J. & Beresford, Shirley A.A. & Sheppard, Lianne & White, Emily, 2016. "Contribution of health behaviors to the association between area-level socioeconomic status and cancer mortality," Social Science & Medicine, Elsevier, vol. 148(C), pages 52-58.
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