Malignancies among adolescents and young adults in the province of Trieste,Italy, 1972-1993

We analysed incidence, survival and mortality from cancer among people aged 15-24 years resident in the province of Trieste, Italy, during 1972-1993, and evaluated the quality of the local diagnostic facilities and of the care provided by local hospital departments. We compared the results with those previously published on childhood cancer. We recorded 118 new cases of cancer (96% microscopically verified) corresponding to a rate, age-standardized to the world population, of 162.3 (standard error SE = 15.0) per million person-years. The diagnostic group with the highest rate was that of carcinomas (54.5; SE = 8.7; 40 cases). The diagnosis was reached at hospitals in the province of Trieste for 107 cases, with a median time of nine days (25th-75th percentile = 5-23) between admission and diagnosis. Among patients with leukaemias, lymphomas and brain tumours, this interval was longer than in children affected by the same neoplasms. One girl with cancer of the uterine cervix refused all treatment. The therapy of the other 117 cases were co-ordinated by 29 different departments of hospitals located in Trieste for 86 cases, in other Italian hospitals for 26 cases and in European hospitals for five cases. On the other hand, out of 123 childhood cancers 107 were co-ordinated by three departments in Trieste, seven by other Italian hospitals and nine by foreign hospitals. The 10-year survival probabilities of children with acute lymphoblastic leukaemia and non-Hodgkin lymphomas were higher than those of patients aged 15-24 years: 66.7% (SE = 9.1) vs 14.3% (SE = 13.2) and 77.8% (SE = 13.9) vs 40.0% (SE = 21.9), respectively.