{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T18:12:59Z","timestamp":1777918379930,"version":"3.51.4"},"reference-count":48,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2013,5,1]],"date-time":"2013-05-01T00:00:00Z","timestamp":1367366400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Tumori"],"published-print":{"date-parts":[[2013,5]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>In the last decades the demographics of most Western countries have undergone a deep transformation, which has caused a steady increase in degenerative chronic diseases and has made maintaining health and social support by the welfare system difficult. This paper aims to present a set of indicators pertaining to the health status of the Italian population and to the national economic and social systems, as an aid to a better interpretation of the cancer burden impact and of its future tendencies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>All indicators were derived from the ISTAT Health for All database. They were presented by region or macro area, globally or by gender, considering the most recent regional distribution and their time trends. The following features of the Italian population were chosen: percent of people aged over 65 years; life expectancy at birth; birth rate; crude and age-standardized overall mortality rates; dependency ratio; percent of single persons; percent of people with no more than a junior high school diploma; percent of people attaining at least the short first university degree; percent of people employed in the service and tertiary sectors; unemployment rate; incidence of poverty; total health expenditure (THE) as an absolute value and as percent of GDP; percent of public THE; percent of out-of-pocket THE of households; percent of smokers; proportion of overweight and obese people aged \u226518 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Italy presented an unbalanced demographic situation with an increasingly old population, a decreasing middle-aged age group, a low birth rate, high crude overall mortality rates, and decreasing standardized overall mortality rates. The Italian population is characterized by a constant increase in the dependency ratio and in the percentage of people living alone, together with increasing expenses for health care, both at the public and households levels. Smoking has reduced its impact in men but not yet in women. The increasing proportion of overweight and obese people may explain the convergence in time of the mortality rates of the different Italian macro areas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and conclusion<\/jats:title>\n                    <jats:p>The Italian situation seems to be not well fitted to face the expected growing cancer burden. Along with the aging of the population, the corresponding lowering of the national GDP due to the persisting global economic crisis will lead the public sector and families to reduce health expenditure, while the number of people affected by cancer is bound to increase. Moreover, the social support provided by family members and the advantages of the Mediterranean dietary habits are declining. The strategies for facing the challenging evolution of the future should focus on successful primary prevention and a wider application of evidence-based medicine to optimize the choice of diagnostic and therapeutic procedures offered to citizens.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/030089161309900319","type":"journal-article","created":{"date-parts":[[2018,2,27]],"date-time":"2018-02-27T04:40:26Z","timestamp":1519706426000},"page":"425-438","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Useful indicators to interpret the cancer burden in Italy"],"prefix":"10.1177","volume":"99","author":[{"given":"Marina","family":"Vercelli","sequence":"first","affiliation":[{"name":"RTRL, Registro Tumori Regione Liguria, c\/o SS Epidemiologia Descrittiva, Azienda Ospedale Universit\u00e0 San Martino, IST, Istituto Nazionale Ricerca sul Cancro, Genoa"},{"name":"DISSAL, Dipartimento di Scienze della Salute, Universit\u00e0 di Genova, Genoa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Quaglia","sequence":"additional","affiliation":[{"name":"RTRL, Registro Tumori Regione Liguria, c\/o SS Epidemiologia Descrittiva, Azienda Ospedale Universit\u00e0 San Martino, IST, Istituto Nazionale Ricerca sul Cancro, Genoa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Lillini","sequence":"additional","affiliation":[{"name":"RTRL, Registro Tumori Regione Liguria, c\/o SS Epidemiologia Descrittiva, Azienda Ospedale Universit\u00e0 San Martino, IST, Istituto Nazionale Ricerca sul Cancro, Genoa"},{"name":"DISSAL, Dipartimento di Scienze della Salute, Universit\u00e0 di Genova, Genoa"},{"name":"Universit\u00e0 \u201cVita-Salute\u201d San Raffaele, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,1,29]]},"reference":[{"key":"bibr1-030089161309900319","unstructured":"ISTAT: Health for All - Italia. Rome, December 2012. http:\/\/www.istat.it\/sanita\/Health\/ (accessed 8 March 2013)."},{"key":"bibr2-030089161309900319","author":"ISTAT","year":"1996","journal-title":"Ricostruzione della popolazione residente per et\u00e0 e sesso nelle province italiane."},{"key":"bibr3-030089161309900319","author":"ISTAT","year":"2006","journal-title":"Ricostruzione della popolazione residente per et\u00e0 e sesso nei comuni italiani."},{"key":"bibr4-030089161309900319","unstructured":"ISTAT: Popolazione residente e bilancio demografico (banche dati)."},{"key":"bibr5-030089161309900319","unstructured":"ISTAT: Previsioni demografiche 1.1.2007 - 1.1.2051 (banche dati)."},{"key":"bibr6-030089161309900319","unstructured":"ISTAT: Demografia in cifre. http:\/\/demo.istat.it\/ (accessed 8 March 2013)."},{"key":"bibr7-030089161309900319","volume-title":"Decessi: caratteristiche demografiche e sociali.","author":"ISTAT (anni vari)"},{"key":"bibr8-030089161309900319","unstructured":"ISTAT: Tavole di mortalit\u00e0 e indicatori demografici. Banche dati. http:\/\/demo.istat.it (accessed 8 March 2013)."},{"key":"bibr9-030089161309900319","volume-title":"Nascite: caratteristiche demografiche e sociali.","author":"ISTAT (anni vari)"},{"key":"bibr10-030089161309900319","unstructured":"ISTAT: Iscritti in anagrafe per nascita (banche dati). http:\/\/demo.istat.it\/ (accessed 8 March 2013)."},{"key":"bibr11-030089161309900319","author":"ISTAT (anni vari)","year":"2013","journal-title":"Cause di morte."},{"key":"bibr12-030089161309900319","volume-title":"Stime preliminari della mortalit\u00e0 per causa.","author":"ISTAT (anni vari)"},{"key":"bibr13-030089161309900319","author":"ISTAT (anni vari)","journal-title":"Cause multiple di morte."},{"key":"bibr14-030089161309900319","unstructured":"ISTAT: I.Stat (datawarehouse ISTAT) http:\/\/dati.istat.it (accessed 8 March 2013)."},{"key":"bibr15-030089161309900319","unstructured":"http:\/\/www.istat.it\/sanita\/health\/ (accessed 8 March 2013)."},{"key":"bibr16-030089161309900319","volume-title":"Famiglie, abitazioni e zona in cui si vive.","author":"ISTAT (anni vari)"},{"key":"bibr17-030089161309900319","volume-title":"La vita quotidiana nel 2008.","author":"ISTAT","year":"2009"},{"key":"bibr18-030089161309900319","unstructured":"ISTAT: La vita quotidiana nel 2008. http:\/\/www.istat.it\/dati\/catalogo\/20100319_01\/ (accessed 8 March 2013)."},{"key":"bibr19-030089161309900319","volume-title":"Forze di lavoro.","author":"ISTAT (anni vari)"},{"key":"bibr20-030089161309900319","unstructured":"ISTAT: Forze di lavoro - Media 2009. http:\/\/www.istat.it\/dati\/catalogo\/20101116_00\/ (accessed 8 March 2013)."},{"key":"bibr21-030089161309900319","unstructured":"http:\/\/www.istat.it\/lavoro (accessed 8 March 2013)."},{"key":"bibr22-030089161309900319","volume-title":"I consumi delle famiglie.","author":"ISTAT (anni vari)"},{"key":"bibr23-030089161309900319","volume-title":"La povert\u00e0 relativa in Italia.","author":"ISTAT (anni vari)"},{"key":"bibr24-030089161309900319","volume-title":"I consumi delle famiglie.","author":"ISTAT (anni vari)"},{"key":"bibr25-030089161309900319","unstructured":"ISTAT: I consumi delle famiglie (2009) http:\/\/www.istat.it\/dati\/catalogo\/20110405_00\/ (accessed 8 March 2013)."},{"key":"bibr26-030089161309900319","unstructured":"ISTAT: Consumi. http:\/\/www.istat.it\/societa\/consumi\/ (accessed 8 March 2013)."},{"key":"bibr27-030089161309900319","unstructured":"ISTAT: Conti economici regionali. http:\/\/www.istat.it\/archivio\/75111 (accessed 8 March 2013)."},{"key":"bibr28-030089161309900319","volume-title":"Stili di vita e condizioni di salute.","author":"ISTAT (anni vari)"},{"key":"bibr29-030089161309900319","volume-title":"La vita quotidiana.","author":"ISTAT (anni vari)"},{"key":"bibr30-030089161309900319","unstructured":"ISTAT: La vita quotidiana nel 2009. http:\/\/www.istat.it\/dati\/catalogo\/20110121_00\/ (accessed 8 March 2013)."},{"key":"bibr31-030089161309900319","unstructured":"http:\/\/www.istat.it\/archivio\/5538 (accessed 8 March 2013)."},{"key":"bibr32-030089161309900319","author":"ISTAT","year":"1997","journal-title":"Condizioni di salute e ricorso ai servizi sanitari."},{"key":"bibr33-030089161309900319","author":"ISTAT","year":"2002","journal-title":"Collana informazioni"},{"key":"bibr34-030089161309900319","volume-title":"Condizioni di salute e ricorso ai servizi sanitari, 2004\u20132005.","author":"ISTAT","year":"2007"},{"key":"bibr35-030089161309900319","volume-title":"Condizioni di salute e ricorso ai servizi sanitari, 2004\u20132005.","author":"ISTAT","year":"2008"},{"key":"bibr36-030089161309900319","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/14.3.331"},{"key":"bibr37-030089161309900319","doi-asserted-by":"publisher","DOI":"10.1186\/1476-069X-10-S1-S7"},{"key":"bibr38-030089161309900319","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2007.11.035"},{"key":"bibr39-030089161309900319","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdj007"},{"key":"bibr40-030089161309900319","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2005.07.032"},{"key":"bibr41-030089161309900319","first-page":"51","volume":"5","author":"Mazza S.","year":"2006","journal-title":"Quaderni europei sul nuovo welfare"},{"key":"bibr42-030089161309900319","doi-asserted-by":"publisher","DOI":"10.1007\/s10552-010-9539-0"},{"key":"bibr43-030089161309900319","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyp262"},{"key":"bibr44-030089161309900319","doi-asserted-by":"publisher","DOI":"10.1111\/j.1542-4774.2010.tb00537.x"},{"key":"bibr45-030089161309900319","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2011.03.011"},{"key":"bibr46-030089161309900319","first-page":"24","volume":"31","author":"Crocetti E.","year":"2007","journal-title":"Epidemiol Prev"},{"key":"bibr47-030089161309900319","first-page":"49","volume":"43","author":"Berrino F.","year":"1989","journal-title":"Eur J Clin Nutr"},{"key":"bibr48-030089161309900319","doi-asserted-by":"publisher","DOI":"10.1177\/1090198106291375"}],"container-title":["Tumori Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/030089161309900319","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/030089161309900319","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T18:37:38Z","timestamp":1777660658000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/030089161309900319"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,5]]},"references-count":48,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2013,5]]}},"alternative-id":["10.1177\/030089161309900319"],"URL":"https:\/\/doi.org\/10.1177\/030089161309900319","relation":{},"ISSN":["0300-8916","2038-2529"],"issn-type":[{"value":"0300-8916","type":"print"},{"value":"2038-2529","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,5]]}}}