Andrea Ferrari1, Paola Quarello2, Maurizio Mascarin3, Giuseppe M Milano4, Assunta Tornesello5, Marina Bertolotti2, Marco Spinelli6, Pamela Ballotta7, Marco Read Borghi8, Milena Maule9, Maria Luisa Mosso9, Franco Merletti10, Marco Zecca11, Andrea Pession12. 1. Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy. 2. Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Azienda Ospedaliera-Universitaria Città della Salute e della Scienza, Regina Margherita Children's Hospital, Torino, Italy. 3. AYA and Pediatric Radiotherapy Unit, Centro di Riferimento Oncologico, Aviano, Italy. 4. Hematology/Oncology, Ospedale Pediatrico Bambino Gesù IRCCS, Roma, Italy. 5. Pediatric Oncology Unit, Ospedale Vito Fazzi, Lecce, Italy. 6. Department of Pediatrics, University of Milano-Bicocca, Fondazione MBBM/Ospedale San Gerardo, Monza, Italy. 7. Hematology-Oncology Division, Department of Women's and Children's Health, Padova University Hospital, Padova, Italy. 8. Centro Operativo AIEOP, Bologna, Italy. 9. Childhood Cancer Registry of Piedmont, Department of Medical Sciences, University of Torino, CPO-Piemonte, AOU Città della Salute e della Scienza di Torino, Torino, Italy. 10. Unit of Cancer Epidemiology, Department of Medical Sciences, University of Torino, Torino, Italy. 11. Department of Pediatric Hematology/Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. 12. Hematology-Oncology Unit, Department of Pediatrics, University of Bologna, Bologna, Italy.
Abstract
Purpose: To describe how the provision of services for adolescents with cancer has evolved in Italy, the study evaluated access to pediatric oncology centers affiliated to the national cooperative group Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP), and the development of dedicated local projects. Methods: We calculated the observed/expected (O/E) ratio of adolescent patients (15-19 years old) admitted to AIEOP centers during the years 2013-2017. Observed cases were obtained from the AIEOP database (model 1.01). Expected cases were calculated on the incidence rates derived from the population-based registries. In addition, a questionnaire investigated the presence of any formal upper age limits for admitting patients, and to the development of local projects. Results: In the years 2013-2017, 9534 cases of cancer were registered in the AIEOP database, that is, 8031 children (0-14 years) and 1503 adolescents (15-19 years). The overall O/E ratio was 0.81, that is, 1.06 for children, and 0.37 for adolescents, and differed according the different tumor types. Concerning the questionnaire, 26% of centers reported age limits <18 years. Nineteen centers reported to have local projects dedicated to adolescents. Conclusions: The study shows an improvement in the services for adolescents in Italy, with an increase percentage of cases treated at AIEOP centers (from 10% of previous study, to 37%), the decrease of centers with admission age limits <18 years (from 44% 10 years ago, to 26%), and the development of many specific local projects. Effective cooperation with adult oncology societies and government recognition remain goals to be achieved.
Purpose: To describe how the provision of services for adolescents with cancer has evolved in Italy, the study evaluated access to pediatric oncology centers affiliated to the national cooperative group Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP), and the development of dedicated local projects. Methods: We calculated the observed/expected (O/E) ratio of adolescent patients (15-19 years old) admitted to AIEOP centers during the years 2013-2017. Observed cases were obtained from the AIEOP database (model 1.01). Expected cases were calculated on the incidence rates derived from the population-based registries. In addition, a questionnaire investigated the presence of any formal upper age limits for admitting patients, and to the development of local projects. Results: In the years 2013-2017, 9534 cases of cancer were registered in the AIEOP database, that is, 8031 children (0-14 years) and 1503 adolescents (15-19 years). The overall O/E ratio was 0.81, that is, 1.06 for children, and 0.37 for adolescents, and differed according the different tumor types. Concerning the questionnaire, 26% of centers reported age limits <18 years. Nineteen centers reported to have local projects dedicated to adolescents. Conclusions: The study shows an improvement in the services for adolescents in Italy, with an increase percentage of cases treated at AIEOP centers (from 10% of previous study, to 37%), the decrease of centers with admission age limits <18 years (from 44% 10 years ago, to 26%), and the development of many specific local projects. Effective cooperation with adult oncology societies and government recognition remain goals to be achieved.
Entities:
Keywords:
access to care; adolescents with cancer; age limits; dedicated project; expected cases; national program
Authors: Francesca Bomben; Maurizio Mascarin; Giuseppe Maria Milano; Paola Quarello; Marco Spinelli; Assunta Tornesello; Carlo Alfredo Clerici; Federico Mercolini; Domitilla Elena Secco; Maria Antonietta Annunziata; Andrea Ferrari; Marina Bertolotti Journal: Behav Sci (Basel) Date: 2022-04-21