6% of women undergoing total major breast procedures [16]. In general, our figures showed inverse trends for mastectomies and quadrantectomies performed in Italy between 2001 and 2008. The increase observed for quadrantectomies and the decrease concerning mastectomies might be interpreted in light of the progressive expansion of the screening programs, and the better adherence to updated treatment protocols [16]. Indeed, mammographic screen-detected cancers show more favorable prognostic features at diagnosis and need less extensive treatment compared to symptomatic cancers [25]. The

heterogeneous distribution of such interventions (i.e., screening programs), particularly in Southern Italy, might account for the differences in trends across macro learn more areas and singular regions. Several studies have investigated the use of hospital discharge records to enhance cancer check details surveillance. In 1996, Huff and co-authors estimated disease occurrence rates from hospital discharge data for breast, cervical and lung cancer at a state- and county level for the state of Maine, US. Consistently with our results,

rates from hospital discharge data were higher than rates from cancer registry data. It is noteworthy that the Copanlisib mw breast cancer rates from NHDRs and Cancer Registry data were the ones with the higher correlation among those considered (correlation coefficients were 0.87, 0.79 and 0.55 for breast, lung and cervical cancer, respectively) [26]. We have previously proposed the use of the NHDRs to evaluate the breast cancer burden in Italy [11]. Results across our two studies are fairly consistent. However, results from our previous study were

limited by the inclusion of repeat hospital admissions. Moreover, a different and more restricted time window was considered (i.e., 2000–2005). Ferretti et al. used an algorithm based on Regional hospital discharge records to estimate breast cancer incidence in three Italian regions covered by the Italian net of CRs (e.g., Emilia Romagna, Toscana and Veneto). Incidence rates of the two methods showed no statistical Thiamine-diphosphate kinase differences. However, the authors ascribed the agreement between hospital discharge records and CRs incidence rates to a cross effect of both sensitivity and specificity limitations of the discharge records algorithm [27]. Conclusions A National system of population-based CRs is essential to monitor cancer patterns and trends at a National and local level and to orient health monitoring and resource allocation decisions [28]. However, the exclusive use of CRs may pose limits to the estimate of cancer burden, mainly due to incomplete and heterogeneous coverage. We suggest the use of the NHDRs to supplement the net of CRs. The latter source (NHDRs) may be a valuable and relatively efficient tool for enhancing cancer surveillance.