No Excess of Mortality from Lung Cancer during the COVID-19 Pandemic in an Area at Environmental Risk: Results of an Explorative Analysis

Francesco Addabbo, Massimo Giotta, Antonia Mincuzzi, Aldo Sante Minerba, Rosa Prato, Francesca Fortunato, Nicola Bartolomeo () and Paolo Trerotoli
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Francesco Addabbo: School of Medical Statistics and Biometry, University of Bari Aldo Moro, Azienda Sanitaria Locale Taranto, 74121 Taranto, Italy
Massimo Giotta: School of Medical Statistics and Biometry, Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy
Antonia Mincuzzi: Unit of Statistics and Epidemiology, Azienda Sanitaria Locale Taranto, 74121 Taranto, Italy
Aldo Sante Minerba: Unit of Statistics and Epidemiology, Azienda Sanitaria Locale Taranto, 74121 Taranto, Italy
Rosa Prato: Hygiene Unit, Policlinico Riuniti Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
Francesca Fortunato: Hygiene Unit, Policlinico Riuniti Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
Nicola Bartolomeo: Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy
Paolo Trerotoli: Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy

IJERPH, 2023, vol. 20, issue 8, 1-16

Abstract: Background: The COVID-19 pandemic and the restrictive measures associated with it placed enormous pressure on health facilities and may have caused delays in the treatment of other diseases, leading to increases in mortality compared to the expected rates. Areas with high levels of air pollution already have a high risk of death from cancer, so we aimed to evaluate the possible indirect effects of the pandemic on mortality from lung cancer compared to the pre-pandemic period in the province of Taranto, a polluted site of national interest for environmental risk in the south of Italy. Methods: We carried out a retrospective observational study on lung cancer data (ICD-10: C34) from the Registry of Mortality (ReMo) for municipalities in Taranto Province over the period of 1 January 2011 to 31 December 2021. Seasonal exponential smoothing, Holt–Winters additive, Holt–Winters multiplicative, and auto-regressive integrated moving average (ARIMA) models were used to forecast the number of deaths during the pandemic period. Data were standardized by sex and age via an indirect method and shown as monthly mortality rates (MRs), standardized mortality ratios (SMRs), and adjusted mortality rates (AMRs). Results: In Taranto Province, 3108 deaths from lung cancer were recorded between 2011 and 2021. In the province of Taranto, almost all of the adjusted monthly mortality rates during the pandemic were within the confidence interval of the predicted rates, with the exception of significant excesses in March (+1.82, 95% CI 0.11–3.08) and August 2020 (+2.09, 95% CI 0.20–3.44). In the municipality of Taranto, the only significant excess rate was in August 2020 (+3.51, 95% CI 0.33–6.69). However, in total, in 2020 and 2021, the excess deaths from lung cancer were not significant both for the province of Taranto (+30 (95% CI −77; +106) for 2020 and +28 (95% CI −130; +133) for 2021) and for the municipality of Taranto alone (+14 (95% CI −47; +74) for 2020 and −2 (95% CI −86; +76) for 2021). Conclusions: This study shows that there was no excess mortality from lung cancer as a result of the COVID-19 pandemic in the province of Taranto. The strategies applied by the local oncological services during the pandemic were probably effective in minimizing the possible interruption of cancer treatment. Strategies for accessing care in future health emergencies should take into account the results of continuous monitoring of disease trends.

Keywords: excess mortality; COVID-19; environmental risk area; forecasting model; lung cancer (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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