ITALY
The “Istituto per lo studio, la prevenzione e la rete oncologica” (ISPRO) is a public Research Institute belonging to the National Health System of Italy and Tuscany Region (3.7 million people), endowed with public legal personality and organizational, administrative, and accounting autonomy. ISPRO main aim is to promote and study primary, secondary and tertiary cancer prevention interventions and to organize and coordinate pathways of research programmes, diagnosis, treatment, and rehabilitation in oncology, in collaboration with hospitals and local health units. ISPRO activities include epidemiological evaluation and surveillance, management of registries, design, implementation and monitoring of screening programmes, and coordination of the Tuscany cancer network for the definition and monitoring of clinical guidelines, and oncological diagnostic and therapeutic pathways.
Cancer-related risks factors in their portfolio include: (a) tobacco prevention and control research led by the ISPRO-Tobacco Control Team (TCT), such as the H2020 project TackSHS on the evaluation of tobacco control policies and implementation of innovative and evidence-based interventions81; the ongoing 2nd Joint Action between EC and Member States on Tobacco Control (JATC-2) with tobacco control studies and trials to prevent use and promote cessation of tobacco use among adolescents, and to reduce SHS exposure82–86 ; and a pilot study combining smoking cessation interventions and lung cancer screening with low-dose Computed Tomography (CT) among high risk population.87,88; (b) nutrition and physical activity interventions: ISPRO, since the early 90s, has managed the Florence European Prospective Investigation into Cancer and Nutrition (EPIC) cohort with 13,597 participants, and has developed several projects to evaluate the role of lifestyle, including dietary habits, physical activity level, alcohol consumption and smoking habits, on the development of cancer.89–91; (c) research on lifestyle and reproductive determinants of high mammographic breast density as an independent risk factor for breast cancer92–94 and the derived DAMA project (Diet, Physical Activity and Mammography), a factorial randomised trial (ISRCTN28492718) that showed the effect of changes in nutrition and physical activity level on a series of indicators of cancer in post-menopausal women95.96–98 A non-randomized dietary and physical activity intervention focused on healthy young women with familial breast cancer risk (The DAMA25; ISRCTN54262307) has been set up.