Tribute to Arduino Verdecchia

Abstract

Arduino Verdecchia left us last February, after a long and terrible disease, the amyotrophic lateral sclerosis, a disease that gradually impaired him first to work, then to communicate and, finally, to live. He was a physicist and an epidemiologist, he directed the Cancer Epidemiology Unit in the Epidemiology and Biostatistics Department of the Italian National Institute of Health (Istituto Superiore di Sanità, Rome Italy) until 2007, when he was forced to leave his profession because of his disease. He dedicated his intelligence to developing models to estimate the diffusion of diseases, both chronic (cardiovascular and cancer) and communicable (HIV/AIDS epidemic). His research activity in the area of cancer epidemiology in Italy, Europe and worldwide, contributed to enrich public health knowledge on the burden of cancer and on the efficacy of cancer control policies. His name is linked particularly to the MIAMOD statistical method, first published in 1989, and still applied today to derive accurate epidemiological profiles of cancer burden by country or region. MIAMOD is a powerful tool for analysing regional differences and forecasting time trends of cancer incidence, prevalence and mortality. Arduino was in the very first group of pioneers of the EUROCARE project who launched the idea of comparing cancer survival in Europe by the joint analysis of population-based cancer registry data. Despite its complexity, international benchmarking of cancer outcome provides a powerful insight into cancer patients’ management and can highly contribute to increase the effectiveness of health care delivery. The beginning was very challenging, first results were received with skepticism by some in the scientific community, yet the research outcomes produced in over 25 years by this European collaborative network proved those pioneers right: comparing cancer outcome is not only possible, but it is also necessary to improve cancer care. Some of the disparities found in EUROCARE were expected, some others were not, but all deserved attention. Measuring patients’ outcome by country, ensuring the highest comparability and data quality standards, provides evidence for research and action, and does indeed make a difference. The European added value was immense. Europe came out to be a sort of ‘natural’ laboratory where different countries, led by specific priorities, resources and approaches for tackling cancer, all learn from benchmarking. In many countries EUROCARE results contributed to design or revise the national cancer plans, and they are nowadays part of the standard indicators to assess the global effectiveness of cancer control activities. Arduino collaborated internationally worldwide, from the CONCORD study, which he contributed to initiate, the National Cancer Institute and the NIH Institute for Aging, in the US, to the North of Africa, where he supported the start of cancer registration in Lybia. Arduino was an inspiring person with wide interests and horizons and he left an indelible mark in all who had the luck to have him as a colleague and a teacher. He loved his profession passionately and was able to transmit to younger researchers the enthusiasm for advancing in knowledge, for accuracy, and for aiming to the highest objectives. Put your heart into it, was one of his most typical expressions. Don’t be afraid to rise on a ridge against the wind, he was used to repeat, as often good research is done in these conditions. He was also a democrat, he participated actively to civil life in all contexts. A painting is still hanging on the wall in his office: it is the Allegory of Good and Bad government, a cycle of frescoes by Ambrogio Lorenzetti for the Town Hall of the city of Siena, in Tuscany. The frescoes, on two opposite walls, recalled the city council the effects of a Bad tyrannical government, i.e., violence, fraud, misery and war, and those of Good government, i.e., peace, justice, progress and prosperity. Arduino conceived his work also as a mean to contribute to the civil progress. These are some of the treasures he leaves as a professional, and as a man. He traced the path we are following today, facing new challenges and horizons. For this heritage we really wish to thank him.