[Lessons learned from the 'Quirra syndrome': more epidemiology and prevention]

The discussion here presented focuses on three issues included in the paper of P. Cocco: the perception of excesses of cancer mortality in selected areas of South-East Sardinia, the report of excesses of cancer mortality in other areas of South Sardinia, the criticism towards public institutions for non-using scientific evidences. The starting point of the tale is the report done in 2001 by a General Practitioner about an excess of haemolymphopoietic cancers located in the Quirra suburb (Municipality of Villaputzu) and about an excess of congenital anomalies in the Municipality of Escalaplano. Cocco quotes four independent epidemiological studies excluding the existence of excesses of cancer mortality and incidence in the Salto di Quirra military area. Three questions are presented and discussed: why in this area, characterized by environmental pressures, where public anxiety and high risk perception have been report even before 2001, a specific surveillance program wasn't activated? why, after the reporting of congenital anomalies, there were neither epidemiological investigations nor a feasibility study about a registry? the ability of the four investigations quoted by Cocco was evaluated a priori? To discuss the conclusions of Cocco, some considerations concerning the methodological limits of the mentioned studies, the lack of micro-geographical and etiological studies are suggested. The whole event indicates problems of communication, participation and relationships among stakeholders, and specifically the role of researchers when they have to face public administrators.