In a heavy large skillet, cook the sausage, onion, garlic, and red pepper over medium heat until sausage is cooked through, stirring to break up pieces of sausage. Drain off excess fat.
Stir in undrained tomatoes; boil gently, uncovered, for 5 to 7 minutes or until most of the liquid has evaporated. Add half-and-half or light cream. Simmer 4 minutes or until mixture thickens slightly.
Meanwhile, cook pasta according to package directions. Drain; return to saucepan.
Add sauce to pasta; heat through, tossing to coat. Serve on warm plates. Sprinkle with basil. Pass the Romano.