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Biomedical subjects

A Agudo

Publications and source records attributed to A Agudo.

At least 19 recordsLinked to original sources
PubMed2001

Lung cancer and cigarette smoking in Europe: an update of risk estimates and an assessment of inter-country heterogeneity.

Ten case-control studies have been carried out in 6 European countries to investigate the major risk factors for lung cancer. Carcinogenic effect from cigarette smoke was the most relevant interest in our study, which has included 7,609 cases of lung cancer and 10,431 controls, mainly population based. The results indicate elevated odds ratios (ORs; 23.9 among men and 8.7 among women) with attributable risks exceeding 90% for men and close to 60% for women. A large, and statistically significant, variability of the results across countries was detected after adjusting for the most common confounding variables, and after controlling, at least in part, for the instability of the ORs due to the small number of non-smokers in some of the study subsets. This pattern of lung cancer risk associated with cigarettes smoke, across different European regions, reflects inherent characteristics of the studies as well as differences in smoking habits, particularly calendar periods of starting, and it is likely to have been influenced by effect modifiers like indoor radon exposure, occupation, air pollution and dietary habits.

Aged↗
PubMed2001

Information about occupational exposure to asbestos given to cases in an etiological study: ethical aspects.

The aim of the study is to consider some ethical aspects of the provision of information, to the cases or their families, about the assessment of occupational asbestos exposure obtained in a case-control study of malignant mesothelioma of the pleura. An informative letter with the result of the evaluation of their occupational exposure to asbestos was sent to the participating cases (and/or their family). Those whose exposure was classified as certain/probable were also informed of the legislation regarding occupational diseases. Of the 132 cases, 32.6% of subjects and/or their families made telephone calls expressing interest in the content of the informative letter. Among the 63 cases classified as certain/probable exposure, this proportion was 47.6%. Out of 43 cases in which the age at diagnosis was < or = 65 years and the exposure to asbestos was certain/probable, only two (4.6%) were signed off work owing to occupational disease. Only one of the mesothelioma cases was recognized by the Spanish National Institute for Social Security (INSS) as having an occupational disease. The process of communication of the results of an epidemiological research should include the provision of information on the exposure data to each one of the subjects, and/or their families. There is a great disparity between the number of cases of certain/probable exposure to asbestos identified in our study, and the number registered as an occupational disease by the INSS.

Asbestos↗
PubMed2000

Lung cancer and cigarette smoking in women: a multicenter case-control study in Europe.

The association between cigarette smoking and lung cancer risk in women was investigated within the framework of a case-control study in 9 centres from 6 European countries. Cases were 1,556 women up to 75 years of age with histologically confirmed primary lung cancer; 2, 450 controls with age distribution similar to cases were selected. The predominant cell type was adenocarcinoma (33.5%), with similar proportions for squamous-cell type (26.4%) and small-cell carcinoma (22.3%). Overall, smoking cigarettes at any time was associated with a 5-fold increase in lung cancer risk (odds ratio 5.21, 95% confidence interval 4.49-6.04); corresponding figures for current smoking habits were 8.94, 7.54-10.6. The association showed a dose-response relationship with duration of the habit and daily and cumulative lifetime smoking. A significant excess risk of 70% was associated with every 10 pack-years smoked. After 10 years of smoking cessation, the relative risk decreased to 20% compared to current smokers. The following characteristics were associated with a higher relative risk: inhalation of smoke, smoking non-filter cigarettes, smoking dark-type cigarettes and starting at young age. The association was observed for all major histological types, being the strongest for small-cell type carcinoma, followed by squamous-cell type and the lowest for adenocarcinoma. The proportion of lung-cancer cases in the population attributable to cigarette smoking ranged from 14% to 85%. We concluded that women share most features of the association between cigarette smoking and lung cancer observed in men.

Adult↗
PubMed2000

[Factors associated with the accumulation of abdominal fat estimated with anthropometric indexes].

BACKGROUND: To evaluate lifestyle and dietary intake factors influencing the accumulation of abdominal fat in a Mediterranean population. SUBJECTS AND METHOD: A cross-sectional study was carried-out in Spain (Asturias, Granada, Murcia, Navarra and Guipuzkoa) among 23,228 women and 14,332 men aged 29-69 years, participants of a large European prospective cohort (EPIC). Information on usual food intake and other non-dietary factors were collected by interviews. Height, weight, waist circumference and hip circumference were taken by previously trained interviewers. RESULTS: In a multiple-linear regression analysis sports activities and educational level were negatively associated with abdominal obesity, while body mass index, age, tobacco and alcohol consumption, saturated fat intake and increased prevalence of hypertension, diabetes and myocardial infarction were positively associated. All dietary and non-dietary variables accounted for 22 and 27% of variance in the waist/hip ratio and 74 and 66% of variance in the waist circumference, in women and men respectively. CONCLUSIONS: Body mass index and age are the most important factors influencing the accumulation of abdominal fat. Dietary factors and other lifestyle factors seem to play a minor role in increasing abdominal obesity.

Abdomen↗
PubMed2000

Occupation and risk of malignant pleural mesothelioma: A case-control study in Spain.

BACKGROUND: The association of mesothelioma and asbestos exposure is well known, but some data suggest that probably many people are still being exposed to asbestos without knowing it. METHODS: Between 1993 and 1996, 132 cases (77% males) of histologically confirmed malignant pleural mesothelioma and 257 controls, residents in two provinces of Spain (Barcelona and C¿adiz), were interviewed. They were classified according to their probability and intensity of occupational asbestos exposure by a panel of industrial hygienists, based on a detailed occupational history. RESULTS: Age and sex-adjusted odds ratio (OR) for the highest probability of exposure to asbestos was 13.2 (95% confidence interval 6.4-27.3), and 27.1 (9. 28-79.3) for high intensity. A dose-response trend was observed for both, probability and intensity. Overall, 61% of cases and 42% of controls had ever worked in an occupation with risk of asbestos exposure, with an OR of 2.59 (1.60-4.22). In our population 62% of cases could be attributed to occupational asbestos exposure. CONCLUSIONS: A high risk of pleural mesothelioma due to occupational asbestos exposure is confirmed, but there is still a sizeable proportion for which no evidence of occupational exposure was found. Most of these cases could be due to other sources of asbestos exposure, mainly domestic or environmental.

Adult↗
PubMed2000

Types of fat intake and body mass index in a Mediterranean country.

BACKGROUND: Although the fatty acid fractions provide similar metabolizable energy, the type of dietary fat consumed could be relevant to the development of obesity. OBJECTIVE: To investigate the relationship between body mass index (BMI), obesity and the consumption of different types of fat and olive oil in a Mediterranean country with high prevalence of obesity, and high intake of monounsaturated fatty acids (MUFA) and olive oil. SUBJECTS: The study was carried out in Spain among 23 289 women and 14 374 men, aged 29-69 years, who were participants of a large European prospective cohort. METHODS: : Information on usual food intake was collected by interviewers by means of a dietary history questionnaire. The association between obesity (BMI >/= 30 kg m2), dietary fat, other dietary patterns and other non-dietary factors were tested using multilinear regression analysis. The ratio of reported energy intake to energy requirement was used as an estimation of dietary underreporting. RESULTS: The association between fatty acid fractions intake (saturated fatty acids (SFA) in women, and MUFA and polyunsaturated fatty acids (PUFA) in both sexes) and BMI was very weak, accounting for less than 1% of variance. All dietary and non-dietary variables accounted for 21% of variance in the measurement of BMI in women and only 6.7% of variance in men. Estimated underreporting of energy intake was 17.5% in obese women and 5.5% in obese men. CONCLUSIONS: The association between consumption of specific types of dietary fat, olive oil and obesity in Spain is not very important. However, because of the cross-sectional design and some level of underreporting of energy intake observed in overweight subjects and overreporting in underweight subjects, systematic bias cannot be completely discarded.

Adipose Tissue↗
PubMed2000

A multicenter case-control study of diet and lung cancer among non-smokers.

OBJECTIVE: We have examined the role of dietary patterns and specific dietary nutrients in the etiology of lung cancer among non-smokers using a multicenter case-control study. METHODS: 506 non-smoking incident lung cancer cases were identified in the eight centers along with 1045 non-smoking controls. Dietary habits were assessed using a quantitative food-frequency questionnaire administered by personal interview. Based on this information, measures of total carotenoids, beta-carotene and retinol nutrient intake were estimated. RESULTS: Protective effects against lung cancer were observed for high consumption of tomatoes, (odds ratio (OR) = 0.5; 95% confidence interval (CI) 0.4-0.6), lettuce (OR = 0.6; 95% CI 0.3-1.2), carrots (OR = 0.8; 95% CI 0.5-1.1), margarine (OR = 0.7; 95% CI 0.5-0.8) and cheese (OR = 0.7; 95% CI 0.5-1.0). Only weak protective effects were observed for high consumption of all carotenoids (OR = 0.8; 95% CI 0.6-1.0), beta-carotene (OR = 0.8; 95% CI 0.6-1.1) and retinol (OR = 0.9; 95% CI 0.7-1.1). Protective effects for high levels of fruit consumption were restricted to squamous cell carcinoma (OR = 0.7; 95% CI 0.4-1.2) and small cell carcinoma (OR = 0.7; 95% CI 0.4-1.2), and were not apparent for adenocarcinoma (OR = 0.9; 95% CI 0.6-1.3). Similarly, any excess risk associated with meat, butter and egg consumption was restricted to squamous and small cell carcinomas, but was not detected for adenocarcinomas. CONCLUSIONS: This evidence suggests that the public health significance of increasing vegetable consumption among the bottom third of the population would include a reduction in the incidence of lung cancer among lifetime non-smokers by at least 25%, and possibly more. A similar protective effect for increased fruit consumption may be present for squamous cell and small cell lung carcinomas.

Adenocarcinoma↗
PubMed2000

Multicentric study on malignant pleural mesothelioma and non-occupational exposure to asbestos.

Insufficient evidence exists on the risk of pleural mesothelioma from non-occupational exposure to asbestos. A population-based case-control study was carried out in six areas from Italy, Spain and Switzerland. Information was collected for 215 new histologically confirmed cases and 448 controls. A panel of industrial hygienists assessed asbestos exposure separately for occupational, domestic and environmental sources. Classification of domestic and environmental exposure was based on a complete residential history, presence and use of asbestos at home, asbestos industrial activities in the surrounding area, and their distance from the dwelling. In 53 cases and 232 controls without evidence of occupational exposure to asbestos, moderate or high probability of domestic exposure was associated with an increased risk adjusted by age and sex: odds ratio (OR) 4.81, 95% confidence interval (CI) 1.8-13.1. This corresponds to three situations: cleaning asbestos-contaminated clothes, handling asbestos material and presence of asbestos material susceptible to damage. The estimated OR for high probability of environmental exposure (living within 2000 m of asbestos mines, asbestos cement plants, asbestos textiles, shipyards, or brakes factories) was 11.5 (95% CI 3.5-38.2). Living between 2000 and 5000 m from asbestos industries or within 500 m of industries using asbestos could also be associated with an increased risk. A dose-response pattern appeared with intensity of both sources of exposure. It is suggested that low-dose exposure to asbestos at home or in the general environment carries a measurable risk of malignant pleural mesothelioma.

Adult↗
PubMed2000

Occupational risks for lung cancer among nonsmokers.

We conducted a case-control study in 12 European study centers to evaluate the role of occupational risk factors among nonsmokers. We obtained detailed occupational histories from 650 nonsmoking cases (509 females/141 males) and 1,542 nonsmoking controls (1,011 females/531 males). On the basis of an a priori definition of occupations and industries that are known (list A) or suspected (list B) to be associated with lung carcinogenesis, we calculated odds ratios (ORs) for these occupations, using unconditional logistic regression models and adjusting for sex, age, and center effects. Among nonsmoking men, an excess relative risk was observed among those who had worked in list-A occupations [OR = 1.52; 95% confidence interval (C) = 0.78-2.97] but not in list-B occupations (OR = 1.05; 95%), CI = 0.60-1.83). Among nonsmoking women, there was an elevation of risk for list-A occupations (OR = 1.50; 95% CI = 0.49-4.53), although this estimate was imprecise, given that less than 1% of cases and controls were exposed. Exposure to list-B occupations was associated with an increase in relative risk (OR = 1.69; 95% CI = 1.09-2.63) in females, but not in males. Women who had been laundry workers or dry cleaners had an OR of 1.83 (95% CI = 0.98-3.40). Our findings confirm that certain occupational exposures are associated with an increased risk for lung cancer among both female and male nonsmokers; however, knowledge on occupational lung carcinogens is biased toward agents to which mainly men are exposed.

Adult↗
PubMed1999

Structure of the standardized computerized 24-h diet recall interview used as reference method in the 22 centers participating in the EPIC project. European Prospective Investigation into Cancer and Nutrition.

A computerized 24-h diet recall interview program (EPIC-SOFT) was developed for use in a large European multi-center study, namely the European Prospective Investigation into Cancer and Nutrition (EPIC). This program, which was adapted for each participating country and translated into nine languages, was developed to standardize interviews between the 22 EPIC centers. Common rules were pre-entered into the system to describe, quantify and probe approximately 1500-2200 foods and 150-350 recipes. Common methods used to classify and export the EPIC-SOFT dietary data facilitate their exchange, comparison and analysis. So far, EPIC-SOFT is the only available computerized 24-h diet recall system developed to provide comparable food consumption data between several European countries.

Databases, Factual↗
PubMed1999

Vegetable and fruit consumption associated with anthropometric, dietary and lifestyle factors in Spain. EPIC Group of Spain. European Prospective Investigation into Cancer.

OBJECTIVE: To evaluate the association of vegetable and fruit intake with several demographic, anthropometric, lifestyle and dietary factors. DESIGN AND SETTING: Cross-sectional analysis. Information on habitual diet was collected by means of the diet history method. Association of vegetable and fruit intakes with other factors was assessed separately by means of multiple lineal regression and the cumulative odds model. SUBJECTS: 39622 healthy subjects aged 29-69 years from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort in Spain. RESULTS: Fruit intake increased with age, education and physical activity and decreased with intake of saturated fatty acids and cholesterol; smoking and alcohol consumption were also negatively associated with fruit, with a very low consumption for current smokers and heavy drinkers. Vegetable intake increased with education and physical activity and with intake of unsaturated fatty acids, mainly monounsaturated. Former smokers consumed more vegetables than never or current smokers and non-consumers of alcohol ate less vegetables than consumers, among whom no differences were observed. All these estimates were adjusted by energy and body mass index (BMI). CONCLUSIONS: When assessing the association of fruit and vegetables with chronic diseases it is important to take into account confounding factors. Furthermore, it would be useful to study dietary patterns including several interrelated factors.

Adult↗
PubMed1999

Intake of specific carotenoids and flavonoids and the risk of gastric cancer in Spain.

OBJECTIVES: To investigate the relationship between gastric cancer and the intake of specific carotenoids (alpha-carotene, beta-carotene, lutein, and lycopene) and flavonoids (quercetin, kaempferol, myricetin, and luteolin) using new data on their concentration in foods. METHODS: Case-control study carried out in Spain that included 354 cases of gastric cancer and 354 controls, matched by age, gender, area of residence and hospital. Usual food intake was assessed using a dietary history questionnaire. RESULTS: In a multivariate model adjusted for several dietary factors, no association was found between intake of any of the studied carotenoids and the risk of gastric cancer. The adjusted OR of gastric cancer for the highest quartile of total flavonoid intake versus the lowest quartile was 0.44 (95 percent confidence interval [CI] = 0.25-0.78; P for trend = 0.003). Kaempferol intake was found to be protective (OR = 0.48; CI = 0.26-0.88; P for trend = 0.04) comparing the highest versus the lowest quartile of intake. A trend toward lower risk of stomach cancer with higher intake of quercetin was also found. CONCLUSIONS: The results of this study support the hypothesis that the well-established protective effect of fruit and vegetables against gastric cancer could, in part, be due to the presence of flavonoids.

Adult↗
PubMed1999

Dietary intake of vegetables and fruits among adults in five regions of Spain. EPIC Group of Spain. European Prospective Investigation into Cancer and Nutrition.

OBJECTIVE: To assess the consumption of vegetables and fruits (V&F) in adults from five regions in Spain according to sex, age and educational level. DESIGN: Cross-sectional study within the members of the EPIC cohort in Spain. SETTING: Three regions of the north of Spain (Asturias, Guipúzcoa and Navarra) and two regions of the south of Spain (Granada and Murcia). SUBJECTS: 41448 healthy volunteers (15365 men, 25813 women), aged 29-69 y. INTERVENTIONS: Information on habitual diet during the previous year was collected by means of a computerised version of a diet history questionnaire. RESULTS: Among men, the mean daily consumption of vegetables and of fruits was 273.7 g (3.4 servings) and 348.3 g (4.4 servings) respectively. Among women, the corresponding vegetables and fruit intakes per day were 244.4g (3.1 servings) and 349.4g (4.4 servings). The total V&F intake tended to increase with age and educational level. Overall, 74% of subjects consumed 400 g/d (5 servings) of vegetables and fruit. CONCLUSIONS: Consumption of vegetables and fruits in healthy adults in Spain is considerably higher than in most European countries and the United States; this complies with what is considered to be the Mediterranean diet. Despite some regional differences, there were no clearly differentiated patterns of V&F intake between southern and northern regions within Spain.

Adult↗