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Biomedical subjects

A Decarli

Publications and source records attributed to A Decarli.

At least 199 records · Page 11Linked to original sources
PubMed1985

Trends in childhood cancer mortality in Italy, 1955-78.

Trends in childhood cancer death rates in Italy from 1955 to 1978 were analyzed. All cancer age-standardized mortality below age 15 fell about 20%, with a clear downward trend since the early 1970's. Declines were evident for leukemias (-25%), Hodgkin's disease (-56%), non-Hodgkin's lymphomas (-27%), kidney cancer (-25%), retinoblastoma (-50%), and bone sarcomas (-31%), for a total number of about 200-250 fewer deaths per year in the late 1970's compared to the expected values using rates of the 1950's. The observed fall was apparently confined within the first age group considered (0-4 years), but the age-specific patterns of trend were partly influenced by simple postponement of some deaths to older age groups. Comparisons with similar data in other developed countries suggest that, although there has undoubtedly been some progress, there is still wide scope for further reduction in childhood cancer mortality in Italy, simply through more rational use of currently available diagnostic and therapeutic knowledge.

Adolescent↗
PubMed1985

ABO blood-groups and the risk of gestational trophoblastic disease.

The relation between ABO blood group, mating patterns of patient/husband blood group, and the risk of gestational trophoblastic disease was investigated in a case-control study conducted in Milan on 286 women with histologically confirmed trophoblastic disease (245 benign hydatidiform moles and 41 persistent trophoblastic disease) and 433 control subjects admitted for normal delivery to the same hospitals where cases had been identified. ABO blood groups were associated with the risk of gestational trophoblastic disease (chi 2(6) for heterogeneity = 14.46, p = 0.02). Compared to women of group O or B, women of group A and AB had an elevated relative risk (RR) of benign mole (RR = 1.4 and 2.3, respectively). The risk estimates were higher for persistent trophoblastic disease, i.e., 2.2 for women of group A and 4.8 of group AB. The tests for linear trend in risk from benign to persistent disease were statistically significant in both A and AB groups. There was a significant interaction between blood group and age, since the ABO-related risk was elevated only for women over the age of 35. When mating combinations of maternal/paternal blood groups were considered, women of group A married to males of group O had a risk estimate not substantially different than those married to group A males.

ABO Blood-Group System↗
PubMed1985

Risk factors for benign breast disease and their relation with breast cancer risk. Pooled information from epidemiologic studies.

Information from published case-control studies on benign breast disease was pooled using standard statistical methods to obtain single, overall risk estimates. This analysis showed that higher socio-economic status (pooled relative risk, RR = 1.24, 95% confidence interval, CI = 1.13-1.37), later menopause (pooled RR = 1.87, 95%, CI = 1.67-2.11) and late age at first birth (pooled RR = 1.30, 95%, CI = 1.13-1.50) were associated with an increased risk of benign breast disease, whereas an apparent protection was given by greater body mass index (pooled RR = 0.58, 95%, CI = 0.50-0.67) and the use of oral contraceptives (pooled RR = 0.75, 95%, CI = 0.67-0.83). The role of these factors did not appear to be materially different in the various histopathologic categories considered, although available information allowed only a general distinction between breast dysplasia (fibrocystic disease) and benign tumors, chiefly fibroadenoma. In conclusion, the general evidence from published studies indicates that benign breast lumps appear to share a number of important risk factors with breast cancer.

Adolescent↗
PubMed1985

Menstrual cycle patterns and the risk of breast disease.

The relationship between menstrual cycle patterns and the risk of breast disease was evaluated using data from a hospital-based case-control study of 288 women with benign breast disease (203 chronic cystic diseases and 85 benign tumours), 317 with breast cancer and 602 age-matched controls with a spectrum of acute conditions unrelated to any of the established or potential risk factors for breast disease. A lifelong irregular menstrual pattern [defined as frequent occurrence of menstrual-like episodes of bleeding less than 21 or more than 35 days apart) was negatively associated with the risk of benign breast lesions (relative risk, RR = 0.6, with 95% confidence interval = 0.4-1.0) and of breast cancer (RR = 0.4, with 95% confidence interval = 0.3-0.8]. This inverse association could not be explained by any of the identified potential confounding factors, including the major risk factors for breast disease. The findings of this study, showing that a lifelong history of irregular (and hence more likely anovular) cycles was less frequent among women with benign and malignant breast diseases, support the hypothesis that frequent ovular cycles might be more carcinogenic than anovular ones.

Adolescent↗
PubMed1985

Characteristics of women undergoing induced abortion: results of a case-control study from Northern Italy.

In order to identify subgroups of women at elevated risk of induced abortion, personal characteristics and habits, selected medical histories and contraceptive practices of 873 women undergoing legal abortion in various areas of Northern Italy were compared with those of 504 control subjects identified in family planning clinics of the same hospitals or area health authorities. When age was allowed for, the risk of induced abortion was not strongly influenced by marital status, education or other indicators of social class. However, women who were employed, independently from the type of occupation, showed markedly lower abortion risks than housewives. Among various indicators of sexual habits investigated, the strongest determinant of legal abortion was the frequency of sexual intercourses over the previous six months, women with less frequent intercourses showing a markedly elevated risk estimate (RR = 2.82). Induced abortion was less frequent among ex-smokers and more frequent in heavy smokers, but was not appreciably influenced by several other indicators of lifestyle habits and history of gynaecological or psychiatric complaints. The risk of abortion was not influenced by the number of livebirths, but was lower for women with later age at first birth. Less than 5% of case and control subjects reported more than two previous induced abortions, thus indicating that abortion is more of an "accidental" event rather than a widespread contraceptive practice. However, over three-quarters of abortions occurred in women reporting no contraception at all or coitus interruptus, thus underlining the scope for family planning education in this population.

Abortion, Legal↗
PubMed1985

Bladder cancer mortality of workers exposed to aromatic amines: analysis of models of carcinogenesis.

The effects of various factors were evaluated on both relative risk (multiplicative model), and absolute excess risk (additive model) of bladder cancer among 664 workers of a dyestuff factory in Northern Italy. These workers were exposed to aromatic amines in fairly constant working conditions from 1922 to 1970, and were employed for at least one year. They were followed up till the end of 1981 for a total of 12,302 man-years at risk. Under both models, the risk was greater for workers directly involved in aromatic amine manufacture than for those with only intermittent exposure. There was no marked effect of age at first exposure on the absolute excess risk of bladder cancer, but the relative risk was strongly and negatively related to age at first exposure. Under the multistage theory of carcinogenesis, this pattern of risk indicates an early stage effect. Absolute excess risk increased sharply during exposure, and continued to rise, although less sharply, after exposure had ceased. Relative risk, however, decreased after cessation of exposure, indicating a possible late stage effect. Thus, the results derived from both additive and multiplicative models are not in contrast when interpreted in terms of the multistage theory of carcinogenesis, though they are not totally consistent with a single-stage effect, either early or late. Aromatic amines may act on a stage somewhere between the first and penultimate, or on more than one stage of the process of carcinogenesis. Alternatively, it is possible that imprecision in the job classification or other observational problems may obscure the trends, or produce fictitious trends in the effects of variables such as age at first exposure and time since last exposure. Finally, such a pattern of trends could emerge if there were only two stages and the first and penultimate stage were the same.

Amines↗
PubMed1985

Reproductive and hormonal factors and breast cancer in a Northern Italian population.

Between January 1980 and March 1983, data were collected to evaluate risk factors for breast cancer in a case-control study based on 368 women with breast cancer admitted to the General Hospital of Pordenone (a district in North Eastern Italy with a particularly high breast cancer mortality rate), and 373 age-matched controls. Nulliparity or low parity, late age at first birth and later menopause were associated with an increased risk of breast cancer. The elevated risk associated with nulliparity could be almost completely explained by marital status, thus pointing to a specific protection given by parity, rather than some putative influence of infertility or subfertility in breast cancer cases. Likewise, risk did not vary materially according to history of abortions when marital status was controlled for. Increased risk associated with later age at first birth, on the other hand, was not accounted for by marital status or parity. The population studied, though frequently multiparous, showed late average at first birth: this might, at least partly, explain its high mortality rate from breast cancer. The risk estimate was higher if menarche occurred below age 15; however, there was no evidence of a trend for the relative risk to rise with lower age at menarche. The use of oral contraceptives or other female hormones (such as oestrogen replacement therapy) did not appear to be related to the risk of breast cancer. The role of the major menstrual and reproductive variables considered (age at menarche, parity, age at first birth) was apparently stronger in pre-menopausal women, thus suggesting an influence of these factors (and possibly, their hormonal correlates) on one of the latter stages of the process of carcinogenesis.

Abortion, Spontaneous↗
PubMed1985

Geographical variation of cancer mortality in Italy.

The distribution of death certification rates from various cancers or groups of cancers in broad Italian geographical areas (north/centre/south) was analysed. In both sexes, total cancer mortality was considerably elevated in the north of the country compared to southern regions (around 70% for males and 30% for females in the truncated 35-64 rate), and generally intermediate in central areas. Northern mortality rates were higher for respiratory cancers and other tobacco related neoplasms (excluding bladder), with a north/south ratio ranging from 1.5 for lung and most respiratory sites to about 4.0 for oesophageal cancer in males. There was little tendency towards a leveling of these differences in younger (40-49 year old) males. Northern areas showed higher death certification rates for cancers of the stomach, large bowel, liver and most other digestive sites. The lower gastric cancer mortality registered in southern Italy is curious, since this is the poorest part of the country. Death certification rates from all other common neoplasms (uterus apart) were also elevated in the north. The geographical variation, however, appeared more limited for non-epithelial neoplasms. The substantial differences in cancer mortality between various Italian geographical areas can hardly be dismissed as due to lower death certification accuracy in the south. Some of the differences can be explained in terms of available knowledge of the causes of cancer (eg reproductive factors for breast and ovarian neoplasms, alcohol plus tobacco for oesophageal cancer). However, the lower mortality from respiratory cancers in southern areas can only with some difficulty be totally explained in terms of tobacco consumption. Likewise, the north/south variation cannot be related to non-specific consequences of industrialization, since cancer mortality was similarly elevated in highly industrialized and chiefly rural northern areas. It is conceivable that dietary factors may also explain some of the differences. However, at present, there is no obvious general explanation for this quite peculiar geographical distribution of cancer mortality within a single country.

Adult↗
PubMed1985

Risk factors for gestational trophoblastic disease in Italy.

Between June 1981 and March 1983, data were collected to assess risk factors for gestational trophoblastic disease in a case-control study of 100 women with trophoblastic tumors (17 partial hydatidiform moles, 63 complete moles, and 20 choriocarcinomas) and 200 age-matched controls admitted for normal deliveries to university or general hospitals in Lombardy, Northern Italy. Questions were asked about each patient's general life-style, and medical, obstetric, menstrual, contraceptive, and social history. The risk of trophoblastic disease increased with increasing paternal age: women whose husbands were aged 40-44 years and 45 years or more had a relative risk of 2.4 and 4.2, respectively, compared to women married to men aged under 40 years. This association was independent of maternal age. Cigarette smoking was associated with trophoblastic tumors (relative risk estimate for smokers vs. never smokers = 2.0, 95% confidence interval = 1.2-3.2), the risk being greater for women who smoked more cigarettes and for longer. The effect of cigarette smoking was not explained by any other identified potential distorting factor. A positive history of fertility problems or difficulties in conception and a personal or family history of gestational trophoblastic disease were more common among the cases. Past use of oral contraceptives was not related to the risk of trophoblastic tumors, but use of an intrauterine device was significantly more common among the cases. The findings give epidemiologic support to the evidence of an androgenetic role in the origin of hydatidiform mole; moreover, they provide new hypotheses on the risk factors for gestational trophoblastic disease in developed countries. Further exploration of these factors may lead to a more coherent body of evidence on the etiology of these diseases.

Adolescent↗
PubMed1985

Benign breast disease and consumption of beverages containing methylxanthines.

The relationship between methylxanthine (Mx) consumption and benign breast disease was evaluated in a case-control study of 288 women with histologically confirmed benign breast lumps (203 dysplastic lesions and 85 benign tumors) and 2 groups of control women--285 patients in the hospital for acute conditions apparently unrelated to the consumption of Mx-containing beverages and 291 outpatients. The relative risk estimates of dysplastic breast lesions (fibrocystic disease), with allowance for all identified potential distorting factors, for women who drank 1-2 or 3 or more cups of coffee per day were 4.1 and 6.4, respectively, when the hospital controls were the comparison group and 2.0 and 3.7, respectively, when the outpatient controls were the comparison group. The relationship was even stronger when the total consumption of Mx-containing beverages (coffee plus tea) was considered and increased with increasing duration of use. The association was not explained by any of the major risk factors for fibrocystic breast diseases or by differences in general characteristics or other lifestyle habits between cases and controls. Mx consumption was not related to the risk of benign breast tumors (fibroadenomas). These findings support the hypothesis that Mx consumption is related to the risk of dysplastic lesions of the breast.

Adult↗
PubMed1985

Alcohol consumption and the risk of breast cancer in women.

The relationship between breast cancer and alcoholic beverage consumption was investigated in a case-control study of 437 women with breast cancer and 437 age-matched controls admitted to the hospital for acute conditions apparently unrelated to alcohol consumption. Compared to the relative risks (RR) for women who had never drunk alcohol, the RR for those reporting 1-3 and more than 3 alcoholic drinks per day were 1.24 and 1.93, respectively. A similar positive trend in risk with increasing daily consumption was evident for wine alone, and the point estimates were above unity for beer and spirits. Allowance for all identified potential confounding factors (including the major risk factors for breast cancer and a few selected dietary items) did not appreciably change any of the alcohol-related estimates. The RR, however, were higher at younger ages and did not rise with increasing duration of use. Nonetheless, the findings of the present study and their similarity with those of another case-control study conducted in northeastern Italy indicate that the association between alcoholic beverage consumption and breast cancer in this population is probably real, though not necessarily causal.

Adult↗
PubMed1985

[Association between arterial pressure and other cardiovascular risk factors in adolescence].

A screening for hypertension and other cardiovascular risk factors was carried out during 1981 in a population of 1142 subjects (675 males and 467 females) aged 14-18 years. Aim of the study was to analyze the distribution of blood pressure values and of variables possibly associated with hypertension in a population of adolescents. The mean value of systolic blood pressure was higher in males than in females, slightly increasing with age in males and decreasing in females. The diastolic blood pressure was similar, and increased with age in both sexes. The prevalence of individuals with systolic blood pressure greater than or equal to 140 mmHg resulted of 16.1% in males and of 5.6% in females; the prevalence of adolescents with diastolic blood pressure greater than or equal to 90 mmHg was much lower, being of 2.5% and 1.5% respectively. The average value of heart rate was higher in females and decreased with age in both sexes. Males showed significantly greater height and weight, but the body mass index was nearly equal in the two sexes; females had thicker skinfolds. All these variables only in males were clearly associated with age. Among anamnestic variables, only smoking habits, alcohol consumption and physical activity were significantly different in the two sexes. A positive family history for hypertension was present in 31.4% of the adolescents in whom an objective assessment was possible. In both sexes the systolic blood pressure appeared significantly related to heart rate, body weight, body mass index and skinfold thickness.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

Electrocoagulation and the risk of cervical neoplasia.

The relationship between electrocoagulation diathermy and the risk of cervical neoplasia was evaluated in a case-control study of 145 women with cervical intraepithelial neoplasia compared with 145 age-matched outpatient control subjects, and 191 cases of invasive cervical cancer compared with 191 control subjects in the hospital for acute conditions unrelated to any of the identified or suspected risk factors for cervical cancer. History of electrocoagulation was associated with an apparently reduced risk of cervical intraepithelial neoplasia (relative risk = 0.50, with 95% confidence interval = 0.29-0.87), and of invasive cancer (relative risk = 0.42, 95% confidence interval = 0.22-0.82). However, this apparent protection could be largely explained in terms of a different frequency of previous Papanicolaou smears in patients and control subjects. When adjustment was made for that variable, the risk estimates of CIN and invasive cancer among women who had undergone electrocoagulation increased to 0.62 and 0.83 and became statistically nonsignificant. Further allowance for other identified potential confounding factors by means of multiple logistic regression raised these estimates to 0.73 and 0.94, respectively. Thus, these data provide evidence against the hypothesis that electrocoagulation may have an important and independent role in the prevention of cervical neoplasia.

Adult↗
PubMed1984

"Pap" smear and the risk of cervical neoplasia: quantitative estimates from a case-control study.

The relation between Papanicolau ("Pap") smear and the risk of cervical neoplasia was evaluated in a case-control study in which 145 women with cervical intra-epithelial neoplasia (CIN) were compared with 145 age-matched outpatient controls, and 191 cases of invasive cervical cancer were compared with 191 control subjects in hospital for acute conditions unrelated to any of the established or suspected risk factors for cervical cancer. Compared with women with no previous screening smear, the relative risk (RR) estimate for invasive cancer was 0.44 (with 95% confidence interval [CI] = 0.24-0.80) for those who had had one smear and 0.20 (95% CI = 0.13-0.32) for those who had had two or more smears. The corresponding estimates for CIN were 0.27 (95% CI = 0.10-0.71) and 0.12 (95% CI = 0.06-0.25), respectively. The risk estimates for intervals of more than 5, 3-5, and less than 3 years were 0.36, 0.18, and 0.10 for invasive cancer, and 0.45, 0.31, and 0.07 for CIN. These results were not materially modified by adjustment for the major risk factors for cervical cancer, such as indicators of socioeconomic status and sexual habits. According to the estimates of this study, 64% of invasive cervical cancers could be prevented by screening at intervals of more than 5 years, an additional 18% by reducing the interval to 3-5 years, and a further 8% to less than 3 years.

Adult↗
PubMed1984

Dietary vitamin A and the risk of invasive cervical cancer.

The relation between dietary vitamin A and the risk of invasive cervical cancer was evaluated using data from a hospital-based case-control study of 191 women with cervical cancer and 191 age-matched controls. There was no association between dietary retinoids and cervical cancer risk. Intake of dietary beta-carotene, on the other hand, was inversely and strongly related to the risk of cervical cancer. Compared to risks for women reporting a monthly intake of 150,000 or more international units (IU) of beta-carotene, the estimated relative risks for those with 100,000 to 149,000 and those with less than 100,000 IU per month were 2.8 and 6.1 respectively. The inverse association was not explained by any of the major identified risk factors for cervical cancer (including indicators of socio-economic status or sexual habits), or by differences in general characteristics and other lifestyle habits between cases and controls. Thus, although the uncertainties of the vitamin A measurements used are substantial, these findings support the hypothesis that dietary beta-carotene-or some related aspect of a vegetable-rich diet-is protective against invasive cervical cancer.

Animals↗