Biomedical subjects

A Decarli

Publications and source records attributed to A Decarli.

At least 217 records · Page 12Linked to original sources

PubMed1984

Oral contraceptives and benign breast disease: a case-control study.

The relationship between benign breast disease and use of oral contraceptives was analyzed in a case-control study conducted in Milan with 288 cases of clinically relevant and histologically confirmed benign breast disease and 285 age-matched controls with a spectrum of acute conditions apparently unrelated to use of oral contraceptives. Compared to the risk for women who had never used oral contraceptives, the relative risk for users was 1.0 (95% confidence interval: 0.6 to 1.5). There was no significant association with duration of use; however, a significantly lower relative risk was found in women using oral contraceptives during the year before breast biopsy (relative risk: 0.4; 95% confidence interval: 0.2 to 0.8). The protection in current users increased with increasing duration of use. In spite of this finding, the overall results of the present study do not support the hypothesis that oral contraceptive use protects against development of histologically confirmed and clinically relevant benign breast disease.

Adolescent↗

PubMed1984

Coffee drinking and the risk of epithelial ovarian cancer.

The relation between ovarian cancer and coffee drinking habits was evaluated in a case-control study of 247 histologically confirmed epithelial ovarian cancers and 494 age-matched controls, admitted to hospital for acute conditions apparently unrelated to coffee consumption. Compared to rates for women who had never drunk coffee, the crude relative risk estimates for those who drank less than two, two or three, and four or more cups per day were 1.3, 1.5 and 1.4 respectively; however, when allowance was made for smoking habits, these risk estimates became 1.3, 1.7 and 1.8 respectively, and a significant linear trend of increasing risk with more elevated coffee consumption was evident. These results were not explained by various other potential confounding factors, including the major risk factors for ovarian cancer, but we had no information on dietary variables. The relative risk, however, did not increase with increasing duration of use. The findings of this study give apparent support in favour of the hypothesis that coffee consumption, or related dietary variables, may be associated with the risk of epithelial ovarian cancer. Further studies in different settings, however, are required in order to establish whether this association is real, and if so, whether it is causal.

Adult↗

PubMed1984

Social factors, diet and breast cancer in a northern Italian population.

The relation of breast cancer to social and dietary variables was evaluated in a case-control study of 368 women with breast cancer admitted to the General Hospital of Pordenone (a town in the eastern side of Northern Italy) and 373 age-matched controls. Occupation was related to the risk of breast cancer, housewives and non-manual workers (teachers and other professionals, clerical workers, etc.) showing relative risks of 1.7 and 2.4 respectively when compared to women occupied in agriculture. The role of education was apparently less important, and not statistically significant. The risk was higher in women who were obese, the trend of increasing risk with increasing body mass index being confined to post-menopausal women. When indicators of dietary fat intake were analysed, a significantly increased risk was found with more frequent consumption of milk and dairy products but the risk estimates were only slightly above unity with reference to meat consumption. Women who drank alcoholic beverages showed a relative risk of 2.5 compared to women who had never drunk, when allowance was made for all identified potential confounding factors. The association between alcohol and breast cancer was not explained by the other dietary variables considered, and the risk estimates were higher for women who drank more wine, or more than one type of alcoholic beverage. Thus, the findings of the present study give evidence in favour of the hypothesis that alcohol consumption is related to the risk of breast cancer.

Adult↗

PubMed1984

Oral contraceptive use and the risk of epithelial ovarian cancer.

The relation between the use of combination oral contraceptives (OCs) and the risk of epithelial ovarian cancer was investigated in a case-control study conducted in Milan on 209 women below the age of 60 with histologically confirmed epithelial ovarian cancer, and 418 age-matched controls with a spectrum of acute conditions apparently unrelated to OC use. Combination oral contraceptives were used by 18 (9%) cases, and 59 (14%) controls, giving a relative risk estimate of 0.6 (95% confidence interval = 0.3-1.0, P less than 0.05). The risk of ovarian cancer decreased with increasing duration of use and the point estimate remained below unity long after cessation of use. These results were not accounted for by parity, infertility, or other identified potential confounding factors. Thus, the findings of the present study add further support to the evidence emerging from American data of a reduction of approximately 40% in the risk of epithelial ovarian cancer among women who had used oral contraceptives.

Adult↗

PubMed1984

Risk factors for pathologically confirmed benign breast disease.

Between November 1981 and March 1983, data were collected to evaluate risk factors for benign breast lesions in a case-control study based on 288 women with histologically proven benign breast disease, admitted for biopsy to the Tumor Institute of Milan, and 285 age-matched controls. Questions were asked about menstrual and reproductive characteristics, marital status, education, history of various diseases, and lifetime use of oral contraceptives and other hormonal treatments. Nulliparity or low parity, late age at first birth, and late menopause were associated with an increased risk of benign breast disease. The elevated risk associated with late age at first birth was not accounted for by parity. Early age at menarche was associated with an increased risk, but the estimate was not statistically significant. The data do not suggest that the use of oral contraceptives or other female hormones (such as estrogen replacement therapy) is related to the risk of benign breast disease. Risk was apparently lower, however, among current and long-term oral contraceptive users. There was no evidence of a trend with reference to body mass index. The present data indicate a substantial agreement between the risk factors for (pathologically confirmed) benign and malignant breast disease, not only directly, by showing a relationship with parity, age at first birth, and age at menopause, but also indirectly, by failing to produce evidence that greater weight or the use of oral contraceptives has a protective effect.

Adolescent↗

PubMed1984

Invasive cervical cancer in young women.

Between 1970 and 1979, 103 women below 35 years of age with invasive cervical cancer were treated at the First Obstetrics and Gynaecology Clinic of the University of Milan. Nine patients were pregnant or less than 3 months postpartum. Estimated 10-year disease-free survival, determined by the life-table method, was 100% in stage IA (37 patients), 79% in stage IB (45 patients), 67% in stage II (15 patients), 0% in stages III (5 patients) and IV (1 patient). Prognosis was also strongly associated with lymph-node involvement, 10-year actuarial survival decreasing from 93% in lymph-node-negative to 44% in lymph-node-positive patients (P less than 0.001). The prognostic relevance of the clinical stage decreased after adjustment for lymph-node involvement, but the statistical significance of lymph-node involvement was unaffected when stage was allowed for. In the present series, the estimated 10-year disease-free survival was 80% in patients treated by radical hysterectomy compared with 62% in the group treated by total hysterectomy (stage IB to IV patients only); this difference, however, was not statistically significant when the data were adjusted for clinical stage (P = 0.10). None of the 20 patients with recurrent disease could be managed successfully.

Adenocarcinoma↗

PubMed1984

Age of parents and risk of gestational trophoblastic disease.

The relationship of gestational trophoblastic disease (GTD) to parental age was evaluated in a case-control study of 132 women with hydatidiform mole (108) or choriocarcinoma (24) and 304 control subjects hospitalized for normal deliveries. Cases and controls were recruited in Lombardy (Northern Italy), and all were white and Italian. Compared to the risk of developing trophoblastic tumors in women 21-35 years old, the risk of developing trophoblastic tumors was elevated both in younger [less than or equal to 20 yr old, relative risk (RR) = 1.4, with 95% confidence interval (Cl) of 0.7-2.8] and in older subjects, RR being 1.2 (95% Cl 0.7-2.8) and 5.2 (95% Cl 2.2-12.3) for women 36-40 years old and over 40, respectively. The risk estimates for the last two categories were reduced to 0.7 (with 95% Cl of 0.3-1.9) and 2.5 (with 95% Cl of 0.7-8.9) when adjustment was made for paternal age by means of the Mantel-Haenszel procedure. Higher paternal age also was associated with GTD: Women whose husbands were 41-45 years old and over 45 had RR of 1.6 (with 95% Cl = 0.7-3.7) and 4.9 (with 95% Cl = 2.2-11.1), respectively, compared to women married to men less than 40 years old. These risk estimates were practically unchanged when adjustment was made for the woman's age. Examination of the effects of parental and maternal ages suggests that the highest risk estimate was observed when both parents were older. The findings of the present study were consistent with increased risk in the youngest maternal age group and confirm that older maternal age is associated with increased risk of GTD. Furthermore, showing a strong, independent effect of paternal age, they give epidemiologic support to the cytogenetic evidence of an androgenetic role in the origin of GTD.

Adult↗

PubMed1984

Increased androgenic activity and breast cancer risk in premenopausal women.

Blood and urine specimens from 27 premenopausal breast cancer patients and 62 healthy controls have been compared with respect to concentration of testosterone and progesterone in blood and of testosterone and androstanediol in urine, measured in the luteal phase of the menstrual cycle. There was a strong positive association between the concentration of the two androgens, either in blood or urine, and breast cancer risk. A strong association was also observed with decreasing levels of progesterone. The association was statistically significant (p for trend less than 0.01) for each hormone; the rate ratios were 10.2 for serum testosterone (highest category), 5.6 for serum progesterone (lowest category), 8.4 for urinary testosterone (highest category), and 5.2 for androstanediol (highest category). The rate ratio for women presenting both high serum testosterone and low progesterone was 21.8 (4.1 to 116.1). Considering the exposure to at least one of three androgens at the highest level and low progesterone, the rate ratio was as high as 90.2 (8.2 to 989.7). This study provides evidence for the hypothesis that increased androgenic activity is an important risk indicator for breast cancer, particularly when associated with anovulation, as indicated by low serum progesterone level.

Androgens↗

PubMed1984

Age at first birth and the risk of epithelial ovarian cancer.

The relationships between age at first birth, parity, and the risk of ovarian cancer were evaluated in a case-control study of 272 women with histologically confirmed epithelial ovarian cancer and 544 age-matched controls with a spectrum of acute conditions unrelated to any of the established or potential risk factors for ovarian cancer. Late age at first birth was associated with increased risk: Compared to women who first had a child before the age of 22 years, the relative risks (RR) for those who first gave birth at ages 22-24, 25-27, and 28 or more were 2.7, 3.2, and 4.0, respectively. Nulliparous women showed increased RR (3.9) comparable to the RR among women who first bore a child at age 25 or more, regardless of the number of births. The elevated risk associated with later age at first birth was not accounted for by low parity. The risk of ovarian cancer, as expected, increased with decreasing parity: RR estimates for women having 5 or more, 3 or 4, and 1 or 2 children and for nulliparae were 1.0, 1.7, 1.9, and 2.6, respectively. However, the inverse association between parity and ovarian cancer could be accounted for largely by the importance of age at first birth, because when adjustment was made for that variable, the RR for 3 or 4 and 1 or 2 children decreased to 1.3 and 1.2, respectively. Thus the results of the present study show a strong independent effect of age at first birth on the risk of epithelial ovarian cancer, whereas the association with parity can be explained largely or totally in terms of a high correlation between total parity and age at first birth. The pattern of ovarian cancer risk that emerges from this study, therefore, is similar to the epidemiology of breast cancer. General evidence on this issue from various other studies, however, is rather controversial, and similar analysis of other data-sets would be useful.

Adult↗

PubMed1984

Risk factors for endometrial cancer at different ages.

The importance of the major risk factors for endometrial cancer in women of different ages was evaluated with the use of data from a hospital-based case-control study conducted in Milan, Italy, on 283 women with endometrial cancer and 566 age-matched controls. Current weight was related strongly to the risk of endometrial cancer both in younger (premenopausal) and in older women (with risk estimates for the heaviest categories of 20.3 and 7.7, respectively), thus confirming that obesity is the major cause of endometrial cancer in Northern Italy. Endometrial cancer risk appeared to be approximately proportional to the second power of body mass index. Early menarche and nulliparity were associated with an increased risk of endometrial cancer in premenopausal women, the point estimate for nulliparity rising to 35.1 (with lower confidence limit of 10.2) after adjustment for marital status. However, no association with these factors was evident in postmenopausal women. Combination oral contraceptives were used by 2 cases and 19 controls only [relative risk (RR) = 0.2, with 95% confidence interval = 0.1-0.8]. The use of noncontraceptive estrogens was associated with an elevated risk, which was greater in perimenopausal women (RR = 5.1 for greater than 2 yr of use), and decreased progressively with increasing time after menopause. Late menopause was also related to endometrial cancer. However, the risk estimates for late menopause apparently were more elevated in older women (greater than or equal to 65 yr) than in perimenopausal women. Most of the risk factors identified (excluding late menopause) apparently act on one of the later stages of the process of carcinogenesis, because the excess risk drops after cessation of exposure.

Adolescent↗

PubMed1983

Delayed diagnosis of endometrial cancer in Italy.

This study considers the prevalence of early bleeding in a series of 173 cases of endometrial cancer, with particular reference to the lag time between the onset of symptoms and diagnosis. The length of this interval is examined in the light of patients' and tumor characteristics. Findings show a general delay in endometrial cancer diagnosis in the population studied. In addition there was a significant trend towards worsening of the tumor stage, depth of myometrial invasion and histological differentiation with increasing delay, thus underlining the need for more care in detection of endometrial cancer.

Adenocarcinoma↗

PubMed1983

Incessant ovulation and ovarian cancer: a critical approach.

The total duration of 'ovulatory activity' or 'ovulatory age' has been reported to be the strongest indicator of the risk of ovarian cancer. In the case-control study examined in this paper this variable was found to be a strong correlate of the risk of ovarian cancer. However, the finding that in older women the major determinant of 'ovulatory age' was age at menopause (which is a very unreliable indicator of 'ovarian activity'), and that age at menopause by itself was related to the risk of ovarian cancer as strongly as the total duration of ovulatory age, threw doubt on the biological consistency of that model. Furthermore, the protection conferred by pregnancies was different at different ages, and age at first pregnancy was more strongly associated with the risk of ovarian cancer than the actual number of pregnancies. The model of carcinogenesis for epithelial ovarian cancer appears, therefore, to be more complex than is indicated simply by the total duration of 'ovarian activity.'

Adult↗

PubMed1982

Prognostic features of endometrial cancer in estrogen users and obese women.

In a case-control study to evaluate risk factors for endometrial cancer in Italy, use of noncontraceptive estrogens was associated with a moderately increased risk, whereas obesity appeared to be the most important single risk factor related to cancer of the endometrium. This report considers the estrogen and obesity-related relative risks with regard to various prognostic features of tumors (clinical stage, histologic grade, extent of myometrial invasion, lymph node involvement). In both estrogen users and obese women, the increase in relative risk was greater for earlier than for more advanced tumors. These findings, therefore, provide further support for a specific role of both exogenous and endogenous estrogens in endometrial cancer.

Adult↗

PubMed1982

Oestrogens and obesity as risk factors for endometrial cancer in Italy.

In a case-control study to evaluate risk factors for endometrial cancer, obesity, history of various diseases, reproductive and menstrual characteristics, marital status, education, and lifetime use of female hormones were examined in 173 histologically proven endometrial cancers and 347 controls. Obesity, non-contraceptive oestrogen use, late menopause, low parity and history of uterine fibromyomas were associated with an increased risk of endometrial cancer. The relative risks of obesity and oestrogen use seem to fit well for an additive model. Histological differentiation was positively correlated both to oestrogen use and to level of overweight, supporting the hypothesis of a specific role of oestrogens in endometrial cancer.

Adult↗

PubMed1980

[Ocular rotation and corneal reflexes (author's transl)].

The location of the corneal reflex (Purkinje's first image) produced by an electronic flash was studied at various degrees of ocular rotation both in adduction and abduction. A statistical analysis of the results showed a good correlation between the decentration of the corneal reflex and the degrees of ocular rotation. The results thus obtained give an experimental basis to the clinical use of the so-called Hirschberg test for measuring the strabismus angle.

Adult↗

PubMedDate not supplied

Trends in mortality from cerebrovascular disease in Italy, 1955-78.

Trends in age-specific and age-standardized death certification rates from all cerebrovascular diseases and various diagnostic subcategories in Italy during the period 1955-78 have been analysed. In both sexes, a decrease in excess of 25% was evident in the overall age-standardized cerebrovascular disease mortality. However, rates were roughly stable in males up to age 50 and in females up to age 45, and slightly but consistently increasing in the younger age groups (under 40), mostly in females. The largest downward trends were for both sexes in the 55 to 74 age groups, and the declines were more marked in females, averaging 3% per year. Since death certification is most reliable in the younger age groups and it is difficult to imagine any modification of risk factors which should affect mortality in later middle age but not in younger age groups, there is no obvious and simple interpretation of this pattern of trends. A comparison with similar trends in ischemic heart disease and other causes of death suggests that the decline in overall cerebrovascular disease mortality might be partially or largely artefactual, though a between-sexes comparison indicates that at least part of the decrease registered in females may well be real. The extent of the decline, however, has been almost certainly more limited in Italy than in most other Western countries. Only in the younger age group (30-34) did rates show a larger increase in females, which might be related to increased prevalence of cigarette smoking, or the use of oral contraceptives.

Adult↗

PubMedDate not supplied

Cancer mortality in Italy, 1997: quantifying the fall in rates in women and men.

AIMS AND BACKGROUND: To update data and statistics on cancer death certification in Italy to 1997. METHODS: Data and statistics for 1997 subdivided into 31 cancer sites are presented. Trends in age-standardized rates for major cancer sites are plotted from 1955 to 1997. RESULTS: The age-standardized (world standard) death certification rates from all neoplasms steadily declined from the peak of 199.2/100,000 males in 1988 to 174.7 in 1997 and for females from 102.5 to 93.0. The decline was larger in truncated rates, by about 26% for males since 1983 and by 24% for females since the top rate of the early 1960's. A major component of the favorable trend in males was lung cancer, which showed a 16% decline from the peak of 1987-88, to reach 50.6/100,000 in 1997, corresponding to about 5,000 avoided deaths. The decline in lung cancer was about 34% at age 35 to 64. For females, in contrast, both the absolute number of lung cancer deaths and the age-standardized rate of 7.9/100,000 were among the highest values ever registered, reflecting the different pattern of spread of the tobacco-related lung cancer epidemic in the two sexes. Intestinal cancer rates were stable for males but declined by approximately 10% for females, mostly in middle age, as did breast cancer mortality. Among neoplasms showing favorable trends, there were other tobacco-related neoplasms in men, plus the continuing fall in stomach and cervix uteri. Upward trends were observed for non Hodgkin's lymphomas. CONCLUSIONS: The fall in cancer mortality observed over the last decade in Italy is attributable to a decline in lung and other tobacco-related neoplasms in males, together with a persistent fall in stomach and uterine (cervical) cancer. In women, there were also recent falls in intestinal and breast cancer rates, and declines in both sexes in rarer neoplasms influenced by therapeutic advancements.

Female↗

PubMedDate not supplied

Smoking in Italy, 1994.

The prevalence of smoking in Italian males and females has been investigated using data from the National Health Survey (first cycle), collected between January and March 1994, and based on a total sample of 13,048 individuals (6,307 males and 6,741 females) representative of the general Italian population. Overall, 24.2% of Italians aged 15 years or over described themselves as current smokers (32.6% of males and 16.3% of females). Ex-smokers were 14.2%, including 22.3% of males and 6.6% of females; never smokers were 61.6% (45.1% of males, 77.1% of females). In both sexes, the highest proportions of smokers were young to middle-aged (35-44 years), and there was a substantial decline in smoking rates in the youngest age group (15-24 years), to reach 19.8% of males and 9.9% of females. A steady and substantial decline in reported smoking prevalence over time was observed in males (from 54.2% in 1980 to 32.6% in 1994), whereas smoking prevalence remained approximately stable around 17% in females. This was due to some increase in smoking prevalence among women over 35 years of age, following a cohort effect, and the low quit rate among females. The average number of cigarettes per smoker per day was slightly up, to reach 18.3 in males and 13.4 in females in 1994. The fall in reported cigarette consumption was only partly reflected in legal sale data, which showed for 1993 a consumption of 1.86 kg per adult per year, corresponding to 5.1 cigarettes per day. Taking into account also smuggling, this indicates that interview-based figures were underestimated by at least 25%. In males, but not in females, smoking was less frequent in northern and more developed areas of the country and among more educated individuals. Among Italians with a university degree, smoking rates were for the first time higher in females (31.5%) than in males (23.7%). Thus, the data from the 1994 National Health Survey confirm the long-term decline in smoking prevalence among Italian males, in the absence however of appreciable changes in females.

Adolescent↗