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Biomedical subjects

Carlo La Vecchia

Publications and source records attributed to Carlo La Vecchia.

At least 19 recordsLinked to original sources
PubMed2007

Flavonoids and risk of squamous cell esophageal cancer.

The relation between 5 classes of flavonoids (flavanones, flavan-3-ols, flavonols, flavones and anthocyanidines) and esophageal cancer was investigated using data from a case-control study conducted between 1992 and 1997 in 3 areas of northern Italy. The study included 304 cases (275 men, 29 women) with a first diagnosis of squamous-cell carcinoma of the esophagus and 743 controls (593 men, 150 women) with no history of cancer, admitted for acute illnesses, unrelated to tobacco and alcohol consumption, to major hospitals of the areas under surveillance. Dietary habits were investigated using a validated food frequency questionnaire. Odds ratios (ORs) and 95% confidence intervals (CI) were computed after allowance for age, sex, study centre, years of education, alcohol drinking, tobacco smoking, body mass index and energy intake. An inverse association emerged between flavanone intake and esophageal cancer risk (OR=0.38 for the highest vs. the lowest quintile, 95% CI=0.23-0.66). The inverse relation between flavanones and esophageal cancer tended to be stronger in those who drank >or=6 drinks/day. In conclusion, this study suggests that flavanone intake is inversely associated with esophageal cancer risk and may account, with vitamin C, for the protective effect of fruit, especially citrus fruit, on esophageal cancer.

Adult↗
PubMed2007

Coffee and tea consumption and risk of hepatocellular carcinoma in Italy.

The role of coffee in the aetiology of hepatocellular carcinoma has raised great interest. In Italy, coffee consumption is high, thus allowing the investigation of the topic over a broad range of consumption. A hospital-based case-control study was conducted in Italy in 1999-2002, including 185 incidents, histologically confirmed cases of hepatocellular carcinoma aged 43-84 years. Controls were 412 subjects admitted to the same hospitals' networks for acute, non-neoplastic diseases unrelated to diet. Coffee and tea consumption were assessed using a validated food-frequency questionnaire. Odds ratios (ORs) and corresponding the 95% confidence intervals (CI) were computed using unconditional multiple logistic regression, adjusting for hepatitis viruses seropositivity, alcohol intake, smoking habits and other potential confounding factors. Compared to people who drunk <14 cups/week of coffee, the risk of hepatocellular carcinoma decreased for increasing levels of consumption (OR=0.4, 95% CI: 0.2-1.1 for >or=28 cups/week, p for trend = 0.02). In the present study, inverse relations were observed across strata of hepatitis C and, B virus infections and alcohol drinking. No significant association emerged with consumption of decaffeinated coffee (OR=0.7, 95% CI=0.2-2.5) or tea (OR=1.4, 95% CI=0.8-2.7). The present study supports the hypothesis of a favourable effect of coffee, though not decaffeinated coffee and tea, on the risk on hepatocellular carcinoma.

Adult↗
PubMed2007

Micronutrients and the risk of renal cell cancer: a case-control study from Italy.

The role of various micronutrients on the risk of renal cell cancer (RCC) was examined in a multicentric case-control study from Italy, in which information on dietary habits were collected using a validated food-frequency questionnaire. Cases were 767 patients (494 men and 273 women) with incident, histologically confirmed RCC; controls were 1,534 subjects (988 men and 546 women) admitted to the same hospitals as cases for a wide spectrum of acute, nonneoplastic conditions. After allowing for energy and other major covariates, a significant inverse association was found for vitamin E (odds ratio, OR, for the highest quintile of intake versus the lowest one 0.56, 95% confidence interval, CI 0.41-0.75), and vitamin C (OR = 0.72, 95% CI = 0.54-0.96), although the trend in risk for vitamin C was of borderline significance. No significant trend of decreasing risk was found for other micronutrients analyzed, although for most of them the risk estimates were below unity for intakes above the lowest. The ORs for the upper quintile of intake when compared with the lowest one were 0.80 (95% confidence interval, CI = 0.59-1.08) for retinol, 0.82 (95% CI = 0.61-1.10) for alpha-carotene, 0.90 (95% CI = 0.68-1.20) for beta-carotene, 0.94 (95% CI = 0.73-1.21) for beta-criptoxanthin, 0.85 (95% CI = 0.63-1.14) for lutein/zeaxanthin, 0.76 (95% CI = 0.57-1.01) for vitamin D, 0.75 (95% CI = 0.55-1.01) for thiamine, 0.88 (95% CI = 0.66-1.19) for riboflavin, 0.85 for vitamin B6 (95% CI = 0.64-1.13), 0.85 (95% CI = 0.64-1.12) for folate and 0.80 (95% CI = 0.60-1.07) for niacin. No meaningful associations emerged for lycopene (OR = 1.11). The present findings support a possible beneficial effect of vitamin E and C on RCC.

Adult↗
PubMed2007

Food groups and renal cell carcinoma: a case-control study from Italy.

Although nutrition and diet have been related to renal cell carcinoma (RCC), the role of specific foods or nutrients on this cancer is still controversial. We evaluated the relation between a wide range of foods and the risk of RCC in an Italian case-control study including 767 patients (494 men and 273 women) younger than 79 years with incident, histologically confirmed RCC, and 1,534 controls (988 men and 546 women) admitted to the same hospitals as cases for a wide spectrum of acute, non-neoplastic conditions, not related to long term diet modifications. A validated and reproducible food frequency questionnaire, including 78 foods and beverages, plus a separate section on alcohol drinking, was used to assess patients' dietary habits 2 years before diagnosis or hospital admission. Multivariate odds ratios (OR) were obtained after allowance for energy intake and other major confounding factors. A significant direct trend in risk was found for bread (OR = 1.94 for the highest versus the lowest intake quintile), and a modest excess of risk was observed for pasta and rice (OR = 1.29), and milk and yoghurt (OR = 1.27). Poultry (OR = 0.74), processed meat (OR = 0.64) and vegetables (OR = 0.65) were inversely associated with RCC risk. No relation was found for coffee and tea, soups, eggs, red meat, fish, cheese, pulses, potatoes, fruits, desserts and sugars. The results of this study provide further indications on dietary correlates of RCC, and in particular indicate that a diet rich in refined cereals and poor in vegetables may have an unfavorable role on RCC.

Aged↗
PubMed2006

Family history of hematopoietic malignancies and risk of non-Hodgkin lymphoma (NHL): a pooled analysis of 10 211 cases and 11 905 controls from the International Lymphoma Epidemiology Consortium (InterLymph).

A role for genetic susceptibility in non-Hodgkin lymphoma (NHL) is supported by the accumulating evidence of common genetic variations altering NHL risk. However, the pattern of NHL heritability remains poorly understood. We conducted a pooled analysis of 10 211 NHL cases and 11 905 controls from the International Lymphoma Epidemiology Consortium (InterLymph) to evaluate NHL risk among those with hematopoietic malignancies in first-degree relatives. Odds ratios (ORs) and 95% confidence intervals (CIs) of NHL and its subtypes were estimated from unconditional logistic regression models with adjustment for confounders. NHL risk was elevated for individuals who reported first-degree relatives with NHL (OR = 1.5; 95% CI = 1.2-1.9), Hodgkin lymphoma (OR = 1.6; 95% CI = 1.1-2.3), and leukemia (OR = 1.4; 95% CI = 1.2-2.7). Risk was highest among individuals who reported a brother with NHL (OR = 2.8; 95% CI = 1.6-4.8) and was consistent for all NHL subtypes evaluated. If a first-degree relative had Hodgkin lymphoma, NHL risk was highest if the relative was a parent (OR = 1.7; 95% CI = 1.0-2.9). If a first-degree relative had leukemia, NHL risk was highest among women who reported a sister with leukemia (OR = 3.0; 95% CI = 1.6-5.6). The pattern of NHL heritability appeared to be uniform across NHL subtypes, but risk patterns differed by specific hematopoietic malignancies and the sex of the relative, revealing critical clues to disease etiology.

Case-Control Studies↗
PubMed2006

Food groups and risk of hepatocellular carcinoma: A multicenter case-control study in Italy.

The role of diet, except for alcohol drinking and aflatoxin contamination, in the etiology of hepatocellular carcinoma (HCC) is unclear. A hospital-based case-control study was conducted in Italy in 1999-2002, including 185 incident, histologically-confirmed cases of HCC. Controls were 412 subjects admitted to hospitals for acute, nonneoplastic diseases unrelated to diet. Dietary habits were assessed using a validated food-frequency questionnaire. Odds ratios (ORs) and the corresponding 95% confidence intervals (CI) were computed using unconditional multiple logistic regression, adjusting for hepatitis B (HBV) and hepatitis C (HCV) virus infection and alcohol drinking. Energy adjustment was carried out by means of the residual model. A significant inverse relation was found between intakes of milk and yoghurt (OR = 0.28; 95% CI: 0.13-0.61), white meats (OR = 0.44; 95% CI: 0.20-0.95), eggs (OR = 0.31; 95% CI: 0.14-0.69), and fruits (OR = 0.48; 95% CI: 0.22-1.05) and HCC risk. The favourable effect of high intakes of milk and yoghurt, white meats, eggs and fruits was consistent across strata of HBV and HCV infections. The present study supports the hypothesis of a role of diet in HCC aetiology. Dietary modifications may be indicated in subjects at high-risk for HCC.

Adult↗
PubMed2006

Second primary oral and pharyngeal cancers in subjects diagnosed with oral and pharyngeal cancer.

Patients diagnosed with oral and pharyngeal (OP) cancer have a substantial excess risk of second OP cancer, but risk quantification is still uncertain and scanty information is available on the absolute excess risk of second OP cancer. We considered the risk of second OP primary cancer in a population-based series of 3,092 first primary OP cancers registered between 1974 and 2003 in the Swiss Cantons of Vaud and Neuchâtel (total population of about 786,000 inhabitants). A total of 233 second OP cancers were registered, versus 7.4 expected, corresponding to a SIR of 31.7 (95% confidence interval (CI) 27.7-36.0). The SIR was 68.5 in the first year after diagnosis of the first primary, and declined thereafter, leveling around 20. The SIR was 30.7 when the site of first neoplasm was the oral cavity, 42.5 for the tongue and 28.1 for the oropharynx or hypo-pharynx. Corresponding values for topographies of second primaries were 28.8, 50.4 and 26.2. The cumulative risk of second OP cancer 15 years after diagnosis of first OP cancer approached 22% in men and 17% in women. The incidence of first primaries increased over 20-fold between age 30-39 and 70-79, whereas there was no rise with age for second neoplasms.

Aged↗
PubMed2006

Risk factors for histological types and anatomic sites of cutaneous basal-cell carcinoma: an italian case-control study.

Different clinico-pathologic subtypes and anatomic sites of basal-cell carcinoma (BCC) may display distinct characteristics and mechanisms of development. However, scanty information exists on potential differences in etiological factors for BCC according to histotype and anatomic location. Thus, we analyzed data from an Italian case-control study, including 528 subjects with newly diagnosed, histologically confirmed BCC and 512 controls admitted to the same hospitals with acute conditions. The multivariate odds ratio (OR) of nodular (OR=1.53) but not superficial (OR=0.71) BCC was increased for occupational exposure to sunlight. Considering the anatomic site of BCC, the corresponding values were 1.46 for head/neck and 0.74 for truncal location. Direct associations were observed with recreational sunlight exposure, eye color, red hair, and number and early age of severe sunburn episodes, along with some differences in risk between histotypes and anatomic sites. This study confirmed the role of (intermittent) sun exposure and phenotypic characteristics as risk factors for BCC, and suggested etiological differences between nodular and superficial histotypes and between head/neck and truncal locations.

Basal Cell Carcinoma↗
PubMed2006

Benign ovarian cysts and breast cancer risk.

Benign ovarian cysts have been suggested to influence breast cancer risk. To provide a comprehensive picture of the relation between ovarian cysts and breast cancer, we analyzed the data of 3 case-control studies conducted in northern Italy and the Swiss Canton of Vaud between 1983 and 2001. These studies included 6,315 incident, histologically confirmed breast cancer cases and 6,038 hospital-based controls. Odds ratios (OR) and the corresponding 95% confidence intervals (CI) were estimated using unconditional multiple logistic regression models, including terms for sociodemographic, menstrual and reproductive factors. Overall, 4.9% of breast cancer cases and 6.6% of controls reported a history of ovarian cysts, with a multivariate OR of 0.72 (95% CI 0.62-0.85). The inverse association between ovarian cysts and breast cancer was consistent in separate strata of age at menarche, parity, age at menopause status and family history of breast cancer. No meaningful differences were also found across strata of menstrual cycle length, oral contraceptive use, history of oophorectomy and body mass index. Thus, the inverse relation between ovarian cysts and breast cancer risk was not accounted for by earlier menopause, or by any difference in reproductive and menstrual characteristics. Although some hormonal correlates of ovarian cysts may have a role on breast cancer risk, a biological explanation of this inverse association is still unclear.

Adult↗
PubMed2006

High incidence of second basal cell skin cancers.

We considered the risk of second basal cell cancers (BCC) of the skin using a population-based series of 1,868 BCC collected between 1976 and 1985 in the Swiss Cantons of Vaud and Neuchâtel, and followed-up to the end of 2003. Overall, 507 second BCC were observed versus 59.98 expected, corresponding to a standardized incidence ratio (SIR) of 8.45 (95% CI: 7.73-9.22). The SIRs were similar in men and women in subsequent calendar periods, but tended to decline with advancing age at diagnosis of first BCC, from 13.98 below age 50 to 7.13 at age 70 or over. Consequently, the rate of first BCC increased to approximately 30-fold between 7/100,000 at age 30-39 and 200/100,000 at age 70-79, but the rate of second BCC increased only about 3-fold between 31/1,000 at age 30-39 and 110/1,000 at age 70-79. The cumulative risk of second BCC was 11% at 5 years, 21% at 10 years and 40% at 20 years. This study indicates that the relative (but not the absolute) risk of second BCC is greater at younger age and declines with advancing age, and is therefore compatible with an excess baseline risk in a population of susceptible individuals.

Adult↗
PubMed2006

Family history of cancer provided by hospital controls was satisfactorily reliable.

OBJECTIVE: Our aim was to investigate the reliability of the information on family history of cancer in first-degree relatives in a hospital-based case-control study. STUDY DESIGN AND SETTING: We re-interviewed at home 294 controls of an Italian hospital-based case-control study on digestive tract neoplasms using the same questionnaire and compared the responses reported by these patients in the two settings. RESULTS: A satisfactory agreement between the two interviews was reported for family history of any cancer (kappa=0.7) and of cancers of the digestive tract (kappa=0.8). The agreement was apparently higher for esophageal and stomach cancers (kappa>0.8) than for intestinal cancers (kappa=0.6) and lower for lung cancer (kappa=0.5). We found a systematic tendency to report a history of cancer more frequently in the hospital setting than in the home setting. CONCLUSION: The present study showed a good reliability of data on family history of all cancers, including cancers of the digestive tract, provided by hospital controls through a structured interview-administered questionnaire. It suggests, moreover, that controls in the hospital setting tend to recall more often, and presumably more completely, a family history of cancer.

Adult↗
PubMed2006

Effects of smoking cessation on the risk of laryngeal cancer: an overview of published studies.

Epidemiological studies showed that stopping smoking substantially decreases the risk of lung cancer. With reference to laryngeal cancer, at least four cohort studies and 15 case-control studies reported information on smoking cessation. These studies indicated that the risk of laryngeal cancer is considerably reduced in ex-smokers as compared to current smokers. The relative risk steeply decreases with time since stopping smoking, with reductions by about 60% after 10-15 years since cessation, and even larger after 20 years. The favorable effect of stopping smoking is already evident within few years after cessation, thus suggesting that smoking has a relevant impact on the late stage of laryngeal carcinogenesis. However, several years after stopping smoking, ex-smokers still have elevated risks of laryngeal cancer as compared to never smokers. In conclusion, the epidemiological evidence clearly indicates that cessation of smoking is the best measure to reduce laryngeal cancer risk, the beneficial effect being evident within a few years after cessation, and steadily increasing with passing time since cessation.

Case-Control Studies↗
PubMed2006

Smoking cessation and the risk of oesophageal cancer: An overview of published studies.

The epidemiologic studies on oesophageal cancer and smoking cessation published before December 2005 were reviewed here. The results from at least 10 cohort and 10 case-control studies indicated that former smokers had a lower risk of squamous-cell or unspecified oesophageal cancer than current smokers. Most investigations showed that the risk of oesophageal cancer remains elevated many years (at least 10) after cessation of smoking, to decline by about 40% only thereafter. Moreover, after 10 years since cessation of smoking, ex-smokers still have a twofold increased risk as compared to never smokers. A few studies investigated the effect of smoking cessation on adenocarcinoma, and did not report a clear reduction of risk. Data on oesophageal adenocarcinoma are however too limited to provide adequate inference on the relation with time since smoking cessation. In conclusion, cessation of smoking could have an appreciable impact in reducing (squamous-cell) oesophageal cancer, and represents an obvious priority for prevention and public-health purposes.

Adenocarcinoma↗
PubMed2006

The burden of cancer attributable to alcohol drinking.

We estimated the number of cancer cases and deaths attributable to alcohol drinking in 2002 by sex and WHO subregion, based on relative risks of cancers of the oral cavity, pharynx, esophagus, liver, colon, rectum, larynx and female breast obtained from recent meta- and pooled analyses and data on prevalence of drinkers obtained from the WHO Global Burden of Disease project. A total of 389,100 cases of cancer are attributable to alcohol drinking worldwide, representing 3.6% of all cancers (5.2% in men, 1.7% in women). The corresponding figure for mortality is 232,900 deaths (3.5% of all cancer deaths). This proportion is particularly high among men in Central and Eastern Europe. Among women, breast cancer comprises 60% of alcohol-attributable cancers. Although our estimates are based on simplified assumptions, the burden of alcohol-associated cancer appears to be substantial and needs to be considered when making public health recommendations on alcohol drinking.

Alcohol Drinking↗
PubMed2006

Trends in laryngeal cancer mortality in Europe.

After a steady increase since the 1950s, laryngeal cancer mortality had tended to level off since the early 1980s in men from most European countries. To update trends in laryngeal cancer mortality in Europe, age-standardized (world standard) mortality rates per 100,000 were derived from the WHO mortality database for 33 European countries over the period 1980-2001. Jointpoint analysis was used to identify significant changes in mortality rates. In the European Union (EU) as a whole, male mortality declined by 0.8% per year between 1980 and 1989, by 2.8% between 1989 and 1995, by 5.3% between 1995 and 1998, and by 1.5% thereafter (rates were 5.1/100,000 in 1980-1981 and 3.3/100,000 in 2000-2001). This mainly reflects a decrease in rates in men from western and southern European countries, which had exceedingly high rates in the past. Male laryngeal mortality rose up to the early 1990s, and leveled off thereafter in several countries from central and eastern Europe. In 2000-2001 there was still a 10-15-fold variation in male laryngeal mortality between the highest rates in Croatia (7.9/100,000) and Hungary (7.7/100,000) and the lowest ones in Sweden (0.5/100,000) and Finland (0.8/100,000). Laryngeal cancer mortality was comparatively low in women from most European countries, with stable rates around 0.3/100,000 in the EU as a whole over the last 2 decades. Laryngeal cancer trends should be interpreted in terms of patterns and changes in exposure to alcohol and tobacco. Despite recent declines, the persistence of a wide variability in male laryngeal cancer mortality indicates that there is still ample scope for prevention of laryngeal cancer in Europe.

Adult↗