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Biomedical subjects

D Trichopoulos

Publications and source records attributed to D Trichopoulos.

At least 235 records · Page 13Linked to original sources
PubMed1995

Oral contraceptives, menopausal estrogens, and the risk of breast cancer: a case-control study in Greece.

In a hospital-based case-control study in Athens, we examined the association between the use of oral contraceptives and menopausal estrogens and the risk of breast cancer. Eight hundred and twenty patients with confirmed breast cancer were compared with 795 orthopedic patient controls and 753 healthy visitor controls, matched to the cases by age and interviewer. The data were modeled through logistic regression, controlling for demographic and reproductive variables. Odds ratio patterns were similar for the 2 control series, which were therefore combined to increase precision of the estimates. The risk for breast cancer was not elevated among ever-users of oral contraceptives, regardless of age at diagnosis of breast cancer, duration of oral contraceptive use or timing of use in relation to first full-term pregnancy. Among peri- and post-menopausal women who ever used menopausal estrogens, with never-users as the baseline, a statistically significant elevated odds ratio was found after adjusting for age at menopause.

Breast Neoplasms↗
PubMed1995

Contribution of dihydrotestosterone to male sexual behaviour.

OBJECTIVE: To document the relative importance of endogenous sex steroids in modulating the frequency of orgasms, the dominant aspect of sexual behaviour in healthy eugonadal men. DESIGN: Measurement of adrenal and testicular sex steroids in a sample of army recruits and study of their relation to frequency of orgasms ascertained by questionnaire after potential confounding variables were controlled for. SETTING: Military campus and military hospital laboratories in Athens, Greece. SUBJECTS: 92 consecutively enrolled healthy male recruits aged 18-22 years. MAIN OUTCOME MEASURES: Weekly number of orgasms. Serum concentrations of testosterone, dehydroepiandrosterone sulphate, dihydrotestosterone, oestradiol, oestrone, delta-4-androstenedione, and sex hormone binding globulin. RESULTS: Serum dihydrotestosterone concentration was the only independent hormonal predictor of the frequency of orgasms; an increase in concentration of 1.36 nmol/l (about 2 SD) corresponded to an average increase of one orgasm a week. CONCLUSIONS: Differences in concentrations of circulating dihydrotestosterone within the normal range may represent a major predictor of sexual activity in healthy young men.

Adult↗
PubMed1995

Perinatal characteristics and adult mammographic patterns.

We retrieved breast mammograms for 370 women 40 to 74 years old with no history of breast cancer, for whom birth weight, birth length, placental weight and other birth characteristics were indicated in their standard birth records at the Uppsala University Hospital. Blind evaluation of the mammograms allowed these to be classified according to Wolfe's pattern. Logistic regression analysis was applied using as independent variables the recorded birth characteristics and as outcome variable, high risk (P2 and DY) versus low risk (N1 and P1) mammographic parenchymal pattern. After controlling for all the recorded variables, the odds ratio for a high-risk pattern (P2 or DY) increased consistently and significantly (P for trend 0.02) with the weight of the placenta, i.e. the main estrogen-producing organ during pregnancy. There were weak and non-significant positive associations with increasing birth weight (P for trend 0.53) and birth length (P for trend 0.52). These results are compatible with hypotheses suggesting that pregnancy estrogens or other perinatal characteristics may play a risk-modulating role influencing breast cancer in the offspring.

Adult↗
PubMed1995

Abortion and the risk of breast cancer: a case-control study in Greece.

We have examined the association between induced or spontaneous abortion and breast cancer risk in Greece. In a hospital-based case-control study in Athens, 820 patients with confirmed breast cancer were compared with 795 orthopedic patient controls and 753 healthy visitor controls, matched to cases by age and interviewer. Logistic regression was used to analyze the data, controlling for demographic, reproductive and nutritional variables. Odds ratio (OR) patterns were similar for the 2 control series, which were therefore combined to increase precision of the estimates. The risk for breast cancer was not increased for women who had a history of abortion, compared to nulliparous women with no history of abortion. Thus ORs and 95% confidence intervals were for nulliparous women with spontaneous abortion, 1.17 (0.64-2.13); for nulliparous women with induced abortion, 0.98 (0.56-1.73); for parous women with no abortion, 0.56 (0.31-1.01); for parous women with spontaneous abortion, 0.61 (0.33-1.14) and for parous women with induced abortion, 0.99 (0.56-1.74). When the analysis was restricted to parous women, using parous women with no history of abortion as the baseline, ORs and 95% confidence intervals were for induced abortion before first full-term pregnancy, 2.06 (1.45-2.90); for induced abortion after first full-term pregnancy, 1.59 (1.24-2.04) and for spontaneous abortion, 1.10 (0.82-1.40). Our findings suggest that an interrupted pregnancy does not impart the long-term protective effect of a full-term pregnancy attributable to terminal differentiation.

Abortion, Induced↗
PubMed1995

A case-control study of hepatitis B and C virus infections in the etiology of hepatocellular carcinoma.

During a 16-month period in 1991-1992, blood samples and questionnaire data were obtained from 65 incident cases of hepatocellular carcinoma (HCC) as well as from 2 control groups of hospitalized patients matched on gender and age, which included 65 metastatic liver cancer (MLC) patients and 65 patients hospitalized for eye, ear, nose or throat conditions. Coded sera were tested for hepatitis B surface antigen (HBsAg), antibody to hepatitis B core antigen, antibody to HBsAg and antibody to hepatitis C virus (anti-HCV) by enzyme immunoassay. The odds ratios (with 95% confidence intervals) in logistic regression modeling comparing the HCC cases to the combined control series were 18.8 (8.2-43.2) for the presence of HBsAg and 7.7 (1.7-35.1) for anti-HCV. In the present hospital-based case-control study anti-HCV testing was conducted on recently collected sera, using a second-generation enzyme immunoassay with confirmation by immunoblot assay. Comparisons with previous work in a similar population demonstrated that, when second-generation anti-HCV assays are applied to sera stored for 7-15 years, confirmatory assays or a higher diagnostic cut-off point may be necessary to ensure that the testing is specific.

Adult↗
PubMed1995

Consumption of olive oil and specific food groups in relation to breast cancer risk in Greece.

BACKGROUND: Experimental animal studies suggest that olive oil consumption, as contrasted to consumption of other fat types, does not enhance the occurrence of chemically induced mammary tumors, but human data are sparse. Furthermore, evidence is inconclusive concerning the role of food groups, as distinct from that of major nutrients, in the etiology of breast cancer in women. PURPOSE: This analysis was conducted to evaluate and quantify the effect of consumption of olive oil, margarine, and a range of food groups on the risk of breast cancer. METHODS: Data from a comprehensive, semiquantitative food-frequency questionnaire administered to 820 women with breast cancer and 1548 control women from the study base were used to calculate odds ratios (ORs) and X statistics of linear trend for the consumption of olive oil, margarine, and a series of food groups classified in quintiles. Adjustment for the effects of reproductive risk factors, energy intake, and mutual confounding influences was implemented through unconditional logistic regression modeling. RESULTS: Vegetable consumption and fruit consumption were independently associated with statistically significant reductions of breast cancer risk by 12% and 8%, respectively, per quintile increase; no significant associations were evident for the other food groups examined. Increased olive oil consumption was associated with significantly reduced breast cancer risk (OR = 0.75 [95% confidence interval = 0.57-0.98] for more than once a day versus once a day), whereas increased margarine consumption was associated with significantly increased risk (OR = 1.05 [95% confidence interval = 1.00-1.10] for an increment of four times a month). The olive oil association was apparently concentrated among postmenopausal women, but the relevant interaction term was not statistically significant; there was no suggestion of interaction with menopausal status for consumption of either vegetables, fruits, or margarine. CONCLUSIONS: Although major categories of macronutrients do not show significant associations with breast cancer risk in most studies, including the present one, vegetables and fruits are inversely, significantly, and strongly associated with this risk. There also is evidence that olive oil consumption may reduce the risk of breast cancer, whereas margarine intake appears to be associated with an elevated risk for the disease.

Breast Neoplasms↗
PubMed1995

Short-term effects of air pollution on hospital emergency outpatient visits and admissions in the greater Athens, Greece area.

The short-term effects of air pollution on morbidity in the Athens population were studied. Data were collected on the daily number of emergency outpatient visits and admissions for cardiac and respiratory causes (diagnoses at time of admission) to all major hospitals in the greater Athens area during 1988. Measurements of air pollution made by the Ministry of the Environment monitoring network included values for smoke, carbon monoxide, and nitrogen dioxide. Statistical analysis was done using multiple linear regression models controlling for potential confounding effects of meteorological and chronological variables, separately for winter (1/1-3/21 and 9/22-12/31) and summer (3/22-9/21). It was found that the daily number of emergency visits was related positively with the levels of air pollution, but this association did not reach the nominal level of statistical significance for most pollutants. The number of emergency admissions for cardiac and respiratory causes was related to a statistically significant degree with all indices of air pollution during the winter. Thus, the average adjusted increase in the daily number of cardiac admissions corresponding to an increase from the 5th to the 95th percentile of the season-specific distribution of each pollutant ranges from 15 to 17% or from 11 to 12.5 admissions per day, and for the daily number of respiratory admissions from 20 to 29% or from 8.3 to 12.1 admissions. The results of the present study indicate that air pollution in the Athens area has short-term effects on morbidity in the population.

Air Pollution↗
PubMed1995

Abortion and breast cancer risk in seven countries.

Epidemiologic studies have been inconsistent in suggesting an association between abortion and breast cancer risk. Whether the protection provided by a full-term pregnancy also results from a short-term pregnancy or whether a prematurely terminated pregnancy could increase the risk of breast cancer is unclear. Data from a large, international collaborative study were used to evaluate the association between abortions, whether spontaneous or induced, and breast cancer risk. The data from seven countries included 3,958 breast cancer cases and 11,538 hospital controls with information on abortion history obtained through interviews. Compared with nulliparous women with no abortion (baseline), the odds ratios (OR) and 95 percent confidence intervals (CI) were: for nulliparous women with a history of prior abortion, 0.86 (CI = 0.68-1.08); for parous women with no history of abortion, 0.63 (CI = 0.57-0.69); for parous women with abortion before first birth, 0.82 (CI = 0.69-0.97); and, for parous women with abortion only after first birth, 0.70 (CI = 0.63-0.79). When restricting analysis to parous women, those with a history of abortion exhibited an elevated OR suggesting a 29 percent risk increase if the incomplete pregnancy occurred before first birth (CI = 1.16-1.36) and an 11 percent risk increase for abortion only after first birth (CI = 1.02-1.20) compared with women without such history. The associations observed were stronger among the youngest women. These results do not support a large overall association between abortion and breast cancer risk.

Abortion, Induced↗
PubMed1995

Organochlorine compounds and estrogen-related cancers in women.

The organochlorines, a diverse group of some 15,000 compounds, have been implicated increasingly as being harmful to humans. Some congeners of DDT and PCB elicit very weak estrogenic responses in animals, while the dioxin TCDD and related compounds have antiestrogenic properties. This review summarizes the evidence regarding whether certain organochlorine compounds, usually as persistent food-chain contaminants, increase the risk of breast and endometrial cancers through their estrogenic potential. In humans, neither ecologic data nor occupational studies provide clear support for an association between organochlorine exposure and the occurrence of these cancers. In our summary analysis of occupational exposure, the rate ratio of breast cancer for exposed cf unexposed women was 0.84 (95 percent confidence interval [CI] = 0.50-1.33) for PCBs and 1.08 (CI = 0.68-1.58) for TCDD. Similarly, effect estimates close to unity were found in summary analysis of breast cancer case-control studies regarding levels of DDE and PCB in adipose tissue or serum. In two recent nested case-control studies using stored specimens, the odds ratio per standard deviation increase in serum p,p'-DDE was 1.27 (CI = 0.95-1.69). Although estrogenic effects of certain organochlorine compounds should be easier to detect on the endometrium, we know of no analytic epidemiologic studies of endometrial cancer published to data. We conclude that available data do not indicate that organochlorines will affect the risk of these two cancers in any but the most unusual situation.

Adipose Tissue↗
PubMed1995

The aetiology and pathogenesis of human breast cancer.

Whilst investigators have clearly shown that non-hereditary factors dominate the aetiology of human breast cancer, they have failed to identify quantitatively important causes, and prospects for prevention remain indeed limited. However, progress in epidemiological and basic research has taken place during the last few years. Current evidence suggests that breast cancer may be affected by the intra-uterine environment, that exposures during adolescence are particularly important, and that pregnancy has a dual effect on breast cancer risk: an early increase followed by long-term protection. Great variation exists in the structural development of the breast ductal system already in the newborn--and by inference in utero--and a pregnancy induces permanent structural changes in the mammary gland. We suggest that these observations fit into an aetiological model with the following key components: (1) breast cancer risk depends on the number of cells at risk, the susceptibility of individual cells to malignant transformation, and on the degree of cellular proliferation, notably cells which can act as founders of breast cancer; (2) the number of target cells is determined by the hormonal environment mainly early in life, perhaps already in utero; (3) in adult life, hormones which are non-genotoxic, increase breast cancer risk by increasing selective cell proliferation and thus number of target cells and the risk of retention of spontaneous somatic mutations; (4) while a pregnancy stimulates the growth of already malignant cells or cells close to malignant transformation (and thereby entails a short-term risk increase) the dominating long-term protection occurs due to permanent structural changes, terminal differentiation and perhaps decreased cell proliferation and carcinogen-binding in combination.

Adult↗
PubMed1995

Blood lipids in Greek adolescents and their relation to diet, obesity, and socioeconomic factors.

A study of blood lipid levels in adolescent students in rural and urban areas of Greece was undertaken. Blood samples were drawn from 307 adolescents aged 12 to 18 years attending two rural and two urban high schools of different socioeconomic level (urban/lower, urban/higher). Obesity among adolescents had statistically significant detrimental effects on the lipids profile, being associated with higher total and low-density-lipoprotein (LDL) cholesterol and lower high-density-lipoprotein (HDL) cholesterol levels. Adolescents living in urban areas had substantially and significantly higher levels of total and LDL cholesterol, but among urban residents, higher socioeconomic status was associated with lower levels of total and LDL cholesterol. There was no clear evidence that total, LDL, and HDL cholesterol levels were substantially affected by qualitative aspects of diet as evaluated through a food frequency questionnaire. The results of this study indicate that the traditional Mediterranean pattern of living and eating in the rural areas of Greece is associated with a favorable lipid profile in adolescents, which may explain the very low incidence of coronary heart disease (CHD) in these areas. In urban areas lipid profiles are satisfactory in children of high socioeconomic status but unfavorable in children of low- to middle-class families, which are known to be at higher risk for CHD.

Adolescent↗
PubMed1995

Diet and survival of elderly Greeks: a link to the past.

In 1988 and 1989, we investigated in three Greek villages the dietary patterns of 182 men and women aged > 70 y by using a validated semiquantitative food-frequency questionnaire and compared these dietary patterns with the traditional Greek diet as ascertained in the late 1950s by Keys and his colleagues. As in the traditional diet, olive oil dominated fat intake, total fat exceeded 35% of total energy intake, average daily consumption of fruits and vegetables exceeded 500 g, and average ethanol intake for men corresponded to two to three glasses of wine per day. In contrast, consumption of meat and meat products has substantially increased and intake of bread and other cereals has apparently declined. We observed no differences between the two periods with respect to consumption of legumes, eggs and egg products, and sugar confectionery. We have also attempted to assess whether a gradient of adherence to the traditional Greek diet can be identified in the diets of the study subjects, and whether it can subsequently predict total mortality. During a follow-up period of approximately 5 y, 53 deaths were observed. The risk of death was apparently higher among the minority of study subjects whose diet deviated substantially from the traditional Greek pattern, compared with the majority whose diet adhered closely to the traditional pattern.

Aged↗