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Biomedical subjects

E Buiatti

Publications and source records attributed to E Buiatti.

At least 109 records · Page 6Linked to original sources
PubMed1982

Occupation and the high risk of lung cancer in Northeast Florida.

A case-control study involving interviews with 321 male patients with lung cancer and 434 controls, or their next of kin, was undertaken to identify reasons for the high lung cancer mortality along the northeast coast of Florida. In Duval county (Jacksonville), the age-adjusted rate for lung cancer, 1970-1975, among white males was the highest of all urban counties in the United States. Increased risks on the order of 40-50% were associated with employment in the shipbuilding, construction, and lumber/wood industries, particularly among workers with reported exposures to asbestos or wood dust. Excess risks were also linked to fishing and forestry occupations, although the numbers of cases involved were small. Occupational factors did not appear to fully account for the area-wide excess of lung cancer, but no evidence was found to implicate smoking habits, migration patterns, or diagnostic and reporting practices as factors responsible for the exceptional mortality rates.

Aged↗
PubMed1980

Adenocarcinoma of the nose and paranasal sinuses in shoemakers and woodworkers in the province of Florence, Italy (1963-77).

Adenocarcinoma of the nose and paranasal sinuses has been associated with occupational exposure to wood and leather dust. Strong evidence has been found for such an association in Florence, Italy, from 1963 to 1977. Sixty-nine cases of primary cancer of the nose and paranasal sinuses were identified from hospital records. There were 13 cases of adenocarcinoma, 11 of which were successfully traced and interviewed (patient or relative). Of the 11 cases, three were woodworkers with substantial exposure to wood dust (17 years' average employment) and seven were shoemakers, mostly trimmers. When matched to either of two separate sets of controls (non-cancer hospital patients, and non-adenocarcinoma nose or paranasal sinus cancer patients), the association with occupation was statistically significant. Smoking was ruled out as a source of bias.

Adenocarcinoma↗
PubMed1978

Relationship between clinical and electromyographic findings and exposure to solvents, in shoe and leather workers.

A very high prevalence of polyneuropathy was observed in shoe and leather workers from the area of Florence. In addition, normal workers showed abnormally low maximal nerve motor conduction velocity. A linear decrease of motor conduction velocity was observed as a function of age and of the length of exposure to solvents. The worker population showed a steeper decrease with age than controls. A higher prevalence of polyneuropathy was observed when the amount of glue used by each worker per day was higher, and when the air volume of the plant was smaller. The subjective symptoms most frequently associated with polyneuropathy were muscle spasms, leg weakness and pain, and arm paresthesiae. Cases of polyneuropathy were more frequent in the workers exposed to solvents and in the older age group. A solvent aetiology of the disease is suggested, and glue substitution and proper hygienic conditions are recommended.

Adhesives↗
PubMedDate not supplied

Risk factors in male infertility: a case-control study.

A case-control study was undertaken to evaluate environmental risk factors potentially involved in male infertility. One hundred twelve azoospermic or oligospermic subjects and 127 controls were interviewed, before sperm count results were available, about coffee and alcohol consumption, smoking habits, x-ray exposure, usual sitting posture, drug consumption, other nonoccupational risk factors, socioeconomic status, education level, and occupational history. An unmatched analysis was then conducted. None of the occupational risk factors appeared to be related to azoospermia or oligospermia. A high relative risk was associated with (1) occupation in the radioelectric industry, (2) nonsedentary clerical workers, (3) clerical work in the typographic industry, and (4) occupation in the textile industry, but none of these figures were statistically significant. Because of the population from which cases and controls were drawn, certain occupational risks could not be investigated in this study, e.g., exposure of agricultural workers to chemicals.

Adult↗
PubMedDate not supplied

Exposure to carcinogenic chemicals and smoking increases urinary excretion of mutagens in humans.

Urine samples from a control population and from a population of chemical workers from two chemical plants near Florence, Italy, were analyzed for the presence of mutagenic chemicals by the Salmonella/microsome test. When tested with strain TA1538, the urine of nonsmoking chemical workers showed higher mutagenic activity than that of controls in the presence of in vitro metabolic activation, but no difference was found between controls and chemical workers who both smoked. Increased mutagenic activity was observed in the group of control smokers compared to control nonsmokers, but the same effect was not observed for chemical workers. When TA100 was used as the tester strain, the chemical workers, both smoking and nonsmoking, had significantly higher mutagenic activity than controls. The mutagenic activity fell to control levels in some workers' urine after 20 d leave. Although some perturbing effects of smoking habits were observed, the results seemed to indicate the usefulness of the Salmonella/microsome test for detection of mutagens in human urine. The results also suggest that people exposed to potentially carcinogenic chemicals may show high enough traces of those chemicals and/or their metabolites in their body fluids to be detected with current mutagenesis techniques.

Adult↗
PubMedDate not supplied

Prostate cancer: population-based survival rates in central Italy.

AIMS: To evaluate survival in prostate cancer patients in the Province of Florence where the Tuscany Cancer Registry is active. METHODS: The survival of 777 patients with prostate cancer diagnosed in the period 1985-87 was evaluated. The observed and relative survival rates 1, 3 and 5 years after diagnosis were computed. Also the prognostic effect of age, disease extension, tumor grade, histological verification, place of residence and year of diagnosis were evaluated using univariate and multivariate analysis. RESULTS: The observed survival was 73.4% 1 year, 42.5% 3 years and 29.2% 5 years after diagnosis. The relative survival was respectively 78.7%, 53.0% and 43.0%. Significant independent risks were evident when the disease was extended out of the prostate, for patients older than 80 years, for high grade tumors and for patients without histological verification. CONCLUSION: The 5-year relative survival rate in the province of Florence is similar to those from other European Registries and the Latina Registry, but much lower than the one reported by the SEER program in the US. Data on histological verification percentage, availability of information on disease extension, and tumor grade are discussed as indicators of the quality of the diagnostic approach in comparison with other registries.

Aged↗
PubMedDate not supplied

Linkage between AIDS surveillance system and population-based cancer registry data in Italy: a pilot study in Florence, 1985-90.

The role of the Tuscany population-based Cancer Registry (TCR) in the assessment of cancer incidence in AIDS patients, and the completeness of cancer reporting to the Italian AIDS surveillance system (RAIDS) was evaluated through a linkage between the TCR and the RAIDS in the period 1985-90. In the Province of Florence, the incidence of Kaposi's sarcoma in AIDS cases was underestimated by 24% (95% CI; 9.8%-47%; 6/25 cases) by RAIDS in comparison with the TCR. Of kaposi's sarcomas unknown to RAIDS, 2 were incident at the time of AIDS diagnosis ("truly" unreported cases) and 4 were late manifestations of AIDS. Moreover, 1 non-Hodgkin lymphoma unknown to RAIDS and 10 other malignancies (4 lung cancers) were identified through the TCR. In AIDS patients, the incidence of lung cancer was 95-fold (99% CI, 16-310) the expected one on the basis of age-sex-specific incidence rates in the general population of the same area. Altogether, about 25% of AIDS cases developed a cancer during HIV infection. In spite of the small size of the present study, the results confirm the role of population-based cancer registries in the assessment of the occurrence of malignancies in AIDS patients.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Agreement estimate among three Italian cancer registries in the coding of multiple primary cancers.

AIMS: The aim of the study was to compare agreement on the coding of multiple primary cancers (MPs) between three italian cancer registries, the Ragusa Cancer Registry (RCR), the Cancer Registry of Romagna (RTRo), and the Tuscany Tumor Registry (RTT), that adhere to different rules for accepting MPs and to study whether coding according to common International rules (IARC-IACR) increased comparability. METHODS: One hundred cases were randomly extracted from the archives of each registry from those recorded as having more than one cancer. For each of the 300 patients, the number of independent cancers was attributed independently by one coder from each registry. The coders coded the series twice: once following the local registry rules and once according to the IARC-IACR rules. The agreement was estimated by couples of coders by means of Cohen's kappa statistics. RESULTS: The agreement on MP status between coders using local rules and definitions was good between the RTT and RCR (kappa = 0.77) and very good between the RTRo and RCR (kappa = 0.81) and the RTT and RTRo (kappa = 0.96). Exclusion of 23 expected discordant cases increased the agreement. The agreement reached with the use of the IARC-IACR rules was very good (RTRo vs RCR, 0.95; RTT vs RTR, 0.94; RTT vs RTRo, 0.95). CONCLUSIONS: The comparison among the RTT, RTRo and RCR confirmed that the number of tumors considered MPs may be modified depending on the rules adopted. There were minor differences between the RTT and the RTRo since their rules were very similar. Most differences in agreement were with the RCR since its classification was conceptually different from the other two. The result on agreement with IARC-IACR rules is encouraging from the point of view of conducting a cooperative study among different registries on the incidence of MPs.

Humans↗
PubMedDate not supplied

Comparability issues within the ITACARE data base.

AIMS AND BACKGROUND: The aim of the study was to describe the extent of variability among Italian cancer registries in data managing practices that may affect differences in incidence and possibly in survival estimates. METHODS: a self-administered questionnaire was sent to each participating registry. The definitions of the diseases, of the start point and of the end point of survival computation were investigated. Moreover, information on the proportion of histologic confirmation, of ill-defined sites and of DCO (death certificate only) was also considered. RESULTS: There were some differences in cancer registration techniques among Italian cancer registries. As regards disease definition, the most relevant problems arose for urinary bladder. Skin melanoma should also be considered with some caution, due to variability among registries in coding in situ cases. For the CNS and meninges, the proportion of cases that could be differently considered was so limited that no effect on survival is expected. For female breast, colorectum and cervix uteri, the effect of early diagnosis services (which are active only in some areas) may lead to better survival estimates. The variability in incidence date definition was high among registries and sites, but its effect on survival was very limited. There was a wide variability in the proportion of DCOs and of DCIs (initially known from death certificate), which should be considered in survival comparisons. All the registries stated that they carried out an active follow-up of their patients. CONCLUSIONS: In general, quality standards of the registries are good and allow comparability of survival data. The variability of rules adopted by Italian registries may affect geographic survival differences only in a limited number of cancer sites, so that results should be interpreted with caution.

Bias↗
PubMedDate not supplied

Variations in the survival of adult cancer patients in Italy.

AIMS: As part of the ITACARE project, the present study analyzed and compared population-based data on the survival of adult cancer patients in Italy, according to sex, age, period of diagnosis and geographical area. METHODS: Nine Italian population-based cancer registries provided data on all their cancer patients (total 90,431 cases) followed for at least 5 years and diagnosed during the period 1978-1989. About 10% of the Italian population is covered by these registries. The data was analyzed by means of a multivariate model. RESULTS: The major findings were that there was a general improvement in 5-year relative survival over the study period (from 33% to 39%) and that there were significant differences in survival between different areas of the country, particularly for cancer sites which respond well to treatment. In general, the area covered by the Ragusa (Sicily) registry was characterized by significantly worse survival than other registry populations. Other important findings were that for all malignant cancer sites 5-year relative survival decreased with age from 50% for the youngest age class (15-44 years) to 27% for the oldest age class (75+ years) and that women have a better prognosis for most cancer sites (overall 5-year relative survival in women 48% vs 32% in men). CONCLUSIONS: The significant regional differences in survival may reflect unequal provision of care, particularly between northern-central Italy and the south. The reasons for the general survival improvement with time are not completely understood, whereas the marked overall sex difference is related to the fact that the commonest cancer in women (breast cancer) is eminently more treatable than the commonest malignancy in men (lung cancer). The unfavorable trend with increasing age may be due to increasing difficulty in applying complete therapy protocols as general health declines, sometimes in relation to an advanced cancer stage at diagnosis.

Adolescent↗
PubMedDate not supplied

Synchronous and metachronous diagnosis of multiple primary cancers.

AIMS: In the time period near to the diagnosis of a new cancer, other tumors (synchronous cancers), especially slow-growing tumors, may be detected because several diagnostic examinations are performed. The frequency of synchronous in comparison with metachronous carcinomas has been evaluated in a population-based series of multiple primary cancers. METHODS: The case series of multiple primary cancers of the Tuscany Tumor Registry, incident during the period 1985-1991 was analyzed. For each site of a second independent tumor, the proportions of synchronous (diagnosed within 2 months of the first primary) and metachronous cancers were compared with the mean distribution (all sites except the specific one). RESULTS: During 1985-1991, 1095 patients had two independent tumors diagnosed; 216 were synchronous. The proportion of synchronous compared to metachronous cancers was significantly higher for bladder, prostate and renal cell carcinomas; it was significantly lower for lung cancer. When cancers following skin epitheliomas were evaluated, only the proportion of synchronous skin cancers was significantly increased. CONCLUSIONS: Silent slow-growing tumors are suspected to be more frequent in patients with prostate, bladder or renal cell carcinomas. In fact, they were most frequently diagnosed during ascertainment for another cancer. When few examinations were performed, as after the diagnosis of a skin epithelioma, no difference between metachronous and synchronous cancers was evident, except for skin.

Female↗
PubMedDate not supplied

The role of cancer registration for programming health services.

The Italian National Health Plan 1998-2000 indicates quantitative and qualitative goals in the fight against cancer. This approach stresses the need of reliable and updated descriptive data to evaluate, at a population level, the burden of neoplastic disease, the results of primary and secondary preventive actions, and the efforts towards a more equal distribution of diagnostic and therapeutic services. The aims of this paper is to evaluate the use of descriptive data to quantify the burden of neoplastic disease, using the data provided by the network of Italian cancer registries (the most reliable source of information on neoplastic disease in Italy). Crude rates are the most adequate for describing the "burden" of cancer patients who are expected in a certain period and will need specific diagnostic or therapeutic activities. Incidence, prevalence and mortality rates provide information on different phenomena (i.e., patients requiring diagnostic and therapeutic activities related with the first definition and treatment of the disease; patients requiring periodic follow-up or treatment of disease relapse; need palliative care). The use of these measures combined is highly informative in relation with the different objectives of health planners (i.e., patients requiring diagnostic and therapeutic activities related with the first definition and treatment of the disease; patients requiring periodic follow-up or treatment of disease relapse; need palliative care).

Cost of Illness↗
PubMedDate not supplied

The role of chemoprevention in cancer control.

Chemoprevention can be defined as the use of chemical compounds or medicines to prevent the occurrence of precancerous lesions (markers) or to slow down or revert the progression of clinically established disease. The use of randomized trial design is considered the gold standard for evaluating the preventive value of chemicals against cancer, since they control for confounding and avoid information bias. The principal school in relation to cancer control through chemoprevention is based on studies of cancer and diet. Initially, ecological studies set the cornerstone, but later case-control studies supported the hypothesis of an inverse association between foods and cancer risk (principally epithelial), suggesting that determined micronutrients participate as protection in this process. Other studies include specific chemical analyses, which have potential problems that could lead to erroneous conclusions, such as sample and measurement errors. During this decade randomized intervention trials have been carried out to test this hypothesis, but conclusions have been so diverse and the designs used have been so different in terms of levels of exposure, that consistent conclusions are not possible. We can conclude that using studies with randomized, double-blind, controlled designs is interesting, but problems remain to be solved, including: agent selection, the design to be chosen, and especially the balance between benefits sought and secondary effects, including cost-effectiveness, since some chemicals cannot compete with other preventive or therapeutic measures.

Anticarcinogenic Agents↗
PubMedDate not supplied

[The quantification of tuberculous disease in an Italian area and the estimation of underreporting by means of record linkage].

The description and interpretation of tuberculosis spatial and temporal variations in Italy is rather difficult because of well-grounded suspicions of disease underestimation, related with the bad working of the compulsory notification system. In this study, the record-linkage technique was used to estimate the proportion of TB undernotification in an Italian area, in order to give a first quantitative estimate of tuberculosis at a geographical level. The area considered was the Local Health Agency of Florence (population in 1994: 803,588) in 1995. Information for record-linkage was taken from: the Regional TB Archive, Hospital Discharge files, Laboratories, Pathology Departments, the Regional AIDS Registry, the Regional Mortality Registry. The linkage among the different sources was based on first and last name, date and place of birth, or only on first and last name for the laboratories. Prevalent cases and relapses were excluded through comparison with various historical archives. Most cases signalled only in hospital discharges were re-evaluated through original medical records. In such a way, the original sample was reduced from 690 to 182 cases incident in 1995, diagnosed in the area considered, and mostly resident in the same area. Among these cases, 98 (53.8%) were unknown to the compulsory notification system. The most of them come from hospital departments (27 cases) and from laboratories (47 cases). Fourty-nine of the unknown cases concerned pulmonary TB. The notification rate in the area moves then from 10.5/1000 to 22.7/1000.

Disease Notification↗