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Biomedical subjects

Eva Negri

Publications and source records attributed to Eva Negri.

At least 91 records · Page 5Linked to original sources

Hormone replacement therapy and cancer risk: a systematic analysis from a network of case-control studies.

To provide comprehensive and quantitative information on the benefits and risks of hormone replacement therapy (HRT) on several cancer sites, we systematically examined the relation between HRT use and the risk of various cancers in women aged 45-79 by using data from a framework of case-control studies conducted in Italy between 1983 and 1999. The overall data set included the following incident, histologically confirmed neoplasms: oral cavity, pharynx, larynx and esophagus (n = 253), stomach (n = 258), colon (n = 886), rectum (n = 488), liver (n = 105), gallbladder (n = 31), pancreas (n = 122), breast (n = 4,713), endometrium (n = 704), ovary (n = 1,614), urinary bladder (n = 106), kidney (n = 102), thyroid (n = 65), Hodgkin's disease (n = 26), non-Hodgkin's lymphomas (n = 145), multiple myeloma (n = 65) and sarcomas (n = 78). The control group comprised 6,976 women aged 45-79 years, admitted for a wide spectrum of acute, nonneoplastic conditions. Odds ratios (OR) and the corresponding 95% confidence intervals (CI) for use of HRT were derived from multiple logistic regression equations. There was an inverse association between ever use of HRT and colon (OR = 0.7), rectum (OR = 0.5) and liver cancer (OR = 0.2), with a consistent pattern of protection for duration of use. An excess risk was found for gallbladder (OR = 3.2), breast (OR = 1.1), endometrial (OR = 3.0) and urinary bladder cancer (OR = 2.0). These data from a southern European population add some useful information on the risk-benefit assessment of HRT among postmenopausal women.

Aged↗

Glycemic index and glycemic load in endometrial cancer.

Glycemic index (GI) and glycemic load (GL) are measures of the metabolic effects of dietary carbohydrates. The higher their value, the greater the glucose and insulin responses. Raised insulin levels are associated with endometrial cancer and with its risk factors including obesity, diabetes and hypertension. To study the role of the GI and GL we analyzed the data of two hospital-based case-control studies on endometrial cancer conducted between 1988-98 in Italy and Switzerland, including a total of 410 women with incident, histologically confirmed endometrial cancer and 753 controls admitted for acute, non-neoplastic diseases. A food frequency questionnaire was used to assess the subjects usual diet and to derive estimates of dietary GI and GL. The odds ratios (OR) of endometrial cancer, after adjustment for major risk factors, for the highest versus the lowest quintile of dietary GI and GL were 2.1 (95% confidence interval [CI] = 1.4-3.2) and 2.7 (95% CI = 1.8-4.2), respectively. The associations were stronger in older women, in those with higher body mass index and in hormone replacement therapy users. Our study supports the hypothesis of a direct association between GI and endometrial cancer risk.

Adult↗

n-3 polyunsaturated fatty acid intake and cancer risk in Italy and Switzerland.

Data from a series of case-control studies, conducted in Italy and Switzerland between 1991 and 2001, have been analyzed to evaluate the role of n-3 polyunsaturated fatty acid (PUFA) intake in the etiology of cancer of oral cavity and pharynx (736 cases, 1772 controls), esophagus (395 cases, 1066 controls), large bowel (1394 colon, 886 rectum, 4765 controls), breast (2900 cases, 3122 controls) and ovary (1031 cases, 2411 controls). Controls were patients admitted to hospital for acute, non-neoplastic conditions, unrelated to modifications in diet. The multivariate odds ratios (OR) for the highest quintile of n-3 PUFAs compared to the lowest one were 0.5 for oral and pharyngeal cancer, 0.5 for oesophageal cancer, 0.7 for colon cancer, 0.8 for rectal and breast cancer and 0.6 for ovarian cancer; the estimates and the trends in risk were significant for all cancer sites, excluding rectal and breast cancer. The estimates for an increase in n-3 PUFAs of 1 g/week were 0.70 for oral and pharyngeal cancer, 0.71 for oesophageal, 0.88 for colon, 0.91 for rectal, 0.90 for breast and 0.85 for ovarian cancer. All the estimates were statistically significant, excluding that for rectal cancer, and consistent across strata of age and gender. These results suggest that n-3 PUFAs decrease the risk of several cancers.

Adult↗

An update of a mortality study of talc miners and millers in Italy.

BACKGROUND: While talc containing asbestiform fibers is considered a human carcinogen, only limited animal and human data are available on non-asbestiform talc. To provide further evaluation on the issue, we updated the analysis of an Italian cohort of talc miners and millers in Val Chisone; talc found here is free from asbestiform fibers. METHODS: The cohort was comprised of 1,795 men who had worked for at least 1 year in the mine and/or in the factory between 1946 and 1995. Vital status and death certificates were obtained from registration offices in the municipality of death or of birth. Employment, termination of employment, and detailed job history were obtained from personnel records at the plant. RESULTS: No excess was found for total cancer mortality, nor mortality for lung cancer. No case of mesothelioma was reported. There was a significant excess mortality from non-neoplastic respiratory diseases (SMR 228.2, 95% CI 190.2-271.5). Mortality excess for non-neoplastic respiratory diseases was mainly due to silicosis. CONCLUSIONS: This study provides additional support for an association between talc in mining and milling and non-neoplastic respiratory diseases, while showing no significant excess risk for lung cancer and mesothelioma. The results also provide additional information of interest to evaluate the potential association between silica and lung cancer.

Asbestos↗

Mortality in long-stay patients from psychiatric hospitals in Italy--results from the Qualyop Project.

BACKGROUND: Mortality in psychiatric patients both from natural and non-natural causes was reported to be markedly higher than in the general population. The effect of the psychiatric hospital (PH) closure process on mortality has nonetheless seldom been investigated. We studied mortality in a cohort of PH patients, taking into account the closure process in Italy. METHODS: A total of 2915 patients from 12 PH were described in the period 1994-1996 and followed up until June 2000, and discharges and deaths were registered. Standardized mortality ratios (SMR) for natural and non-natural causes were computed on the basis of regional death rates. RESULTS: Observed deaths were 714 vs. 291.2 expected. The all-causes SMR was 2.47 in males and 2.43 in females. The SMR was 26.92 in males and 13.75 in females for psychiatric causes, 6.84 and 7.89 for undefined causes, 9.57 and 7.27 for pneumonia, 6.38 and 7.78 for chronic obstructive respiratory disease, and 1.27 and 1.58 for ischemic heart disease. No excess was observed for all cancers in males, but the SMR was 1.50 for lung cancer in males, 2.30 for breast cancer and 1.48 for all neoplasms in females. SMR for suicide was 3.85 in males and 2.73 in females. Most SMR were higher at younger age, although the rate of absolute excess deaths was greater above age 60. The SMR for all causes was 2.66 before discharge from PH, and 2.09 after discharge. CONCLUSIONS: Mortality remained high after leaving the PH, but no increase was associated to the PH closure.

Adult↗

Family history of ischemic heart disease and risk of acute myocardial infarction.

BACKGROUND: Several aspects of the relation between family history of ischemic heart disease (IHD) and risk of acute myocardial infarction (AMI) need further quantification. METHODS: A case-control study was conducted in Italy in 1995-1999 on 378 men and 129 women with a first nonfatal AMI, and 297 male and 181 female controls in a hospital for selected acute conditions. Odds ratios (OR) of AMI according to family history of IHD were estimated using unconditional logistic regression, adjusting for other AMI risk factors and family size. RESULTS: The overall OR for those having > or =1 first-degree relatives with IHD was 2.1, and 3.8 for > or =2 relatives. The OR for those with an affected parent or sibling were similar. The OR were also similar across strata of sex, age at diagnosis of the proband or the relative, and selected AMI risk factors, which were risk factors also in those with a positive family history. CONCLUSIONS: Family history of IHD is an independent risk factor for AMI, and intervention on modifiable risk factors may be beneficial also in those with a family history of the disease.

Adult↗

Micronutrients and laryngeal cancer risk in Italy and Switzerland: a case-control study.

OBJECTIVE: To investigate the relation between various micronutrients and laryngeal cancer risk. METHODS: A case-control study was conducted in Italy and Switzerland between 1992 and 2000. Cases were 527 patients with incident cancer of larynx, admitted to the major teaching and general hospitals of the study areas. Controls were 1297 subjects admitted for acute, non-neoplastic diseases to the same network of hospitals. Dietary habits were assessed using a validated food-frequency questionnaire. Odds ratios (OR) and their corresponding 95% confidence intervals (CI) were computed using multiple logistic regression. RESULTS: Significant inverse relations emerged between laryngeal cancer risk and intake of vitamin C (OR = 0.2, for the highest versus the lowest intake quintile; 95% CI: 0.2-0.4), beta-carotene (OR = 0.2; 95% CI: 0.2-0.4), alpha-carotene (OR = 0.3; 95% CI: 0.2-0.5), lutein/zeaxanthin (OR = 0.4; 95% CI: 0.3-0.6), vitamin E (OR = 0.4; 95% CI: 0.3-0.6), beta-criptoxanthin (OR = 0.4; 95% CI: 0.2-0.5), folic acid (OR = 0.4; 95% CI: 0.2-0.6), thiamin (OR = 0.4; 95% CI: 0.3-0.6), glutathione (OR = 0.5; 95% CI: 0.4-0.8), reduced glutathione (OR = 0.6; 95% CI: 0.4-0.8), vitamin B6 (OR = 0.6; 95% CI: 0.4-0.9) and potassium (OR = 0.6; 95% CI: 0.4-0.9). Direct associations were found with zinc (OR = 1.5; 95% CI: 1.0-2.2) and vitamin D (OR = 1.8; 95% CI: 1.2-2.6). Combining low intakes of vitamin C, carotene, vitamin E, and folate with heavy smoking and drinking led to ORs between 80 and 170. CONCLUSIONS: This study provides further support that, independently from smoking and alcohol consumption, the intake of several micronutrients, including selected antioxidants, is inversely related to laryngeal cancer risk.

Adult↗

Glycemic index and load and risk of upper aero-digestive tract neoplasms (Italy).

BACKGROUND: The ability of dietary carbohydrates to affect blood glucose and insulin levels by dietary carbohydrates is best measured by the glycemic index (GI) and glycemic load (GL) which have been directly associated with risk of several chronic conditions, including cancer. PATIENTS AND METHODS: Three case-control studies were conducted between 1992 and 2000 in Italy. The first one included 598 hospital patients with incident, histologically confirmed oral and pharyngeal cancer and 1491 controls admitted to the same hospital networks for acute, non-neoplastic diseases; the second study included 304 subjects with squamous cell oesophageal cancer and 743 controls; the third one included 460 cases with laryngeal cancer and 1088 controls. All subjects were interviewed using a validated food frequency questionnaire. RESULTS: The odds ratios (OR) of upper aero-digestive tract neoplasms for the highest versus the lowest quintile of dietary GI and GL were 1.5 (95% confidence interval [CI]: 1.1-2.0) and 1.8 (95% CI: 1.1-2.9), respectively. The associations were in the same direction for various cancer sites. The ORs were apparently stronger in women, in those with high body mass index and reporting low alcohol consumption. CONCLUSIONS: This study supports the hypothesis that high dietary GI and GL are associated with cancers of the upper aero-digestive tract.

Adult↗

A pooled analysis of case-control studies of thyroid cancer: cigarette smoking and consumption of alcohol, coffee, and tea.

OBJECTIVE: To analyze the role of smoking, alcohol, coffee and tea in relation to thyroid cancer, we conducted a pooled analysis of 14 case-control studies conducted in the United States, Europe, and Asia. METHODS: The sample consisted of 2725 thyroid cancer cases (2247 females, 478 males) and 4776 controls (3699 females, 1077 males). Conditional logistic regression with stratification on study, age at diagnosis, and gender was used to compute odds ratios and 95% confidence intervals. RESULTS: Thyroid cancer risk was reduced in persons who had ever smoked. The relationship was more pronounced in current smokers (OR = 0.6, 95% CI = 0.6-0.7) than former smokers (OR = 0.9, 95% CI = 0.8-1.1). There were significant trends of reduced risk with greater duration and frequency of smoking. For consumption of wine and beer, there was a significant trend of decreasing thyroid cancer risk (p = 0.02) that was not maintained after adjustment for current smoking (p = 0.12). Thyroid cancer risk was not associated with consumption of coffee or tea. These findings were consistent in both gender-specific and histology-specific (papillary and follicular) analyses. CONCLUSIONS: Pooled analyses of these geographically diverse case-control data indicate a reduced thyroid cancer risk associated with current smoking. A reduced risk associated with alcohol was eliminated after adjustment for smoking, and caffeinated beverages did not alter thyroid cancer risk.

Alcohol Drinking↗

Session: whole cereal grains, fibre and human cancer wholegrain cereals and cancer in Italy.

The relationship between frequency of consumption of whole-grain foods and cancer risk has been analysed using data from an updated series of case-control studies conducted in Northern Italy between 1983 and 1997. The overall dataset included the following incident histologically-confirmed neoplasms: oral cavity and pharynx 524, oesophagus 410, stomach 745, colon 955, rectum 625, liver 435, gallbladder 65, pancreas 402, larynx 388, soft tissue sarcomas 217, breast 3412, endometrium 750, ovary 971, prostate 127, bladder 431, kidney 190, thyroid 428, Hodgkin's disease 201, non-Hodgkin's lymphomas 529, multiple myelomas 185. Controls were 10 058 patients admitted to hospital for acute non-neoplastic conditions unrelated to long-term modifications in diet, tobacco or alcohol use. The multivariate odds ratios for the highest category of wholegrain cereal consumption were 0.3-0.5 for upper digestive tract and respiratory neoplasms and colon, 0.6 for rectum and liver, 0.4 for gallbladder, 0.8 for pancreas, 0.2 for soft tissue sarcomas, 0.9 for breast and endometrium, 0.7 for ovary, 0.7 for prostate, 0.4 for bladder and kidney, 1.1 for thyroid and about 0.5 for lymphomas and 0.6 for myelomas. In this population whole-grain food consumption is an indicator of reduced risk of several neoplasms.

Adult↗

Pancreatic cancer mortality in Europe: the leveling of an epidemic.

Mortality rates from pancreatic cancer have increased throughout Europe between the late 1950s and the 1980s. Trends in 22 European countries, the European Union (EU) and 6 selected eastern European countries have been updated using official death certification data for pancreatic cancer abstracted from the WHO database over the period 1980 to 1999. In EU men, a rise from 7.2 to 7.5/100,000 was observed between the early and the late 1980s, followed by a leveling off in the 1990s. For women, rates tended to rise up to the early 1990s, and to level off thereafter around 4.7/100,000. In eastern countries, rates for both sexes rose between the early 1980s and the mid-1990s, and leveled off thereafter around 8.5/100,000 men and 5/100,000 women. Thus, rates for men only were higher in Eastern Europe than in the EU. This analysis first documents a leveling of pancreatic cancer mortality in Europe, after decades of steady rises. This is partly or largely attributable to the decline in smoking, at least in men, but other factors, including mainly nutrition and diet, may also have played some role on these trends.

Adult↗

Laryngeal cancer in women: tobacco, alcohol, nutritional, and hormonal factors.

Laryngeal cancer is the neoplasm with the largest male to female sex ratio in most populations. Thus, inadequate data are available on women. We analyzed several risk factors in the combined dataset from two case-control studies conducted between 1986 and 2000 in northern Italy and Switzerland. Cases were 68 women under age 79 years, with incident, histologically confirmed cancer of the larynx. Controls were 340 women, admitted to the same network of hospitals as cases, for acute, nonmalignant conditions, unrelated to tobacco and alcohol consumption. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated by logistic regression models, conditioned by age, study center and year of interview, and including terms for education, body mass index, tobacco, alcohol drinking, and nonalcohol energy intake. Laryngeal cancer was strongly associated with cigarette smoking (OR = 435.7, 95% CI: 38.2-4964.4 for smokers of >/=25 cigarettes/day) and alcohol drinking (OR = 4.3, 95% CI: 0.8-24.1 for >/=5 drinks/day). An inverse relation was found for vegetables (OR = 0.3, 95% CI: 0.1-0.9 for the highest level of consumption), fruit (OR = 0.5, 95% CI: 0.2-1.3), and olive oil (OR = 0.3, 95% CI: 0.1-0.9). Reproductive and hormonal factors were not consistently associated to laryngeal cancer risk. This investigation, based on a uniquely large number of laryngeal cancers in women, provides definite evidence that cigarette smoking is the prominent risk factor for laryngeal cancer in women, accounting for 78% of cases in this population. Alcohol and selected dietary aspects account for approximately 30% of cases, whereas menstrual and hormonal factors do not appear to have a consistent role in laryngeal carcinogenesis.

Aged↗

Influence of the Mediterranean diet on the risk of cancers of the upper aerodigestive tract.

The hypothesis that the Mediterranean diet has a beneficial role on the risk of cancers of the upper aerodigestive tract has been evaluated using data from three case-control studies conducted in Italy between 1992 and 2000. The first study included 598 cases with incident, histologically confirmed cancers of the oral cavity and pharynx and 1491 hospital controls admitted to the same network of hospitals as cases for acute, nonneoplastic diseases. The second one included 304 subjects with squamous cell carcinoma of the esophagus and 743 controls. The third one included 460 laryngeal cancer cases and 1088 controls. A score summarizing eight of the major characteristics of the Mediterranean diet was used. Odds ratios and corresponding 95% confidence intervals (CIs) for increasing levels of this score were estimated using unconditional regression models, adjusted for age, sex, study center, years of education, tobacco consumption, body mass index, and total energy intake. For all cancers considered, a reduced risk was found for increasing levels of the Mediterranean score: the odds ratios for subjects with six or more Mediterranean characteristics, compared with those with less than three characteristics, were 0.40 (95% CI, 0.26-0.62) for oral and pharyngeal, 0.26 (95% CI, 0.13-0.51) for esophageal, and 0.23 (95% CI, 0.13-0.40) for laryngeal cancer. All of the estimates were consistent in strata of the major identified risk factors for these neoplasms. This study provides evidence that an a priori defined nutritional pattern, which includes several aspects of the Mediterranean diet, favorably affects the risk of cancers of the upper aerodigestive tract.

Aged↗

Dietary folate and colorectal cancer.

Folate may be inversely related to colorectal cancer risk, possibly in combination with low methionine and high alcohol consumption. We considered, therefore, the relation between folate and colorectal cancer in a multicentric case-control study of 1,953 cases and 4,154 controls from Italy, i.e., a population with frequent regular alcohol drinking. In the overall data set, the odds ratio (OR) was 0.72 for the highest quintile of folate, and the continuous OR per 100 microg was 0.86. The inverse relation was similar in men and women and somewhat stronger for the rectum (OR = 0.59 for the highest quintile) compared to the colon (OR = 0.81). It was also somewhat stronger in the highest tertile of alcohol drinking (OR = 0.65), though trends were not heterogeneous across strata of alcohol, whereas no appreciable difference was observed across strata of methionine intake. Compared to subjects reporting low alcohol, high methionine and high folate intake, the OR was 1.83 for those reporting high alcohol, low methionine and low folate intake. The present findings support a favorable role of folate in colorectal carcinogenesis.

Adult↗

Alcohol drinking outside meals and cancers of the upper aero-digestive tract.

In our integrated series of case-control studies conducted in Italy and Switzerland (324 oral, 397 pharyngeal, 271 oesophageal, 506 laryngeal cancers and 3,263 controls), individuals who also drank alcoholic beverages outside meals showed an increased risk compared to those who drank at meals only. At any alcohol intake level, subjects also drinking between meals showed a more elevated risk of developing an upper aero-digestive tract cancer than subjects drinking only at meals. After adjustment for potential covariates, and, after allowance for the number of daily drinks to adjust for different alcohol-intake levels, the odds ratios for subjects reporting drinking outside meals were 1.5 (95% confidence interval [CI]: 1.0-2.2) for oral, 1.8 (95% CI: 1.3-2.5) for pharyngeal, 1.7 (95% CI: 1.2-2.5) for oesophageal and 1.2 (95% CI: 0.9-1.7) for laryngeal cancers. Our findings show that drinking pattern with respect to food consumption may influence alcohol carcinogenesis in the upper digestive and respiratory tract. An "alcohol washing effect" by chewing and swallowing is suggested.

Adult↗