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Biomedical subjects

Eva Negri

Publications and source records attributed to Eva Negri.

At least 109 records · Page 6Linked to original sources

Long-term effects of oral contraceptives on ovarian cancer risk.

Several epidemiologic studies have reported a protective effect of oral contraceptives (OCs) on ovarian cancer. However, there remain open issues, including better quantification of time-related factors such as time since last use, age at first use and time since first use. We performed a collaborative reanalysis of 6 case-control studies conducted between 1978 and 1999 in the United Kingdom, Greece and Italy, including a total of 2,768 incident, histologically confirmed cases of epithelial ovarian cancer and 6,274 hospital controls under age 70 years. A reduced risk of ovarian cancer was found for ever- compared to never-users [odds ratio (OR) = 0.66, 95% confidence interval (CI) 0.56-0.79], and a stronger reduction was observed for women who had used OCs for > or =5 years (OR = 0.50, 95% CI 0.33-0.76) compared to those who had used them for <5 years. The protective effect of OCs on ovarian cancer was consistent across strata of age, parity, menopausal status and family history of breast or ovarian cancer. After allowance for duration of use, no other time factor was related to ovarian cancer risk: the reduced risk was similar for women who stopped OC use > or =20 years before compared to <10 years; likewise, no significant modification of risk reduction was observed for age at first OC use and time since first OC use. The present analysis indicates that, after taking into account duration of OC use, the OC protection from ovarian cancer persists for a long time after stopping use.

Adult↗

Oesophageal adenocarcinoma: a paradigm of mechanical carcinogenesis?

Incidence of adenocarcinoma of the oesophagus and gastric cardia is increasing in most developed countries and strongly associated with obesity and male gender. An underlying increase in the prevalence of gastro-oesophageal reflux has generally been postulated. We suggest that the increase in frequency of reflux and the 2 associated forms of cancer can be explained by growing abdominal pressure brought about by increasing central obesity, most common among men, and sedentary lifestyle, including car use. Abdominal pressure is further accentuated mainly in men by the shift in Western male dressing towards the general use of belts.

Adenocarcinoma↗

Food groups and laryngeal cancer risk: a case-control study from Italy and Switzerland.

Besides tobacco and alcohol, diet has been thought to be associated with laryngeal cancer risk. We thus analyzed the role of various food groups, as well as specific seasoning fats, in a case-control study conducted in Northern Italy and the Swiss Canton of Vaud from 1992 to 2000. Our study included 527 incident, histologically confirmed cases and 1,297 frequency-matched controls, selected among patients admitted to the same hospitals as cases for acute, nonneoplastic conditions, unrelated to smoking, alcohol consumption and long-term modifications of diet. The subjects' usual diet was investigated through a validated food frequency questionnaire, including 78 foods and beverages. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using unconditional multiple logistic regression models. After adjustment for major confounding factors, a significant trend of increasing risk was observed for eggs (OR = 1.7 for the highest compared to the lowest quintile), red meat (OR = 3.1), processed meat (OR = 1.7), fish (OR = 1.6) and sugars (OR = 1.6). Significant inverse associations were observed for pulses (OR = 0.7), raw vegetables (OR = 0.2), cooked vegetables (OR = 0.3), citrus fruit (OR = 0.6) and other fruit (OR = 0.5). In regard to seasoning fats, a significant reduction of cancer risk was observed for olive oil (OR = 0.4) and specific seed oils (OR = 0.6), while mixed seed oils were directly associated with laryngeal cancer risk (OR = 2.2). Our study suggests that increasing vegetables and fruit, decreasing meat consumption and perhaps substituting olive oil or specific seed oils for other types of seasoning lipids might help reduce laryngeal cancer risk.

Adult↗

Post-menopausal hormonal therapy and gallbladder cancer risk.

The relation between post-menopausal hormone replacement therapy (HRT) and gallbladder cancer was analyzed in women above age 45 years, using data of a case-control study conducted in Italy between 1985 and 1997, on 31 incident, histologically confirmed cases and 3,702 controls in hospital for acute, non-neoplastic conditions. The multivariate odds ratio (OR) was 3.2 (95% confidence interval: 1.1-9.3) for those who had ever used HRT and the OR tended to rise with longer duration. Although based on small numbers, due to the rarity of the disease, these findings provide the first direct epidemiological evidence of an association between HRT and gallbladder cancer.

Aged↗

Cancer mortality in the European Union, 1988-1997: the fall may approach 80,000 deaths a year.

After the peak rate of cancer mortality reached in 1988 in the European Union, steady declines were observed: 9.1% for both sexes combined over the period 1988-1997 (from 147.0 to 133.6/100,000, world standard), corresponding to the avoidance of about 80,000 deaths in 1997 (approximately 39,000 below age 65 and 41,000 above). In 1997, the total number of cancer deaths also declined, for the first time. The major determining cancers for these favorable trends were stomach (-30%), lung (-10%), intestines (-15%), breast (-10%), uterus (mainly cervix; -22%), leukemias (-10%) and, after 1995, prostate (-3%).

Age Factors↗

Smoking and other risk factors for bladder cancer in women.

BACKGROUND: Bladder cancer is three to five times more frequent in men than in women, and hence only a few studies have focused only on females. METHODS: A case-control study was conducted between 1985 and 1992 in two areas of northern Italy, and included 110 women with histologically confirmed bladder cancer and 298 controls, admitted to the same network of hospitals of cases for acute, non-neoplastic, non-urinary or genital tract diseases. Multivariate odds ratios (ORs) were computed using unconditional multiple logistic regression. RESULTS: Compared to never smokers, current smokers (OR = 2.87) had significantly elevated risks of bladder cancer. High intake of vegetables was inversely related to the disease (OR = 0.32), while history of occupation in chemical, dyes/paints or pharmaceutical industry (OR = 3.01) was directly associated to risk of bladder cancer. The OR was 3.29 for ever use of menopause hormone replacement therapy. CONCLUSIONS: This study confirms that cigarette smoking is the prominent risk factor for bladder cancer in women as in men, with similar relations in both sexes. It also confirms that selected occupational factors are related to bladder cancer risk, and supports a favourable role of vegetables. The apparent relation with hormone replacement therapy in menopause needs interpretation and further investigation.

Adult↗

Trends in mortality from non-Hodgkin's lymphomas.

Trends in death certification rates from non-Hodgkin's lymphomas (NHL) were analyzed on the basis of the World Health Organization database over the period 1969-1998. Until the late 1970s, mortality from NHL was similar in the European Union (EU), the USA and Japan, i.e. around 3/100,000 males and 2/100,000 females. Over the last two decades, NHL mortality in the EU rose to 4.4/100,000 males and 2.8/100,000 females. Upward trends were greater in the USA, whose rates approached 6/100,000 males and 4/100,000 females in the late 1990s, and were observed in Japan, too.

Adolescent↗

Alcohol drinking and bladder cancer.

The relation between alcoholic beverage consumption and bladder cancer risk was investigated using data from a case-control study conducted between 1985 and 1992 in two areas of northern Italy. Cases were 727 patients with incident, histologically confirmed bladder cancer, and controls 1,067 patients admitted to the same network of hospitals for acute, non-neoplastic, nonurologic, or genital tract diseases. Compared to nondrinkers, the odds ratio (OR) was 0.79 (95% confidence interval, CI, 0.58-1.08) for drinkers, and 0.84 (95%CI, 0.58-1.22) for > or =6 drinks/day. The OR was 0.86 (95%CI, 0.60-1.23) for > or =5 wine drinks/day, 0.69 for beer, and 0.85 for spirits. No trend was observed with duration (OR =1.00 for > or =40 years). ORs were consistent across various strata of covariates including age, sex, and smoking habits. Our study, based on a population with high alcohol (mainly wine) intake, found no association between bladder cancer risk and alcohol intake, even at high levels of consumption.

Adult↗

Diabetes mellitus as a contributor to the risk of acute myocardial infarction.

The risk of nonfatal acute myocardial infarction (AMI) has been studied in relation to diabetes and other risk factors, combining data from three Italian case-control studies including 1,737 cases with nonfatal AMI and 2,317 controls in hospital for acute diseases unrelated to AMI risk factors. The multivariate odds ratio (OR) of AMI for diabetes was 2.3 (95% confidence interval, 1.8-2.9); the association with AMI risk was apparently stronger in patients diagnosed with diabetes when aged <40 years (OR 2.9), and in women (OR 4.4). When the combined effect of diabetes and other known risk factors on the risk of AMI was considered, compared to nondiabetic subjects with each factor at the lowest risk level, the OR for diabetic subjects was 4.7 in smokers, 2.8 in heavy coffee drinkers, 2.7 in those with higher body mass index, 3.4 in patients with high cholesterol levels, 3.3, 4.3, and 2.7 for diabetic subjects with history of hyperlipidemia, hypertension, and obesity, respectively, and 4.3 for those with a family history of AMI in first degree relatives. The association of each risk factor was much stronger in diabetic women. Preventive measures to reduce the prevalence of each additional risk factors in diabetic subjects could led to a substantial reduction of risk of AMI.

Adolescent↗

Does coffee protect against liver cirrhosis?

PURPOSE: To evaluate the relation between consumption of coffee and other methylxanthine-containing beverages and liver cirrhosis. METHODS: A hospital-based case-control study of digestive tract and liver diseases was conducted in Greater Milan, Italy, including 101 cases with liver cirrhosis and 1538 controls. RESULTS: Compared with coffee non-drinkers, the multivariate odds ratio (OR) was 0.77 for one cup of coffee per day, 0.57 for two, and 0.29 for three or more. The OR for 40 years of coffee consumption or more was 0.45. Trends in risk were significant for both number of cups and duration of coffee drinking. No significant association was observed with decaffeinated coffee, tea and cola-containing beverages. The relation between coffee consumption and liver cirrhosis was not attributable to confounding and was observed across strata of tobacco, alcohol, and other major covariates of interest. In particular, an inverse relation was observed also in subjects reporting moderate alcohol drinking. CONCLUSIONS: The present study confirms, and further quantifies, the existence of an inverse association between coffee consumption and liver cirrhosis. However, the metabolism of caffeine is impaired in fasting subjects with liver cirrhosis, and the association could be due to a reduction of coffee drinking in subjects with liver cirrhosis.

Adult↗

Nutrient intake and ovarian cancer: an Italian case-control study.

OBJECTIVE: The role of selected macronutrients, cholesterol, and fatty acids in the etiology of epithelial ovarian cancer was analyzed using data from a case-control study carried out in five Italian areas between January 1992 and December 1999. METHODS: Cases comprised 1,031 women with incident, histologically confirmed epithelial ovarian cancer, admitted to the major teaching and general hospitals of the study areas. Controls comprised 2,411 women admitted for acute, non-neoplastic conditions to the same network of hospitals. Information on dietary habits was elicited using a validated food-frequency questionnaire including 78 food groups and recipes. Odds ratios (OR) and their corresponding 95% confidence intervals (CI) were computed by subsequent quintiles of nutrient intake. RESULTS: Direct associations with ovarian cancer emerged for starch intake (OR = 1.4 in the highest vs the lowest quintile of intake; 95% CI 1.1-1.8), while inverse associations emerged for monounsaturated (OR=0.7; 95% CI 0.5-0.9), and polyunsaturated (OR = 0.7; 95% CI 0.5-0.9) fatty acids. Among fatty acids, oleic (OR = 0.7; 95% CI 0.5-0.9), linoleic (OR = 0.7; 95% CI 0.5-0.9), and linolenic (OR = 0.8; 95% CI 0.6-1.0) acids were inversely related to ovarian cancer. When, however, six macronutrients were included in the same model, only the adverse effect of high starch intake remained significant. Results were consistent in separate strata of menopausal status, parity, and energy intake. CONCLUSIONS: Starch was directly associated, and unsaturated fatty acids were inversely associated, with ovarian cancer risk.

Adult↗

Risk factors for medullary thyroid carcinoma: a pooled analysis.

OBJECTIVE: To investigate risk factors for medullary thyroid cancer (MTC). METHODS: We conducted a pooled analysis of 14 case-control studies from Europe, North America, and Asia, including 67 medullary cancers (43 women and 24 men) diagnosed in ten studies. Of the original 4776, we selected five controls per case matched on study, gender, and age. The pooled odds ratios (OR) were estimated using conditional logistic regression. RESULTS: Education, weight, and body mass were not associated with MTC, but a significant positive relationship was seen with height (OR = 2.6 for highest vs lowest tertile). Significant excess risks were associated with a history of thyroid nodules (OR = 12), hypertension (OR = 2.3), gallbladder disease (OR = 4.3), and allergies (OR = 2.2). Among current smokers, a decreased risk of MTC was observed with increasing number of cigarettes. The risk was significantly elevated among women having a first birth after age 25 years, but no clear pattern emerged for other reproductive factors. CONCLUSIONS: Although the number of MTC was small, we detected several significant associations, including prior thyroid and other diseases.

Adult↗

Olive oil, seed oils and other added fats in relation to ovarian cancer (Italy).

OBJECTIVE: This study investigates the potential role of olive oil and other added fats used for seasoning or cooking on ovarian carcinogenesis. METHODS: We analyzed data from a multicentre case-control study conducted between 1992 and 1999 in Italy, including a total of 1031 incident with a first diagnosis, histologically confirmed epithelial ovarian cancer cases and 2,411 hospital controls with acute, non-malignant and non-gynecological conditions. The subjects' usual diet was investigated through a validated food-frequency questionnaire, including specific questions aimed at assessing added fat intake patterns. RESULTS: After allowance for study centre, year at interview, age, education, parity, oral contraceptive use, and total energy intake, a reduced risk of ovarian cancer was observed for high intake of olive oil (odds ratio (OR) = 0.68, 95% confidence interval (CI) 0.50-0.93 for the highest quintile of intake, compared to the lowest one) and for a group of specific seed oils (i.e. sunflower, maize, peanut, and soya) (OR = 0.59, 95% CI 0.46-0.76). No significant associations were observed for mixed seed oils, butter, and margarine. CONCLUSIONS: The present study suggests a favorable effect of olive oil and other vegetable oils on ovarian cancer in this Italian population.

Adolescent↗

A pooled analysis of case-control studies of thyroid cancer. VII. Cruciferous and other vegetables (International).

OBJECTIVE: To investigate the association between cruciferous and other vegetables and thyroid cancer risk we systematically reanalyzed the original data from 11 case-control studies conducted in the US, Asia, and Europe. METHODS: A total of 2241 cases (1784 women, 457 men) and 3716 controls (2744 women, 972 men) were included. Odds ratios (OR) and the corresponding 95% confidence intervals (CI) were estimated for each study by logistic regression models, conditioned on age and sex, and adjusted for history of goiter, thyroid nodules or adenomas, and radiation. Summary ORs for all studies combined were computed as the weighted average of the estimates from each study. RESULTS: A decreased risk for the highest level of cruciferous vegetable intake, as compared to the lowest, was observed in Los Angeles, Hawaii, Connecticut, southeastern Sweden, Tromsø, and Switzerland; the OR were above unity in Japan and Uppsala, whereas no material association was found in northern Sweden, Italy, or Greece. The OR values for all studies combined were 0.87 (95% CI 0.75-1.01) for moderate and 0.94 (95% CI 0.80-1.10) for high cruciferous vegetables intake. The results were similar in studies from iodine-rich areas and endemic goiter areas, and were consistent when the analysis was restricted to papillary carcinomas and women. The summary OR values for vegetables other than cruciferous were 1.04 (0.88-1.22) for moderate and 0.82 (0.69-0.98) for high consumption. CONCLUSIONS: This combined analysis indicates that cruciferous vegetables are not positively related to thyroid cancer risk. Their effect does not seem to be substantially different from that of other vegetables, which appear to be protective on this cancer.

Brassica↗

Joint effects of family history and adult life dietary risk factors on colorectal cancer risk.

BACKGROUND: We analyzed the joint effects of family history of colorectal cancer and adult life dietary risk factors on colorectal cancer risk. METHODS: We used data from a case-control study conducted in northern Italy between 1985 and 1992, including 1584 cases with colorectal cancer and 2879 controls. We created an adult life dietary risk factor score. RESULTS: Among subjects with family history of colorectal cancer, those in the lowest risk score tertile were not at elevated risk of colorectal cancer (odds ratio = 1.2; 95% confidence interval = 0.7-2.1), whereas those in the highest score tertile were at increased risk (odds ratio = 5.5; 95% confidence interval = 3.5-8.7). CONCLUSIONS: These findings indicate that the expression of familial susceptibility can be substantially modified by adult life risk factors.

Adult↗

[Tumors of the testis: a paradigm of a curable neoplasm?].

Mortality from testicular cancer has been declining in the USA since the 1970's and in western Europe since the late 1970's, and the rates in the late 1990's were about 70% lower than in the 1970's. In Eastern Europe, however, some decline was observed only since the late 1980's and was substantially smaller (only approximately 20%). Consequently, a few hundred avoidable deaths from a curable neoplasm, mainly of young adults, are still registered in Eastern Europe. This underlines the urgency of implementation of available and effective therapeutic schemes for testicular cancer in Eastern Europe.

Adult↗