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Biomedical subjects

F Levi

Publications and source records attributed to F Levi.

At least 181 records · Page 10Linked to original sources
PubMed1997

Trends of in situ carcinoma of the breast in Vaud, Switzerland.

Time trends in incidence of in situ carcinoma of the breast over the period of 1977-1994 were analysed by histological type and age group, using data from the Cancer Registry of the Swiss Canton of Vaud, covering a population of approximately 295,000 women in 1990. Overall, 399 women with carcinoma in situ of the breast were registered. Age-adjusted (on the world population) incidence rates increased from 2.1/100,000 women in 1977-1979 to 9.4 in 1992-1994 (4.5-fold increase), and the rise was appreciably greater for ductal carcinoma in situ (DCIS, from 1.0 to 7.1/100,000) than for lobular carcinoma in situ (LCIS, from 1.0 to 2.3/100,000). The largest increase was registered between 1983 and 1992, whereas incidence rates tended to level off over the most recent calendar period. The upward trends were observed in all age groups above 40 years, but chiefly in the age groups 40-49 and 50-69, whose rates were higher than for women over the age of 70 years. These findings suggest that the adoption of mammography in this population during the 1980s is partly or largely responsible for the observed trends. Incidence rates of in situ breast carcinoma in Vaud are still significantly lower than those observed in the United States (between 15 and 17/100000) over the same calendar period. This is attributable to a lower utilisation of mammography, but may also be related to real differences in the incidence of breast lesions in Europe compared to North America.

Adult↗
PubMed1997

Epidemiology and prevention of oral cancer.

Descriptive epidemiology of oral and pharyngeal cancer over the last four decades is reviewed, with specific focus on Europe. Substantial rises in mortality rates have been observed for younger males, mostly in eastern Europe. The independent role of alcohol and tobacco and their interaction on oral carcinogenesis is discussed, since these factors account for about three quarters of oral cancers in Europe. The influence of dietary factors, and in particular of a diet poor in fresh fruit and vegetables on oral carcinogenesis, is also discussed, since diet may account for 10-15% of oral cancer cases in Europe. Finally, among other carcinogens, the possibility of human papillomavirus involvement in the aetiology of cancer of the oral cavity and pharynx is overviewed. Implications for prevention are discussed.

Adult↗
PubMed1996

Circadian rhythm in toxic effects of cystemustine in mice: relevance for chronomodulated delivery.

Cystemustine is a new nitrosourea with high anti-tumor activity and a short plasma half-life in mice. The influence of circadian dosing time upon its toxicities was first investigated in a total of 368 synchronized male B6D2F1 mice. Late survival rate varied from 4% in mice receiving a single dose of cystemustine (conventional lethal dose 50%) at 7 hours after light onset (HALO) up to 88% in mice treated at 15 or at 19 HALO. Target organ toxicities (bone marrow, circulating blood cells, spleen, colon and duodenum) were studied following a single slightly lower dose of cystemustine. Leukopenia was the major hematologic effect encountered. Leukocyte count nadir occurred 7 days after injection and was lowest following cystemustine at 7 HALO as compared to 13 or 19 HALO. Recovery was faster after cystemustine at 19 HALO as compared to other dosing times. Bone-marrow necrotic lesions were more pronounced 1 day after cystemustine at 7 HALO than after cystemustine at 19 HALO. Thus, a large-amplitude circadian rhythm characterized the toxicity of this nitrosourea in mice. The lowest cystemustine toxicity was found near the middle of the active span of the rest-activity circadian cycle of mice.

Animals↗
PubMed1996

Lactation and the risk of breast cancer in an Italian population.

The relation between breast feeding and breast cancer was investigated in a multicentric case-control study conducted in Italy on 2,167 parous women with histologically confirmed breast cancer, diagnosed within 1 year, and 2,208 parous control women admitted to hospitals in the same catchment areas of cases for acute, non-neoplastic, non-gynecological non-hormone-related diseases. Compared with women who had never tried to lactate, those who had always failed had a multivariate odds ratio (OR; adjusted for parity, education and several other potential confounding factors) of 0.94, and those who had lactated had an OR of 1.17. The multivariate ORs of women who had breast fed 1, 2 and 3 or more children were, respectively, 1.14, 1.18 and 1.32, compared with women who had never lactated. None of these ORs was statistically significant. Compared with women who had never breast fed, the multivariate ORs were 1.19 for women reporting less than 6 months of breast feeding, 1.15 for 6-11 months, 1.34 for 12-17 months, 1.10 for 18-23 months and 0.86 for 24 months or more. No appreciable difference was evident across strata of age, menopausal status, parity and age at first birth, while there was a hint of interaction with education. Our study therefore excluded any appreciable protective role for lactation in breast cancer risk, with the patterns of lactation in this European population, aside from the protective role of parity on breast carcinogenesis.

Adult↗
PubMed1996

Site distribution of different types of skin cancer: new aetiological clues.

Since the investigation, at an individual level, of lifetime sun exposure remains difficult the site distribution of different types of skin cancer can be an important source of aetiological clues. The present report deals with 1,149 cases of cutaneous malignant melanoma (CMM), 7,685 of basal-cell carcinoma (BCC) and 3,049 of squamous-cell carcinoma (SCC) reported between 1976 and 1992 to the Vaud Cancer Registry, in Switzerland. Site- and type-specific age-standardized (on the world population) incidence rates per 100,000 population and per 100,000 unit surface were computed, together with relative age-standardized incidence rates (i.e., rates per 100,000 surface unit in each anatomical site relative to rates for the body as a whole). The highest rates per unit surface were seen for both genders in the face, thus indicating same role of cumulative sun exposure in all skin-cancer types. Relative to the incidence in the whole body, the excess on the face was, however, more than 20-fold for BCC and SCC, but only 4-fold for CMM. The relative incidence in males was very much higher for SCC than for CMM and BCC in the neck, ears and scalp, a heavily sun-exposed area in men but not in women. Conversely, a substantial lack of SCC was seen in the trunk. In conclusion, site distribution of different skin-cancer types suggests that short-duration UV-light exposure is sufficient to increase CMM risk substantially, but has little influence on SCC risk. With the increase of exposure, however, SCC rises more steeply than BCC. Age-related behaviour (i.e., another indirect indicator of duration of exposure to UV light) is consistent with the anatomical distribution of skin cancer.

Age Factors↗
PubMed1996

Intake of selected micronutrients and the risk of endometrial carcinoma.

BACKGROUND: There is some evidence that dietary habits independent of body mass may influence endometrial carcinoma risk, but the specific aspects of this hypothesis are not yet clear. METHODS: A case-control study was conducted between 1988 and 1994 in the Swiss Canton of Vaud and Northern Italy including 368 patients with histologically confirmed endometrial carcinoma and 713 controls in hospital for acute, nonneoplastic conditions, unrelated to known or potential risk factors for endometrial carcinoma. Multiple logistic regression was used to estimate the odds rations of carcinoma of the corpus uteri according to quintile of intake of the micronutrients considered, and adjusted for potential confounding factors. RESULTS: Total energy intake was directly related to endometrial carcinoma risk. Adjustment for energy substantially modified the estimated odds ratios. After allowance for calories, the relative risk of endometrial carcinoma in the highest quintile of intake, compared with the lowest quintile of intake, was 1.2 for retinol, 0.5 for beta-carotene, 0.6 for ascorbic acid, 1.8 for vitamin D, 0.9 for vitamin E, 2.9 for methionine, 0.7 for folate, and 1.5 for calcium. Allowance for other micronutrients significantly associated with endometrial carcinoma did not substantially modify the risks estimated for beta-carotene, while associations with ascorbic acid were weaker and nonsignificant. CONCLUSIONS: This study suggests that some micronutrients, including beta-carotene, may have a protective effect against endometrial carcinoma.

Aged↗
PubMed1996

Worldwide trends in cancer mortality in the elderly, 1955-1992.

Trends in age-standardised mortality for all cancers and 21 cancers or groups of cancers over the period 1955-1992 were analysed for 33 countries from four continents in a population aged 65-84 years. Mortality from all neoplasms in the elderly showed heterogeneous patterns in various countries and in the two sexes. Trends were generally more favourable for females than for males, reflecting essentially the earlier and more extensive impact of the lung cancer (and other tobacco-related neoplasms) epidemic in elderly males, in addition to the earlier decline of gastric cancer and a widespread decline of cervical cancer rates in females. In several countries, particularly from western Europe, but also Japan, cancer mortality trends were more favourable over the last two decades than in earlier calendar periods. Some countries of northern and central Europe (including Finland, Germany, Austria and Switzerland) showed stable or even downward trends over time for total cancer mortality in both sexes, particularly in males. This reflects the different patterns of the tobacco-related (lung) cancer epidemic in various countries, and the impact of a few other major neoplasms, including in particular the systematic downward trends in stomach cancer. In contrast, rates were moderately upwards in males in North America, and several countries of southern and eastern Europe, where cancer mortality in the elderly was comparatively low in the 1950s, showed appreciable upward trends, mostly in males. Thus, there was a generalised tendency towards a levelling of the differences in certified cancer mortality in the elderly population in various areas of the world. Although there are substantial limits and uncertainties in the reliability and validity of cancer death certification and their trends in the elderly, there is no widespread and generalised upward trend in cancer mortality, with a major exception of lung and other tobacco-related neoplasms. Furthermore, in several countries, cancer mortality trends over the last four decades have been favourable for elderly women.

Aged↗
PubMed1996

Alcohol and breast cancer in the Swiss Canton of Vaud.

The relationship between alcoholic beverage drinking and the risk of breast cancer was considered using data from a case-control study of breast cancer conducted between 1990 and 1995 in the Swiss Canton of Vaud on 230 incident cases of breast cancer below age 75 years, linked with the Vaud Cancer Registry, and 507 controls admitted to the same network of hospitals for a wide spectrum of acute, non-neoplastic, non-hormone-related conditions. Overall, 70.4% of cases versus 57.4% of controls consumed alcohol, corresponding to a multivariate odds ratio (OR) of 1.5 (95% confidence interval (CI): 1.1-2.2). The ORs were 1.3 for < 1 drink per day, 1.8 for 1 to 2, 1.5 for 2 to 4, and 2.7 for > 4 drinks per day, and the trend in risk with dose was significant. The association was consistent for wine (OR = 2.0), beer (OR = 2.6) and spirits (OR = 2.0) and was apparently stronger in premenopausal women, whereas no noticeable interaction was observed with any of the hormonal or reproductive risk factors for breast cancer. The alcohol-related risk was unrelated to duration; the OR was 1.8 for women who started drinking below the age of 30 years and 1.4 for those starting at the age of > or = 30 years. Thus, the present study confirms that alcohol is a correlate of breast cancer risk in this European population, where alcohol drinking among women is common and relatively high. Assuming that this association reflects causality, in terms of attributable risk, alcohol could explain 25% (8-42%) of breast cancer cases.

Adult↗
PubMed1996

Incidence of invasive cancers following carcinoma in situ of the cervix.

Women with carcinoma in situ (CIS) of the cervix uteri, notified to the population-based Cancer Registry of the Swiss Canton of Vaud between 1974 and 1993, were actively followed up to 31 December 1993 for the occurrence of subsequent invasive neoplasms. Among 2190 incident cases of CIS, followed for a total of 22,225 person-years, 95 metachronous cancers were observed vs 77.9 expected, corresponding to a significant standardised incidence ratio (SIR) of 1.2. Ten cases of invasive cervical cancer were observed vs 3.0 expected (SIR = 3.4, P < 0.01), the excess being larger in the first 10 years since CIS diagnosis. A total of 11 cases of four major tobacco-related sites (lung, mouth or pharynx, oesophagus and urinary bladder) were observed vs 5.1 expected, corresponding to a significant SIR of 2.2. The excess was observed > or = 10 years after CIS diagnosis. There was also an excess of non-melanomatous skin cancers (29 observed, 16.9 expected, SIR = 1.7; P < 0.01), but not of skin melanoma and of any of the other neoplasms considered, including breast and corpus uteri. This population-based study, therefore, finds an excess of invasive cervical cancer in the short term after CIS diagnosis, and a medium- to long-term excess risk of tobacco-related and non-melanomatous skin neoplasms. These findings are discussed in terms of increased surveillance and case ascertainment after CIS, and of potential shared risk factors (tobacco and/or viral infections).

Adolescent↗
PubMed1996

Non-Hodgkin's lymphomas, chronic lymphocytic leukaemias and skin cancers.

Data from the Cancer Registries of the Swiss Cantons of Vaud and Neuchâtel were analysed to examine possible associations between skin cancers (including basal cell carcinoma, BCC), non-Hodgkin's lymphomas (NHL) and chronic lymphocytic leukaemias (CLL). Between 1974 and 1993, 1767 cases of NHL, 351 of CLL, 1678 of cutaneous malignant melanoma (CMM), 4131 of squamous cell carcinoma (SCC) and 10575 of BCC were registered, and contributed to a total of 120103 person-years at risk. Following NHL, 36 cases of SCC were registered compared with 5.1 expected, corresponding to a standardised incidence ratio (SIR) of 7.0 (95% confidence interval, CI, 4.9-9.7); 37 cases of BCC were observed compared with 10.2 expected (SIR = 3.6; 95% CI 2.6-5.0). Following CLL, nine cases of SCC were observed compared with 1.8 expected (SIR = 5.0; 95% CI 2.3-9.5) and nine cases of BCC were observed compared with 3.3 expected (SIR = 2.7; 95% CI 1.2-5.2). After SCC, 23 cases at NHL were observed compared with 9.0 expected (SIR = 2.6; 95% CI 1.6-3.8); after BCC, 43 cases of NHL were registered compared with 22.5 expected (SIR = 1.9; 95% CI 1.4-2.6); and after CMM, four cases of NHL were observed compared with 2.0 expected (SIR = 2.0). No significant excess of CLL was recorded following skin cancer, but the absolute numbers were small and the SIR was above unity. The findings of this study, conducted in populations with a high level of ascertainment and registration of skin cancers, confirm an excess of skin cancers including BCC, following NHL and CLL, and an excess of NHL following skin cancers. This may be related to shared aetiological factors such as U.V. radiation and associated immunosuppression. Individual-based data on the relationship between U.V. exposure and lymphoid neoplasms are needed to clarify the issue.

Age Factors↗
PubMed1996

Trends in cancer incidence and mortality in Vaud, Switzerland, 1974-1993.

BACKGROUND: Comparing incidence of and mortality from cancer within a given population yields several benefits. One of these is the opportunity, when trends in incidence differ from those in mortality, to derive inferences about the potential role of improved diagnosis in the rise of incidence rates, and about therapeutic advancements in reducing mortality. MATERIALS AND METHODS: Trends in incidence of and mortality from various cancers or groups of cancers (comprising 55,682 new malignant tumours and 26,528 certified cancer deaths) over the period 1974-1993 were compared using, respectively, data from the Cancer Registry of the Swiss Canton of Vaud (with about 600,000 inhabitants) and those provided by the Swiss Federal Statistical Office. RESULTS: The overall cancer incidence increased by 10% to 30% in both sexes and various age groups, whereas mortality remained approximately the same. The sites primarily responsible for these divergent trends were breast, prostate and colorectal, three sites where cancers have been less frequently diagnosed since the advent of certain technical advancements and the introduction of screening. Other contributors to the divergent trends were testicular cancer, Hodgkin's disease and leukaemias, i.e., the sites for which the most substantial therapeutic advancements have been achieved. CONCLUSIONS: These data are fairly reassuring, since they are inconsistent with an ongoing cancer epidemic in this European population. However, they are also incompatible with the presence of major advancements in the prevention and treatment of cancer.

Adult↗
PubMed1996

Circadian variation in O6-methylguanine-DNA methyltransferase activity in mouse liver.

Bifunctional chloroethylating cytostatic agents produce lethal DNA lesions, as a result of the formation of O6-alkylguanines. These lesions can be repaired by O6-methylguanine-DNA methyltransferase (MGMT). This ubiquitous nuclear and cytosolic enzyme removes the alkyl group by accepting it to the cysteine residue of its active site, thus preventing the formation of DNA interstrand cross-links. The role of the circadian organization in cellular protection against such DNA insults was examined in male B6D2F1 mice, synchronized with an alternation of 12 h of light and 12 h of darkness (LD12:12). MGMT activity was determined in liver of mice obtained at eight different circadian times, located 3 h apart. MGMT activity varied 5-fold along the 24 h time-scale, from 7 +/- 1 pmol/g of tissue at 7 h after light onset (HALO), during the rest span, up to 32 +/- 9 pmol/g at 19 HALO (second mid to late activity span). This large amplitude circadian rhythm in MGMT activity may be an important determinant of the susceptibility rhythms to alkylating agents. The greatest DNA repair activity occurred at night when mice were active, eat and drink, and thus are at a higher risk of being exposed to chemical insults.

Animals↗
PubMed1996

Oral contraceptives, menopausal hormone replacement treatment and breast cancer risk.

The relationship between oral contraceptives (OC), menopausal hormone replacement treatment (HRT) and breast cancer risk was analysed in a case-control study conducted in the Swiss canton of Vaud on 230 cases below the age of 75, linked with the Vaud cancer registry, and 507 controls in hospital for a wide spectrum of acute, non-neoplastic, non-hormone-related diseases. A total of 77 (37.4%) cases and 134 (31.6%) of controls below the age of 70 had ever used OC, corresponding to a multivariate odds ratio (OR) of 1.5, of borderline significance. The risk was related to duration of use, but this might be partly due to a recency effect. In fact, with reference to time since last OC use, the OR was above unity for up to 14 years, but declined to 1.0 for women who had stopped OC use for > or = 15 years. With reference to HRT, ever users were 64 (27.8%) of cases and 113 (23.3%) of controls, yielding a multivariate OR of 1.3. Also, for HRT the association was stronger for shorter time since last use; the OR was 1.5 for women who had stopped for < 10 years, but declined to 0.8 for those who had stopped for 10 years or longer. The association with HRT was stronger for women aged > or = 65. Thus, the present study confirms that breast cancer risk is moderately related to OC and HRT. The association, however, is essentially restricted to the 10-15 years after stopping use. This pattern of risk is consistent with a late-stage effect of steroid hormone preparations on the process of breast carcinogenesis, and has relevant implications for any risk/benefit assessment and public health evaluation.

Age Factors↗
PubMed1996

Comparative descriptive epidemiology of oral and oesophageal cancers in Europe.

The two main determinants of oral and oesophageal cancer in Europe are alcohol and tobacco, and the two cancer sites show several similarities in their descriptive epidemiology. This study compares mortality from cancers of the oral cavity and oesophagus in European countries to evaluate similarities and differences. From official death certification numbers and population estimates, we obtained age-standardized rates for all ages and truncated (35-64 years). In most countries, rates for men tended to increase between 1955-59 and 1990-92 for both sites, although the increases were more marked for oral cancer. In the UK and Ireland, however, oral cancer decreased and oesophageal cancer increased, while in Finland and Iceland mortality for both sites decreased. The most striking increases were in Hungary, where the truncated rate in most recent calendar periods reached the highest levels in Europe. In France, rates for both cancers were extremely high: oral cancer increased from 1955-59 to the early 1980s, but started to decline afterwards. Mortality rates were much lower for women than men, and the correlation between the two sites was less marked. An age, period and cohort model, applied to the rates for men in selected European countries, suggested strong cohort effects for both cancers, generally more marked for oral cancer, with substantial increases in the cohorts born after 1920. The mortality rates of cancers of the oral cavity and oesophagus show several analogies, as expected from their relation to tobacco and alcohol; but some discrepancies suggest that other, less well-identified, factors may also influence their rates and trends in Europe.

Adult↗
PubMed1996

The difference between activity when in bed and out of bed. I. Healthy subjects and selected patients.

The activity records of five groups of healthy or ill subjects have been measured for 4-26 days by an accelerometer placed on the nondominant wrist. These data, together with a record of times retiring to/rising from bed, have been used to produce a series of dichotomy indices for comparing the amounts of activity when in bed and out of bed. Reliable differences between individuals were found, with healthy subjects showing a greater degree of dichotomy than one subject with delayed sleep phase syndrome or three subjects with colorectal cancer. The method is convenient for extended data collection and offers the possibility of describing an individual's activity profile in a variety of circumstances.

Adolescent↗