Suicide mortality in adolescents and young adults, 1980-1999.
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Adolescent↗
Biomedical subjects
F Levi
Publications and source records attributed to F Levi.
Monitoring falls in gastric cancer mortality in Europe.
We have considered trends in age-standardized mortality from gastric cancer in 25 individual European countries, as well as in the European Union (EU) as a whole, in six selected central-eastern European countries and in the Russian Federation over the period 1950-1999. Steady and persisting falls in rates were observed, and the fall between 1980 and 1999 was approximately 50% in the EU, 45% in eastern Europe and 40% in Russia. However, the declines were greater in Russia and eastern Europe, since rates were much higher, in absolute terms. Joinpoint regression analysis indicated that the falls were proportionally greater in the last decade for men (-3.83% per year in the EU) and in the last 25 years for women (-3.67% per year in the EU) than in previous calendar years. Moreover, steady declines in gastric cancer mortality were observed in the middle-aged and the young population as well, suggesting that they are likely to persist in the near future. In terms of number of deaths avoided, however, the impact of the decline in gastric cancer mortality will be smaller, particularly in the EU.
Adult↗
Processed meat and the risk of selected digestive tract and laryngeal neoplasms in Switzerland.
BACKGROUND: Processed meat has been related to the risk of digestive tract neoplasms but the evidence remains inconclusive. We examined data from a network of case-control studies conducted between 1992 and 2002 in the Swiss Canton of Vaud. PATIENTS AND METHODS: We studied 316 patients with incident, histologically confirmed oral and pharyngeal cancer, 138 patients with oesophageal cancer, 91 patients with laryngeal cancer and 323 patients with colorectal cancer. Controls were 1271 subjects admitted to the same hospital for a wide spectrum of acute non-neoplastic conditions, unrelated to long-term modification of diet. RESULTS: There were strong direct trends in risk between consumption of processed meat and the various neoplasms considered: the multivariate odds ratios for the highest quartile of intake compared to the lowest were 4.7 for oral and pharyngeal cancer, 4.5 for oesophageal cancer, 3.4 for laryngeal cancer and 2.5 for colorectal cancer. The association was stronger in younger subjects, in moderate drinkers and in non-smokers. CONCLUSION: Processed meat represents a strong indicator of unfavourable diet for digestive tract and laryngeal cancer risk in this population.
Adult↗
Declining mortality from kidney cancer in Europe.
Mortality rates from kidney cancer increased throughout Europe up until the late 1980s or early 1990s. Trends in western European countries, the European Union (EU) and selected central and eastern European countries have been updated using official death certification data for kidney cancer abstracted from the World Health Organisation (WHO) database over the period 1980-1999. In EU men, death rates increased from 3.92 per 100,000 (age standardised, world standard) in 1980-81 to 4.63 in 1994-95, and levelled off at 4.15 thereafter. In women, corresponding values were 1.86 in 1980-81, 2.04 in 1994-95 and 1.80 in 1998-99. Thus, the fall in kidney cancer mortality over the last 5 years was over 10% for both sexes in the EU. The largest falls were in countries with highest mortality in the early 1990s, such as Germany, Denmark and the Netherlands. Kidney cancer rates levelled off, but remained very high, in the Czech Republic, Baltic countries, Hungary, Poland and other central European countries. Thus, in the late 1990s, a greater than three-fold difference in kidney cancer mortality was observed between the highest rates in the Czech Republic, the Baltic Republics and Hungary, and the lowest ones in Romania, Portugal and Greece. Tobacco smoking is the best recognised risk factor for kidney cancer, and the recent trends in men, mainly in western Europe, can be related to a reduced prevalence of smoking among men. Tobacco, however, cannot account for the recent trends registered in women.
Adult↗
Trends in cancer mortality in the European Union and accession countries, 1980-2000.
Cancer mortality rates and trends over the period 1980-2000 for accession countries to the European Union (EU) in May 2004, which include a total of 75 million inhabitants, were abstracted from the World Health Organization (WHO) database, together with, for comparative purposes, those of the current EU. Total cancer mortality for men was 166/100,000 in the EU, but ranged between 195 (Lithuania) and 269/100,000 (Hungary) in central and eastern European accession countries. This excess related to most cancer sites, including lung and other tobacco-related neoplasms, but also stomach, intestines and liver, and a few neoplasms amenable to treatment, such as testis, Hodgkin's disease and leukaemias. Overall cancer mortality for women was 95/100,000 in the EU, and ranged between 100 and 110/100,000 in several central and eastern European countries, and up to 120/100,000 in the Czech Republic and 138/100,000 in Hungary. The latter two countries had a substantial excess in female mortality for lung cancer, but also for several other sites. Furthermore, for stomach and especially (cervix) uteri, female rates were substantially higher in central and eastern European accession countries. Over the last two decades, trends in mortality were systematically less favourable in accession countries than in the EU. Most of the unfavourable patterns and trends in cancer mortality in accession countries are due to recognised, and hence potentially avoidable, causes of cancer, including tobacco, alcohol, dietary habits, pollution and hepatitis B, plus inadequate screening, diagnosis and treatment. Consequently, the application of available knowledge on cancer prevention, diagnosis and treatment may substantially reduce the disadvantage now registered in the cancer mortality of central and eastern European accession countries.
Europe↗
Trends in cancer mortality in Mexico, 1970-1999.
BACKGROUND: Few data on cancer mortality have been published for Mexico over the last few decades. It is therefore of interest to conduct a systematic and updated analysis of cancer mortality in this country. PATIENTS AND METHODS: Age-standardised (world population) mortality rates, at all ages and truncated at age 35-64 years, from major cancers and all cancers combined were computed on the basis of certified deaths derived from the World Health Organization database for the period 1970-99. RESULTS: Mortality rates for all neoplasms showed an upward trend in men of all ages (from 58.2/100,000 in 1970-74 to 87.1/100,000 in 1995-99) and in middle-aged men (from 76.1 to 93.7/100,000, respectively). This reflects the rise until the early 1990s in lung cancer mortality (from 8.1/100,000 in 1970-74 to 15.6/100,000 in 1995-99) and prostate cancer (from 5.5 to 12.2/100,000, respectively). In women, overall mortality rates showed an increase between the early 1970s (75.4/100,000) and the late 1990s (82.3/100,000). Total cancer mortality rates remained low, however, compared with other American countries (e.g. 153.3/100,000 men and 108.6/100,000 women in 1999 in the United States). Truncated rates were stable (126.5/100,000 in 1970-74 and 125.8/100,000 in 1995-99), although they were much higher than overall rates, reflecting exceedingly high rates for uterine (mostly cervical) cancer mortality in middle-aged women (29.5/100,000 in 1995-99). CONCLUSIONS: Total cancer mortality in Mexico has remained comparably low on a worldwide scale, and the upward trends in mortality rates for lung and other tobacco-related neoplasms have tended to level off over the last decade. However, steady rises have been observed for other major cancers, including prostate and breast. Cervical cancer remains a major health problem in women.
Adult↗
Incidence of anal carcinoma in Vaud, Switzerland, 1979-2001.
Substantial rises in anal cancer incidence have been registered over the last few decades in the USA and a few Nordic countries. Incidence trends in the Swiss population of Vaud (about 602,000 inhabitants) over the period 1979-2001 were considered. Rates were around 0.3-0.5 per 100,000 men (age-standardized, world population) and 1.1-1.4 per 100,000 women, in the absence of any consistent trend over time. The epidemiology of anal cancer appears therefore different in this Swiss population as compared with North America and northern Europe.
Adolescent↗
Reattendance in the Swiss mammography screening pilot programme.
OBJECTIVES: To explore the patterns and determinants of reattendance among initial attendees at an organised breast cancer screening programme. SETTING: Swiss mammography screening pilot programme, based on first-round enrollment in 1993-1995. METHODS: Data on socio-demographic features, health preventive behaviour and history, prior screening round and referring physicians' attributes were collected at initial attendance. First-round attendees (n=4162) were followed prospectively through next screening round. Determinants of reattendance were identified by multivariate logistic regression. RESULTS: Reattendance rate was high (80%). Women most likely to reattend were urban, Swiss residents with a true-negative first-round screening result. The more intensive the initial recruitment efforts, the lesser were the odds of reattendance. Mammography screening prior to screening enrolment increased reattendance. Having a gynaecologist, a female and a younger doctor as a referring physician was positively associated with reattendance. CONCLUSION: Mammography screening attendance is not only influenced by women-related factors but also by structural factors, and thus requires a global approach. For strategies aimed at improving performances of organised cancer screening programmes, understanding and quantification of determinants of (re)attendance are key elements to consider.
Aged↗
Chronotherapy for cancer.
Cancer chronotherapy is attracting attention as a novel and logical therapy in which anti-cancer drugs are administered with optimal timing according to circadian rhythms of anti-cancer action and those of adverse effects on normal cells. Advances in chronobiology have identified the suprachiasmatic nucleus (SCN) as the center of biological rhythms and the area in which clock genes such as PER1, PER2, PER3, CLOCK, BMAL1, TIM, CRY1, CRY2, tau act to generate and coordinate biological rhythms. These findings have led to the development of chronotherapy. Clinically, patients with advanced gastrointestinal cancer have been treated by chronomodulated chemotherapy with good response. For colorectal cancer patients with unresectable liver metastases, chronotherapy with l-OHP + 5-FU + FA (folinic acid) has been reported to allow complete surgical resection of liver metastases, resulting in 39-50% 5-year survival. Many believe that chronotherapy will become accepted as a refined and advantageous therapeutic option for not only cancer but also for other diseases, due to its universally applicable principles.
Antineoplastic Combined Chemotherapy Protocols↗
Trends in cancer mortality at age 15 to 24 years in Europe.
Trends in death certification rates from all cancers and seven selected cancer sites (bone sarcoma, soft-tissue sarcoma, ovary, testis, non-Hodgkin's lymphomas, Hodgkin's disease, leukaemias) were analysed for the population aged 15-24 years in Europe and, for comparative purposes, in the United States of America (USA) and Japan over the period of 1965-1998. Overall, there was a decrease in total cancer mortality of approximately 40% for both sexes. The declined mortality is largely attributable to better treatments and inclusion in multicentre clinical trials. The degree of improvement was similar in Japan and the USA, but was less in Eastern European countries, reflecting delays in the application of effective treatments, and limited involvement in large, well-designed clinical trials for these curable cancers in Eastern Europe.
Adolescent↗
[Circadian variations of dihydropyrimidine dehydrogenase (DPD) activity in oral mucosa of healthy volunteers].
UNLABELLED: Dihydropyrimidine dehydrogenase (DPD) is the rate limiting enzyme of 5-fluoro-uracil (5-FU) catabolism. DPD rhythmicity, peak at 1:00 is an important determinant of 5-FU tolerability and has practical implications for the pattern of chronomodulated delivery of the drug. Maximal tolerated doses have been highed and anti-tumour activity also. But 30% patients have toxicities expressed by mucositis in oral mucosa. PURPOSE: Titrate DPD activity in oral mucosa in healthy subjects, in oral mucosa which is the target of 5-FU, at 10:00 and midnight could help to understand toxicities in patients. SUBJECTS AND METHODS: Eight healthy subjects participated (information note signed by patients). One oral mucosa sample was drawn at 10:00 and an other at midnight. DPD activity was analyzed by a H.P.L.C. method. RESULTS: DPD activity in oral mucosa varied from 0.004 to 0.13 nmol x min(-1) x mg(-1) prot at 10:00 and from 0.07 to 0.16 nmol x min(-1) x mg(-1) prot at midnight, with a 30% average relative increase from morning to midnight (range: -20% to +100%; statistical significant difference with P <0.073). CONCLUSION: DPD circadian changes in healthy oral mucosa subjects remained to agree to mononuclear cell, with increase at midnight.
Adult↗
Results from the Swiss mammography screening pilot programme.
The first Swiss mammography screening pilot programme operated between 1993 and 1998. Approximately 15000 women aged 50-69 years and residing in western Switzerland (canton of Vaud) were offered a biennial screening. Quality standard recommendations for screening were met for most performance indicators. Some 4.6%/2.3% (prevalent/incident round) of participants were referred for further assessment, and 84.7%/75.6% of them turned out not to have cancer. Specificity was high (96.1%/98.2%) and the cancer detection rate amounted to 7.0/1000 and 5.9/1000 in the prevalent and incident rounds, respectively. Some 30%/26% of cancers in screened women were interval cancers, which were at a more advanced stage than screen-detected tumours. Screening performances improved with time and age. The objectives of feasibility and acceptability of an organised mammography screening programme in the liberal Swiss healthcare system, where routine opportunistic screening existed, were achieved and contributed to the implementation of screening programmes in two additional Swiss cantons.
Aged↗
Oral contraceptives and colorectal cancer.
BACKGROUND: Only limited information and understanding are available on the potential relation between oral contraceptive use and the risk of colorectal cancer. Further data on the issue are therefore useful and may help informed choice of contraception. METHODS AND RESULTS: Data were derived from a case-control study of colorectal cancer conducted between 1992 and 2001 in the Swiss Canton of Vaud, including 131 women with colorectal cancer and 373 controls admitted in the same hospital as the cases with diagnosis of acute, non-neoplastic disease, unrelated to long-term modification of diet. Oral contraceptive use was reported by 11% of cases versus 17% of controls, corresponding to multivariate odds ratio of 0.8 (95% CI: 0.4-1.7). The odds ratio was non-significantly below unity across strata of duration, time since first and last oral contraceptive use. CONCLUSION: These findings add further evidence on a possible inverse relation between oral contraceptive and colorectal cancer risk.
Adult↗
Trends in mortality from suicide, 1965-99.
OBJECTIVE: To analyse trends in mortality from suicide over the period 1965-99. METHOD: Data were derived from the WHO database, including data for 47 countries. RESULTS: In the European Union (EU), all age suicide mortality peaked at 16.1/100,000 in men in 1980-84, and declined thereafter to 14.4/100,000 in 1995-98. In females, the fall was 29% to reach 4.6/100,000. A similar pattern of trends was observed in several eastern European countries. In contrast, mortality from suicide rose substantially in the Russian Federation, from 37.7/100,000 in males in 1985-89 to 58.3/100,000 in 1995-98 (+55%), and to 9.5/100,000 (+12%) in females. In the USA and most other American countries providing data, no consistent pattern was evident for males, but falls were observed in females. Steady declines were registered for Japan, starting from the highest suicide rates worldwide in the late 1950s. Suicide rates were upwards in Ireland, Italy, Spain, the UK, Cuba, Australia and New Zealand. Substantial rises were observed in a few countries (Ireland, Cuba, Mexico, Australia and New Zealand) for young males. CONCLUSION: In spite of mixed trends, suicide remains a significant public health problem worldwide.
Adolescent↗
Lung cancer mortality in European regions (1955-1997).
BACKGROUND: The different spread of tobacco smoking across European countries has caused a substantial variability in lung cancer mortality. The objective of this investigation was to analyse the trends in lung cancer mortality rates in three broad European regions (Northern and Western countries, Eastern countries, and Mediterranean countries) during the second half of the 20th century. PATIENTS AND METHODS: Mortality data were obtained from the World Health Organisation database. Lung cancer mortality rates were age-standardised by the direct method to the world standard population. Trends from 1955 to 1997 were assessed by means of joinpoint regression analysis. RESULTS: In men, rates in Eastern Europe increased to reach in the 1990s the highest values ever registered, while downward trends were observed in Northern and Western Europe since 1979, and in Mediterranean countries since the 1990s. In women, upward trends were observed in the three regions considered for the whole period. CONCLUSIONS: Different smoking prevalences over time explain the shift of almost one decade in the trends in Mediterranean men as compared with Northern and other Western European men. The persisting upward trends in women in the three regions are of concern.
Databases, Factual↗
Cancer risk in women with previous breast cancer.
BACKGROUND: Excess risks of several second neoplasms following breast cancer have been reported. However, these risks have still to be quantified. PATIENTS AND METHODS: We considered 9,729 breast cancer patients registered by the Swiss Cancer Registries of Vaud and Neuchâtel (covering about 786,000 inhabitants) and followed up from 1974 to 1998. RESULTS: Overall, 443 second primary neoplasms (other than second primary breast cancers) were observed versus 389 expected [standardised incidence ratio (SIR): 1.14; 95% confidence interval (CI) 1.04-1.25]. The SIRs were above unity for endometrium (SIR = 1.5), ovary (1.3), colorectum (1.1), gallbladder (1.4), cutaneous malignant melanoma (1.4), kidney (1.4), lymphomas (1.4) and leukaemias (1.2), as well as for selected tobacco-related neoplasms. The largest excess risk was found for soft tissue sarcomas (STS) with 10 cases observed versus 3.1 expected (SIR = 3.2; 95% CI 1.5-5.9). Of these, eight occurred in potentially irradiated areas. CONCLUSIONS: This analysis confirms the existence of a modest excess in several neoplasms occurring after breast cancer. The substantial excess of STS confirms the strong association between irradiation and STS.
Aged↗
Fibre intake and laryngeal cancer risk.
BACKGROUND: Consumption of vegetables, fruit and whole grain cereals has been inversely related to laryngeal cancer risk. Among the potential protective agents found in these foods, information on dietary fibres and laryngeal cancer risk are scanty. PATIENTS AND METHODS: A multi-centric, hospital-based case-control study was conducted on 527 patients with squamous-cell carcinoma of the larynx and 1,297 non-neoplastic controls. Cases and controls, frequency matched by age, sex and study centre, were interviewed using a validated food frequency questionnaire. RESULTS: Compared with the lowest quintile of fibre intake, the odds ratios (ORs) for the highest quintile were 0.3 [95% confidence interval (CI) 0.2-0.4] for total fibre, 0.3 (95% CI 0.2-0.5) for soluble non-cellulose polysaccharides (NCP) and for total insoluble fibre, including cellulose (OR = 0.3, 95% CI 0.2-0.4) and insoluble NCP (OR = 0.4, 95% CI 0.3-0.7). The ORs were 0.2 (95% CI 0.1-0.4) for fibre from vegetables, 0.5 (95% CI 0.3-0.7) from fruit and 1.1 (95% CI 0.6-1.9) from grains. The inverse association observed was similar among different subsites of laryngeal cancer, and consistent across strata of various covariates. CONCLUSIONS: This study found a strong inverse association between fibre intake and laryngeal cancer risk, which points to fibre as one of the beneficial components of vegetables and fruit.
Adult↗
Cigarette tar yield and risk of upper digestive tract cancers: case-control studies from Italy and Switzerland.
BACKGROUND: Tobacco smoking is one of the main risk factors for oral, pharyngeal and oesophageal cancers in developed countries. Information on the role of the tar yield of cigarettes in upper digestive tract carcinogenesis is sparse and needs to be updated because the tar yield of cigarettes has steadily decreased over the last few decades. PATIENTS AND METHODS: We analysed two case-control studies, from Italy and Switzerland, conducted between 1992 and 1999, involving 749 cases of oral and pharyngeal cancer and 1770 controls, and 395 cases of squamous-cell oesophageal carcinoma and 1066 matched controls. Odds ratios (ORs) were estimated by unconditional multiple logistic regression models, including terms for age, sex, study centre, education and alcohol consumption. RESULTS: Based on the brand of cigarettes smoked for the longest time, the multivariate ORs for current smokers compared with never smokers were 6.1 for <20 mg and 9.8 for >or=20 mg tar for oral and pharyngeal neoplasms, and 4.8 and 5.4 for oesophageal cancer, respectively. For the cigarette brand smoked in the previous six months, the ORs for >or=10 mg compared with <10 mg were 1.9 for cancer of the oral cavity and pharynx and 1.8 for oesophageal cancer, after allowance for number of cigarettes and duration of smoking. CONCLUSIONS: The present study confirms the direct relationship between the tar yield of cigarettes and upper digestive tract neoplasms, and provides innovative information on lower tar cigarettes, which imply reduced risks compared with higher tar ones. However, significant excess risks were observed even in the lower tar category, thus giving unequivocal indications for stopping smoking as a priority for prevention of upper digestive tract neoplasms.
Aged↗