Epidemiology of unknown primary tumours.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to F Levi.
Explore the source record for details and available documents.
OBJECTIVE: To provide information on the effects of alcohol and tobacco on laryngeal cancer and its subsites. METHODS: This was a case-control study conducted between 1992 and 2000 in northern Italy and Switzerland. A total of 527 cases of incident squamous-cell carcinoma of the larynx and 1297 hospital controls frequency-matched with cases on age, sex, and area of residence were included. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated using multiple logistic regression. RESULTS: In comparison with never smokers, ORs were 19.8 for current smokers and 7.0 for ex-smokers. The risk increased in relation to the number of cigarettes (OR = 42.9 for > or = 25 cigarettes/day) and for duration of smoking (OR = 37.2 for > or = 40 years). For alcohol, the risk increased in relation to number of drinks (OR = 5.9 for > or = 56 drinks per week). Combined alcohol and tobacco consumption showed a multiplicative (OR = 177) rather than an additive risk. For current smokers and current drinkers the risk was higher for supraglottis (ORs 54.9 and 2.6, respectively) than for glottis (ORs 7.4 and 1.8) and others subsites (ORs 10.9 and 1.9). CONCLUSIONS: Our study shows that both cigarette smoking and alcohol drinking are independent risk factors for laryngeal cancer. Heavy consumption of alcohol and cigarettes determined a multiplicative risk increase, possibly suggesting biological synergy.
BACKGROUND: A role of energy and various nutrients, including protein, sugar, saturated and unsaturated fats, in colorectal cancer risk has been suggested, but should be better defined. PATIENTS AND METHODS: The association between dietary intake of various macronutrients and colorectal cancer risk was analysed using data from a case-control study conducted between 1992 and 2000 in the Swiss Canton of Vaud. The study comprised 286 case subjects (174 males, 112 females; median age 65 years) with incident, histologically confirmed colon (n = 149) or rectal (n = 137) cancer, and 550 control subjects (269 males, 281 females; median age 59 years) admitted to the same University Hospital for a wide spectrum of acute non-neoplastic conditions. Dietary habits were investigated using a validated food frequency questionnaire, including questions on 79 foods or recipes and on individual fat intake pattern. Multivariate odds ratios (OR) were obtained after allowance for age, sex, education, physical activity and energy intake. RESULTS: The risk of colon and rectal cancer increased with total energy intake (OR in highest and lowest tertile, 2.0 and 2.2, respectively). There was no significant relation with starches or proteins, a significant inverse relation with sugars (OR for the highest tertile, 0.5), a direct trend in risk of borderline significance for saturated fats (OR = 1.4 for the highest tertile), and significant inverse trends for monounsaturated (OR = 0.6) and polyunsaturated fats (OR = 0.6). CONCLUSIONS: These findings confirm that energy intake is directly related to colorectal cancer risk, and that different types of fat may have different roles in colorectal carcinogenesis.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
OBJECTIVE: To analyse trends in mortality from coronary heart disease (CHD) and cerebrovascular disease (CVD) over the period 1965 to 1998 in the European Union, other European countries, the USA, and Japan. METHODS AND RESULTS: Data were derived from the World Health Organization database. In the European Union, CHD mortality in men rose from 146/100 000 in 1965-9 to 163/100 000 in 1975-9 and declined thereafter to 99/100 000 in 1995-8 (-39%). In women, the fall was from 70 to 45/100 000 (-36%). A > 55% decline in CVD was registered in both sexes. In eastern Europe, mortality from both CHD and CVD rose up to the early 1990s but has declined over the past few years in Poland and the Czech Republic. In the Russian Federation during 1995-8, mortality rates from CHD reached 330/100 000 men and 154/100 000 women and mortality rates from CVD were 203/100 000 men and 150/100 000 women-that is, they were among the highest rates worldwide. In the USA and Japan, long term trends were favourable for both CHD and CVD. CONCLUSIONS: Trends in mortality from CHD and CVD were favourable in several developed areas of the world, but there were major geographical differences. In a few eastern European countries, mortality from CHD and CVD remains exceedingly high.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
We analysed 3 case-control studies from Italy and Switzerland including 114 women with squamous cell oesophageal cancer and 425 controls. The multivariate odds ratio was 4.5 for heavy smoking and 5.4 for heavy alcohol drinking. Fruit intake, vegetable intake, oral contraceptive and HRT use were inversely related to oesophageal cancer.
Testicular cancer is curable if treated appropriately. We used national mortality data to compare specific death rates from the disorder in western and eastern Europe, the USA, and Japan. Testicular cancer mortality rates have fallen by about 70% in the USA and western Europe since the 1970s. In eastern Europe, however, death rates from testicular cancer have been declining only since the late 1980s, and at a much slower rate than that recorded elsewhere (about 20%). Consequently, many avoidable deaths, mainly in young adults, are still occurring in eastern Europe. Available effective treatment strategies for testicular cancer must be implemented in these countries.
Explore the source record for details and available documents.
The relation between 17 micronutrients and breast-cancer risk was analyzed in a case-control study conducted between 1993 and 1999 in the Swiss Canton of Vaud. Cases were 289 women with incident, histologically confirmed breast cancer, and controls were 442 women admitted to the same hospital for a wide spectrum of acute non-neoplastic conditions unrelated to long-term modifications of diet. Dietary habits were investigated using a validated food-frequency questionnaire. Odds ratios (ORs) were obtained after allowance for age, education, parity, menopausal status, body mass index, total energy intake and alcohol drinking. For several micronutrients, the ORs tended to decline with increasing tertile of intake, with significant inverse trends in risk for potassium (OR for the highest tertile = 0.21), total carotenoids (OR = 0.42), lycopene (OR = 0.43), folic acid (OR = 0.45), vitamin C (OR = 0.19), vitamin E (OR = 0.37) and vitamin B(6) (OR = 0.54). In a model including a continuous term for the 7 micronutrients significantly related to breast cancer, the only persisting significant inverse relations were for vitamin C (OR = 0.23) and lycopene (OR = 0.64).
BACKGROUND: Surgical resection is the most effective treatment for colorectal liver metastases but only a minority of patients are candidates for a potentially curative resection. Our experience with neoadjuvant chemotherapy followed by resection and five years survival analysis of the patients treated is presented. METHODS: Between February of 1988 and September of 1996, 701 patients with unresectable colorectal liver metastases were treated with neoadjuvant chemotherapy. Four categories of nonresectable disease were defined: large size, ill location, multinodularity, and extrahepatic disease. Liver resection was performed in those patients whose disease became resectable. After resection, the patients were followed up every 3 months. A 5-year survival analysis by the different categories described was performed. RESULTS: Ninety-five patients (13.5%) were found to be resectable on reevaluation and underwent a potentially curative resection. There was no perioperative mortality, and the complication rate was 23%. As of December of 1999, 87 patients have completed 5 years of follow-up. The overall 5-year survival is 35% from the time of resection and 39% from the onset of chemotherapy. Respective 5-year survival rates are 60% for large tumors, 49% for ill-located lesions, 34% for multinodular disease, and 18% for liver metastases with extrahepatic disease. In this latter category, however, a 35% 5-year survival was found when all the patients with extrahepatic disease were analyzed rather than only those for whom extrahepatic disease was the main cause of nonresectability. CONCLUSIONS: Neoadjuvant chemotherapy enables liver resection in some patients with initially unresectable colorectal metastases. Long-term survival is similar to that reported for a priori surgical candidates.
Childhood cancer (0--14 years) mortality rates for six cancer sites, including bone, kidney, eye, Hodgkin's disease, non-Hodgkin's lymphomas, leukaemias, plus total cancer mortality were computed for subsequent calendar periods from 1955 to 1997, and graphically presented for 16 Western European countries, seven Eastern European countries, plus the European Union as a whole. All Western European countries showed substantial declines in mortality from leukaemias and from all neoplasms considered from the mid-1960s onwards, for an average fall over 60%, and an estimated total number of approximately 4500 avoided deaths per year. Favourable trends were observed also in Eastern Europe, but the declines started later (i.e. around the mid-1970s or the late 1980s), and were only approximately 30%.
Explore the source record for details and available documents.
The relationship between various types of fibre and colorectal cancer risk was investigated using data from a case-control study conducted in the Swiss Canton of Vaud between January 1992 and December 2000. The study included 286 cases of incident, histologically-confirmed colorectal cancers (149 colon and 137 rectal cancers) admitted to the University Hospital of Lausanne, and 550 controls whose admission diagnosis was of acute, non-neoplastic diseases. Dietary habits were investigated using a validated food frequency questionnaire (FFQ). Odds ratios (ORs) were computed after allowance for age, sex, education, physical activity and energy intake. Fibre was analysed both as a continuous variable and in tertiles. There was a significant inverse relationship of total fibre intake (determined by the Englyst method as non-starch polysaccharides) and of its components with the risk of colorectal cancer. ORs for a difference in intake of one standard deviation from the mean fibre intake of the control distribution was 0.57 for total fibres, 0.55 for soluble non-cellulose polysaccharides (NCPs), 0.58 for total insoluble fibres, 0.57 for cellulose, 0.62 for insoluble NCP and 0.62 for lignin. When fibre was classified according to its source, the OR was 0.60 for vegetables, 0.78 for fruit and 0.74 for grain fibre. The ORs were similar for colon and rectal cancer and consistent across the strata of the major covariates and of several types of fibres.
BACKGROUND: Squamous cell oesophageal cancer is one of the few neoplasms inversely related to body mass index (BMI). However, it is not clear whether this is due to cancer-related weight loss or to other correlates of leanness. PATIENTS AND METHODS: 395 incident, histologically confirmed cases of squamous cell oesophageal cancer and 1,066 controls, admitted for acute, non-neoplastic diseases, in Italy and Switzerland. Odds ratios (ORs) were derived from multiple logistic regression, including terms for education, tobacco. alcohol, non-alcohol energy, fruit and vegetable intake. RESULTS: The ORs for the lowest vs. the highest quartile of BMI in the year before diagnosis were 2.0 in men, 1.6 in women, and 1.9 (95% confidence interval: 1.3-2.9) in both sexes combined. The association with leanness was stronger in heavy smokers, but was not accounted for by smoking and drinking, nor by differences in diet. Weight change in the decade prior to diagnosis showed no linear association with risk. However, cases were not leaner than controls at age 30 (OR = 0.6 for the lowest BMI quartile) and 50 (OR = 1.1). CONCLUSIONS: Leanness appears to be an indicator of squamous cell oesophageal carcinogenesis. However, low BMI in the distant past was unrelated to oesophageal cancer risk.