Biomedical subjects
Publications and source records attributed to F Levi.
In a case-control study from Italy and Switzerland with 404 oesophageal cancer cases and 1070 hospital controls, the risk of oesophageal cancer declined with time since cessation of smoking or drinking, and was significantly reduced (odds ratio = 0.11) 10 or more years after cessation of both habits.
In Vaud, Switzerland, the incidence of carcinoids based on 218 malignant and 215 benign cases rose from 19.6/10(6)in 1974-85 to 28. 2/10(6)in 1986-97, more so among males and malignant neoplasms. Lung was the commonest site for malignant and large intestine for benign carcinoids. Sixty-eight (16%) carcinoids had another neoplasm.
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Colorectal cancer is the leading cancer in non-smokers in Western countries, and over the last decades its trends have been generally more favourable for women than for men. Possible explanations of the sex differentials in colorectal cancer relate to different exposure to exogenous hormones and to other risk factors including diet, physical activity and alcohol drinking. The objective of this investigation was to systematically analyse the trends in colorectal cancer mortality sex ratios in major European countries over the last four decades. Trends in death certification rates from colorectal cancer over the period 1955-1996 were analysed for 20 European countries (excluding the former Soviet Union and a few of the smaller countries). In all countries, the mortality sex ratios (M/F) were around or slightly above unity in the 1950s, and systematically increased to approach 1.5 in the 1990s. The extent of the rises varied across countries, ranging between + 0.8% in Germany, + 9.7% in Sweden, and + 12.1% in Denmark (the lowest increases) to + 65.3% in Spain, + 56.2% in Portugal, and + 50.4% in Hungary (the highest ones). Mortality sex ratios in Europe show more favourable trends for females, which may be attributable, in part, to the introduction of exogenous hormones in the late 1950s and 1960s, and, in part, to differential sex exposure to major environmental risk factors.
The influence of food groups on oesophageal cancer risk was analysed using data from a case-control study conducted between 1992 and 1999 in the Swiss Canton of Vaud on 101 incident, histologically confirmed cases (92 squamous cell, 9 adenocarcinomas) and 327 controls admitted to hospital for acute, non-neoplastic conditions. Multivariate odds ratios (OR) were computed after allowance for age, sex, tobacco, alcohol and non-alcohol energy. Significant increased risks emerged for red meat (OR = 1.7 for an increase of one serving per day), pork and processed meat (OR = 1.6), and eggs (OR = 1.5), whereas inverse associations were observed for milk (OR = 0.7), raw and cooked vegetables (OR = 0.5), citrus and other fruits (OR = 0.5), as well as for a more varied diet (OR = 0.5). Most associations were apparently stronger in heavy alcohol drinkers, suggesting an interaction between poor diet and alcohol drinking in oesophageal carcinogenesis.
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Death certification data from pleural cancer in eight European countries providing data to the World Health Organization database over the period 1970-1994 were analysed using a log-linear Poisson model to disentangle the effects of age, birth cohort and period of death. The age effect reached values between 10 and 15/100,000 males at age 80-84 in most countries, except Hungary (6.7), Switzerland (18.0), France (20.6) and the Netherlands (36.5). Cohort effects were steadily and appreciably upwards in all countries up to the generations born in 1940 or 1945, and levelled off for the 1950 cohort, except in Hungary, where persistent rises were observed. Thus, most rises in pleural cancer mortality in Europe were on a cohort of birth basis. Since most pleural cases were asbestos-related mesotheliomas, and since asbestos has an early-stage effect on subsequent mesothelioma risk, exposure early in life is important for determining the subsequent mesothelioma risk of each generation. Consequently, the data indicate that the peak mortality from pleural cancer in most western European countries will be reached in the first decades of the 21st century, i.e. around 2010-2020, when the generations born between 1940 and 1950 will reach the peak age for mesothelioma incidence and mortality. This contrasts with US data, where the peak of pleural cancer incidence has been reached at the end of the 20th century, and reflects a delay in adopting adequate prevention measures since the 1940-1945 generations entered the workforce in the 1960s, when cancer risk from asbestos exposure was already recognized.
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BACKGROUND: Several large datasets have shown a reduced risk of all neoplasms after a diagnosis of prostate carcinoma but an increased incidence rate of urologic carcinoma has been suggested. METHODS: Data collected by the Cancer Registries of the Swiss Cantons of Vaud and Neuchâtel (approximately 760,000 inhabitants) were used to estimate the incidence rate of a second primary tumor after a diagnosis of prostate carcinoma. A total of 4503 cases registered between 1974 and 1994 were followed until the end of 1996 (17,065 person-years). RESULTS: A total of 380 second primary neoplasms were observed versus 534.1 expected primary neoplasms (standardized incidence ratio [SIR] = 0.7; 95% confidence interval, 0.6-0.8). SIRs were significantly below unity for lung carcinoma (SIR = 0.7) and other major tobacco-related neoplasms, including those of the mouth or pharynx (SIR = 0.5), esophagus (SIR = 0.4), pancreas (SIR = 0.5), and larynx (SIR = 0.8). There was no excess rate of subsequent urologic carcinoma (SIR = 1.0) or colorectal carcinoma (SIR = 0.9). The reduced SIRs for lung carcinoma were stronger in elderly men (age >/= 75 years) and in patients with a shorter period since diagnosis (< 5 years). CONCLUSIONS: The incidence of all neoplasms was reduced significantly in men diagnosed with prostate carcinoma. Selection of the population, under-registration of second primary tumors, and reduced surveillance in elderly men with prostate carcinoma may, at least in part, explain this reduction in risk. No excess risk was observed for the complex of urologic neoplasms nor for tobacco-related neoplasms. This finding would not support an association between cigarette smoking and prostate carcinoma.
To compare the separate and combined effects of alcohol drinking and smoking between the 2 sites, we evaluated 274 men with oral cancer, 364 with pharyngeal cancer and 1,254 controls, frequency-matched for age and area of residence, from Italy and Switzerland. Extremely elevated risk increases for oral cancer (odds ratio, OR = 228) and pharyngeal cancer (OR = 100) were found for the highest joint level of drinking (>/=77 drinks/week) and smoking (>/=25 cigarettes/day). Ratios of ORs between oral cancer and pharyngeal cancer vs. controls, obtained by polytomous logistic regression, suggested that the risk increase for oral cancer was about 2-fold greater than that for pharyngeal cancer at each combined level of smoking and drinking, except at low levels of drinking in smokers. A clear departure from risk difference additivity was present for both oral and pharyngeal cancer in individuals heavily exposed to both factors versus non-smoking abstainers/light drinkers. Our findings thus help explain observations from descriptive epidemiology that, if smoking level in a population does not change substantially, but alcohol consumption increases, increase in oral cancer would be greater than at any other site in the upper aero-digestive tract, including cancer of the pharynx.
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Over the past few years, age-standardised mortality rates have levelled off or declined for most cancer sites in the European Union, with the main exception of lung cancer in women.
BACKGROUND: There are only limited population-based data available regarding the risk of developing a second cancer after a diagnosis of lung carcinoma. METHODS: Data collected from the Cancer Registry of the Swiss Canton of Vaud (comprised of approximately 600,000 inhabitants) were used to estimate the incidence of a second metachronous primary cancer following a diagnosis of lung carcinoma. Between 1974 and 1996, 5794 cases of lung carcinoma (occurring in 4728 males and 1066 females) were followed actively until the end of 1996. RESULTS: One hundred seventy-five second primary neoplasms were registered (occurring in 146 males and 29 females). Significant excess rates were observed for all cancer sites (standardized incidence ratio [SIR] = 1.2), cancers of the oral cavity and pharynx (SIR = 2.7), and lung (SIR = 1.7). SIRs also were above unity for cancers of the esophagus (SIR = 1.8), pancreas (SIR = 1.5), bladder (SIR = 1.8), kidney (SIR = 2.3), and the female breast (SIR = 2.0). Excess rates for all cancer sites together and tobacco-related neoplasms were systematically higher at a younger age (< 60 years). The overall cumulative risk of lung cancer was 1.8% at 5 years and 4.7% at 10 years and was 5% and 11%, respectively, for any tobacco-related tumor. The estimates were consistent for squamous cell carcinoma and adenocarcinoma of the lung. CONCLUSIONS: There were substantial excesses of second lung carcinomas as well as other major tobacco-related neoplasms, but not of colorectal carcinoma, prostate carcinoma, or lymphoid neoplasms after the diagnosis of a primary lung carcinoma. This study emphasizes the importance of smoking cessation even after a diagnosis of lung carcinoma.
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Trends in age-standardised death-certification rates for skin cancer [mainly cutaneous malignant melanoma (CMM)] over the period 1955-1995 were considered for 22 developed countries (18 from Europe, Canada, the United States, Australia and New Zealand) on the basis of the World Health Organization database. Between 1955 and 1984, mortality from CMM has been rising in both young adults (20 to 44 years) and middle aged population (45 to 64 years) in most European countries, North America and Australia. Between 1985 and 1995, CMM mortality rates were still rising in several countries for middle-aged males, though, to a lesser extent, they were more favourable in middle-aged women and declined in young adults in most countries, particularly in northern Europe.
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