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Biomedical subjects

F Levi

Publications and source records attributed to F Levi.

At least 163 records · Page 9Linked to original sources
PubMed1998

Cancer mortality in Europe: effects of age, cohort of birth and period of death.

Death certification data for 19 cancers or groups of cancers, plus total cancer mortality, in 16 major European countries were analysed using a log-linear Poisson model with arbitrary constraints on the parameters to disentangle the effects of age, birth cohort and period of death. Three major patterns emerged including: first, the prominent role of cohort of birth in defining trends in mortality from most cancer sites (except testis or Hodgkin's disease, where newer treatments had a major period of death effect); and second, the major role of lung and other tobacco-related neoplasm epidemics in determining the diverging pattern of cancer mortality, for each sex and in various European countries and geographic areas. In most countries, the peak male cohort values were reached for generations born between 1900 and 1930. This was observed in women only for Denmark and the U.K., i.e. the two countries where lung and other tobacco-related neoplasm epidemics had already reached appreciable levels. This confirms the importance of cigarette smoking in subsequent generations as a major cause of cancer deaths in Europe. Further, there is a persistent rise in several cancer rates, again chiefly on a cohort basis, in Eastern Europe, which calls for urgent intervention to control the cancer burden in these countries.

Adult↗
PubMed1998

Trends in mortality from major diseases in Europe, 1980-1993.

Trends in age-standardized death certification rates from all causes, coronary heart disease (CHD), cerebrovascular diseases, all neoplasms and lung cancer were analysed over the period 1980-1993 in 20 major European countries. There were steady and substantial declines of overall mortality in all western European countries for both sexes, although appreciable geographic differences persisted. These favourable trends reflect a decline in CHD mortality in most western countries, besides a persisting fall in cerebrovascular disease, and a substantial stability (with some decline in a few northern and central European countries) in cancer mortality. In contrast, in eastern European countries appreciable rises were registered in mortality from major causes of death considered for males. For females, only moderate declines were observed in Eastern Europe. In the early 1990s, overall mortality was 30 to 100% higher for males and 20 to 100% higher for females as compared to Western Europe. As indicated by the trends in lung cancer death rates, this reflects a major impact of the tobacco-related disease epidemic in subsequent cohorts, as well as more unfavourable lifestyle factors (i.e. aspects of diet, other environmental factors), and a delayed control of hypertension in Eastern Europe, together with a substantial excess of suicides, (road) accidents, homicides and alcohol-related diseases, and the delayed introduction of rational treatment for some conditions. An indication of reversal of mortality trends was evident in the early 1990s only in Poland. In conclusion, there is ample scope for intervention on avoidable mortality in eastern European countries.

Cerebrovascular Disorders↗
PubMed1998

Incidence, mortality and survival from prostate cancer in Vaud and Neuchâtel, Switzerland, 1974-1994.

BACKGROUND: Prostate cancer incidence has been increasing in most developed countries in the absence of similar trends in mortality, and with variable patterns in different areas of the world. MATERIALS AND METHODS: Trends in incidence and mortality from prostate cancer for the period 1974-1994 were analysed using data from the Cancer Registries of the Swiss Cantons of Vaud and Neuchâtel. Of 5,010 cases registered, 80% were histologically or cytologically confirmed. RESULTS: Age-standardized incidence rates increased from 33.1 to 48.6 per 100,000 (+47%). The upward trends were greater in the most recent calendar periods, and in the younger age groups (+77% at age 45 to 54; +57% at age 55 to 64). In contrast, mortality was stable, with an overall increase of only 3% in age-standardized rates (from 20.4 to 21.0 per 100,000), due to some increase in men aged 65 or above. Consequently, the incidence/mortality rate ratios increased from 1.6 in 1974-1979 to 2.3 in 1990-1994. Five-year observed and relative survivals increased from 26% to 41% and from 46% to 58%, respectively. Ten-year observed and relative survival for cases diagnosed in 1985-1989 were 19% and 42%, respectively. Survival improvements were greater below age 75. CONCLUSION: The pattern of trends in incidence, mortality and survival confirms the influence of improved diagnosis of prostate cancer over the last few years in this European population. Still, while Swiss prostatic cancer mortality rates are the highest in the world (20.3 per 100,000, world standard), i.e., about 30% higher than in the United States, all races combined, incidence rates are still half as much. On account of the steady increase of prostate-specific antigen testing in Switzerland, further incidence increases are likely.

Age Distribution↗
PubMed1998

Descriptive epidemiology of vulvar and vaginal cancers in Vaud, Switzerland, 1974-1994.

BACKGROUND: To analyse trends in incidence, survival and risk of second neoplasms following vaginal and vulvar cancers using data collected by the Swiss Cancer Registry of Vaud over the 21-year period 1974-1994. MATERIALS AND METHODS: Subjects were 257 vulvo-vaginal cancers. Of these, 69 were vaginal, 153 vulvar cancers, and 35 non-specified lower genital tract neoplasms; 94 in situ neoplasms were also registered (85 for the vulva). RESULTS: Invasive vaginal cancer incidence decreased from 0.8 in 1974-1984 to 0.4/100,000 women in 1985-1994, while invasive vulvar cancer incidence remained approximately stable around 1.2/100,000 (world standard); incidence of in situ vulvar cancer increased from 0.8 to 1.3/100,000, the rise being larger in younger women. Significant excesses for second primary neoplasms were observed for pro-pharyngeal and lung cancer, and for non-melanomatous skin neoplasms, as well as for invasive vulvar cancers following in situ cancers. CONCLUSIONS: This population-based dataset confirms that the incidence of in situ vulvar (but not invasive vulvar or vaginal cancer) has been increasing over the last 20 years. The excess second primary neoplasms supports the hypotheses that human papillomavirus and cigarette smoking are related to vulvo-vaginal neoplasms.

Adult↗
PubMed1998

Spatial temporal patterns in childhood leukaemia: further evidence for an infectious origin. EUROCLUS project.

The EUROCLUS project included information on residence at diagnosis for 13351 cases of childhood leukaemia diagnosed in the period 1980-89 in defined geographical regions in 17 countries. A formal algorithm permits identification of small census areas as containing case excesses. The present analysis examines spatial-temporal patterns of the cases (n = 970) within these clustered areas. The objectives were, first, to compare these results with those from an analysis conducted for UK data for the period 1966-83, and, second, to extend them to consider infant leukaemias. A modification of the Knox test investigates, within the small areas, temporal overlap between cases in a subgroup of interest at a putative critical time and all other cases at any time between birth and diagnosis. Critical times were specified in advance as follows: for cases of acute lymphoblastic leukaemia aged 2-4 years, the 18-month period preceding diagnosis; for cases of total leukaemia aged 5-14 years, 1 year before to 1 year after birth; and for infant cases (diagnosed < 1 year), 1 year before to 6 months after birth. Each of the analyses found evidence of excess space-time overlap compared with that expected; these were 10% (P = 0.005), 15% (P= 0.0002) and 26% (P= 0.03) respectively. The results are interpreted in terms of an infectious origin of childhood leukaemia.

Adolescent↗
PubMed1998

Spatial clustering of childhood leukaemia: summary results from the EUROCLUS project.

The interpretation of reports of clusters of childhood leukaemia is difficult, first because little is known about the causes of the disease, and second because there is insufficient information on whether cases show a generalized tendency to cluster geographically. The EUROCLUS project is a European collaborative study whose primary objective is to determine whether the residence locations of cases at diagnosis show a general tendency towards spatial clustering. The second objective is to interpret any patterns observed and, in particular, to see if clustering can be explained in terms of either infectious agents or environmental hazards as aetiological agents. The spatial distribution of 13351 cases of childhood leukaemia diagnosed in 17 countries between 1980 and 1989 has been analysed using the Potthoff-Whittinghill method. The overall results show statistically significant evidence of clustering of total childhood leukaemia within small census areas (P=0.03) but the magnitude of the clustering is small (extra-Poisson component of variance (%) = 1.7 with 90% confidence interval 0.2-3.1). The clustering is most marked in areas that have intermediate population density (150-499 persons km[-2]). It cannot be attributed to any specific age group at diagnosis or cell type and involves spatial aggregation of cases of different ages and cell types. The results indicate that intense clusters are a rare phenomenon that merit careful investigation, although aetiological insights are more likely to come from investigation of large numbers of cases. We present a method for detecting clustering that is simple and readily available to cancer registries and similar groups.

Adolescent↗
PubMed1998

Trends in male:female ratio among newborn infants in 29 countries from five continents.

We have analysed trends in male:female ratios among newborns between 1950 and 1990 in 29 countries from five continents. The numbers of liveborn males and females over the period 1950-1994 were derived from the World Health Organization (WHO) database. Countries for which reliable data were available included 20 major European countries (excluding the former Soviet Union, Albania and a few small countries), Canada, the USA, selected countries of Central and South America, Japan, Australia and New Zealand. From the original numbers of males and females, we computed the proportion of males among liveborns for each country and for selected broader areas within Europe. In most countries the proportion of male liveborns was constant during the study period. In particular, the proportion of male newborns in the European Union was 0.515 in 1950-1954, 0.514 in 1970-1974 and 0.514 in 1990-1994. In the USA, corresponding values were 0.513, 0.513 and 0.512. In Japan the ratios were 0.513 in 1950-1954, 0.516 and 1970-1974 and 0.514 in 1990-1994. Decreasing ratios were observed in some northern and eastern European countries plus Greece and Portugal and, particularly, in Mexico. In contrast, the proportion of male liveborns tended to increase in southern Europe and Australia. Overall, among the 29 countries considered, the proportion of males declined in 16, increased in six, and remained stable in seven.

Americas↗
PubMed1998

Trends in cancer mortality in Argentina, 1966-91.

Trends in death certification rates for 12 major cancer sites and total cancer mortality in Argentina were analysed for the period 1966-91 on the basis of the World Health Organization database. In the late 1960s, total cancer mortality rates in Argentina (184/100,000 men, 117/100,000 women, world standard) were among the highest in the world. Over the 25-year period considered, however, cancer mortality in Argentina declined by 15% in both sexes, to reach 157/100,000 in men and 99/100,000 in women, for 1990-91. These rates were somewhat lower than those of North America and, particularly for women, relatively low on a worldwide scale. The favourable trends, observed mostly between the 1960s and the 1980s, reflect the steady decline in gastric cancer rates in both sexes, together with some decline in oesophageal, lung and other tobacco-related neoplasms, mostly in men, following some decline in tobacco consumption over the last two decades. The fall in oesophageal cancer may be related to decreased consumption of hot maté, too. Colorectal cancer rates were high in the 1960s, but declined by 17% in men and 35% in women. An approximately 50% decline was observed for skin cancer mortality, which was among the lowest in the world in the early 1990s, and some decline was observed also for leukaemias and uterine cancer, while breast and prostate neoplasms showed a general stability. The two major unfavourable features of cancer mortality in Argentina were the persistently high rates for oesophageal in men, and for uterine cancer mortality in women. These are likely a result of hot maté drinking for oesophageal cancer and inadequate screening for cervical cancer.

Age Distribution↗
PubMed1997

Incidence of invasive cancers following squamous cell skin cancer.

The authors describe the incidence of new primary cancers among 4,639 cases of squamous cell skin cancer (SCC) diagnosed between 1974 and 1994 in the cancer registries of the Swiss cantons of Vaud and Neuchâtel (total person-years at risk = 23,152). Overall, 729 metachronous cancers were observed versus 527.6 expected, corresponding to a standardized incidence ratio (SIR) of 1.4 (95% confidence interval (CI) 1.3-1.5). After exclusion of skin cancers, however, 384 second primary neoplasms were observed versus 397.2 expected (SIR = 1.0). Excesses were observed for cancers of the lip (SIR = 3.1) and lung (SIR = 1.3), for basal cell (SIR = 4.3) and melanomatous skin cancers (SIR = 3.3), and non-Hodgkin's lymphomas (SIR = 1.7). Rates were elevated for cancers of the salivary glands (SIR = 4.3) and for Hodgkin's disease (SIR = 2.7), and, below age 65 years, for cancers of the lung (SIR = 1.6), breast (SIR = 1.5), and prostate (SIR = 1.8), for Hodgkin's disease (SIR = 15.8), as well as for all neoplasms except skin (SIR = 1.2; 95% CI 1.0-1.5). The cumulative risk of basal cell skin cancer reached 17% after 15 years. The authors believe that the excesses for basal cell carcinomas and melanomas of the skin following SCC, and possibly of lymphomas, were likely attributable to common phenotypic characteristics and exposure to UV radiation. The elevated rates of lung cancer are suggestive for a role of tobacco as a cause of squamous cell skin cancer.

Adult↗
PubMed1997

Incidence of invasive cancers following cutaneous malignant melanoma.

It has long been suggested that subjects diagnosed with cutaneous malignant melanoma (CMM) have an excess rate of subsequent neoplasms. To provide further quantitative information on the issue, we have considered 1,780 histologically confirmed CMM diagnosed between 1974 and 1994 by the Cancer Registries of the French-speaking Swiss Cantons of Vaud and Neuchatel (760,000 inhabitants) and followed up to the end of 1994 for the occurrence of a second primary. A total of 194 neoplasms was observed vs. 111.7 expected, corresponding to a standardized incidence ratio (SIR) of 1.7 [95% confidence interval (CI) 1.5-2.0]. When skin cancers were excluded, 87 subsequent neoplasms were observed vs. 84.9 expected (SIR 1.0). Significant excess rates were observed for basal cell (SIR 4.4), squamous cell (SIR 3.1) and melanoma (SIR 4.7) of the skin, as well as for prostatic cancer (SIR 2.1). The increased rates of subsequent skin cancer were somewhat larger in males, whereas all the SIRs were systematically greater below age 60. The SIRs of subsequent skin cancer remained above unity for 5 years or longer since diagnosis of CMM, in the absence of a clear pattern in trend with time since diagnosis. The cumulative incidence following CMM was 3% for CMM, 4% for squamous cell and 14% for basal cell carcinoma 20 years after diagnosis of CMM. Our results confirm that patients diagnosed with CMM have excess risks of subsequent melanoma and non-melanomatous skin neoplasms which justify focused prevention and surveillance of skin lesions in these patients. Subjects with CMM do not have any appreciable overall excess of non-skin neoplasms, even after long-term follow-up.

Adult↗
PubMed1997

Lung carcinoma trends by histologic type in Vaud and Neuchâtel, Switzerland, 1974-1994.

BACKGROUND: Shifts in the distribution of histologic types have reportedly accompanied changes in lung carcinoma incidence in the last two decades. In the United States, incidence rates of squamous cell and small cell carcinoma have been showing a decline in males, after peaks in 1981-82 and 1986-87, respectively; however, no decline has been observed in females. In both genders, adenocarcinoma incidence is increasing. The authors evaluated lung carcinoma incidence rates in two Swiss cantons for changes in trends by gender, birth cohort, and histologic type. METHODS: The authors analyzed data on population-based lung carcinoma incidence from the Swiss cantons of Vaud and Neuchatel (the populations of which total about 760,000). Cancers were grouped into four major histologic types. The proportion of cancers not histologically confirmed was approximately 8% across the entire study period. Incidence rates were age-standardized on the basis of the world standard population. RESULTS: Overall, of 7423 cancer cases diagnosed in the period 1974-1994, squamous cell carcinomas accounted for 37%, small cell carcinomas and adenocarcinomas 18% each, and other carcinomas 16%. Rates of squamous cell and small cell carcinoma incidence in males of all ages dropped in the last quinquennium, while corresponding rates in females increased steadily. Conversely, adenocarcinoma incidence increased in both genders by approximately 2.5-fold; and during the period 1990-1994, in young adults of both genders, it was more than 3-fold higher than the incidence of squamous cell carcinoma. At variance with squamous cell carcinoma, the incidence of which reached its peaks in the 1910-20 birth cohorts in males and in the 1930-40 birth cohorts in females, adenocarcinoma revealed a similar birth cohort pattern in the two genders, with still no sign of decline. CONCLUSIONS: Although changes in diagnostic practices may have played a role, the incidence data presented in this study suggest that adenocarcinoma is sustaining a new lung carcinoma epidemic, chiefly attributable to the switch to low-tar, filtered cigarettes. Its pattern seems remarkably similar in the two genders. Thus, the authors conclude that similar exposure to tobacco-related carcinogens leads to similar rates of histologic type-specific lung carcinoma incidence in males and females.

Adult↗
PubMed1997

Pharmacologic modulation of reduced glutathione circadian rhythms with buthionine sulfoximine: relationship with cisplatin toxicity in mice.

The relationship between the rhythm in reduced glutathione (GSH) and that in cisplatin (CDDP) toxicity was investigated in a total of 560 male B6D2F1 mice, using buthionine sulfoximine (BSO). GSH was measured by high-performance liquid chromatography (HPLC) in four tissues, at each of six sampling times, 4 hr apart. A significant 24-hr rhythm was statistically validated in liver, jejunum, and colon, but not in bone marrow. Relative to liver, glutathione content was 56% in colon, 38% in bone marrow, 25% in jejunum, and negligible in kidney, where cysteine, a final product of GSH catabolism, displayed a 12-hr rhythmic variation. This rhythm may reflect that in the activity of GSH-degrading enzymes. BSO (450 mg/kg ip, 4 hr before sampling) reduced liver GSH threefold and kidney cysteine content was halved, but this pretreatment had no significant effect upon GSH content in the other organs. Furthermore, the period of the physiologic liver GSH rhythm changed from 24 hr to a composite (24 + 12 hr) period. This change in the period may result from an unmasking of the 12-hr rhythm in GSH-degrading enzyme activity by GSH synthesis blockade. Maximal values occurred in the mid-rest span and in the mid-active span after BSO administration. In the other tissues, the 24-hr period remained unchanged. BSO injection largely enhanced CDDP toxicity (as assessed by survival, leukopenia, and histologic lesions in kidney and bone marrow) and kidney mean platinum concentration. Furthermore, BSO pretreatment modified the period of CDDP toxicity rhythm: survival followed a significant 12-hr-rhythm, instead of a 24-hr rhythm. The cycling of GSH concentration results from a balance between synthesis and catabolism and likely constitutes one of the main components of the circadian rhythm in CDDP toxicity in mice.

Animals↗
PubMed1997

Cancer mortality in Switzerland, 1990-1994.

Data and statistics are presented on cancer death certification in Switzerland in 1990-1994, updating previous publications covering the period 1951-1989. Data for 1990-1994, grouped into 30 categories, are presented in 10 tables as 5-years age- and sex-specific absolute and percentage frequencies of deaths, and average annual crude, age-specific and age-standardized rates, at all ages and truncated for the 35-64 years age group. Male-to-female ratios of mortality rates, and ranks of the ten most frequent cancer sites have also been tabulated, and all-ages and truncated age-standardized rates for most cancer sites plotted for 9 calendar quinquennia. Total cancer mortality rates decreased in both sexes (from 268.7 in 1985-1989 to 251.8/100,000 males in 1990-1994, and from 201.5 to 190.6/100,000 females; age-standardized rates on the 1980 Swiss population), particularly at younger ages and in males. Decreases in rates were observed in males for lung (from 68.7 to 62.7/100,000), oesophagus, larynx and prostate (at younger middle age), in females, for breast and genital sites and, in both sexes, for stomach, colorectum, gall-bladder, pancreas, skin, bladder, kidney, brain and most lymphohaemopoietic neoplasms. Increases were observed for pleura in males, and for larynx and lung (from 11.9 to 14.8/100,000) in females. Thus, with the major exception of lung cancers and a few other tobacco-related neoplasms in females, cancer mortality rates in Switzerland over the period 1990-1994 were generally favourable.

Adolescent↗
PubMed1997

Trends in neonatal and infant mortality in five continents.

Trends in the mortality rates for the periods 0-6, 7-27, 28-365 and 0-365 days after birth have been analysed in 48 European, American, African, Asian and Australian countries included in the World Health Organization (WHO) mortality database. From the late 1960s to the early 1990s infant mortality rates declined steadily and markedly in most countries worldwide. Only three countries (Bulgaria, Dominican Republic and Ecuador) showed some increase in rates in the late 1980s after, however, appreciable decreasing trends in earlier calendar periods. In the late 1980s or early 1990s three Latin American countries (Ecuador, Colombia and Dominican Republic) showed the highest rates in all the indicators considered, with the exception of 0-6 days of life mortality, where Sri Lanka ranked second in mortality rates. Intermediate rates (around 10-25/1000 live births for 0-365 days of life mortality) were reported by a number of Latin American, Asian and Central European countries. Rates lower than 10/1000 live births for the 0-365 days of life mortality were reported from the USA. Canada, most western European countries and four Asian countries (Israel, HongKong, Singapore and Japan, which registered the lowest rate). The major decreases were observed in the 0-6 days mortality rates. The proportional reductions were comparable for the period 7-27 and 28-365 days of life in several countries, and generally did not show a consistent pattern, some countries showing greater reduction for 7-27 days of life mortality rates and others vice versa. Thus, in the late 1960s in most countries the large majority of infant deaths occurred in the first month of life, but in the early 1990s this proportion had declined, and the 0-6/7-365 days of life rates ratios were below unity in most countries. In most South American countries, however, the ratio was generally close to unity in both calendar periods.

Birth Rate↗