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Biomedical subjects

Fabio Levi

Publications and source records attributed to Fabio Levi.

At least 55 records · Page 3Linked to original sources

Glycemic index and glycemic load in endometrial cancer.

Glycemic index (GI) and glycemic load (GL) are measures of the metabolic effects of dietary carbohydrates. The higher their value, the greater the glucose and insulin responses. Raised insulin levels are associated with endometrial cancer and with its risk factors including obesity, diabetes and hypertension. To study the role of the GI and GL we analyzed the data of two hospital-based case-control studies on endometrial cancer conducted between 1988-98 in Italy and Switzerland, including a total of 410 women with incident, histologically confirmed endometrial cancer and 753 controls admitted for acute, non-neoplastic diseases. A food frequency questionnaire was used to assess the subjects usual diet and to derive estimates of dietary GI and GL. The odds ratios (OR) of endometrial cancer, after adjustment for major risk factors, for the highest versus the lowest quintile of dietary GI and GL were 2.1 (95% confidence interval [CI] = 1.4-3.2) and 2.7 (95% CI = 1.8-4.2), respectively. The associations were stronger in older women, in those with higher body mass index and in hormone replacement therapy users. Our study supports the hypothesis of a direct association between GI and endometrial cancer risk.

Adult↗

n-3 polyunsaturated fatty acid intake and cancer risk in Italy and Switzerland.

Data from a series of case-control studies, conducted in Italy and Switzerland between 1991 and 2001, have been analyzed to evaluate the role of n-3 polyunsaturated fatty acid (PUFA) intake in the etiology of cancer of oral cavity and pharynx (736 cases, 1772 controls), esophagus (395 cases, 1066 controls), large bowel (1394 colon, 886 rectum, 4765 controls), breast (2900 cases, 3122 controls) and ovary (1031 cases, 2411 controls). Controls were patients admitted to hospital for acute, non-neoplastic conditions, unrelated to modifications in diet. The multivariate odds ratios (OR) for the highest quintile of n-3 PUFAs compared to the lowest one were 0.5 for oral and pharyngeal cancer, 0.5 for oesophageal cancer, 0.7 for colon cancer, 0.8 for rectal and breast cancer and 0.6 for ovarian cancer; the estimates and the trends in risk were significant for all cancer sites, excluding rectal and breast cancer. The estimates for an increase in n-3 PUFAs of 1 g/week were 0.70 for oral and pharyngeal cancer, 0.71 for oesophageal, 0.88 for colon, 0.91 for rectal, 0.90 for breast and 0.85 for ovarian cancer. All the estimates were statistically significant, excluding that for rectal cancer, and consistent across strata of age and gender. These results suggest that n-3 PUFAs decrease the risk of several cancers.

Adult↗

Prognosis of bilateral synchronous breast cancer in Vaud, Switzerland.

Out of 6084 first breast cancers registered between 1974 and 1993 in the Cancer Registry of the Swiss Canton of Vaud, 81 (1.3%) were synchronous bilateral breast cancers (BBCs). The 5-year relative survival rates were 73% for women with unilateral breast cancer (UBC) and 65% for those with synchronous BBC. The corresponding 10-year figures were 59% and 51%. This large, population-based series indicates that women with synchronous BBC have a moderately lower long-term survival than women with UBC.

Adult↗

Coffee and tea intake and risk of oral, pharyngeal and esophageal cancer.

The relation between coffee, decaffeinated coffee, tea and oral/pharyngeal, and esophageal cancer risk is inadequately quantified. Data were derived from hospital-based case-control studies conducted in Italy and Switzerland. The study on oral/pharyngeal cancer included 749 cases and 1772 controls, and that of esophageal cancer 395 cases and 1066 controls. Multivariate odds ratios (OR) and 95% confidence intervals (CI) were computed. The OR for >3 cups/day of coffee compared with </=1 were 0.6 (95% CI 0.5-0.9) for oral/pharyngeal, and 0.6 (95% CI 0.4-0.9) for esophageal cancer, consistent across strata of age, sex, education and alcohol. The inverse trends in risk were significant. No association emerged with decaffeinated coffee (OR 1.1 for oral/pharyngeal and 0.6 for esophageal cancer) or tea (OR 0.9 for both cancers), consumed in low amounts by these populations. Coffee may decrease the risk of oral/pharyngeal and esophageal cancer.

Adult↗

Micronutrients and laryngeal cancer risk in Italy and Switzerland: a case-control study.

OBJECTIVE: To investigate the relation between various micronutrients and laryngeal cancer risk. METHODS: A case-control study was conducted in Italy and Switzerland between 1992 and 2000. Cases were 527 patients with incident cancer of larynx, admitted to the major teaching and general hospitals of the study areas. Controls were 1297 subjects admitted for acute, non-neoplastic diseases to the same network of hospitals. Dietary habits were assessed using a validated food-frequency questionnaire. Odds ratios (OR) and their corresponding 95% confidence intervals (CI) were computed using multiple logistic regression. RESULTS: Significant inverse relations emerged between laryngeal cancer risk and intake of vitamin C (OR = 0.2, for the highest versus the lowest intake quintile; 95% CI: 0.2-0.4), beta-carotene (OR = 0.2; 95% CI: 0.2-0.4), alpha-carotene (OR = 0.3; 95% CI: 0.2-0.5), lutein/zeaxanthin (OR = 0.4; 95% CI: 0.3-0.6), vitamin E (OR = 0.4; 95% CI: 0.3-0.6), beta-criptoxanthin (OR = 0.4; 95% CI: 0.2-0.5), folic acid (OR = 0.4; 95% CI: 0.2-0.6), thiamin (OR = 0.4; 95% CI: 0.3-0.6), glutathione (OR = 0.5; 95% CI: 0.4-0.8), reduced glutathione (OR = 0.6; 95% CI: 0.4-0.8), vitamin B6 (OR = 0.6; 95% CI: 0.4-0.9) and potassium (OR = 0.6; 95% CI: 0.4-0.9). Direct associations were found with zinc (OR = 1.5; 95% CI: 1.0-2.2) and vitamin D (OR = 1.8; 95% CI: 1.2-2.6). Combining low intakes of vitamin C, carotene, vitamin E, and folate with heavy smoking and drinking led to ORs between 80 and 170. CONCLUSIONS: This study provides further support that, independently from smoking and alcohol consumption, the intake of several micronutrients, including selected antioxidants, is inversely related to laryngeal cancer risk.

Adult↗

Pleural mesothelioma incidence in Europe: evidence of some deceleration in the increasing trends.

OBJECTIVE: To summarize the geographical and temporal variations in incidence of pleural mesothelioma in Europe, using the extensive data available from European general cancer registries, and consider these in light of recent trends in asbestos extraction, use and import in European countries. MATERIAL AND METHODS: The data were extracted from the European Cancer Incidence and Mortality database (EUROCIM). The inclusion criteria was acceptance in Volume VII of Cancer Incidence in Five Continents. Truncated age-standardized rates per 100,000 for the ages 40-74 were used to summarise recent geographical variations. Standardized rate ratios and 95% confidence intervals for the periods 1986-1990 and 1991-1995 were compared to assess geographical variations in risk. To investigate changes in the magnitude of most recent trends, regression models fitted to the latest available 10-year period (1988-1997) were compared with trends in the previous decade. Fitted rates in younger (40-64) and older adults (65-74) in the most recent period were also compared. RESULTS: There was a great deal of geographical variation in the risk of mesothelioma, annual rates ranging from around 8 per 100,000 in Scotland, England and The Netherlands, to lower than 1 per 100,000 in Spain (0.96), Estonia (0.85), Poland (0.85) and Yugoslavia, Vojvodina (0.56) among men. The rank of the rates for women was similar to that observed for men, although rates were considerably lower. Between 1978 and 1987, rates in men significantly increased in all countries (excepting Denmark). In the following 10 years, there was a deceleration in trend, and a significant increase was detectable only in England and France. In addition, the magnitude of recent trends in younger men was generally lower than those estimated for older men, in both national and regional cancer registry settings. CONCLUSIONS: While mesothelioma incidence rates are still rising in Europe, a deceleration has started in some countries. A decrease may begin in the next few years in certain European populations considering the deceleration of observed trends in mesothelioma and asbestos exposure, as well as the recent ban on its use.

Asbestos↗

A pooled analysis of case-control studies of thyroid cancer: cigarette smoking and consumption of alcohol, coffee, and tea.

OBJECTIVE: To analyze the role of smoking, alcohol, coffee and tea in relation to thyroid cancer, we conducted a pooled analysis of 14 case-control studies conducted in the United States, Europe, and Asia. METHODS: The sample consisted of 2725 thyroid cancer cases (2247 females, 478 males) and 4776 controls (3699 females, 1077 males). Conditional logistic regression with stratification on study, age at diagnosis, and gender was used to compute odds ratios and 95% confidence intervals. RESULTS: Thyroid cancer risk was reduced in persons who had ever smoked. The relationship was more pronounced in current smokers (OR = 0.6, 95% CI = 0.6-0.7) than former smokers (OR = 0.9, 95% CI = 0.8-1.1). There were significant trends of reduced risk with greater duration and frequency of smoking. For consumption of wine and beer, there was a significant trend of decreasing thyroid cancer risk (p = 0.02) that was not maintained after adjustment for current smoking (p = 0.12). Thyroid cancer risk was not associated with consumption of coffee or tea. These findings were consistent in both gender-specific and histology-specific (papillary and follicular) analyses. CONCLUSIONS: Pooled analyses of these geographically diverse case-control data indicate a reduced thyroid cancer risk associated with current smoking. A reduced risk associated with alcohol was eliminated after adjustment for smoking, and caffeinated beverages did not alter thyroid cancer risk.

Alcohol Drinking↗

Pancreatic cancer mortality in Europe: the leveling of an epidemic.

Mortality rates from pancreatic cancer have increased throughout Europe between the late 1950s and the 1980s. Trends in 22 European countries, the European Union (EU) and 6 selected eastern European countries have been updated using official death certification data for pancreatic cancer abstracted from the WHO database over the period 1980 to 1999. In EU men, a rise from 7.2 to 7.5/100,000 was observed between the early and the late 1980s, followed by a leveling off in the 1990s. For women, rates tended to rise up to the early 1990s, and to level off thereafter around 4.7/100,000. In eastern countries, rates for both sexes rose between the early 1980s and the mid-1990s, and leveled off thereafter around 8.5/100,000 men and 5/100,000 women. Thus, rates for men only were higher in Eastern Europe than in the EU. This analysis first documents a leveling of pancreatic cancer mortality in Europe, after decades of steady rises. This is partly or largely attributable to the decline in smoking, at least in men, but other factors, including mainly nutrition and diet, may also have played some role on these trends.

Adult↗

Laryngeal cancer in women: tobacco, alcohol, nutritional, and hormonal factors.

Laryngeal cancer is the neoplasm with the largest male to female sex ratio in most populations. Thus, inadequate data are available on women. We analyzed several risk factors in the combined dataset from two case-control studies conducted between 1986 and 2000 in northern Italy and Switzerland. Cases were 68 women under age 79 years, with incident, histologically confirmed cancer of the larynx. Controls were 340 women, admitted to the same network of hospitals as cases, for acute, nonmalignant conditions, unrelated to tobacco and alcohol consumption. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated by logistic regression models, conditioned by age, study center and year of interview, and including terms for education, body mass index, tobacco, alcohol drinking, and nonalcohol energy intake. Laryngeal cancer was strongly associated with cigarette smoking (OR = 435.7, 95% CI: 38.2-4964.4 for smokers of >/=25 cigarettes/day) and alcohol drinking (OR = 4.3, 95% CI: 0.8-24.1 for >/=5 drinks/day). An inverse relation was found for vegetables (OR = 0.3, 95% CI: 0.1-0.9 for the highest level of consumption), fruit (OR = 0.5, 95% CI: 0.2-1.3), and olive oil (OR = 0.3, 95% CI: 0.1-0.9). Reproductive and hormonal factors were not consistently associated to laryngeal cancer risk. This investigation, based on a uniquely large number of laryngeal cancers in women, provides definite evidence that cigarette smoking is the prominent risk factor for laryngeal cancer in women, accounting for 78% of cases in this population. Alcohol and selected dietary aspects account for approximately 30% of cases, whereas menstrual and hormonal factors do not appear to have a consistent role in laryngeal carcinogenesis.

Aged↗

[Quality assurance in organized screening of breast cancer].

Quality assurance is an essential process which should be applied for any organised breast cancer screening program since mammography it the only test available for an early diagnosis. It should also assess the quality of diagnostic and treatment processes in order to ascertain that the quality of the screening program would not be altered by the procedures which take place after the screening. Quality assurance must be applied to each component of the screening process: equipment, radiographers (technicians) as well as radiologists. It is a multidisciplinary approach following a well defined protocol, which should be supervised by a coordination unit, the Breast Cancer Screening Foundation in Canton of Vaud. Performances of the Vaud program show clearly at what extend multiple reading method improves the quality of screening. It seems that there is no inconvenient to involve radiologists who wish to participate without any selection to the reading process provided that there is in place a team of 2nd and 3rd readers who benefit of an appropriate training and experience.

Breast Neoplasms↗

Alcohol drinking outside meals and cancers of the upper aero-digestive tract.

In our integrated series of case-control studies conducted in Italy and Switzerland (324 oral, 397 pharyngeal, 271 oesophageal, 506 laryngeal cancers and 3,263 controls), individuals who also drank alcoholic beverages outside meals showed an increased risk compared to those who drank at meals only. At any alcohol intake level, subjects also drinking between meals showed a more elevated risk of developing an upper aero-digestive tract cancer than subjects drinking only at meals. After adjustment for potential covariates, and, after allowance for the number of daily drinks to adjust for different alcohol-intake levels, the odds ratios for subjects reporting drinking outside meals were 1.5 (95% confidence interval [CI]: 1.0-2.2) for oral, 1.8 (95% CI: 1.3-2.5) for pharyngeal, 1.7 (95% CI: 1.2-2.5) for oesophageal and 1.2 (95% CI: 0.9-1.7) for laryngeal cancers. Our findings show that drinking pattern with respect to food consumption may influence alcohol carcinogenesis in the upper digestive and respiratory tract. An "alcohol washing effect" by chewing and swallowing is suggested.

Adult↗

Food groups and laryngeal cancer risk: a case-control study from Italy and Switzerland.

Besides tobacco and alcohol, diet has been thought to be associated with laryngeal cancer risk. We thus analyzed the role of various food groups, as well as specific seasoning fats, in a case-control study conducted in Northern Italy and the Swiss Canton of Vaud from 1992 to 2000. Our study included 527 incident, histologically confirmed cases and 1,297 frequency-matched controls, selected among patients admitted to the same hospitals as cases for acute, nonneoplastic conditions, unrelated to smoking, alcohol consumption and long-term modifications of diet. The subjects' usual diet was investigated through a validated food frequency questionnaire, including 78 foods and beverages. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using unconditional multiple logistic regression models. After adjustment for major confounding factors, a significant trend of increasing risk was observed for eggs (OR = 1.7 for the highest compared to the lowest quintile), red meat (OR = 3.1), processed meat (OR = 1.7), fish (OR = 1.6) and sugars (OR = 1.6). Significant inverse associations were observed for pulses (OR = 0.7), raw vegetables (OR = 0.2), cooked vegetables (OR = 0.3), citrus fruit (OR = 0.6) and other fruit (OR = 0.5). In regard to seasoning fats, a significant reduction of cancer risk was observed for olive oil (OR = 0.4) and specific seed oils (OR = 0.6), while mixed seed oils were directly associated with laryngeal cancer risk (OR = 2.2). Our study suggests that increasing vegetables and fruit, decreasing meat consumption and perhaps substituting olive oil or specific seed oils for other types of seasoning lipids might help reduce laryngeal cancer risk.

Adult↗