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S Franceschi

Publications and source records attributed to S Franceschi.

At least 181 records · Page 10Linked to original sources

Risk factors for adenocarcinoma of the small intestine.

We have investigated the relation between alcohol, tobacco and dietary habits and risk of adenocarcinoma of the small intestine using data from 2 hospital-based case-control studies on intestinal cancers conducted in 6 Italian centres between 1985 and 1996. Cases were 23 patients below age 75 years with adenocarcinoma of the small intestine. Controls were 230 patients admitted to hospital for a wide spectrum of acute, non-neoplastic, non-digestive tract diseases, matched to cases on sex, age, study and centre. Odds ratios (ORs) were estimated using conditional logistic regression. Alcohol and tobacco consumption did not increase the risk of adenocarcinoma of the small intestine. The risk appeared to be directly related to intake of bread, pasta or rice (OR = 3.8), sugar (OR = 2.9) and red meat (OR = 4.6), and inversely to coffee (OR = 0.4), fish (OR = 0.3), vegetables (OR = 0.3) and fruit (OR = 0.6). Our results suggest that dietary correlates of adenocarcinoma of the small intestine are similar to those of colon cancer and at least of the same magnitude. While the present data are inconsistent with a major effect of tobacco or alcohol, a moderate association between these factors and small bowel cancer may have been obscured by the play of chance.

Adenocarcinoma↗

Hormonal therapy for menopause and ovarian cancer in a collaborative re-analysis of European studies.

The relationship between hormonal therapy for menopause (hormone replacement therapy, HRT) and the risk of epithelial ovarian cancer was evaluated in a collaborative re-analysis of 4 European case-control studies, 2 conducted in Greece and 1 each in Italy and the United Kingdom, including a total of 1,470 ovarian cancer cases and 3,271 hospital controls. Odds ratios (ORs) for HRT use were derived after allowance for study centre, age, socio-economic level, parity, menopausal status, type of menopause, age at menopause and oral contraceptive use. Overall, 109 (8.0%) ovarian cancer cases and 146 (4.7%) controls had ever used HRT, corresponding to an adjusted OR of 1.71 (95% confidence interval 1.30-2.25). The point estimates of the OR were 1.77 in the first Greek study, 1.40 in the second Greek study, 1.66 in the Italian study and 1.68 in the British study. Adjustment for possible confounders, including menopausal status, type of menopause, age at menopause and oral contraceptive use, slightly increased the OR. Limiting the analysis to women with information on relevant aspects of HRT use revealed a weak positive association with duration and some evidence that the excess relative risk for ovarian cancer declined with time since last use. These findings are compatible with a promoting effect of HRT in ovarian carcinogenesis. It is also possible, however, that the positive association reflects chance or selective administration of HRT to high-risk individuals, since until recently in Europe HRT was prescribed mainly for alleviation of peri-menopausal symptoms.

Age Factors↗

A computer program to calculate indicators of descriptive epidemiology.

Comparison of incidence and mortality data between areas is useful for monitoring the health status of a population, for exploring quality of health care, and for planning studies on determinant(s) of heterogeneous patterns. Common statistical indicators involved, together with their confidence intervals, are age-specific and cumulative rates, age-standardized rates and ratios, and expected numbers. The data required for calculations include information of event distribution according to age and residence, and corresponding population at risk. The calculations of these indicators, although conceptually simple, can be a cumbersome task to carry out with available statistical packages; lack of flexibility to suit the need of specific researches represents another problem. In order to facilitate descriptive epidemiological studies, we developed a set of Statistical Analysis System macros to compute indicators but, also, to read and write data from/to some standard file formats. Important features of these macros are their flexibility, expandability, and ability to be transferred to various computer platforms. Moreover, macros give an added value to raw data. The method is illustrated using published incidence data from Italy.

Adolescent↗

Alcohol and cancer.

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Alcohol Drinking↗

Risk factors for breast cancer in women under 40 years.

The relation between hormonal and lifestyle factors and breast cancer risk in women younger than 40 years was investigated using data from two case-control studies conducted in Italy between 1983 and 1994. Cases were 579 women with histologically confirmed, incident breast cancer and controls were 668 women admitted to hospital for acute, non-neoplastic, non-hormone-related diseases. Breast cancer risk was inversely related to age at menarche with a multivariate odds ratio (OR) of 0.53 (95% confidence interval, CI, 0.31-0.89) for women reporting menarche at the age of > or = 15 years compared with < 12 years. Breast cancer risk was significantly higher in parae than in nulliparae (OR 1.58), and was directly associated with age at first birth (OR 5.31 among women aged > or = 30 years at first birth compared with those aged < 20), and inversely with time since last birth (OR 3.80 for < 3 years compared with > or = 12). Compared with women reporting no abortion, the OR were 1.10 for any spontaneous, 0.87 for any induced and 0.90 for > or = 2 abortions. With reference to oral contraceptive use, the OR was 1.05 for ever users compared with never users, and no material association was evident with duration, time since first and last use. The OR was 1.79 for more than 13 years of education compared with < 9, 1.85 for a family history of breast cancer and 1.85 for a history of benign breast disease. Breast cancer risk was inversely related to body mass index with an OR of 0.51 (95% CI 0.26-0.97) for > or = 30 kg/m2 compared to < 20. Total energy and alcohol intake were directly related to the risk (OR 1.38 and 1.27 for the highest tertiles of intake compared with the lowest), although the estimates were not significant, whilst raw vegetable and beta-carotene consumption were inversely related to breast cancer risk (OR 0.57 and 0.67 for the highest tertile of intake compared with the lowest). Thus, most risk factors in this large dataset of women aged less than 40 years were similar to those described in breast cancer epidemiology at any age. Of interest are the inverse associations with body mass index, age at menarche and time since last birth, the direct ones with age at first and last birth, and the higher risk of parous women compared with nulliparae.

Abortion, Induced↗

Allergy and other selected diseases and risk of colorectal cancer.

It has been reported that allergy and other diseases may be related to colorectal cancer risk. The aim of this study was to perform a systematic analysis using information about medical histories specifically to see if there was any relation between allergies or other medical conditions and colorectal cancer risk. A multicentric case-control study was conducted in six Italian areas between 1992 and 1996 on 1225 incident cases of colon cancer, 728 cases of rectal cancer and 4154 controls comparable with cases according to sex and age group, admitted for acute conditions to the same network of hospitals where cases had been identified. Unconditional logistic regression models including terms for sex, age, study centre, years of education, body mass index, physical activity, smoking, history of colorectal cancer in first-degree relatives and energy intake were used to estimate the odds ratios (OR) of colon and rectal cancer according to history of allergy and other selected diseases. The OR for history of allergy was 0.88 (95% confidence interval, CI, 0.67-1.14) for colon and 0.64 (95% CI, 0.44-0.92) for rectal cancer, and the inverse association was stronger when allergy was diagnosed at age 35 years or more, or less than 10 years before the cancer diagnosis. No clear pattern emerged in strata of age and sex. History of other selected diseases, including hypertension and cholelithiasis, was not related to colon or rectal cancer risk, though there was a moderate increase in the risk of colon cancer (OR = 1.18, 95% CI, 0.66-2.14) in patients with a history of intestinal polyps. This study lends support to the hypothesis that allergic individuals may be at a lower risk of developing colorectal cancer.

Adult↗

Risk factors for oral and pharyngeal cancer in never smokers.

Information on the etiology of oral and pharyngeal cancer in never smokers should help us to understand and quantify risk factors for the disease in the absence of the residual confounding and interaction by smoking. Out of a total of 528 cases with histologically confirmed incident cancers of the oral cavity and pharynx, 42 (10 men and 32 women) who described themselves as lifelong non-smokers were considered. Controls were 864 lifelong non-smokers (442 men and 422 women) admitted to hospital for acute, non-neoplastic, non-alcohol-related conditions. The major risk factor for cancer of the oral cavity and pharynx in never smokers was alcohol consumption (mainly wine) with an odds ratio (OR) about three-fold higher in drinkers than non-drinkers. A direct relation was also found for the duration of the habit, with an OR of 3.6 (95% confidence intervals, CI, 1.2-11.2) for drinking for 35 years or longer. Among the few selected indicator foods considered, a direct association was found with butter (OR 2.7, 95% CI 1.4-5.1 for high intake compared to low), and a non-significant inverse association with carrots (OR 0.6, 95% CI 0.3-1.3) and fresh fruit (OR 0.7, 95% CI 0.3-1.6) for the highest tertile of intake compared to the lowest. Thus, even in the absence of smoking, reducing alcohol and saturated fat intake and increasing fruit and carrot consumption may have favorable effects on oral and pharyngeal cancer risk.

Adult↗

A pooled analysis of case-control studies of thyroid cancer. III. Oral contraceptives, menopausal replacement therapy and other female hormones.

OBJECTIVE: The relations between oral contraceptives (OC), hormone replacement therapy (HRT) for menopause, and other female hormone use and thyroid cancer risk was analyzed using the original data from 13 studies from North America, Asia and Europe. METHODS: Based on 2,132 cases and 3,301 controls, odds ratios (OR) and the corresponding 95% confidence intervals (CI) were obtained by conditional regression models, conditioning on study and age at diagnosis, and adjusting for age, radiation exposure and parity. RESULTS: Overall, 808 (38%) cases versus 1,290 (39%) controls had ever used OCs, corresponding to an OR of 1.2 (95% CI 1.0 to 1.4). There was no relation with duration of use, age at first use, or use before first birth. The OR was significantly increased for current OC users (OR = 1.5, 95% 1.0 to 2.1), but declined with increasing time since stopping (OR = 1.1 for > 10 years since stopping). The association was stronger for papillary cancers (OR = 1.6 for current users) than for other histologic types. No significant heterogeneity was observed across studies or geographic areas. Eight studies had data on HRT, for a total of 1,305 cases and 2,300 controls: 110 (8%) cases and 205 (9%) controls reported ever using HRT (OR = 0.8; 95% CI 0.6 to 1.1). The ORs were 1.6 (95% to 0.9 to 2.9) for use of fertility drugs, and 1.5 (95% CI 1.1 to 2.1) for lactation suppression treatment. CONCLUSIONS: The studies considered in these analyses include most of the epidemiological data on the role of exogenous hormone use in the etiology of thyroid cancer, and they provide reassuring evidence on the absence of an association of practical relevance. The moderate excess risk in current OC users, if not due to increased surveillance for thyroid masses among OC users, is similar to that described for breast cancer, and would imply a role of female hormones on thyroid cancer promotion. There was no indication of increased thyroid cancer risk 10 or more years after discontinuing OC use.

Adenocarcinoma, Papillary↗

A pooled analysis of case-control studies of thyroid cancer. I. Methods.

OBJECTIVE: Because the etiology of thyroid cancer is not well described, we conducted a pooled analysis of all published case-control studies, as well as two identified unpublished studies. This paper describes the major characteristics of the 14 studies included in the analysis, as well as the statistical methods employed. Four studies were conducted in the United States (1 each in Washington State, California, Connecticut and Hawaii), 8 in Europe (3 in Sweden, 2 in Norway, 1 in Switzerland, 1 in Italy and 1 in Greece), and 2 in Asia (1 in China and 1 in Japan). METHODS: The original datasets were obtained and restructured in a uniform format. Data on socio-demographic characteristics, anthropometric measures, smoking and alcohol consumption, history of benign thyroid diseases and of other selected medical conditions and treatments, family history of cancer and of benign thyroid conditions, occupation, residence in endemic goitre areas, and dietary habits were analyzed. For women, we also analyzed menstrual and reproductive factors and use of female hormones. Radiotherapy and, in Japan, exposure to the A-bombs were considered as potential confounding factors. RESULTS: A total of 2,725 cases (2,247 females and 478 males) and 4,776 controls (3,699 females and 1,077 males) were included in this study. Of the cases, 79% were classified as papillary thyroid carcinomas, 14% as follicular, 2% medullary, 1% anaplastic, 1% other histologies, and 3% histological type unknown. Each of the datasets was checked for outliers and consistency. Data were analysed separately by study center, gender, and the two major histologic types (papillary, follicular). Frequency tables and simple statistics were computed for each variable under study. Conditional logistic regression was used to compute odds ratios. For matched studies, the original matching was preserved, whereas, for unmatched ones, five-year age groups were used for matching. Study-specific analyses were computed, and then the data from all the studies were pooled conditioning on study. Heterogeneity between studies, geographic areas and study designs was assessed, and the modifying effect of age was also evaluated.

Adenocarcinoma, Follicular↗

A pooled analysis of case-control studies of thyroid cancer. II. Menstrual and reproductive factors.

OBJECTIVE: It has been suggested that female hormones, and hence menstrual and reproductive factors, play a role in thyroid cancer etiology. Epidemiological data, however, are limited and inconsistent, partly because of the small number of cases included in each study. To clarify the etiology of thyroid cancer, we conducted a pooled analysis of original data from 14 case-control studies, 4 from the United States, 2 from Asia, and 8 from Europe. METHODS: This analysis included a total of 2,247 female cases of thyroid cancer (80% papillary) and 3,699 control women. Pooled odds ratios (OR) were estimated using logistic regression, conditioning on study and (i) matching sets for individually matched studies, or (ii) quinquennia of age for the other studies. Additional terms for age and history of radiation exposure were included in the regression equations. RESULTS: The OR per year of later menarche was 1.04 (95% confidence interval (CI) 1.0-1.1). Compared to premenopausal women, the OR was 1.3 for women with natural menopause, and 1.8 for those with artificial menopause, but the studies were heterogeneous and the association may be due, at least in part, to diagnostic or ascertainment bias. Parity, spontaneous or induced abortions and history of infertility were not associated with thyroid cancer risk. The OR was above unity in women reporting later age at first birth (OR = 1.1, 95% CI 1.0-1.3 for 5-year delay) and higher in the first years after a birth. CONCLUSIONS: The associations of menstrual and reproductive factors with thyroid cancer risk were generally weak, but appeared stronger among women diagnosed with thyroid cancer at younger ages.

Adenocarcinoma, Papillary↗

A pooled analysis of case-control studies of thyroid cancer. IV. Benign thyroid diseases.

OBJECTIVE: To obtain more precise estimates of the association between thyroid cancer and benign thyroid diseases and to elucidate the role of potential confounders or effect modifiers. METHODS: The original data from 12 case-control studies from the United States, Asia, and Europe were pooled. Based on 2,094 women and 425 men with cancer of the thyroid and, respectively, 3,248 and 928 control subjects, odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) were obtained by conditional regression models, conditioning on study and age at diagnosis, and adjusting for age and radiotherapy. RESULTS: A history of hypothyroidism was not associated with cancer risk (pooled ORs = 0.9, 95% confidence interval, CI: 0.7-1.3 in women and 1.7, 95% CI: 0.3-11.7 in men). ORs for hyperthyroidism were 1.4 (95% CI: 1.0-2.1) in women and 3.1 (95% CI: 1.0-9.8) in men. In women, however, risk was lower in the absence of or after allowance for history of goiter. Pooled ORs for a history of goiter were 5.9 (95% CI: 4.2-8.1) in women and 38.3 (95% CI: 5.0-291.2) in men. Risk for a history of benign nodules/adenomas was especially high (OR = 29.9, 95% CI: 14.5-62.0, in women; 18 cases versus 0 controls in men). The excess risk for goiter and benign nodules/adenomas was greatest within 2-4 years prior to thyroid cancer diagnosis, but an elevated OR was present 10 years or more before cancer. CONCLUSIONS: Goiter and benign nodules/adenomas are the strongest risk factors for thyroid cancer, apart from radiation in childhood.

Adenoma↗