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Biomedical subjects

S Franceschi

Publications and source records attributed to S Franceschi.

At least 217 records · Page 12Linked to original sources
PubMed1999

Hypertension and hormone-related neoplasms in women.

The relation between hypertension and the risk of selected hormone-related neoplasms in women was investigated in a network of case-control studies conducted in Italy during 1983-1996. Cases were women younger than 75 years with histologically confirmed cancer of the breast (n=3406), endometrium (n=745), ovary (n=970), and thyroid (n=145). Controls were 3054 women admitted in the same geographic area for acute, nonneoplastic, non-hormone-related diseases. Odds ratios (ORs) of treated hypertension were computed after allowance for sociodemographic factors, smoking habits, alcohol consumption, parity, menopausal status, and body mass index (BMI) by means of unconditional logistic regression. The ORs were 1.2 (95% CI, 1.1 to 1.4) for breast cancer and 1.6 (95% CI, 1.3 to 1.9) for endometrial cancer, and the elevated ORs persisted after >/=5 years since diagnosis of hypertension. No significant association was observed for ovarian and thyroid cancer. For breast cancer, the association was apparently stronger at age 55 years or over and consequently after menopause. No appreciable effect modification was evident for endometrial cancer. Allowance for BMI did not explain the association of postmenopausal breast cancer and endometrial cancer with hypertension. The OR of postmenopausal breast cancer was 1.5 (95% CI, 1.1 to 2.0) in hypertensive women with BMI >/=30 kg/m(2) compared with normotensive women with BMI <25 kg/m(2). The corresponding figure for all endometrial cancers was 4.9 (95% CI, 3. 4 to 6.9). Even in the absence of a clear understanding of biological mechanisms, the definition of a role of hypertension on female hormone-related cancers can have relevant implications on individual risk assessment.

Adult↗
PubMed1999

Population-attributable risk for colon cancer in Italy.

Risk factors for colon cancer have essentially been considered in terms of relative risks. From a public health viewpoint, however, their impact depends not only on the strength of the association, but also on the distribution of exposures in the population. Thus we used data from a case-control study conducted in Italy between 1992 and 1996 to estimate the population-attributable risks (PARs) for colon cancer in relation to educational level, physical activity, energy and vegetable intake, eating frequency, and family history of colorectal cancer. Cases were 1,225 incident, histologically confirmed colon cancer patients admitted to the major teaching and general hospitals in six Italian areas; controls were 4,154 subjects with no history of cancer, admitted to hospitals in the same catchment areas for acute, nonneoplastic diseases. By use of the distribution of the risk factors in the cases and the multivariate relative risk estimates, PARs were computed, i.e., the proportion of colon cancer that would have been avoided if all subjects were moved to the lowest exposure level. The PARs were 12% for high education, 14% for low physical activity, 14% for high energy intake, 22% for low vegetable intake, 7% for high eating frequency, and 8% for a family history of colorectal cancer. These factors together accounted for 56% of colon cancer cases. PARs were similar across age strata. Men had higher PARs for education, physical activity, and their combination, but lower PARs for energy, eating frequency, vegetable intake, and their combination than women. The percentage of colon cancers attributable to all factors considered together was 50% in men and 67% in women. Even if the PAR estimates were based on several arbitrary assumptions on the exposure distribution for various risk factors, available knowledge could, in principle, explain > 50% of cases in this Italian population, thus indicating and quantifying the theoretical scope for prevention.

Adult↗
PubMed1999

Paediatric AIDS incidence in Europe and the USA, 1985-96.

BACKGROUND: AIDS has shown dramatic increases among women in the last decade; this has facilitated the spread of paediatric AIDS. Incidence rates of AIDS in children are essential for international comparisons at a population level. METHODS: Incidence rates of AIDS 1985-96 by 3-year period in children < 13 years of age were computed for 15 European countries and, for comparative purposes, the USA. For each country, the rates were adjusted for reporting delay and standardised on the world standard population. RESULTS: In European countries with > 100 cases, the steepest rises were seen in the UK (whose rates increased from 0.8/1,000,000 children in 1985-87 to 4.1/1,000,000 in 1994-96), and Spain (from 4.4/1,000,000 to 16.5/1,000,000). In 1985-87, rates were substantially higher in USA (8.3/1,000,000) than in any European country but, in recent years, they have become similar to those of Spain. Very elevated rates were observed in Romania, with incidences of 120.4/1,000,000 in the early 1990s, due to nosocomial HIV transmission. In most countries, 1994-96 rates tended to level off, or decrease. In a few countries (Germany, Greece, Denmark, Austria, and the Netherlands) AIDS incidence rates were < 2 cases per million children in 1994-96. The proportion of cases acquired by transfusion, in 1985-96, is about 20% or less of paediatric AIDS cases in most countries. No substantial heterogeneity emerges between countries in the distribution of AIDS indicator diseases. CONCLUSIONS: During 1985-93, paediatric AIDS incidence rates increased in most European countries and levelled off thereafter. No paediatric AIDS epidemic occurred; in a few countries, incidence rates persisted at around one case per million.

AIDS-Related Opportunistic Infections↗
PubMed1999

The role of energy and fat in cancers of the breast and colon-rectum in a southern European population.

BACKGROUND: Several uncertainties remain with respect to the role of intake of fat and/or total energy in the etiology of cancer of the breast and colon-rectum. PATIENTS AND METHODS: Between 1991 and 1996, 2569 women with incident breast cancer (median age: 55 years), 1953 subjects with cancer of the colon-rectum (median age = 62), and 5155 hospital controls were interviewed in six Italian areas. The validated food frequency questionnaire included questions on 78 foods and recipes and specific questions on individual fat intake pattern. RESULTS: Significant trends of increasing breast and colorectal cancer risk with increasing intake emerged for bread and pasta, pork and processed meats and potatoes (breast cancer only), cakes and desserts (colon-rectum cancers only), and refined sugar. Most vegetables were inversely associated with cancer of the colon and rectum, whereas only carrots and raw vegetables seemed to lower breast cancer risk. High fruit intake was associated only with a reduction of rectal cancer. Total energy intake was directly associated with all cancer sites. Among macronutrients, high intake of starch and saturated fat seemed to lead to an increase of cancer risk. High intakes of polyunsaturated fatty acids (chiefly derived from olive oil and seed oils) were protective. Among micronutrients, beta-carotene, vitamin E, and calcium showed inverse associations with breast and colorectal cancer risk. CONCLUSIONS: An excess of energy intake, particularly from refined bread and pasta, can be an unfavourable feature of the Mediterranean diet, in the presence of a sedentary lifestyle.

Animals↗
PubMed1999

Nutrients and food groups and large bowel cancer in Europe.

Several uncertainties remain with respect to the role of intake of fat and/or total energy in the aetiology of cancer of the colon-rectum. Between 1992 and 1996, 1953 subjects with cancer of the colon-rectum (median age = 62 years) and 4154 hospital controls were interviewed in six Italian areas. The validated food-frequency questionnaire included questions on 78 foods and recipes, and specific questions on individual fat intake pattern. Significant trends of increasing colorectal cancer risk with increasing intake emerged for bread and pasta, cakes and desserts, and refined sugar. Most vegetables, including pulses, were inversely associated with cancer of the colon and rectum. High fruit intake was associated only with a reduction of rectal cancer. Total energy intake was directly associated with colorectal cancer risk. Among macronutrients, a high intake of starch and saturated fat seemed to lead to an increased risk of cancer. High intakes of polyunsaturated fatty acids (chiefly derived from olive oil and seed oils) showed a marginal inverse association with colorectal cancer risk. Among micronutrients, beta-carotene, vitamin E and calcium showed the most consistent inverse associations. An excess of energy intake, particularly from refined bread and pasta, can be an unfavourable feature of the Mediterranean diet with respect to colorectal cancer risk, especially in the presence of sedentary life.

Adult↗
PubMed1999

Energy intake, overweight, physical exercise and colorectal cancer risk.

Epidemiological studies on risk factors for CRC have focused mainly on diet. In any case, the results of these studies show several inconsistencies, except for the beneficial role of high intake of vegetables and, to some lesser extent, of fruit. Weight and height have also been studied, partly because they reflect the balance between energy intake and expenditure in different age periods. Energy intake, body size and physical activity will be reviewed in this paper focusing mostly on recent data coming from Italian, English and Scandinavian studies. Overweight has long been recognized as a risk factor for hormone related and other cancers and this is confirmed not simply from case-control studies but from large cohort studies as well. The major findings of recent Italian studies are that excessive weight at various ages predicts colorectal cancer risk in men while in women, abdominal obesity, as indicated by a high WHR, represents a more reliable risk indicator. If all men could reduce their BMI below 25, about 9% of male colorectal cancer might be avoided in Italy. A decrease of WHR below 0.82 might reduce colorectal cancer in women by 19%. In addition, the epidemiological evidence consistently shows that physical activity reduces the risk of colon cancer. On the contrary, evidence on rectal cancer is less impressive. Some uncertainty still exists in relation to the intensity and duration of physical activity. In conclusion, body size control along all life and physical activity represent important factors to prevent colon cancer and a wide range of chronic conditions. Therefore, strategies to favour these goals through counselling from health-care providers, regulatory changes and programs aimed at individuals and communities should be implemented.

Adult↗
PubMed1998

Prognostic factors for cutaneous malignant melanoma in Vaud, Switzerland.

We considered, by means of a multivariate approach, trends in survival from cutaneous malignant melanoma in relation to patient and tumor characteristics, using data from the Cancer Registry of the Swiss Canton of Vaud. Between 1980 and 1994, 1,229 cases of incident cutaneous malignant melanoma were registered. There was a decline in the proportion of neoplasms in the head and neck and lower limbs, and a rise in those of the trunk and upper limbs, an increase in superficial spreading melanoma and in tumors of limited thickness, mostly in females. Five-year crude survival was 0.68 for males and 0.82 for females, and relative survival of 0.79 for males and 0.89 for females, corresponding to a multivariate hazard ratio (HR) of 0.63 for females vs. males. Survival was inversely related to age, with 5-year relative survival of 0.92 at age 15-44 years, 0.85 at age 45-64 years, and 0.79 at age > or = 65 years. With reference to histological type, no significant difference was observed in males, but in females nodular melanoma showed reduced survival. Compared with melanoma of the limbs, the HR was 1.46 for melanoma of the trunk, and 1.23 for those in the head and neck, and the difference was greater in females. A strong relation, in both sexes, was observed between survival and tumor thickness, with an HR of 3.96 for tumors > or = 4 mm vs. those < 1.50 mm. After allowance for all other factors considered, most recent calendar period of diagnosis was associated with improved survival in both sexes (HR = 0.72), but mostly in females. Although differences in survival tended to be larger during the first 2 years after diagnosis, the pattern was similar for most prognostic factors considered up to 10 years after diagnosis.

Adolescent↗
PubMed1998

Body size and colorectal-cancer risk.

Individuals whose energy intake exceeds expenditure are at increased risk of colorectal cancer. To determine whether body-size measurements at different ages were risk factors for cancer of the colon-rectum, we carried out a hospital-based case-control study in 6 Italian areas, 2 of which were in the South. Interviews were conducted with 1,217 subjects of both genders with incident histologically confirmed cancer of the colon, 726 with cancer of the rectum, and 4,136 controls hospitalized for acute, non-neoplastic, non-digestive conditions. The questionnaire included information on sociodemographic factors, and physical activity, a validated dietary history, height, weight at diagnosis and at 12, 30 and 50 years of age and waist-to-hip ratio (WHR). After allowance for education, physical activity, energy intake, family history of colorectal cancer and recent change in weight, the body-mass index (BMI) was significantly associated with colorectal-cancer-risk in men (odds ratio, OR, in highest vs. lowest quintile = 1.7; 95% confidence interval, CI, 1.3-2.3), but not in women (corresponding OR = 0.9; 95% CI, 0.7-1.2). Cases of both gender tended to have higher BMI than controls in adolescence, young adulthood and middle age. Height appeared unrelated to risk. In women, but not in men, WHR was positively associated with risk, independently of BMI (OR for > or = 0.90 vs. < or = 0.81 = 1.6; 95% CI; 1.2-2.1). Thus, excessive weight predicts colorectal-cancer risk in men, whereas abdominal obesity (i.e., a high WHR) represents a more reliable risk indicator in women.

Adult↗
PubMed1998

Expression status of BCL-6 and syndecan-1 identifies distinct histogenetic subtypes of Hodgkin's disease.

The tumor cells in most cases of Hodgkin's disease (HD) have been recently recognized to originate from the B-cell lineage, but their precise differentiation stage is not fully clarified. Recently, we have reported that the histogenesis of B-cell lymphomas may be assessed by monitoring the expression pattern of BCL-6, a transcription factor expressed in germinal center (GC) B cells, and CD138/syndecan-1 (syn-1), a proteoglycan associated with post-GC, terminal B-cell differentiation. In this study, we have applied these two markers to the study of HD histogenesis. We have found that in nodular lymphocyte predominance HD (NLPHD) tumor cells consistently display the BCL-6(+)/syn-1(-) phenotype, indicating their derivation from GC B cells. Conversely, classic HD (CHD) is heterogeneous because the tumor cells of a fraction of CHD display the BCL-6(-)/syn-1(+) phenotype of post-GC B-cells, whereas another fraction of CHD is constituted by a mixture of tumor cells reflecting the GC (BCL-6(+)/syn-1(-)) or post-GC (BCL-6(-)/syn-1(+)) phenotypes. BCL-6(-)/syn-1(+) tumor cells of CHD are mostly found surrounded by T cells expressing CD40L, consistent with the observation that CD40 signaling downregulates BCL-6 expression. These data indicate that tumor cells of NLPHD uniformly display a GC B-cell phenotype, whereas the phenotype of tumor cells of CHD appears to be modulated by the surrounding cellular background, particularly CD40L+ reactive T cells.

Antigens, Differentiation, B-Lymphocyte↗
PubMed1998

Food groups and risk of oral and pharyngeal cancer.

The role of specific food groups and diet variety on the risk of oral and pharyngeal cancer has been considered using data from a case-control study conducted between 1992 and 1997 in the Swiss Canton of Vaud. Cases were 156 patients (126 males, 30 females) aged under 75 (median age 56) years with incident, histologically confirmed cancer of the oral cavity and pharynx, and controls were 284 subjects (246 males, 38 females, median age 57 years), admitted to the same university hospital for a wide spectrum of acute, non-neoplastic conditions unrelated to tobacco and alcohol consumption or to long-term modification of diet. After allowance for education, alcohol, tobacco and total energy intake, significant trends of increasing risk with more frequent intake emerged for eggs (OR = 2.3 for the highest tertile), red meat (OR = 2.1) and pork and processed meat (OR = 3.2). Inverse trends in risk were observed for milk (OR = 0.4 for the highest tertile), fish (OR = 0.5), raw vegetables (OR = 0.3), cooked vegetables (OR = 0.1), citrus fruit (OR = 0.4) and other fruits (OR = 0.2). The addition of a serving per day of fruit or vegetables was associated with an about 50% reduction in oral cancer risk. The most favourable diet for oral cancer risk is therefore given by infrequent consumption of red and processed meat and eggs and, most of all, frequent vegetable and fruit intake. Diet diversity was inversely related to oral and pharyngeal cancer: ORs were 0.35 for the highest tertile of total diversity, 0.24 for vegetable and 0.34 for fruit diversity. In terms of attributable risk, high meat intake accounted for 49% of oral and pharyngeal cancers in this population, low vegetable intake for 65% and low fruit intake for 54%.

Adult↗
PubMed1998

Second cancers following in situ carcinoma of the breast.

Carcinoma in situ (CIS) of the breast has increased many-fold in incidence rates and as a proportion of new breast cancers following the introduction of mammographic breast screening. To provide population-based estimates of invasive breast cancer risk following CIS, we linked data on 249 incident primary CIS (median age 53 years) to the Cancer Registry of the Swiss Canton of Vaud (about 600,000 inhabitants) over the period 1977-1994. Women with concurrent invasive cancers of the breast were not included. Standardized incidence ratios (SIR) were determined according to the exact Poisson distribution, with stratification for age and year of diagnosis. A total of 24 cases of breast cancer vs. 3.4 expected [SIR = 7.2, 95% confidence interval (CI): 4.6-10.6], and 7 cases of other neoplasms (except non-melanomatous skin cancer) vs. 6.9 expected (SIR=1.0, 95% CI: 0.4-2.1) were observed. The SIR was 10.4 during the first year, 5.6 between I and 4 years, and 7.7 after > or = 5 years after CIS diagnosis. SIRs were consistent in women below and above age 55 years, but somewhat higher for ductal (SIR=8.6) than lobular (SIR = 4.2) CIS. Six deaths from breast cancer were observed vs. 1.5 expected (standardized mortality ratio=4.0, 95% CI: 1.5-8.7). In 13/19 ductal CIS, but in 2/4 lobular CIS, invasive cancer occurred in the same breast. In most women, CIS and subsequent invasive cancer showed the same morphological (i.e., ductal or lobular) features. The cumulative risk of breast cancer was 16% 10 years after CIS diagnosis, emphasizing the importance of adequate surveillance of women after CIS of the breast.

Adult↗