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Biomedical subjects

S Franceschi

Publications and source records attributed to S Franceschi.

At least 253 records · Page 14Linked to original sources
PubMed1998

Alcohol consumption and risk of breast cancer: a multicentre Italian case-control study.

The relationship between alcohol consumption and breast cancer risk was investigated using data from a co-operative case-control study conducted in Italy between 1991 and 1994 on 2569 incident, histologically confirmed breast cancer cases and 2588 controls in hospital for acute, non-neoplastic, non-hormone related conditions. Overall, 915 (38%) cases and 1048 (43%) controls were abstainers. Compared with them, the odds ratio (OR), adjusted only for age, was 1.31 (95% confidence interval (CI) 1.13-1.53) for drinkers and became 1.39 (95% CI 1.(1)21-1.60) after correction for measurement error. The multivariate OR was 1.21 for drinkers of < or = 5.87 g/day and 1.23, 1.19, 1.21, 1.41 for drinkers of 5.88-13.40, 13.41-24.55, 24.56-27.60, > 27.60 g/day, respectively. The trend in risk was significant (chi 2 = 12.28, P < 0.0005). The association was apparently stronger in premenopausal women (OR = 1.80 for > 27.60 g/day). Considering the different types of alcoholic beverages (wine, beer, digestives, grappa and other spirits), a significant direct trend in breast cancer risk was seen for wine with an OR of 1.27 (95% CI 1.06-1.53) for the category > 26.34 g/day. The ORs were also above unity for beer, grappa, digestives and spirits drinkers. No appreciable interaction was observed between alcohol drinking and body mass index, smoking, or any other covariate considered. Thus, the present data, based on a validated alcohol consumption questionnaire and on a population characterised by a relatively high alcohol consumption in women, confirmed that alcohol drinking is moderately related to breast cancer risk. If causal, this association could explain 12% (95% CI, 5-19%) of breast cancers in Italy, thus representing one of the major avoidable risk factor for breast cancer.

Adult↗
PubMed1998

Risk factors for cervical presence of human papillomavirus DNA among women at risk for HIV infection. DIANAIDS Collaborative Study Group.

Risk factors for cervical infection with human papillomavirus (HPV) were assessed among 236 Italian women at risk for human immunodeficiency virus (HIV) infection (intravenous drug users (IVDU) or sexual partners of males at risk for HIV infection). All study participants underwent a structured interview, determination of HIV serostatus and detection of HPV cervical infection by means of polymerase chain reaction (PCR). Overall, the cervical presence of HPV DNA was ascertained in 86 of these 236 women (36.4%), while squamous intraepithelial lesions (SIL) were diagnosed in 57 (24.1%). HPV-infected and non-infected women did not differ in age, education and cigarette smoking. A statistically significant trend in the risk of HPV infection with increasing number of lifetime sexual partners was noted (P = 0.01), but such trend was attenuated in multivariate analysis (multiple logistic regression (MLR) odds ratio (OR) for > or = 20 partners vs 1 = 1.6, 95% confidence intervals (CI): 0.4-5.9). A nearly threefold higher risk of HPV cervical infection emerged among IVDU women (MLR-OR: 2.7, 95% CI: 1.4-5.0), and this difference was not influenced by HIV serostatus. The prevalence of HIV infection was higher among HPV-positive than HPV-negative women (62.8% and 54.0%, respectively) (MLR-OR = 1.9, 95% CI: 0.9-3.8), and the proportion of women with less than 200 CD4+ cells/mm3 was slightly and not significantly higher among HPV-positive (47.1%) than negative women (37.2%).

DNA, Viral↗
PubMed1998

Frequency and determinants of use of antiretroviral and prophylactic therapies against Pneumocystis carinii Pneumonia (PCP) before AIDS diagnosis in Italy.

To determine the frequency and the determinants of use of antiretroviral drugs and prophylaxis for Pneumocystis carinii Pneumonia (PCP) among HIV-infected individuals before AIDS diagnosis, a questionnaire was sent to all physicians reporting at least one AIDS case during the first six months of 1994 to the Italian National AIDS Registry. Information on cases diagnosed between 1 January and 31 March 1995 was collected. Information was obtained for 878 (66.4%) of the 1323 persons with AIDS: 447 (50.9%) had received antiretroviral drugs and 343 (39.1%) PCP prophylaxis, whereas 303 cases (34.5%) had received both. Individuals who became aware of being HIV-positive shortly before AIDS diagnosis were less likely to have started antiretroviral therapy (adjusted odds ratio (AOR): 0.05, 95% CI: 0.03-0.09). Homosexual men and heterosexuals were more likely to begin therapy (AOR: 1.40, 95% CI: 0.83-2.37 and AOR: 1.79, 95% CI: 1.05-3.05, respectively) compared to injecting drug users. Individuals living in Southern Italy and foreigners were less likely to start therapy (AOR: 0.75, 95% CI: 0.49-1.16 and AOR: 0.40, 95% CI: 0.15-1.09, respectively) compared to those living in Northern Italy. Results were similar for PCP prophylaxis. Lack of awareness of HIV infection, HIV exposure category, and geographical area were the most important factors associated with treatment before AIDS diagnosis.

Adolescent↗
PubMed1998

Physical activity and bone mineral density in Italian middle-aged women.

Osteoporosis is a major health issue in post-menopausal women on account of the association between low bone mineral density and fractures. A role of physical activity in the prevention and treatment of low bone mineral density is possible but still unclear. The relationship between low spine bone mineral density measured by means of dual photon absorptiometry at lumbar spines, and levels of past and recent physical activity has been assessed by means of a population-based screening study carried out on 1373 women (age 40-64 years) in the North-East of Italy. Physical activity at work and in leisure time was investigated for three specific periods of life: at age 12, between 15 and 19 years (during bone formative years), and in the recent years prior to the interview (30-39 or 50-59 years). Data were analysed comparing low versus high bone mineral density tertile (i.e., 458 and 461 women, respectively), after controlling for other known contributory factors in the development of osteoporosis. A positive association emerged with leisure time physical activity, with significant trends at age 15-19 (odds ratio (OR) for low versus high tertile of leisure time activity: 1.4, 95% confidence interval (CI): 0.8-2.4) and at most recent age (OR: 1.7, 95% CI: 1.1-2.6). Risk trends with occupational physical activity were less clear and non-statistically significant. The present Southern European cross-sectional study lends further support to the possibility that past and recent physical activity helps increasing bone mineral density in middle-aged women. Although the most beneficial type and intensity level of exercise has yet to be determined, the present results provide further evidence that participation in even moderate exercise programs should be encouraged.

Absorptiometry, Photon↗
PubMed1998

Cigarette smoking and risk of cancers of the colon and rectum: a case-control study from Italy.

The relationship between smoking habit and risk of colon and rectal cancers was considered in a case-control study conducted between 1991 and 1996 in six Italian centers. Cases were 1225 patients below age 75 with histologically confirmed cancer of the colon and 728 with cancer of the rectum. Controls were 4154 patients admitted to hospital for a wide spectrum of acute, non-neoplastic diseases. Compared to neversmokers, the odds ratios (OR) for current smokers of 25 or more cigarettes/day was 0.90 for patients with colon and 0.86 for those with rectal cancer and those for ex-smokers were 1.02 and 1.09 for colon and rectal cancer, respectively. No increase in risk was found with duration of the habit, the OR for 40 or more years being 0.79 for colon and 0.87 for rectal cancer. Furthermore, no relationship was apparent with time since starting (the OR for 40 or more years were 0.94 for colon and 1.05 for rectal cancer), or age at starting (the OR for < 18 years were 1.02 for colon and 1.01 for rectal cancer), or for pack-years smoked (the OR for 40 or more pack-years were 0.93 for colon and 0.91 for rectal cancer) or time since stopping among ex-smokers. No increase in risk was found in smokers of > or = 15 cigarettes/day for 40 years or longer (OR: 0.93). No significant heterogeneity was found across strata of age at diagnosis, sex, education, physical activity at work, intake of alcohol, coffee, vegetables, total energy, and number of meals/day. Likewise, no significant association was apparent for various intestinal subsites. Thus, this study did not find cigarette smokers at higher risk for cancer of the bowel even after a long duration and a long period since starting.

Adult↗
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

Determinants of risk of invasive cervical cancer in young women.

We analysed determinants of risk of cervical cancer in women aged less than 45 years using data from a case-control study conducted in Italy. Cases were 261 women aged < 45 years with histologically confirmed invasive cervical cancer. Controls were 257 women aged < 45 years, with acute, non-neoplastic conditions, judged to be unrelated to any of the known or suspected risk factors for cervical cancer. In comparison with women reporting one or no sexual partner, the multivariate odds ratio (OR) of cervical cancer was 2.4 (95% confidence interval, CI, 1.3-4.6), for women reporting two or more sexual partners, and, in comparison with women reporting their first intercourse at 17 years of age or before, the multivariate OR was 0.5 (95% CI 0.3-0.9) in women aged > or =23 years at first intercourse. The risk of cervical cancer was higher in parous women and increased with number of births (OR = 8.1 for three or more births). Among parous women the risk tended to increase with later age at last birth; in comparison with parous women reporting their last birth before age 25, the OR was 1.9 in those reporting their last birth at > or =35 years. No clear association emerged between oral contraceptive use, smoking, education, social class and risk of cervical cancer.

Acute Disease↗
PubMed1998

Schistosomiasis and the risk of bladder cancer in Alexandria, Egypt.

The relationship between history of schistosomiasis and bladder cancer risk was investigated using data from a case-control study conducted between January 1994 and July 1996 in Alexandria, Egypt. Cases were 190 subjects with incident, histologically confirmed invasive cancer of the bladder, and controls were 187 subjects admitted to hospital for acute, non-neoplastic, non-urinary tract conditions. Eighty-six cases (45%) vs 69 controls (37%) reported a history of urinary schistosomiasis. The corresponding multivariate odds ratio (OR) of bladder cancer -- after allowance for age, sex, education, smoking, other urinary infections and high-risk occupations -- was 1.72 (95% confidence interval (CI) 1.0-2.9). The ORs were 0.22 (95% CI 0.1-0.4) for intestinal schistosomiasis and 0.32 (95% CI 0.1-1.9) for schistosomiasis of other types. The OR for urinary schistosomiasis was higher in subjects who were younger at first diagnosis (OR of 3.3 for <15 years) and in those with a long time since first diagnosis (OR of 3.0 for > or = 35 years). The ORs were 15.8 for male ever-smokers with a history of urinary schistosomiasis, compared with never-smokers without such a history, and 3.2 for men ever-infected with urinary Schistosoma haematobium and ever-employed in high-risk occupations, compared with those never-infected and with no high-risk occupational history. This study confirms that clinical history of urinary schistosomiasis is significantly, but modestly, associated with increased bladder cancer risk, explaining some 16% of bladder cancer cases in this Egyptian population.

Adult↗
PubMed1998

Family history of cancer and risk of colorectal cancer in Italy.

Subjects with a family history of colorectal cancer (CRC) are at increased risk of CRC, but quantification of the risk in different populations, the possible differences in risk according to localization of the cancer and the association of family history of other cancers with CRC risk are still open issues. We have therefore analysed data from a multicentric case-control study conducted in six Italian areas between 1992 and 1996 of 1225 incident cases of colon cancer, 728 cases of rectal cancer and 4154 controls admitted for acute conditions to the same network of hospitals as the cases. Unconditional logistic regression models including terms for gender, age, study centre, years of education and number of siblings were used to estimate the odds ratios (ORs) of CRC according to various aspects of history of CRC and other cancers in first-degree relatives. The OR for family history of CRC was 3.2 (95% confidence interval, CI, 2.5-4.1) for colon cancer and 2.2 (95% CI 1.6-3.1) for rectal cancer. Colon cancer was significantly associated with a family history of stomach (OR 1.4), bone (OR 2.1) and kidney (OR 2.3) cancers, while rectal cancer was significantly associated with a family history of lymphomas (OR 2.8). There was a 30% higher risk of colon and rectal cancer in subjects with a family history of any cancer, excluding intestine. The ORs for family history of CRC were 5.2 for colon and 6.3 for rectum when the proband's age was below 45 years. The ORs were similar when the affected relative was a parent or a sibling and in different strata of age of relative(s). For subjects with two or more first-degree relatives with CRC, the risk was 6.9 for the right colon, 5.8 for the transverse and descending colon, 3.8 for the sigma, 3.2 for the rectosigmoid junction and 1.9 for the rectum. This study confirms that a family history of CRC in first-degree relatives increases the risk of both colon and rectal cancer, the association being stronger at younger ages and for right colon.

Adult↗
PubMed1998

Hepatitis C virus, non-Hodgkin's lymphomas and hepatocellular carcinoma.

In a case-control study in northeastern Italy hepatitis C virus infection seemed to increase by about 50-fold the risk of non-Hodgkin's lymphoma involving the liver and major salivary glands (i.e. larger than that for hepatocellular carcinoma) and by about fourfold the risk of lymphomas at other sites.

Adult↗
PubMed1998

Risk of cancer other than Kaposi's sarcoma and non-Hodgkin's lymphoma in persons with AIDS in Italy. Cancer and AIDS Registry Linkage Study.

Record linkage was carried out between the national Registry of AIDS and 13 Cancer Registries (CRs) covering, in 1991, about 15% of the Italian population. Observed and expected numbers of cancers and standardized incidence ratios (SIRs) were assessed in 6067 persons with AIDS, for a total of 25,759 person-years. Significantly increased SIRs were found for Hodgkin's disease [8.9, 95% confidence interval (CI) 4.4-16.0], in which seven of 11 cases were of mixed cellularity type; invasive carcinoma of the cervix uteri (15.5; 95% CI 4.0-40.1); and non-melanomatous skin cancer (3.0, 95% CI 1.3-5.9), in which five of eight cases were basal cell carcinoma. An excess was also seen for brain tumours, but this may be partly due to misdiagnosis of brain non-Hodgkin's lymphoma or other brain diseases occurring near the time of the AIDS diagnosis. The risk for all cancer types, after exclusion of Kaposi's sarcoma (KS) and non-Hodgkin's lymphoma (NHL), was approximately twice the general population risk. An increased SIR for Hodgkin's disease in persons with AIDS is thus confirmed, though it is many times smaller than that for NHL. An association with invasive carcinoma of the cervix is also shown at a population level. The excess of non-melanomatous skin cancer seems to be lower than in transplant recipients.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Iodine intake and thyroid carcinoma--a potential risk factor.

The role of enhanced thyroid-stimulating hormone (TSH) secretion, in the aetiology of thyroid cancer is not totally consistent. Circumstances and conditions which cause (e.g., iodine deficiency, through suboptimal intake in water and food) or indicate (e.g., goitre) increased TSH secretion have been associated to increased risk of thyroid cancer, most notably follicular and anaplastic carcinomas. Elevated incidence and mortality rates of thyroid cancer, however, are also found in areas were iodine intake is high (Hawaii, Iceland). At least in some countries (Switzerland), a favourable impact of the introduction of iodized salt on mortality from thyroid cancer has been reported. Elsewhere, the correction of iodine deficiency has coincided with elevations of diagnostic standards (e.g., spread of thyroid scintigraphy, ultrasound, and fine-needle biopsy) and corresponding increases in incidence of papillary carcinomas, often clinically silent, thus hampering a distinction of the two phenomena. Upward trends of papillary carcinoma incidence have, however, been seen in most affluent countries, irrespective of the iodine status of the population.

Female↗
PubMed1998

Meal frequency and coffee intake in colon cancer.

Several studies suggested that frequent eating may increase colon cancer risk. To further clarify this issue, a case-control study was carried out in six areas of Italy on 1,225 incident cases < 75 years of age with histologically confirmed colon cancer and 4,154 control subjects. The controls were hospitalized for acute, nonneoplastic conditions unrelated to long-term dietary modifications. After allowance for education, physical activity, intake of vegetables, and major energy sources, there was a trend of increasing risk with increasing eating frequency (odds ratio for > or = 4 vs. < or = 2 daily meals = 1.24). Coffee intake, which was inversely associated with cancer risk, exerted a modification effect, with an odds ratio of 1.89 for frequent eaters who drank fewer than two cups of coffee per day. Frequent eating increases, whereas high coffee intake decreases, the excretion of bile acids, which are suspected to be carcinogenic to the colon. Thus, it is conceivable that frequent coffee intake may counterbalance the effect of frequent eating.

Adult↗
PubMed1998

Alcohol intake and risk of cancers of the colon and rectum.

The relationship between alcohol drinking (mainly wine) and risk of colon and rectal cancer was considered in a case-control study conducted between 1991 and 1996 in six Italian centers. Cases were 1,225 patients < 75 years of age with histologically confirmed cancer of the colon and 728 patients with cancer of the rectum; controls were 4,154 patients admitted to hospital for a wide spectrum of acute, nonneoplastic diseases. Compared with never drinkers, the odds ratios (OR) for current drinkers in the higher quintile of total alcohol intake (> 51.82 g ethanol/day) were 1.01 for colon cancer and 0.90 for rectal cancer, and those for ex-drinkers were 1.20 and 1.07, respectively. The OR for wine drinkers in the highest quartile of intake were 1.07 for colon cancer and 0.97 for rectal cancer. No association was found with duration of the habit, time since starting, or age at starting. Among ex-drinkers, no association appeared with time since stopping. No significant heterogeneity was found across strata of age at diagnosis, sex, education, smoking status, physical activity, family history of colorectal cancer, beta-carotene, vitamin C, coffee, total fiber and folate intake, and number of meals per day. No significant association appeared for various intestinal subsites.

Adult↗
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

Italian study on colorectal cancer with emphasis on influence of cereals.

To elucidate the influence of diet on colorectal carcinogenesis, 1225 subjects with cancer of the colon, 728 with cancer of the rectum and 4154 controls, hospitalized with acute non-neoplastic diseases, were interviewed between 1992 and 1996 in six Italian areas. The validated food frequency questionnaire included 79 questions on food items and recipes which were grouped into 16 food groups. After allowing for nondietary confounding factors and total energy intake, a significant trend towards an increasing risk of colorectal cancer with increasing intake was found for bread and cereal dishes (odds ratio for increase of one daily serving 1.11), cakes and desserts (odds ratio 1.02) and refined sugar (odds ratio 1.11). The intake of fish (odds ratio 0.53), raw and cooked vegetables (odds ratios 0.79 and 0.65, respectively) and fruit (odds ratio 0.93) showed an inverse association with risk. Wholemeal bread was consumed by only 12.5% of cases and 13.9% of controls and, at variance with refined bread, did not show a significant direct association with colorectal cancer risk (odds ratio 0.88). In view of these findings, current hypotheses on the carcinogenic effects of refined starchy foods and refined sugar should be revised to take into account the digestive physiology of carbohydrates and the possible relationship between insulin and colon cancer. The beneficial influence of most vegetables is confirmed, and a possible difference between refined and wholemeal bread is suggested.

Adult↗
PubMed1998

Liver cirrhosis and the risk of primary liver cancer.

The relationship between liver cirrhosis and hepatocellular carcinoma is recognized, but quantification of risk is still uncertain. Therefore, we analysed data from a case-control study conducted in Italy between 1984 and 1997 on 499 cases of incident, histologically confirmed hepatocellular carcinoma and 1,552 controls in hospital with acute, non-neoplastic disease. Overall, 87 (17.4%) cases vs 10 (0.6%) controls reported clinical history of liver cirrhosis. The corresponding odds ratio (OR) was 27.5 (95% confidence interval (CI), 14.3-15.2) after allowance for sociodemographic factors, and 16.2 (95% CI, 7.9-32.9) after simultaneous allowance for all identified confounding factors, including alcohol consumption and clinical history of hepatitis. The association was of similar magnitude for subjects whose cirrhosis was diagnosed < 55 years (OR = 14.8) or at age 55 or over (OR = 20.0), and the multivariate OR was 33.7 < 5 years after diagnosis of cirrhosis, 37.3 between 5 and 9 years, and 7.6 (95% to 2.7-21.3) > or = 10 years since diagnosis of cirrhosis. The association was stronger in males (OR = 23.4) than in females (OR = 5.9), similar in various age groups, and somewhat stronger in more educated subjects (OR = 53.7), with history of hepatitis (OR = 33.1), reporting heavy alcohol consumption (OR = 24.9) or high body mass index (OR = 58.1), although the interaction term was significant only for sex. In terms of population attributable risk, 17% of hepatocellular carcinomas in this population can be attributed to clinical history of liver cirrhosis.

Adult↗