Search PubMed⌕ Search

Biomedical subjects

S Franceschi

Publications and source records attributed to S Franceschi.

At least 271 records · Page 15Linked to original sources
PubMed1998

Colorectal cancer and hormone replacement therapy: an unexpected finding.

Over the last two decades, mortality rates for colorectal cancer in many developed countries have declined in women but not in men. A role of exogenous female hormones (i.e. oral contraceptives and hormone replacement therapy (HRT) in such different trends is possible. Seven cohort studies reported information on HRT use and colorectal cancer risk, for a total of over 2,400 cases. Most studies showed relative risks (RRs) around or below unity. A significant inverse association was found in two cohort investigations, including the largest one dealing with fatal colon cancer. Of 12 case-control studies, for a total of over 5,000 cases, five reported 20-40% significant risk reductions among ever-users of HRT. Two additional investigations showed moderate, non-significant inverse associations. Studies showing an inverse association between HRT use and colorectal cancer were among the largest and best controlled ones. The apparent protection tended to be stronger among recent users. Differences in RRs by duration of HRT use and anatomic subsite were not consistent, but the protective effect seemed stronger in most recent publications. Available studies support the possibility of an inverse association between colorectal cancer and HRT, but prevention and surveillance bias cannot be ruled out.

Adult↗
PubMed1998

Diet, alcohol, coffee and pancreatic cancer: final results from an Italian study.

The relation between selected indicator foods, alcohol and coffee intake, and the risk of pancreatic cancer was evaluated in a case-control study conducted between 1983 and 1992 in northern Italy on 362 patients with histologically confirmed, incident cancers of the pancreas, and 1,552 controls in hospital for acute, non-neoplastic diseases. Odds ratios (ORs) for subsequent tertiles of intake were computed after allowance for sociodemographic factors and tobacco smoking. Pancreatic cancer risk was directly associated with consumption of meat (OR for the highest frequency tertile = 1.43), liver (OR = 1.43) and ham and sausages (OR = 1.64), and inversely with consumption of fresh fruit (OR = 0.59), fish (OR = 0.65) and olive oil (OR = 0.58). No appreciable association was found with coffee (OR = 1.21) and alcohol consumption (OR = 1.20). A summary score was derived by summing the six related food items; compared to the lowest level, the OR was 2.7 for the highest quintile, and the population attributable risk was 36% (95% confidence interval, 15-57%), indicating the scope of diet for the prevention of this common neoplasm in the Italian population.

Adult↗
PubMed1998

Monounsaturated and other types of fat, and the risk of breast cancer.

We considered the role of monounsaturated and other types of fats on breast carcinogenesis, using data from a case-control study of 2,569 incident, histologically confirmed cases of breast cancer and 2,588 controls from six Italian areas. The multivariate odds ratios, adjusted for age, education, parity, menopausal status plus various sources of energy and types of fats, were 1.10 (95% confidence interval 0.99-1.23) for an increase of 10 g/day of saturated fat intake, 0.99 (0.94-1.04) for an increase of 10 g/day of monounsaturated fats, and 0.91 (0.87-0.96) for an increase of 5 g/day of polyunsaturated fats. The present data confirm that saturated, but not mono- or polyunsaturated fats, are directly, though moderately, related to breast cancer risk.

Adult↗
PubMed1998

Coffee consumption and the risk of breast cancer.

On the basis of clinical observations that some women with fibrocystic breast disease experienced resolution of the disease on eliminating methylxanthines from their diet, it has been suggested that coffee intake might be related to breast carcinogenesis. The relationship between coffee (mostly expresso and mocha), decaffeinated coffee and tea intake and breast cancer risk was therefore considered, combining data from two case-control studies, conducted in Italy between 1983 and 1994. Cases were 5,984 women, below age 75, with histologically confirmed breast cancer, and controls were 5,504 women admitted to hospital for a wide spectrum of acute, non-neoplastic, non-hormone-related diseases. The odds ratios (ORs) were estimated from multiple logistic regression equations including terms for study/centre, age, education, body mass index, smoking status, total alcohol intake, age at menarche and menopause, parity and age at first birth, use of oral contraceptives, use of hormone replacement therapy, history of benign breast disease and family history of breast cancer. No relationship was observed between coffee intake and the risk of breast cancer. The multivariate ORs were 1.17 (1.03-1.33), 1.17 (1.04-1.33), 1.21 (1.06-1.37) and 0.96 (0.83-1.11) for women drinking < 2, 2, > 2 to < 4 and > or = 4 cups/day compared to non-drinkers. Decaffeinated coffee was consumed only by 6-7% of cases and controls and the corresponding OR was 0.84 (0.72-0.98). Tea consumption was also low and not associated with the risk of breast cancer (OR 0.94, 95% CI 0.85-1.03). No significant heterogeneity was found for coffee intake across strata of age at diagnosis, education, body mass index, smoking status, total alcohol intake, age at menarche and menopause, parity, age at first birth, ever use of oral contraceptives, hormone replacement therapy, history of benign breast disease and family history of breast cancer. Thus, this study, based on a large data set, allows us to exclude the hypothesis that coffee intake is related to breast cancer risk in this Italian population.

Adult↗
PubMed1998

Hormone replacement therapy and risk of colon and rectal cancer.

The hypothesis that sex hormones may influence colorectal cancer risk was formulated in the early 1980s, but epidemiological studies on a relationship between colorectal cancer risk and hormone replacement therapy (HRT) have only accumulated over the last few years. To investigate the relationship between HRT and colon and rectal cancer and the role of other covariates that might modify it, we analyzed combined data from two case-control studies conducted in Italy between 1985 and 1996, including 994 women with incident colon cancer, 542 with rectal cancer, and 3110 controls with acute, non-neoplastic, nondigestive, non-hormone-related disorders. Odds ratios (ORs) and 95% confidence intervals (CIs) were derived from unconditional multiple logistic regression equations including terms for age, center/study period, education, family history of colorectal cancer, status and age at menopause, parity, use of oral contraceptives, total energy intake, and body mass index. Ever use of HRT was inversely associated with cancer of the colon (OR = 0.64, 95% CI = 0.46-0.88) and of the rectum (OR = 0.46, 95% CI = 0.29-0.72). Increasing duration of use of HRT was related to decreasing risk for colon and rectal cancers (P for trend < 0.01). No interaction emerged, and the inverse association persisted across separate strata of other risk factors. This study, one of the largest case-control investigations on exogenous female hormones and colorectal cancer thus far, provides further evidence that women who have ever used HRT are at lower risk of colon and rectal cancer. Because colorectal cancer is the second most common neoplasm and cause of death among nonsmoking women in developed countries, these results may have a major public health impact.

Aged↗
PubMed1998

Oral contraceptive use and risk of colorectal cancer.

To evaluate the relation between oral contraceptives and colon and rectal cancer, we analyzed combined data from two case-control studies conducted in six Italian regions between 1985 and 1996. The studies included 803 women with incident colon cancer, 429 with rectal cancer, and 2,793 controls with acute, nonneoplastic, nondigestive, non-hormone-related disorders. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) from unconditional multiple logistic regression equations, including terms for age, center/study period, education, family history of colorectal cancer, menopausal status, age at menopause, parity, use of hormone replacement therapy, body mass index [weight (kg) per height squared (m2)], and total energy intake. Ever-use of oral contraceptives was inversely associated with colon cancer (OR = 0.63; 95% CI = 0.45-0.87) and rectal cancer (OR = 0.66; 95% CI = 0.43-1.01). Duration of use of oral contraceptives was inversely related to risk of colon but not rectal cancer. This study suggests that women who have ever used oral contraceptives are at lower risk of colon and rectal cancer.

Adult↗
PubMed1998

Role of different types of vegetables and fruit in the prevention of cancer of the colon, rectum, and breast.

We compared the effect of 26 types or groups of vegetables and fruit on the risk of cancer using data from two case-control studies that included 1,225 cases of cancer of the colon, 728 cases of cancer of the rectum, 2,569 cases of cancer of the breast, and 5,155 hospital controls interviewed between 1991 and 1996 in six Italian areas. Most vegetables were inversely associated with cancer of the colon and rectum, whereas only carrots and raw vegetables lowered breast cancer risk. High fruit intake was associated only with a reduction of rectal cancer. Different contents of sugar, fiber, carotenoids, and folic acid in fruits vs vegetables plus the concurrent consumption of oil with vegetables may partly explain these findings.

Breast Neoplasms↗
PubMed1998

Fiber intake and risk of colorectal cancer.

The relationship between various types of fiber and colorectal cancer risk was investigated using data from a case-control study conducted between January 1992 and June 1996 in Italy. The study included 1953 cases of incident, histologically confirmed colorectal cancers (1225 colon cancers and 728 rectal cancers) admitted to the major teaching and general hospitals in the study areas and 4154 controls with no history of cancer admitted to hospitals in the same catchment areas for acute nonneoplastic diseases. Dietary habits were investigated using a validated food frequency questionnaire. Odds ratios (ORs) were computed after allowance for age, sex, and other potential confounding factors, including physical activity and protein, fat, and carbohydrate intake. Fiber was analyzed both as a continuous variable and in quintiles. For most types of fiber, the OR of colon and rectal cancers was significantly below 1, and no appreciable differences emerged between the two. When the unit was set at the difference between the upper cutpoints of the fourth and first quintile, i.e., the 80th and 20th percentiles, the ORs for colorectal cancer were 0.68 for total fiber (determined by the Englyst method as nonstarch polysaccharides), 0.67 for soluble noncellulose polysaccharides (NCPs), 0.71 for total insoluble fiber, 0.67 for cellulose, 0.82 for insoluble NCPs, and 0.88 for lignin. When fiber was classified according to the source, the OR was 0.75 for vegetable fiber, 0.85 for fruit fiber, and 1.09 for cereal fiber. The ORs were similar for the two sexes and the strata of age, education, physical activity, family history of colorectal cancer, and energy intake. Likewise, no appreciable differences emerged when subsites of the colon and rectum were investigated separately. This study provides additional support for a protective and independent effect of fiber on colorectal cancer, particularly for cellulose and soluble NCPs, and of fiber of vegetable or fruit origin.

Adult↗
PubMed1997

Intake of selected micronutrients and risk of colorectal cancer.

The relationship between various micronutrients and colorectal cancer risk was investigated using data from a case-control study conducted between January 1992 and June 1996 in Italy. Cases were 1,953 incident, histologically confirmed colorectal cancers (1,225 of the colon and 728 of the rectum), admitted to the major teaching and general hospitals in the study areas, and 4,154 controls with no history of cancer, admitted to hospitals in the same catchment areas for acute, non-neoplastic diseases unrelated to the digestive tract and requiring no long-term modifications of the diet. Dietary habits were investigated using a validated food-frequency questionnaire. Odds ratio (ORs) were computed after allowance for age, sex and other potential confounding factors, including physical activity, total energy and fibre intake. For most micronutrients, ORs were below unity with increasing quintile of intake. The most consistent protective effects were for carotene, riboflavin and vitamin C (Multivariate ORs from the continuous model, with unit set as the difference between the upper cut-point of the 4th quintile and that of the 1st one, were 0.65, 0.73 and 0.80, respectively). Inverse relationships were observed also for calcium and vitamin D (ORs of 0.85 and 0.93, respectively). When the combined effect of calcium and vitamin D and selected anti-oxidants was considered, the OR reached 0.46 in subjects reporting high calcium/vitamin D and high anti-oxidant intake compared to those reporting low intake of both groups of micronutrients. Most results were apparently stronger for colon cancer and among females. Our results provide further support for a protective effect of several micronutrients on colorectal cancer risk and some indications for a specific and stronger effect of selected anti-oxidants.

Adult↗
PubMed1997

Coffee and tea intake and risk of cancers of the colon and rectum: a study of 3,530 cases and 7,057 controls.

The relationship between coffee, decaffeinated coffee and tea intake and risk of cancers of the colon and rectum was considered combining data from 2 case-control studies, one conducted between 1985 and 1991 in Northern Italy and the other between 1991 and 1996 in 6 Italian centers. Cases were patients below age 80, with histologically confirmed cancer of the colon (n = 2,166) or rectum (n = 1,364), and controls were 7,057 patients admitted to hospital for a wide spectrum of acute, non-neoplastic, non-digestive tract diseases. Compared with coffee non-drinkers, the risk of colon cancer was reduced in drinkers of 4 or more cups/day [multivariate odds ratios (ORs) 0.73; 95% confidence intervals 0.60-0.89), with a significant trend in risk with dose; no significant association emerged between coffee drinking and risk of rectal cancer (OR 1.00 for drinkers of 4 or more cups/day). Decaffeinated coffee was consumed in small amounts by about 4% of cases and controls and the OR was 0.92 for colon and 0.88 for rectal cancers. Tea consumption was generally limited to 1 cup/day or to occasional intake and did not substantially modify the risk of colon and rectal cancers. No significant heterogeneity was found for the inverse relationship between coffee intake and colon cancer risk across strata of age at diagnosis, sex, smoking status, total alcohol and meat and vegetable intake, while the protection of coffee was stronger in people eating 3 or more meals/day. Thus, our results confirm that coffee intake has a quantifiable protective effect on colon cancer risk.

Adult↗
PubMed1997

Diabetes mellitus and the risk of primary liver cancer.

The relationship between diabetes mellitus and primary liver cancer was investigated in a case-control study conducted in Italy between 1984 and 1996 on 428 cases with incident, histologically confirmed hepatocellular carcinoma, 59 with gallbladder and bile duct cancer, and 1,502 control subjects in the hospital for acute non-neoplastic diseases. Sixty-four cases of hepatocellular carcinoma vs. 87 controls reported a history of diabetes, corresponding to an odds ratio (OR) of 2.3 after allowance for age, sex and area of residence, and of 2.1 [95% confidence interval (CI) = 1.4-3.2] after further allowance for alcohol and tobacco consumption, history of hepatitis and liver cirrhosis, body mass index and history of liver cancer in first-degree relatives. The ORs were similar both for subjects diagnosed with diabetes below age 45, who most likely had insulin-dependent diabetes, and for those diagnosed later, who were likelier to have non-insulin-dependent diabetes. The OR was 2.3 for subjects whose diabetes was diagnosed <5 years before diagnosis of liver cancer, 1.9 for those diagnosed 5-9 years in advance and 2.2 for those diagnosed since 10 years or more. Five cases of gallbladder and bile duct cancer reported a history of diabetes: the corresponding OR was 1.2 (95% CI 0.5-2.9). The OR of hepatocellular carcinoma was 2.4 for males and 2.0 for females, 3.0 for subjects diagnosed with liver cancer under age 60 and 1.8 for those diagnosed at age 60 or over. None of the other covariates considered, including education, history of hepatitis, liver cirrhosis and alcohol drinking showed any meaningful modifying effect or interaction. The potential pathogenic mechanisms include liver alteration-and consequent cell proliferation-in subjects with diabetes. Thus a history of diabetes mellitus could explain about 8% (95% CI 5-11) of cases of liver cancer in this population.

Adult↗
PubMed1997

Epidemiology of bladder cancer in Alexandria, Egypt: tobacco smoking.

The relationship between smoking 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 151 males with incident, histologically confirmed invasive cancer of the bladder, and controls were 157 males admitted to hospital for acute, non-neoplastic, non-urinary tract, non-smoking-related conditions. With reference to never smokers, ex-smokers had a multivariate odds ratio (OR) of 4.4 [95% confidence interval (CI) 1.7-11.7] and current smokers of 6.6 (95% CI 3.1-13.9). The ORs were 5.4 for < 20 and 7.6 for > or = 20 cigarettes per day. After adjustment for cigarette smoking, the ORs were 0.8 for waterpipe and 0.4 for hashish smokers. The risk was significantly related to duration of smoking (OR of 16.5 for > 40 years), and inversely related to age at starting (OR of 8.8 for starting < 20 years), and inversely related to time since quitting smoking. Compared with never smokers who did not report a clinical history of schistosomiasis, the OR was 9.4 for smokers with a history of schistosomiasis, and 10.7 for smokers ever employed in high-risk occupations compared with non-smokers not reporting such a history. Thus, our results, while not giving indications of an increased bladder cancer risk with habits other than cigarette smoking, found a remarkably strong association with various measures of cigarette smoking that could explain 75% of bladder cancer cases among males from Alexandria. The prevalence of smoking was very low among women, and consequently tobacco was not a relevant risk factor for female bladder cancer.

Adult↗
PubMed1997

Family history of cancer and risk of breast cancer.

The relationship between breast cancer risk and family history of cancer in first-degree relatives was investigated using data from a multicentric case-control study conducted in Italy between June 1991 and April 1994 on 2,569 women aged less than 75 years, with histologically confirmed incident breast cancer, and 2,588 control women admitted to hospital for acute, non-neoplastic, non-gynaecological conditions. Relative to women with no history, those with a family history of breast cancer had an odds ratio (OR) of 2.4 [95% confidence interval (CI) 1.9-3.0], and those with family history of intestinal cancer had an OR of 1.3 (95% CI 1.0-1.7). No significant relations emerged between breast cancer risk and family history of prostate (OR 1.1), ovarian (OR 1.3), cervical or endometrial (OR 1.2) or other cancers, except gallbladder (OR 8.6). The OR for family history of any type of cancer except breast cancer was 1.1. For family history of breast cancer the ORs were similar across strata of age of the proband, being 2.4 below age 45, 2.2 at age 45-59 and 2.7 above age 60, and whether the relative affected was the mother, sister(s) or both, while the risk appeared higher if the age at onset of breast cancer in the relative was lower than 40 years (OR 3.5), rather than higher (OR 2.2). Thus, our results, based on the investigation of all neoplasms in first-degree relatives, confirm that breast cancer risk is increased in women with a family history of breast cancer, while there was no material association with family history of cancer in general, excluding breast cancer.

Adult↗
PubMed1997

Case-control study of oestrogen replacement therapy and risk of cervical cancer.

OBJECTIVE: To examine the relation between use of oestrogen replacement therapy and risk of cervical cancer. DESIGN: Case-control study. SETTING: Northern Italy. SUBJECTS: 645 women aged 40-75 years with cervical cancer admitted between 1981 and 1993 to university and general hospitals. The control group consisted of 749 women aged 40-75 years admitted to the same hospitals with acute conditions judged to be unrelated to any of the known or suspected risk factors for cervical cancer. MAIN OUTCOME MEASURES: Use of oestrogen replacement therapy and risk of cervical cancer. RESULTS: 40 cases versus 86 controls had ever used oestrogens, and the corresponding multivariate odds ratio was 0.5 (95% confidence interval 0.3 to 0.8). The odds ratios of cervical cancer decreased with duration of use, being 0.6 (0.4 to 1.1) for less than 12 months' use and 0.5 (0.2 to 1.0) for use for 12 months or more compared with never users. The protection tended to be somewhat stronger for women reporting first oestrogen use before age 50. The odds ratio was 0.9 (0.5 to 1.7) for women who had taken oestrogens within the past 10 years and 0.4 (0.2 to 0.7) for those who had taken them 10 or more years ago. CONCLUSION: These findings suggest that exogenous oestrogens do not increase the risk of cervical cancer and may decrease the risk.

Adenocarcinoma↗
PubMed1997

Food groups and risk of colorectal cancer in Italy.

The proportion of colorectal cancer attributed to dietary habits is high, but several inconsistencies remain, especially with respect to the influence of some food groups. To further elucidate the role of dietary habits, 1,225 subjects with cancer of the colon, 728 with cancer of the rectum and 4,154 controls, hospitalized with acute non-neoplastic diseases, were interviewed between 1992 and 1996 in 6 different Italian areas. The validated food-frequency questionnaire included 79 questions on food items and recipes, categorised into 16 food groups. After allowance for non-dietary confounding factors and total energy intake, significant trends of increasing risk of colorectal cancer with increasing intake emerged for bread and cereal dishes (odds ratio [OR] in highest vs. lowest quintile = 1.7), potatoes (OR = 1.2), cakes and desserts (OR = 1.1), and refined sugar (OR = 1.4). Intakes of fish (OR = 0.7), raw and cooked vegetables (OR = 0.6 for both) and fruit other than citrus fruit (OR = 0.7) showed a negative association with risk. Consumption of eggs and meat (white, red or processed meats) seemed uninfluential. Most findings were similar for colon and rectum, but some negative associations (i.e., coffee and tea, and fish) appeared stronger for colon cancer. Our findings lead us to reconsider the role of starchy foods and refined sugar in light of recent knowledge on the digestive physiology of carbohydrates and the insulin/colon cancer hypothesis. The beneficial role of most vegetables is confirmed, with more than 20% reduction in risk of colorectal cancer from the addition of one daily serving.

Adult↗
PubMed1997

Loss and/or formation of antioxidants during food processing and storage.

It is well known that natural antioxidants contained in foods are significantly lost during processing. Nevertheless it was recently demonstrated that thermal treatments can induce the formation of compounds with new antioxidant properties. This is the case of the Maillard reaction products (MRPs) whose presence as well as their potential effects have been scarcely investigated. In the present work the loss of natural antioxidants in relation to processing and the formation of MRPs with antioxidant activity were studied in different food systems such as tomato derivatives and coffee. Results showed that, although the concentration of natural antioxidants was significantly reduced as a consequence of the thermal treatments, the overall antioxidant properties of the food products were maintained or even enhanced by the development of MRPs.

Antioxidants↗
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↗