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Biomedical subjects

S Franceschi

Publications and source records attributed to S Franceschi.

At least 289 records · Page 16Linked to original sources
PubMed1997

Attributable risks for breast cancer in Italy: education, family history and reproductive and hormonal factors.

The percent population attributable risk (AR) for breast cancer was estimated in relation to education, family history of the disease and some reproductive and hormonal factors, using data from a case-control study conducted between June 1991 and February 1994 in 6 Italian centres on 2,569 histologically confirmed incident breast cancer cases and 2,588 controls, admitted to hospital for a wide range of acute, non-neoplastic, non-hormone-related diseases. On the basis of multivariate odds ratios, a high level of education accounted for 20% of cases, elevated age at first birth and nulliparity for 38% and a family history of breast cancer in first-degree relatives for 7%. Education and nulliparity and age at first birth together explained 47% of all breast cancer cases, and the combination of these 2 factors plus a family history of the disease explained 50% of cases. In pre-menopausal women a high level of education accounted for 31% of all breast cancer cases, older age at first birth for 44% and the combination of the 2 factors for 49%. In post-menopausal women the corresponding values were 13%, 31% and 42%; further addition of risk associated with family history of the disease explained 52% of pre-menopausal cases. In post-menopausal women older age at menopause and the use of hormone replacement therapy accounted for 15% and 2% of breast cancer cases, respectively. The combination of risks associated with a high level of education, old age at first birth and nulliparity and older age at menopause accounted for 51% of cases; further inclusion of risk associated with use of hormone replacement therapy explained 52%, and the AR resulting from these 4 risk factors combined plus a family history of breast cancer was 56%. Thus, a few selected and well-identified risk factors explain about one-half the breast cancer cases in this Italian population.

Age Factors↗
PubMed1997

Hysterectomy, oophorectomy in premenopause, and risk of breast cancer.

OBJECTIVE: To analyze the risk of breast cancer in women who underwent pelvic surgery in premenopause using data from two case-control studies conducted between 1983 and 1994 in six Italian centers. METHODS: Subjects were 5984 women with histologically confirmed breast cancer diagnosed within the year before interview who were admitted to the major teaching and general hospitals in the areas included in the studies. Controls were 5504 women who resided in the same geographic areas and were admitted for acute conditions to the same network of hospitals in which cases had been identified. Women were not included if they had been admitted for gynecologic, hormonal, or neoplastic disease. RESULTS: A total of 719 cases (12%) and 801 controls (15%) underwent pelvic surgery before menopause. The risk of breast cancer was reduced in women who underwent bilateral oophorectomy with hysterectomy (odds ratio [OR] adjusted for age, calendar year at interview, study, and center, 0.8, 95% confidence interval [CI] 0.7, 0.9) and hysterectomy alone (OR 0.7, 95% CI 0.6, 0.8). The protection tended to increase with time since surgery, but no relationship emerged when age at menopause was included in the analysis. No clear relationship emerged between time since unilateral oophorectomy with or without hysterectomy or since hysterectomy alone and breast cancer risk. CONCLUSION: The risk of breast cancer is lower in women who undergo bilateral oophorectomy before menopause, and the protection increases with time from surgery.

Adult↗
PubMed1997

Pathological and immunophenotypic features of adult non-Hodgkin's lymphomas by age group.

To elucidate age-related differences in non-Hodgkin's lymphoma (NHL), the authors evaluated 950 consecutive, human immunodeficiency virus-negative patients (age range, 15 to 96 years) observed between July 1988 and June 1995 in the same Italian cancer institute. Patients were grouped into six age groups and cross-tabulated by Working Formulation (WF) categories and other newly recognized entities according to the Revised European American Lymphoma (REAL) classification, cell immunophenotype, and nodal or extranodal location. There was a tendency of the low-grade category to increase with increasing age (16.8% in the age group 15 to 34 years to 32.4% in the age group 65 to 74 years), although a subsequent decline was seen at age 75 years or older (23.2%). Also the intermediate-grade category was more frequent in the elderly (46.6% and 49.4% at 65 to 74 years and at 75 years or older, respectively). High-grade category showed compared with low and intermediate grade ones, a significant downward trend with age (X2 for trend = 25.31; P < .001), interrupted in only the oldest age group. The relative excess of low-grade NHL in patients older than 55 years. of age was accounted for by the high proportion of small lymphocytic lymphomas, which, however, somewhat declined at age 75 years or older. Conversely, the relative excess of high-grade NHL below age 35 years chiefly derived from the high percentage (28.4%) of CD30-positive anaplastic large cell lymphomas. B- and T-cell lymphomas accounted for 85.9% and 9.0% of all cases, respectively. B- and T- and non-B, non-T-cell and histiocytic NHL accounted for the remaining 5.1%. A highly significant trend of increase in the proportion of B-cell lymphomas with age increase was noted (X2 for trend = 21.90; P < .001); chiefly attributable to the excess of T-cell (15.1%) and undetermined phenotype (18.6%) in patients younger than 35 years of age. Extranodal location was not significantly related to age groups. Thus, the present study showed some interesting differences in NHL morphology and cell phenotype according to age, avoiding, at the same time, the arbitrariness of patients' dichotomization into elderly and nonelderly.

Adolescent↗
PubMed1997

A case-control study of reproductive factors and risk of lymphomas and myelomas.

The relationship between reproductive factors and risk of lymphoid neoplasms was investigated in a hospital-based case-control study conducted in northern Italy on women with histologically confirmed incident Hodgkin's disease (HD) (n = 68), non-Hodgkin's lymphomas (NHL) (n = 180) and multiple myelomas (MM) (n = 71), and 448 controls admitted to hospitals, for acute, non-neoplastic, non-immunological and non-gynecological conditions. The odds ratios (OR) of HD were 0.6 for > or = 3 pregnancies compared to nulligravidae, and 0.5 for > or = 1 total (spontaneous and induced) abortions compared to women reporting no abortions. Compared to nulliparae, the OR of HD was 0.9 in parae and 0.3 in those with first birth when aged < 20 years. The OR of NHL and MM in relation to number of pregnancies, abortions and births, age at first birth and time since last birth were close to unity. Results were similar for the relation between reproductive factors and HD in women younger than 50 years. The OR of NHL was above unity (OR 2.2, 95% CI 1.0 to 4.9) for women aged < 50 years reporting one or more pregnancies as compared to nulliparae, and for women reporting the last birth since less than 10 years (OR 2.9, 95% CI 1.1 to 7.4). Early events in pregnancy, including changes in immunological status, rather than exposure to female sex hormones are likely mechanisms for the protection of pregnancies and abortions on the risk of HD.

Abortion, Induced↗
PubMed1997

Attributable risks for hepatocellular carcinoma in northern Italy.

The population attributable risks (ARs) for hepatocellular carcinoma (HCC) were estimated in relation to low education level, heavy alcohol consumption, low vegetable and fruit intake, history of hepatitis, diabetes, liver cirrhosis and oral contraceptive use, using data from a case-control study conducted between 1984 and 1993 in Northern Italy. Cases were 320 patients (235 males and 85 females) with histologically or serologically confirmed HCC, and controls were 1408 patients (1031 males and 377 females) admitted to the same network of hospitals for acute, non-neoplastic or non-digestive tract conditions, unrelated to any of the known or likely risk factors for primary liver cancer. The ARs were 40% for low vegetable and fruit consumption, 31% for low education, 18% for liver cirrhosis, 16% for hepatitis, 8% for diabetes and 7% for heavy alcohol consumption. Together, these factors explained 74% of hepatocellular cancer cases. Compared with females, males had higher ARs for cirrhosis (21% versus 11%), diabetes (10% versus 2%) and heavy alcohol consumption (9% versus 1%). The percentage of HCC attributable to all factors considered together was 78% for males and 67% for females. Thus, even if available information on hepatitis and dietary factors was limited, and the AR estimates were based on several arbitrary assumptions, available knowledge could, in principle, reduce the burden of the disease in Italy from 3300 deaths to approximately 750 for males, and from 1600 to approximately 500 for females.

Adult↗
PubMed1997

Changes in lung cancer histological types in Varese Cancer Registry, Italy 1976-1992.

Shifts in histological tumour type distribution, chiefly an increase in adenocarcinoma, have been reported to accompany changes in lung cancer incidence in the last two decades in the United States and several other developed countries. To elucidate this phenomenon further, we analysed population-based lung cancer incidence rates in the period 1976-1992 from the Varese province, an area with 788,000 inhabitants in Northern Italy. Rates were age-standardised on the world standard population. Overall, lung cancer had stopped increasing in males since the late 1980s, and had started declining in middle-aged men. Conversely, upward trends persisted in females up to 1991-1992. Although it decreased from 13 to 9, the male-to-female incidence ratio was, in 1991-1992 still substantially higher than in the U.S. and North Europe. Specific trends emerged according to histological type(s), with declines (males) or stabilisation (females) for squamous-cell carcinoma and gradual increases for small-cell carcinoma in males. Adenocarcinoma was the only lung cancer type whose incidence rates increased similarly (2.5-fold) in males and females thus approaching, in 1991-1992, in the two sexes combined, the rate for squamous-cell carcinoma. Although advances in diagnostic techniques may have played a role, the absolute and relative increases in the adenocarcinoma rate reflect changes in cigarette manufacture (i.e. spread of filter tips and low-nicotine low-tar cigarettes) and the decrease in smokers.

Adenocarcinoma↗
PubMed1997

Epidemiology and prevention of oral cancer.

Descriptive epidemiology of oral and pharyngeal cancer over the last four decades is reviewed, with specific focus on Europe. Substantial rises in mortality rates have been observed for younger males, mostly in eastern Europe. The independent role of alcohol and tobacco and their interaction on oral carcinogenesis is discussed, since these factors account for about three quarters of oral cancers in Europe. The influence of dietary factors, and in particular of a diet poor in fresh fruit and vegetables on oral carcinogenesis, is also discussed, since diet may account for 10-15% of oral cancer cases in Europe. Finally, among other carcinogens, the possibility of human papillomavirus involvement in the aetiology of cancer of the oral cavity and pharynx is overviewed. Implications for prevention are discussed.

Adult↗
PubMed1997

Screening for cancer of the head and neck: if not now, when?

There is as yet no evidence to support population screening for oral cancer, although the mouth is easy to examine, and the disease is common in certain parts of the world and/or subsegments of the population. Oral cancer screening programs have been carried out on several hundred thousands of individuals in developing countries (mostly India and Cuba) and several thousands in developed countries (mostly the U.S.A., U.K. and Italy). Especially in developed countries, lesions of the pharynx and larynx were also searched for. Substantial portions of individuals with suspicious lesions (around 10%), mostly leukoplakia, could be identified, but major difficulties were found in targeting highest-risk individuals and referring them to a specialised centre, when necessary. When oral inspection was repeated, relatively high incidence of oral cancer, after removal of prevalent cases, suggested a rather short sojourn time for preclinical cancer (in the order of one year). Oral cancer screening programmes would be greatly facilitated by screening tests able to anticipate the detection of a preclinical phase, compared to visual inspection, thus allowing screening intervals to be prolonged. Finally, even if dysplastic lesions of the oral cavity were better recognised and understood (e.g. as for intra-epithelial lesions of the cervix uteri), surgical control of the disease would be harder than for the uterus, breast, or colon-rectum.

Head and Neck Neoplasms↗
PubMed1997

Quitting smoking in northern Italy: a cross-sectional analysis of 2621 subjects.

To describe the relationship between sociodemographic factors, life-style habits, selected dietary indicators, smoking-related variables, and quitting smoking we analyzed data derived from the comparison group of a case-control study of colorectal and breast cancers based on a network of teaching and general hospitals in Northern Italy. A total of 2621 subjects (1215 women and 1406 men) who were ever cigarette smokers were included for analysis. Age-adjusted rates of stopping smoking (quit rates) and multivariate odds ratios (OR) of quitting smoking were computed. The overall age-adjusted quit rate was 38.6% for males and 24.9% for females, corresponding to an OR of quitting of 0.6 (95% CI: 0.5-0.7) for females vs males. The quitting rate increased with increasing age. After allowing for age, smoking cessation was more frequently reported by more educated or higher social class individuals. No relationship was present between quitting smoking and alcohol consumption, but quitting smoking was inversely related to coffee consumption. The probability of quitting smoking increased directly with number of cigarettes among males but not among females, who showed a J-shaped pattern. Older, heavy smokers were more likely to give up smoking. A general pattern of increasing rates of quitting smoking with higher consumption of vegetables and fruit, and hence beta-carotene, was present. This study confirms a positive association between quitting smoking and increasing age, higher education, low coffee consumption, heaviness of smoking and high consumption of vegetables and fruit.

Adult↗
PubMed1997

Risk factors for colorectal cancer in subjects with family history of the disease.

The relationship between lifestyle factors, past medical conditions, daily meal frequency, diet and the risk of 'familial' colorectal cancer has been analysed using data from a case-control study conducted in northern Italy. A total of 1584 colorectal cancer patients and 2879 control subjects were admitted to a network of hospitals in the Greater Milan area and the Pordenone province. The subjects included for analysis were the 112 cases and the 108 control subjects who reported a family history of colorectal cancer in first-degree relatives. Colorectal cancer cases and control subjects with family history were similarly distributed according to sex, age, marital status, years of schooling and social class. Familial colorectal cancer was associated with meal frequency, medical history of diabetes (relative risk, RR = 4.6) and cholelithiasis (RR = 5.2). Significant positive trends of increasing risk with more frequent consumption were observed for pasta (RR = 2.5, for the highest vs the lowest intake tertile), pastries (RR = 2.4), red meat (RR = 2.9), canned meat (RR = 1.9), cheese (RR = 3.5) and butter (RR = 1.9). Significant inverse associations and trends in risk were observed for consumption of poultry (RR = 0.4), tomatoes (RR = 0.2), peppers (RR = 0.3) and lettuce (RR = 0.3). Significant inverse trends in risk with increasing consumption for beta-carotene and ascorbic acid were observed (RR = 0.5 and 0.4 respectively, highest vs lowest intake tertile). These results suggest that risk factors for subjects with a family history of colorectal cancer in first-degree relatives are not appreciably different from recognized risk factors of the disease in the general population.

Aged↗
PubMed1997

Selected medical conditions and risk of breast cancer.

Several diseases are known or suspected to be associated with altered levels of hormones and growth factors that may influence breast cancer risk. To elucidate this possibility, we studied the relationship between 23 medical conditions or procedures and breast cancer risk by means of data from a multicentric case-control study conducted between 1991 and 1994 in six Italian areas. The study included 2569 histologically confirmed incident cases of breast cancer (median age 55 years, range 23-74 years) and 2588 control women (median age 56 years, range 20-74 years) admitted to the same hospitals as cases for a variety of acute conditions unrelated to known or suspected risk factors for breast cancer. After allowance for education, parity and body mass index, elevated odds ratios (ORs) emerged for history of diabetes mellitus in post-menopausal women (OR = 1.5, 95% CI 1.1-2.0), hypertension in pregnancy (OR = 1.8, 95% CI 1.0-3.4) and breast nodules (OR = 1.3, 95% CI 1.0-1.7). Risk decreases were associated with ovarian ablation for ovarian cysts (OR = 0.5, 95% CI 0.3-0.7) and with thyroid nodules (OR = 0.7, 95% CI 0.5-0.9) but not with the combination of any type of benign thyroid disease. While most examined conditions seemed unrelated to breast cancer risk, the association with late-onset diabetes is of special interest as it suggests a role of hyperinsulinaemia and insulin resistance in breast cancer promotion. It also points to preventive lifestyle modifications.

Adult↗
PubMed1997

Trends of Kaposi's sarcoma at AIDS diagnosis in Europe and the United States, 1987-94.

As a proportion of AIDS-defining illnesses, Kaposi's sarcoma (KS) decreased from 1987-89 to 1993-94 in homosexual and bisexual men in all European regions and in the United States. Albeit underestimated, AIDS KS rates in the general male population at ages 25-49 are higher than those of the majority of cancer sites in the same age group.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Aspirin and colorectal cancer.

The relationship between aspirin use and colorectal cancer risk was examined by a case-control study in Italy. Regular aspirin use was reported by only 47 (3.5%) cases and 77 (4.1%) control subjects, giving a multivariate odds ratio (OR) of 0.7 (95% CI 0.5-1.0) after allowance for education, physical exercise and selected dietary factors.

Adult↗
PubMed1997

Body mass index and post-menopausal breast cancer: an age-specific analysis.

The relationship between body mass index (BMI, Quetelet's index, kg m(-2)) and post-menopausal breast cancer risk was considered in age-specific strata on the basis of a pooled analysis of three Italian case-control studies, including a total of 3108 post-menopausal breast cancer patients aged 50 years or over and 2664 control subjects. Overall, there was a moderate, but significant, association between BMI and post-menopausal breast cancer: the odds ratios (ORs) were around 1.3 for the three intermediate quintiles compared with the lowest one, and 1.4 for the highest one. The association was moderate among women aged 50-59 years and 60-69 years, with ORs around 1.3 for the highest BMI quintiles, but stronger among elderly women, with ORs of 1.6 for the fourth and 2.1 for the fifth quintile. An 8-unit increase in BMI involved an OR of 1.18 at age 50-59 years, of 1.14 at age 60-69 years and of 1.59 above age 70 years. This pattern of risk is similar to that observed for post-menopausal hormone replacement treatment and is consistent with a duration-risk relationship in the exposure to high oestrogen levels and with a greater differential in oestrogen levels in overweight elderly women. In terms of population attributable risk, 19.6% of all post-menopausal breast cancer patients and 27.1% of those in women above age 70 years were attributable to overweight and obesity in this population. This has, therefore, major preventive implications as to reduce breast cancer risk late in life, it is essentially important to control weight gain in elderly women.

Age Factors↗
PubMed1997

Genetic heterogeneity of AIDS-related small non-cleaved cell lymphoma.

AIDS-related small noncleaved cell lymphoma (AIDS-SNCCL) includes Burkitt's lymphoma (BL) and high-grade B-cell Burkitt-like lymphoma (BLL). Due to the marked polymorphism of AIDS-related non-Hodgkin's lymphomas (AIDS-NHL), the morphologic distinction between these two types of lymphomas is frequently controversial, although it may bear clinical relevance. Although the molecular features of AIDS-BL have been clarified to a certain extent, the genetic peculiarities of AIDS-BLL have not been investigated in detail. In this study we have compared morphologic and genetic features of AIDS-BL and AIDS-BLL in a blind coded fashion. Molecular studies were focused on the genetic lesions known to be implicated in AIDS-NHL, including alterations of c-MYC, BCL-6, p53, deletions of 6q, as well as infection by EBV and HHV-8. Alterations of c-MYC occurred in 10/10 AIDS-BL, whereas they were restricted to 2/10 AIDS-BLL (P < 0.01). Mutations of p53 were present in 5/10 AIDS-BL, whereas they were consistently absent among AIDS-BLL (n = 10; P < 0.05). Infection by EBV occurred in 30% of both AIDS-BL and AIDS-BLL. Rearrangements of BCL-6, deletions of 6q and infection by HHV-8 scored consistently negative in both AIDS-BL and AIDS-BLL. Based on the genetic lesions tested, the molecular profile of AIDS-BLL appears to be closer to that of AIDS-related diffuse large cell lymphoma (AIDS-DLCL) than to that of AIDS-BL. In contrast to AIDS-BLL however, AIDS-DLCL carried rearrangements of BCL-6 in a fraction of cases (2/9). This study, the largest of its kind reported so far, suggests that AIDS-BL and AIDS-BLL have a different molecular pathogenesis and that characterization of genetic lesions may help to distinguish between these two lymphomas.

Blotting, Southern↗
PubMed1997

Lack of correlation between the incidence of bloodborne AIDS and overall AIDS incidence in Western Europe.

BACKGROUND: The incidence of bloodborne AIDS and the total incidence of AIDS in various areas of the United States are strongly correlated. STUDY DESIGN AND METHODS: To determine whether the same held true for Western Europe, data for 1985 through 1993 from the World Health Organization's European Non-Aggregate AIDS Data Set and for 1985 through 1992 from the Centers for Disease Control and Prevention's AIDS Public information Data Set were compared. Incidence rates per million population were adjusted for reporting delays in each country and age-standardized (world standard population). RESULTS: In Western Europe, there were no significant correlations between the annual incidence of transfusion-associated (TA)-AIDS (correlation coefficient, r = 0.38) and that of hemophilia-associated AIDS (r = 0.24) and the corresponding incidence of all AIDS cases. Whereas similar age-specific incidence rates for hemophilia-associated AIDS emerged in all countries examined, those for TA-AIDS varied and increased greatly with age in France and the United States. Male-to-female ratios of TA-AIDS ranged between 0.5 in the United Kingdom and > or = 1.5 in Italy, Portugal, Spain, Sweden, and the United States. CONCLUSION: Lack of significant correlation between the incidence of bloodborne AIDS and that of all AIDS in Western Europe points to important, but little-quantified sources of variation by country in the safety of blood and blood derivatives. Higher rates of TA-AIDS in the elderly and in males in some countries suggest international differences in transfusion practices by age and sex.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Case-control study on influence of methionine, nitrite, and salt on gastric carcinogenesis in northern Italy.

A new mutagen, 2-chloro-4-methylthiobutanoic acid, has recently been identified from a nitrite-treated Japanese salted fish. Its structure suggests that it derives from methionine in the presence of salt and nitrite. We thus considered the interaction between intake of methionine, salt, and nitrites on gastric cancer risk using data from a case-control study conducted in Northern Italy on 746 cases of incident histologically confirmed gastric cancer and 2,053 controls in hospital for acute nonneoplastic nondigestive tract disorders. Compared with subjects reporting low-methionine and low-salt intake, the odds ratios (ORs) were 2.4 [95% confidence interval (CI) = 1.5 - 4.0] for those reporting low-salt and high-methionine, 1.5 (95% CI = 1.0 - 2.2) for those with high-salt and low-methionine, and 2.8 (95% CI = 1.9 - 4.2) for those with high-salt and high-methionine intake. Likewise, with reference to nitrites, compared with subjects with low-methionine and low-nitrite intake, the ORs were 1.9 (95% CI = 1.3 - 2.6) in the high-methionine and low-nitrite stratum, 1.5 (95% CI = 1.0 - 2.1) in the low-methionine and high-nitrite stratum, and 2.5 (95% CI = 1.9 - 3.2) in the high-methionine and high-nitrite stratum. All these estimates were statistically significant. Thus the present findings from a large case-control study conducted in a relatively high-incidence area for gastric cancer suggest that a diet rich in methionine, salt, and nitrite is associated with increased gastric cancer risk.

Adult↗