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Biomedical subjects

S Franceschi

Publications and source records attributed to S Franceschi.

At least 307 records · Page 17Linked to original sources
PubMed1997

Diet and risk of lymphoid neoplasms and soft tissue sarcomas.

The relationship between frequency of intake of selected indicator foods, lymphoid neoplasms, and soft tissue sarcomas was investigated in an updated case-control study conducted in Northern Italy between 1983 and 1992 on 158 incident, histologically confirmed cases of Hodgkin's disease (HD), 429 cases of non-Hodgkin's lymphoma (NHL), 141 cases of multiple myelomas, 101 cases of soft tissue sarcomas, and 1,157 controls admitted to hospital for acute, nonneoplastic diseases unrelated to long-term modifications of diet. Compared with the lowest tertile, the odds ratio (OR) for the highest tertile of milk intake was 1.8 for NHL and 1.9 for sarcomas. Liver intake was an indicator of the risk of HD (OR = 1.8), NHL (OR = 1.6), and myelomas (OR = 2.0), ham an indicator of HD (OR = 1.7), and butter an indicator of myelomas (OR = 2.8). A high consumption of green vegetables was inversely related to myelomas (OR = 0.4), and frequent use of whole-grain foods was inversely related to NHL (OR = 0.4) and soft tissue sarcomas (OR = 0.2). No material association with meat was observed for any of the neoplasms considered. Likewise, coffee and alcohol intakes were not associated with lymphoid neoplasms and soft tissue sarcomas. The OR for the highest tertile of intake of beta-carotene ranged between 0.5 and 0.7, whereas the OR for retinol ranged between 1.5 and 2.3. Although available data do not point to any specific inference, this study suggests that certain aspects of diet are a correlate or an indicator of the risk of lymphoid neoplasms and soft tissue sarcomas.

Adolescent↗
PubMed1997

Nutrient intake according to education, smoking, and alcohol in Italian women.

The control group of a hospital-based case-control study on breast cancer was used to assess the relationships between education, smoking habits, alcohol consumption, and intake of selected macro- and micronutrients in Italian women. The study subjects were 2,588 women admitted to a network of hospitals in various Italian regions for nonneoplastic, acute diseases unrelated to long-term changes in the diet. Although relatively few differences were observed, less educated subjects consumed more linoleic acid and polyunsaturated fats than did more educated women. Smoking habits were associated with the largest differences in selected antioxidant vitamins. Significant differences were observed for beta-carotene and vitamin C intake, with an 11% higher intake of beta-carotene and a 12% higher intake of vitamin C in ex-smokers than in current smokers. Heavier alcohol drinkers tended to consume more retinol and iron but less beta-carotene than did moderate or nondrinkers. Thus the differences in macro- and micronutrient intake were generally moderate across categories of education, smoking, and alcohol consumption in this data set of Italian women. Nonetheless, they confirm the importance of allowing for these variables in analyzing the relationship between nutritional factors and disease risk.

Adult↗
PubMed1997

Intake of selected foods and nutrients and breast cancer risk: an age- and menopause-specific analysis.

The relationship between selected foods and nutrients and breast cancer risk was investigated in strata of age and menopausal status using data from a case-control study on breast cancer conducted between June 1991 and April 1994 in six Italian areas. Cases were 2,569 women with histologically confirmed incident breast cancer admitted to the major teaching and general hospitals of the study areas; controls were 2,588 women with no history of cancer admitted to hospitals in the same catchment area as cases for acute, nonneoplastic, nongynecological conditions unrelated to hormonal or digestive tract diseases or to long-term modifications of diet. Dietary habits were investigated using a validated food frequency questionnaire, including 78 foods or food groups. Among food groups, bread was directly and significantly related to breast cancer risk in older women and, consequently, in postmenopause, whereas the protection conferred by fish consumption was stronger in postmenopause and that exerted by raw vegetables was stronger in premenopause. Among nutrients, unsaturated fatty acids were inversely related to breast cancer risk, the association being stronger in postmenopausal and elderly women. The pattern was similar for total fats. For starch, available carbohydrates, and total proteins, no heterogeneity emerged across strata of age and menopausal status. Among micronutrients, protection diminished with increasing age for beta-carotene and calcium, whereas no heterogeneity emerged for vitamin E. Thus this age-specific analysis of the largest investigation to date on diet and breast cancer did not show any consistent pattern of breast cancer risk in relation to selected dietary factors across strata of age and menopausal status.

Adult↗
PubMed1997

Fibers and breast cancer risk.

Data from a multicenter case-control study on breast cancer conducted in Italy were used to analyze the relationship between various types of fibers and breast cancer risk. Cases were 2,569 women with histologically confirmed, incident breast cancer; controls were 2,588 women admitted to the same network of hospitals for acute, nonneoplastic, non-hormone-related diseases. Cases and controls were interviewed between 1991 and 1994 using a validated food frequency questionnaire. The data were modeled through multiple logistic regression, controlling for demographic and reproductive breast cancer risk factors. The continuous odds ratios for the difference between the upper cut point of the fourth and the first quintile of intake were 0.90 [95% confidence interval = 0.82-0.98, p (for trend) < 0.05] for cellulose and 0.94 (95% confidence interval = 0.86-1.02) for soluble fibers. The protection tended to be stronger in premenopausal women. No material association was found for noncellulose polysaccharides and lignin. This study, based on a large data set from various Italian regions, suggests that fiber intake may confer some protection against breast cancer, particularly for cellulose and also for soluble fibers, i.e., those of vegetable origin. This possible protection has been related to an influence of fibers on levels and availability of estrogens and other steroid hormones in breast carcinogenesis.

Adult↗
PubMed1997

Treatment for infertility and risk of invasive epithelial ovarian cancer.

The relationship between the use of fertility drugs and the risk of ovarian cancer was analysed using data from an Italian case-control study. The study comprised 971 women below the age of 75 years with histologically confirmed invasive epithelial ovarian cancer diagnosed within the year before the interview. The controls were 2758 women admitted to the same network of hospitals where the cases of ovarian cancer had been identified. Five cases (0.5%) and 11 controls (0.4%) reported use of fertility drugs. In comparison with women who had never used fertility drugs, the multivariate odds ratio (OR) for women who had taken fertility drugs was 1.1 [95% confidence interval (CI) 0.4-3.3]. The OR were 0.7 (95% CI 0.1-7.9) and 1.0 (95% CI 0.2-3.8) for women who had used fertility drugs for <6 and > or =6 cycles respectively. Considering the 14 cases and 45 controls reporting difficulty in conception, the risk of ovarian cancer was 0.5 (95% CI 0.1-3.6) for women who reported use of fertility drugs. Considering nulliparous women only, the estimated OR of ovarian cancer for any fertility drug use was 0.6 (95% CI 0.1-3.5). Although the present results have limitations in terms of statistical power and available information, they provide reassuring evidence of the absence of a strong association between fertility drugs and subsequent risk of developing epithelial ovarian cancer.

Adult↗
PubMed1997

Macronutrients, energy intake, and breast cancer risk: implications from different models.

We used data from a case-control study, conducted in Italy on 2,569 incident cases of breast cancer and 2,588 controls, to fit various energy adjustment models in the estimate of the effect of selected nutrients and alcohol on breast cancer risk. When we fit the standard multivariate and residual models, including total energy intake and the different macronutrients one at a time, the odds ratios (OR) related to 100 kcal per day were 0.90 for protein, 0.96 for saturated fat, 0.88 for unsaturated fat, 0.95 for sugar, 1.07 for starch, and 1.06 for alcohol. When we included all of the different sources of calorie intake in a single model with energy sources partitioned, the OR of adding 100 kcal per day was 0.91 for protein, 1.22 for saturated fat, 0.89 for unsaturated fat, 0.98 for sugar, 1.08 for starch, and 1.07 for alcohol. The estimates from the residual models that included various macronutrients separately were similar to those of the extended energy partition model.

Adult↗
PubMed1997

Risk of stomach cancer in patients with gastric or duodenal ulcer.

It has been suggested that the risk of stomach cancer is increased when there is a history of gastric ulcer, but decreased in those with a history of duodenal ulcer. To provide further information on the issue, data from a case-control study of gastric cancer conducted in greater Milan, northern Italy, between 1985 and 1993, were examined. There were 746 cases of gastric cancer below the age of 75 and 2,053 controls admitted to hospital for acute, non-neoplastic, non-hormone-related diseases. A total of 76 (10.2%) cases and 84 (4.1%) controls reported a history of gastric ulcer, corresponding to a multivariate odds ratio (OR) of 2.6 (95% confidence interval, CI = 1.8-3.6). Fifty nine cases (7.9%) and 111 (5.4%) controls reported a history of duodenal ulcer, corresponding to an OR of 1.3 (95% CI = 0.9-1.8). The OR of gastric cancer was significantly above unity for the first five years after diagnosis of gastric ulcer (OR = 7.4, 95% CI 3.7-14.8), and declined thereafter. No consistent pattern of risks was observed after duodenal ulcer. The present data therefore confirm that the risk of gastric cancer is increased after gastric ulcer. They do not support, however, a reduced risk after duodenal ulcer. This may be due to variable baseline characteristics of the populations studied, or to the different role and impact of Helicobacter pylori and other determinants of duodenal ulcer and gastric cancer in various countries.

Age Distribution↗
PubMed1997

Micronutrients and breast cancer.

A large part of the epidemiological debate on diet and breast cancer has been dominated by the issue of whether fat, particularly animal fat, increases risk. Lately, the possible protective effect of various dietary constituents has received more attention. Vitamins C and E, and beta-carotene have antioxidant activity and may thus provide a cellular defence against reactive oxygen species that damage DNA. Dietary fibre may influence oestrogen metabolism. A large case-control study (2,569 breast cancer and 2,588 hospital controls) conducted in six Italian areas between 1991 and 1994 suggested that a diet rich in several micronutrients was associated with significantly lowered risk. After allowance for non-dietary risk correlates, energy intake and the mutual confounding effect of the various micronutrients, beta-carotene, vitamin E and calcium were associated with odds ratios in the highest intake quintile compared to the lowest one of 0.84, 0.75 and 0.81, respectively. Among different types of fibre, only cellulose intake showed a moderate inverse association. Evidence from other studies suggests that a favourable role of some micronutrients is possible, albeit probably less important than for cancers of the stomach and colon-rectum. Indeed, the relationship between fruit and vegetable intake is also less marked/consistent for breast cancer than for other sites. Among agents that have only recently been investigated, isoflavones, which are weak oestrogens, are of particular interest.

Ascorbic Acid↗
PubMed1997

Surgical second look in ovarian cancer: a randomized study in patients with laparoscopic complete remission--a Northeastern Oncology Cooperative Group-Ovarian Cancer Cooperative Group Study.

PURPOSE: The usefulness of extensive and repetitive surgery for patients with ovarian cancer still remains unproven (at least for some conditions). We planned an accurate prospective test of the hypothesis that patients with advanced-stage disease, after they had reached a clinical complete remission (CR), may benefit from surgical second look (SSL). PATIENTS AND METHODS: One hundred two patients in CR (as assessed by clinical findings, markers, and visualization by computed tomographic [CT] scan and laparoscopy), after initial debulking and first-line chemotherapy, were randomized to two arms, which were well balanced for predictive criteria such as age, stage at presentation, histology, grading, date of randomization, and residua after first surgery. Forty-eight patients were randomly assigned to receive follow-up evaluation only, while 54 were assigned to receive second surgery (eight of them refused). Of 46 surgical patients, 35 had negative and 11 positive surgical findings (24% clinically false-negative). RESULTS: Despite the microscopic residua found at open surgery, and the fact that the patients were then treated with second-line chemotherapy, SSL did not increase the probability of survival in this setting. In an analysis of the results according to the intention-to-treat criteria, after a 60-month follow-up period, the overall survival rates in the two groups of patients (SSL v no SSL) were 65% and 78%, respectively (P = .14). Multivariate analysis according to predictive criteria confirmed there was no significant difference between the two groups (P = .39). CONCLUSION: Our study shows the following: (1) our second-line treatment is scarcely effective; (2) SSL accurately defines complete responders to first-line chemotherapy; (3) SSL per se does not prolong survival; and (4) if confirmed, a less invasive procedure could replace SSL as a valuable method in new first-line regimens in ovarian cancer patients with clinical CR confirmed by laparoscopy.

Female↗
PubMed1997

Hormone replacement treatment and breast cancer risk: an age-specific analysis.

The relationship between hormone replacement treatment (HRT) and breast cancer risk was considered in age-specific groups of women, combining data from two case-control studies conducted between 1983 and 1994 in six Italian centers. Cases were comprised of 5984 women, below age 75 years, with histologically confirmed breast cancer, and controls were comprised of 5504 women admitted to the hospital for a wide spectrum of acute, nonneoplastic, nonhormone-related diseases. Ever-use of HRT was reported by 6.1% of the cases and 5.5% of the controls, corresponding to a multivariate odds ratio (OR) of 1.2 [95% confidence interval (CI), 1.0-1.4]. A significant trend in risk with duration of use was observed. Separate analysis for women < 55, 55-64, and 65-74 years old at diagnosis showed that the excess risk of breast cancer associated with ever-use of HRT was not observed in the youngest age group (OR, 0.9) and increased with age at diagnosis to 1.2 (95% CI, 0.9-1.5) for women 55-64 years old and 1.6 (95% CI, 1.2-2.3) for those 65-74 years old at diagnosis. A significant trend in risk with duration was observed only in the oldest group (65-74 years old), with ORs of 1.6 (95% CI, 1.1-2.3) and 2.2 (95% CI, 1.1-4.7), respectively, for < 60 and > or = 60 months of use. Thus, this study suggests that the relationship between HRT and breast cancer risk is influenced by age at diagnosis and that any risk-benefit assessment is particularly critical for women using HRT several years after menopause.

Adult↗
PubMed1997

Histamine-2-receptor antagonists and oesophageal cancer.

Peptic ulcer and gastrectomy are associated with an increased risk of oesophageal cancer. We considered the relation between treatment with histamine-2 (H-2)-receptor antagonists and subsequent risk of oesophageal cancer. Data from a case-control study conducted between 1984 and 1995 in northern Italy were used. These comprised 407 incident, histologically confirmed cases and 1168 controls admitted for acute, non-neoplastic, non-digestive tract conditions, unrelated to known risk factors for oesophageal cancer. Ten (2.5%) cases and 52 (4.5%) controls reported using H-2-receptor antagonists at some time, corresponding to a multivariate odds ratio (OR) of 0.5 (95% confidence interval 0.2-1.0). The OR was 0.4 for subjects who had started use seven years earlier or less, and 0.6 for those who had started use more than seven years ago. These findings indicate that risk of oesophageal cancer is not increased among H-2-receptor antagonist users. This trend to protection may be explained in terms of chance alone, or may be partly related to a possible favourable impact of H-2-receptor-antagonists on chronic oesophageal carcinogenesis.

Adult↗
PubMed1997

Sources of macro- and micronutrients in Italian women: results from a food frequency questionnaire for cancer studies.

The knowledge of major sources of macro- and micronutrients is essential in order to interpret differences in the diet-cancer link in various geographical areas and to provide better nutritional guidelines. For this purpose we took advantage of the control group of a case-control study on breast cancer carried out in six Italian areas. The dietary habits of 2,588 cancer-free women aged 20-74 years (median age 56) were elicited between 1991 and 1994 by means of an interviewer-administered food frequency questionnaire (FFQ) that included 78 foods or food groups, in addition to several questions on general dietary pattern (e.g., fat in seasoning). Bread was the first contributor for total energy (12%), protein (8%) and starch (32%) intake, whereas, for saturated fatty acid, the first sources were different types of cheese (28%); for monounsaturated fatty acids the dressing oils of salad and tomatoes (12%); and, for sugars, apples and pears (19%). Raw vegetables and fresh fruit represented the most important source of most vitamins. The first contributors of vitamin C and beta-carotene were citrus fruits (29%) and raw carrots (17%), respectively. Thus, between 40 and 80% of specific macronutrient intake and up to 90% intake of several micronutrients were derived from the first ten foods or food groups. Often, the major contributors to the intake of a specific component were foods with a relatively low content, but eaten in large quantities. This work further highlights the specificity of nutrient sources in southern European populations.

Adult↗
PubMed1997

Low-risk diet for breast cancer in Italy.

To define a low-risk diet for breast cancer in Italy, a multicentric case-control study of 2569 incident cases of breast cancer and 2588 controls from Italy was analyzed. A logistic regression model was applied to the estimated intake of five macronutrients and used to compute a diet-related risk score (RS). The pattern of macronutrient and food group intake across RS deciles was defined. The mean of diet-related RSs across subsequent risk deciles ranged from 0.83 to 1.44. Total energy intake first decreased slightly, from the first to the second decile, and then increased, mostly in the last three risk deciles. Intake of starch increased in absolute and relative terms, whereas saturated fat intake rose in absolute terms but remained stable as a proportion. A relative decline was observed for unsaturated fat and sugars, with a hint, however, of U-shape effect. From a food group viewpoint, there was a marked increase in the intake of bread and cereal dishes, cakes and desserts, and refined sugar across subsequent deciles, whereas the consumption of vegetables, olive and seed oils, and fruit decreased.

Adult↗
PubMed1997

Diabetes mellitus and colorectal cancer risk.

The relationship between diabetes mellitus and the risk of colorectal cancer was investigated in a multicenter case-control study, conducted in Italy between 1992 and 1996 on 1225 cases of incident, histologically confirmed colon cancer, 728 cases of rectal cancer, and 4154 controls, who were in the hospital for acute, nonneoplastic diseases. Overall, 66 (5.4%) cases of colon cancer, 50 (6.9%) cases of rectal cancer, and 185 (4.4%) controls reported a history of diabetes. The corresponding multivariate odds ratios (ORs) were 1.2 [95% confidence interval (CI), 0.8-1.6] for colon, 1.5 (95% CI, 1.1-2.2) for rectal, and 1.3 (95% CI, 1.0-1.6) for all colorectal cancers. No association was observed for subjects who were diagnosed with diabetes at ages of < 40 years (7 cases and 27 controls, OR = 0.9). The OR was 1.4 (95% CI, 1.1-1.7) for subjects who were diagnosed with diabetes at ages of > or = 40 years and were likely to have non-insulin-dependent diabetes. The association was also stronger (OR = 1.6; 95% CI, 1.1-2.3) among subjects whose diabetes was diagnosed 10 or more years in advance and who were > or = 60 years old at the time of colorectal cancer diagnosis. None of the other covariates, including sex, education, body mass index, physical activity, energy intake, alcohol drinking, and fiber intake, showed any appreciable modifying effect. Thus, this uniquely large case-control study of colorectal cancer confirms that subjects with non-insulin-dependent diabetes mellitus have a slightly increased risk of colorectal cancer. More importantly, allowance for a large number of identified potential confounding factors, including body mass index, diet, and physical activity, could not explain the excess colorectal cancer risk among subjects with diabetes mellitus. These findings have plausible biological correlations because insulin-like-growth factor-I is a promoter of colon tumor cell growth in vitro.

Adult↗
PubMed1997

[Replacement therapy in menopause and risk for breast tumors].

The relationship between hormone replacement therapy (HRT) and breast cancer risk was analysed in a case-control study, conducted in the period 1991-1994 in six Italian areas, on 2569 patients with breast cancer and 2588 controls. Ever HRT use was reported by 7.5% of cases and controls (OR = 1.2; 95% CI: 0.9-1.5). The risk increased with increasing duration of use. There was no clear pattern of risk with reference to time since starting use, but the OR was significantly elevated for women who had stopped HRT within the last 10 years; the result was consistent across strata of identified covariates, and was significantly related to duration of use. This study confirms the absence of a strong association between HRT and breast cancer risk, although the risk estimate was above unity for women who had used HRT for 5 years or longer. However, the risk was significantly elevated in the short to medium term after use, particularly for long-term use.

Adult↗