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Biomedical subjects

S Franceschi

Publications and source records attributed to S Franceschi.

At least 361 records · Page 20Linked to original sources
PubMed1996

Oral contraceptives and cancer. A review of the evidence.

The following review considers epidemiological data published from 1990 onwards on oral contraceptives (OCs) and the risk of cancers of the breast, cervix uteri, endometrium, ovary, liver and skin. In several studies, breast cancer risk was seen to be elevated among women who were current users of an OC, or had recently stopped using an OC, whereas there was no residual risk 5 or more years after stopping OC use. No interaction was observed between type of OC, or with any recognised risk factor for breast cancer, or time-factor, except for some potential excess risk for women who started OC use at a young age. Most studies have confirmed that OCs moderately increase the risk of cervical cancer, particularly in human papilloma virus (HPV)-positive women, thus suggesting that OCs may act as a promoter for HPV-induced carcinogenesis. Recent epidemiological studies have confirmed that combined OCs provide substantial protection against endometrial and ovarian cancers, and results suggest that such protection is long-lasting, and may persist for 15 years or more after stopping OC use. Most case-control studies have shown a relationship between OC use and hepatocellular carcinoma. However, data from cohort studies or analysis of vital statistics indicate that the public health impact of such an association is modest, if not negligible. No association was observed between combined OC use and the incidence of skin melanoma, or any other common skin neoplasm. In terms of clinical and public health implications, the most relevant points regarding OC use are: (i) recent data confirm that OCs confer presistent protection against ovarian cancer; and (ii) any increased risk of breast cancer in OC users is moderate and is restricted to current/recent users. This is reassuring for younger women, whose baseline risk of this disease is extremely low.

Contraceptives, Oral, Hormonal↗
PubMed1996

Diet diversity and the risk of colorectal cancer in northern Italy.

The relationship between diet diversity (i.e., variety in food intake computed as the total number of foods consumed at least once per week) and the risk of colorectal cancer was investigated using data from a hospital-based, case-control study carried out between 1985 and 1992 in Northern Italy. Subjects were patients with histologically confirmed incident cancers of the colon (n = 828) and rectum (n = 498) and 2024 controls admitted for acute, nonneoplastic, non-digestive tract conditions. A significant inverse association (multivariate relative risk, 0.7) for the highest (more diverse diet) versus the lowest quartile of total diet diversity was observed, together with a significant trend in risk. A similar risk was observed for diversity within vegetables (RR, 0.6, highest versus lowers quartile), but no consistent association was found for fruit, meat and fish, and "other food" diversity. A similar pattern was observed when colon and rectal cancers were considered separately or across separate strata of sex and age. Diet diversity is related to a moderately decreased risk of colorectal cancer. These results add epidemiological support to the dietary guidelines recommending a more varied diet, and, if confirmed by other studies, would have considerable public health implications.

Adult↗
PubMed1996

The epidemiology of esophageal cancer.

The present paper examines the epidemiological aspects of cancers of the esophagus. Esophageal cancer is the sixth most common cancer in the world. Large geographical and temporal variations in its incidence, even within small areas, suggest that environmental exposure is causally important. Smoking and alcohol consumption are major risk factors for esophageal cancer, and alcohol has been identified as a major cause of this neoplasm in industrialised countries. In addition to smoking and alcohol consumption, dietary habits are important risk determinants of this disease. Epidemiological evidence suggests that nutritional deficiencies and, possibly, ingestion of mycotoxins and nitrosamines are factors for the development of esophageal cancer.

Alcohol Drinking↗
PubMed1996

Human papillomavirus and cancers of the upper aerodigestive tract: a review of epidemiological and experimental evidence.

Human papillomaviruses (HPVs) are recognized as important causes of cancer of the anogenital tract and may be involved also in the etiology of cancers of the upper aerodigestive tract (UADT). Epidemiological and experimental evidence lend some support to this possibility. Increased risk of cancer of the oral cavity, pharynx, and larynx subsequent to the occurrence of cancer of the cervix has been found and suggests common etiological factors besides smoking. HPV has been found in a substantial proportion of benign UADT lesions, most notably laryngeal papillomas and oral verrucal-papillary lesions. Largest and most accurate case series (i.e., > 15 UADT cancer cases, based on best HPV detection techniques) showed HPV DNA in 46% of cancers of the oral cavity and pharynx, 15% of cancers of the esophagus, and 24% of cancers of the larynx, with however, great discrepancies from one study to another. An additional 14 case series with a comparison group of noncancer patients revealed approximately a 4-fold higher HPV prevalence in UADT cancer tissues than in normal ones. The only two strictly designed case-control studies dealt with cancer of the oral cavity and provided inconclusive results, possibly because of interference of primary treatment with HPV detection in buccal exfoliated cells. An increasing bulk of experimental and in vitro evidence suggests that at least a proportion of UADT cancers harbor a relatively high copy number of HPV DNA. E6/E7 region transcripts and a clonal association with HPV have been demonstrated in these tumors. The combination of a good study design with reliable and noninvasive viral measurement will ultimately allow researchers to elucidate the role of HPV in the development of UADT cancer. Allowance for the strong effect of smoking, alcohol drinking, and betel quid chewing on UADT cancer and exclusion of noncausal associations will be the most difficult challenges of such studies.

Animals↗
PubMed1996

Physical activity and breast cancer risk.

Data from a multicentric case-control study on breast cancer conducted in Italy were used to analyze the relationship of occupational and leisure-time physical activity with breast cancer risk. Cases were 2569 histologically confirmed incident breast cancer cases, and controls were 2588 patients admitted to the same network of hospitals of cases for acute, nonneoplastic, nonhormone related diseases. After allowance for major identified potential confounding factors (including an estimate of total calorie intake), the odds ratios (ORs) were 0.70, 0.71, 0.64, and 0.54 in subsequent levels of physical activity at work at ages 30-39, compared to the lowest level. The association was similar for occupational physical activity at ages 15-19 and still apparent at ages 50-59, with risk estimates of 0.86, 0.85, 0.85, and 0.62. The ORs for the highest versus the lowest category of leisure-time physical activity were also below unity (ORs for the highest level of leisure-time physical activity at ages 15-19, 0.95; at ages 30-39, 0.76; and at ages 50-59, 0.66). The protection of physical activity was apparently stronger below age 60 at diagnosis and was consistent across the strata of selected covariates, although the protection was somewhat greater for more educated women.

Adolescent↗
PubMed1996

[Evaluation of the effectiveness of screening for tumors of the digestive system].

Some features of digestive cancers encourage screening programs, even though no such program has been shown so far effective in reducing mortality rates. The visual inspection of the oral cavity and pharynx, with the addition of flexible endoscopy and, possibly, blue-toluidine staining, can be easily performed by specialists and dentists. The strong association with smoking habits and alcohol consumption favours the organization of screening programs but primary prevention maintains the highest priority. For cancer of the colon-rectum two different screening approaches are under close scrutiny: fecal occult blood testing, on an yearly basis, and once-in-a-life sigmoidoscopy at 55-60 years of age. Only one of five ongoing randomized prospective studies on occult blood testing has reported, so far, a significant reduction, around 33%, of mortality from colorectal cancer, with, however, a large burden of sigmoidoscopies.

Colorectal Neoplasms↗
PubMed1995

Influence of food groups and food diversity on breast cancer risk in Italy.

Although debate on breast cancer and diet has been concentrated on nutrients, assessment of the role of specific foods and food groups and variety of food intake retains a considerable importance. To further elucidate the role of dietary habits, 2,569 women with incident breast cancer (median age 55 years) and 2,588 control women (median age 56 years), hospitalised with acute non-neoplastic diseases, were interviewed between 1991 and 1994 in 6 different Italian areas. The validated food frequency questionnaire included 79 food items and recipes, which were grouped into 18 food groups (5 for "diversity" analyses purpose). After allowance for non-dietary confounding factors and total energy intake, significant trends of increasing breast cancer risk with increasing intake emerged for the following food groups: bread and cereal dishes, pork and processed meats, and sugar and candies. Conversely, high intake of milk, poultry, fish, raw vegetables, potatoes and coffee and tea seemed to exert a protection against the development of breast cancer. Intake of soups, eggs, other meats, cheese, cooked vegetables, citrus fruits, other fruits and cake and desserts were not significantly related to breast cancer risk. The variety of vegetable types consumed weekly seemed to have a beneficial effect beyond the advantage of high vegetable intake per se.

Breast Neoplasms↗
PubMed1995

Trends in incidence of AIDS associated with transfusion of blood and blood products in Europe and the United States, 1985-93.

OBJECTIVE: To quantify patterns and trends in incidence of AIDS associated with transfusion of blood and its products in 14 European countries and the United States. DESIGN: Data were derived from the World Health Organisation's European non-aggregate AIDS dataset and, for the United States, from the Centers for Disease Control AIDS public information dataset. Rates were standardised by using the world standard populations and adjusted for reporting delays in each country. SUBJECTS: Cases of AIDS in patients with haemophilia and recipients of transfusions. RESULTS: Overall, between 1985 and 1993 almost 6000 cases of AIDS associated with transfusions were registered in the 14 European countries considered and over 8000 in the United States between 1985 and 1992. Most European countries had annual age adjusted rates lower than 0.5 per million children aged 12 or less and between 1 and 2 per million adults. The United States had rates around 1 per million children and 5 per million adults in the most recent period. For children, the highest rates were generally reached in 1985-7, whereas in adults the highest rates were in the late 1980s. France had the highest overall incidence of AIDS related to transfusion in Europe (3.3 per million). Romania had a major epidemic in children (over 30 cases per million children in 1988-90). Incidence rates of AIDS associated with transfusion were still increasing in some southern European countries in the early 1990s. CONCLUSIONS: Apart from in France and Romania it is clear that rates of bloodborne AIDS in European countries are lower than those registered in the United States.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Risk of cutaneous melanoma associated with a family history of the disease. The International Melanoma Analysis Group (IMAGE).

In a combined analysis of 2952 melanoma patients and 3618 controls from 8 case-control studies in white populations the risk of cutaneous melanoma was 2.24-fold higher (95% CI, 1.76-2.86) in subjects who reported at least one affected first-degree relative than in subjects who did not. There was no evidence for heterogeneity in the relative risk between the studies, which were from a wide range of latitudes and hence degrees of sun exposure. The effect of family history on melanoma risk was independent of age, naevus count, hair and eye colour, and freckling. There was no evidence for a relationship between family history and primary site of melanoma but there was some suggestion that the familial patients were more likely to have superficial spreading melanoma or lentigo maligna melanoma than acral lentiginous melanoma or nodular melanoma.

Case-Control Studies↗
PubMed1995

Analysis of the p53 gene in relation to tobacco and alcohol in cancers of the upper aero-digestive tract.

To elucidate the relationship, if any, of p53 gene expression according to smoking and drinking habits, 135 subjects with cancer of the upper aero-digestive tract were sampled from a case-control investigation conducted in Pordenone province, Northeast Italy, between 1986 and 1991. Adequate pathological material for immunohistochemical analysis was available for 83 subjects. Level of p53 expression was classified according to intensity on immunoreaction and percentage of p53-positive cells. Mutations were analyzed by means of single-strand conformation polymorphism and sequencing in 8 p53-positive life-long non-smokers exposed to various levels of alcohol intake. The association between p53 expression and smoking status and alcohol intake was evaluated by means of odds ratios, and 95% confidence intervals. Significantly, more men (39/65) than women (6/18) had elevated p53 expression. No significant trend of increasing percentage of p53-positive cancers with increasing smoking and drinking level was detected, especially after allowance for gender. With respect to specific mutation pattern, in 8 life-long non smokers who drank alcohol, 6 mutations involved G:C base pairs. G-to-A transitions were identified in 4 cases. The present study does not support an association between elevated p53 expression and tobacco smoking or alcohol intake. It provides an example of a molecular biology study in the framework of a large epidemiological investigation.

Aged↗
PubMed1995

Oral contraceptives and breast cancer: a cooperative Italian study.

The relationship between oral contraceptives (OC) and breast-cancer risk was analysed using data from a case-control study conducted between June 1991 and February 1994 in 6 Italian centres on 1,991 patients below age 65 with histologically confirmed incident breast cancer and 1,899 controls admitted to hospital for a wide range of acute, non-neoplastic, non-hormone-related diseases. "Ever OC use" was reported by 18% of cases versus 14% of controls, corresponding to a multivariate odds ratio (OR) of 1.1 (95%) confidence interval, Cl 0.9 to 1.4). The ORs were 1.3 for use lasting < 1 year, 1.1 for 1 to 4 years, 0.9 for 5 to 8 years, and 1.2 for over 8 years. With reference to age at first use, there was some indication that the OR was elevated in women who had started use before age 30, but not in those starting at a later age. With reference to time since last OC use, the OR was above unity for women who had stopped for less than 10 years (1.6 for 1 to 4 years; 1.7 for 5 to 9 years), but the OR declined to unity for women who had stopped OC use for 10 years or longer. The OR for women who had stopped OC use for less than 10 years was consistently elevated across strata of selected covariates, and was directly related to the duration of use (OR 1.3 for < 5 years, 1.7, for > or = 5 years). In contrast, the OR was 0.6, for use lasting > or = 5 years in women who had stopped for 10 years or more. The elevated OR for women who had recently stopped OC use, together with the absence of association (or the suggestion of some protection) for those who had stopped for 10 years or more is consistent with the pattern of breast-cancer risk observed after a full-term pregnancy, and provides important reassurance on a public health level on the long-term impact of OCs on breast carcinogenesis.

Adult↗