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Biomedical subjects

S Franceschi

Publications and source records attributed to S Franceschi.

At least 379 records · Page 21Linked to original sources

Cigarette smoking and colorectal cancer: a study of 1,584 cases and 2,879 controls.

BACKGROUND: Although colorectal cancer is not one of the major tobacco-related cancers, a possible association with tobacco has been suggested following the observation of a relationship between cigarette smoking and colorectal adenomas. The issue of a long latency of tobacco on colorectal carcinogenesis has also been suggested, since elevated relative risks were observed in long-term smokers. METHODS: The association between colorectal cancer and cigarette smoking has been investigated using data from a case-control study conducted in northern Italy between 1985 and 1991 on 955 cases of colon and 629 cases of rectal cancer and 2,879 controls in hospital for acute, nonneoplastic, nondigestive tract, nontobacco-related diseases. Odds ratios (OR), and the corresponding 95% confidence intervals, of colorectal cancer according to various measures of tobacco smoking were derived from multivariate models, including terms for sex, age, total calorie intake and selected dietary variables, alcohol consumption, and family history of colorectal cancer. RESULTS: No association between smoking and colorectal cancer was observed. Compared with people who had never smoked, the overall multivariate OR for colorectal cancer was 0.9 in ex-smokers and 0.7 in current smokers. No relationship was found with number of cigarettes smoked (OR = 0.7 for both < 15 and 15-24, and 0.8 for > or = 25 cigarettes per day), age at starting (OR = 0.7 for < 20, 0.8 for 20-29, and 0.9 for > or = 30 years), duration (OR = 0.8 for < 10, 0.7 for 10-19, 0.8 for 20-29, and 0.7 for > or = 30 years), and time since starting (OR = 0.7, for < 30, 0.8 for > or = 30 years) and since stopping (OR = 1.1 for < 10, 0.7 for > or = 10 years). There was no evidence of a trend in risk with increasing lifelong pack-years (OR for > or = 40 pack-years = 0.8 for colon and rectum), pack-years before age 30 (OR = 0.7 for > or = 20 pack-years), or pack-years after age 30 (OR = 0.8 for > or = 30 pack-years). The results were similar for males and females. CONCLUSIONS: The findings of this study indicate that smoking was not a strong risk factor for colorectal cancer, even after a long induction period.

Adult↗

Olive oil, other dietary fats, and the risk of breast cancer (Italy).

Data from a multicenter case-control study on breast cancer conducted in Italy have been used to analyze the relationship of olive oil and other dietary fats to breast cancer risk. Cases were 2,564 women hospitalized with histologically confirmed, incident breast cancer. Controls were 2,588 women admitted to the same network of hospitals for acute, non-neoplastic, non-hormone related, non-digestive tract disorders. Cases and controls were interviewed between 1991 and 1994 using a validated food-frequency questionnaire. The data were modelled through multiple logistic regression controlling for demographic and reproductive breast-cancer risk factors, energy intake and, mutually, for types of dietary fat. For olive oil, compared with the lowest quintile, the odds ratios (OR) were 1.05, 0.99, 0.93, and 0.87 for increasing quintiles of intake; in a model postulating linear logit increase, the OR per unit (30 g) was 0.89 (95 percent confidence interval [CI] = 0.81-0.99, P = 0.03). Among other oils or fats considered, the OR for the highest level of intake was 0.72 (CI = 0.6-0.9) for a group of specific seed oils (including safflower, maize, peanut, and soya) compared with nonusers. The ORs for the highest cf lowest level of intake were 0.80 for mixed or unspecified seed oils, 0.95 for butter, and 0.96 for margarine. The study, based on a large dataset from various Italian regions, shows an inverse relationship of breast cancer risk with intake of olive oil and other vegetable oils, but not with butter or margarine.

Adult↗

Trends in mortality from nonneoplastic gallbladder disease.

Trends in mortality rates from gallstones and other nonneoplastic gallbladder and biliary tract diseases between 1955 and 1990 for 38 countries (8 from America, 3 from Asia, 25 from Europe, Australia, and New Zealand) were analyzed. Age-adjusted mortality rates standardized on the world population were computed from official death certifications derived from the World Health Organization database. There were generalized and substantial declines in the rates in both sexes and all countries considered, except for males in Czechoslovakia and Poland. Over the calendar period considered, the average declines were over 70% for males and over 80% for females in North America, over 60% for males and 70% for females in Latin America, although mortality remained relatively high in Chile. The declines were 80% for both sexes in Japan and over 70% for males and 80% for females in Australia. The pattern was more heterogeneous in Europe, with decreases of approximately 70 to 80% in northern Europe, but more modest in central and southern Europe, with particularly moderate downward trends for males. In several countries the decreases were rather steady over the calendar period considered, but in a few others the decline was restricted or larger during the most recent calendar period. The trends in gallstone and other gallbladder disease mortality in various areas are affected by differences and potential biases in death certification reliability, and by underlying variations and changes in the prevalence of gallstones and gallbladder surgical removal. A likely interpretation for the generalized decline in mortality over the last calendar period is, however, improved diagnosis and treatment of gallstone disease.

Adult↗

Reproducibility of an Italian food frequency questionnaire for cancer studies. Results for specific nutrients.

The reproducibility of measures of the intake of total energy and 27 selected nutrients from a quantitative food frequency questionnaire (FFQ) used in a case-control study on cancer of the breast, ovary, and digestive tract was evaluated. The results of two FFQ administrations at an interval of 3 to 10 months (median = 5.4 months) to 452 volunteers (144 males and 308 females; median age = 50 years) from three Italian provinces (Pordenone, Genoa, and Forì) were compared. Pearson correlation coefficients (r) between crude nutrient intake (unadjusted for energy) ranged from 0.50 for vegetable fat to 0.80 for alcohol, with most values falling between 0.60 and 0.70 (median r = 0.67). Adjustment of nutrient intakes for total energy slightly decreased most coefficients (median r = 0.60). The agreement between the two measurements did not differ substantially by sex, age, education, and interval between interviews. The contribution of specific FFQ components (i.e., frequency-only questions, open questions, portion size, and fat intake pattern) was also assessed separately with respect to the performance and reproducibility of nutrient measures, yielding, in general, very similar results. The seven questions concerning individual fat intake pattern, which were used to modulate the composition of various recipes, led, however, to a significant increase in mean daily intake of vegetable fat, oleic acid, and vitamin E, but a reduction of estimated daily intake of linoleic acid and polyunsaturated fatty acids.(ABSTRACT TRUNCATED AT 250 WORDS)

Case-Control Studies↗

Hormone replacement treatment and breast cancer risk: a cooperative Italian study.

The relationship between hormone replacement treatment (HRT) and breast cancer risk was analysed using data from a case-control study conducted between June 1991 and February 1994 in six Italian centres on 2569 patients aged below 75 with histologically confirmed breast cancer and 2588 controls admitted to hospital for a wide spectrum of acute, non-neoplastic, non hormone-related diseases. Ever HRT use was reported by 7.5% of cases and 7.5% of controls, corresponding to a multivariate odds ratio (OR) of 1.2 [95% confidence interval (CI), 0.9-1.5]. The risk increased with increasing duration of use: the ORs were 1.0 for use lasting less than 1 year, 1.3 for 1-4 years and 1.5 for 5 years or more. There was no clear pattern of risk with reference to time since starting use, but the OR was significantly elevated (OR = 2.0, 95% CI 1.3-2.9) for women who had stopped HRT within the last 10 years. No association was observed in those who had stopped HRT more than 10 years ago (OR = 1.0). The increased OR for women who had stopped HRT within the last 10 years 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. This short-term increased risk is consistent with an effect of HRT on one of the later stages of the process of breast carcinogenesis. The flattening of risk with increasing time since stopping, and hence the absence of a long-term cumulative excess in breast cancer risk after stopping HRT exposure, has relevant implications on individual risk assessment and public health.

Adult↗

Trends of skin cancer in the Canton of Vaud, 1976-92.

Trends in incidence and mortality for basal cell carcinomas (BCC), squamous cell carcinomas (SCC) and cutaneous malignant melanoma (CMM) for the period 1976-92 were analysed using data from the Cancer Registry of the Swiss Canton of Vaud. Among the 12,473 cases registered, 63% were basal cell carcinomas, 25% squamous cell cancers, 9% cutaneous malignant melanomas and 3% other miscellaneous histological types. Age-standardised incidence rates increased substantially for all histological types considered, from 44% increase for BCC in males to a more than 3-fold increase for SCC in females, with only signs of a levelling off in 1991-92, following a peak of incidence rates in 1986-90. From 1976-80 to 1991-92 CMM incidence increased by approximately 80% in both sexes. In 1991-92, age-standardised (world) incidence rates per 100,000 were 69.3 for basal cell, 29.1 for squamous cell cancers and 11.5 for melanomas in males, and, respectively, 62.2, 18.0 and 12.3 in females. With respect to mortality, in males rates increased for both non-melanocytic cancer (> 40%) and CMM (> 53%) whereas in females CMM, BCC and SCC rates remained approximately stable over the calendar periods examined. In 1991-92, age-standardised mortality rates per 100,000 were 2.6 for melanoma and 0.7 for other skin cancers in males, and, respectively, 1.6 and 0.2 in females. Upward trends in incidence were also present, and relatively homogeneous across, various age groups examined. However, SCC and CMM levelled off over the last period, and some decline was apparent in males below age 45. Separate analysis by anatomical site showed substantial increases in the head and neck for SCC and BCC, and in the trunk for CMM. In 1991-92, middle-aged women had almost equalled male incidence rates of BCC and SCC. A female excess of CMM incidence seemed to have disappeared since 1981-86. The increase in skin cancer incidence thus continued in this population up to the late 1980s, with a plateau only after 1990.

Adolescent↗

High frequency of CD45RO expression in AIDS-related B-cell non-Hodgkin's lymphomas.

Although immunophenotypic abnormalities have been reported in B-cell non-Hodgkin's lymphomas (NHLs) occurring in the general population, there are no extensive studies on such abnormalities in AIDS-related B-cell NHLs. Reactivity of CD45RO/UCHL1 and expression of other T-cell associated antigens (CD43, OPD4, CD3, CD5, EMA) were examined by immunohistochemistry in 66 diffuse aggressive AIDS-related B-cell NHLs and in 296 AIDS-unrelated B-cell NHLs of similar morphology analyzed in the same institution. EBER in situ hybridization studies were also carried out in 57 of the 66 AIDS-related B-cell NHLs investigated. CD45RO/UCHL1 was expressed in 27% of AIDS-related B-cell NHLs, but only in 8% of diffuse aggressive AIDS-unrelated B-cell NHLs. The difference was highly significant (P < .001) overall and, within the Working Formulation subtypes, especially marked among small noncleaved cell (SNCC) lymphomas. Conversely, the reactivity of other T-cell associated antigens seemed to be very similar in AIDS-related and AIDS-unrelated NHLs. However, for CD43, a significantly lower number of positive cases was found in AIDS-related NHLs among SNCC lymphomas. Among AIDS-related B-cell NHLs, the highest frequency of CD45RO/UCHL1 expression was found in the immunoblastic subset with plasmacytoid differentiation. In the latter CD45RO/UCHL1 preferentially associated with EMA expression and EBV infection of the tumor clone, but not with CD45RA. The present finding of an excess of CD45RO/UCHL1 expression in AIDS-related B-cell lymphomas may reflect the preferential expansion of CD45RO expressing B-cell clones with putative autoreactive potential, as suggested by the expansion of CD45RO expressing B-cells in autoimmune disorders.

Antibodies, Monoclonal↗

Number of sexual partners, condom use and risk of human immunodeficiency virus infection.

BACKGROUND: To analyse the relation between number of sexual partners, selected sexual habits and the risk of human immunodeficiency virus (HIV) infection. METHODS: We conducted a case-control study nested in a cross-sectional survey conducted among subjects attending sexually transmitted diseases (STD) clinics in Northern Italy. Eligible for the study were 1711 subjects (1259 males, 452 females) who referred themselves for the first time between September 1988 and March 1993 to three STD clinics in Northern Italy for suspected STD or STD treatment. A total of 145 subjects (113 males and 32 females) were HIV positive. RESULTS: In comparison with subjects reporting no or one sexual partner over the 3 years before the interview, the estimated odds ratios (OR) of HIV serum positivity were 1.2 (95% confidence interval [CI]: 0.6-2.3), 0.8 (95% CI: 0.4-1.8) and 0.3 (95% CI: 0.4-2.5) in subjects reporting 2-3, 4-5, and > or = 6 partners, respectively. The results were similar considering separately males and females and in men reporting only homosexual partners. Regular condom use decreased the risk of HIV infection: in comparison with subjects reporting no or occasional use of condoms, the OR of HIV infection was 0.5 (95% CI: 0.4-0.8) for regular users. Considering men only, compared with men with no homosexual intercourse, the OR of HIV infection was 2.3 (95% CI: 1.4-3.9) in those reporting bisexual intercourse and 2.2 (95% CI: 1.2-4.2) in men reporting only homosexual intercourse (among homosexuals). There was no relation between HIV infection risk and receptive anal sex. CONCLUSIONS: The risk of HIV infection does not increase linearly with the number of sexual partners in this population. This is reasonable, as the prevalence of HIV infection in this population is essentially determined by drug use. Caution is needed in the interpretation of these results since the analysis of role of number of sexual partners in male intravenous drug users is impaired by low statistical power.

Adult↗

Prevalence of chronic diseases in alcohol abstainers.

We used data from the 1983 Italian National Health Survey, based on 58,462 adults ages 25 years and over who are representative of the general Italian population, to compare the prevalence of 16 major chronic diseases or groups of diseases in alcohol abstainers (ex- and never-drinkers combined) and current drinkers. We found elevated odds ratios among alcohol abstainers for diabetes, hypertension, myocardial infarction, other heart diseases, anemias, gastroduodenal ulcer, cholelithiasis, liver cirrhosis, urolithiasis, and renal insufficiency.

Adult↗

HIV transmission and Kaposi's sarcoma among European women.

OBJECTIVE: To assess the association between the presence of Kaposi's sarcoma (KS) as an AIDS-defining illness and HIV transmission categories among European women with AIDS. DESIGN: Comparison of the prevalence of KS as an AIDS-defining illness in different HIV transmission categories. METHODS: Odds ratios (OR) and 95% confidence intervals (CI) for KS were computed by means of unconditional multiple logistic regression equations. RESULTS: KS was reported in 344 (2.2%) out of 15,809 women diagnosed with AIDS. Women who reported HIV infection via heterosexual intercourse had a > twofold increase of KS risk than intravenous drug users (OR, 2.4; 95% CI, 1.9-3.0). Particularly elevated OR were observed among women originating from African or Caribbean countries (OR, 4.9; 95% CI, 3.7--6.5), and in partners of bisexual men (OR, 4.8; 95% CI, 2.8--8.2). Such risk patterns for KS were consistent in different countries, age groups and year of AIDS diagnosis. CONCLUSIONS: These results are in agreement with similar analyses from the United States, and support the existence of some putative KS agent(s) which can be acquired via sexual intercourse with bisexual men, or earlier in life in countries where non-AIDS-associated KS is frequent.

Acquired Immunodeficiency Syndrome↗

Number of siblings and subsequent gastric cancer risk.

The number of siblings is an indirect indicator of living and, possibly, dietary conditions in childhood and adolescence. The relationship between the number of siblings and subsequent gastric cancer risk was analysed using data from a case--control study conducted in Italy between 1985 and 1992 on 723 cases of incident, histologically confirmed gastric cancer and 2,024 controls in hospital for acute, non-neoplastic, non-digestive tract disorders. After allowance for age and sex, there was a significant trend of increasing gastric cancer risk with increasing number of siblings (P < 0.01). Compared with subjects with no siblings, the relative risk (RR) was 1.1 for those with one, 1.3 for 2, 1.4 for 3-6 and 1.7 for 7 or more siblings. The association was stronger in subjects above the age of 60: the RR for > or = 5 siblings was 1.8, as compared with 1.2 for younger subjects. These patterns of trends are consistent with the hypothesis that domestic crowding and deprivation in childhood and adolescence is a correlate of subsequent gastric cancer risk, and offer therefore interesting clues to our understanding of the process of gastric carcinogenesis.

Adolescent↗

Hodgkin's disease and human immunodeficiency virus infection: clinicopathologic and virologic features of 114 patients from the Italian Cooperative Group on AIDS and Tumors.

PURPOSE: To describe virologic, clinicopathologic, and therapeutic features of a large series of Italian patients with Hodgkin's disease (HD) and human immunodeficiency virus (HIV) infection. PATIENTS AND METHODS: From November 1986 to March 1994, 114 cases were observed. The relationship between Epstein-Barr virus (EBV) and HD was determined by an in situ hybridization technique, immunostaining for EBV-encoded latent membrane protein-1 (LMP-1) expression, and Southern blotting. Twenty-six patients were included in a prospective study evaluating the combination of chemotherapy (CT) with zidovudine. RESULTS: Combined approach on EBV study revealed that 14 (78%) of 18 patients were EBV-associated. An almost equivalent distribution of EBV subtypes was observed in EBV-carrying cases, indicating that in the HIV setting, type 2 EBV also may be pathogenetically involved in HD development. In comparing these 114 patients with our single-institutional series of 104 HIV-negative patients with HD, we observed at presentation a younger median age (29 v 38 years); a prevalence of males (90% v 56%); and a higher percentage of stage IV disease (52% v 15%), presence of B symptoms (77% v 35%), and extranodal disease (63% v 29%). The complete remission (CR) rate (58%) and median survival (13 months) of patients treated prospectively were similar to that of patients treated with standard CT regimens. The statistically significant favorable prognostic factors for survival being the following: achievement of CR, CD4+ count greater than 250/microL, and no prior diagnosis of AIDS at onset of HD. CONCLUSION: Our virologic findings indicate that HIV-related HD is more closely associated with EBV than HD in the general population. The peculiar clinicopathologic findings, the role of some prognostic factors, and the possibility of cure of HIV-related HD have been demonstrated.

Acquired Immunodeficiency Syndrome↗

Brief report: prognostic importance of cellular DNA content in T1-2 N0 laryngeal squamous cell carcinomas treated with radiotherapy.

One hundred fifty-two unselected, consecutive patients with T1-2N0 laryngeal squamous cell carcinoma received radical radiation therapy at the Division of Radiotherapy, Centro di Riferimento Oncologico, Aviano, Italy. Thirty-one (20.4%) of the patients showed disease recurrence or persistence (R/P) after radiotherapy. Flow-cytometric DNA ploidy measurements were performed in 72 cases; 20 had tumor R/P and 52 did not. Tumor R/P occurred more frequently (in 17 [85%] of 20 cases) in patients with diploid tumors. The hazard ratio of recurrence in diploid tumors as compared with aneuploid tumors, after inclusion of all the other significant prognostic factors in a Cox proportional hazards model, was 8.9 (P < .01). Therefore DNA ploidy seems to be an important marker of tumor R/P in patients with T1-2N0 laryngeal carcinoma after radiotherapy.

Carcinoma, Squamous Cell↗

The classification of AIDS cases: concordance between two AIDS surveillance systems in Italy.

This study assessed the concordance between the transmission classification of 725 acquired immunodeficiency syndrome (AIDS) cases by the Italian AIDS Registry (the national surveillance system) and the classification of the same cases by the Italian Cooperative Group on AIDS-Related Tumors. A high degree of concordance emerged for intravenous drug users in both sexes (kappa = 0.88; 95% confidence interval [CI] = 0.84, 0.92), for homosexual men (kappa = 0.83; 95% CI = 0.79, 0.87), and for persons infected through contaminated blood or blood derivatives (kappa = 1.00). The concordance was lower among heterosexual men (kappa = 0.51; 95% CI = 0.37, 0.65) and especially among men whose risk group was not determined (kappa = 0.28; 95% CI = 0.12, 0.44). The discrepancies observed among heterosexual men indicate a need for continuing and accurate monitoring of AIDS reporting by transmission category.

Acquired Immunodeficiency Syndrome↗