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Biomedical subjects

S Franceschi

Publications and source records attributed to S Franceschi.

At least 433 records · Page 24Linked to original sources
PubMed1993

Dietary factors and the risk of endometrial cancer.

BACKGROUND: Endometrial cancer is associated with overweight, but little is known on its possible relationship with specific aspects of diet. METHODS: The relationship between dietary factors and the risk of endometrial cancer was investigated in a case-control study conducted in Switzerland and Northern Italy on 274 patients with histologically confirmed endometrial cancers and 572 control subjects admitted to the hospital for acute nongynecologic disorders that were not hormone related, metabolic, or neoplastic. RESULTS: Significant direct associations were observed with (1) the total energy intake (odds ratio [OR] for the highest versus the lowest consumption tertile = 2.7) and, after allowance for energy intake, (2) the frequency of consumption of most types of meats, eggs, beans or peas, added fats (OR for total added fat = 2.5), and sugar (OR = 2.5). Significant protection, of the order of 40-60% reduction in the highest versus the lowest consumption tertile, was conferred by elevated intake of most vegetables and fresh fruit and whole grain bread and pasta. This was reflected in the low OR for the highest tertiles of intake of beta-carotene and ascorbic acid (OR for the highest versus the lowest consumption tertile after allowance for energy intake = 0.5). CONCLUSIONS: The current study suggests that, aside from the predictable adverse effects of overeating and consequent overweight, some qualitative aspects of the habitual diet may also be associated with the risk of endometrial cancer, chiefly, the intake of animal proteins and fat (directly) and of fresh fruit, vegetables, and fibers (inversely).

Adult↗
PubMed1993

Cancer risk in farmers: results from a multi-site case-control study in north-eastern Italy.

The relationship between farming and cancer risk was investigated in an integrated series of case-control studies conducted from 1985 to 1991 in the Friuli Venezia Giulia region, north-east Italy. Patients with cancer of the oral cavity and pharynx, larynx, oesophagus, colon and rectum, pancreas, breast, thyroid gland, kidney and urinary tract, bladder, prostate, soft-tissue sarcomas, Hodgkin's diseases, non-Hodgkin's lymphomas and multiple myelomas, and controls admitted to hospital for acute, non-neoplastic conditions, were interviewed. For males, a significantly elevated relative risk was seen for oral cavity and pharynx. Farming, however, was associated with a significant protection against cancer of the colon and rectum and bladder. In females, only one significant association emerged, for multiple myeloma. A few significant interactions between cancer risk and year of birth (i.e., before 1930 or 1930 and after) were observed. The risk of cancer of the larynx was significantly elevated in younger male farmers but not in older ones. Our multi-site case-control study confirms that farmers have, for some cancer sites, a distinctive pattern. Excesses of cancer of the oral cavity and pharynx in farmers are characteristic of the present study area and, possibly, of similar European rural populations who have in common high levels of alcohol consumption and, at least in the past, unbalanced diets.

Adolescent↗
PubMed1993

Long-term impact of reproductive factors on cancer risk.

The relationship between reproductive variables (parity, age at first birth, number of induced and spontaneous abortions) and cancer risk has been analysed using data from an integrated series of case-control studies conducted in northern Italy between 1983 and 1992. The overall data-set included women below age 75 with histologically confirmed cancers of the following sites: oesophagus, 58; stomach, 280; colon, 405; rectum, 210; liver, 82; gall-bladder, 29; pancreas, 129; breast, 3,415; cervix, 742; endometrium, 725; ovary, 953; bladder, 68; kidney, 56; thyroid, 180; lymphomas, 80; myelomas, 57; and a total of 5,619 controls admitted to hospital for acute non-neoplastic, non-gynaecological, non-hormone-related conditions. Multivariate odds ratios, as estimators of relative risks (RR), were obtained after allowance for age, education, use of oral contraceptives and oestrogen replacement treatments, plus various reproductive factors. Direct significant trends with parity were observed for cancer of the liver (RR for women with > or = 4 births vs. nulliparae = 3.3) and cervix uteri (RR = 4.1). The risk of gall-bladder cancer was also elevated for multiparae (RR = 1.9). No significant inverse trend in risk emerged. However, the RRs in multiparae were significantly below unity for breast (RR = 0.8), endometrium (RR = 0.7), and ovary (RR = 0.8). With reference to age at first birth, a significant trend in risk was observed for breast cancer (RR = 1.4 for 25 to 29 and 1.5 for > or = 30 vs. < 25 years). In contrast, the risk of cervical cancer was inversely related to age at first birth. For spontaneous abortions, the only significant inverse trend was for ovarian cancer (RR = 0.7 for > or = 2 vs. 0 abortions), but also the point estimate for endometrial cancer in women with > or = 2 abortions was below unity. For induced abortions, there was a strong inverse trend in risk for endometrial cancer (RR = 0.5), and the RRs were below unity also for colon and breast cancer. In contrast, cervical cancer was directly associated with the number of spontaneous abortions. Although the underlying aetiological interpretations are different for various cancer sites, this study provides, in a large and uniform data-set, quantitative information on the long-term impact of reproductive factors on cancer risk.

Abortion, Induced↗
PubMed1993

Trends in uterine cancer mortality in the Americas, 1955-1988.

Trends in uterine cancer mortality over the period 1955-1988 were analyzed for 14 selected Latin American countries and for the United States and Canada on the basis of the official death certification data from the World Health Organization database. In the late 1960s uterine cancer mortality in Latin America ranged from 7.8/100,000 in the Dominican Republic to 26.4/100,000 in Venezuela and was around 10/100,000 in the United States and Canada. Over the last two decades most Latin American countries (with the exception of the Dominican Republic and Ecuador) showed declines in mortality rates ranging from about 10% in Argentina and Mexico to 25-35% in Cuba, Chile, Uruguay, and Venezuela. These declines were however appreciably smaller than those in the United States and Canada, where falls in uterine cancer mortality approached 50%. In comparison with recent rates in the United States and Canada (around 5/100,000), mortality from uterine cancer was still high in all Central and South American countries (between 11 and 20/100,000), with the sole exception of Puerto Rico (6.3/100,000). The highest rates were in Paraguay and Ecuador (over 20/100,000). The overall variation in all age-standardized uterine cancer mortality in Latin America remained around threefold during the period 1965-1988 (i.e., between 22/100,000 in Paraguay and 6.3/100,000 in Puerto Rico). However, if the United States and Canada were also considered, the ratio between the highest and lowest mortality rate at all ages increased from about threefold during the period 1965-1969 to over fourfold in the late 1980s. This diverging pattern between North and Latin America was even clearer in young women (20-44 years), when most uterine cancer originates from the cervix, and less evident in the elderly. In the young, recent upward trends were observed in Argentina, Costa Rica, and the Dominican Republic. These mortality patterns are discussed with reference to risk factor exposure, cytologic screening programs, changes in hysterectomy rates, treatment, and case ascertainment and certification.

Adult↗
PubMed1993

Cigarette smoking recidivism after participation in the "Five-Day Plan to Stop Smoking" in northeastern Italy.

BACKGROUND: This study was designed to evaluate the efficacy of the "Five-Day Plan to Stop Smoking" (the "Five-Day Plan") in helping smokers to give up the habit and to identify the characteristics of those smokers who succeeded in quitting. METHODS: Five hundred and forty-five smokers (363 men, mean age 41 years, and 182 women, mean age 37 years) of a total of 683 (80%) who participated in eight courses of the Five-Day Plan, held in northeastern Italy between October 1985 and April 1988, constitute the study group. They were contacted from 28 to 70 months after their participation in the Five-Day Plan. RESULTS: Approximately 70% of smokers tried to stop smoking for fear of smoking-related health hazards, and 15% (18% of men and 9% of women, P < 0.001) of these stopped because of smoking-related diseases or symptoms. Overall, 18% of the participants interviewed relapsed to cigarette smoking within 1 month after having taken the course, 44% within 1 year, and 59% after 5 years. Higher rates of recidivism after the Five-Day Plan were recorded among women than among men (55 and 39% after 1 year, respectively). Among men, older age and heavy smoking were significantly associated with a reduced probability of relapsing. Among women, a high level of education was the only significant predictor of smoking recidivism. CONCLUSIONS: These data indicate that the Five-Day Plan is useful in helping smokers who are already predisposed to quit their habit, but its efficacy seems to be largely restricted to men, in particular to older and heavier smokers.

Adult↗
PubMed1993

Smoking habits and prostate cancer: a case-control study in northern Italy.

BACKGROUND: Cigarette smoking has been associated with increased risk for prostate cancer in 2/13 case-control studies and 4/12 cohort studies conducted on this topic. The relationship between tobacco smoking and prostate cancer was further studied in a hospital-based case-control study in northern Italy. METHODS: Two hundred seventy-one cases of histologically confirmed prostate cancer and 685 controls were interviewed during their hospital stay about smoking habits and various other covariates. Controls comprised a group of males admitted to the same hospitals as the cases, but with acute conditions exclusive of malignant tumors, urological diseases, or any condition known to be related to tobacco or alcohol consumption. Odds ratios and 95% confidence intervals from logistic regression equations were reported for all smoking characteristics. RESULTS: No increased risk was found among the current smokers (odds ratio = 0.9; 95% confidence interval, 0.6-1.4), or the ex-smokers (odds ratio = 0.8; 95% confidence interval, 0.5-1.1). No trend in risk emerged with number of cigarettes smoked per day (odds ratio = 1.0; 95% confidence interval, 0.5-2.0 for smokers of 30 or more cigarettes compared with nonsmokers). Similarly, long duration of smoking habit, early smoking onset, and consumption of high-tar cigarettes were not associated with prostate cancer. CONCLUSION: The present study did not demonstrate any association between prostate cancer and various measures of tobacco smoking.

Aged↗
PubMed1993

Oestrogen replacement treatment and the risk of endometrial cancer: an assessment of the role of covariates.

The relationship between oestrogen replacement treatment and the risk of endometrial cancer was analysed in a case-control study of 158 histologically confirmed incident cases below the age of 75 and 468 controls in hospital for acute, non-neoplastic, non-hormone-related conditions conducted in the Swiss Canton of Vaud in 1988-1992. Overall, 60 (38%) cases vs. 93 (20%) controls had ever used oestrogen replacement treatment: the corresponding multiple logistic regression relative risk (RR) was 2.7 (95% confidence interval, CI: 1.7-4.1). The risk was directly related to duration of use, and rose to 5.1 (95% CI: 2.7-9.8) for > 5 year-use. The RR was still significantly elevated 10 or more years after stopping use (RR = 2.3, 95% CI: 1.2-4.5). When the role of covariates was considered, a significant interaction was observed with body mass index (RR for long-term oestrogen use = 6.0 for lean or normal weight women vs. 2.4 for overweight women). There was also a hint of a negative interaction with oral contraceptive (OC) use, since the RR for oestrogens was higher (or restricted) to women who had never used OC (RR = 5.4, for long-term oestrogen use), as compared with those who had used OC, who showed no significant evidence of association with oestrogens (RR = 0.9 for long-term use). There was no significant interaction with cigarette smoking. Thus, this study confirms the presence of a strong association between oestrogen replacement treatment and endometrial cancer risk, since in the late 1980s or early 1990s about 25% of cases could be attributed to oestrogen replacement treatment in this Swiss population. Further, it confirms the presence of significant negative interactions of oestrogen use with obesity, and, possibly, with OC as well.

Adult↗
PubMed1993

Risk factors for epithelial ovarian cancer in women under age 45.

Risk factors for ovarian cancer in young women were investigated using data from a case-control study conducted between 1983 and 1992 in Milan, northern Italy, on 194 women below age 45 with histologically confirmed incident cancers of the ovary and 710 controls admitted to the same network of hospitals for acute non-gynecological, nonhormonal and non-neoplastic diseases. An elevated relative risk (RR) of ovarian cancer was found among women reporting 12 or more years of education [RR 1.6, 95% confidence intervals (CI) 1.0-2.03] and belonging to the highest social class (RR 1.8, 95% CI 1.1-3.0). Women whose mothers had had ovarian cancer had a multivariate RR of 2.7 (95% CI 0.7-10.5) compared to those with no family history. Menarche above age 13 and irregular menstrual cycles were significantly protective against ovarian cancer (RR 0.6 for both risk factors). There was a significant inverse relationship with abortions, the RR being 0.6 both for spontaneous and for induced abortions, while protection of parity was not significant. Higher risks of ovarian cancer were observed in women having first or last birth when older than 30 years (RR 2.0 and 2.4, respectively, compared to those delivering under age 25). A significant trend toward an increased risk of ovarian cancer was also observed with decreasing time since last birth. Compared with women whose last birth occurred 10 or more years before diagnosis, the RR was 2.1 (95% CI 1.1-3.9) for those reporting a birth during the last 5 years. The RR for oral contraceptive users was 0.7 (95% CI 0.5-1.0) and the protection increased with duration, with RR of 0.3 (95% CI 0.1-0.7) for 5 or more years of use. This study indicates that, although the incidence of ovarian cancer is higher in older women, recognised risk and protective factors are similar below age 45. An excess risk in the few years after a term delivery is also suggested.

Adult↗
PubMed1993

Reproducibility of an Italian food frequency questionnaire for cancer studies: results for specific food items.

To evaluate the reproducibility of a quantitative food frequency questionnaire (FFQ) used in a case-control study on cancer of the breast, ovary and digestive tract, we compared the result of a 98-item questionnaire administered twice at an interval of 3-10 months (median = 5.4 months) to 452 volunteers (144 males and 308 females, median age = 50 years) from three Italian provinces (Pordenone, Genoa and Forlí). Spearman correlation coefficients (r) for intake frequency of 87 dietary items ranged from 0.35 ("chicken or turkey, boiled") to 0.84 ("wine"). Most coefficients were between 0.60 and 0.80, only two being below 0.40 and five equal or above 0.80 (mean r = 0.59). The concordance of the two measurements tended to be somewhat better for alcoholic and non-alcoholic beverages, bread, cereals and first courses, fruits and summary questions at the end of each section of the questionnaire than for side dishes, sweets and desserts. Also, the reproducibility of 11 subjective questions, such as those concerning the amount of fat in seasoning and the intake of garlic or salt, seemed to be high. Age, sex, educational level of the volunteers and interval between the two FFQ did not have a large or systematic impact on the concordance of the two measurements. In conclusion, the present study has shown a good level of reproducibility of our questionnaire and has provided a few important hints on ways of improving the description of various food items.

Adult↗
PubMed1993

Increased frequency of lymphocyte depletion and mixed cellularity subtypes of Hodgkin's disease in HIV-infected patients. Italian Cooperative Group on AIDS and Tumours.

To assess whether the histological pattern of Hodgkin's disease (HD) in human immunodeficiency virus (HIV)-infected patients differs from that among HD patients without HIV infection, the observed (O) number of HD cases according to histological subtype [i.e. lymphocyte predominance (LP), nodular sclerosis (NS), mixed cellularity (MC) and lymphocyte depletion (LD)] among 92 Italian HIV-infected patients was compared with the expected (E) number derived from two case series of HD from Europe and the U.S.A. (14,315 cases of HD) and Italy (125 cases). After age standardisation, the O/E ratio was computed, along with its 95% confidence interval (CI). In comparison with 125 Italian HD patients not infected with HIV, a 4-fold higher frequency of the MC histological subtype (95% CI: 2.9-5.1) and an approximately 12-fold higher frequency of the LD subtype (95% CI: 7.0-18.0) emerged among HIV-infected patients. These results were substantially confirmed when the comparison was made with the case series from Europe and the U.S.A. These data show different histological patterns of HD between a group of HIV-infected patients and HD patients from the general population. Although caution is needed in their interpretation, the study results seem to indicate that HD of the MC or LD subtypes may be considered an AIDS-related malignancy.

Adult↗
PubMed1993

Diet and human oral carcinoma in Europe.

There are substantial variations in incidence and mortality from oral and pharyngeal cancer in Europe, with systematic tendencies towards increasing rates in most European countries, particularly in younger males. Most of the geographical differences are due to tobacco and alcohol consumption, which explain over three quarters of approximately 20,000 deaths from oral cancer registered every year in Europe, excluding the former Soviet Union. Nonetheless, dietary factors have an established and quantifiable role in oral carcinogenesis in Europe. Two studies showed a significant protective effect by vegetables and fresh fruit, which appeared particularly strong and consistent for fruit, but were not explained by measures of intake of beta-carotene or other micro-nutrients. Although it is not clear whether the observed associations simply reflected a generally poorer nutritional status of oral cancer cases, they open interesting perspectives for aetiological research and prevention, since about one in six oral cancers in European populations can be attributed to dietary deficiencies or imbalances.

Adult↗
PubMed1993

Decaffeinated coffee and acute myocardial infarction. A case-control study in Italian women.

The relationship between consumption of decaffeinated coffee and acute myocardial infarction was analyzed in a case-control study conducted in Italy between 1983 and 1992. Case patients were 433 women with acute myocardial infarction, aged 24 to 69 years (median age, 52 years), and control subjects included 869 women in hospital for a wide spectrum of acute conditions, other than cardiovascular, neoplastic, digestive, and hormone-related diseases or conditions associated with long-term modification of diet. Regular use of decaffeinated coffee was reported by 11% of the case patients and 7% of the control subjects. Compared with women who did not drink decaffeinated coffee, the relative risk (RR) was 1.3 (95% confidence interval (CI), 0.8 to 2.2) for one cup/d and 2.1 (95% CI, 1.1 to 3.9) for 2 or more cups (chi 2(1) for trend = 5.62, P = 0.02). The estimates were somewhat higher after allowance for education, marital status, body mass index, and smoking status (RR for > or = 2 cups of decaffeinated coffee per day, 2.5; 95% CI, 1.2 to 4.9), and somewhat lower after further allowance for diabetes, hypertension, and hyperlipidemia (RR, 1.7; 95% CI, 0.8 to 3.6). There was no association between duration of use of decaffeinated coffee and infarction risk. The relationship between decaffeinated coffee and infarction was consistent across strata of age, education, smoking, and history of hyperlipidemia. Thus, a relationship of marginal significance was observed in this study between decaffeinated coffee and myocardial infarction, of similar magnitude to that described for caffeinated coffee. This indicates that (i) caffeine is unlikely to be a relevant factor in any potential coffee-myocardial infarction relationship, and (ii) shifting from caffeinated to decaffeinated coffee is unjustified in order to reduce any possible coffee-related infarction risk.

Adult↗
PubMed1993

Female hormone utilisation and risk of hepatocellular carcinoma.

The relationship between female hormone use and primary liver cancer was analysed using data from a case-control study conducted between 1984 and 1992 in Milan on 82 female incident cases with histologically or serologically confirmed hepatocellular carcinoma and 368 controls admitted to hospital for acute non-neoplastic, non-hormone-related diseases. An elevated relative risk (RR) or primary liver cancer was observed in oral contraceptive (OC) users (RR 2.6, for ever versus never users, 95% confidence interval, CI 1.0-7.0). The RR was directly related to duration of use (RR 1.5 for < or = 5 years and 3.9 for > 5 years) and persisted for longer than 10 years after stopping use (RR 4.3%, 95% CI 1.0-18.2). The RR were below unity, although not significantly, for women ever using oestrogen replacement therapy (RR 0.2, 95% CI 0.03-1.5) and female hormones for indications other than contraception and menopausal therapy (RR 0.4, 95% CI 0.1-1.5). The long-lasting, association between risk of hepatocellular carcinoma and OC use has potential implications on a public health scale, since primary liver cancer is a relatively rare disease among young women, but much more common at older ages. This study provides limited but reassuring evidence on the possible relationship between oestrogen replacement treatment and subsequent risk of hepatocellular carcinoma.

Adult↗
PubMed1993

Selected physical activities and the risk of endometrial cancer.

The relationship between various indicators of physical activity and endometrial cancer risk was analysed using data of a case-control study conducted in 1988-1991 in Switzerland and Italy on 274 histologically confirmed cases and 572 controls admitted to hospital for acute, non neoplastic, non hormone-related diseases. Using a self-rated assessment of total physical activity, there was a systematic tendency for the cases to report more frequently 'low' or 'very low' physical activity. The relative risks were similar for 'very high' or 'moderately high' physical activity, but increased in the two lowest levels, with point estimates, in various decades of age, between 1.3 and 2.3 for 'moderately low' and over 2.5 for 'very low' physical activity. Although the association was apparently stronger at older ages, all the trends in risk were significant. Allowance for major identified potential distorting factors, including body mass index and a measure of total energy intake, could explain only in part the association, and the inverse trends in risk remained statistically significant. When selected types of physical activity were analysed, no association was observed with climbing stairs or walking, but the risk estimates for the lowest level of activity was over 4 for housework, and between 1.5 and 1.9 for sport and leisure and occupational activity. Thus, the present findings suggest that a moderate or high physical activity is an indicator of reduced endometrial cancer risk, although this observation still requires epidemiologic confirmation and clearer definition from a pathogenic point of view.

Activities of Daily Living↗
PubMed1993

Oral contraceptives and breast cancer in northern Italy. Final report from a case-control study.

To assess the relation between oral contraceptive (OC) use and breast cancer, we analysed data from a case-control study conducted in Northern Italy between 1983 and 1991 on 2,309 cases below age 60 and 1,928 controls admitted to hospital for acute diseases unrelated to OC use and to any of the known or potential risk factors for breast cancer. OC use was reported by 16% of cases and 14% of controls. The multivariate relative risk (RR) for ever vs never use of combination OC was 1.2 (95% confidence interval (CI) 1.0-1.4). However, there was no trend in risk with duration. The RR was elevated for very short use, but declined to 0.8 (95% CI = 0.5-1.0) for five or more years' use. No noteworthy relationship was found for other major measures of OC use, although RR estimates were above unity for women who had stopped use less than 5 years before (RR = 1.5, 95% CI = 1.1-2.0), started use less than 10 years before (RR = 1.3, 95% CI = 1.0-1.9), started when 25 or more years old (RR = 1.4, 95% CI = 1.1-1.7), or after first birth (RR = 1.2, 95% CI = 1.0-1.5). No interaction was observed between OC use and family history of breast cancer, parity and age at first birth. A separate analysis of 373 cases and 456 control below age 40 showed no association with ever use (RR = 0.9, 95% CI = 0.6-1.2).

Adult↗
PubMed1993

Trends in lip cancer incidence in Vaud, Switzerland.

Recent trends in lip cancer incidence in the Swiss Canton of Vaud (approximately 600,000 inhabitants in 1990) were analysed over the period 1975-1990, when a total of 87 cases were registered. A steady and substantial decline was observed in both sexes, since age-standardised (world) rates declined from 1.8 to 0.6/100,000 males and from 0.14 to 0.02/100,000 females. These downward trends were evident across subsequent age groups. These trends were apparently not due to changes in registration or classification criteria in the study period and are discussed in terms of decreased occupational exposure to ultraviolet light, and reduced pipe and cigar smoking.

Adult↗