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Biomedical subjects

S Franceschi

Publications and source records attributed to S Franceschi.

At least 451 records · Page 25Linked to original sources
PubMed1993

Multiple primary cancers in the Vaud Cancer Registry, Switzerland, 1974-89.

Data collected by the Cancer Registry of the Swiss Canton of Vaud (whose population in 1980 was about 530,000 inhabitants) were used to estimate the incidence of second metachronous primary cancers following any specific neoplasm. Among 34,615 cases of incident neoplasms registered between 1974 and 1989 and followed through integrated active follow-up to the end of 1989, for a total of 118,241 person-years at risk, there were 2,185 second primaries (1,280 males, 905 females). For both sexes, the standardised incidence ratios (SIR) were significantly elevated by about 20%. Overall significantly elevated ratios were registered for cancers of the oral cavity and pharynx (SIR = 1.6 for males, 2.0 for females), oesophagus in males (SIR = 1.5), lung in males (SIR = 1.4), skin melanoma (SIR = 1.7 for males, 1.5 for females), non-melanomatous skin cancers (SIR = 1.6 for males, 1.5 for females), female breast (SIR = 1.3), kidney (SIR = 1.5 for males, 1.9 for females), and thyroid in males (SIR = 2.4). When specific first cancer sites were considered, the SIR following a cancer of the oral cavity and pharynx was around 3 in both sexes, mainly on account of a substantial excess of second primaries of the oral cavity, oesophagus, larynx and lung. The overall SIR following laryngeal cancer was 3.0, and significant excesses were observed for oral cavity and pharynx, oesophagus and lung. After lung cancer, the overall SIR was 1.7 for males and 2.6 for females, and significantly elevated SIRs were observed for oral cavity, lung and oesophagus. Following non-melanomatous skin cancers, elevated SIRs were observed in both sexes for skin melanoma and non-melanomas. The incidence of any cancer after breast cancer was significantly elevated (SIR = 1.2), mainly on account of an elevated risk of subsequent breast cancer (SIR = 1.7). With reference to cervical cancer, there was a significant excess for any subsequent primary (SIR = 1.6), and for lung cancer (SIR = 7.8). Significantly elevated SIRs were observed for kidney following bladder cancer, and for bladder after kidney cancer. In both sexes, the incidence of cancers of any site was elevated following leukaemias (SIR = 1.7 for males, 2.5 for females), and a significant excess was registered for lung in males and non-melanomatous skin cancers in both sexes.(ABSTRACT TRUNCATED AT 400 WORDS)

Female↗
PubMed1993

Moderate beer consumption and the risk of colorectal cancer.

The relationship between beer consumption and the risk of colon and rectal cancer was considered in a case-control study conducted in northern Italy. The study was based on 828 histologically confirmed incident cases of colon cancer, 498 of rectal cancer, and 2,024 controls in hospital for a wide spectrum of acute, nonneoplastic, nonalcohol-related diseases. Beer drinking was reported by 6% of colon cancer cases, 7% of rectal cancer cases, and 10% of controls; regular beer drinkers (> or = 1 drinks/day) made up 2.6% of colon cancer cases, 3.2% of rectal cancer cases, and 4.1% of controls. Thus the multivariate relative risks (RR) for irregular drinkers were 0.6 [95% confidence interval (CI) 0.4-1.0] for colon and 0.7 (95% CI 0.4-1.2) for rectum. Corresponding values for regular drinkers were 0.7 (95% CI 0.4-1.2) for colon and 0.9 (95% CI 0.5-1.5) for rectal cancer. Despite the low frequency of beer drinking in this study, and hence its limited statistical power, the originality of the population in terms of colorectal cancer incidence, patterns of risk factor exposure, and the large dataset provide interesting and useful confirmation that moderate beer drinking is not associated with elevated colon or rectal cancer risk.

Adult↗
PubMed1993

Family history of breast, ovarian and endometrial cancer and risk of breast cancer.

The relationship between family history of breast, ovarian and endometrial cancer and risk of breast cancer was analysed using data from a case-control study of breast cancer conducted in the greater Milan area, Northern Italy. The cases studied were 3415 women (median age 52 years, range 23-74) who had histologically confirmed breast cancer diagnosed within the year preceding the interview. The controls were 2916 women (median age 54 years; range 21-74) in hospital for a spectrum of acute illnesses excluding gynaecological, hormonal or neoplastic conditions. A total of 375 cases (11.0%) and 128 controls (4.4%) reported a history of breast cancer in first degree relatives. Compared with women with no family history of breast cancer, the RR was 2.7 (95% confidence interval [CI] : 2.2-3.3) in those with one first degree relative affected and 2.8 (95% CI : 1.3-5.7) in those with two or more affected relatives. In comparison with women without family history of ovarian cancer the RR of breast cancer was 1.4 (95% CI : 0.9-2.3) for those reporting one or more first degree relatives with ovarian cancer. However, the multivariate estimate for family history of ovarian cancer, including a term for familial breast cancer, decreased to 0.8 (95% CI : 0.5-1.4). The risk of breast cancer was similar in women reporting a family history of breast cancer (RR = 2.2) and in those reporting a family history of both breast and ovarian cancer (RR = 2.5), in comparison with women reporting no family history of breast and/or ovarian cancer.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

The impact of mammography on breast cancer detection.

BACKGROUND: Mammography has different effects on the epidemiology of breast cancer, i.e., while increasing the registered incidence it can reduce mortality. This study was aimed at obtaining quantitative estimates of the impact of mammography on breast cancer detection. SUBJECTS AND METHODS: A case-control study was conducted in Northern Italy between 1985 and 1991 on 2596 cases of histologically confirmed breast cancer and 2005 controls in hospital for acute diseases unrelated to known or suspected risk factors for breast cancer. RESULTS: 15.6% of the patients reported one screening mammography and 9.7% two or more. The age-adjusted breast cancer diagnosis odds ratios (OR) were 1.3 (95% confidence interval, CI 1.1 to 1.5) for one mammography and 2.0 (95% CI 1.6 to 2.6) for two or more. When allowance was made for major identified potential distorting factors, the OR decreased to 1.0 (95% CI 0.8 to 1.2) for one, and 1.3 (95% CI 1.0 to 1.8) for two or more mammographies. In the age-adjusted analysis, the association between screening mammography and breast cancer detection was apparently stronger for younger and pre-menopausal women, among more educated women and those with no history of benign breast disease or breast biopsy, and among women who had first-degree relatives with histories of breast cancer. CONCLUSIONS: Although the association between mammography and breast cancer was largely explained by selective screening, confirming at the epidemiological level that the relationship is incidental, the unadjusted ratios are of public health interest, since they give a measure of the role of mammography in breast cancer detection.

Adult↗
PubMed1993

Epidemiologic pathology of ovarian cancer from the Vaud Cancer Registry, Switzerland.

OBJECTIVE: To provide further information on the descriptive epidemiology and survival of ovarian cancer patients by specific histologic types. STUDY DESIGN: Descriptive epidemiological study. Cases of ovarian cancer registered between 1974 and 1988 in the Vaud Cancer Registry, Switzerland (based on a population of approximately 530,000 inhabitants), were analysed. RESULTS: A total of 649 cases were registered, corresponding to an overall age-standardized (world population) incidence of 9.6/100,000. The most common histotype was serous carcinoma (41%, incidence rate 4.0/100,000), followed by endometrioid (13%), mucinous (12%), clear cell (5%), and undifferentiated carcinomas (3%); 20% of the cases were classified as 'epithelial, unspecified', and 6% were non-epithelial cancers. There was a tendency for the incidence of all epithelial types to rise up to the seventh decade of age, and to level off thereafter. The increases between the ages of 45 and 65 were, however, mostly in serous carcinomas whose proportion of total ovarian epithelial cancer peaked in middle age. Overall, 5-year relative survival was 32%. Survival rate was 32% for serous carcinomas, but was significantly higher for endometrioid (51%) and, among nonepithelial neoplasms, for germ-cell cancers (68%). Survival rates were poor for undifferentiated and 'epithelial, unspecified' carcinomas (16%). Relative survival was systematically higher below age 60 than at age 60 or over. In the two subsequent calendar periods examined (divided according to the approximate time when the use of platinum-based chemotherapy began to spread, i.e., 1982), 5-year relative survival rates were 28% and 36%, respectively (chi 1(2) = 6.1, p = 0.02). CONCLUSION: The present report is a population-based description of the epidemiologic pathology and prognosis of ovarian cancer, and provides evidence of a significant improvement of survival over the past decade. This may be due to changed diagnostic methods (e.g., ultrasonography), improved surgical approach, (platinum-based) chemotherapy, or a combination of all these factors.

Adult↗
PubMed1993

Alcohol consumption and the risk of acute myocardial infarction in women.

STUDY OBJECTIVE: To investigate the relationship between alcohol consumption and the risk of acute myocardial infarction in women. DESIGN: This was a hospital based, case-control study carried out between 1983 and 1990. Main outcome measures were average daily number of drinks of various alcoholic beverages consumed and corresponding multivariate relative risk estimates and 95% confidence intervals (CI). SETTING: A network including major teaching and general hospitals in northern Italy. SUBJECTS: Cases were 298 women with acute myocardial infarction but no history of ischaemic heart disease and controls 685 women admitted to hospital for acute conditions, unrelated to alcohol consumption or to known or suspected risk factors for ischaemic heart disease. MEASUREMENTS AND MAIN RESULTS: Compared with non-drinkers, the estimated relative risks (RR) were 0.7 (95% CI 0.5, 1.0) for one drink or less per day, 0.8 (95% CI 0.6, 1.2) for more than one to two drinks per day, 1.4 (95% CI 0.8, 2.3) for more than two to three, and 2.6 (95% CI 1.5, 4.6) for more than three drinks per day. These estimates were consistent across strata of selected covariates, including age, education, and smoking. Allowance for major identified risk factors for myocardial infarction did not materially modify the risk estimate for light drinkers (RR 0.7, 95% CI 0.5, 1.1), but reduced the RR in heavy drinkers to 1.8 (95% CI 0.9, 3.5). CONCLUSIONS: This study indicates that women who do not drink alcohol have a risk of myocardial infarction that is higher than that of light drinkers, although the protection of light drinking was not significant. Among drinkers, however, there was a significant direct trend in risk with dose. The raised risks in heavy drinkers may reflect a real association or result from other unfavourable characteristics or habits associated with high alcohol consumption.

Adult↗
PubMed1993

Marital status, indicators of sexual activity and prostatic cancer.

STUDY OBJECTIVE: To analyse the relationship between marital status, indicators of sexual activity, history of urological and venereal diseases, and the risk of prostatic cancer. DESIGN: Case-control study. SETTING: A network of cooperating hospitals from northern Italy. PARTICIPANTS: A total of 271 patients with histologically confirmed prostatic cancer and 685 controls in hospital because of acute, non-neoplastic, non-genital or urological conditions. MEASUREMENTS AND MAIN RESULTS: Relative risks (RR) and the corresponding 95% confidence intervals (CI) derived from multiple logistic regression equations, including terms for age, area of residence, and education were determined. The risk of prostatic cancer was lower in never married than in married men (RR = 0.6), but not significantly so. Cases reported a significantly higher number of marriages than control subjects, and the RR was 3.2 (95% CI = 1.2, 8.9) for two or more marriages compared with never married men. Prostatic cancer patients also reported being significantly older at the time of their first marriage: compared with men who first married under age 25 years, the RR was 1.6 for marriage at age 25 to 29, and 1.8 for age 30 or more. With regard to urological or venereal diseases, only cystitis and nephrolithiasis were more frequently reported by cases, although there was no tendency for the risk to increase with the number of cystitis episodes and the RR decreased for longer periods since the first episode. CONCLUSIONS: Although these results do not show a totally cohesive picture, they confirm that some aspects of sexual lifestyle are associated with prostatic cancer in Italy.

Age Factors↗
PubMed1993

Coffee consumption and risk of acute myocardial infarction in Italian males. GISSI-EFRIM. Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto, Epidemiologia dei Fattori di Rischio del'Infarto Miocardico.

The relationship between coffee consumption and acute myocardial infarction (AMI) was analyzed using data from a case-control study conducted in 1988 to 1989 within the framework of the GISSI-2 trial on streptokinase versus alteplase and heparin versus no heparin in the treatment of AMI. A total of 801 male patients with AMI and 792 control subjects who were hospitalized in several Italian regions for diseases unrelated to known or potential risk factors for cardiovascular diseases were included. Compared with coffee nondrinkers, the multivariate relative risks (RRs), after allowance for age, education, body mass index, smoking habits, alcohol consumption, family history of AMI, cholesterol level, history of diabetes, and hypertension, were 0.8 (95% confidence interval (CI), 0.5 to 1.2) for consumption of one cup/d, 1.3 (95% CI, 0.9 to 2.0) for two cups/d, 1.8 (95% CI, 1.1 to 2.7) for three cups, 2.5 (95% CI, 1.5 to 4.1) for four cups, and 2.6 (95% CI, 1.6 to 4.2) for five cups or more. The trend in risk with dose was statistically significant (P < 0.001). Duration of coffee consumption was not associated with the risk of AMI. The RRs for daily coffee consumption were elevated across strata of various covariates, including age, smoking habits, cholesterol level, diabetes, and hypertension, with a particularly elevated (although not significantly heterogeneous) estimate in patients younger than 50 years (RR, 5.7; 95% CI, 3.0 to 10.9 for four or more cups/d). The RR in patients who drank four or more cups of coffee per day and were current smokers was 8.1 (95% CI, 5.1 to 13.0), suggesting an unfavorable effect on the combination of cigarette smoking and high coffee intake on the risk of AMI.

Adult↗
PubMed1993

Physical activity and the risk of acute myocardial infarction. GISSI-EFRIM Investigators. Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto-Epidemiologia dei Fattori di Rischio dell'Infarto Miocardico.

The relationship between physical activity and acute myocardial infarction (AMI) was examined in a case-control study conducted in Italy in 1988 to 1989 within the framework of the GISSI-2 trial of streptokinase versus alteplase and heparin versus no heparin in the treatment of AMI. A total of 916 case patients admitted to coronary care units from various Italian regions for AMI were interviewed. Control subjects were 1106 patients admitted to the same network of hospitals for a broad spectrum of acute diseases not related to known or potential risk factors for myocardial infarction. Among various types of physical activity (occupational activity, walking, stair climbing, and sport and leisure-time physical activity), occupational physical exercise emerged as the most protective. Multivariate odds ratios (ORs) were 1.4 (95% confidence interval (CI), 1.0 to 2.0) and 1.6 (95% CI, 1.2 to 2.1) for the two lowest levels of occupational physical activity. The trends of increasing risk with decreasing activity were consistent, although less strong, when other types of activity were considered. The protection conveyed by occupational physical activity was similar across various strata of sex, age, education, smoking habits, and diabetes, and was not explained by serum cholesterol, body weight, or hypertension. This study therefore confirms that low physical activity is an indicator of subsequent risk of AMI.

Adult↗
PubMed1993

Assessment of fat intake in retrospective epidemiological studies.

The evidence on the positive association between fat intake and the risk of several cancers, including cancer of the breast, digestive tract and female genital tract, is substantial. Further, the interpretation of some null associations is hampered by various difficulties in the evaluation of the fat and cancer link.

Bias↗
PubMed1993

Cancer mortality by urbanization and altitude in a limited area in Northeastern Italy.

The geographical patterns of cancer mortality have been studied in Friuli-Venezia Giulia Region (1.2 million inhabitants), the North-eastern part of Italy, with respect to certain characteristics (i.e., rural, mixed, urban) and the altitude of the commune where the deceased subjects lived permanently at the time of death. In males, significantly increased mortality rates in rural versus urban communes (after allowance for altitude) were found for cancer of the oral cavity and pharynx, oesophagus and stomach. Conversely, significantly decreased mortality rates emerged for cancer of the colo-rectum, liver, lung, bladder, kidney and Hodgkin's disease. In females, significantly increased mortality rates in rural as compared to urban communes were observed for stomach cancer while significantly decreased mortality rates emerged for cancer of the colo-rectum, gallbladder, lung, breast, ovary, bladder and brain. With respect to altitude, residence above 200 meters retained a significant association in males, after allowance for the degree of urbanization of the commune of residence, for cancer of the oral cavity and pharynx, stomach and larynx (positive) and cancer of the colorectum and brain (negative). Women in locations above 200 meters seemed significantly at risk for stomach cancer, but protected from cancer of the colo-rectum and kidney. These results may provide a useful summary guide for further aetiological investigations into the risk factors associated with the diseases and give practical indications for local strategies of cancer control.

Adolescent↗
PubMed1993

The epidemiology of thyroid carcinoma.

Thyroid cancer is one of the rarest forms of cancer, yet there are wide variations in the degree of malignancy, ranging from the most rapidly fatal to the relatively benign. This is almost entirely dependent on the histological type. Generally speaking, data available on changing trends of incidence and mortality are subject to reservation, dependent on the degree to which they have been influenced by changing diagnostic criteria and the precision of histopathological description. Nevertheless, there is evidence that mortality is slowly decreasing, while incidence is slowly increasing. The purpose of this review is to try to interpret the temporal trends of incidence and mortality rates for thyroid carcinoma in the last 3 decades in light of the problems arising from changes in diagnostic standards and histological classification regarding thyroid neoplasms. Attention is also drawn to the implications, from a public health viewpoint, of the present intensive detection and treatment of occult thyroid carcinomas.

Causality↗
PubMed1993

Number of sexual partners and age at first intercourse in subsequent generations of Italian males and females.

Trends in the number of sexual partners and in age at first intercourse were analyzed using data on 706 men and 1206 women drawn from the hospital control groups of two case-control studies conducted since 1981 in Northern Italy. The overall lifelong mean number of sexual partners was 7.5 +/- 12.8 for men and 1.4 +/- 1.8 for females. The mean number of sexual partners was 6.0 for men born between 1910 and 1919, and 7.3, 9.0, 6.3 and 5.5 for subsequent 10 year birth cohorts. Mean age at first intercourse was 20.7 for the cohort born in 1910-19 and was fairly stable in men born after 1919, ranging from 18.4 to 18.8. Women had a substantially lower number of sexual partners than men in each subsequent birth cohort. However, the mean number of sexual partners increased from 1.1 in the 1910-19 cohort to 1.2, 1.2, 1.4 and 2.3 in subsequent birth cohorts, and the mean age at first intercourse decreased from 23.6 years to 23.1, 22.7, 21.3 and 19.7. These figures should be considered with caution, on account of the non-representativeness of the sample and of a possible under-reporting of number of partners by women. Still, Italian women, although not necessarily men, report substantially fewer sexual partners than northern European on American ones.

Adolescent↗
PubMed1992

Education and cancer risk.

BACKGROUND: Socioeconomic factors have been associated, to a variable degree, with the risk of serious cancers. METHODS: The relationship between education and cancer risk was analyzed using data from a series of case-control studies conducted in northern Italy between 1983 and 1990, including 119 histologically confirmed cancers of the oral cavity and pharynx, 294 of the esophagus, 564 of the stomach, 673 of the colon, 406 of the rectum, 258 of the liver, 41 of the gallbladder, 303 of the pancreas, 149 of the larynx, 2860 of the breast, 692 of the cervix, 567 of the corpus uteri, 742 of the ovary, 107 of the prostate, 365 of the bladder, 147 of the kidney, and 120 of the thyroid, 72 Hodgkin diseases, 173 non-Hodgkin lymphomas, 117 myelomas, and a total of 6147 control subjects admitted to the same network of hospitals for acute, non-neoplastic conditions. RESULTS: Nine types of cancer were inversely related to education. Those were oral cavity and pharynx, with a relative risk (RR) of 0.3 for the highest versus the lowest level; esophagus, RR = 0.6; stomach, RR = 0.5; liver, RR = 0.7; gallbladder, RR = 0.5; larynx, RR = 0.3; cervix, RR = 0.7; endometrium, RR = 0.5; and non-Hodgkin lymphomas, RR = 0.6. Five cancer sites were directly related to education: colon, RR = 1.3; pancreas, RR = 1.3; breast, RR = 1.5; kidney, RR = 1.3; and thyroid, RR = 1.5. No consistent gradient in risk with education was observed for the six other neoplasms considered, including rectum, prostate, bladder, Hodgkin disease, and multiple myeloma. The patterns of risk for education were consistent in men and women for most cancer sites except colon, for which the direct relationship was stronger in males. CONCLUSIONS: This study confirms the existence of and quantifies a number of strong socioeconomic correlates of cancer risk and indicates a few points open to additional investigation, such as the different pattern of risk for rectal and colon cancer, the strong negative gradient for endometrial cancer, and the absence of any clear association with education for cancers of the ovary, prostate, urinary tract, lymphomas, and myeloma.

Aged↗
PubMed1992

Risk factors for cancer of the tongue and the mouth. A case-control study from northern Italy.

BACKGROUND: The role of tobacco and alcohol consumption and the frequency of intake of a selected number of indicator foods as causes of cancer were investigated in a case-control study conducted in northern Italy. METHODS: One hundred two men with cancer of the tongue, 104 patients with cancer of the mouth, and 726 control subjects (the latter admitted to the hospital for acute nonneoplastic disease without respiratory illness) were interviewed. RESULTS: Similarly strong associations were observed with cigarette smoking (odds ratio [OR], 10.5 and 11.8 for current smokers versus never smokers in cancer of the tongue and mouth, respectively) and alcohol (OR, 3.4 and 3.0 for > or = 60 versus < or = 19 drinks/week). The risk conferred by pipe or cigar smoking, although based on only 12 smokers who did not smoke cigarettes, seemed, however, to be lower for cancer of the tongue (OR, 3.4) than cancer of the mouth (OR, 21.9). Selected indicator foods and beverages, including green vegetables, carrots, fresh fruits, whole-grain bread and pasta, coffee, and tea also affected the cancer risk similarly in the two sites. The beneficial influence of such foods and beverages seemed, however, to be more marked for cancer of the mouth than for cancer of the tongue. CONCLUSIONS: This study suggested that, although none of the differences in the effects between cancer sites was statistically significant, tobacco from pipes and cigars and the cleansing effect of some foods of plant origin and nonalcoholic beverages may influence the risk of cancer of the tongue less strongly than the risk of cancer of the mouth.

Aged↗
PubMed1992

Reproductive factors and the risk of hepatocellular carcinoma in women.

The relationship between reproductive factors and the risk of primary liver cancer was analyzed using data of a case-control study conducted in Northern Italy between 1984 and 1991 on 79 women with histologically or serologically confirmed hepatocellular carcinoma and 344 controls in hospital for a wide spectrum of acute, non-neoplastic diseases. The multivariate relative risk (RR) for parous vs. nulliparous women was 2.6 (95% confidence interval (CI) 1.2 to 5.8), and the risk increased with parity from 2.1 for 1, to 2.6 for 2, to 3.2 for 3, to 3.5 for 4 or more births (chi 2(1) trend = 6.49, p = 0.01). The relative risks were above unity, though not significantly, in women reporting spontaneous (RR = 1.3) and induced (RR = 1.6) abortions, and there was a significant trend in risk with total number of abortions. An apparent inverse trend in risk with age and first birth was accounted for by parity. No relationship emerged with age at menarche, at menopause or other menstrual factors. The association between parity and hepatocellular carcinoma was, if anything, more marked at older ages, since the RR was 1.6 (95% CI 0.5 to 4.6) below age 60, and 4.8 (95% CI 1.3 to 18.1) at age 60 or over. This observation has relevant public-health implications, since in developed countries primary liver cancer is extremely rare among young women, but not at older ages. The association between parity and hepatocellular carcinoma is similar to that described for combined oral contraceptives, again confirming that the impact of contraceptives on the risk of several neoplasms is similar to that of pregnancy.

Adult↗