Biomedical subjects

S Franceschi

Publications and source records attributed to S Franceschi.

At least 541 records · Page 30Linked to original sources

PubMed1991

The epidemiology of cutaneous malignant melanoma: aetiology and European data.

Increases in cutaneous malignant melanoma (CMM) incidence and mortality rates have occurred in the last decades in virtually all white populations, more markedly in those which permanently (immigrants) or temporarily (tourists/vacationers) reside in very sunny areas distant from their original living environment. The strong relationship between sex and site of CMM in these upward trends (ie trunk in males, lower limbs and, more recently, trunk as well in females) points to intense intermittent ultraviolet light exposure as the cause of the CMM epidemic. In Europe the highest rates of melanoma are seen in Denmark, The Netherlands, the United Kingdom, Ireland and Germany, where many individuals have light complexion with tendency to burn. Increases of 2 to 7% per year in mortality rates appeared earlier in these countries, but were subsequently seen also in relatively low-risk areas such as southern European countries. The interpretation of data from case-control studies is, however, hampered by the difficulties in quantifying retrospectively CMM risk correlates (ie host factors, sun exposure, clothing habits, sunburns etc) in various periods during the life span.

Adult↗

PubMed1991

Dairy products and the risk of prostatic cancer.

Dietary indicators of prostatic cancer risk were analyzed in a case-control study conducted in Northern Italy on 96 histologically confirmed cases and 292 controls in hospital for acute, nonneoplastic or genital tract diseases. There was a significant trend in risk as regards frequency of milk consumption: compared with nondrinkers or occasional milk drinkers, the relative risk (RR) was 1.2 (95% confidence interval, Cl, 0.7-1.9) for 1 or 2 glasses per day and 5.0 (95% Cl 1.5-16.6) for 2 or more glasses per day. By contrast, no consistent association was observed with measures of cheese or butter intake. This might, at least in part, be attributable to the lower measurement errors for milk (which tends to be consumed in regular and uniform patterns) as compared with other dairy products. However, the interpretation of these findings is not clear, since other sources of animal fat, like eggs or meat, as well as a summary fat score, were unrelated to prostatic cancer. Although these limitations and uncertainties are substantial, this study provides further evidence that elevated milk consumption may be an indicator of prostatic cancer risk.

Aged↗

PubMed1991

Alcohol and breast cancer in an area with high alcohol consumption.

The association between alcohol drinking and breast cancer risk was investigated in 132 breast cancer cases and 499 controls with acute conditions unrelated to alcohol or any of the suspected risk factors for breast cancer, in an area which shows among the highest levels of alcohol consumption and prevalence of alcohol-related diseases in Europe (i.e. Pordenone Province, Northeastern part of Italy). Compared with non-drinkers, the multivariate odds ratio (OR) for ever drinkers was 1.5 (95% confidence interval, CI: 0.8-2.6). The risks for wine (the almost exclusive source of alcohol in the present investigation) were 1.2 for up to 1 drink, 1.4 for up to two drinks, 1.9 for up to 3 and 1.6 for over 3 drinks per day. Time-related factors (i.e. drinking habit duration and age at start of drinking) did not seem to be risk indicators.

Adult↗

PubMed1990

Type of alcoholic beverage and cancer of the oral cavity, pharynx and oesophagus in an Italian area with high wine consumption.

The role of different types of alcoholic beverage on cancer of the upper digestive tract was investigated in a case-control study conducted in the northern part of Italy on 305 male cases of cancer of the oral cavity and pharynx, 288 of oesophageal cancer and 1621 controls admitted to hospital for acute, non-neoplastic conditions, unrelated to alcohol intake. Similar significant trends of risk increase with increasing alcohol intake were seen for cancers of the oral cavity, pharynx and oesophagus independent of type (or types) of beverage consumed. Among the heaviest drinkers (i.e. greater than or equal to 84 drinks/week) odds ratios (ORs) of cancer of the oral cavity and pharynx for wine only, wine and spirits, and combination of wine, spirits, and beer were 11.2, 9.9 and 4.1, respectively. Corresponding oesophageal cancer ORs were 15.0, 10.0 and 6.0. This study from an area with high wine consumption confirms that wine per se can greatly enhance the risk of cancer of the upper digestive tract and suggests that the most frequently used alcoholic beverage in each study appears to be the most important determinant of these tumours.

Alcoholic Beverages↗

PubMed1990

The influence of female hormones on malignant melanoma.

Several lines of biological evidence have suggested a relationship between the behaviour of melanocytes and cutaneous malignant melanoma (CMM) and the action of female hormones. The present overview, however, indicates that the effect of reproductive, menstrual and hormonal factors, including oral contraceptives, on onset and outcome of CMM must be very weak, if any. The only consistent findings which may suggest a role of female hormones on CMM seem to be: 1) a different distribution by anatomic site in men and women, and 2) a more favorable outcome of CMM in women as compared to men. Neither of them, however, necessarily implies a direct effect of female hormones on CMM.

Adolescent↗

PubMed1990

Smoking and drinking in relation to cancers of the oral cavity, pharynx, larynx, and esophagus in northern Italy.

A hospital-based case-control study of upper aerodigestive tract tumors was conducted between June 1986 and June 1989 in Northern Italy. One hundred fifty-seven male cases of oral cavity cancer, 134 of pharyngeal cancer, 162 of laryngeal cancer, and 288 of esophageal cancer, and 1272 male inpatients with acute conditions unrelated to tobacco and alcohol were interviewed. Odds ratios for current smokers of cigarettes were 11.1 for oral cavity, 12.9 for pharynx, 4.6 for larynx, and 3.8 for esophagus. For all 4 sites, the risk increased with increasing number of cigarettes and duration of smoking habits and, with the exception of esophageal cancer, decreased with increasing age at the start of and years since quitting smoking. Smokers of pipes and cigars showed a more elevated risk of cancer of the oral cavity and esophagus than did cigarette smokers. Significantly increased risks emerged also in heavy drinkers (odds ratio greater than 60 versus greater than or equal to 19 drinks/week = 3.4, 3.6, 2.1, and 6.0 for oral cavity, pharynx, larynx, and esophagus, respectively), deriving predominantly from wine consumption.

Adult↗

PubMed1990

Medical history and primary liver cancer.

The relationship between selected aspects of medical history and the risk of primary liver cancer was analyzed in a hospital-based case-control study conducted in Northern Italy on 242 patients with histologically or serologically confirmed hepatocellular carcinoma and 1169 controls in hospital for acute, nonneoplastic, or digestive diseases. Significant associations were observed for clinical history of hepatitis [odds ratio (OR), 3.7; 95% confidence interval (CI), 2.3-5.9], cirrhosis (OR, 16.8; 95% CI, 9.8-28.8), and three or more episodes of transfusion in the past (OR, 2.2; 95% CI, 1.4-4.1). Among other diseases considered, there was a significant association with diabetes (OR, 2.5; 95% CI, 1.7-3.8), and a protection by history of drug allergies (OR, 0.5; 95% CI, 0.2-0.9). These associations were not appreciably modified by allowance for major identified potential confounding factors and were observed for diseases occurring less than 5 or 5 or more years before liver cancer diagnosis, although for cirrhosis the risk was higher in the short term occurrences (OR, 50). For hepatitis, the association was more evident at older ages, confirming the long lead time between infection and cancer occurrence, while for diabetes it was stronger (or restricted) to cases aged less than 60, suggesting a possible specific role of type I diabetes. While for hepatitis, cirrhosis, and blood transfusion this study offers further quantitative estimates of risk in a European population, the possible direct association with diabetes and protection by drug allergy were unexpected, lacked plausible biological or previous epidemiological support, and should be simply regarded as working hypotheses for further work.

Age Factors↗

PubMed1990

The role of alcohol in oral and pharyngeal cancer in non-smokers, and of tobacco in non-drinkers.

Data from a hospital-based case-control study of oral and pharyngeal cancer conducted in Northern Italy were used to analyse the risk associated with alcohol in non-smokers and with tobacco in non-drinkers. Out of a total of 336 cases (291 males and 45 females) and 1,652 controls (1,272 males and 380 females) 27 cases and 572 controls described themselves as lifelong non-smokers. Odds ratios (ORs) were 1.5 for 14-55 vs. 0-13 alcoholic drinks per week and 2.2 for 56 or over; the trend in risk was statistically significant. Among 19 cases and 213 controls who described themselves as non-drinkers, the ORs were 3.8 and 12.9 for smokers of less than 15 and greater than or equal to 15 cigarettes per day, with a highly significant trend. This study therefore confirms that tobacco has an independent role in the aetiology of oral and pharyngeal cancer, and suggests that alcohol may have an independent role as well, even where, as in Northern Italy, wine is its predominant source. Indeed, ORs were similar to those for tobacco and alcohol individually, each adjusted for the other factor, in the overall data-set.

Aged↗

PubMed1990

Food temperature and gastric cancer.

The relationship between preference for food temperature and the risk of stomach cancer was analysed using data from a case-control study conducted in Northern Italy on 563 histologically confirmed incident gastric cancers and 1,501 controls admitted to hospital for acute, non-neoplastic, non-digestive tract disorders. A specific question was related to food temperature, subjectively defined as "warm", "hot" or "very hot". Compared with subjects indicating preference for "warm" foods, the relative risk (RR) was 1.1 (95% confidence interval, CI, 0.9-1.4) for "hot" and 1.8 (95% CI = 1.3-2.4) for "very hot". The test for trend in risk was statistically significant, and the results were not appreciably modified by allowance for a number of identified potential distorting factors. The elevated risk, however, appeared to be restricted to the 17% of cases reporting a preference for "very hot" foods. This may be due to an absence of substantial misclassification between "warm" and "very hot", but also to the existence of a threshold temperature, below which no appreciable thermal irritation is evident. Thus, although the difficulties and uncertainties on measures of food temperature are substantial, these data suggest that thermal irritation may have a role in gastric carcinogenesis.

Adult↗

PubMed1990

Maize and risk of cancers of the oral cavity, pharynx, and esophagus in northeastern Italy.

The relationship between maize consumption and risk of cancer of the upper digestive tract was investigated in 107 patients with oral cancer, 107 with pharyngeal cancer, 68 with esophageal cancer, and 505 hospital controls who permanently resided in Pordenone Province in the northeastern part of Italy. The analysis was restricted to males. The population of this province has a high incidence of these neoplasms and shows particularly elevated levels of alcohol and tobacco use, in addition to high maize consumption. Highly significant associations with frequent intake of maize emerged for oral cancer, pharyngeal cancer, and esophageal cancer (odds ratios = 3.3, 3.2, and 2.8, respectively). The risk elevation could not be explained in terms of differences in education, occupation, tobacco use, or consumption of fresh fruits and vegetables. The unfavorable effect of maize on risk of cancer of the upper digestive tract, however, was evident only in those individuals who reported heavy drinking (i.e., greater than or equal to 42 alcoholic drinks/wk). The present findings are likely to be related to the fact that maize can cause deficiencies of various micronutrients (chiefly, niacin and riboflavin) and agree with previous observations from Africa, the People's Republic of China, the United States, and Italy.

Adult↗

PubMed1990

Smoking and renal cell carcinoma.

The relationship between smoking habits and the risk of renal cell carcinoma was investigated in a case-control study conducted in northern Italy on 131 cases of histologically confirmed cancers of the renal parenchyma (85 males, 46 females) and 394 controls in hospital for acute, nonneoplastic, nonurological disorders. Compared with never smokers, the relative risk (RR) was 1.7 (95% confidence interval = 1.0-3.1) among ex-smokers. A direct and significant dose-risk relationship was observed among current smokers, with RR of 1.1, 1.9, and 2.3 for moderate, intermediate, and heavy smokers. This trend in risk was statistically significant (chi2(1) = 5.04; P = 0.02). The risk was directly related to duration of smoking (RR = 1.7 for less than 30 versus 1.8 for greater than or equal to 30 years, P = 0.04), and inversely with age at starting (RR = 2.0 for less than or equal to 20 versus 1.7 for greater than 20 years) and, among ex-smokers, with time elapsed since stopping (RR = 2.2 for less than 10 versus 1.3 for greater than or equal to 10 years). This pattern of risk, together with the absence of appreciable confounding, adds further evidence for a causal nature of the association between smoking and renal cell cancer.

Age Factors↗

PubMed1990

Diet and epithelial cancer of the thyroid gland.

Enhanced secretion of thyroid stimulating hormone (TSH) has been linked with increased risk of thyroid carcinoma. Diet can increase TSH secretion in various ways: 1) low iodine intake, 2) high goitrogen intake, especially in subjects living in iodine-deficiency areas and 3) direct stimulation of anterior pituitary gland. Excessive iodine intake, however, has also been shown to increase risk of goitre and, perhaps, also thyroid carcinoma. Epidemiological evidence on the role of diet in the etiology of thyroid carcinoma is reviewed here. Ad hoc studies in affluent countries are few and often conflicting. A case-control study conducted in the North of Italy suggests that perhaps dietary aspects other than iodine or goitrogens (i.e. fresh fruit and vegetables and animal fat) may be involved.

Adult↗

PubMed1990

Histamine-2-receptor antagonists and gastric cancer risk.

The relation between use of histamine-2-receptor (H2-receptor) antagonists and gastric cancer risk was investigated in a case-control study in northern Italy. 563 patients with newly diagnosed, histologically confirmed gastric cancer were compared with 1501 controls who did not have neoplastic or gastrointestinal disorders. 36 (6.3%) cases and 59 (3.3%) controls had used H2-receptor antagonists (cimetidine or ranitidine). The relative risk (RR) for ever-use was 1.8 (95% confidence intervals [CI] 1.2, 2.7). The increased risk was restricted to patients who had started treatment with H2-receptor antagonists within 5 years of the diagnosis of stomach cancer (RR 3.1; 95% CI 1.8, 5.3). For first use of H2-receptor antagonists 5-9 years previously the RR was 1.5 (95% CI 0.7, 3.3), and for first use 10 or more years previously RR was 0.2 (95% CI 0.03, 0.8). Although the incidence of gastric cancer was raised for the first few years after the start of treatment with H2-receptor antagonists, this may reflect misdiagnosis of some early gastric cancers. The findings are against long-term persistence of an excess risk of gastric cancer in association with use of H2-receptor antagonists.

Adult↗

PubMed1990

Dietary indicators of laryngeal cancer risk.

The relationship between frequency of intake of a selected number of indicator foods and the risk of laryngeal cancer was investigated in a case-control study conducted in northern Italy on 110 males with histologically confirmed cancer of the larynx and 843 controls in the hospital for acute, nonneoplastic or respiratory diseases. Significant direct associations were observed with tobacco [relative risk (RR) = 5.8 for current versus never smokers] and alcohol (RR = 2.3 for the upper versus lower tertile of consumption), while the frequency of consumption of three food items was inversely related with laryngeal cancer risk. These were fish (RR = 0.6 for the upper tertile), green vegetables (RR = 0.4), and fresh fruit (RR = 0.3). Multiple logistic regression analysis, including simultaneously major nondietary covariates and various food items, suggested that the strongest and most consistent protective effect was given by fruit. These findings can be generally interpreted as an indication that a "poorer" diet is related to a raised risk of laryngeal cancer, although the confirmed observation that fruit appears to be the main protective dietary factor against cancers of the upper respiratory and digestive tract is of potential interest and may suggest useful etiological clues. Dietary findings were similar in different strata of alcohol and tobacco consumption.

Adult↗

PubMed1990

Survival analysis of 378 surgically treated cases of laryngeal carcinoma in south Sardinia.

The effect of various patient and tumor characteristics were evaluated in 378 laryngeal carcinomas treated only surgically between November 1974 and December 1987 at the Ear, Nose and Throat Clinic of Cagliari Medical University in South Sardinia. The overall three-year survival rate was 68%, the five-year survival rate was 61% (approximate 95% confidence interval (CI), 54-68%), and then a plateau seemed to emerge, with the ten-year survival rate being 51%. Tumor ulceration exerted a strong influence on survival: patients with ulcerated tumors had a twofold (95% CI, 1.4-2.9%) higher death rates. Conversely, the influence of tumor site and type of operation was not statistically significant in the multivariate analysis. A median delay in diagnosis of 4 months was found, with 30% of patients reporting an interval longer than 6 months between first symptoms and referral to a physician; overall, however, the influence of delay in diagnosis on survival rate was not significant. Dysphonia seemed to be the symptom less promptly recognized by the patient.

Adult↗

PubMed1990

Height and cancer risk in a network of case-control studies from northern Italy.

The relationship between self-reported height and cancer risk was investigated in an integrated series of case-control studies including 273 cases of cancer of the oesophagus, 474 of the stomach, 558 of the colon, 352 of the rectum, 227 of the liver, 267 of the pancreas, 110 of the larynx, 2,388 of the breast, 545 of the cervix uteri, 563 of the endometrium, 688 of the ovary, 80 of the prostate, 263 of the bladder, 105 of the kidney, 43 Hodgkin's disease, 152 non-Hodgkin's lymphomas, 109 multiple myelomas, and a total of 5,574 controls admitted to hospital for acute, non-neoplastic conditions. No significant positive trend in risk was observed for any of the cancer sites considered, and some suggestion of elevated risks for the upper quintile of height was observed only for prostate (relative risk, RR = 1.4), kidney (RR = 2.7) and colon (RR = 1.2) in males (but not in females). For breast cancer, all the RRs for subsequent quintiles of height were close to unity. Four neoplasms showed significant inverse trends with height: oesophagus (RR = 0.7 for highest vs. lowest quintile), cervix (RR = 0.4), endometrium (RR = 0.7) and ovary (RR = 0.6). For oesophagus and cervix the trends could be explained, at least in part, in terms of social class correlates (multivariate RR 0.8 and 0.5, respectively), while for endometrium they could possibly be related to an inverse correlation between height and body mass (multivariate RR 0.9). Thus, our study did not support the hypothesis that nutrition in childhood and adolescence (which in this population is a determinant of adult height) is directly related to the subsequent risk of cancer at several major cancer sites. A number of inverse associations emerged, which may be either spurious and incidental, or suggest that poorer nutrition early in life may be an unfavourable indicator of the subsequent risk of selected neoplasms.

Adult↗

PubMed1990

A case-control study of risk factor for renal cell cancer in northern Italy.

A hospital-based case-control study of renal cell cancer was conducted in northern Italy between 1986 and 1989, with 240 cases of renal cell cancer (150 males and 90 females), and 665 controls (445 males and 220 females) chosen on the basis of age, sex, and area of residence. No associations were found between renal cell cancer and: body mass index (BMI); number of cigarettes smoked; age at starting to smoke; years of smoking; consumption of wine, beer, spirits, coffee, decaffeinated coffee; tea; intake of animal protein, fruits, and vegetables; various reproductive factors; hormonal use; sexual habits; sexually transmitted diseases; or selected occupational exposures. The odds ratio (OR) was above unity in smokers (OR = 1.34 for greater than or equal to 15 cigarettes/day), but the trends in risk with dose or duration were not statistically significant. Significant positive associations were found between renal cell cancer and sources of fat intake, especially margarine (OR for highest vs lowest intake = 1.71), and oils (OR = 1.89) whereas carrot intake showed a negative association (OR = 0.62). Also, a history of nephrolithiasis and multiple episodes of cystitis showed weak positive associations (OR = 2.00, 95 percent confidence interval (CI) 1.07-3.73; and OR = 1.60, 95 percent CI 0.95-2.70, respectively).

Adult↗

PubMed1990

Type of cigarettes and cancers of the upper digestive and respiratory tract.

The relationship between type of cigarettes smoked and the risk of cancer of upper digestive and respiratory sites was investigated in a case-control study conducted in Northern Italy on 291 males with cancer of the oral cavity or pharynx, 288 with cancer of the esophagus, 162 with cancer of the larynx, and 1,272 control subjects in hospital for acute conditions unrelated to tobacco or alcohol consumption. Using a distinction based on tar-yield or the brand smoked for the longest time (less than 22 mg, low to medium tar; greater than or equal to 22 mg, high tar), the multivariate relative risks among ever-smokers were 8.5 for low/medium and 16.4 for high tar cigarettes for oral and pharyngeal neoplasms, 3.3 and 7.8 for esophageal, and 4.8 and 7.1 for laryngeal cancers. The differences according to type of cigarettes were similar in proportional terms, and hence larger in absolute terms, when analysis was restricted to current smokers only. Thus, these data provide further quantitative evidence on the importance of type of cigarette smoked on the risk of upper-digestive and respiratory tract cancers and have important public health implications.

Adult↗