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Biomedical subjects

S Franceschi

Publications and source records attributed to S Franceschi.

At least 631 records · Page 35Linked to original sources
PubMed1985

Electrocoagulation and the risk of cervical neoplasia.

The relationship between electrocoagulation diathermy and the risk of cervical neoplasia was evaluated in a case-control study of 145 women with cervical intraepithelial neoplasia compared with 145 age-matched outpatient control subjects, and 191 cases of invasive cervical cancer compared with 191 control subjects in the hospital for acute conditions unrelated to any of the identified or suspected risk factors for cervical cancer. History of electrocoagulation was associated with an apparently reduced risk of cervical intraepithelial neoplasia (relative risk = 0.50, with 95% confidence interval = 0.29-0.87), and of invasive cancer (relative risk = 0.42, 95% confidence interval = 0.22-0.82). However, this apparent protection could be largely explained in terms of a different frequency of previous Papanicolaou smears in patients and control subjects. When adjustment was made for that variable, the risk estimates of CIN and invasive cancer among women who had undergone electrocoagulation increased to 0.62 and 0.83 and became statistically nonsignificant. Further allowance for other identified potential confounding factors by means of multiple logistic regression raised these estimates to 0.73 and 0.94, respectively. Thus, these data provide evidence against the hypothesis that electrocoagulation may have an important and independent role in the prevention of cervical neoplasia.

Adult↗
PubMed1984

"Pap" smear and the risk of cervical neoplasia: quantitative estimates from a case-control study.

The relation between Papanicolau ("Pap") smear and the risk of cervical neoplasia was evaluated in a case-control study in which 145 women with cervical intra-epithelial neoplasia (CIN) were compared with 145 age-matched outpatient controls, and 191 cases of invasive cervical cancer were compared with 191 control subjects in hospital for acute conditions unrelated to any of the established or suspected risk factors for cervical cancer. Compared with women with no previous screening smear, the relative risk (RR) estimate for invasive cancer was 0.44 (with 95% confidence interval [CI] = 0.24-0.80) for those who had had one smear and 0.20 (95% CI = 0.13-0.32) for those who had had two or more smears. The corresponding estimates for CIN were 0.27 (95% CI = 0.10-0.71) and 0.12 (95% CI = 0.06-0.25), respectively. The risk estimates for intervals of more than 5, 3-5, and less than 3 years were 0.36, 0.18, and 0.10 for invasive cancer, and 0.45, 0.31, and 0.07 for CIN. These results were not materially modified by adjustment for the major risk factors for cervical cancer, such as indicators of socioeconomic status and sexual habits. According to the estimates of this study, 64% of invasive cervical cancers could be prevented by screening at intervals of more than 5 years, an additional 18% by reducing the interval to 3-5 years, and a further 8% to less than 3 years.

Adult↗
PubMed1984

Dietary vitamin A and the risk of invasive cervical cancer.

The relation between dietary vitamin A and the risk of invasive cervical cancer was evaluated using data from a hospital-based case-control study of 191 women with cervical cancer and 191 age-matched controls. There was no association between dietary retinoids and cervical cancer risk. Intake of dietary beta-carotene, on the other hand, was inversely and strongly related to the risk of cervical cancer. Compared to risks for women reporting a monthly intake of 150,000 or more international units (IU) of beta-carotene, the estimated relative risks for those with 100,000 to 149,000 and those with less than 100,000 IU per month were 2.8 and 6.1 respectively. The inverse association was not explained by any of the major identified risk factors for cervical cancer (including indicators of socio-economic status or sexual habits), or by differences in general characteristics and other lifestyle habits between cases and controls. Thus, although the uncertainties of the vitamin A measurements used are substantial, these findings support the hypothesis that dietary beta-carotene-or some related aspect of a vegetable-rich diet-is protective against invasive cervical cancer.

Animals↗
PubMed1984

Oral contraceptives and benign breast disease: a case-control study.

The relationship between benign breast disease and use of oral contraceptives was analyzed in a case-control study conducted in Milan with 288 cases of clinically relevant and histologically confirmed benign breast disease and 285 age-matched controls with a spectrum of acute conditions apparently unrelated to use of oral contraceptives. Compared to the risk for women who had never used oral contraceptives, the relative risk for users was 1.0 (95% confidence interval: 0.6 to 1.5). There was no significant association with duration of use; however, a significantly lower relative risk was found in women using oral contraceptives during the year before breast biopsy (relative risk: 0.4; 95% confidence interval: 0.2 to 0.8). The protection in current users increased with increasing duration of use. In spite of this finding, the overall results of the present study do not support the hypothesis that oral contraceptive use protects against development of histologically confirmed and clinically relevant benign breast disease.

Adolescent↗
PubMed1984

Childhood nonovarian female genital tract cancers in Britain, 1962-1978. Descriptive epidemiology and long-term survival.

The files of the Childhood Cancer Research Group ( CCRG ) and of the Oxford Survey of Childhood Cancers ( OSCC ) were scrutinized for all malignant genital neoplasms other than ovarian tumor registered in England, Scotland, and Wales in the period 1962 to 1978. After a review of the records and of the available pathologic reports, a total of 55 cases were confirmed, indicating an average incidence of about 0.5 cases per million female children per year, with no obvious trend over the study period. These included 9 (16.4%) cases originating from the vulva, 28 (50.9%) from the vagina, 3 (5.5%) from the cervix, 12 (21.8%) from the corpus uteri, and also 3 (5.5%) cancers of unspecified pelvic sites. A total of 45 (81.8%) cases were sarcomas, most frequently of the botryoid type, 7 (11.7%) were carcinomas, and 3 (5.5%) were germ cell neoplasms. Fifteen cases (27.3%) occurred in children younger than 1 year of age, and incidence showed a declining trend over age. Long-term survival was more common in tumors of the external genitalia, vagina, or cervix, and significantly better in carcinomas (100%) than in germ cell neoplasms (67%), or sarcomas (34%). A significant improvement in survival was noted over the period of time considered (5-year survival rates were 23% in the cases diagnosed in the 1960s, but 52% for those diagnosed in the 1970s), suggesting that a more rational integrated therapeutic approach may appreciably improve the prognosis of these rare neoplasms.

Adolescent↗
PubMed1984

Familial trophoblastic disease: case report.

Presented is a report of familial trophoblastic disease (repeated hydatidiform mole) which is of interest because of the double familial components. The patients were sisters who were married to two brothers.

Abortion, Missed↗
PubMed1984

Coffee drinking and the risk of epithelial ovarian cancer.

The relation between ovarian cancer and coffee drinking habits was evaluated in a case-control study of 247 histologically confirmed epithelial ovarian cancers and 494 age-matched controls, admitted to hospital for acute conditions apparently unrelated to coffee consumption. Compared to rates for women who had never drunk coffee, the crude relative risk estimates for those who drank less than two, two or three, and four or more cups per day were 1.3, 1.5 and 1.4 respectively; however, when allowance was made for smoking habits, these risk estimates became 1.3, 1.7 and 1.8 respectively, and a significant linear trend of increasing risk with more elevated coffee consumption was evident. These results were not explained by various other potential confounding factors, including the major risk factors for ovarian cancer, but we had no information on dietary variables. The relative risk, however, did not increase with increasing duration of use. The findings of this study give apparent support in favour of the hypothesis that coffee consumption, or related dietary variables, may be associated with the risk of epithelial ovarian cancer. Further studies in different settings, however, are required in order to establish whether this association is real, and if so, whether it is causal.

Adult↗
PubMed1984

The clinical relevance of the epidemiology of ovarian cancer.

This paper reviews some clinically relevant aspects of the epidemiology of ovarian cancer. The items presented and discussed are: (1) incidence and mortality data: they show substantial stability in all Western countries over the last few decades; (2) risk factors: the relationships with child-bearing patterns and other reproductive variables (age at menarche and at menopause; oral contraceptives) appear well established but no risk factor is sufficiently strong to be of practical value in prevention or early diagnosis: (3) long-term survival: in spite of the large number of clinical studies that have claimed 'more effective' treatments, no improvement of long-term survival in the population as a whole has been established. Some discrepancies and drawbacks in published trials are discussed, and a different approach towards clinical studies is suggested.

Adult↗
PubMed1984

Social factors, diet and breast cancer in a northern Italian population.

The relation of breast cancer to social and dietary variables was evaluated in a case-control study of 368 women with breast cancer admitted to the General Hospital of Pordenone (a town in the eastern side of Northern Italy) and 373 age-matched controls. Occupation was related to the risk of breast cancer, housewives and non-manual workers (teachers and other professionals, clerical workers, etc.) showing relative risks of 1.7 and 2.4 respectively when compared to women occupied in agriculture. The role of education was apparently less important, and not statistically significant. The risk was higher in women who were obese, the trend of increasing risk with increasing body mass index being confined to post-menopausal women. When indicators of dietary fat intake were analysed, a significantly increased risk was found with more frequent consumption of milk and dairy products but the risk estimates were only slightly above unity with reference to meat consumption. Women who drank alcoholic beverages showed a relative risk of 2.5 compared to women who had never drunk, when allowance was made for all identified potential confounding factors. The association between alcohol and breast cancer was not explained by the other dietary variables considered, and the risk estimates were higher for women who drank more wine, or more than one type of alcoholic beverage. Thus, the findings of the present study give evidence in favour of the hypothesis that alcohol consumption is related to the risk of breast cancer.

Adult↗
PubMed1984

Oral contraceptive use and the risk of epithelial ovarian cancer.

The relation between the use of combination oral contraceptives (OCs) and the risk of epithelial ovarian cancer was investigated in a case-control study conducted in Milan on 209 women below the age of 60 with histologically confirmed epithelial ovarian cancer, and 418 age-matched controls with a spectrum of acute conditions apparently unrelated to OC use. Combination oral contraceptives were used by 18 (9%) cases, and 59 (14%) controls, giving a relative risk estimate of 0.6 (95% confidence interval = 0.3-1.0, P less than 0.05). The risk of ovarian cancer decreased with increasing duration of use and the point estimate remained below unity long after cessation of use. These results were not accounted for by parity, infertility, or other identified potential confounding factors. Thus, the findings of the present study add further support to the evidence emerging from American data of a reduction of approximately 40% in the risk of epithelial ovarian cancer among women who had used oral contraceptives.

Adult↗
PubMed1984

Risk factors for pathologically confirmed benign breast disease.

Between November 1981 and March 1983, data were collected to evaluate risk factors for benign breast lesions in a case-control study based on 288 women with histologically proven benign breast disease, admitted for biopsy to the Tumor Institute of Milan, and 285 age-matched controls. Questions were asked about menstrual and reproductive characteristics, marital status, education, history of various diseases, and lifetime use of oral contraceptives and other hormonal treatments. Nulliparity or low parity, late age at first birth, and late menopause were associated with an increased risk of benign breast disease. The elevated risk associated with late age at first birth was not accounted for by parity. Early age at menarche was associated with an increased risk, but the estimate was not statistically significant. The data do not suggest that the use of oral contraceptives or other female hormones (such as estrogen replacement therapy) is related to the risk of benign breast disease. Risk was apparently lower, however, among current and long-term oral contraceptive users. There was no evidence of a trend with reference to body mass index. The present data indicate a substantial agreement between the risk factors for (pathologically confirmed) benign and malignant breast disease, not only directly, by showing a relationship with parity, age at first birth, and age at menopause, but also indirectly, by failing to produce evidence that greater weight or the use of oral contraceptives has a protective effect.

Adolescent↗
PubMed1984

Invasive cervical cancer in young women.

Between 1970 and 1979, 103 women below 35 years of age with invasive cervical cancer were treated at the First Obstetrics and Gynaecology Clinic of the University of Milan. Nine patients were pregnant or less than 3 months postpartum. Estimated 10-year disease-free survival, determined by the life-table method, was 100% in stage IA (37 patients), 79% in stage IB (45 patients), 67% in stage II (15 patients), 0% in stages III (5 patients) and IV (1 patient). Prognosis was also strongly associated with lymph-node involvement, 10-year actuarial survival decreasing from 93% in lymph-node-negative to 44% in lymph-node-positive patients (P less than 0.001). The prognostic relevance of the clinical stage decreased after adjustment for lymph-node involvement, but the statistical significance of lymph-node involvement was unaffected when stage was allowed for. In the present series, the estimated 10-year disease-free survival was 80% in patients treated by radical hysterectomy compared with 62% in the group treated by total hysterectomy (stage IB to IV patients only); this difference, however, was not statistically significant when the data were adjusted for clinical stage (P = 0.10). None of the 20 patients with recurrent disease could be managed successfully.

Adenocarcinoma↗
PubMed1984

Age of parents and risk of gestational trophoblastic disease.

The relationship of gestational trophoblastic disease (GTD) to parental age was evaluated in a case-control study of 132 women with hydatidiform mole (108) or choriocarcinoma (24) and 304 control subjects hospitalized for normal deliveries. Cases and controls were recruited in Lombardy (Northern Italy), and all were white and Italian. Compared to the risk of developing trophoblastic tumors in women 21-35 years old, the risk of developing trophoblastic tumors was elevated both in younger [less than or equal to 20 yr old, relative risk (RR) = 1.4, with 95% confidence interval (Cl) of 0.7-2.8] and in older subjects, RR being 1.2 (95% Cl 0.7-2.8) and 5.2 (95% Cl 2.2-12.3) for women 36-40 years old and over 40, respectively. The risk estimates for the last two categories were reduced to 0.7 (with 95% Cl of 0.3-1.9) and 2.5 (with 95% Cl of 0.7-8.9) when adjustment was made for paternal age by means of the Mantel-Haenszel procedure. Higher paternal age also was associated with GTD: Women whose husbands were 41-45 years old and over 45 had RR of 1.6 (with 95% Cl = 0.7-3.7) and 4.9 (with 95% Cl = 2.2-11.1), respectively, compared to women married to men less than 40 years old. These risk estimates were practically unchanged when adjustment was made for the woman's age. Examination of the effects of parental and maternal ages suggests that the highest risk estimate was observed when both parents were older. The findings of the present study were consistent with increased risk in the youngest maternal age group and confirm that older maternal age is associated with increased risk of GTD. Furthermore, showing a strong, independent effect of paternal age, they give epidemiologic support to the cytogenetic evidence of an androgenetic role in the origin of GTD.

Adult↗
PubMed1984

Age at first birth and the risk of epithelial ovarian cancer.

The relationships between age at first birth, parity, and the risk of ovarian cancer were evaluated in a case-control study of 272 women with histologically confirmed epithelial ovarian cancer and 544 age-matched controls with a spectrum of acute conditions unrelated to any of the established or potential risk factors for ovarian cancer. Late age at first birth was associated with increased risk: Compared to women who first had a child before the age of 22 years, the relative risks (RR) for those who first gave birth at ages 22-24, 25-27, and 28 or more were 2.7, 3.2, and 4.0, respectively. Nulliparous women showed increased RR (3.9) comparable to the RR among women who first bore a child at age 25 or more, regardless of the number of births. The elevated risk associated with later age at first birth was not accounted for by low parity. The risk of ovarian cancer, as expected, increased with decreasing parity: RR estimates for women having 5 or more, 3 or 4, and 1 or 2 children and for nulliparae were 1.0, 1.7, 1.9, and 2.6, respectively. However, the inverse association between parity and ovarian cancer could be accounted for largely by the importance of age at first birth, because when adjustment was made for that variable, the RR for 3 or 4 and 1 or 2 children decreased to 1.3 and 1.2, respectively. Thus the results of the present study show a strong independent effect of age at first birth on the risk of epithelial ovarian cancer, whereas the association with parity can be explained largely or totally in terms of a high correlation between total parity and age at first birth. The pattern of ovarian cancer risk that emerges from this study, therefore, is similar to the epidemiology of breast cancer. General evidence on this issue from various other studies, however, is rather controversial, and similar analysis of other data-sets would be useful.

Adult↗
PubMed1984

Risk factors for endometrial cancer at different ages.

The importance of the major risk factors for endometrial cancer in women of different ages was evaluated with the use of data from a hospital-based case-control study conducted in Milan, Italy, on 283 women with endometrial cancer and 566 age-matched controls. Current weight was related strongly to the risk of endometrial cancer both in younger (premenopausal) and in older women (with risk estimates for the heaviest categories of 20.3 and 7.7, respectively), thus confirming that obesity is the major cause of endometrial cancer in Northern Italy. Endometrial cancer risk appeared to be approximately proportional to the second power of body mass index. Early menarche and nulliparity were associated with an increased risk of endometrial cancer in premenopausal women, the point estimate for nulliparity rising to 35.1 (with lower confidence limit of 10.2) after adjustment for marital status. However, no association with these factors was evident in postmenopausal women. Combination oral contraceptives were used by 2 cases and 19 controls only [relative risk (RR) = 0.2, with 95% confidence interval = 0.1-0.8]. The use of noncontraceptive estrogens was associated with an elevated risk, which was greater in perimenopausal women (RR = 5.1 for greater than 2 yr of use), and decreased progressively with increasing time after menopause. Late menopause was also related to endometrial cancer. However, the risk estimates for late menopause apparently were more elevated in older women (greater than or equal to 65 yr) than in perimenopausal women. Most of the risk factors identified (excluding late menopause) apparently act on one of the later stages of the process of carcinogenesis, because the excess risk drops after cessation of exposure.

Adolescent↗