Search PubMed⌕ Search

Biomedical subjects

S Franceschi

Publications and source records attributed to S Franceschi.

At least 649 records · Page 36Linked to original sources
PubMed1983

Lung cancer care in general hospitals.

Diagnostic procedure, therapeutic care and degree of follow-up delivered to 1692 lung cancer patients over 2 years (1978-79) in 31 Italian hospitals were reviewed. The data show marked deficiencies in the various indicators analysed: staging by standard methods was recorded only in 13% of patients; reliable histocytologic classification in 54% of patients. A group of commonly accepted protocols was adopted as first-line therapy only in 49% of treated cases; 19% of patients were regularly followed according to standard programs, whereas 49% had been dropped without any information in the charts. Better performance, although not satisfactory, was found in hospitals with oncologic facilities and wards compared to centers without "ad hoc" organizations. The discussion focussed on the limits of organizational measures and efforts to determine widespread improvement in care for a disease such as lung cancer for which real therapeutic gains are still hard to achieve.

Adult↗
PubMed1983

Delayed diagnosis of endometrial cancer in Italy.

This study considers the prevalence of early bleeding in a series of 173 cases of endometrial cancer, with particular reference to the lag time between the onset of symptoms and diagnosis. The length of this interval is examined in the light of patients' and tumor characteristics. Findings show a general delay in endometrial cancer diagnosis in the population studied. In addition there was a significant trend towards worsening of the tumor stage, depth of myometrial invasion and histological differentiation with increasing delay, thus underlining the need for more care in detection of endometrial cancer.

Adenocarcinoma↗
PubMed1983

Genital warts and cervical neoplasia: an epidemiological study.

Cervical carcinoma and cervical intra-epithelial neoplasia (CIN) are likely to be associated with all sexually transmitted diseases (STDs). To help discover which (if any) of the recognised STDs might actually cause these conditions, a key question is whether one particular such association is much stronger than the others. The present study is therefore only of women newly attending an STD clinic, and compares the prevalences of cytological abnormalities of the cervix among 415 women attending with genital warts, 135 with genital herpes, and 458 with trichomoniasis or gonorrhoea. Significantly more genital wart patients (8.1%) than trichomoniasis or gonorrhoea patients (1.9%) showed dyskaryotic changes (adjusted relative risk (RR) = 5.8 with 95% limits 2.5-13.5) at, or a few months before, first attendance, while no excess whatever was seen in women with genital herpes. Moreover, half the women had a subsequent smear (at an average of 3-4 years after first attendance) and, although the diagnosis at first attendance was not related to the onset rate of dyskaryotic changes observed in these subsequent smears, it was related to the onset rate of grade III cervical intra-epithelial neoplasia (CIN III), which was found in 7 previous genital wart patients, in 2 previous trichomonas patients, but in 0 previous genital herpes patients. Thus, our findings suggest that herpes is not directly relevant to dyskaryotic change, but that one or more of the human papilloma viruses that cause genital warts may be.

Adult↗
PubMed1983

Incessant ovulation and ovarian cancer: a critical approach.

The total duration of 'ovulatory activity' or 'ovulatory age' has been reported to be the strongest indicator of the risk of ovarian cancer. In the case-control study examined in this paper this variable was found to be a strong correlate of the risk of ovarian cancer. However, the finding that in older women the major determinant of 'ovulatory age' was age at menopause (which is a very unreliable indicator of 'ovarian activity'), and that age at menopause by itself was related to the risk of ovarian cancer as strongly as the total duration of ovulatory age, threw doubt on the biological consistency of that model. Furthermore, the protection conferred by pregnancies was different at different ages, and age at first pregnancy was more strongly associated with the risk of ovarian cancer than the actual number of pregnancies. The model of carcinogenesis for epithelial ovarian cancer appears, therefore, to be more complex than is indicated simply by the total duration of 'ovarian activity.'

Adult↗
PubMed1983

Ten-year survival in 290 patients with endometrial cancer: prognostic factors and therapeutic approach.

Between 1970 and 1976, 290 patients with endometrial cancer were treated at the 1st Obstetrics and Gynecology Clinic of the University of Milan. The median age was 62 years. Surgery was completed in 262 (90.3%) patients. Abdominal hysterectomy was used in 158 (70.9%) stage I and 40 (71.4%) stage II/III) patients; vaginal hysterectomy in 55 (24.7%) stage I and nine (16.1%) stage II/III patients. Resection of the upper vagina was performed in 168 patients. Postoperative external beam radiotherapy was used in stage II/III patients and in 44 (19.7%) stage I high-risk patients. Ten-year survival, determined by the life-table method, was 84.8% in stage I (223 patients), 53.4% in stage II (37 patients), 64.4% in stage III (19 patients), and 9.1% in stage IV (11 patients). Factors associated with poorer prognosis were: late age at diagnosis (P less than 0.001); deep myometrial invasion (P less than 0.001); poorly differentiated histological grade (P = 0.11); lack of resection of the upper vagina (P = 0.13). The role and importance of surgery is discussed, with special emphasis on the selective use of the vaginal route in aged, obese and medically high-risk patients.

Adult↗
PubMed1982

Prognostic features of endometrial cancer in estrogen users and obese women.

In a case-control study to evaluate risk factors for endometrial cancer in Italy, use of noncontraceptive estrogens was associated with a moderately increased risk, whereas obesity appeared to be the most important single risk factor related to cancer of the endometrium. This report considers the estrogen and obesity-related relative risks with regard to various prognostic features of tumors (clinical stage, histologic grade, extent of myometrial invasion, lymph node involvement). In both estrogen users and obese women, the increase in relative risk was greater for earlier than for more advanced tumors. These findings, therefore, provide further support for a specific role of both exogenous and endogenous estrogens in endometrial cancer.

Adult↗
PubMed1982

Quality of breast-cancer care in Italian general hospitals.

The diagnostic and therapeutic care and degree of follow-up delivered to 2406 breast-cancer patients over two years (1978-79) in 31 Italian hospitals are reviewed. Although there was broad agreement about recommended treatment protocols, staging by standard methods was recorded in only 44% of patients, assessment and reporting of side-effects was considered in only 49% of all treated patients, follow-up data at two years were available for only 54% of living patients, and the dropout rate from chemotherapy protocols was 35%. Improvement of these unsatisfactory aspects of care would allow a better appreciation of the real benefit that could be achieved with recommended protocols and would result in a more effective use of health resources.

Female↗
PubMed1982

Oestrogens and obesity as risk factors for endometrial cancer in Italy.

In a case-control study to evaluate risk factors for endometrial cancer, obesity, history of various diseases, reproductive and menstrual characteristics, marital status, education, and lifetime use of female hormones were examined in 173 histologically proven endometrial cancers and 347 controls. Obesity, non-contraceptive oestrogen use, late menopause, low parity and history of uterine fibromyomas were associated with an increased risk of endometrial cancer. The relative risks of obesity and oestrogen use seem to fit well for an additive model. Histological differentiation was positively correlated both to oestrogen use and to level of overweight, supporting the hypothesis of a specific role of oestrogens in endometrial cancer.

Adult↗
PubMed1982

Risk factors for epithelial ovarian cancer in Italy.

In a case-control study conducted between May 1979 and February 1980, in Milan, Italy, to evaluate risk factors for ovarian cancer, various reproductive and menstrual characteristics, marital status, education, history of various diseases, and lifetime drug use were examined among 161 women with histologically proven epithelial cancer and 561 controls. Early menarche, late menopause, low parity, late age at first pregnancy and total ovulatory years were associated with an increased risk of ovarian cancer. The elevated risk associated with late age at first pregnancy was not accounted for by low parity. Many of the risk factors identified in this study are also accounted for by low parity. Many of the risk factors identified in this study are also related to the risk of adenocarcinoma of the endometrium and to breast cancer. Further exploration of these factors may lead to an improved understanding of the etiology of all three cancers.

Adult↗
PubMed1982

Management of gestational trophoblastic disease: results of a cooperative study.

Three hundred fifty-four evaluable cases of hydatidiform mole diagnosed from 1970 to 1979 in 10 regional hospitals in Lombardy are analyzed in the present report. Twenty-six (7.3%) of the patients developed persistent trophoblastic disease. Younger (less than 20 years) and older (40 years or more) age at diagnosis, a large-for-dates uterus, and ovarian enlargement were associated with an increased risk of developing persistent trophoblastic disease. Twenty-three (9%) cases of persistent trophoblastic disease were observed among 250 women not prophylactically treated, but only in 3 (3%) among 104 who received prophylactic chemotherapy. High-risk groups are defined and the role of prophylactic chemotherapy is discussed.

Adolescent↗
PubMedDate not supplied

Cutaneous malignant melanoma: epidemiological considerations.

Large geographic and ethnic variations in incidence and mortality rates of cutaneous malignant melanoma (CMM) suggest inverse correlations with the degree of skin pigmentation and latitude. Increases in CMM incidence and mortality rates have occurred in virtually all white populations, more markedly in those that permanently (immigrants) or temporarily (tourists/vacationers) reside in very sunny areas outside their primitive living environment. The interpretation of data from case-control studies is, however, hampered by the difficulties in quantifying retrospectively, but reliably, CMM risk correlates (e.g., host factors, sun exposure, clothing habits, sunburns) in various periods during the life span. There is, thus, a need for large prospective studies on the development of CMM and naevi, ideally in different contexts as concerns host factors, sun exposure, and other life-style habits within and across different populations.

Case-Control Studies↗
PubMedDate not supplied

Worldwide distribution of human papillomavirus types in cytologically normal women in the International Agency for Research on Cancer HPV prevalence surveys: a pooled analysis.

BACKGROUND: The proportion of women infected with human papillomavirus (HPV) varies greatly across populations, as might the distribution of HPV types. We aimed to compare HPV-type distribution in representative samples of women from different world regions. METHODS: Women were randomly selected from the general population of 13 areas from 11 countries (Nigeria, India, Vietnam, Thailand, Korea, Colombia, Argentina, Chile, the Netherlands, Italy, and Spain). A standardised protocol was used for cervical specimen collection. All HPV testing was by GP5+/6+ PCR-based EIA. The proportion of HPV-positive women infected with different HPV types was compared by study area and between pooled regions with age-adjusted odds ratios (ORs) with corresponding 95% floating CIs. FINDINGS: 15 613 women aged 15-74 years without cytological abnormalities were included in a pooled analysis. Age-standardised HPV prevalence varied nearly 20 times between populations, from 1.4% (95% CI 0.5-2.2) in Spain to 25.6% (22.4-28.8) in Nigeria. Although both overall HPV prevalence and HPV16 prevalence were highest in sub-Saharan Africa, HPV-positive women in Europe were significantly more likely to be infected with HPV16 than were those in sub-Saharan Africa (OR 2.64, p=0.0002), and were significantly less likely to be infected with high-risk HPV types other than HPV16 (OR 0.57, p=0.004) and/or low-risk HPV types (OR 0.44. p=0.0002). Women from South America had HPV-type distribution in between those from sub-Saharan Africa and Europe. Heterogeneity between areas of Asia was significant. INTERPRETATION: Heterogeneity in HPV type distribution among women from different populations should be taken into account when developing screening tests for the virus and predicting the effect of vaccines on the incidence of infection.

Adolescent↗