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Biomedical subjects

S Franceschi

Publications and source records attributed to S Franceschi.

At least 109 records · Page 6Linked to original sources

Fiber intake and the risk of oral, pharyngeal and esophageal cancer.

The relation between various types of fiber and oral, pharyngeal and esophageal cancer was investigated using data from a case-control study conducted between 1992 and 1997 in Italy. Cases were 271 hospital patients with incident, histologically confirmed oral cancer, 327 with pharyngeal cancer and 304 with esophageal cancer. Controls were 1,950 subjects admitted to the same network of hospitals as the cases for acute, nonneoplastic diseases. Cases and controls were interviewed during their hospital stay using a validated food frequency questionnaire. Odds ratios (OR) were computed after allowance for age, sex, and other potential confounding factors, including alcohol, tobacco consumption, and energy intake. The ORs for the highest vs. the lowest quintile of intake of oral, pharyngeal and esophageal cancer combined were 0.40 for total (Englyst) fiber, 0.37 for soluble fiber, 0.52 for cellulose, 0.48 for insoluble non cellulose polysaccharide, 0.33 for total insoluble fiber and 0.38 for lignin. The inverse relation were similar for vegetable fiber (OR = 0.51), fruit fiber (OR = 0.60) and grain fiber (OR = 0.56), and were somewhat stronger for oral and pharyngeal cancer than for esophageal cancer. The ORs were similar for the two sexes and strata of age, education, alcohol and tobacco consumption, and total non-alcohol energy intake. Our study indicates that fiber intake may have a protective role on oral, pharyngeal and esophageal cancer.

Alcohol Drinking↗

Physical activity and risk of ovarian cancer: an Italian case-control study.

The relationship between physical activity and the risk of ovarian cancer was analyzed using data from a case-control study conducted between 1992 and 1999 in Italy. Cases were 1,031 women with incident, histologically confirmed, invasive epithelial ovarian cancer and controls were 2,411 women admitted to hospital for acute non-neoplastic, non-hormonal conditions. Compared to women with the lowest level of occupational physical activity, the ORs of ovarian cancer obtained adjusting for center, year of interview and age for women with the highest level of physical activity were 0.70, 0.52 and 0.64 (all statistically significant) respectively, at ages 15-19, 30-39 and 50-59 years, with significant trends in risk for the 2 youngest age groups. The corresponding ORs became 0.89, 0.67 and 0.76 after further allowance for several co-variates of ovarian cancer, including education, which was positively associated with cancer risk. No significant association was found with leisure-time physical activity though the risk was below unity in women with the highest level of activity. The multivariate OR was 0.44 for women with the highest level of combined occupational plus leisure-time physical activity. The inverse relationship between occupational physical activity and ovarian cancer risk was not heterogeneous across strata of selected co-variates.

Adolescent↗

Diet and ovarian cancer risk: a case-control study in Italy.

To assess the dietary correlates of cancer of the ovary, the consumption of a wide range of food groups has been investigated in a case-control study conducted between January 1992 and September 1999 in 4 Italian areas. Cases were 1,031 women with incident, histologically confirmed epithelial ovarian cancer; controls were 2,411 women admitted to the same network of hospitals as the cases for acute, non-malignant and non-gynecological conditions, unrelated to hormonal or digestive tract diseases or to long-term modifications of diet. The subjects' usual diet was investigated through a validated food frequency questionnaire including 78 foods and recipes, then grouped into 18 food groups. Odds ratios (OR), and the corresponding 95% confidence intervals (CI) were estimated using unconditional multiple logistic regression models including terms for age, study center, education, year at interview, parity, oral contraceptive use and energy intake. Significant trends of increasing risk emerged for red meat (OR = 1.53 for the highest compared with the lowest quintile of consumption), whereas inverse associations were observed for consumption of fish (OR = 0.51), raw (OR = 0.47) and cooked vegetables (OR = 0.65), and pulses (OR = 0.77).

Adolescent↗

Time since last birth and the risk of ovarian cancer.

OBJECTIVES: While parity is a protective factor in ovarian cancer, the role of time factors of pregnancy and birth is still controversial. We considered therefore the role of birth timing in the risk in ovarian cancer from a large case-control study. METHODS: Cases were 971 women (age range 22-74 years, median age 54) with histologically confirmed, incident epithelial ovarian cancer, interviewed between 1983 and 1991 in a network of hospitals in Milan, Italy. Controls were 2758 women (age range 23-74 years, median age 52) admitted to the same hospitals where cases were identified for acute, nonneoplastic conditions. RESULTS: In comparison with nulliparous women, the multivariate odds ratios (OR) were 0.8 for women reporting one or two and 0.6 for those with three or more births. No clear association emerged between time since last birth and ovarian cancer. Compared to women who had last given birth since > or =20 years, a moderately increased risk of ovarian cancer was observed in the first 10 years after last birth, with an OR of 1.7 (95% confidence interval, CI 1.0-2.9). When we considered only multiparous women and included in the multivariate analysis allowance for age at first birth, the OR decreased to 1.2 (95% CI 0.6-2.4). No consistent pattern of trends was observed > or =10 years since last pregnancy. CONCLUSIONS: This study confirms the protective effect of parity on ovarian carcinogenesis, but shows no consistent pattern of risk across time since last birth.

Adult↗

Methodology used for "software for automated linkage in Italy" (SALI).

Linkage of epidemiological registries can provide cost-effective information on the associations between different diseases or exposures in the population under study and on completeness of surveillance system databases. We describe the program SALI (software for automated linkage in Italy) aimed at matching individual records from medium-sized registries (in the order of 100,000 records), where the desired outcome is to miss as few links as possible and, because of low link-likelihood (< 1%), a manual revision of matched pairs is feasible. SALI, developed in CA-Clipper language, uses registry files in dBase format. It requires only name, surname, and date of birth as key fields, and it allows for spelling errors in Italian or other Latin languages through a specific algorithm. Furthermore, a double-blind procedure ensures data confidentiality. The main linkage procedure is based on four stages, two automatic ones, and two where the operator can decide through specific windows whether to accept stage-selected matches. SALI takes into account possible errors in key fields thus reducing false negatives. It was used to solve the problem of linkage between AIDS and cancer registries in Italy. It can be used with every IBM-compatible computer system, assuring uniquely high portability.

Acquired Immunodeficiency Syndrome↗

Epidemiology of AIDS-related tumours in developed and developing countries.

AIDS-associated illnesses include Kaposi's sarcoma (KS), non-Hodgkin's lymphoma (NHL), and, since 1993, invasive cervical cancer (ICC). Between 1988 and 1998, among AIDS cases reported in western Europe, 9.6% had KS and 3.9% had NHL as AIDS-defining illnesses. Between 1988 and 1998, the frequency of KS decreased from 13.4 to 6.4%, while NHL increased from 3.8 to 5.3%. Estimates of the relative risk (RR) of neoplasms in HIV-seropositive populations came from population-based cancer and AIDS registries linkage studies conducted in the United States, Italy and Australia and from a few cohort and case-control studies. In adults with HIV/AIDS, the RR was over 1000 for KS and ranged between 14 for low-grade NHL and over 300 for high-grade NHL. For Hodgkin's disease (HD), a consistent 10-fold higher RR was observed. For cervical and other anogenital tumours associated with human papilloma virus, risk increases were 2- and 12-fold, depending upon location. In Africa, the AIDS epidemic led to KS becoming the most common cancer type in men in several areas. The RR of AIDS-associated tumours were lower in Africa than those reported in western countries.

Acquired Immunodeficiency Syndrome↗

Dietary fibres and ovarian cancer risk.

Data from an Italian multicentre case-control study on ovarian cancer were used to analyse the relationship between various types of fibres and ovarian cancer risk. The study, conducted between 1992 and 1999, included 1031 cases of incident, histologically-confirmed epithelial ovarian cancer. Controls were 2411 women admitted to the same network of hospitals for acute, non-malignant, non-hormonal-related diseases. Cases and controls were interviewed using a validated food frequency questionnaire (FFQ). Odds ratios (ORs), and the corresponding 95% confidence intervals (CI), were estimated using unconditional multiple logistic regression models. For total (Englyst) fibre, the OR for the highest versus the lowest quintile of intake was 0.68, and the continuous OR for the difference between the 80th and the 20th percentile of intake was 0.87. For most types of fibre, the continuous OR was significantly below 1. The OR was 0.83 for cellulose, 0.89 for soluble non-cellulose polysaccharides (NCPs), 0.86 for total insoluble fibre, 0.92 for insoluble NCP, and 0.95 (non-significant) for lignin. The inverse association was consistent across strata of age, family history and menopausal status, even if the association was apparently stronger in postmenopausal women. When fibre was classified according to the source, vegetable (but not grain) fibres, showed a significant protective effect, with an OR of 0.78.

Adult↗

Cancer epidemiology in the elderly.

Although age per se is not an important determinant of cancer risk, but rather a surrogate of prolonged carcinogen exposure, the increased life expectancy over the last few decades in most areas of the world has greatly increased cancer burden in the elderly. Trends in mortality for most common cancer sites in the elderly tended systematically to increase up to the early 1990s, but declined thereafter in North America and Western Europe in both sexes, and in Japanese females. Most trends remain unfavourable for elderly population of both sexes in eastern Europe, mainly reflecting patterns in smoking. Trends of incidence in elderly populations are more difficult to interpret, on account of changed diagnosis and certification for several cancer sites, including prostate cancer, brain tumours and multiple myeloma. Screening and early diagnosis for cancer in the elderly should be critically considered for prostate, but also for colorectal, breast and other selected neoplasms.

Age Distribution↗

Dietary glycemic load and colorectal cancer risk.

BACKGROUND: Insulin and insulin-like growth factors can stimulate proliferation of colorectal cells. High intake of refined carbohydrates and markers of insulin resistance are associated with colorectal cancer. To test the insulin/colon cancer hypothesis, we determined whether the dietary glycemic index and the glycemic load are associated with colorectal cancer risk. DESIGN: A case-control study on colorectal cancer conducted in Italy. Cases included 1125 men and 828 women with histologically confirmed incident cancer of the colon or rectum. Controls were 2073 men and 2081 women hospitalized for acute conditions. We calculated average daily dietary glycemic index and glycemic load, and fiber intake from a validated food frequency questionnaire. RESULTS: Direct associations with colorectal cancer risk emerged for glycemic index (odds ratio (OR) in highest vs. lowest quintile = 1.7; 95% confidence interval (CI): 1.4-2.0) and glycemic load (OR = 1.8; 95% CI: 1.5-2.2), after allowance for sociodemographic factors, physical activity, number of daily meals, and intakes of fiber, alcohol and energy. ORs were more elevated for cancer of the colon than rectum. Overweight and low intake of fiber from vegetables and fruit appeared to amplify the adverse consequences of high glycemic load. CONCLUSIONS: The positive associations of glycemic index and load with colorectal cancer suggest a detrimental role of refined carbohydrates in the etiology of the disease.

Adult↗

Leanness and squamous cell oesophageal cancer.

BACKGROUND: Squamous cell oesophageal cancer is one of the few neoplasms inversely related to body mass index (BMI). However, it is not clear whether this is due to cancer-related weight loss or to other correlates of leanness. PATIENTS AND METHODS: 395 incident, histologically confirmed cases of squamous cell oesophageal cancer and 1,066 controls, admitted for acute, non-neoplastic diseases, in Italy and Switzerland. Odds ratios (ORs) were derived from multiple logistic regression, including terms for education, tobacco. alcohol, non-alcohol energy, fruit and vegetable intake. RESULTS: The ORs for the lowest vs. the highest quartile of BMI in the year before diagnosis were 2.0 in men, 1.6 in women, and 1.9 (95% confidence interval: 1.3-2.9) in both sexes combined. The association with leanness was stronger in heavy smokers, but was not accounted for by smoking and drinking, nor by differences in diet. Weight change in the decade prior to diagnosis showed no linear association with risk. However, cases were not leaner than controls at age 30 (OR = 0.6 for the lowest BMI quartile) and 50 (OR = 1.1). CONCLUSIONS: Leanness appears to be an indicator of squamous cell oesophageal carcinogenesis. However, low BMI in the distant past was unrelated to oesophageal cancer risk.

Adult↗

Reproductive and hormonal factors and ovarian cancer.

BACKGROUND: Menstrual, reproductive and hormonal factors have been related to ovarian cancer risk, but further quantification of their role in various populations is required. PATIENTS AND METHODS: Cases were 1031 women, below age 79, with incident, histologically confirmed epithelial ovarian cancer, and controls 2411 women, admitted between 1992 and 1999 to a network of hospitals in 4 Italian areas for acute, non-neoplastic, diseases. Odds ratios (OR) were obtained using multiple logistic regression. RESULTS: Multiparity was associated with a significant reduction in risk of ovarian cancer (OR = 0.6 for 3, and 0.5 for > or = 4 births). No consistent association was observed with time since first or last birth, nor with spontaneous or induced abortions. Late age at menarche (OR = 0.8), and early menopause (OR = 0.6) were inversely related to risk, as did long-term oral contraceptive use (OR = 0.5, for > or = 5 years). Hormone replacement therapy in menopause was associated with a non-significantly elevated risk (OR = 1.4). The pattern of risk was similar for women with and for those without family history of breast or ovarian cancer. CONCLUSIONS: This uniquely large study confirms and further quantities the relation between hormonal and reproductive factors and ovarian cancer. The pattern of risk observed cannot be totally explained by a role of ovulation in ovarian carcinogenesis.

Adult↗

Changing socioeconomic correlates for cancers of the upper digestive tract.

BACKGROUND: Cancers of the upper digestive tract have long been associated with low socio-economic levels. It has however been suggested that in recent times the social gradient for these cancers is leveling off. PATIENTS AND METHODS: Data from three case-control studies on oral, pharyngeal and oesophageal cancer conducted in Northern Italy during the periods 1984-1992 and 1992-1997 were combined and re-analyzed. Cases were subjects admitted to the major teaching and general hospitals in the areas under study with incident, histologically confirmed cancer of the oral cavity and pharynx (n = 1126) and oesophagus (n = 714). Controls were subjects admitted to the same hospitals for a wide spectrum of acute, non-neoplastic conditions, not related to smoking or alcohol consumption (n = 4642). RESULTS: In the 1980s a significant association was observed with low education and social class level. The multivariate odds ratios for oral, pharyngeal and oesophageal cancers combined was 1.78 for the lowest versus the highest educational level, and 1.75 for the lowest versus the highest social class. No consistent pattern of risk was observed with any of the socio-economic indicators considered in the studies conducted in the 1990s. CONCLUSIONS: The present study indicates that the socio-economic correlates of cancers of the upper digestive tract have changed over the last few years in Italy, with a disappearance of the social gradient.

Aged↗

Leanness as early marker of cancer of the oral cavity and pharynx.

BACKGROUND: It is not clear whether the purported association of leanness with cancer of the oral cavity and pharynx was due to cancer-related weight loss or to the influence of factors associated with leanness. PATIENTS AND METHODS: Seven hundred fifty-four incident cases of cancers of the oral cavity and pharynx and 1775 controls, admitted to hospital for acute, non-neoplastic diseases, in Italy and Switzerland. Questionnaire included height, lifetime history of weight and of physical activity, waist and hip measurements, and a validated food-frequency section. RESULTS: Leanness at diagnosis was associated with elevated risk in men (adjusted odds ratio, OR for 5-unit decrease in body-mass index, BMI = 1.9; 95% confidence interval (CI): 1.6-2.2 in men). Male cases were significantly leaner than control subjects at the age of 30 and of 50. Thinner women also had an increased risk, but the inverse association with BMI was non linear. In both sexes, the association with leanness was restricted to smokers and moderate/heavy drinkers, but was not accounted for by drinking and smoking habits, nor by differences in physical activity or dietary habits. CONCLUSIONS: Leanness appears to be an early marker of some unknown biological effect of smoking and/or of alcohol abuse, which may contribute to the prediction of cancers of the oral cavity and pharynx. Cessation of smoking and substantial reduction of alcohol intake may improve nutritional status, besides stopping carcinogen exposure.

Adult↗

A pooled analysis of case-control studies of thyroid cancer. VI. Fish and shellfish consumption.

OBJECTIVE: To better understand the role of fish and shellfish on thyroid cancer risk, we systematically re-analyzed the original data from 13 case-control studies conducted in the US, Japan, China, and Europe. METHODS: A total of 2497 cases (2023 women, 474 men) and 4337 controls (3268 women, 1069 men) were considered. Odds ratio (OR) and corresponding 95% confidence interval (CI) were estimated for each study by logistic regression models, conditioned on age and sex, and adjusted for history of goiter, thyroid nodules or adenomas, and radiation. Combined ORs were computed as the weighted average of the estimates from each study. RESULTS: The ORs for the highest level of total fish consumption (three or more times per week) as compared to the lowest one (less than once per week) was above unity in Hawaii, Connecticut, Japan, Norway, Tromsø, and Vaud. Conversely, the ORs for the studies in Los Angeles. Shanghai, southeastern Sweden, Uppsala, northern Sweden, northern Italy, and Athens were below one. The pattern of risk for salt water fish and shellfish was not substantially different from that of total fish. Fish was not associated with thyroid cancer risk in all studies combined (OR = 0.99, 95% CI 0.85-1.2 for moderate, and OR=0.88, 95% CI 0.71-1.1 for high total fish consumption), but there was a suggestion of a protective effect in endemic goiter areas (OR = 0.65, 95% CI 0.48-0.88). CONCLUSION: This combined analysis indicates that relatively elevated fish consumption does not appreciably increase thyroid cancer risk, and may have a favorable influence in areas where iodine deficiency is, or was, common.

Adult↗

Micronutrients and ovarian cancer: a case-control study in Italy.

BACKGROUND: The role of selected micronutrients, vitamins and minerals in the aetiology of epithelial ovarian cancer was investigated using data from a case-control study conducted between 1992 and 1999 in five Italian areas. PATIENTS AND METHODS: Cases were 1,031 patients with histologically confirmed incident epithelial ovarian cancer. Controls were 2,411 subjects admitted for acute, non-neoplastic diseases to major hospitals in the same catchment areas. Dietary habits were elicited using a validated food frequency questionnaire including 78 food groups and recipes. Odds ratios (OR) and 95% confidence intervals (95% CI) were computed by quintiles of intake of nutrients. RESULTS: Inverse associations emerged for vitamin E (OR = 0.6; 95% CI: 0.5-0.8), beta-carotene (OR = 0.8; 95% CI: 0.6-1.0), lutein/zeaxanthin (OR = 0.6; 95% CI: 0.5-0.8 for the highest vs. the lowest quintile of intake), and calcium intake (OR = 0.7; 95% CI: 0.6-1.0). When the combined effect of calcium and vitamin E was considered, the OR reached 0.4 (95% CI: 0.3-0.7) for subjects in the highest compared to those in the lowest intake tertile of both micronutrients. Results were consistent across strata of menopausal status, parity and family history of ovarian or breast cancer. CONCLUSIONS: The intake of selected micronutrients, which were positively correlated to a diet rich in vegetables and fruits, was inversely associated with ovarian cancer.

Adolescent↗

A seroprevalence study of human herpesvirus type 8 (HHV8) in eastern and Central Africa and in the Mediterranean area.

Human herpes virus type 8 (HHV8) is the major determinant of Kaposi's sarcoma (KS), a neoplasm with wide geographic variations in incidence rates. To assess the prevalence of HHV8 infection among populations with differing rates of KS, we used sera from 1,402 persons (Central Africa: Cameroon, n = 293, age range: 5-40; eastern Africa: Uganda, n = 315, age range: 1-64: Mediterranean area: Egypt, n = 236, age range: 13-19: Italy, blood donors n = 134, age range: 20-67: Italy. HIV seroconverters n = 424, age range: 16-65). Serum samples were tested for antibodies to lytic and latent antigens of HHV8 using two immunofluorescence assays. HHV8 prevalence was evaluated according to geographic area, gender and age groups. Overall, the highest prevalence of HHV8 lytic antigens (47.5%) was recorded among children and adults in Africa. Approximately 40% of children and adolescents from Egypt and of Italian HIV-positive persons (39.9%) were HHV8 seropositive. In eastern and Central Africa and in Egypt, no differences emerged between males and females for both types of HHV8 antibodies. Conversely, Italian females were at lower HHV8 risk than their male counterparts. Moreover the prevalence of HHV8 infection tended to increase with age. This investigation partially confirms that HHV8 infection mirrors incidence rates of KS. The high prevalence of HHV8 infection in newborns, children and adolescents in Egypt, in eastern and in Central Africa strongly suggests the existence of transmission modes other than sexual.

Adolescent↗

Alcohol drinking and risk of non-Hodgkin's lymphoma.

OBJECTIVE: To analyse the relation between alcohol intake and the risk of non-Hodgkin's lymphoma (NHL). DESIGN: Hospital-based case-control study. SETTINGS: The greater Milan area and the province of Pordenone, Northern Italy. SUBJECTS: Cases were 446 (256 men and 190 women) with histologically confirmed incident NHL, and controls were 1295 (791 men and 504 women) with acute non-neoplastic conditions. RESULTS: Compared to non-drinkers, the odds ratio (OR) was 0.92 for <3 drinks per day, 0.98 for 3-6 drinks, and 1.02 for > or =7 drinks per day. Wine drinking was also not associated with risk, and the OR was 0.85 for drinkers of > or =7 drinks/day compared to non-drinkers. Beer and spirit intake was also not associated with NHL risk. CONCLUSIONS: Our study, based on a population with relatively high alcohol intakes, indicates that there is no appreciable association between intake of various alcoholic beverages and the risk of NHL. SPONSORSHIP: Italian Association for Research on Cancer, Milan, Italy.

Adolescent↗