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Biomedical subjects

S Franceschi

Publications and source records attributed to S Franceschi.

At least 145 records · Page 8Linked to original sources
PubMed2000

Cessation of alcohol drinking and risk of cancer of the oral cavity and pharynx.

A strong, dose-dependent association exists between alcohol consumption and risk of cancer of the oral cavity and pharynx. The impact on risk of temporal aspects of drinking habits has been inadequately evaluated. Our case-control study included 754 individuals with incident cancer of the oral cavity and pharynx (median age 57) and 1,775 controls (median age 57) in the hospital for acute, non-neoplastic diseases who were interviewed in 2 Italian areas and in the Swiss Canton of Vaud between 1992 and 1997. The questionnaire included lifetime drinking and smoking habits. No influence of age at starting or duration of alcohol drinking was found. Risk increased substantially with the increase of weekly alcoholic drinks [Odds Ratios (OR) for >/= 91 drinks/week vs. never drinkers = 11.6]. Risk in former compared with current drinkers was 1.9-fold elevated. However, among individuals who had also stopped smoking, former drinkers showed lower ORs than current drinkers. The persistence of risk elevation several years after drinking cessation suggests that the role of alcohol is complex and it probably affects more than one stage of oral carcinogenesis. It remains to be clarified which impact prevention-driven drinking cessation may have on the excess of cancer of the oral cavity and pharynx due to elevated alcohol intake.

Adult↗
PubMed2000

Menstrual and reproductive factors and risk of soft tissue sarcomas.

BACKGROUND: Soft tissue sarcomas (STS) are a heterogeneous group of neoplasms whose etiology remains largely undefined. A role for female hormones in the development of STS has been suggested. To investigate this possibility, the authors analyzed data from a hospital-based case-control study conducted in Northern Italy between 1983 and 1998. METHODS: Cases were 104 women aged < 79 years with incident STS who were admitted to the cancer institutes and major teaching and general hospitals. Controls were 505 women admitted to the same network of hospitals for acute, nonneoplastic, nongynecologic, and nonimmune-related conditions. RESULTS: The multivariate odds ratio (OR) for women aged >/= 15 years compared with those aged < 12 years at menarche was 1.94 (95% confidence intervals [95% CI], 0.80-4.74). No association with STS risk was observed for menstrual cycle pattern, age at menopause, parity, and abortions. Late age at first pregnancy and birth were found to be related to an increased risk of STS, with an OR of 3.16 (95% CI, 0. 96-10.44) and 2.79 (95%% CI, 0.79-9.90) for women aged >/= 30 years at first pregnancy and birth compared with those aged < 20 years. The trend in risk was significant for age at first pregnancy. No relation with the risk of STS emerged for age at last birth and time since first or last birth. CONCLUSIONS: The risk of STS was found to be weakly related to late age at first pregnancy or birth, but not to other menstrual and reproductive factors.

Abortion, Induced↗
PubMed2000

Classic kaposi sarcoma: epidemiology and risk factors.

BACKGROUND: Although Kaposi sarcoma (KS) initially was described over a century ago, its biology remains enigmatic and conflicting. Whereas the classic type occurs mainly in older men of Mediterranean or Eastern European backgrounds and is not linked to impairment of the host immune response, iatrogenic and human immunodeficiency virus (HIV)-associated KS are linked to such conditions. A recently discovered pathogen, KS-associated herpesvirus (KSHV) (also known as human herpesvirus 8 [HHV8]), is found in tissues from all four forms of KS (classic, iatrogenic, endemic [African], and HIV-associated). This universal detection of KSHV/HHV8 suggests a central role for the virus in the development of KS and a common etiology for all KS types. The epidemiology and risk factors of classic KS, along with the biology of KSHV/HHV8 and the prevalence of the virus among different populations, is presented. METHODS: The current review is based on multiple information sources, electronic health data in all languages from 1966 onward, and previously published scientific reports from the Americas, Europe, and Africa. RESULTS: Nearly 5000 cases of morphologically characterized classic KS have been reported in Europe, Mediterranean countries, and the Americas up to 1998. Geographic location, ethnicity, time interval, age, and gender heavily influence the incidence rate of classic KS. The rate of incidence of nonacquired immunodeficiency syndrome-associated KS correlates with the KSHV/HHV8 seroprevalence in the general population. CONCLUSIONS: Many contributory factors undoubtedly have etiologic and pathogenic significance in the development of classic KS; however, the interplay between these factors has complicated the understanding of the induction and development of the disease as well as the significance of each factor. As with other cell-transforming human DNA viruses, infection with KSHV/HHV8 alone is not sufficient for the development of KS and additional cofactors are required.

Adolescent↗
PubMed2000

Primary cytoreductive surgery with rectosigmoid colon resection for patients with advanced epithelial ovarian carcinoma.

BACKGROUND: The impact of radical bowel resection with multiple organ resection on the survival if patients with advanced ovarian carcinoma has not been well defined. The authors investigated whether primary cytoreductive surgery including rectosigmoid colon resection would affect the recurrence free interval and survival of these patients. METHODS: Between April 1990 and April 1997, 66 previously untreated Stage IIIC-IV ovarian carcinoma patients with macroscopic involvement of the rectosigmoid colon were enrolled. All patients underwent cytoreductive surgery with rectosigmoid colon resection to remove residual tumor less than 2 cm in greatest dimension and received 6 cycles of cisplatin-based postoperative chemotherapy. RESULTS: The median follow-up was 26 months (range, 7-104 months). In multivariate analysis, residual disease and depth of tumor infiltration of the bowel wall were independently associated with overall survival and recurrence free interval. Disease stage was independently associated only with overall survival. Residual tumor was the most strongly predictive factor for recurrence or death. The 2-year estimated survival rates according to the amount of residual tumor were 100% for 24 patients with no macroscopic residual disease and 77.3% for 28 patients with residual disease less than 1 cm. None of the 14 patients with residual disease larger than 1 cm were alive 2-years after operation. Overall, 48 patients (72.7%) developed disease recurrence: 43 (65.1%) in the abdomen, 19 (29.8%) in the liver, and 3 (4.5%) in the pelvis. CONCLUSIONS: The current findings suggest that cytoreductive surgery with rectosigmoid colon resection should be considered for ovarian carcinoma patients with bulky pelvic disease to help ensure that they are left with no residual disease after debulking surgery.

Adult↗
PubMed2000

Diet diversity and colorectal cancer.

BACKGROUND: Food diversity has been recommended to achieve a healthy diet and prevent cancer. The relation between diet diversity and the risk of colorectal cancer was investigated using data from a multicenter case-control study carried out between 1992 and 1996 in Italy. METHODS: The study included 1225 subjects with cancer of the colon (688 men and 537 women), 728 with cancer of the rectum (437 men and 291 women), and 4154 controls (2073 men and 2081 women) residing in the same geographical areas. Odds ratios (ORs) of colon and rectal cancer and the corresponding 95% confidence intervals (CI) according to food diversity were derived from unconditional multiple logistic regression equations. RESULTS: For colon cancer, an inverse association for total diversity was found in males (adjusted OR of 0.65 for the highest vs the lowest quintile of total diversity; 95% CI: 0.46-0.93) and in females (OR = 0.85; 95% CI: 0.57-1.26). With respect to specific food groups, there was an inverse association only with diversity within vegetables (OR = 0.66; 95% CI: 0.54-0.81 in colon cancer and OR = 0.71; 95% CI: 0.55-0.91 in rectal cancer). CONCLUSIONS: This study suggests that total diversity is moderately related to a decreased risk of colorectal cancer risk. A better understanding of the potential influence of dietary patterns on colorectal cancer is needed.

Adult↗
PubMed2000

Trends in mortality from primary liver cancer in Europe.

Upward trends in incidence and mortality from primary liver cancer have been reported from Japan, the USA and a few European countries. Thus, we systematically reviewed trends in age-standardised death certification rates from primary liver cancer between 1970 and 1996 in 20 European countries providing data for the World Health Organisation database. Overall age-standardised (world population) mortality rates were approximately stable or showed no consistent trends in seven countries, including Bulgaria and Hungary (with exceedingly high rates), Finland, The Netherlands and the UK. Moderate rises were observed in Austria, Germany and Switzerland, and much larger upward trends in France and Italy, particularly for males. Downward trends were observed in both sexes in Belgium, Spain, Ireland, Greece and several Scandinavian countries. The per cent change in rates per year ranged, for males, from -7.4% for Ireland and -5.1% for Spain to +4.4% for Italy and +8.6% for France. Trends were more favourable in women, with 15 out of 20 countries showing downward trends in rates, and moderately more favourable in middle age (45-64 years) and, in major European countries, in young adults (20-44 years of age). In conclusion, trends in liver cancer mortality in Europe are heterogeneous. The fall in mortality in countries like Spain may be largely explained by improvements in the distinction between primary and secondary liver neoplasms, whereas upward trends in Central Europe and Italy are likely to be, at least in part, real. Increases in infection with the hepatitis C virus, and improved and increased searches for liver cancer in cirrhotic patients are two of the likeliest explanations for these observations.

Adult↗
PubMed2000

Cervical cancer screening in Europe. What next?

This paper reviews how knowledge of human papilloma virus (HPV) and its association with cervical cancer has evolved over the years and discusses the potential usefulness of HPV testing as a replacement and or adjunct to current screening practices.

Europe↗
PubMed2000

Cervical cancer mortality in young women in Europe: patterns and trends.

On the basis of overall national death certification data, it is not possible to analyse mortality from cervical cancer in Europe, since 20-65% of deaths from uterine cancer in largest countries are still certified as uterus, unspecified. We analysed, therefore, age-standardised death certification rates from uterine cancer between 1960 and 1998 in women aged 20-44 years, since most deaths from uterine cancer below the age of 45 years arise from the cervix. In all Western European countries, except Ireland, substantial declines in cervical cancer mortality in younger women were observed, although the falls were larger and earlier for some Nordic countries. The trends were irregular in the UK, with earlier declines between 1960 and 1970, followed by a rise between 1970 and 1985, and a subsequent fall. In Ireland, mortality from uterine cancer at age 20 to 44 years has been rising since the early 1980s, to reach 3.4/100000 in 1995-1996. In Eastern Europe, some fall in mortality was observed in Hungary and Poland, while trends were upwards in Romania since 1980, and in Bulgaria. In all these countries, moreover, absolute rates remained appreciably higher than in most of Western Europe, and in the late 1990s there was over a 10-fold variation between the highest rates in Romania (10.6/100000 women aged 20-44 years) and the lowest ones in Finland (0.5/100000) or Sweden (0.9/100000). Within the European Union, the variation was over 6-fold, the highest rates being registered in Ireland (3. 4/100000) and Portugal (3.2/100000). The declines registered in cervical cancer mortality in young women were largely due to screening, and the persisting variations in mortality across Europe underline the importance of the adoption of organised screening programmes, with specific urgency in Eastern Europe.

Adult↗
PubMed2000

Comparison of cancers of the oral cavity and pharynx worldwide: etiological clues.

We assessed separate and combined sex-specific incidence rates of oral and pharyngeal cancer for 1988-92 and oral/pharyngeal ratios from 49 different cancer registries in five continents. Incidence trends over a period of approximately 30 years were evaluated in 16 long active registries for men and four for women. Cancers of the lip, salivary glands, and nasopharynx were excluded. The incidence of both oral and pharyngeal cancer among men is highest in northern France, southern India, a few areas of central and eastern Europe, and Latin America. Among women, the highest incidence is observed in India. Oral/pharyngeal ratio is everywhere systematically lower in men compared to women. Recent trends for oral cancer are more favourable than those for pharyngeal cancer in developing countries. In developed countries, trends in oral cancer appears to be more closely correlated to changes in alcohol consumption than those of pharyngeal cancer.

Alcohol Drinking↗
PubMed2000

A population at high risk for esophageal cancer in the north-east of Italy.

Esophageal cancer is generally characterised by relatively low incidence and mortality rates in Europe. However, a high-risk population for this tumour is resident in the north-east of Italy. Several studies have been conducted on this population of males confirming the major role of alcohol and tobacco consumption alone and in combination. The inhabitants of this area of Italy constitute an ideal target population for studies of molecular epidemiology aimed at elucidating the natural history of the disease which is still ill-defined, and the distribution of genetic alterations at a population level.

Adult↗
PubMed2000

Trends in survival for patients diagnosed with cancer in Vaud, Switzerland, between 1974 and 1993.

BACKGROUND: Analysis of trends in cancer survival in defined well surveilled populations can provide useful indications on advancements in cancer management and treatment. PATIENTS AND METHODS: Survival rates from the Vaud Cancer Registry were computed for 31,158 cases registered in 1984-1993, and compared with those registered in 1974-1978 and 1979-1983. RESULTS: A systematic, albeit generally moderate, tendency towards increasing five-year relative survival was observed for both sexes and most major cancer sites, including oral cavity and pharynx (0.38-0.43). stomach (0.21-0.26), colon (0.49-0.55), rectum (0.45-0.51), lung (0.08-0.12), skin melanoma (0.67-0.89), female breast (0.67-0.80), endometrium (0.72-0.84), ovary (0.28-0.37). prostate (0.44-0.66), testis (0.73-0.96), bladder (0.31-0.50), kidney and renal pelvis (0.41-0.59), thyroid (0.73-0.81), non-Hodgkin's lymphomas (0.37-0.63), Hodgkin's disease (0.61-0.81), and leukaemias (0.27-0.39). Survival for all cancers and both sexes combined, rose from 0.51 0.64 (0.57 for males, 0.71- for females). No appreciable change in survival was observed for cancers of oesophagus, liver, gallbladder, pancreas, larynx, cervix uteri, brain, multiple myeloma, as well as unidentified or unknown origin neoplasms. CONCLUSIONS: Survival estimates for most cancer sites are comparable to the US SEER dataset, and their pattern of trends are discussed in terms of improved diagnosis and treatment for various neoplasms.

Adult↗
PubMed2000

Strategies to reduce the risk of virus-related cancers.

BACKGROUND: Experimental and epidemiological evidence has established an association between at least eight viruses and various cancer sites. Recent estimates (at least 10% of cancer worldwide) have revealed that viruses, together with tobacco and diet, account for the largest proportion of cancer in the world. RESULTS: Improvements in the detection of viruses and biomarkers of chronic infection have led to the identification of strong associations with cancer, particularly for human papillomavirus (HPV), hepatitis B virus (HBV), and human immunodeficiency virus (HIV). For some cancer viruses (e.g., HIV and hepatitis C virus, HCV), the spectrum of malignancies involved has still to be well defined. For HBV and HPV, vaccination aimed at cancer prevention is already a reality or a possibility. Whereas HBV vaccination already emerged as one of the most cost-effective ways to reduce adult cancer mortality, for HPV vaccination some technical problems still await a solution. For other infectious agents (e.g., HCV, HIV) prospects for a vaccine are not immediate. CONCLUSIONS: In order to apply new knowledge on viruses to cancer prevention, large vaccination trials are warranted. These will have to be large (many thousands of people), prolonged (5-10 years), and match scientific excellence with a feasible design. Mistrust between scientists and the public will have to be prevented by means of absolute openness in scientific information and economical interests involved.

Adult↗
PubMed2000

Aspirin and ovarian cancer: an Italian case-control study.

BACKGROUND: A role for inflammation, and consequently of non-steroidal anti-inflammatory drugs, in ovarian carcinogenesis has been proposed, but epidemiological evidence is scanty. PATIENTS AND METHODS: Data were derived from a hospital-based case-control study conducted in Italy between 1992 and 1999. Cases were 749 women, aged 18-80 years (median age 56 years), with incident, histologically confirmed ovarian cancer. Controls were 898 non-hysterectomized women, aged 17-80 years (median age 58 years), admitted to hospital for acute conditions, unrelated to risk factors for ovarian cancer. RESULTS: The multivariate odds ratio (OR) was 0.93 (95% confidence interval (95% CI): 0.53-1.62) for regular aspirin use for more than six months, 1.38 (95% CI: 0.57-3.36) for current use and 0.72 (95% CI: 0.35-1.47) for former use. The OR was not significantly different from unity for duration of use, age at starting use, indication (analgesia or cardiovascular prevention), and in women aged < 60 and > or = 60 years at ovarian cancer diagnosis. CONCLUSIONS: This study provides little support for the hypothesis that aspirin may reduce the risk of ovarian cancer.

Adolescent↗
PubMed2000

A pooled analysis of thyroid cancer studies. V. Anthropometric factors.

OBJECTIVE: To assess the relation between anthropometric factors and thyroid cancer risk in a pooled analysis of individual data from 12 case-control studies conducted in the US, Japan, China and Europe. METHODS: 2056 female and 417 male cases, 3358 female and 965 male controls were considered. Odds ratios (OR) were derived from logistic regression, conditioning on age, A-bomb exposure (Japan) and study, and adjusting for radiotherapy. RESULTS: Compared to the lowest tertile of height, the pooled OR was 1.2 for females for the highest one, and 1.5 for males, and trends in risk were significant. With reference to weight at diagnosis, the OR for females was 1.2 for the highest tertile, and the trend in risk was significant, whereas no association was observed in males. Body mass index (BMI) at diagnosis was directly related to thyroid cancer risk in females (OR = 1.2 for the highest tertile), but not in males. No consistent pattern of risk emerged with BMI during the late teens. Most of the associations were observed both for papillary and follicular cancers, and in all age groups. However, significant heterogeneity was observed across studies. CONCLUSIONS: Height and weight at diagnosis are moderately related to thyroid cancer risk.

Adult↗
PubMed2000

Wine drinking and diet in Italy.

OBJECTIVE: To investigate the relation between wine drinking and intake of selected indicator foods, which may vary in various populations. DESIGN: Cross-sectional analysis of the comparison group of a case- control study. SETTING: A network of teaching and general hospitals from six Italian areas. SUBJECTS: 5642 control subjects (3261 females and 2381 males) aged 20-74 y (median age 58 y), admitted for acute, non-neoplastic conditions unrelated to alcohol consumption. Participation rate was over 95%. INTERVENTION: Trained interviewers collected information using a structured and validated questionnaire. The average intakes of selected food items were computed, together with the multivariate odds ratios (OR) of eating above the median of each food. RESULTS: No appreciable difference in either sex for any food indicator considered (fruit, raw vegetables, cooked vegetables, salad and fish) was observed between abstainers, wine, and other alcoholic beverage drinkers. If anything, female wine drinkers reported less frequently high consumption of salad (OR=0.8) and raw vegetables (OR=0.8), both estimates being of borderline significance. CONCLUSIONS: In no instance did wine drinkers or mixed drinkers (who include a large proportion of wine drinkers, too) show an association with indicators of healthy diet. SPONSORSHIP: Italian Association for Cancer Research, Milan, Italy. European Journal of Clinical Nutrition (2000) 54, 177-179

Adult↗
PubMed2000

Wine and other types of alcoholic beverages and the risk of esophageal cancer.

OBJECTIVE: To investigate the separate and combined effect of wine-drinking and other alcoholic beverages on esophageal cancer, in a high wine-consuming population. DESIGN: Combined analysis of two hospital-based case-control studies. SETTING: Major teaching and general hospitals in the greater Milan area and in the province of Pordenone, in northern Italy. SUBJECTS: A total of 714 incident cases of esophageal cancer, and 3137 controls admitted to hospital for acute, non-neoplastic conditions, unrelated to alcohol consumption. INTERVENTION: Trained interviews identified and questioned cases and controls using standardized structured questionnaires, including information on the average number of days per week each type of alcoholic beverages (wine, beer, spirits) was consumed, and the average number of drinks per day. Odds ratios (ORs) were calculated using unconditional multiple logistic regression equations. RESULTS: With reference to total alcohol drinking, as compared to non- or moderate drinkers (<3 drinks per day), the multivariate ORs were 1.98 for drinkers of 3-4 drinks per day, 4.22 for 5-7, 7.60 for 8-11, and 12.35 for > or =12 drinks per day. Higher risks were observed for wine-only drinkers and the corresponding values were 1.70, 4.21, 8.76 and 17.90. After allowance for wine intake, no association was observed between beer and spirit drinking and esophageal cancer, in a population in which 80% of alcohol came from wine. CONCLUSION: The amount of ethanol determines the risk of esophageal cancer, and the most commonly used alcoholic beverage appear to be most strongly associated.

Adult↗