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Biomedical subjects

Silvia Franceschi

Publications and source records attributed to Silvia Franceschi.

At least 109 records · Page 6Linked to original sources

Chlamydia trachomatis and invasive cervical cancer: a pooled analysis of the IARC multicentric case-control study.

To determine whether Chlamydia trachomatis infection is consistently associated with an increased risk of invasive cervical carcinoma (ICC) after accounting for the strong effect of human papillomavirus (HPV) infection, a case-control study of 1,238 cases of ICC and 1,100 control women from 7 countries was carried out (hospital-based studies in Thailand, the Philippines, Morocco, Peru, Brazil and population-based studies in Colombia and Spain, all coordinated by the International Agency for Research on Cancer, Lyon, France). C. trachomatis serum antibody detection was made by means of a microfluorescence assay. Among HPV DNA-positive cases and controls, the risk of squamous cell ICC was elevated in C. trachomatis seropositive women (OR = 1.8; 95% CI = 1.2-2.7) after adjustment for age, center, oral contraceptive use, history of Pap smears, number of full-term pregnancies and herpes simplex virus 2 seropositivity. The effect of C. trachomatis seropositivity on squamous cell ICC risk increased with increasing C. trachomatis antibody titers and was higher in women under 55 years of age. C. trachomatis antibodies were not associated with adeno- or adenosquamous cell carcinoma (OR = 1.0; 95% CI = 0.53-1.9) in HPV DNA-positive women. An association of C. trachomatis with squamous cell ICC was found among all cases and control women with or without adjustment for HPV.

Adult↗

B-cell non-Hodgkin's lymphoma and hepatitis C virus infection: a systematic review.

A high prevalence of hepatitis C virus (HCV) infection in patients with B-cell non-Hodgkin's lymphoma (B-NHL) has been reported in some, but not all, studies, and the association showed a strong regional variation. We conducted a systematic review of the prevalence of HCV infection in case series of B-NHL and, when an appropriate control group was available, of the odds ratio of B-NHL associated with HCV infection. A high HCV prevalence in B-NHL was found in southern and eastern Europe, Japan and the southern United States, but not in central and northern Europe, Canada, northern United States, or a few Asian countries. Possible sources of heterogeneity and bias are discussed. The odds ratio of B-NHL for HCV infection was relatively weak, ranging from 2 to 4 in most studies. Thus, even if the observed association were causal, the percentage of cases of B-NHL attributable to HCV infection would be relatively low (10%) also in countries with a high prevalence of HCV infection in the general population, and extremely low in other countries. This may explain apparent inconsistencies between studies. Potential mechanisms of action are also discussed.

Case-Control Studies↗

Prevalence and determinants of genital infection with papillomavirus, in female and male university students in Busan, South Korea.

BACKGROUND: Little is known about the prevalence of human papillomavirus (HPV) infection in young adults in Asia. METHODS: We invited female and male students in Busan, South Korea, to participate in a survey that included, for females, self-collection of vaginal cells and, for males, physician-performed collection of exfoliated genital cells. The prevalences of 25 HPV types were evaluated, by a polymerase chain reaction-based assay, in 672 female students (median age, 19 years) and in 381 male students (median age, 22 years). RESULTS: HPV DNA was detected more frequently in female students (15.2%) than in male students (8.7%); in both sexes, high-risk HPV types were predominant. Among sexually active students, HPV prevalence was 38.8% in females and 10.6% in males. In female students, currently smoking cigarettes and having multiple lifetime sex partners were the strongest risk factors for HPV infection; in male students, associations between HPV prevalence and sexual habits were similar to those in female students but never attained statistical significance. CONCLUSIONS: Young women in South Korea start having penetrative sexual intercourse relatively late (median age, 18 years), but, once they begin, HPV prevalence quickly rises to levels comparable with those found in university students in the United States and in northern Europe. The high rate of participation in our study suggests that trials of new vaccines against HPV may be feasible among university students in South Korea.

Adolescent↗

Non-Hodgkin's lymphoma and hepatitis C virus: a case-control study from northern and southern Italy.

HCV has been associated with NHL, but the evidence from case series and case-control studies is not totally consistent. Between 1999 and 2002, we conducted a hospital case-control study on the association between HCV, HBV and NHL in 2 areas of Italy where HCV infection is relatively frequent. Cases (n = 225, median age 59 years) were consecutive patients with a new diagnosis of NHL admitted to local specialized and general hospitals. Controls (n = 504, median age 63 years) were patients with a wide spectrum of acute conditions admitted to the same hospitals as cases. HCV prevalence was 19.6% among NHL cases and 8.9% among controls (adjusted OR = 2.6, 95% CI 1.6-4.3). The ORs for HCV were similar for low-grade and intermediate-/high-grade B-cell NHL (3.2 and 2.4, respectively) as well as for nodal and extranodal NHL (2.7 and 2.6, respectively). Positivity for HBsAg was found in 3.8% of cases and 0.9% of controls (OR = 4.1, 95% CI 1.2-14.4). An elevated OR was also found for history of hepatitis C (OR = 4.7, 95% CI 2.3-9.5). History of blood transfusion before 1990 was associated with HCV positivity among controls but not with NHL risk. In conclusion, HCV infection was associated with an increase in NHL risk, and the fraction of NHL cases attributable to HCV was 12.4% (range 6.3-18.5%).

Adolescent↗

Food groups and risk of prostate cancer in Italy.

Although several studies have been conducted, the relation between diet and prostate cancer remains unclear. The role of a wide range of foods on the risk of prostate cancer has thus been analyzed in a case-control study conducted in Italy between 1991 and 2002. Cases were 1,294 patients below age 75 years with incident, histologically confirmed carcinoma of the prostate; controls were 1,451 subjects below age 75 years admitted to the same hospitals as cases for a wide spectrum of acute, non-neoplastic conditions. Multivariate odds ratios (ORs) were obtained after allowance for major potential confounding factors, including calorie intake. Among the 19 food groups considered, 4 showed some significant association with prostate cancer risk. A significant trend of increasing risk with more frequent consumption was found for milk and dairy products (OR = 1.2 for highest vs. lowest quintile, p = 0.03) as well as bread (OR = 1.4, p = 0.01), whereas inverse associations were observed for soups (OR = 0.8, p = 0.02) and cooked vegetables (OR = 0.7, p = 0.01). This uniquely large study on prostate cancer and diet in a southern European population confirms that no strong association exists between any specific foods and prostate cancer, apart from an increased risk for milk and dairy products and a possible protective effect of vegetables.

Aged↗

p53 mutations are common in human papillomavirus type 38-positive non-melanoma skin cancers.

In cervical cells, the E6 protein of the oncogenic human papillomavirus (HPV) types inactivates p53, promoting its degradation. Consequently, mutations of the p53 gene are rarely seen in these cancers. Our recent data indicate that the cutaneous HPV38 is involved in skin carcinogenesis. In this study, we have determined the presence of HPV38 and the status of p53 gene in 32 non-melanoma skin cancers. We found that p53 gene is frequently mutated in HPV38-positive skin cancers and that HPV38 E6 does not promote p53 degradation. Thus, different mechanisms appear to be involved in the development of HPV-positive cervical and skin cancers.

Animals↗

Fibre intake and prostate cancer risk.

Dietary fibre has been reported to protect from several neoplasms, but the issue remains controversial. No previous study considered in depth the topic of fibres and prostate cancer. A multicentre case-control study was conducted in Italy from 1991 to 2002, including 1,294 men with incident, histologically confirmed prostate cancer and 1,451 controls admitted to the same network of hospitals as cases with acute nonmalignant conditions. Multivariate odds ratios (OR) and 95% confidence intervals (CI) were obtained after allowance for major identified confounding factors, including total energy intake. Compared to the lowest quintile, the OR of prostate cancer for the highest quintile of total fibre intake was 0.93 (95% CI 0.71-1.22). The risk was inversely related with soluble fibre (OR = 0.89, 95% CI 0.78-1.02, for a difference between 80th and 20th percentile), cellulose (OR = 0.88, 95% CI 0.78-1.01) and vegetable fibre (OR = 0.82, 95% CI 0.73-0.93). These relationships were consistent across strata of age, family history of prostate cancer, body mass index and education. Vegetable fibres appear, therefore, to have a favourable association with prostate cancer risk.

Aged↗

The role of type of tobacco and type of alcoholic beverage in oral carcinogenesis.

Incidence rates of oral and oropharyngeal cancers (oral cancer) in Spain are among the highest in Europe. Spain has a population heavily exposed to various types of tobacco and alcoholic beverages but the role and impact of tobacco type and beverage type in oral carcinogenesis remain controversial. To estimate the independent and joint effects of tobacco smoking and alcohol drinking habits on the risk of developing oral cancer, we carried out a multicenter, hospital-based, case-control study in Spain. Data from 375 patients newly diagnosed with cancer of the oral cavity or oropharynx and 375 matched control subjects were analyzed using multivariate logistic regression procedures. All exposure characteristics of amount, duration and cessation of both tobacco smoking and alcohol drinking were strongly associated with cancer risk following a dose-dependent relationship. At equal intake or duration levels, black-tobacco smoking and drinking of spirits were both associated with a 2- to 4-fold increase in cancer risk compared to blond tobacco smoking or drinking of wine or beer, respectively. While ever exposure to smoking only or drinking only was associated with a moderate and nonsignificant increase in cancer risk, a history of simultaneous exposure to both habits was associated with a 13-fold increase that was compatible with a synergistic effect model (p-value for interaction: 0.008). Exposure to black tobacco smoking and/or drinking of spirits may account for up to 77% of oral cancer occurrence in Spain. Both black tobacco smoking and drinking of spirits place individuals at a very high risk of developing oral cancer. Simultaneous exposure to tobacco and alcohol consumption increases oral cancer risk in a synergistic fashion, even when consumption levels are moderate. These results underline the importance of type of tobacco and alcohol concentration in oral carcinogenesis.

Aged↗

Human papillomavirus type 16 and TP53 mutation in oral cancer: matched analysis of the IARC multicenter study.

TP53 mutations were analyzed in 35 human papillomavirus (HPV) type 16 DNA-positive cancers of the oral cavity and oropharynx and in 35 HPV DNA-negative cancers matched by subsite, country, sex, age, and tobacco and alcohol consumption. Wild-type TP53 was found more frequently in cancer specimens that contained HPV16 DNA than in those that did not. All 14 HPV16 DNA-positive cancers in HPV16 E6 antibody-positive patients contained wild-type TP53, compared with 50% of corresponding HPV DNA-negative cancers (matched odds ratio, infinity; 95% confidence interval, 1.4- infinity ). In contrast, for HPV16 DNA-positive cancers in E6-negative patients, wild-type TP53 frequency was similar to that in corresponding HPV DNA-negative cancers (matched odds ratio, 1.0; 95% confidence interval, 0.2-5.4). TP53 inactivation is a major mechanism of HPV-related carcinogenesis in the oral cavity and oropharynx. The role of HPV in cancers also containing TP53 mutations remains to be clarified.

Base Sequence↗

Analysis of human papillomavirus type-16 variants in Italian women with cervical intraepithelial neoplasia and cervical cancer.

Human papillomavirus type 16 (HPV-16) classes (E, AA, As, Af1, Af2) and their variants have different geographic distribution and different degrees of association with cervical lesions. This study was designed to examine HPV-16 variants among Italian women and their prevalence in case patients (affected by invasive cervical carcinoma or cervical intraepithelial neoplasia grade 2-3 and cervical intraepithelial neoplasia grade 1), versus control subjects with normal cervical epithelium (controls). A total of 90 HPV-16 positive cervical samples from women of Italian Caucasian descent have been tested, including 36 invasive cervical carcinomas, 21 with cervical intraepithelial neoplasias grade 2-3, 17 with cervical intraepithelial neoplasia grade 1 and 16 controls. HPV-16 was detected with an E6/E7 gene-specific polymerase chain reaction, and variant HPV-16 classes and subclasses were identified by direct nucleotide sequencing of the region coding for the E6 and the E7 oncoproteins, the MY09/11-amplified highly conserved L1 region, and the long control region (LCR). Among the 90 HPV-16 samples, nine viral variants have been identified belonging to the European (Ep-T350 and E-G350) and non-European (AA and Af-1) branches. The E-G350 is the prevalent variant in all analyzed different disease stages being present in 55.5% of ICC, 52.4% of cervical intraepithelial neoplasias 2-3, 47.1% of cervical intraepithelial neoplasia grade 1, and 50.0% of control samples. The non-European variants AA and Af1, rarely detected in control samples, represent 33.3% of all HPV-16 infections in invasive cervical carcinoma (with a peak of 19.4% and 13.9%, respectively), showing a statistically significant increase in frequency in more advanced lesions (chi(2) trend = 7.2; P < 0.05). The prevalence of HPV-16 Ep-T350, however, is higher in controls (43.7%) and in of cervical intraepithelial neoplasia grade 1 (41.2%) than in cervical intraepithelial neoplasia grade 2-3 (28.6%) and in invasive cervical carcinoma (11.1%) cases strongly suggesting lack of progression for pre-neoplastic lesions associated with such variant. The increased frequency of non-European variants in invasive lesions suggests that they are more oncogenic than European variants. This could have implications for future diagnostic and therapeutic strategies.

Adult↗

Kaposi's sarcoma in Vaud and Neuchatel, Switzerland, 1978-2002.

We have considered trends in the incidence of Kaposi sarcoma (KS) between 1978 and 2002, using data from the Swiss Cancer Registries of Vaud and Neuchâtel (786000 inhabitants). Overall, 163 cases were registered, 149 in men and 14 in women. After a peak reached in 1988-1992 in both men (2.71/100000, world-standard) and women (0.26/100000), a considerable decline was observed thereafter, to reach 0.80/100000 men and 0.06/100000 women in 1998-2002. In men, there was a substantial decline (from 4.91/100000 in 1988-1992 to 0.56 in 1998-2002) at age 15-44 years, a fall from 2.91 in 1993-1997 to 2.37 in 1998-2002 at age 45-64 years, but some increases over the last decade in the elderly, likely due to cases of classic KS. The declines in KS confirm that earlier anti-retroviral therapies (HAART) had already reduced the risk of KS, and the newest highly active anti-retroviral therapies have further contributed to the decline of KS in recent years.

Adolescent↗

Risk factors for oral and pharyngeal cancer in young adults.

Mortality from oral cancer has been rising in the young in several areas of the world until the early 1990s. We analysed data from two case-control studies from Italy and Switzerland including 137 cases of oral and pharyngeal cancer below age 46 and 298 hospital controls. The multivariate odds ratios (OR) were 20.7 for heavy smokers and 4.9 for heavy drinkers. The combination of high tobacco and alcohol consumption led to an OR of over 48. Body mass index (OR=0.28, for the highest tertile), high consumption of coffee (OR=0.25), fresh vegetables (OR=0.39), fruit (OR=0.73) and beta-carotene (OR=0.48) were inversely related to risk. Tobacco accounted for 77% of all cancer cases in this population, alcohol for 52%, low vegetable consumption for 52%, and the combination of the three factors for 85%.

Adult↗

Wine, beer and spirits and risk of oral and pharyngeal cancer: a case-control study from Italy and Switzerland.

We examined the relation between consumption of different types of alcoholic beverages and the risk of oral and pharyngeal cancer, using data from a case-control study conducted in Italy and Switzerland between 1992 and 1997. This included a total of 749 cases of oral and pharyngeal cancer and 1,772 hospital controls, admitted for acute, non-neoplastic conditions, unrelated to alcohol and smoking consumption. Significant trends in risk were found with increasing total alcohol intake, with multivariate odds ratios (OR) of 2.1 for drinkers of 3-4 drinks/day, as compared to abstainers or light drinkers (< or = 2 drinks/day), 5.0 for 5-7, 12.2 for 8-11 and 21.1 for > or = 12 drinks/day. Similar increased risks for subsequent levels of consumption were found for wine drinkers. After allowance for wine intake, the ORs for beer drinkers were 1.2 for 1-2 drinks/day, and 2.3 for > or = 3 drinks/day. Corresponding values for spirit drinkers were 1.0 and 1.9. Patterns of risk for wine drinkers were similar for wine only drinkers and drinkers of wine, plus beer and spirits. Our study indicates that in populations with frequent wine consumption, wine per se can strongly increase the risk of cancer of the oral cavity and pharynx, and confirms that the most prevalent alcoholic beverage in each population tends to be the one with the highest risk.

Adult↗

Influence of selected hormonal and lifestyle factors on familial propensity to ovarian cancer.

AIM: To study the influence of established risk factors for ovarian cancer in women with a family history of ovarian and/or breast cancer. METHODS: Italian hospital-based case-control study. Cases were 1031 women with incident epithelial ovarian cancer and controls were 2411 women. Two "Adult life risk scores" (ALRS) were defined combining the effect of hormonal and lifestyle risk factors. RESULTS: Ovarian cancer risk increased with low number of children, late menopause, never or short oral contraceptive use, physical inactivity, rich red meat intake and low fish, pulse and vegetable intake. For hormonal factors, compared to women without a family history and low ALRS, the odds ratios (OR) was 1.77 for women without family history and high ALRS, 2.51 for women with family history and low ALRS and 5.99 for women with family history and high ALRS. The corresponding values for the lifestyle ALRS were 2.00, 2.24 and 7.43. CONCLUSIONS: Intervention on selected hormonal and lifestyle risk factors might be more important for women with family history of ovarian and/or breast cancer.

Adolescent↗

Marital status and cancer risk in Italy.

BACKGROUND: Marital status has long been related to cancer incidence and mortality rates. However, only few analytical studies have been conducted on this issue considering known or potential confounding factors. METHODS: We systematically examined the relation between marital status and cancer risk using data from a network of case-control studies conducted between 1983 and 2001, including a total of 17,976 incident cases with the following cancer sites: oral cavity and pharynx, esophagus, stomach, colon, rectum, liver, gallbladder, pancreas, larynx, breast, endometrium, ovary, prostate, bladder, kidney, thyroid, Hodgkin's disease, non-Hodgkin's lymphomas, multiple myelomas, and sarcomas. Controls were 15,345 patients admitted to the hospital for non-neoplastic conditions. RESULTS: As compared to married subjects, never married ones were at significantly increased risk of oral cavity and pharyngeal cancers and at reduced risk of cancer of the colon, liver, bladder, kidney, and thyroid. However, for other cancer sites considered, most odds ratios were close to unity. Likewise, there was no consistent excess risk for divorced or widowed subjects. CONCLUSIONS: Despite some significant associations, our study suggests that marital status is not materially associated with cancer risk. Thus, the evidence that married subjects are at lower risk of several other major diseases may not be applicable to cancer.

Case-Control Studies↗

TP53 mutations in squamous-cell carcinomas of the conjunctiva: evidence for UV-induced mutagenesis.

Squamous cell carcinoma of the conjunctiva is associated with sun exposure and often occurs in HIV-positive individuals. We have analysed TP53 mutations in 21 cases of squamous cell carcinoma and 22 controls with benign conjunctival lesions from a region (Uganda, Africa) with a high prevalence of heavy sun exposure and HIV infection. TP53 mutations were detected in 11 cases (52%) and 3 controls (14%). Seven of the mutations (6 in cases and 1 in controls) were CC-->TT transitions, a molecular signature of mutagenesis by solar UV rays. A similar prevalence (56%) of TP53 mutations was found in 18 squamous cell carcinoma cases positive for epidermodysplasia verruciformis human papillomavirus types. The prevalence of CC-->TT transitions reported here is the highest observed in any cancer type and matches that of skin cancers in subjects with xeroderma pigmentosum, an inherited disease with hypersensitivity to UV damage. These results confirm at the molecular level the causal role of solar UV rays in the aetiology of squamous cell carcinoma of the conjunctiva and suggest that infection with epidermodysplasia verruciformis types of human papillomavirus may act as a cofactor to increase the sensitivity of conjunctiva cells to UV-induced mutagenesis.

Adult↗

Association between components of the insulin-like growth factor system and endometrial cancer risk.

OBJECTIVE: The insulin-like growth factor (IGF) system has been related to cell proliferation, obesity, diabetes, hyperinsulinemia and endometrial cancer risk. We used data from a case-control study conducted in Italy to provide additional information on the relation between the IGF system and endometrial cancer. METHODS: A case-control study was conducted between 1999 and 2002 in Italy, including a total of 73 women with incident, histologically confirmed endometrial cancer and 108 controls admitted to the same hospital network for acute, nonneoplastic diseases. All subjects were interviewed using a validated questionnaire. RESULTS: The odds ratios for endometrial cancer comparing the highest versus the lowest tertile of various IGF components were as follows: 0.5 [95% confidence interval (CI) 0.2-1.2] for free IGF-I, 1.1 (95% CI 0.5-2.6) for total IGF-I, 1.2 (95% CI 0.6-2.6) for total IGF-II, 2.4 (95% CI 1.0-5.9) for IGF binding protein (IGFBP)-1 and 0.8 (95% CI 0.4-2.0) for IGFBP-3. Further allowance for all IGF components in the model did not modify the results. The direct relation with IGFBP-1 was stronger and limited to heavier and older women. CONCLUSIONS: The present findings suggest a limited effect of the IGF system on endometrial cancer risk. Increasing IGFBP-1 levels seem to be associated with endometrial cancer risk in older women and in women with a higher body mass index.

Adult↗

Association between components of the insulin-like growth factor system and epithelial ovarian cancer risk.

BACKGROUND: Components of the insulin-like growth factor (IGF) system have been associated with several cancers, but very few studies are available for ovarian cancer. METHODS: A case-control study conducted between 1999 and 2003 in Italy, including a total of 59 women with incident, histologically confirmed ovarian cancer and 108 controls admitted to the same hospital network as cases, for acute non-neoplastic diseases. All subjects were interviewed using a validated questionnaire. RESULTS: After adjustment for potential confounders, the multivariate odds ratios for the highest versus the lowest tertile of various IGF components were 0.6 (95% confidence interval, CI: 0.2-1.4) for free IGF-I, 0.4 (CI: 0.1-1.5) for total IGF-I, 2.6 (CI: 0.9-6.9) for IGF-binding protein (IGFBP)-1, and 0.2 (CI: 0.0-0.6) for IGFBP-3. CONCLUSIONS: This study suggests a protective role of IGFBP-3 and a positive association of IGFBP-1 with ovarian cancer. The complex role of the IGF system in ovarian carcinogenesis deserves further clarification.

Adult↗