PubMed Health⌕ Search

Biomedical subjects

A Decarli

Publications and source records attributed to A Decarli.

At least 55 records · Page 3Linked to original sources
PubMed1997

Low-risk diet for breast cancer in Italy.

To define a low-risk diet for breast cancer in Italy, a multicentric case-control study of 2569 incident cases of breast cancer and 2588 controls from Italy was analyzed. A logistic regression model was applied to the estimated intake of five macronutrients and used to compute a diet-related risk score (RS). The pattern of macronutrient and food group intake across RS deciles was defined. The mean of diet-related RSs across subsequent risk deciles ranged from 0.83 to 1.44. Total energy intake first decreased slightly, from the first to the second decile, and then increased, mostly in the last three risk deciles. Intake of starch increased in absolute and relative terms, whereas saturated fat intake rose in absolute terms but remained stable as a proportion. A relative decline was observed for unsaturated fat and sugars, with a hint, however, of U-shape effect. From a food group viewpoint, there was a marked increase in the intake of bread and cereal dishes, cakes and desserts, and refined sugar across subsequent deciles, whereas the consumption of vegetables, olive and seed oils, and fruit decreased.

Adult↗
PubMed1997

Diabetes mellitus and colorectal cancer risk.

The relationship between diabetes mellitus and the risk of colorectal cancer was investigated in a multicenter case-control study, conducted in Italy between 1992 and 1996 on 1225 cases of incident, histologically confirmed colon cancer, 728 cases of rectal cancer, and 4154 controls, who were in the hospital for acute, nonneoplastic diseases. Overall, 66 (5.4%) cases of colon cancer, 50 (6.9%) cases of rectal cancer, and 185 (4.4%) controls reported a history of diabetes. The corresponding multivariate odds ratios (ORs) were 1.2 [95% confidence interval (CI), 0.8-1.6] for colon, 1.5 (95% CI, 1.1-2.2) for rectal, and 1.3 (95% CI, 1.0-1.6) for all colorectal cancers. No association was observed for subjects who were diagnosed with diabetes at ages of < 40 years (7 cases and 27 controls, OR = 0.9). The OR was 1.4 (95% CI, 1.1-1.7) for subjects who were diagnosed with diabetes at ages of > or = 40 years and were likely to have non-insulin-dependent diabetes. The association was also stronger (OR = 1.6; 95% CI, 1.1-2.3) among subjects whose diabetes was diagnosed 10 or more years in advance and who were > or = 60 years old at the time of colorectal cancer diagnosis. None of the other covariates, including sex, education, body mass index, physical activity, energy intake, alcohol drinking, and fiber intake, showed any appreciable modifying effect. Thus, this uniquely large case-control study of colorectal cancer confirms that subjects with non-insulin-dependent diabetes mellitus have a slightly increased risk of colorectal cancer. More importantly, allowance for a large number of identified potential confounding factors, including body mass index, diet, and physical activity, could not explain the excess colorectal cancer risk among subjects with diabetes mellitus. These findings have plausible biological correlations because insulin-like-growth factor-I is a promoter of colon tumor cell growth in vitro.

Adult↗
PubMed1996

Age at any birth and breast cancer in Italy.

To provide quantitative information on the role of age at any birth for breast cancer risk, we analyzed data from a cooperative Italian case-control study conducted between 1991 and 1994 on 2,569 incident, histologically confirmed breast cancer cases and 2,588 controls in hospital for acute, non-neoplastic, non-gynecological conditions. A single logistic model was fitted, including terms for number of births, age at each birth and at menarche, plus age and center. Age at first birth was the strongest reproductive determinant of subsequent breast cancer risk, with an estimated increase of 4.6% per year of delay of first birth. This was similar to the influence of age at menarche (4.7% decrease in risk per year of delay of menarche). Ages at subsequent births had an independent effect on breast carcinogenesis, with an estimated 0.7% increase in risk per year of delay. Multiparity showed also an independent protection on breast cancer risk, and a protective effect of parity > or = 3 was evident in all strata of age at first birth: the odds ratio was 0.81 for 3 births and 0.70 for > or = 4 births. However, the effect of parity was determined by the age of occurrence of various births.

Adolescent↗
PubMed1996

Intake of macronutrients and risk of breast cancer.

BACKGROUND: The association between risk of breast cancer and dietary fat and intakes of other energy sources remains controversial. The Italian population offers special opportunities to assess the influence of high intakes of unsaturated fat and starch and, because the population has low awareness of diet and cancer issues, there is less scope for recall bias. We have assessed the relations of various macronutrient intakes with risk of breast cancer. METHODS: In this case-control study, 2569 women with incident breast cancer (median age 55 years) and 2588 control women (median age 56 years) in hospital with acute, non-neoplastic diseases, were interviewed in six different areas of Italy between 1991 and 1994. A validated food-frequency questionnaire was used. It included questions on 78 foods and recipes grouped into six sections, as well as specific questions on individual fat intake pattern. FINDINGS: The risk of breast cancer decreased with increasing total fat intake (trend p 0.01) whereas the risk increased with increasing intake of available carbohydrates (trend p = 0.002). The odds ratios for women in the highest compared with the lowest quintile of energy-adjusted intake were 0.81 for total fat and 1.30 for available carbohydrates. Starch was the chief contributor to the positive association with available carbohydrates. High intakes of polyunsaturated and unsaturated fatty acids (i.e., polyunsaturated fatty acids plus oleic acid) were associated with a decreased risk of breast cancer (odds ratios for highest vs lowest quintile 0.70 and 0.74, respectively). Conversely, the intakes of saturated fatty acids, protein, and fibre were not significantly associated with breast-cancer risk. INTERPRETATION: This case-controls study shows that unsaturated fatty acids protect against breast cancer, possibly because intake of these nutrients is closely correlated with a high intake of raw vegetables. The findings also suggest a possible risk in southern European populations, of reliance on a diet largely based on starch.

Adult↗
PubMed1996

Attributable risks for colorectal cancer in northern Italy.

Using data from a case-control study conducted between 1985 and 1992 in northern Italy on 828 cases of colon cancer, 498 cases of rectal cancer and 2,024 controls in hospital for acute, non-neoplastic, non-digestive tract disorders, we estimated the percent population attributable risk (PAR) for colorectal cancer in relation to beta-carotene, vitamin C (as markers of a diet rich in fruit and vegetables), red meat and seasoning fat intake, daily meal frequency and family history of the disease. On the basis of multivariate odds ratios, adjusted for total calorie intake, a low intake of beta-carotene accounted for 39% of all the cases and a low intake of vitamin C for 14%. These two micronutrients together explained 43% of all colorectal cancer cases in this population. A high frequency of intake of red meat consumption explained 17% of all cases, and a high score of seasoning fats 4%. A higher daily meal frequency was responsible for 13% of the cases, and these 5 dietary factors together explained 63% of colorectal cancer cases in this population. Family history of colorectal cancer accounted for 4% of all cases. These estimates were similar for colon and rectal cancers separately, in males and females, and in younger and elderly subjects, except for seasoning fats and family history, whose PARs were apparently greater for colon cancer and at younger age. Thus, even though available dietary data were limited in several aspects, and the PAR estimates were based on somewhat arbitrary assumptions regarding the exposure distribution, about two-thirds of all colorectal cancers in this population could be explained in terms of a few risk factors or risk indicators considered. This would correspond to the avoidance of a large proportion of the over 18,000 deaths from colorectal cancer registered per year in the whole of Italy.

Adult↗
PubMed1996

Measurement of exposure to nutrients: an approach to the selection of informative foods.

Frequently, epidemiologic questionnaires are designed to measure several individual level exposures, including exposure to one or more nutrients. Although most nutrients are contained in a large number of foods, constraints on questionnaire length permit the inclusion of only a subset of these. In this paper, the authors review the two common methods of food selection, and they propose two new methods. When the intent is to estimate the effect of the nutrient on disease risk using a logistic regression model, the authors show that their Max_r method is optimal. With the use of case-control data, they examine the assumption of non-differential measurement error that is essential to the validity of all analyses that rely on shortened questionnaires. They conclude by combining the statistical considerations developed for judging adequacy of a selection method with their empirical results and suggest new goals for dietary questionnaires and a new approach to questionnaire construction consistent with those goals.

Bias↗
PubMed1996

Abortion and breast cancer risk.

The relationship between spontaneous and induced abortions and breast cancer risk was analyzed using data from a case-control study conducted between June 1991 and February 1994 in 6 Italian centers on 2,569 histologically confirmed incident breast cancer cases and 2,588 controls admitted to hospital for a wide range of acute, non-neoplastic, non-hormone-related diseases. One or more abortions were reported by 31% of cases and 32% of controls, corresponding to a multivariate odds ratio (OR) of 1.0 (95% confidence interval [CI], 0.8-1.1). No trend in risk was observed with increasing number of total abortions or spontaneous and induced abortions separately. No significant relationship was found between the risk of breast cancer and history of spontaneous or induced or total abortions in separate strata of age at diagnosis, number of children, time of abortion in relation to first birth and family history of breast cancer. When abortion was the outcome of the first pregnancy, the OR was 1.2 for spontaneous and 1.3 for induced abortion, in relation to women with birth as outcome of the first pregnancy, and 1.0 and 1.1, respectively, when the reference category was nulligravidae. Thus, our results indicate a lack of association between induced and spontaneous abortions and breast cancer risk.

Abortion, Induced↗
PubMed1996

Intake of selected micronutrients and the risk of breast cancer.

To investigate the relation between selected micronutrients and breast cancer risk, we conducted a case-control study of breast cancer between June 1991 and April 1994 in 6 Italian areas. The study included 2569 women admitted to the major teaching and general hospitals of the study areas with histologically confirmed incident breast cancer and 2588 control women with no history of cancer, who were admitted to hospitals in the same catchment areas for acute, non-neoplastic, nongynecological conditions unrelated to hormonal or digestive tract diseases or to long-term modifications of the diet. Dietary habits, including alcoholic beverage consumption, were investigated using a validated food frequency questionnaire, including 78 foods or food groups, several types of alcoholic beverages, some "fat intake pattern" questions and some open sections for foods consumed frequently by the subject and not reported in the questionnaire. To control for potential confounding factors, several multiple logistic regression models were used. When major correlates, energy intake and the mutual confounding effect of the various micronutrients were taken into account, beta-carotene, vitamin E and calcium showed a significant inverse association with breast cancer risk. The estimated odds ratios of the 5th quintile compared to the lowest one were 0.84 for beta-carotene, 0.75 for vitamin E and 0.81 for calcium. No significant association emerged for retinol, vitamin C, thiamin, riboflavin, iron and potassium. Our results suggest that a diet rich in several micronutrients, particularly beta-carotene, vitamin E and calcium, may be protective against breast cancer.

Adult↗
PubMed1996

Software for attributable risk and confidence interval estimation in case-control studies.

The increasing interest in obtaining model-based estimates of attributable risk (AR) and corresponding confidence intervals, in particular when more than one risk factor and/or several confounding factors are jointly considered, led us to develop a program based on the procedure described by Benichou and Gail for case-control data. This program is structured as an SAS-macro. It is suited to analysis of the relationship between risk factors and disease in case-control studies with simple random sampling of controls, in terms of relative risks and ARs, by means of unconditional logistic regression analysis. The variance of the AR is obtained by the delta method and is based on three components, namely, (i) the variance-covariance matrix of the vector of the estimated probabilities of belonging to joint levels of the exposure and confounding factors conditional on being a case, (ii) the variance-covariance matrix of the odds ratio parameter estimates from the logistic model, and (iii) the covariances between these probability and parameter estimates. Only a limited number of commands is requested from the user (i.e., the name of the work file and the names of the variables considered). The estimated relative risks for all the factors included in the model, the attributable risk for the exposure factor under consideration, and the corresponding 95% confidence intervals are given as outputs by the macro. Computational problems, if any, may arise for large numbers of covariates because of the resulting large size of vectors and matrices. The macro was tested for reliability and consistency on published data sets of case-control studies.

Age Factors↗
PubMed1996

Validation of a food-frequency questionnaire to assess dietary intakes in cancer studies in Italy. Results for specific nutrients.

The validity of a 77-item food-frequency questionnaire (FFQ) developed for a multicenter case-control study on diet and cancer in Italy was assessed. Trained interviewers administered the same FFQ to 452 volunteers from three Italian provinces (Pordenone, Genoa, and Forli) completed in two different seasons, at an interval of 3 to 10 months. For 395 (130 males, 265 females; median age = 52 years; range = 35 to 69 years) volunteers, two 7-day dietary (7-DD) records were available. Average intake obtained by means of the FFQ was overestimated by approximately 18% in comparison with the corresponding values based on the two 7-DD records (reference method). Pearson partial correlation coefficients, adjusted for total energy intake between the nutrient intakes assessed by the FFQ and reference method, ranged from 0.19 for vegetable fat to 0.64 for sugar (median value r = 0.46). The unadjusted deattenuated coefficients, which took into account the interindividual variability of consumption, estimated by means of the two 7-DD records, ranged from 0.29 for vegetable fat to 0.72 for starch (median value r = 0.54). The proportion of subjects correctly classified within the lowest two quintiles ranged between 59% for vegetable fat and vitamin E, and 96% for alcohol, and those correctly classified within the highest two quintiles ranged between 44% for vegetable fat and 94% for alcohol. The average proportion of subjects correctly classified within one quintile was 73%. These data indicate that this FFQ provides valid estimates of intakes for major nutrients, comparable to those reported from other studies in North America and other European countries.

Adult↗
PubMed1996

Validity and reproducibility of alcohol consumption in Italy.

BACKGROUND: The reproducibility and validity of alcohol consumption has not been adequately studied, particularly in mediterranean countries, where alcohol drinking is a widespread habit, especially during meals. METHODS: We compared alcohol consumption measured by two interviewer-administered food frequency questionnaires (FFQ) with average intake derived from two 7-day dietary (7-DD) records (the reference method) on 395 volunteers. Different types of alcoholic beverages were considered separately in order to verify the ability of the questionnaire to assess detailed patterns of alcohol intake. RESULTS: A satisfactory level of reproducibility and validity of the pattern of alcohol consumption across different levels and types of alcoholic beverage intake was observed. The reproducibility of wine and total alcohol intake showed correlation coefficients > 0.75 in both sexes. The validity was somewhat higher for wine (around 0.70) than for other alcoholic beverages and total alcohol intake. This is probably accounted for by the more regular pattern of wine consumption during the year as compared to other alcoholic beverages (beer, grappa, etc) which are more strongly influenced by seasonal and daily variations. However, about 30% of abstainers according to FFQ were drinkers by the reference method. The opposite was observed in only 4% of subjects. CONCLUSION: The FFQ is a reliable and valid instrument for collecting alcohol intake in regular drinkers. Lower validity in irregular drinkers may be due to seasonal variation and/or inadequacy of the FFQ to capture irregular patterns of consumption and/or inadequacy of the average of two 7-DD as a reference method. Furthermore, a considerable degree of misclassification was observed between non-drinkers and moderate drinkers.

Adult↗
PubMed1996

Attributable risks for pancreatic cancer in northern Italy.

The proportions of pancreatic cancer cases attributable (or attributable risks) to tobacco smoking, high consumption of meat, low consumption of fruit, family history of pancreatic cancer, and previous history of pancreatitis were computed by using data from a case-control study conducted in Northern Italy. Between 1983 and 1992 a total of 362 incident, histologically confirmed exocrine pancreatic cancer cases and 1408 controls admitted to the same network of hospitals for acute, non-neoplastic, nondigestive, nonhormone-related disorders, were interviewed. The ARs were 14% for tobacco smoking, 14% for high consumption of meat, and 12% for low consumption of fruit. Overall, these factors explained 23% of pancreatic cancer in the population. The proportion of cases attributable to tobacco smoking was greater among males (20%) as compared with females (5%), as well as were the attributable risks for a diet with a high consumption of meat and a low consumption of fruit (25% in males versus 18% in females). In conclusion, almost one-fourth of pancreatic cancer cases in this population were explainable in terms of a few identified simple risk factors. Smoking cessation and a healthier eating pattern would prevent approximately 1500 pancreatic cancer deaths in Italy every year. In the absence of effective early detection and therapeutic tools for the disease, the intervention on these factors would, thus, have a relevant impact in reducing pancreatic cancer mortality.

Adult↗
PubMed1996

Physical activity and breast cancer risk.

Data from a multicentric case-control study on breast cancer conducted in Italy were used to analyze the relationship of occupational and leisure-time physical activity with breast cancer risk. Cases were 2569 histologically confirmed incident breast cancer cases, and controls were 2588 patients admitted to the same network of hospitals of cases for acute, nonneoplastic, nonhormone related diseases. After allowance for major identified potential confounding factors (including an estimate of total calorie intake), the odds ratios (ORs) were 0.70, 0.71, 0.64, and 0.54 in subsequent levels of physical activity at work at ages 30-39, compared to the lowest level. The association was similar for occupational physical activity at ages 15-19 and still apparent at ages 50-59, with risk estimates of 0.86, 0.85, 0.85, and 0.62. The ORs for the highest versus the lowest category of leisure-time physical activity were also below unity (ORs for the highest level of leisure-time physical activity at ages 15-19, 0.95; at ages 30-39, 0.76; and at ages 50-59, 0.66). The protection of physical activity was apparently stronger below age 60 at diagnosis and was consistent across the strata of selected covariates, although the protection was somewhat greater for more educated women.

Adolescent↗
PubMed1996

[Time trends of digestive system tumor mortality in Italy, 1970-89].

Time trends of mortality from digestive cancers in Italy during the period 1970-1989 were here studied either at the national level and for wide geographical areas (North, Center and South). Cancers of oral cavity and pharynx, of colon and rectum, of gallbladder and of the pancreas presented, during the considered period a generalized increasing trend. Stomach cancer mortality was decreasing in both sexes and in all areas, but a less marked rate of decrease appeared for younger cohorts, particularly for women. Trends almost stable, or contrasting across sexes and age classes, were observed for malignant tumours of the oesophagus and of the liver.

Adolescent↗
PubMed1996

[Esophageal carcinoma].

After early rises, oesophageal cancer mortality rates have tended to level off in Italy over the last two decades, and are now intermediate on a European scale (4.7/100000 males, 0.8/100000 females, world standard). This reflects the trends in consumption of the major risk factors for the disease, tobacco and alcohol, particularly in men. Within Italy, there is also a substantial variation in oesophageal cancer rates, with high mortality areas in the North-East of the country. On the basis of a case-control study conducted in northern Italy, the relative risk (RR) of the disease was 4.3 in heavy smokers and 3.5 in heavy drinkers. A diet poor in fresh fruit and vegetables was also related to the risk of the disease (RR = 2.5). In terms of population attributable risk, 71% of cases in men and 32% in women were accounted for tobacco smoking, 45% in males and 10% in females by alcohol drinking, 40% in men and 29% in women by a diet poor in fresh fruit and vegetables (and hence in beta-carotene). These three factors together accounted for 90% of cases in Italian men, and 58% in women (83% in both sexes combined).

Adult↗
PubMed1995

Influence of food groups and food diversity on breast cancer risk in Italy.

Although debate on breast cancer and diet has been concentrated on nutrients, assessment of the role of specific foods and food groups and variety of food intake retains a considerable importance. To further elucidate the role of dietary habits, 2,569 women with incident breast cancer (median age 55 years) and 2,588 control women (median age 56 years), hospitalised with acute non-neoplastic diseases, were interviewed between 1991 and 1994 in 6 different Italian areas. The validated food frequency questionnaire included 79 food items and recipes, which were grouped into 18 food groups (5 for "diversity" analyses purpose). After allowance for non-dietary confounding factors and total energy intake, significant trends of increasing breast cancer risk with increasing intake emerged for the following food groups: bread and cereal dishes, pork and processed meats, and sugar and candies. Conversely, high intake of milk, poultry, fish, raw vegetables, potatoes and coffee and tea seemed to exert a protection against the development of breast cancer. Intake of soups, eggs, other meats, cheese, cooked vegetables, citrus fruits, other fruits and cake and desserts were not significantly related to breast cancer risk. The variety of vegetable types consumed weekly seemed to have a beneficial effect beyond the advantage of high vegetable intake per se.

Breast Neoplasms↗