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A Decarli

Publications and source records attributed to A Decarli.

At least 91 records · Page 5Linked to original sources
PubMed1994

A reduced questionnaire to investigate the Mediterranean diet in epidemiologic studies.

We evaluated the performance of two reduced dietary questionnaires (RDQ). They were derived from a more complex questionnaire used to investigate the relation between diet and gastric cancer in a case-control study recently concluded in Italy. The full dietary questionnaire (FDQ) used in that study included 181 questions on the frequency/portion size of consumption of 146 different foods and drinks. Two different RDQs were defined, including subgroups of the original food items able to reproduce at least 90% (RDQ90) or 75% (RDQ75), respectively, of the total variability captured by the FDQ on the nutrient intake of controls. Each RDQ provided estimates of nutrients highly correlated with the estimates produced by the FDQ. For different quintiles of nutrient intake, we compared the estimated relative risk obtained by means of the RDQs and the FDQ. For various nutrients, the differences in relative risks were relatively minor, below 20%, but were larger for protein and beta-carotene. These analyses indicate that a RDQ is able to quantify adequately various aspects of the Italian diet for the purpose of epidemiologic inference.

Case-Control Studies↗
PubMed1994

The application of different correlation coefficients to assess the reproducibility of a food frequency questionnaire.

We computed four different correlation coefficients to investigate the degree of reproducibility of the weekly consumption of 77 food items or groups of foods and of seven summary questions from a food frequency questionnaire developed in Italy for a case-control study on cancers of the breast and digestive tract. The questionnaire had been administered twice to 452 Italian men and women. These included Pearson correlation coefficients (a) using the weekly frequencies of consumption without any transformation (P1); (b) after applying the transformation log (x + 1) (P2); (c) after applying the transformation log (x + 0.01) (P3); and (d) the Spearman correlation coefficient (SP). The mean values were 0.55 for P1, 0.59 for P2, 0.56 for P3 and 0.59 for SP. All coefficients were positively correlated, although to variable extents: the Spearman correlation coefficient between P2 and SP was 0.92, and that between P1 and P3 was 0.53. Differences between the four coefficients were more marked for food items with a lower kappa statistic and lower intraclass correlation, ie for those items with more severe reproducibility problems. Thus, a single correlation coefficient may not be enough to detect zones of the distribution of a food item where misclassification problems are more severe. The correlation coefficients used to investigate reproducibility should therefore be chosen on the basis of subsequent data analyses.

Feeding Behavior↗
PubMed1994

Alcohol drinking and prevalence of self-reported gallstone disease in the 1983 Italian National Health Survey.

We studied the relation between alcohol drinking and gallstone disease, using data from the 1983 Italian National Health Survey. This survey included information on 58,462 adults age 25 years and over (27,912 males and 30,550 females), randomly selected within strata of geographical area, size of the municipality of residence, and size of the household. The prevalence of gallstone disease or cholecystectomy was 2.4% among males and 4.8% among females. Compared with alcohol abstainers, the relative risk of gallstone disease, controlling for age, sex, education, smoking, and body mass index, was 0.83 [95% confidence interval (CI) = 0.73-0.92] for occasional and regular moderate drinkers (< 25 ml of ethanol per day), 0.67 (95% CI = 0.59-0.77) for intermediate drinkers (25-50 ml per day), and 0.58 (95% CI = 0.47-0.70) for heavy drinkers. This inverse association was consistent across strata of age, sex, and body mass index.

Adult↗
PubMed1993

Naturally occurring anticoagulants and bone marrow transplantation: plasma protein C predicts the development of venocclusive disease of the liver.

Venocclusive disease (VOD) of the liver is the major dose-limiting complication of pretransplant regimens for bone marrow transplantation. Recent reports from different groups point to the involvement of the hemostatic mechanism in the development of VOD. We measured the naturally occurring anticoagulants protein C, antithrombin III, and protein S in 45 patients undergoing bone marrow transplantation for hematologic malignancies before cytoreductive therapy and after transplant. The aim of this prospective study was both to evaluate the status of the naturally occurring anticoagulant pathway in patients who develop VOD compared with patients who do not, and to find a predictive marker of VOD. In transplant patients, protein C decreased from before cytoreductive therapy to posttransplant, whereas protein S and antithrombin III did not. In a multivariate analysis, protein C was the only variable that could independently discriminate between VOD and non-VOD patients at all times. Discriminant function analysis established that low protein C levels before cytoreductive therapy predicted the occurrence of VOD with good sensitivity and specificity.

Adolescent↗
PubMed1993

Analysis of the cost-effectiveness ratio of the health campaign for the early diagnosis of cutaneous melanoma in Trentino, Italy.

BACKGROUND: The cost-effectiveness ratio of a health campaign for the early diagnosis of cutaneous melanoma (CM), currently the only means to reduce mortality from this melanoma, was calculated for the Trentino region in Italy. METHODS: Health campaigns in Trentino were carried out, and comparisons were made with neighboring regions where there had been no campaigns. To do this, the trend of the mortality rates calculated according to sex and age using the direct standardized method and data provided by ISTAT (the Central Italian Institute of Statistics) was considered. RESULTS: It was determined that 22.3 lives were saved by early diagnosis during the period 1977-1985, resulting in a savings of $494,636 to the Italian National Health Service in avoided treatments. The total cost to the Health Service of the campaign was $70,800. The cost per year of lives saved was calculated to be $400. CONCLUSIONS: The outcome of this campaign was a recommendation for the use of such programs in other countries and regions.

Aged↗
PubMed1993

Trends in lung cancer mortality in three broad Italian geographical areas between 1969 and 1987.

Trends in death certification rates from lung cancer in broad Italian geographical areas (north/centre/south) were analysed over the period 1969-1987. In northern Italy, lung cancer rates in young and middle-aged males reached a peak between the mid and late 1970s, and tended to decline afterwards; only above age 60 was mortality still rising in the 1980s. A similar pattern of age-specific rates was observed in central areas, while in the South rates tended to level off in the early 1980s only below age 55, but were still upwards in subsequent age groups. Consequently, the north/south ratio for the overall age-standard rate increased slightly between the late 1960s and mid 1970s, from 1.68 (corresponding to a world standardised rate of 47.1/100,000 in the north vs. 28.1 in the south) to 1.73, but declined to 1.55 between 1985 and 1987 (for a rate of 69.1/100,000 males in the north vs. 44.6 in south). In the younger age groups a diverging pattern was observed: at ages of 25-34 rates in 1985 and 1987 were apparently higher in the south (1.0 vs. 0.9/100,000 in the north), and in the 35-44 age group the north/south ratio decreased from 1.7 to 1.2 (with rates of 12.9 and 10.7, respectively, in 1985 and 1987). Among females, lung cancer rates increased in all geographical areas and age groups except the youngest (25-34 years). Under the age of 50, the rises were proportionally similar in various geographical areas, thus widening the north/south difference in absolute terms. Above the age of 50, the north/south difference tended to be wider in relative terms too, reaching a factor of 2 in the 65-74 age group. The overall age-standardised north/south ratio for females increased from 1.51 in 1969-1974 (5.6 vs. 3.7/100,000) to 1.87 in 1985-1987 (8.4 vs. 4.5/100,000). These trends reflect changes in smoking habits in subsequent generations of Italian males and females from different areas of the country, and confirm the central role of cigarette smoking in lung cancer rates in various populations, although this does not exclude some influence by other, mainly occupational, lung carcinogens on the substantial differences in lung cancer rates in various Italian geographical areas.

Adult↗
PubMed1993

Reproducibility of an Italian food frequency questionnaire for cancer studies: results for specific food items.

To evaluate the reproducibility of a quantitative food frequency questionnaire (FFQ) used in a case-control study on cancer of the breast, ovary and digestive tract, we compared the result of a 98-item questionnaire administered twice at an interval of 3-10 months (median = 5.4 months) to 452 volunteers (144 males and 308 females, median age = 50 years) from three Italian provinces (Pordenone, Genoa and Forlí). Spearman correlation coefficients (r) for intake frequency of 87 dietary items ranged from 0.35 ("chicken or turkey, boiled") to 0.84 ("wine"). Most coefficients were between 0.60 and 0.80, only two being below 0.40 and five equal or above 0.80 (mean r = 0.59). The concordance of the two measurements tended to be somewhat better for alcoholic and non-alcoholic beverages, bread, cereals and first courses, fruits and summary questions at the end of each section of the questionnaire than for side dishes, sweets and desserts. Also, the reproducibility of 11 subjective questions, such as those concerning the amount of fat in seasoning and the intake of garlic or salt, seemed to be high. Age, sex, educational level of the volunteers and interval between the two FFQ did not have a large or systematic impact on the concordance of the two measurements. In conclusion, the present study has shown a good level of reproducibility of our questionnaire and has provided a few important hints on ways of improving the description of various food items.

Adult↗
PubMed1993

HDL-cholesterol and breast cancer: a joint study in northern Italy and southern France.

The goal of the present study is to evaluate HDL-cholesterol (HDL-C) as a marker of breast cancer (BC) risk. It is based on several epidemiological and biological studies and is justified by the rising incidence of breast cancer throughout the world. A hospital-based study on host-related risk factors and breast cancer, conducted with similar methods in northern Italy and southern France, provided the biological data, the information on the established BC risk factors and on nutrition for 307 cases and 329 controls. This data set allowed for a thorough analysis of the relationship of HDL-C with established risk factors for BC and also of its association with BC at the time of diagnosis. Most of our findings on HDL-C determinants in the control sample are comparable to previous studies. The BC risk factors associated with reproductive life correlate with HDL-C levels: the protective factors are associated with a lower level of HDL-C and inversely. The same is true for nutritional factors such as alcohol. For these determinants, the trend is similar for cases and controls, and HDL-C level appears to be related to oestrogen metabolism. Thus it may be considered as a marker of BC risk. Our results indicate that high HDL-C levels should be especially checked in women aged > or = 60 years, or in premenopausal women presenting a low BMI, or in postmenopausal women with an early menopause.

Breast Neoplasms↗
PubMed1993

Adult mortality from leading sites of cancer in Italy and a note on European data.

An overview is given of recent patterns of trends in cancer mortality in various age groups in Italy and, for comparative purposes, in other European countries. Important changes in mortality for several major cancer sites have been observed over the last two decades, such as the declines in gastric cancer or the increases in lung cancer mortality. These are difficult to understand and justify from an epidemiological and public health viewpoint, since the main cause of lung cancer (cigarette smoking) has long been known, while the determinants of stomach cancer are still largely undefined. Changes were minor, and inconsistent across countries, for other major cancers, such as intestines or breast. Furthermore, trends were systematically more favourable in young adults (and, to a less extent middle age), as compared to the elderly. The decline in young adults reflects more favourable exposure to risk factors (eg declined smoking prevalence, better diet), but also improvements in diagnostic and therapeutic procedures for some cancers. Due caution is required in any extrapolation, particularly since the distribution of the most common types of cancer changes in subsequent age groups. These favourable trends in young adults offer, none the less, important (and positive) indications as to the likely future trends when the same generations will reach middle and older age.

Adult↗
PubMed1992

Attributable risks for oesophageal cancer in northern Italy.

The population attributable risk for oesophageal cancer in relation to cigarette smoking, elevated alcohol use and low beta-carotene intake has been estimated with 300 cases and 1203 controls in Greater Milan. In males 71% of oesophageal cancers were attributable to smoking, 45% to elevated alcohol use and 40% to low beta-carotene consumption. The corresponding figures were 32%, 10% and 29% in females and 61%, 39% and 38% in total. The overall estimate, including the joint effect of the three factors, was 90% in males, 58% in females and 83% in total. The discrepancies between the sums are due to the assumption of a multiplicative model and to the great percentage of oesophageal cancers attributable to each single factor. Cigarette smoking is the major known cause of oesophageal cancer and the three factors account for practically all the difference between male and female mortality rates. Elimination of smoking, reduction of alcohol consumption and enrichment of diet with fruit and vegetables would make oesophageal cancer a rare disease in Italians of both sexes.

Adult↗
PubMed1992

A case-control study of cancers of the gastric cardia in Italy.

In a case-control study of gastric cancer (GC) in high-risk and low-risk areas in Italy, 923 GCs were reviewed by one pathologist and classified according to anatomic site. There were 68 (7.4%) cancers occurring in the gastric cardia. Compared to other GCs, cardia cancer tended to occur more often in males (sex ratio 2.8 vs 1.7) and as intestinal or unclassified histologic types. Nutritional factors for cardia tumours resembled those of other GCs, showing inverse associations with the consumption of raw vegetables, citrus and other fresh fruit, and ascorbic acid, and positive associations with the intake of traditional soups and meat, protein and cholesterol, and preference for salty foods. Cigarette smoking and wine consumption were unrelated to cardia cancer risk, and there was only a weak association with total alcohol intake. Cardia tumours showed a greater familial occurrence of GC than did other sites, with a 7-fold increase in risk for those reporting two first-degree relatives with GC. The authors discuss these findings in view of the rising incidence of adenocarcinomas of the cardia and lower oesophagus that has been reported in some western countries.

Adult↗
PubMed1992

Differences in dietary intake with smoking, alcohol, and education.

Differences in the frequency of consumption of 30 selected foods and in the estimated intake of total calories and selected nutrients in relation to alcohol drinking, tobacco smoking, and education were described using information obtained from 1,774 controls of a case-control study of digestive tract cancers conducted in northern Italy. Heavy alcohol consumption, tobacco smoking, and lower level of education were associated with a diet poorer in several aspects, including lower consumption of fresh fruit and green vegetables and higher intake of specific indicator foods, such as sausages and canned meat. For instance, the mean number of portions of fresh fruit per week was 10.5 among male nondrinkers vs. 9.0 among heavy drinkers, 10.4 among male nonsmokers vs. 8.1 among heavy smokers, and 8.8 in less educated individuals vs. 10.7 among those more educated. Consequently, intake of beta-carotene, ascorbic acid, and calcium tended to be inversely related to alcohol and tobacco and directly related to education. Most associations were stronger in males, for whom alcohol consumption was also more common in less educated individuals. Calorie intake was directly related to alcohol consumption, largely reflecting calories provided by alcohol itself. However, alcohol drinking was also directly related to fat consumption. In both sexes, there was a strong positive correlation between cigarette smoking and coffee drinking. These results provide quantitative documentation that alcohol drinking, tobacco smoking, and education, three of the major determinants of cancer risks, were also correlates of dietary patterns and, hence, may exert an important confounding or modifying effect on the diet and cancer relationship.

Adult↗
PubMed1992

The role of age at menarche and at menopause on breast cancer risk: combined evidence from four case-control studies.

The role of age at menarche and at menopause on breast cancer risk was reassessed in a combined analysis of four Italian case-control studies including a total of 6,075 cases and 5,492 controls. The risk of breast cancer was lower in women whose menarche occurred at age 15 or over, but there was no evidence for the risk to increase with decreasing age at menarche below age 15. Compared with women with earlier menarche, the relative risk (RR) was 0.9 (95% confidence interval, CI 0.7-1.0) for those with menarche at age 15, 0.8 (95% CI 0.6-0.9) for menarche at 16, and 0.7 (95% CI 0.5-0.8) for menarche at age 17 or over. There was no significant interaction between age at menarche and study centre or age at diagnosis, parity and age at first birth. In relation to age at menopause, compared with women whose menopause occurred at age 40 or less, the relative risk was 1.1 (95% CI 0.8-1.3) between 40 and 44, 1.2 (95% CI 0.9-1.4) between 45 and 49, 1.4 (95% CI 1.2-1.8) between 50 and 53, and 1.4 (95% CI 1.1-1.8) above 53. The risk estimates were comparable in various studies, and the trend in risk with age at menopause was statistically significant. The risk estimates tended to be somewhat higher at peri-menopausal age (45 to 54 years), but no consistent pattern was evident across subsequent strata of age, and the interaction with age was not significant. Likewise, no consistent interaction was observed with parity, age at first birth or body mass index.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

[Trends in mortality from respiratory tract tumors in Italy, 1969-1987].

Trends of Italian death certification for cancers of the lung, larynx, pleura and nasal sinuses were analyzed for both sexes in the period from 1969 to 1987. For lung and laryngeal cancer, the analyses have been conducted for broad geographical areas within Italy (North, Center and South). Mortality rates for males aged 35-44 years consistently decreased in the North; increased until the late 1970's, and then decreased in the Center; and consistently increased in the South. In the 45-54 age group, mortality rates peaked in all areas between the late 1970's and the early 1980's, subsequently decreasing. For ages over 54 years, the rates continued to increase even in the 1980's. Female lung cancer rates increased in all areas and in all age groups over 35 years. In the 25-34 years old age group the rates decreased in the North and tended to increase in the Center and in the South. Below age 50, the increases were proportional in the three areas, while for older ages the increase was greater in the North both in absolute and proportional terms. Cohort effects showed a general increase for the generations born up to 1930, in both sexes and in all geographical areas. Different trends were observed for cohorts born after 1940: decreasing for both sexes in the North, and steady for men and increasing for women in the other areas. From the mid 1970's, laryngeal cancer standardized rates for 35-64 age group decreased, or at most remained constant, in all geographical areas. The decreasing tendency was more marked in men. Larynx cancer cohort effects for men were at a maximum for cohorts born around 1990, decreasing thereafter. In women, cohort effects appeared to consistently decrease. Overall rates of pleural cancer mortality increased during the period 1969-1987, and the sex ratio was stable, from 1980 onwards, at a value of about 2.4. Cohort effects showed, for pleural cancer, a general increase for all the cohorts. The increase was particularly apparent in male cohorts born after 1930. Overall mortality rates for cancer of the nasal sinuses was rather stable in both sexes from 1975 onwards. However, in the 35-64 year age group, mortality rates increase for males and decreased for females.

Adult↗
PubMed1992

Height and the prevalence of chronic disease.

The relationship of stature with the prevalence of 18 chronic diseases or groups of diseases was analysed using data from the 1983 Italian National Health Survey, based on a sample of 63,859 individuals aged 20 or over randomly selected within strata of geographical area, size of the place of residence and of the household in order to be representative of the Italian population. Rate ratios (RR) were computed using multiple logistic regression, including terms for sex, age, geographical area, education and smoking. For 15 out of 18 diseases or groups of diseases the RR was below unity in the highest quartiles of height, and the inverse trends with stature were significant for 11 (diabetes, RR 0.90 for highest vs lowest quartile; heart disease, RR 0.92; chronic bronchitis and emphysema, RR 0.84; bronchial asthma, RR 0.70; anaemias, RR 0.70; liver cirrhosis, RR 0.62; urolithiasis, RR 0.76; renal insufficiency, RR 0.71; arthritis, RR 0.89; psychiatric and neurological disorders, RR 0.82). None of the diseases considered showed significant direct trends with height, but hypertension (RR 1.09 for the highest vs lowest quartile), haemorrhoids or varices (RR 1.09) and cancers (RR 1.22) tended to be elevated in the highest quartile of height. The generalised inverse relationship between height and prevalence of chronic disease suggests that poorer nutrition in childhood and adolescence is an unfavourable indicator for the subsequent occurrence of several diseases. Major exceptions were hypertension and varices, two conditions highly dependent on the pattern of health care utilization, and cancer.

Adult↗
PubMed1991

A case-control study of gastric cancer and diet in Italy. III. Risk patterns by histologic type.

In a case-control study of gastric cancer (GC) in high-risk and low-risk areas of Italy, 923 GCs were systematically categorized by one pathologist according to the Lauren classification distinguishing 2 main histologic types, intestinal (55%) and diffuse (23%). Intestinal types outnumbered diffuse types by a 3 to 1 margin in high-risk regions in the north-central part of the country, while both types occurred at nearly equal rates in low-risk areas. Intestinal types also occurred relatively more frequently at older ages and among males. Relative risks of each type of GC were evaluated in relation to dietary and other data obtained from interviews with the cancer patients and controls. The risk patterns for intestinal and diffuse types were remarkably similar. Increased risks of both types were associated with high intake of meat, salted/dried fish, seasoned cheeses and traditional soups, while decreased risks of both types were found among heavy consumers of fresh vegetables and fruits. Correspondingly similar patterns were seen with indices of nutrients, with risks of both intestinal and diffuse GC rising with animal protein intake and declining with consumption of vitamins C and E. Both types were inversely related to socio-economic status, and neither was associated with cigarette smoking. A familial history of GC was reported more frequently by patients with each type than by controls, although the highest risk was for unclassified GC, a group of poorly differentiated and medullary carcinomas accounting for 15% of all GCs in this study. The findings suggest that, despite differences in geographic and demographic patterns, the intestinal and diffuse types of GC have etiologic factors in common.

Adult↗