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Biomedical subjects

A Decarli

Publications and source records attributed to A Decarli.

At least 109 records · Page 6Linked to original sources
PubMed1991

The association between alcohol and breast cancer risk: evidence from the combined analysis of six dietary case-control studies.

Data from 1,575 cases and 1,974 controls enrolled in 6 previously conducted case-control studies of diet and breast cancer have been analysed with respect to alcohol intake. There appears to be an absence of any association between consumption of up to 40 g of alcohol per day and risk of breast cancer, and a highly statistically significant and consistent elevated risk of breast cancer for drinkers of 40 g or more of alcohol per day, for whom the relative risk, as compared with that of non-drinkers, is 1.69 (95% confidence interval 1.19 to 2.40). This association is not due to confounding by a number of diet-related factors, including total calories, fat, fibre and vitamin C.

Adult↗
PubMed1991

Smoking habits and risk of benign breast disease.

The relationship between smoking habits and the risk of benign breast disease (BBD) was analyzed using data from a case-control study conducted between 1981 and 1983 in the greater Milan area, Northern Italy. Cases (n = 288) were women with histologically confirmed BBD (203 dysplasia, 85 benign tumours) referred to the National Cancer Institute of Milan for biopsies. Controls were women (n = 291) seen on selected days for a cytological smear for cervical cancer in outpatient clinics of the same Institute. No consistent association emerged between various indicators of smoking habits (smoking status, number of cigarettes smoked per day, duration of smoking) and the risk of BBD. Compared with never smokers the relative risk (RR) of all BBD combined was 0.7 (95% confidence interval, Cl: 0.4-1.3) in exsmokers, 1.4 (95% Cl: 0.8-2.5) in smokers of less than 10 cigarettes per day, and 1.1 (95% Cl: 0.7-1.7) in smokers of 10 or more cigarettes per day. There was some suggestion that the risk may be below unity post-menopause, but the relative risks for smokers were not statistically different in pre- (RR = 1.2; 95% Cl: 0.8-1.8) and post-menopausal (RR = 0.6; 95% Cl: 0.2-1.7) women. The risk of benign tumours (chiefly fibradenoma) was higher in current smokers, but this finding was not statistically significant (RR = 1.5; 95% Cl: 0.9-2.6) and the highest risks were observed in the strata of lighter smokers and those with shorter duration of smoking. Overall these results fail to support a negative association between smoking habits and benign breast disease.

Adenofibroma↗
PubMed1991

Alcohol and breast cancer risk: a case-control study from northern Italy.

From May 1982 to June 1985 a hospital-based case-control study of diet and breast cancer (214 cases and 215 controls) was conducted in Milan in northern Italy, an area where wine consumption is widespread. The study used a detailed diet questionnaire to obtain an estimation of total calories as well as major micro- and macro-nutrient intake. The data thus allowed an investigation of the role of alcohol in breast cancer risk, adjusting for other dietary factors, in particular total energy intake. We found positive associations between breast cancer risk and total caloric intake (chi 2 trend = 6.05, P = 0.014) but no effect for the other nutrients, when adjusted for total caloric intake. The relative risk of breast cancer, for women reporting more than 24.35 g/day of alcohol consumption (highest quintile), was 2.1 (95% confidence interval (CI): 1.1-3.9) when adjusted for non-dietary risk factors for breast cancer and 1.8 (95% CI: 1.0-3.3) when adjusted for non-alcohol caloric intake. The relative risks were moderately elevated (50% or less) for low levels of consumption and comparable to those recorded in most American studies. This finding provides further support for a moderate association between alcohol consumption and breast cancer risk, even when allowance is made for potentially relevant nutrients.

Adult↗
PubMed1990

Projections to the end of the century of mortality from major cancer sites in Italy.

We used an age-period-cohort model with arbitrary constraints on the parameters, fitted to the mortality data for the period 1955-84, to project rates in mortality from all cancers and 11 major cancer sites in Italy for the period 1985-1999. For all neoplasms considered, using estimated age and cohort values, two models were fitted, one based on constant period effects, and one on a linear regression on the logarithm of the six calendar periods. Furthermore, "a priori" defined coefficients based on epidemiologic inferences were given to period values for tobacco-related neoplasms (below unity for males, above unity for females, on the basis of recent trends in tobacco prevalence in the two sexes), for breast and ovarian cancer (in relation to the potentially different effect of oral contraceptives, other female hormones, reproductive factors and treatment on these neoplasms), and for total cancer mortality. This produced a range of potential estimates, which were reasonably similar for neoplasms (such as stomach, intestines, breast, ovary or prostate) for which no major change in slope of the cohort effects was evident, but wider (i.e., between 188 and 264/100,000 males aged 40 to 79 in 1995-99) for lung or other tobacco-related cancers. Although this range of variation is far from negligible, the estimated values indicate that lung cancer among Italian males aged 40 to 79, even under the more optimistic assumption, will probably be higher at the end of the century than in the early 1980's, and that lung cancer alone will account for 35 to 42% of all cancer deaths in males between 40 and 79 years. Though any prediction has, by definition, inherent difficulties and uncertainties, cancer mortality in the near future will be strongly influenced by age and cohort effects already known, and hence its projections may offer some indication of public health relevance.

Adult↗
PubMed1990

Dietary indicators of laryngeal cancer risk.

The relationship between frequency of intake of a selected number of indicator foods and the risk of laryngeal cancer was investigated in a case-control study conducted in northern Italy on 110 males with histologically confirmed cancer of the larynx and 843 controls in the hospital for acute, nonneoplastic or respiratory diseases. Significant direct associations were observed with tobacco [relative risk (RR) = 5.8 for current versus never smokers] and alcohol (RR = 2.3 for the upper versus lower tertile of consumption), while the frequency of consumption of three food items was inversely related with laryngeal cancer risk. These were fish (RR = 0.6 for the upper tertile), green vegetables (RR = 0.4), and fresh fruit (RR = 0.3). Multiple logistic regression analysis, including simultaneously major nondietary covariates and various food items, suggested that the strongest and most consistent protective effect was given by fruit. These findings can be generally interpreted as an indication that a "poorer" diet is related to a raised risk of laryngeal cancer, although the confirmed observation that fruit appears to be the main protective dietary factor against cancers of the upper respiratory and digestive tract is of potential interest and may suggest useful etiological clues. Dietary findings were similar in different strata of alcohol and tobacco consumption.

Adult↗
PubMed1990

A case-control study of gastric cancer and diet in Italy: II. Association with nutrients.

A case-control study involving interviews with 1,016 gastric cancer (GC) patients and 1,159 population-based controls in high- and low-risk areas was conducted to evaluate dietary factors and their contribution to the marked geographic variation in mortality from this cancer within Italy. Risks of GC were found to vary significantly with estimated nutrient intake. Risk rose with increasing consumption of nitrites and protein, and decreased in proportion to intake of ascorbic acid, beta-carotene, alpha-tocopherol, and vegetable fat. The associations with nitrite and beta-carotene tended to fade, however, in multivariate analyses adjusting for intake of other nutrients. Ascorbic acid showed the strongest geographic gradient, with highest consumption in low-risk areas. The findings suggest that the protective effects we previously reported for consumption of fresh fruit, fresh vegetables and olive oil may be linked to the vitamins C and E contained in these foods. The findings are consistent with the hypothesis that N-nitroso compounds are involved in GC risks, since elevated risks were apparent for agents (nitrites, protein) that promote nitrosation, while decreased risks were found for nutrients (ascorbic acid and alpha-tocopherol) which inhibit the process.

Case-Control Studies↗
PubMed1990

Cancer mortality in Italy: an overview of age-specific and age-standardised trends from 1955 to 1984.

Number of certified deaths, age-specific and age-standardised rates and percentages of all cancer deaths from 30 cancers or groups of cancers (plus total cancer mortality) for each five-year calendar period between 1955 and 1984 in Italy are presented in tabular form. From these data, three graphs are derived, including trends in age-standardised rates, age-specific rates centered on birth cohorts and maps plotted in different shades of grey to represent the surfaces defined by the matrix of various age-specific rates. These analyses quantified the rises in overall cancer mortality in males (from 137 to 192/100,000 world standard), chiefly due to increases in lung and other tobacco-related neoplasms. Overall cancer mortality was stable in females (around 100/100,000). Appreciable cohort effects were evident for tobacco related neoplasms, but also for other major cancer sites, such as intestines or breast, whose rates, after earlier rises, are now stable in earlier middle age. Since the early 1970's, cancer mortality rates have been declining in all age groups below 40 in males and below 55 in females. These declines reflect improvements in therapy for leukemias, lymphomas and germ cell tumors, and general improvements in food availability and storage, hygiene and early diagnosis, which have led to the declines in stomach and cervical cancer. Although moderate in absolute terms and smaller than in other western countries where tobacco-related neoplasms have also been falling in more recent cohorts, these declines are encouraging for the indication they provide on the most likely patterns over the next decades in the same and subsequent generations.

Adolescent↗
PubMed1990

The application of age, period and cohort models to predict Swiss cancer mortality.

In order to project trends in mortality from 11 major cancer sites in Switzerland to the end of the current century, a log-linear Poisson age/period/cohort model with arbitrary constraints on the parameters was used, fitted to the observed rates for the period 1950-84. One projection was based on the assumption of a total absence of change in the effect of period, the second was based on a linear extrapolation of the logarithms of the seven known periods, and the third was related to a series of a priori external epidemiological hypotheses, whenever available. For instance, coefficients below unity were used for lung and other tobacco-related neoplasms in men, since some decline in exposure to tobacco carcinogens was observed among Swiss men, and above unity for women since the prevalence of smoking has risen among successive generations of women. Although the method has limitations and uncertainties, several qualitative indications could be derived from this exercise. For instance, the various models suggest that the age-standardized mortality from oral cancer in men will probably increase up to the end of the century, even under the optimistic assumption of an appreciable decline in smoking, while cancer of the oesophagus is likely to level-off around current values, as other tobacco-related neoplasms, prostate cancer in men, and breast cancer in women will probably do. Some steady decline is predicted by various models fitted to the incidence of stomach and intestinal cancer in both sexes, and to ovarian cancer. Lung cancer will continue to rise in women but will stop rising in men, and it will possibly fall if the hypothesis of a decline in exposure to tobacco carcinogens proves correct. Although any prediction has, by definition, substantial difficulties and uncertainties, projections of cancer mortality in the near future are based on a substantial amount of information already available, and may offer valuable information for epidemiological inferences and health planning purposes.

Adult↗
PubMed1990

Cancer mortality in young adults: Italy 1955-1985.

Although cancer mortality in young adults accounts for only a small proportion of all cancer deaths, it is important since it provides useful indications of the most likely future trends, and relevant information on the role of exposure to specific, or newer, carcinogens. We, therefore, analysed trends in cancer mortality between 1955 and 1985 among Italian men and women aged 20-44 years. In those three decades, overall cancer mortality declined steadily, by 27% in young women (from 33.8 to 24.7/100,000, world standard) but only by 3% (from 27.3 to 26.4/100,000) among men. The decline for men, however, was 16% from the peak rate of 31.5 reached in 1970-1974. The major underlying component causing the different trends in the two sexes was lung and other tobacco-related neoplasms, which had been considerably on the increase in young men up to the early 1970s, and levelled-off thereafter, while showing no appreciable change in women. The falls were about 50% for stomach cancer in both sexes, and over 80% for cervical cancer. A clear impact of improved treatment was reflected in the substantial declines in Hodgkin's disease, of testicular cancer in the last decade and, possibly, in the favourable trends in cancers of the breast, bone, brain and leukemias over the most recent calendar periods. Only two sites showed appreciable and persisting upward trends: oral cavity in men and skin melanoma in both sexes. They therefore constitute priorities for intervention in the near future.

Adult↗
PubMed1990

Identification of high risk groups for breast cancer by means of logistic models.

In order to identify high risk groups for breast cancer, unconditional multiple logistic regression models based on 5 widely recognized and easily identifiable risk factors (age at menarche, at menopause and at first birth, family history of breast cancer and body mass index) were applied to a large dataset including 2085 cases and 1936 controls aged 50 or over derived from two unmatched hospital-based case-control studies conducted in Italy. Although various models provided an excellent fitting, both on the whole dataset and using a training-testing approach to a priori identified separate subset, the observed extent of variation in breast cancer risk between highest and lowest decile of the distribution was limited to a factor 2. This indicates that the 5 variables considered did not allow identification of subgroups with substantially elevated risk of breast cancer to have practical implications for screening/prophylactic treatment purposes.

Adolescent↗
PubMed1990

An update of cancer mortality among chrysotile asbestos miners in Balangero, northern Italy.

The mortality experience of a cohort of chrysotile miners employed since 1946 in Balangero, northern Italy was updated to the end of 1987 giving a total of 427 deaths out of 27,010 man-years at risk. A substantial excess mortality for all causes (standardised mortality ratio (SMR) = 149) was found, mainly because of high rates for some alcohol related deaths (hepatic cirrhosis, accidents). For mortality from cancer, however, the number of observed deaths (82) was close to that expected (76.2). The SMR was raised for oral cancer (SMR 231 based on six deaths), cancer of the larynx (SMR 267 based on eight deaths), and pleura (SMR 667 based on two deaths), although the excess only reached statistical significance for cancer of the larynx. Rates were not increased for lung, stomach, or any other type of cancer. No consistent association was seen with duration or cumulative dust exposure (fibre-years) for oral cancer, but the greatest risks for laryngeal and pleural cancer were in the highest category of duration and degree of exposure to fibres. Although part of the excess mortality from laryngeal cancer is probably attributable to high alcohol consumption in this group of workers, the data suggest that exposure to chrysotile asbestos (or to the fibre balangeroite that accounts for 0.2-0.5% of total mass in the mine) is associated with some, however moderate, excess risk of laryngeal cancer and pleural mesothelioma. The absence of excess mortality from lung cancer in this cohort is difficult to interpret.

Alcohol Drinking↗
PubMed1990

Trends surface models applied to the analysis of geographical variations in cancer mortality.

To discuss different trends of the geographical distribution of cancer mortality, progressively more complex surface models were fitted to cancer death certification data in the 95 Italian provinces for the period 1975-77, using trend surface analysis. This method is based on fitting first to sixth order regression equations, where dependent variables are latitude and longitude, and the independent one is the standardized mortality ratio (SMR) for various cancer sites. The procedure was implemented using the SYMAP package and appropriate routines ad hoc developed. General patterns in geography of cancer in Italy were therefore identified (such as the marked North/South gradient in mortality from most sites), thus helping in discerning main underlying pictures and permitting identification of local abnormalities (positive or negative residuals, corresponding to high or low mortality areas), which are often obscured by more general patterns using standard methods of analysis. Results and maps are presented and discussed in detail with reference to total mortality and three major sites (lung and intestines in males and female breast) for which regression surfaces with satisfactory fitting were identified. Some of the positive residuals (i.e. those for lung and breast cancer in women in urban concentrations of Central and Southern Italy) were already known, and explainable in terms of available knowledge of the causes of the neoplasms, chiefly smoking and reproductive habits in the past. Other findings, such as the consistent area of positive residuals in a chiefly rural area around the mouth of the river Po, offer useful suggestions for further aetiological research.

Breast Neoplasms↗
PubMed1989

Smoking in Italy, 1986-1987.

Smoking trends and patterns in Italy were evaluated using data from the 1986-87 Italian National Health Survey, based on a sample of 30,096 males and 32,176 females aged 15 or over, randomly selected within strata of geographical areas and sizes of the place of residence and of the household in order to be representative of the whole Italian population: 40.8% of Italian males and 17.3% of females described themselves as current smokers (overall estimated prevalence, 28.6%). In comparison with previous survey-based data, self-reported smoking prevalence in males has been steadily decreasing over the last three decades, whereas rates in females have been increasing up to the early 1980s, and have shown a levelling off only in more recent years. The apparent declines in self-reported smoking, however, were not reflected in official sales figures. In fact, in the mid 1980s, there were simultaneously the lowest overall prevalence of the last three decades and the highest sales figures ever reported. The inter-sex differences in smoking prevalence were smaller at younger ages. Education, but not occupation as a measure of social class, was inversely related to smoking prevalence in males. Furthermore, rates for males were lower in the northern (and richer) part of the country. The pattern was totally different in females, since smoking prevalence was higher in more educated women, of higher social class, living in North Italy. This suggests that, in the absence of adequate measures, smoking prevalence is likely to rise among Italian women in the near future. Continued monitoring of smoking patterns gives important information with which to identify the most likely future patterns in smoking and smoking-related diseases, besides providing data for targeting intervention programs.

Adolescent↗
PubMed1989

Descriptive epidemiology of Hodgkin's disease in Italy.

Death certification data on Hodgkin's disease in Italy over the period 1955-84 were studied in terms of age-standardized and age-specific national trends, and of geographical variation in mortality. There were substantial declines in death rates from the early 1970's onward, which can be largely attributed to therapeutic improvements. These led to avoidance of about 350 deaths, with a total 950 reported, which is probably the major absolute therapeutic advance identified for any cancer site. The declines started earlier in childhood and young adult age, and were restricted to population below age 60. The age distribution of the disease was different in the two sexes, since the age curve for males showed steady rises up to age 75, whereas that for females was clearly bimodal, with a peak around age 30, and another at oldest age. This divergent pattern is consistent with different exposure to (infectious) agent(s) in children of the two sexes, but also to occupational exposures potentially related to the risk of the disease. Examination of rates in various geographical areas showed generally higher rates in the North, and a few provinces with exceedingly high mortality in the central part of Northern Italy, particularly in a chiefly rural province (Mantua). This excess mortality (and, more in general, the observation that rates for Northern Italy are higher than in any other area of the EEC) could not be explained by obvious diagnostic or classification problems, were evident in both sexes, appeared to be consistent over the last decade and are reflected in available Italian cancer registration data.

Adolescent↗
PubMed1989

Methodological issues in a multicentric study of gastric cancer and diet in Italy: study design, data sources and quality controls.

The authors examine the problems of planning and conducting a multicentric case-control study on diet and gastric cancer in Italy. The solutions chosen for the study design, cases and controls identification, dietary interview, production of a common protocol for the field work are discussed. Results on the evaluation of the quality and comparability of collected data are presented. Further, compliance of cases and controls to the interview and to the blood and urine sampling with reasons of non-response are shown. Finally, the phases of the study and the methods for improving and controlling homogeneity among Centers are summarized.

Aged↗
PubMed1989

Pattern of cervical screening utilization in Italy.

The pattern of cervical screening utilization in Italy was analyzed using data from the 1986-1987 National Health Survey on the basis of a sample of 27,455 women aged 20 to 79 randomly selected within strata of municipality of residence and age in order to be representative of the whole Italian population. Overall, about 17% of women aged 20 to 79 were screened per year, for a total of 3.5 to 4 million cervical smears per year. The highest frequency was reported in younger middle age, about one in four women being screened per year in the age groups 30 to 49, and there was a substantial decline above age 50. Cervical smear rates were higher in Northern areas (22%), where mortality from cervical cancer is lower, than in the Centre (16%) and South (11%) of the country. Further, there was a strong positive social class gradient in the utilization of cervical screening, in relation to both education and occupation. In spite of the absence of any organised mass screening program, cervical screening is a relatively common procedure among Italian women. However, this study provides further quantitative evidence of a markedly irrational utilization of non-organized cervical screening, which tends to end up selectively used by the groups in which cervical cancer is less common.

Adult↗