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Biomedical subjects

A Decarli

Publications and source records attributed to A Decarli.

At least 163 records · Page 9Linked to original sources
PubMed1987

Vitamin A and other dietary factors in the etiology of esophageal cancer.

The risk of esophageal cancer, in relation to the frequency of consumption of selected dietary items, was evaluated in a hospital-based case-control study; this study was of 105 histologically confirmed cases and 348 control subjects with acute conditions unrelated to any of the established or potential risk factors for esophageal cancer. The frequency of consumption of carrots, green vegetables, or fresh fruits was lower in cases. Further, cases tended to eat meat and fish less frequently and eggs more frequently. The estimated multivariate relative risks were 0.6 for regular (more than once a week) carrot consumption and 0.6 and 0.3, respectively, for the highest levels of vegetable or fruit consumption (compared with the lowest ones). Consequently, a strong negative association emerged between estimated beta-carotene (but not retinol) intake and esophageal cancer risk. The risk of cancer of the esophagus was not significantly related to subjective scores of fat and whole-meal food intake; however, a strong positive association did emerge with measures of alcohol consumption. Although the information collected does not allow precise definition of specific micro-nutrient(s) causally related with esophageal cancer risk, the confirmation of marked differences in reported diet between esophageal cancer cases and controls is still of interest; this is mostly in consideration of the strength and persistence of the associations after allowing for alcohol and tobacco use in addition to indicators of socioeconomic status.

Adult↗
PubMed1987

Dietary factors and the risk of breast cancer.

We evaluated the risk of breast cancer in relation to the frequency of consumption of a few selected dietary items. Data were used from a case-control study of 1,108 histologically confirmed breast cancer patients and 1,281 control subjects who were in the hospital for acute conditions unrelated to any of the established or suspected risk factors for breast cancer. Moderately elevated risk estimates were associated with higher levels of fat consumption in seasonings [butter, margarine, and oil, relative risk (RR) = 1.34, 95% confidence interval (CI) = 1.06-1.71] and meat (RR = 1.36, 95% CI = 1.12-1.65), whereas a reduced risk (RR = 0.42, 95% CI = 0.34-0.51) was associated with a more frequent green vegetable consumption. It was not possible to show that these associations were incidental, because allowance for several identified potential confounding factors, including the major identified or potential risk factors for breast cancer, did not materially modify the risk estimates. Further, no appreciable interaction emerged with age or menopausal status, because the diet-related risk estimates were similar in pre- or postmenopausal women. However, the implications of these findings in terms of specific micronutrients (e.g., retinol or beta-carotene) and biological correlates are still unclear. Alcohol consumption was significantly greater among breast cancer cases, with a multivariate risk estimate of 2.92 for the highest level. Thus, the present findings confirm that various aspects of diet may influence the risk of breast cancer, although the small amount of available knowledge does introduce serious uncertainties in any discussion of the potential implications in terms of prevention on a public health scale.

Adult↗
PubMed1987

General epidemiology of breast cancer in northern Italy.

The role of the major identified risk factors for breast cancer was assessed using data from a hospital-based case-control study conducted in Northern Italy on 1108 women with histologically confirmed breast cancer and 1281 control subjects with a spectrum of acute conditions unrelated to any of the established or potential risk factors for breast disease. With reference to nulliparous women, the risk of breast cancer was below unity for those who first gave birth below age 25, and above unity for those with later first full-term pregnancy. However, in each stratum of age at first birth, the point estimate was below unity for women with five or more births. The relative risk for greater than or equal to 5 births compared with 1 or 2 was 0.6 (95% confidence interval = 0.4-0.9) when allowance was made for age at first birth. Likewise, there was a significant and independent effect of age at last birth which was evident in various strata of parity and age at first birth. The overall relative risk for last birth at 30 years or over compared with under 30 was 1.4 (95% confidence interval = 1.1-1.8). There was little relation of breast cancer risk with abortions or miscarriages. Breast cancer cases reported earlier menarche and later menopause; further, lifelong irregularities in menstrual pattern were less common among the cases (relative risk = 0.6, 95% confidence interval = 0.5-0.8). The risk estimates were elevated in women with positive history of benign breast disease, family history of breast cancer and greater body mass index.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Induced↗
PubMed1987

Nonspecific inflammatory bowel disease and smoking.

The authors assessed the relation between cigarette smoking and nonspecific inflammatory bowel disease in a case-control study of 124 cases of ulcerative colitis, 109 cases of Crohn's disease, and 250 age- and sex-matched control subjects in hospital for acute nongastric or intestinal conditions unrelated to smoking. For ulcerative colitis, the risk for current smoking compared with never smoking was 0.5, with a 95% confidence interval (Cl) of 0.3-1.0. They observed decreasing risk with increasing number of cigarettes smoked. The risk for ex-smokers, however, was greater than that for never smokers (relative risk = 2.7; 95% Cl = 1.5-4.9). The elevated risk of ulcerative colitis in ex-smoking in the presence of an overall lack of association with ever-smoking may plausibly be attributed to either 1) brief induction time of a protective effect of smoking on ulcerative colitis or 2) selective cessation of smoking due perhaps to very early symptoms of the disease. If time at first onset of bowel symptoms, instead of clinical diagnosis, is considered as the index date, the negative association between ulcerative colitis and current smoking would have weakened in men and disappeared in the overall series. There was clear evidence of a positive association between cigarette smoking and Crohn's disease (relative risk for ever smokers vs. never smokers = 4.0; 95% Cl = 2.2-7.3). The risk estimates increased with the number of cigarettes smoked per day and duration of habit. The association between current smoking and Crohn's disease was even stronger when age at first onset of bowel symptoms was considered as the index date, but the risk for ex-smokers fell below unity.

Adolescent↗
PubMed1987

Risk factors for myocardial infarction in young women.

The interim results of a case-control study of myocardial infarction in women below age 55 years conducted in northern Italy since January 1983 are presented, based on 168 cases of acute myocardial infarction and 251 hospital controls. Cigarette smoking was strongly related to myocardial infarction, with risk estimates elevated more than 10-fold for heavy (more than 25 cigarettes per day) smokers. Smoking-related relative risks were of similar magnitude in younger (less than 45 years) and in perimenopausal (45-54 years) women and were largely unaffected by allowance for several potential distorting factors. Other factors independently and strongly related to the risk of myocardial infarction were diabetes, hypertension, and history of coronary heart disease in more than one first-degree relative. Relative risks were also elevated in women who gave birth to their first child earlier (below age 20 years) and in oral contraceptive users. However, these estimates were not significant. The apparent positive associations with clinical history of hyperlipidemia, hypertension in pregnancy, and heavy coffee consumption could be explained largely in terms of confounding, but the protection conveyed by moderate alcohol consumption remained after multivariate analysis. Thus, the interim results of this investigation in a low incidence population confirm the importance of several risk factors previously described in data collected in Northern Europe and the United States. Furthermore, possibly because of the low baseline risk, the proportion of cases attributable to smoking in middle-aged women in this population may be even larger than that previously reported from higher incidence areas.

Adult↗
PubMed1987

Education, prevalence of disease, and frequency of health care utilisation. The 1983 Italian National Health Survey.

The relation between education, prevalence of 17 chronic diseases or groups of diseases, and pattern of health care utilisation was evaluated from data from the 1983 Italian National Health Survey, based on 58 462 individuals aged 25 or over randomly selected within strata of geographical area, size of place of residence, and size of household, in order to be representative of the whole Italian population. Most of the diseases considered, including diabetes, hypertension, myocardial infarction and other heart disease, haemorrhoids or varices, chronic respiratory disease, anaemias, gastroduodenal ulcer, cholelithiasis and liver cirrhosis, kidney and urological diseases, arthritis, and psychiatric and neurological disturbances, were consistently less prevalent among more educated individuals. The age and sex adjusted risk estimates for individuals educated in high school or university compared with those with only a primary school education or less ranged between 0.21 for liver cirrhosis and 0.80 for anaemias. The sole exception was allergy, which was more prevalent among the more educated individuals (relative risk = 1.42). General practitioner visits and hospital admissions were reported less frequently by the more educated individuals, but specialist consultations of potential preventive value were less frequent among the less well educated. The results were similar when occupation was utilised as an indicator of social class. Thus, the findings of this national survey provide confirmation and quantitative assessment of considerable differences in health and health service utilisation according to indicators of social class.

Adult↗
PubMed1987

Dietary factors and the risk of epithelial ovarian cancer.

Dietary factors in the etiology of ovarian cancer were investigated with the use of data from a case-control study conducted in Northern Italy on 455 histologically confirmed epithelial carcinomas and 1,385 control subjects in the hospital for acute conditions unrelated to any of the known or potential risk factors for cancer of the ovary. Women with ovarian cancer reported significantly elevated frequency of consumption of meat [relative risk (RR) = 1.6 for greater than or equal to 7 vs. less than 4 portions/wk], ham (RR = 1.9 for greater than or equal to 4 vs. less than 2 portions/wk), and higher subjective scores of fat intake (RR = 2.1 for highest vs. lowest scores), particularly butter. In contrast, consumptions of fish, green vegetables, carrots, and wholemeal bread or pasta were less frequent in cases; the corresponding risk estimates for highest versus lowest frequencies ranged between 0.6 and 0.8. These results were not materially modified by adjustment for indicators of socioeconomic status, parity, and other identified determinants of ovarian cancer. No relation emerged between alcohol consumption and ovarian cancer risk. The present study provides interesting indications that help to explain the considerable variations in ovarian cancer rates in different populations and, if confirmed, could, in principle, have important public health implications. Due caution, however, is required in interpreting the present results because of the limitations of available information and of the uncertainties of other published material concerning diet and ovarian cancer.

Adult↗
PubMed1987

Epidemiological data on cervical carcinoma relevant to cytopathology.

Epidemiological studies based on cervical cytopathology have aroused widespread interest since it was realized that they could be a useful tool for measuring the effectiveness of screening programs and defining practical measures for the prevention of invasive neoplasms and deaths. In the present article, published evidence from screening programs, cohort investigations and case-control studies is reviewed, and possibilities for further analyses and applications are discussed. In particular, when estimates of the relative protections conveyed by Pap smear from various case-control studies conducted on different populations and using different criteria of selection were pooled, a surprisingly close concordance emerged, with overall risk estimates of invasive cervical cancer of 0.42 for women reporting one smear, and of 0.20 for two or more smears in the past. This protection appeared to be long-lasting in a considerable proportion of cases, since the major determinant of invasive cancer risk was the number of previous smears rather than the interval since last smear, and a noticeable residual effect was evident even more than 10 years after the last smear. Besides providing a measure of the effectiveness of cytological screening and helping define the optimal frequency of screening using the limited resources available, case-control studies should permit accurate estimates of the sensitivity of the test and quantify the probability of transition and the duration of various stages of the neoplastic process, i.e., permit a better understanding of the natural history of the disease.

Carcinoma↗
PubMed1987

Smoking and weight in the 1983 Italian National Health Survey.

The relation between smoking habits and weight was evaluated using data of the 1983 Italian National Health Survey on 72,284 individuals aged 15 years 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 whole Italian population. Female moderate smokers were less frequently overweight or obese, thus confirming previous observations in other populations. However, in contrast with other observations, male current smokers were not lighter than 'never' smokers, and in particular smokers were less frequently underweight. Thus, the relation between smoking status and indicators of body weight was heterogeneous in the two sexes. Further, in both sexes the relationship between amount smoked and obesity was not linear, heavy smokers being more frequently overweight than moderate smokers. In conclusion, although these population-based data confirm that smoking habits are a correlate of weight, the absence of any dose-effect relationship and the inter-sex differences suggest that the relation between smoking and weight in the Italian population is probably partly or largely indirect.

Adolescent↗
PubMed1986

Non-contraceptive oestrogens and the risk of breast cancer in women.

The relationship between use of non-contraceptive oestrogens and risk of breast cancer was investigated using data from a hospital-based case-control study from Northern Italy. This study covered 1,108 patients with histologically confirmed breast cancers and 1,281 control subjects with a large spectrum of acute conditions unrelated to any of the known or suspected risk factors for breast cancer. Compared with "never-users", the age-adjusted relative risk for "ever-users" was 1.93 (95% confidence interval = 1.35-2.75). The risk increased with duration of use (relative risk = 2.08 for over 2 years), but was unrelated to time elapsed since first or last use. Allowance for a large number of identified potential confounding factors, including indicators of socio-economic status and the major determinants of breast cancer risk, failed to account for the observed association (multivariate relative risk = 1.84 for ever use and 2.04 for greater than 2 year use). Possible explanations for these findings and for their apparent discrepancy with some American data are discussed in terms of different baseline incidence of breast cancer in the two populations, and hence of potential baseline differences in availability of endogenous serum oestrogens. Nonetheless, the results of this study should be interpreted cautiously and viewed as a further contribution to a topic still open to debate.

Adult↗
PubMed1986

Descriptive epidemiology of gastric cancer in Italy.

National trends in death certification rates from cancer of the stomach in Italy over the period 1955 to 1979 were analyzed using a standard cross-sectional approach and a log-linear Poisson model to isolate the effects of birth cohort, calendar period, and age. Overall, age-standardized death certification rates decreased from 47.04 to 30.74/100,000 males (average annual rate of change, assuming that the decrease has been constant, -1.8%) and from 34.55 to 19.27/100,000 females (average annual rate of change -2.4%). The decreases were even larger in middle age for both sexes. Both cohort and period of death curves were markedly downwards. However, cohort values did not decrease for generations born around the second world war (1935-1945), thus indirectly confirming the importance of (dietary) habits in childhood on subsequent gastric cancer risk. Further, the geographic distribution of certified mortality from gastric cancer in the 95 Italian provinces over the period 1975 to 1977 was analyzed. Death certification rates were about 10% lower for both sexes in the 14 provinces including the largest urban concentrations (over 250,000 inhabitants) than in the remaining areas. This finding might be related to earlier availability of modern food processing and storage in urban areas. It is, however, more difficult to explain the lower mortality rates (about 50% in both sexes) in the southern compared with the central and northern areas, since southern Italy is the less developed part of the country. Likewise, there appears to be at present little satisfactory explanation for the several clusters of exceedingly high mortality areas scattered in northern and central Italy, since some of these areas are several hundred kilometers apart, and there is no obvious common denominator in diet or other environmental factors that may explain their higher gastric cancer mortality rates.

Adult↗
PubMed1986

Tar yields of cigarettes and the risk of oesophageal cancer.

The relationship between cigarettes with varying tar yields and the risk of oesophageal cancer was evaluated using data from a hospital-based case-control study conducted in Northern Italy on 129 histologically confirmed cases and 426 controls with acute, non-neoplastic of digestive diseases unrelated to tobacco or alcohol consumption. Compared with never-smokers, the relative risks of developing cancer of the oesophagus were 2.9 for subjects who smoked mainly middle- or low-tar (less than 22 mg) cigarettes and 8.9 for those smoking high-tar cigarettes (greater than or equal to 22 mg). The difference between the two categories was evident among ever-smokers and only current smokers, was not explained by adjustment for the major covariates of interest (social class, alcohol consumption and dietary indicators), and persisted when allowance was made for duration of smoking and number of cigarettes smoked per day by means of multiple regression analysis. The present findings suggest that the relation between tar deliveries of cigarettes and risk may be even more marked for oesophageal than for lung cancer. Further, they have important public health implications, in consideration of the current relatively high tar yields of Italian cigarettes, particularly in a few areas of north-eastern Italy where death certification rates from cancer of the oesophagus are among the highest in Europe. Nonetheless, in this study, smokers of prevalently low- to mid-tar cigarettes still did experience a significantly higher oesophageal cancer risk than life-long non-smokers.

Adult↗
PubMed1986

Sexual factors, venereal diseases, and the risk of intraepithelial and invasive cervical neoplasia.

The relation between major indicators of sexual habits (age at first intercourse and total number of sexual partners), history of selected venereal diseases, and cervical neoplasia was investigated using data from a case-control study of 206 cases of cervical intraepithelial neoplasia compared with 206 age-matched outpatient controls, and of 327 cases of invasive cancer compared with 327 control subjects in hospital for acute conditions unrelated to any of the established or suspected risk factors for cervical cancer. The relative risks increased with decreasing age at first intercourse and increasing number of sexual partners both for intraepithelial and for invasive cancers. The effects of these two variables were independent, since they were only marginally affected by reciprocal adjustment, or by allowance for several other identified potential distorting factors. The negative association with age at first intercourse was particularly strong in the case of invasive cancers, with risk estimates over five-fold elevated for women reporting their first intercourse before age 18 compared with those aged over 22 years. This relation might be discussed in terms of multistage models of carcinogenesis, which predict that the incidence of epithelial carcinomas is a function of duration of exposure. In fact, when age was allowed for, the relative risks of cervical neoplasia were positively and strongly related with the total duration of the interval between age at diagnosis/interview and age at first intercourse. Clinical histories of several sexually transmitted diseases were positively associated with the risk of intraepithelial neoplasia. In particular, genital warts were reported by nine cases but no control subject. No such association, however, emerged for invasive carcinomas. Thus, the current findings confirm that, although intraepithelial neoplasia and invasive cervical cancer appear to share several important epidemiological features, the specific (infectious) agents implicated in dysplastic lesions probably differ to some extent from those causing invasive cancer.

Adult↗
PubMed1986

Cancer mortality in broad Italian geographical areas, 1975-1977.

Death certification rates from various cancers or groups of cancers in broad Italian geographical areas (North/Center/South) over the period 1975-1977 were analyzed. In both sexes, there was a clear North/South gradient, with considerably higher rates in the North for total cancer mortality as well as for most common neoplasms. The geographical variation was more marked in males (North/South ratio for total cancer mortality = 1.75 at all ages and 1.70 truncated 35-64 years) than in females (ratio = 1.48 at all ages and 1.28 truncated 35-64). Although, in general terms, the present results confirm previous analyses of cancer mortality in Italy, a few interesting tendencies should be noted. First, the geographical differences in the mid-late 1970's were much more marked for tobacco-related cancers (a factor of over two in males in the North/South ratio) than for other chiefly epithelial carcinomas or nonepithelial cancers. In general, variations for nontobacco-related cancers tended to level off over more recent calendar periods. However, there was little tendency towards decreasing differences in gastric cancer mortality (which was markedly elevated in the North and Center), at least in males. During the 1970's death certification rates from cancer of the (cervix) uteri decreased in northern and central more than in southern Italy. This pattern of trends may have been influenced by a different impact of cervical screening in various areas of the country.

Adult↗