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Andrea Micheli

Publications and source records attributed to Andrea Micheli.

29 records · Page 2Linked to original sources
PubMed2003

Toenail selenium as biomarker: reproducibility over a one-year period and factors influencing reproducibility.

We assessed the reproducibility of selenium levels in toenails, comparing concentrations in two sets of specimens collected about a year apart, from 80 women (40 pre-menopausal and 40 post-menopausal) in the period October 1990 to February 1992. The women were participants in a prospective study on hormones and diet in relation to prediagnostic breast cancer (the ORDET study) conducted in northern Italy. Toenail selenium was determined by electrothermal atomic absorption spectrometry. The data were log-transformed as they were not normally distributed. To assess reproducibility Pearson correlation coefficients (r) for the two selenium determinations were calculated in pre- and post-menopausal women, according to smoking status and acetone treatment. A weighted kappa statistic (k) assessed inter-quintile agreement between the two sets of measures. Toenail selenium levels were highly reproducible (r = 0.57, p < 0.001), especially in pre-menopausal women (r = 0.66, p <0.001). Smoking lowered selenium levels (mean difference of 0.24 microg/g, p < 0.05 between smokers and non smokers) but did not significantly influence reproducibility. Acetone treatment to remove nail polish did not modify selenium levels but affected inter-quintile agreement, with moderate agreement (k = 0.58, p < 0.001) when acetone was used at both or neither samplings; and fair non significant agreement (k = 0.39, p = 0.06) when acetone was used at one sampling but not the other. As selenium levels in toenails are highly reproducible, notwithstanding variation in selenium levels in food and long-term changes in individuals' food choices, toenail selenium may be a useful biomarker of selenium exposure, particularly since toenail samples provide a measure of long-term exposure. However age, smoking status and acetone treatment are possible causes of misclassification.

Acetone↗
PubMed2003

Serum follicle-stimulating hormone and risk of epithelial ovarian cancer in postmenopausal women.

The "gonadotropin hypothesis" postulates that gonadotropin overstimulation of ovarian epithelium results in its increased proliferation and subsequent malignant transformation. To address this hypothesis, we assessed the association between prediagnostic serum levels of follicle-stimulating hormone (FSH) and the risk of epithelial ovarian cancer in postmenopausal women who were part of a case-control study nested within three prospective cohorts in New York City, Umeå, Sweden, and Milan, Italy. Case subjects were 88 women with primary invasive epithelial ovarian cancer diagnosed between 3 months and 13.1 years after the blood donation. Controls were 168 women who were free of cancer and matched the case on cohort, age, and enrollment date. Serum FSH was determined using a quantitative immunoradiometric assay. FSH concentrations were similar in women who subsequently received a diagnosis of epithelial ovarian cancer (median, 44.0 mIU/ml; range, 13.8-101.2) and in controls (median, 43.4 mIU/ml; range, 13.5-109.5; P = 0.17). Compared with women in the lowest third, women in the highest third of serum FSH were not at increased risk of epithelial ovarian cancer after an adjustment for potential confounders (odds ratio, 0.85; 95% confidence interval, 0.36-1.99). These observations provide no evidence for an association between circulating FSH and risk of epithelial ovarian cancer in postmenopausal women and do not appear to support the gonadotropin hypothesis of epithelial ovarian carcinogenesis.

Age Distribution↗
PubMed2002

Circulating levels of insulin-like growth factor-I and risk of ovarian cancer.

Insulin-like growth factor (IGF)-I, a mitogenic and anti-apoptotic peptide, has been implicated in the development of several cancers. We hypothesized that high circulating IGF-I concentrations may be associated with an increased risk of ovarian cancer. A case-control study was nested within 3 prospective cohorts in New York (USA), Umeå (Sweden) and Milan (Italy). One hundred thirty-two women with primary invasive epithelial ovarian cancer diagnosed at least 1 year after blood donation were case subjects. For each case, 2 control subjects were selected, matching the case subject on cohort, menopausal status, age and date of recruitment (n = 263). Only women who did not use exogenous hormones at blood donation were included in the study. There was no association between IGF-I concentrations and ovarian cancer risk in the study group as a whole. In analyses restricted to subjects who had developed ovarian cancer at a young age (<55), circulating IGF-I was directly and strongly associated with ovarian cancer risk (OR = 4.97; 95% CI = 1.22-20.2 for the top vs. the bottom IGF-I tertile after adjustment for parity, BMI categories and smoking). There was no significant association of IGF binding protein-3 with ovarian cancer risk. We found a strong direct relationship between circulating IGF-I levels and risk of developing ovarian cancer before age 55. Additional, larger studies of this association are needed to provide more precise estimates of effect.

Age Factors↗
PubMed2002

Contrasts in cancer prevalence in Connecticut, Iowa, and Utah.

BACKGROUND: Cancer prevalence--the proportion of a population with cancer, including those recently diagnosed, those in treatment, and survivors--is an important indicator of future health care requirements. Only limited information on cancer prevalence is available for the United States. In particular, comparative interstate studies are not available. In this study, we estimate and analyze the prevalence of seven major cancers in Connecticut, lowa, and Utah using the tried and tested PREVAL method applied to National Cancer Institute registry data. METHODS: We analyzed data on 242,851 carcinomas of the stomach, colorectum, pancreas, breast, uterus (corpus), ovary, and non-Hodgkin lymphoma (NHL), diagnosed in white Americans from 1973 through 1992. Observed prevalence was estimated by applying the PREVAL method to incidence and life status data from the cancer registries. Complete prevalence was estimated by applying correction factors obtained by modeling incidence and survival rates. RESULTS: The ratio of the highest to the lowest prevalence (as proportions) ranged from 1.69 for uterine carcinoma to 2.73 for stomach carcinoma, showing that marked differences in cancer prevalence exist within the United States. Utah had the lowest prevalence for each carcinoma. Connecticut and lowa had similar prevalence levels for carcinomas of the colorectum, pancreas, and ovary and for NHL. Breast carcinoma was the most prevalent, with 826 cases per 100,000 of population in Utah, 1518 per 100,000 in lowa, and 1619 per 100,000 in Connecticut. Cancer survival did not differ greatly among the three registry populations. The major determinants of prevalence differences were incidence and the population age distribution. CONCLUSIONS: PREVAL provides reliable estimates of the numbers of living people in a population who have had a cancer diagnosis. Prevalence depends on incidence and survival and on the age structure of population. All these factors have changed markedly in recent years and will continue to do so in the future. Cancer prevalence should be monitored over time to evaluate changes by area, sex, age, and cancer site. The prevalence figures presented are directly comparable with those from European cancer registries.

Adult↗
PubMed2002

Body mass index in relation to ovarian cancer: a multi-centre nested case-control study.

The incidence of ovarian cancer is up to 10 times higher in Western countries than in rural Asia and Africa. One common consequence of a Western lifestyle is the development of excessive body weight and obesity. A multi-centre prospective study was conducted to investigate the association between body mass index (BMI) and ovarian cancer risk. A case-control study was nested within 3 prospective cohorts in New York (USA), Umeå (Sweden) and Milan (Italy). Information on anthropometry, demographic characteristics, medical history and lifestyle was obtained at the time of subjects' recruitment in each cohort. Women diagnosed with primary, invasive epithelial ovarian cancer from the 3 cohorts (n = 122) diagnosed 12 months or later after recruitment into the respective cohort served as case subjects. For each case subject, 2 control subjects that matched the case subject on cohort, menopausal status, age and date of recruitment were randomly identified. Data were analyzed by conditional logistic regression. There was an inverse association between BMI and ovarian cancer risk. For increasing quartiles of BMI above the lowest, the ORs were 0.62 (0.32-1.21), 0.59 (0.30-1.17) and 0.46 (0.23-0.92), p = 0.03. Analyses limited to women diagnosed 3 or more years after recruitment into the cohorts did not alter these findings. When obese women (BMI > 30) were compared to lean women (BMI < or = 23), the inverse association became stronger, with an OR of 0.38 (0.17-0.85), p < 0.02. There was some evidence of direct association of ovarian cancer with height, which was limited to cancers diagnosed before age 55. Our data suggest that increasing body weight may confer a protection against ovarian cancer.

Adult↗
PubMed2002

Projecting SEER cancer survival rates to the US: an ecological regression approach.

OBJECTIVES: Cancer survival information is available only in areas covered by cancer registration. The objective of this study is to project cancer survival for the entire US as well as states from survival data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program. METHODS: Five-year breast, prostate, and colorectal cancer relative survival rates from SEER are regressed on socioeconomic, demographic, and health variables at the county level. These models are first validated by comparing the observed rates with projected rates for counties not used in the estimation process. RESULTS: Education was the best indicator of longer cancer survival. Other important predictors of the geographical variability of survival varied by cancer site. Better survival was predicted for breast and prostate than for colorectal cancer. CONCLUSIONS: Data from cancer registries can be used in ecological models to provide national and state estimates of patients' survival rates. These estimates are useful in targeting areas in which to promote earlier diagnosis or improved access to care, and may also aid in monitoring the quality of survival data collected by individual cancer registries.

Adult↗
PubMed2002

Fat and protein intake and subsequent breast cancer risk in postmenopausal women.

The role of diet in the etiology of breast cancer has been extensively evaluated. Case-control studies generally support an association, while cohort studies have produced inconsistent results. This study, carried out on the ORDET cohort, is the first prospective Italian study to address the relation between diet and breast cancer. Female volunteers were recruited from 1987 to 1992 among residents of Varese Province, Northern Italy, an area covered by a cancer registry. A semiquantitative self-administered food questionnaire was completed by participants. After a mean 5.5 yr of follow-up, 56 cases of invasive breast cancer were identified among the 3,367 postmenopausal members; 214 controls were randomly chosen from the cohort, matched to cases for age, menopausal status at recruitment, recruitment center, and recruitment period. The adjusted odds ratios for the highest tertile of intake vs. the lowest were 3.47 [95% confidence interval (CI) = 1.43-8.44] for total fat, 3.78 (95% CI = 0.95-15.0) for animal protein, and 0.42 (95% CI = 0.18-0.95) for total carbohydrates. These findings indicate a significant positive association between total fat and animal protein and risk of breast cancer and an inverse association with carbohydrates and constitute new evidence for a role of diet in the etiology of breast cancer.

Adult↗
PubMed2002

Fasting glucose is a risk factor for breast cancer: a prospective study.

There is some evidence that glucose and other factors related to glucose metabolism, such as insulin and insulin-like growth-factors (IGFs) may contribute to breast cancer development. The present study analyzed the hypothesis that serum glucose, insulin levels, and IGF-I pattern are associated with breast cancer using a nested case-control study. Between 1987 and 1992, 10,786 women ages 35-69 were recruited in a prospective study in Italy. Women with history of cancer and on hormone therapy were excluded at baseline. At recruitment, blood samples were collected after a 12-h fast between 7:30 and 9:00 a.m. from all of the study participants. After 5.5 years, 144 breast cancer cases were identified among the participants of the cohort. Four matched controls were chosen for each breast cancer case from members of the cohort who did not develop breast cancer during the follow-up period. In premenopausal women, glucose was associated with breast cancer risk: the age, body mass index, and reproductive variable adjusted relative risk (RR) for the highest quartile of serum glucose versus the lowest was 2.8 [95% confidence interval (CI), 1.2-6.5], and P for trend was 0.02. Insulin showed a weaker association with breast cancer, the adjusted RR of the highest quartile versus the lowest was 1.7 (95% CI, 0.7-4.1), and P for trend was 0.14, whereas the adjusted RR of the highest quartile of IGF-I was 3.1 (95% CI, 1.1-8.6), and P for trend was 0.01. Increased levels of insulin-like growth factor binding protein-3 (IGFBP)-3 were related to breast cancer risk: the adjusted RR for the highest quartile was 2.1 (95% CI, 0.95-4.75), and P for trend was 0.02. In postmenopausal women, the associations of glucose, insulin, and IGF-1 pattern were associated with breast cancer risk in heavier subjects characterized by a body mass index higher than 26. These results indicate that chronic alteration of glucose metabolism is related to breast cancer development.

Adult↗
PubMedDate not supplied

National estimates of cancer patients survival in Italy: a model-based method.

AIMS AND BACKGROUND: To provide model-based estimates of all cancers patient survival in Italy and in Italian large geographical areas (North-West, North-East, Center, South), where only partial coverage of cancer registries data is available, and to describe them in terms of time trends. Moreover, to measure the degree of representativeness of cancer patient survival obtained from Italian cancer registries data. METHODS: Relative survival in the four main Italian geographical areas was estimated by a parametric mixture model belonging to the class of "cure" survival models. Data used are from Italian cancer registries, stratified by sex, period of diagnosis and age. The Italian national survival was obtained as a weighted average of these area-specific estimates, with weights proportional to the number of estimated incident cases in every area. The model takes into account also differences in survival temporal trends between the areas. RESULTS: Relative survival for all cancers combined in Italian patients diagnosed in 1990-1994 was estimated to be higher in women (53%) than in men (38%) at 5 years from the diagnosis. The survival trend is increasing by period and decreasing by age, both for men and women. The greatest gain in terms of survival was obtained by the elderly, with annual mean growth rates in the period 1978-1994 equal to 3.5% and 3.2% for men and women, respectively. More than 50% of the youngest cancer patients were "cured", whereas for the elderly this proportion dropped to 15% and 25% for men and women, respectively. The South of Italy had the lowest survival and the North the most pronounced increase. CONCLUSIONS: The obtained national survival estimates are similar, but not identical, to previously published estimates, in which Italian registries' data were pooled without any adjustment for geographical representativeness. The four Italian areas have different survival levels and trends, showing variability within the country. The differences in survival between men and women may be explained by the different proportion of lethal cancers. Among males, most cases had a poor prognosis (lung and stomach cancers), whereas among females the largest proportion was made up of curable and less lethal cancers (breast cancer).

Adolescent↗