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Cristina Bosetti

Publications and source records attributed to Cristina Bosetti.

At least 19 recordsLinked to original sources
PubMed2007

Flavonoids and risk of squamous cell esophageal cancer.

The relation between 5 classes of flavonoids (flavanones, flavan-3-ols, flavonols, flavones and anthocyanidines) and esophageal cancer was investigated using data from a case-control study conducted between 1992 and 1997 in 3 areas of northern Italy. The study included 304 cases (275 men, 29 women) with a first diagnosis of squamous-cell carcinoma of the esophagus and 743 controls (593 men, 150 women) with no history of cancer, admitted for acute illnesses, unrelated to tobacco and alcohol consumption, to major hospitals of the areas under surveillance. Dietary habits were investigated using a validated food frequency questionnaire. Odds ratios (ORs) and 95% confidence intervals (CI) were computed after allowance for age, sex, study centre, years of education, alcohol drinking, tobacco smoking, body mass index and energy intake. An inverse association emerged between flavanone intake and esophageal cancer risk (OR=0.38 for the highest vs. the lowest quintile, 95% CI=0.23-0.66). The inverse relation between flavanones and esophageal cancer tended to be stronger in those who drank >or=6 drinks/day. In conclusion, this study suggests that flavanone intake is inversely associated with esophageal cancer risk and may account, with vitamin C, for the protective effect of fruit, especially citrus fruit, on esophageal cancer.

Adult↗
PubMed2007

Micronutrients and the risk of renal cell cancer: a case-control study from Italy.

The role of various micronutrients on the risk of renal cell cancer (RCC) was examined in a multicentric case-control study from Italy, in which information on dietary habits were collected using a validated food-frequency questionnaire. Cases were 767 patients (494 men and 273 women) with incident, histologically confirmed RCC; controls were 1,534 subjects (988 men and 546 women) admitted to the same hospitals as cases for a wide spectrum of acute, nonneoplastic conditions. After allowing for energy and other major covariates, a significant inverse association was found for vitamin E (odds ratio, OR, for the highest quintile of intake versus the lowest one 0.56, 95% confidence interval, CI 0.41-0.75), and vitamin C (OR = 0.72, 95% CI = 0.54-0.96), although the trend in risk for vitamin C was of borderline significance. No significant trend of decreasing risk was found for other micronutrients analyzed, although for most of them the risk estimates were below unity for intakes above the lowest. The ORs for the upper quintile of intake when compared with the lowest one were 0.80 (95% confidence interval, CI = 0.59-1.08) for retinol, 0.82 (95% CI = 0.61-1.10) for alpha-carotene, 0.90 (95% CI = 0.68-1.20) for beta-carotene, 0.94 (95% CI = 0.73-1.21) for beta-criptoxanthin, 0.85 (95% CI = 0.63-1.14) for lutein/zeaxanthin, 0.76 (95% CI = 0.57-1.01) for vitamin D, 0.75 (95% CI = 0.55-1.01) for thiamine, 0.88 (95% CI = 0.66-1.19) for riboflavin, 0.85 for vitamin B6 (95% CI = 0.64-1.13), 0.85 (95% CI = 0.64-1.12) for folate and 0.80 (95% CI = 0.60-1.07) for niacin. No meaningful associations emerged for lycopene (OR = 1.11). The present findings support a possible beneficial effect of vitamin E and C on RCC.

Adult↗
PubMed2007

Food groups and renal cell carcinoma: a case-control study from Italy.

Although nutrition and diet have been related to renal cell carcinoma (RCC), the role of specific foods or nutrients on this cancer is still controversial. We evaluated the relation between a wide range of foods and the risk of RCC in an Italian case-control study including 767 patients (494 men and 273 women) younger than 79 years with incident, histologically confirmed RCC, and 1,534 controls (988 men and 546 women) admitted to the same hospitals as cases for a wide spectrum of acute, non-neoplastic conditions, not related to long term diet modifications. A validated and reproducible food frequency questionnaire, including 78 foods and beverages, plus a separate section on alcohol drinking, was used to assess patients' dietary habits 2 years before diagnosis or hospital admission. Multivariate odds ratios (OR) were obtained after allowance for energy intake and other major confounding factors. A significant direct trend in risk was found for bread (OR = 1.94 for the highest versus the lowest intake quintile), and a modest excess of risk was observed for pasta and rice (OR = 1.29), and milk and yoghurt (OR = 1.27). Poultry (OR = 0.74), processed meat (OR = 0.64) and vegetables (OR = 0.65) were inversely associated with RCC risk. No relation was found for coffee and tea, soups, eggs, red meat, fish, cheese, pulses, potatoes, fruits, desserts and sugars. The results of this study provide further indications on dietary correlates of RCC, and in particular indicate that a diet rich in refined cereals and poor in vegetables may have an unfavorable role on RCC.

Aged↗
PubMed2007

Flavonoids and the risk of renal cell carcinoma.

Intake of flavonoids has been inversely related to the risk of various common neoplasms, but limited data exist on renal cell carcinoma (RCC). We used data from a case-control study conducted between 1994 and 2002 in four Italian areas to study the relation between major flavonoid classes and RCC. The study included 767 cases with incident, histologically confirmed RCC and 1,534 hospital controls admitted for acute, nonneoplastic conditions and matched with cases by study center, sex, and quinquennia of age. We applied published data on food and beverage content of six major classes of flavonoids to dietary information collected through a validated food frequency questionnaire. After adjustment for major recognized confounding factors and total energy intake, the odds ratios for subjects in the highest versus the lowest quintile of intake were 0.80 [95% confidence interval (95% CI), 0.58-1.11] for total flavonoids, 0.76 (95% CI, 0.56-1.03) for isoflavones, 0.94 (95% CI, 0.60-1.47) for anthocyanidins, 0.77 (95% CI, 0.56-1.06) for flavan-3-ols, 0.90 (95% CI, 0.67-1.21) for flavanones, 0.68 (95% CI, 0.50-0.93) for flavones, and 0.69 (95% CI, 0.50-0.95) for flavonols. Allowance for vegetable and fruit consumption only partly explained these inverse relations. Thus, flavonoids, and particularly flavones and flavonols, may account, at least in part, for the favorable role of plant foods on RCC.

Adult↗
PubMed2006

Female survivors of childhood cancer: preterm birth and low birth weight among their children.

BACKGROUND: Improved survival after childhood cancer raises concerns over the possible long-term reproductive health effects of cancer therapies. We investigated whether children of female childhood cancer survivors are at elevated risk of being born preterm or exhibiting restricted fetal growth and evaluated the associations of different cancer treatments on these outcomes. METHODS: Using data from the Childhood Cancer Survivor Study, a large multicenter cohort of childhood cancer survivors, we studied the singleton live births of female cohort members from 1968 to 2002. Included were 2201 children of 1264 survivors and 1175 children of a comparison group of 601 female siblings. Data from medical records were used to determine cumulative prepregnancy exposures to chemotherapy and radiotherapy. Logistic regression was used to estimate odds ratios (ORs) for the association between quantitative therapy exposures and preterm (<37 weeks) birth, low birth weight (<2.5 kg), and small-for-gestational-age (SGA) (lowest 10th percentile) births. All statistical tests were two-sided. RESULTS: Survivors' children were more likely to be born preterm than the siblings' children (21.1% versus 12.6%; OR = 1.9, 95% confidence interval [CI] = 1.4 to 2.4; P<.001). Compared with the children of survivors who did not receive any radiotherapy, the children of survivors treated with high-dose radiotherapy to the uterus (>500 cGy) had increased risks of being born preterm (50.0% versus 19.6%; OR = 3.5, 95% CI = 1.5 to 8.0; P = .003), low birth weight (36.2% versus 7.6%; OR = 6.8, 95% CI = 2.1 to 22.2; P = .001), and SGA (18.2% versus 7.8%; OR = 4.0, 95% CI = 1.6 to 9.8; P = .003). Increased risks were also apparent at lower uterine radiotherapy doses (starting at 50 cGy for preterm birth and at 250 cGy for low birth weight). CONCLUSIONS: Late effects of treatment for female childhood cancer patients may include restricted fetal growth and early births among their offspring, with risks concentrated among women who receive pelvic irradiation.

Adolescent↗
PubMed2006

Benign ovarian cysts and breast cancer risk.

Benign ovarian cysts have been suggested to influence breast cancer risk. To provide a comprehensive picture of the relation between ovarian cysts and breast cancer, we analyzed the data of 3 case-control studies conducted in northern Italy and the Swiss Canton of Vaud between 1983 and 2001. These studies included 6,315 incident, histologically confirmed breast cancer cases and 6,038 hospital-based controls. Odds ratios (OR) and the corresponding 95% confidence intervals (CI) were estimated using unconditional multiple logistic regression models, including terms for sociodemographic, menstrual and reproductive factors. Overall, 4.9% of breast cancer cases and 6.6% of controls reported a history of ovarian cysts, with a multivariate OR of 0.72 (95% CI 0.62-0.85). The inverse association between ovarian cysts and breast cancer was consistent in separate strata of age at menarche, parity, age at menopause status and family history of breast cancer. No meaningful differences were also found across strata of menstrual cycle length, oral contraceptive use, history of oophorectomy and body mass index. Thus, the inverse relation between ovarian cysts and breast cancer risk was not accounted for by earlier menopause, or by any difference in reproductive and menstrual characteristics. Although some hormonal correlates of ovarian cysts may have a role on breast cancer risk, a biological explanation of this inverse association is still unclear.

Adult↗
PubMed2006

Family history of cancer provided by hospital controls was satisfactorily reliable.

OBJECTIVE: Our aim was to investigate the reliability of the information on family history of cancer in first-degree relatives in a hospital-based case-control study. STUDY DESIGN AND SETTING: We re-interviewed at home 294 controls of an Italian hospital-based case-control study on digestive tract neoplasms using the same questionnaire and compared the responses reported by these patients in the two settings. RESULTS: A satisfactory agreement between the two interviews was reported for family history of any cancer (kappa=0.7) and of cancers of the digestive tract (kappa=0.8). The agreement was apparently higher for esophageal and stomach cancers (kappa>0.8) than for intestinal cancers (kappa=0.6) and lower for lung cancer (kappa=0.5). We found a systematic tendency to report a history of cancer more frequently in the hospital setting than in the home setting. CONCLUSION: The present study showed a good reliability of data on family history of all cancers, including cancers of the digestive tract, provided by hospital controls through a structured interview-administered questionnaire. It suggests, moreover, that controls in the hospital setting tend to recall more often, and presumably more completely, a family history of cancer.

Adult↗
PubMed2006

Effects of smoking cessation on the risk of laryngeal cancer: an overview of published studies.

Epidemiological studies showed that stopping smoking substantially decreases the risk of lung cancer. With reference to laryngeal cancer, at least four cohort studies and 15 case-control studies reported information on smoking cessation. These studies indicated that the risk of laryngeal cancer is considerably reduced in ex-smokers as compared to current smokers. The relative risk steeply decreases with time since stopping smoking, with reductions by about 60% after 10-15 years since cessation, and even larger after 20 years. The favorable effect of stopping smoking is already evident within few years after cessation, thus suggesting that smoking has a relevant impact on the late stage of laryngeal carcinogenesis. However, several years after stopping smoking, ex-smokers still have elevated risks of laryngeal cancer as compared to never smokers. In conclusion, the epidemiological evidence clearly indicates that cessation of smoking is the best measure to reduce laryngeal cancer risk, the beneficial effect being evident within a few years after cessation, and steadily increasing with passing time since cessation.

Case-Control Studies↗
PubMed2006

Smoking cessation and the risk of oesophageal cancer: An overview of published studies.

The epidemiologic studies on oesophageal cancer and smoking cessation published before December 2005 were reviewed here. The results from at least 10 cohort and 10 case-control studies indicated that former smokers had a lower risk of squamous-cell or unspecified oesophageal cancer than current smokers. Most investigations showed that the risk of oesophageal cancer remains elevated many years (at least 10) after cessation of smoking, to decline by about 40% only thereafter. Moreover, after 10 years since cessation of smoking, ex-smokers still have a twofold increased risk as compared to never smokers. A few studies investigated the effect of smoking cessation on adenocarcinoma, and did not report a clear reduction of risk. Data on oesophageal adenocarcinoma are however too limited to provide adequate inference on the relation with time since smoking cessation. In conclusion, cessation of smoking could have an appreciable impact in reducing (squamous-cell) oesophageal cancer, and represents an obvious priority for prevention and public-health purposes.

Adenocarcinoma↗
PubMed2006

Trends in laryngeal cancer mortality in Europe.

After a steady increase since the 1950s, laryngeal cancer mortality had tended to level off since the early 1980s in men from most European countries. To update trends in laryngeal cancer mortality in Europe, age-standardized (world standard) mortality rates per 100,000 were derived from the WHO mortality database for 33 European countries over the period 1980-2001. Jointpoint analysis was used to identify significant changes in mortality rates. In the European Union (EU) as a whole, male mortality declined by 0.8% per year between 1980 and 1989, by 2.8% between 1989 and 1995, by 5.3% between 1995 and 1998, and by 1.5% thereafter (rates were 5.1/100,000 in 1980-1981 and 3.3/100,000 in 2000-2001). This mainly reflects a decrease in rates in men from western and southern European countries, which had exceedingly high rates in the past. Male laryngeal mortality rose up to the early 1990s, and leveled off thereafter in several countries from central and eastern Europe. In 2000-2001 there was still a 10-15-fold variation in male laryngeal mortality between the highest rates in Croatia (7.9/100,000) and Hungary (7.7/100,000) and the lowest ones in Sweden (0.5/100,000) and Finland (0.8/100,000). Laryngeal cancer mortality was comparatively low in women from most European countries, with stable rates around 0.3/100,000 in the EU as a whole over the last 2 decades. Laryngeal cancer trends should be interpreted in terms of patterns and changes in exposure to alcohol and tobacco. Despite recent declines, the persistence of a wide variability in male laryngeal cancer mortality indicates that there is still ample scope for prevention of laryngeal cancer in Europe.

Adult↗
PubMed2006

Dietary acrylamide and human cancer.

Low levels of acrylamide have been found in several foods cooked at high temperatures. While there is sufficient evidence for the carcinogenicity of acrylamide in experimental animals, the few epidemiologic studies conducted to date on occupational and dietary exposure to acrylamide have found no consistent evidence of association with human cancer risk. Using data from an integrated network of Italian and Swiss hospital-based case-control studies, we analyzed the relation between dietary acrylamide intake and cancers of the oral cavity and pharynx (749 cases, 1,772 controls), esophagus (395 cases, 1,066 controls), large bowel (1,394 cases of colon, 886 cases of rectal cancer, 4,765 controls), larynx (527 cases, 1,297 controls), breast (2,900 cases, 3,122 controls), ovary (1,031 cases, 2,411 controls) and prostate (1,294 cases, 1,451 controls). All the studies included incident, histologically confirmed cancer cases and controls admitted to the same network of hospitals for acute nonneoplastic conditions. We calculated odds ratios (ORs) using multivariate logistic regression models, adjusted for energy intake and other major covariates of interest. The ORs for the highest versus the lowest quintile of acrylamide intake were 1.12 (95% CI = 0.76-1.66) for cancer of the oral cavity/pharynx, 1.10 (95% CI = 0.65-1.86) for esophageal, 0.97 (95% CI = 0.80-1.18) for colorectal, 1.23 (95% CI = 0.80-1.90) for laryngeal, 1.06 (95% CI = 0.88-1.28) for breast, 0.97 (95% CI = 0.73-1.31) for ovarian and 0.92 (95% CI = 0.69-1.23) for prostate cancer. None of the trend in risk was significant. This uniquely large and comprehensive data set does not show any consistent association between intake of acrylamide and the risk of breast and several other common cancers.

Acrylamide↗
PubMed2006

Aspirin and cancer risk: an updated quantitative review to 2005.

Aspirin has been associated to a reduced risk of colorectal, and possibly of a few other common cancers. Epidemiological studies on aspirin and cancer risk published up to December 2005 have been reviewed, and pooled relative risks (RR) for several cancers have been provided. Besides a reduction in the risk of cancer of the colorectum (RR = 0.71, 95% confidence interval, CI: 0.67-0.75), there is evidence-although more limited, and mainly from case-control studies-that aspirin has a favourable effect on cancers of the esophagus (RR = 0.72, 95% CI: 0.62-0.84), stomach (RR = 0.84, 95% CI: 0.76-0.93), breast (RR = 0.91, 95% CI: 0.88-0.95), ovary (RR = 0.89, 95% CI: 0.78-1.02) and lung (RR = 0.94, 95% CI: 0.89-1.00). The role of aspirin on other cancers, such as pancreatic, prostate, bladder cancer, and non-Hodgkins' lymphomas is less clear, and an increase of risk has been suggested for kidney cancer. For most cancer sites, however, significant heterogeneity between studies, and particularly across study design, was found, with a reduction in risk generally stronger in case-control than in cohort studies. Further, notwithstanding the large amount of epidemiological evidence, substantial uncertainties remain about the proper aspirin dose and duration of treatment.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2006

Food groups and risk of benign prostatic hyperplasia.

OBJECTIVES: To evaluate the role of a wide range of foods on the risk of benign prostatic hyperplasia (BPH), we conducted a case-control study in Italy between 1991 and 2002. Although BPH is an extremely common condition, particularly among older men, its risk factors, including dietary ones, remain largely undefined. METHODS: Included in the study were 1369 patients younger than 75 years old surgically treated for BPH and 1451 controls younger than 75 years of age who had been admitted to the same hospitals as cases for a wide spectrum of acute, non-neoplastic conditions. A validated and reproducible food frequency questionnaire, including 78 foods and beverages, plus a separate section on alcoholic beverages, was used to assess patients' dietary habits 2 years before diagnosis or hospital admission. Multivariate odds ratios (OR) were obtained after allowance for energy intake and other major potential confounding factors. RESULTS: A significant trend of increasing risk with more frequent consumption was found for cereals (OR 1.55 for the greatest versus lowest quintile), bread (OR 1.69), eggs (OR 1.43), and poultry (OR 1.39). Inverse associations were observed for soups (OR 0.74), pulses (OR 0.74), cooked vegetables (OR 0.66), and citrus fruit (OR 0.82). No association was observed for milk and yogurt products, coffee and tea, pasta and rice, fish, cheese, row vegetables, potatoes, fruit, or desserts. CONCLUSIONS: The results of this study suggest a role for dietary habits on the risk of BPH. In particular, a diet rich in cereals and some types of meat and poor in vegetables and pulses may have an unfavorable effect in this Italian population.

Aged↗
PubMed2006

Macronutrients, fatty acids, cholesterol, and risk of benign prostatic hyperplasia.

OBJECTIVES: To better understand the role of specific macronutrients on the risk of benign prostatic hyperplasia (BPH), we used data from an Italian case-control study. Although BPH is extremely common among the elderly, its etiology-and, particularly, the role of diet and specific macronutrients-is still unclear. METHODS: A case-control study of 1369 patients with BPH and 1451 controls, admitted to the same hospitals for a wide spectrum of acute, non-neoplastic conditions, was conducted in Italy. The subjects' usual diet was investigated through a validated and reproducible food frequency questionnaire. Multivariate odds ratios (ORs) and 95% confidence intervals (CIs) were obtained after allowance for energy intake and other potential confounding factors. RESULTS: A significant direct relation was observed between starch intake (OR 1.51, 95% CI 1.15 to 1.99 for highest quintile compared with lowest one), and an inverse relation was observed for polyunsaturated fatty acids (OR 0.72, 95% CI 0.55 to 0.93), linoleic acid (OR 0.73, 95% CI 0.56 to 0.94), and linolenic acid (OR 0.71, 95% CI 0.54 to 0.93). CONCLUSIONS: The results of this study suggest a role for specific macronutrients in the risk of BPH, including, in particular, an unfavorable effect for starch and a beneficial one for polyunsaturated fatty acids.

Aged↗
PubMed2006

Mechanisms of disease: The epidemiology of bladder cancer.

Mortality from bladder cancer has shown downward trends over the last 2 decades in several western European countries (albeit 10-15 years later than similar trends in the US), but is still increasing in some eastern European countries. Tobacco smoking and occupational exposure to aromatic amines are the two major established environmental risk factors for bladder cancer. Controlling exposure to these factors has been an important contributor to the reduction in bladder cancer mortality, particularly among men. Diet could influence bladder carcinogenesis, as many compounds contained in foods--and their metabolites--are excreted through the urinary tract. Fruit and vegetable consumption was inversely related with bladder cancer in many studies, but no consistent association has emerged between intake of related micronutrients and reduced risk of bladder cancer. Other widely investigated lifestyle habits are probably not associated with risk of developing bladder cancer (e.g. coffee consumption, artificial sweetener use, hair dyes) or are difficult to assess (e.g. fluid intake). Infections and stones in the urinary tract might cause chronic irritation of the bladder epithelium, and thus increase bladder cancer risk. First-degree relatives of bladder cancer patients have a 50-100% increased relative risk of developing the disease, a risk that could be even higher when the proband is diagnosed at an early age.

Europe↗
PubMed2006

Dietary iron intake and risk of non-fatal acute myocardial infarction.

OBJECTIVE: The relation between several measures of body iron and atherosclerotic disease, particularly acute myocardial infarction (AMI), is debated. This is of specific interest since iron is frequently included in supplementation and fortification of foods. We assessed the relation between dietary iron intake and the risk of non-fatal AMI. DESIGN: Case-control study. The information was collected by interviewers using a food-frequency questionnaire tested for validity and reproducibility. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were obtained by multiple unconditional logistic regression models, including terms for energy and alcohol intake, as well as for sociodemographic factors, tobacco and other major recognised risk factors for AMI. SETTING: Milan, Italy, between 1995 and 1999. SUBJECTS: Cases were 507 patients, below age 79 years, with a first episode of non-fatal AMI, and controls were 478 patients admitted to hospital for a wide spectrum of acute conditions unrelated to known or potential AMI risk factors. RESULTS: Compared with patients in the lowest tertile of total iron intake, the OR was 0.48 (95% CI 0.29-0.82) for those in the highest tertile. The corresponding value for haem iron was 0.71 (95% CI 0.48-1.06), for non-haem, non-alcohol iron was 0.80 (95% CI 0.51-1.24) and for iron derived from alcoholic beverages was 0.60 (95% CI 0.40-0.90). Sex-specific OR for total iron intake were not heterogeneous. CONCLUSIONS: In this Italian population dietary iron intake was inversely related to AMI risk. This inverse association may depend on other nutrients present in the major sources of iron in the Italian diet.

Acute Disease↗
PubMed2006

Intake of specific flavonoids and risk of acute myocardial infarction in Italy.

OBJECTIVE: As intake of flavonoids has been associated with reduced risk of coronary heart disease but data on the relation with specific classes of flavonoids are scarce, we assessed the relation between dietary intake of specific classes of flavonoids and the risk of acute myocardial infarction (AMI) in an Italian population. DESIGN: Case-control study. Dietary information was collected by interviewers on a questionnaire tested for validity and reproducibility. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were obtained by multiple logistic regression models including terms for energy and alcohol intake, as well as sociodemographic factors, tobacco and other major recognised risk factors for AMI. SETTING: Milan, Italy, between 1995 and 2003. SUBJECTS: Cases were 760 patients, below age 79 years, with a first episode of non-fatal AMI, and controls were 682 patients admitted to hospital for acute conditions unrelated to diet. RESULTS: A reduced risk of AMI was found for increasing intake of anthocyanidins (OR=0.45, 95% CI 0.26-0.78 for the highest vs. the lowest quintile, Ptrend=0.003) and flavonols (OR=0.65, 95% CI 0.41-1.02, Ptrend=0.02). A tendency towards reduced risks, although not significant, was observed for flavan-3-ols (OR=0.73, 95% CI 0.48-1.10) and total flavonoids (OR=0.74, 95% CI 0.49-1.14). No meaningful heterogeneity was found between the sexes. No association emerged for other flavonoids, including isoflavones, flavanones and flavones. CONCLUSIONS: High intake of anthocyanidins reduced the risk of AMI even after allowance for alcohol, fruit and vegetables, supporting a real inverse association between this class of flavonoids and AMI risk.

Acute Disease↗