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Biomedical subjects

E Negri

Publications and source records attributed to E Negri.

At least 181 records · Page 10Linked to original sources
PubMed1998

Trends in childhood cancer mortality as indicators of the quality of medical care in the developed world.

BACKGROUND: Mortality from childhood cancer in general and childhood leukemia in particular has sharply declined in economically developed countries over the last 30 years, whereas the incidence of these diseases has remained essentially unaltered. Therefore, childhood malignancies can be used as tracers of accessibility to and effectiveness of medical care. The objective of this study was to compare the reduction of mortality from childhood cancer in general, and childhood leukemia in particular, in four economically developed areas of the world, to assess accessibility to and effectiveness of technologically advanced medical care. METHODS: The authors used data from the World Health Organization to compare the evolution over time of gender specific, age-adjusted mortality from childhood cancer in general and childhood leukemia in particular in the childhood (birth to age 14 years) populations of North America, western Europe, Japan, and Australia and New Zealand during the period 1960-1993. They assessed the evolution over time and the cumulative percentage representing the decline in mortality from childhood cancer and childhood leukemia in the four aforementioned areas of the world. RESULTS: The decline in mortality from both the disease entities considered and for both genders has been more pronounced in North America than in other economically developed areas of the world. CONCLUSIONS: When disease control depends on technologically advanced medical care, as in the case of cancer, the North American population is benefited by earlier and effective introduction of new therapeutic approaches. This conclusion does not apply to other childhood diseases, the incidence of which is higher among low-income groups and control of which depends on prevention rather than treatment.

Adolescent↗
PubMed1998

Body size and colorectal-cancer risk.

Individuals whose energy intake exceeds expenditure are at increased risk of colorectal cancer. To determine whether body-size measurements at different ages were risk factors for cancer of the colon-rectum, we carried out a hospital-based case-control study in 6 Italian areas, 2 of which were in the South. Interviews were conducted with 1,217 subjects of both genders with incident histologically confirmed cancer of the colon, 726 with cancer of the rectum, and 4,136 controls hospitalized for acute, non-neoplastic, non-digestive conditions. The questionnaire included information on sociodemographic factors, and physical activity, a validated dietary history, height, weight at diagnosis and at 12, 30 and 50 years of age and waist-to-hip ratio (WHR). After allowance for education, physical activity, energy intake, family history of colorectal cancer and recent change in weight, the body-mass index (BMI) was significantly associated with colorectal-cancer-risk in men (odds ratio, OR, in highest vs. lowest quintile = 1.7; 95% confidence interval, CI, 1.3-2.3), but not in women (corresponding OR = 0.9; 95% CI, 0.7-1.2). Cases of both gender tended to have higher BMI than controls in adolescence, young adulthood and middle age. Height appeared unrelated to risk. In women, but not in men, WHR was positively associated with risk, independently of BMI (OR for > or = 0.90 vs. < or = 0.81 = 1.6; 95% CI; 1.2-2.1). Thus, excessive weight predicts colorectal-cancer risk in men, whereas abdominal obesity (i.e., a high WHR) represents a more reliable risk indicator in women.

Adult↗
PubMed1998

Incidence and prognosis of early primary ventricular fibrillation in acute myocardial infarction--results of the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI-2) database.

Primary ventricular fibrillation (VF) complicating acute myocardial infarction (MI) predicts short-term mortality. The broad category of patients with primary VF might include subgroups with different outcomes. It is still not certain whether early-onset (< or =4 hours) primary VF is a risk predictor, and information on correlates of these early fibrillations is scarce. This study sought to prospectively analyze the incidence and prognosis of early, as opposed to late (time window >4 to 48 hours) primary VF and retrospectively identify predisposing factors for early-onset primary VF. We analyzed the incidence and recurrence rate of early and late primary VF in 9,720 patients with a first acute MI, treated with thrombolytics, enrolled in the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI)-2 trial. The independent prognostic significance of early and late primary VF was assessed by logistic regression analysis. The incidence rates of early and late primary VF were 3.1% and 0.6%, respectively; recurrence rates were 11% and 15%, respectively. The 2 variables most closely related to early primary VF were hypokalemia and systolic blood pressure < 120 mm Hg on admission. Patients with early primary VF had a more complicated in-hospital course than matched controls. Both early (odds ratio [OR] 2.47, 95% confidence interval [CI] 1.48 to 4.13) and late primary VF (OR 3.97, 95% CI 1.51 to 10.48) were independent predictors of in-hospital mortality. Postdischarge to 6-month death rates were similar for both primary VF subgroups and controls. Primary VF, irrespective of its timing, was an independent predictor of in-hospital mortality. Postdischarge to 6-month prognosis was unaffected by the occurrence of either early or late primary VF.

Anti-Arrhythmia Agents↗
PubMed1998

Whole grain food intake and cancer risk.

The relationship between frequency of consumption of whole grain food and risk of selected neoplasms has been analysed using data from an integrated series of case-control studies conducted in northern Italy between 1983 and 1996. The overall dataset included the following incident, histologically confirmed neoplasms: oral cavity and pharynx 181, oesophagus 316, stomach 745, colon 828, rectum 498, liver 428, gallbladder 60, pancreas 362, larynx 242, breast 3,412, endometrium 750, ovary 971, prostate 127, bladder 431, kidney 190, thyroid 208, Hodgkin's disease 80, non-Hodgkin's lymphomas 200, multiple myelomas 120. Controls were 7,990 patients admitted to hospital for acute, non-neoplastic conditions, unrelated to long-term modifications in diet and not likely to have been caused by tobacco or alcohol use. Odds ratios (OR) for subsequent scores (never/occasional/frequent) of whole grain food consumption were derived after allowance for age, sex, education, smoking, alcohol intake and body mass index. High intake of whole grain foods consistently reduced risk of neoplasm at all sites, except thyroid. The ORs for the highest category of consumption were 0.2-0.3 for upper digestive and respiratory tract neoplasms, 0.5 for stomach, colon and gallbladder, 0.7 for rectum, 0.6 for liver, 0.8 for pancreas and prostate, 0.9 for breast and endometrium, 0.6 for ovary, 0.4 for bladder and kidney, 1.3 for thyroid and around 0.5 for lymphomas and myeloma. The tests for trend in risks were significant for all neoplasms, except pancreas, endometrium, Hodgkin's disease and multiple myeloma. No significant heterogeneity was found across strata of age at diagnosis, sex, education, smoking habit, alcohol intake and body mass index. Thus, even in the absence of a univocal and satisfactory biological interpretation, the consistency of the patterns observed indicate that, in this population, higher frequency of whole grain food intake is an indicator of reduced risk of several neoplasms.

Adult↗
PubMed1998

Role of reproductive factors on the risk of endometrial cancer.

We analyzed the role of reproductive factors on the risk of endometrial cancer using data from a case-control study conducted in Italy. Cases were 752 women with histologically confirmed endometrial cancer < 75 years of age. Controls were 2,606 patients < 75 years of age admitted for acute, non-gynecological non-hormone-related, non-neoplastic conditions to the same network of hospitals where cases had been identified. In comparison with nulliparae, the risk of endometrial cancer tended to be lower in parous women, and the estimated multivariate odds ratios (ORs) were 0.9, 0.8 and 0.7, respectively, for women reporting 1, 2 and 3 or more births (chi(2)(1) trend and 10.21). In comparison with women reporting no induced abortion, the ORs of endometrial cancer were 0.6 in women reporting 1 and 0.4 in those reporting 2 or more induced abortions. When considering parous women only, in comparison with women reporting their last birth 20 years before or longer, the ORs of endometrial cancer were 0.6 in those reporting their last birth 10-19 years before and 0.3 in those reporting their last birth < 10 years before. Our results confirm and further quantify a protective role of pregnancy on the risk of endometrial cancer and provide insights on the time-risk relationship between pregnancy and cancer of corpus uteri.

Adult↗
PubMed1998

Macronutrient intake and risk of colorectal cancer in Italy.

To provide further insight on the relationship between macronutrients and colorectal cancer, overall and by specific subsite(s), we carried out between 1992 and 1996 in 6 Italian areas a case-control study on 1,953 individuals of both sexes with incident colorectal cancer (age range 19-74) and 4,154 controls (age range 19-74) in hospital with acute, non-neoplastic diseases. A validated food-frequency questionnaire was used, including questions on 78 foods or recipes and on individual fat-intake pattern. The risk of cancer of the colon and rectum increased with total energy intake (odds ratio in highest vs. lowest quintile 1.43 and 1.50, respectively). The risk also rose significantly with an increase of starch intake, whereas it moderately decreased with an increase of protein intake. Monounsaturated fat intake appeared uninfluential, while saturated fat intake showed a modest direct association with rectal cancer. Polyunsaturated fat intake was inversely associated with colon cancer risk, particularly with the right colon.

Adult↗
PubMed1998

Olive oil, other seasoning fats, and the risk of colorectal carcinoma.

BACKGROUND: An association between fats and colorectal carcinoma has been suggested, but the epidemiologic evidence by type of dietary fat is far less clear. Colorectal carcinoma rates have been relatively low in Mediterranean countries compared with most other Western countries, but the components of the Mediterranean diet responsible for this favorable pattern are unclear. METHODS: The relationship between various added (seasoning) fats and colorectal carcinoma risk was investigated using data from a case-control study conducted between January 1992 and June 1996 in six Italian areas. Cases were 1953 patients with incident, histologically confirmed colorectal carcinoma (1225 of the colon and 728 of the rectum) admitted to the major teaching and general hospitals in the study areas. Controls were 4154 subjects with no history of cancer who were admitted to hospitals in the same catchment areas for acute, nonneoplastic diseases unrelated to the the digestive tract and requiring no long term modifications of diet. Dietary habits were investigated using a validated food frequency questionnaire including 78 items. Lipid intake was estimated by taking into account the content of seasoning lipids in different dishes, the frequency of consumption and portion size of each dish, and individual fat intake patterns. RESULTS: The odds ratios (OR) for successive tertiles of olive oil intake, compared with the lowest one, were 0.87 (95% confidence interval [CI], 0.75-1.01) and 0.83 (95% CI, 0.70-0.99) (chi2trend = 4.49, P = 0.03) when colorectal carcinoma was analyzed as a whole, 0.82 (95% CI, 0.68-0.98) and 0.81 (95% CI, 0.66-0.99) (chi2trend = 4.05, P = 0.04) for colon carcinoma, and 0.96 (95% CI, 0.77-1.19) and 0.88 (95% CI, 0.66-1.12) for rectal carcinoma. For specific seed oils (including sunflower, maize, peanut, and soya), the OR for colorectal carcinoma was 0.91 in the highest tertile of intake, and the corresponding values were 1.01 for mixed seed oils and 0.93 for butter. None of these estimates was significantly different from the unity. Allowance for vegetable intake attenuated the apparent protection from olive oil consumption (OR, 0.94 for colon and 0.97 for rectum for the highest tertile), which still was apparent in younger subjects (OR, 0.82 for colon and 0.69 for rectum). CONCLUSIONS: In this study, seasoning fats did not appear to increase the risk of colorectal carcinoma, and there was little evidence for a differential effect by fat type. If such a differential effect exists, it is minor and could favor olive oil.

Adult↗
PubMed1998

Treatment for fertility and risk of ovarian tumors of borderline malignancy.

The relationship between fertility drug use and risk of borderline ovarian cancer has been analyzed using data from a case-control study. Cases were 93 women aged 23 to 64 years with histologically confirmed diagnosis of borderline ovarian tumor (according to the World Health Organization criteria) who were admitted to the Obstetrics and Gynecology Clinics of the University of Milan. Control subjects were 273 women (ages 24-64 years) admitted for acute nongynecological, nonhormonal, and nonneoplastic conditions. Four cases (4.3%) and no control reported fertility drugs use: this difference was statistically significant (Fisher's exact test P = 0.004).

Adult↗
PubMed1998

Cancer mortality in Europe: effects of age, cohort of birth and period of death.

Death certification data for 19 cancers or groups of cancers, plus total cancer mortality, in 16 major European countries were analysed using a log-linear Poisson model with arbitrary constraints on the parameters to disentangle the effects of age, birth cohort and period of death. Three major patterns emerged including: first, the prominent role of cohort of birth in defining trends in mortality from most cancer sites (except testis or Hodgkin's disease, where newer treatments had a major period of death effect); and second, the major role of lung and other tobacco-related neoplasm epidemics in determining the diverging pattern of cancer mortality, for each sex and in various European countries and geographic areas. In most countries, the peak male cohort values were reached for generations born between 1900 and 1930. This was observed in women only for Denmark and the U.K., i.e. the two countries where lung and other tobacco-related neoplasm epidemics had already reached appreciable levels. This confirms the importance of cigarette smoking in subsequent generations as a major cause of cancer deaths in Europe. Further, there is a persistent rise in several cancer rates, again chiefly on a cohort basis, in Eastern Europe, which calls for urgent intervention to control the cancer burden in these countries.

Adult↗
PubMed1998

Time since last use of oral contraceptives and risk of invasive cervical cancer.

The time-risk relationship for the association between cervical cancer and oral contraceptives (OC) was examined using data on 592 cases of invasive cervical cancer aged 60 years or less and 616 controls with acute, non-gynaecological, non-hormone-related, non-neoplastic diseases. A total of 125 cases and 114 controls reported ever using OC and the multivariate odds ratio (OR) for ever versus never users was 1.21 (95% confidence interval (CI) 0.82-1.74). The risk of invasive cervical cancer was above unity in current users (OR 1.23) and in women who had stopped OC use less than 10 years before diagnosis, but not in those who had stopped their OC use > or = 10 years before (OR 0.85). Similarly, the OR was less for women who had started OC use 15 years or more previously than for more recent users. These data suggest that OCs may have a late stage (promoter) effect on cervical carcinogenesis and thus have public health implications, since the incidence of invasive cervical cancers is low at young ages, when OC use is more common and increases during middle age. The absence of a persisting risk is therefore of interest both for assessing individual risk and for its public health implications.

Adolescent↗
PubMed1998

The influence of reproductive and hormonal factors on the risk of colon and rectal cancer in women.

A case-control study was conducted between 1992 and 1996 in six Italian areas. It included 537 women with colon cancer, 291 women with rectal cancer and 2081 control women in hospital for acute conditions, unrelated to hormonal or gynaecological diseases. A higher age at menopause was associated with increased colon cancer risk (odds ratio (OR) for > or = 53 years compared with < 50 years = 1.39, 95% confidence interval (CI) 1.04-1.87). Among parous women, a significant trend of decreasing colon cancer risk with increasing number of births was seen for colon (OR for > or = 4 births compared with 1 birth = 0.62, 95% CI 0.42-0.90), but not for rectal cancer. Nulliparous women, however, were at lower risk than women with a single birth, and age at first birth was directly associated with risk. While oral contraceptive use showed no significant influence, ever users of hormone replacement therapy had a reduced risk of rectal cancer (OR = 0.56, 95% CI 0.31-1.01). Thus, the association of colorectal cancer with reproductive and menstrual factors is neither strong nor consistent.

Adult↗
PubMed1998

Trends in mortality from major diseases in Europe, 1980-1993.

Trends in age-standardized death certification rates from all causes, coronary heart disease (CHD), cerebrovascular diseases, all neoplasms and lung cancer were analysed over the period 1980-1993 in 20 major European countries. There were steady and substantial declines of overall mortality in all western European countries for both sexes, although appreciable geographic differences persisted. These favourable trends reflect a decline in CHD mortality in most western countries, besides a persisting fall in cerebrovascular disease, and a substantial stability (with some decline in a few northern and central European countries) in cancer mortality. In contrast, in eastern European countries appreciable rises were registered in mortality from major causes of death considered for males. For females, only moderate declines were observed in Eastern Europe. In the early 1990s, overall mortality was 30 to 100% higher for males and 20 to 100% higher for females as compared to Western Europe. As indicated by the trends in lung cancer death rates, this reflects a major impact of the tobacco-related disease epidemic in subsequent cohorts, as well as more unfavourable lifestyle factors (i.e. aspects of diet, other environmental factors), and a delayed control of hypertension in Eastern Europe, together with a substantial excess of suicides, (road) accidents, homicides and alcohol-related diseases, and the delayed introduction of rational treatment for some conditions. An indication of reversal of mortality trends was evident in the early 1990s only in Poland. In conclusion, there is ample scope for intervention on avoidable mortality in eastern European countries.

Cerebrovascular Disorders↗
PubMed1998

Cigarette smoking and risk of cancers of the colon and rectum: a case-control study from Italy.

The relationship between smoking habit and risk of colon and rectal cancers was considered in a case-control study conducted between 1991 and 1996 in six Italian centers. Cases were 1225 patients below age 75 with histologically confirmed cancer of the colon and 728 with cancer of the rectum. Controls were 4154 patients admitted to hospital for a wide spectrum of acute, non-neoplastic diseases. Compared to neversmokers, the odds ratios (OR) for current smokers of 25 or more cigarettes/day was 0.90 for patients with colon and 0.86 for those with rectal cancer and those for ex-smokers were 1.02 and 1.09 for colon and rectal cancer, respectively. No increase in risk was found with duration of the habit, the OR for 40 or more years being 0.79 for colon and 0.87 for rectal cancer. Furthermore, no relationship was apparent with time since starting (the OR for 40 or more years were 0.94 for colon and 1.05 for rectal cancer), or age at starting (the OR for < 18 years were 1.02 for colon and 1.01 for rectal cancer), or for pack-years smoked (the OR for 40 or more pack-years were 0.93 for colon and 0.91 for rectal cancer) or time since stopping among ex-smokers. No increase in risk was found in smokers of > or = 15 cigarettes/day for 40 years or longer (OR: 0.93). No significant heterogeneity was found across strata of age at diagnosis, sex, education, physical activity at work, intake of alcohol, coffee, vegetables, total energy, and number of meals/day. Likewise, no significant association was apparent for various intestinal subsites. Thus, this study did not find cigarette smokers at higher risk for cancer of the bowel even after a long duration and a long period since starting.

Adult↗
PubMed1998

Determinants of risk of invasive cervical cancer in young women.

We analysed determinants of risk of cervical cancer in women aged less than 45 years using data from a case-control study conducted in Italy. Cases were 261 women aged < 45 years with histologically confirmed invasive cervical cancer. Controls were 257 women aged < 45 years, with acute, non-neoplastic conditions, judged to be unrelated to any of the known or suspected risk factors for cervical cancer. In comparison with women reporting one or no sexual partner, the multivariate odds ratio (OR) of cervical cancer was 2.4 (95% confidence interval, CI, 1.3-4.6), for women reporting two or more sexual partners, and, in comparison with women reporting their first intercourse at 17 years of age or before, the multivariate OR was 0.5 (95% CI 0.3-0.9) in women aged > or =23 years at first intercourse. The risk of cervical cancer was higher in parous women and increased with number of births (OR = 8.1 for three or more births). Among parous women the risk tended to increase with later age at last birth; in comparison with parous women reporting their last birth before age 25, the OR was 1.9 in those reporting their last birth at > or =35 years. No clear association emerged between oral contraceptive use, smoking, education, social class and risk of cervical cancer.

Acute Disease↗