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Biomedical subjects

E Negri

Publications and source records attributed to E Negri.

At least 217 records · Page 12Linked to original sources

Selected micronutrient intake and thyroid carcinoma risk.

BACKGROUND: Protection from thyroid carcinoma due to certain dietary factors was suggested by several studies, but the findings were relatively inconsistent. The role of micronutrients has not yet been systematically analyzed. To investigate the relationship between micronutrient intake and thyroid carcinoma risk, the authors used data from a case-control study conducted in northern Italy between 1986 and 1992. METHODS: The study included 399 incident, histologically confirmed thyroid carcinoma cases and 617 controls admitted to the hospital for acute, nonneoplastic, nonhormone-related diseases. RESULTS: Retinol intake showed a direct association with thyroid carcinoma risk, with odds ratios (ORs) of 1.39 (95% confidence Interval [CI], 0.9-2.0) in the third quartile of consumption and 1.52 (95% CI, 1.0-2.3) in the highest quartile, whereas beta-carotene had an inverse relationship, with ORs of 0.63 (95% CI, 0.4-0.9) in the third quartile of consumption and 0.58 (95% CI, 0.4-0.9) in the highest quartile compared with the lowest quartile. Some protection was observed for measures of vitamin C intake (with an OR of 0.72) and vitamin E (with an OR of 0.67) for the highest quartile of consumption, although the estimates were not statistically significant, and were reduced after adjustment for beta-carotene intake. No clear pattern in risk appeared for vitamin D, lolate, calcium, thiamin, or riboflavin. The inverse relationship between beta-carotene and thyroid carcinoma was observed in both papillary and follicular carcinomas. CONCLUSIONS: In this study, a significant inverse association between beta-carotene and thyroid carcinoma was observed, and some protection against thyroid carcinoma from vitamins C and E was also suggested.

Adolescent↗

Attributable risks for breast cancer in Italy: education, family history and reproductive and hormonal factors.

The percent population attributable risk (AR) for breast cancer was estimated in relation to education, family history of the disease and some reproductive and hormonal factors, using data from a case-control study conducted between June 1991 and February 1994 in 6 Italian centres on 2,569 histologically confirmed incident breast cancer cases and 2,588 controls, admitted to hospital for a wide range of acute, non-neoplastic, non-hormone-related diseases. On the basis of multivariate odds ratios, a high level of education accounted for 20% of cases, elevated age at first birth and nulliparity for 38% and a family history of breast cancer in first-degree relatives for 7%. Education and nulliparity and age at first birth together explained 47% of all breast cancer cases, and the combination of these 2 factors plus a family history of the disease explained 50% of cases. In pre-menopausal women a high level of education accounted for 31% of all breast cancer cases, older age at first birth for 44% and the combination of the 2 factors for 49%. In post-menopausal women the corresponding values were 13%, 31% and 42%; further addition of risk associated with family history of the disease explained 52% of pre-menopausal cases. In post-menopausal women older age at menopause and the use of hormone replacement therapy accounted for 15% and 2% of breast cancer cases, respectively. The combination of risks associated with a high level of education, old age at first birth and nulliparity and older age at menopause accounted for 51% of cases; further inclusion of risk associated with use of hormone replacement therapy explained 52%, and the AR resulting from these 4 risk factors combined plus a family history of breast cancer was 56%. Thus, a few selected and well-identified risk factors explain about one-half the breast cancer cases in this Italian population.

Age Factors↗

Cancer mortality among rice growers in Novara Province, northern Italy.

Some excess of non-Hodgkin lymphomas (NHL) and soft tissue sarcomas (STS) was reported in the literature among agricultural workers, mainly in relation to exposure to phenoxyacids and chlorophenols. In this study, information was analyzed for a cohort of rice growers that comprised 1,493 subjects, and for a follow-up that was more than 99% complete with regard to both traced subjects and known causes of deaths. A total of 960 subjects (65%) died during the observation period (1957-1992). Lower than expected standardized mortality ratios (SMRs) were found for all causes, for cardiovascular diseases (especially ischemic heart disease) and for all cancers. Slightly increased SMRs were found for some cancer sites (oral cavity, esophagus, liver, intestines, pancreas, bladder, STS, and NHL), although none of these was statistically significant in the overall analysis. An excess risk of close to statistical significance was found for NHL among workers with longer exposure during the period when phenoxyacid herbicide was in use (1950-1992). Thus, a prolonged follow-up is advisable. At present the study should be evaluated in the context of the data set suggesting a tendency toward an increased risk of NHL among farmers.

Adult↗

Hysterectomy, oophorectomy in premenopause, and risk of breast cancer.

OBJECTIVE: To analyze the risk of breast cancer in women who underwent pelvic surgery in premenopause using data from two case-control studies conducted between 1983 and 1994 in six Italian centers. METHODS: Subjects were 5984 women with histologically confirmed breast cancer diagnosed within the year before interview who were admitted to the major teaching and general hospitals in the areas included in the studies. Controls were 5504 women who resided in the same geographic areas and were admitted for acute conditions to the same network of hospitals in which cases had been identified. Women were not included if they had been admitted for gynecologic, hormonal, or neoplastic disease. RESULTS: A total of 719 cases (12%) and 801 controls (15%) underwent pelvic surgery before menopause. The risk of breast cancer was reduced in women who underwent bilateral oophorectomy with hysterectomy (odds ratio [OR] adjusted for age, calendar year at interview, study, and center, 0.8, 95% confidence interval [CI] 0.7, 0.9) and hysterectomy alone (OR 0.7, 95% CI 0.6, 0.8). The protection tended to increase with time since surgery, but no relationship emerged when age at menopause was included in the analysis. No clear relationship emerged between time since unilateral oophorectomy with or without hysterectomy or since hysterectomy alone and breast cancer risk. CONCLUSION: The risk of breast cancer is lower in women who undergo bilateral oophorectomy before menopause, and the protection increases with time from surgery.

Adult↗

Attributable risks for hepatocellular carcinoma in northern Italy.

The population attributable risks (ARs) for hepatocellular carcinoma (HCC) were estimated in relation to low education level, heavy alcohol consumption, low vegetable and fruit intake, history of hepatitis, diabetes, liver cirrhosis and oral contraceptive use, using data from a case-control study conducted between 1984 and 1993 in Northern Italy. Cases were 320 patients (235 males and 85 females) with histologically or serologically confirmed HCC, and controls were 1408 patients (1031 males and 377 females) admitted to the same network of hospitals for acute, non-neoplastic or non-digestive tract conditions, unrelated to any of the known or likely risk factors for primary liver cancer. The ARs were 40% for low vegetable and fruit consumption, 31% for low education, 18% for liver cirrhosis, 16% for hepatitis, 8% for diabetes and 7% for heavy alcohol consumption. Together, these factors explained 74% of hepatocellular cancer cases. Compared with females, males had higher ARs for cirrhosis (21% versus 11%), diabetes (10% versus 2%) and heavy alcohol consumption (9% versus 1%). The percentage of HCC attributable to all factors considered together was 78% for males and 67% for females. Thus, even if available information on hepatitis and dietary factors was limited, and the AR estimates were based on several arbitrary assumptions, available knowledge could, in principle, reduce the burden of the disease in Italy from 3300 deaths to approximately 750 for males, and from 1600 to approximately 500 for females.

Adult↗

Ovarian cancer risk and history of selected medical conditions linked with female hormones.

To investigate the role of selected medical conditions on the risk of ovarian cancer, we analysed data from a case-control study. Cases were 971 women below the age of 75 years with histologically confirmed epithelial ovarian cancer, admitted to a network of hospitals including the major teaching and general hospitals in the greater Milan area. Controls were 2758 women admitted to the same network of hospitals for acute, non-gynaecological, non-hormone related, non-neoplastic conditions. Obesity/severe overweight were inversely associated with the risk of ovarian cancer (multivariate relative risk, RR, 0.66, 95% confidence interval, CI, 0.52-0.85). Hyperlipidaemia was also inversely related to ovarian cancer risk, (RR 0.64, 95% CI 0.45-0.89). No relationship emerged between ovarian cancer risk and diabetes (RR 0.80, 95% CI 0.54-1.19), hypertension (RR 0.85, 95% CI 0.68-1.06), thyroid diseases (RR 0.89, 95% CI 0.63-1.13) and cholelithiasis (RR 0.86, 95% CI 0.66-1.12). A decreased frequency of ovarian cancer was seen in women with a history of uterine leiomyomas (RR 0.66, 95% CI 0.47-0.92) and benign ovarian cysts (RR 0.69, 95% CI 0.41-1.13).

Adult↗

Epidemiology and prevention of oral cancer.

Descriptive epidemiology of oral and pharyngeal cancer over the last four decades is reviewed, with specific focus on Europe. Substantial rises in mortality rates have been observed for younger males, mostly in eastern Europe. The independent role of alcohol and tobacco and their interaction on oral carcinogenesis is discussed, since these factors account for about three quarters of oral cancers in Europe. The influence of dietary factors, and in particular of a diet poor in fresh fruit and vegetables on oral carcinogenesis, is also discussed, since diet may account for 10-15% of oral cancer cases in Europe. Finally, among other carcinogens, the possibility of human papillomavirus involvement in the aetiology of cancer of the oral cavity and pharynx is overviewed. Implications for prevention are discussed.

Adult↗

Quitting smoking in northern Italy: a cross-sectional analysis of 2621 subjects.

To describe the relationship between sociodemographic factors, life-style habits, selected dietary indicators, smoking-related variables, and quitting smoking we analyzed data derived from the comparison group of a case-control study of colorectal and breast cancers based on a network of teaching and general hospitals in Northern Italy. A total of 2621 subjects (1215 women and 1406 men) who were ever cigarette smokers were included for analysis. Age-adjusted rates of stopping smoking (quit rates) and multivariate odds ratios (OR) of quitting smoking were computed. The overall age-adjusted quit rate was 38.6% for males and 24.9% for females, corresponding to an OR of quitting of 0.6 (95% CI: 0.5-0.7) for females vs males. The quitting rate increased with increasing age. After allowing for age, smoking cessation was more frequently reported by more educated or higher social class individuals. No relationship was present between quitting smoking and alcohol consumption, but quitting smoking was inversely related to coffee consumption. The probability of quitting smoking increased directly with number of cigarettes among males but not among females, who showed a J-shaped pattern. Older, heavy smokers were more likely to give up smoking. A general pattern of increasing rates of quitting smoking with higher consumption of vegetables and fruit, and hence beta-carotene, was present. This study confirms a positive association between quitting smoking and increasing age, higher education, low coffee consumption, heaviness of smoking and high consumption of vegetables and fruit.

Adult↗

Beta-carotene intake and risk of nonfatal acute myocardial infarction in women.

There are indications that beta-carotene, but not pre-formed vitamin A, is protective on the risk of acute myocardial infarction (AMI). The relationship between nonfatal AMI and the intake of beta-carotene and retinol was investigated in a case-control study conducted between 1983 and 1992 in northern Italy on 433 women with nonfatal AMI and 869 controls in hospital for acute, non-cardiovascular, non-neoplastic, non-digestive, non-hormone related conditions. Odds ratios (OR), with their 95% confidence intervals (CI), were computed by unconditional multiple logistic regression analysis, including terms for age, education, body mass index, smoking, alcohol and coffee drinking, menopausal status, hormone replacement therapy and history of diabetes, hypertension and hyperlipidemia. The risk of AMI was inversely related to beta-carotene intake, with an OR of 0.5 (95% CI: 0.3 to 0.8) for the highest quintile of intake compared to the lowest (chi2 trend = 10.53, p < 0.01). Retinol intake was not associated with AMI, with an OR of 0.9 (95% CI: 0.6 to 1.3) for the highest quintile of intake compared to the lowest. Analysis in separate strata of covariates indicated that the inverse association of beta-carotene intake with risk of AMI was appreciably stronger in younger, lean women with no history of diabetes or hypertension, and in current smokers. The results of this study indicate that the risk of nonfatal AMI in women is inversely related to intake of beta-carotene containing foods, but not foods containing retinol.

Adolescent↗

Risk factors for colorectal cancer in subjects with family history of the disease.

The relationship between lifestyle factors, past medical conditions, daily meal frequency, diet and the risk of 'familial' colorectal cancer has been analysed using data from a case-control study conducted in northern Italy. A total of 1584 colorectal cancer patients and 2879 control subjects were admitted to a network of hospitals in the Greater Milan area and the Pordenone province. The subjects included for analysis were the 112 cases and the 108 control subjects who reported a family history of colorectal cancer in first-degree relatives. Colorectal cancer cases and control subjects with family history were similarly distributed according to sex, age, marital status, years of schooling and social class. Familial colorectal cancer was associated with meal frequency, medical history of diabetes (relative risk, RR = 4.6) and cholelithiasis (RR = 5.2). Significant positive trends of increasing risk with more frequent consumption were observed for pasta (RR = 2.5, for the highest vs the lowest intake tertile), pastries (RR = 2.4), red meat (RR = 2.9), canned meat (RR = 1.9), cheese (RR = 3.5) and butter (RR = 1.9). Significant inverse associations and trends in risk were observed for consumption of poultry (RR = 0.4), tomatoes (RR = 0.2), peppers (RR = 0.3) and lettuce (RR = 0.3). Significant inverse trends in risk with increasing consumption for beta-carotene and ascorbic acid were observed (RR = 0.5 and 0.4 respectively, highest vs lowest intake tertile). These results suggest that risk factors for subjects with a family history of colorectal cancer in first-degree relatives are not appreciably different from recognized risk factors of the disease in the general population.

Aged↗

Selected medical conditions and risk of breast cancer.

Several diseases are known or suspected to be associated with altered levels of hormones and growth factors that may influence breast cancer risk. To elucidate this possibility, we studied the relationship between 23 medical conditions or procedures and breast cancer risk by means of data from a multicentric case-control study conducted between 1991 and 1994 in six Italian areas. The study included 2569 histologically confirmed incident cases of breast cancer (median age 55 years, range 23-74 years) and 2588 control women (median age 56 years, range 20-74 years) admitted to the same hospitals as cases for a variety of acute conditions unrelated to known or suspected risk factors for breast cancer. After allowance for education, parity and body mass index, elevated odds ratios (ORs) emerged for history of diabetes mellitus in post-menopausal women (OR = 1.5, 95% CI 1.1-2.0), hypertension in pregnancy (OR = 1.8, 95% CI 1.0-3.4) and breast nodules (OR = 1.3, 95% CI 1.0-1.7). Risk decreases were associated with ovarian ablation for ovarian cysts (OR = 0.5, 95% CI 0.3-0.7) and with thyroid nodules (OR = 0.7, 95% CI 0.5-0.9) but not with the combination of any type of benign thyroid disease. While most examined conditions seemed unrelated to breast cancer risk, the association with late-onset diabetes is of special interest as it suggests a role of hyperinsulinaemia and insulin resistance in breast cancer promotion. It also points to preventive lifestyle modifications.

Adult↗

Aspirin and colorectal cancer.

The relationship between aspirin use and colorectal cancer risk was examined by a case-control study in Italy. Regular aspirin use was reported by only 47 (3.5%) cases and 77 (4.1%) control subjects, giving a multivariate odds ratio (OR) of 0.7 (95% CI 0.5-1.0) after allowance for education, physical exercise and selected dietary factors.

Adult↗

Body mass index and post-menopausal breast cancer: an age-specific analysis.

The relationship between body mass index (BMI, Quetelet's index, kg m(-2)) and post-menopausal breast cancer risk was considered in age-specific strata on the basis of a pooled analysis of three Italian case-control studies, including a total of 3108 post-menopausal breast cancer patients aged 50 years or over and 2664 control subjects. Overall, there was a moderate, but significant, association between BMI and post-menopausal breast cancer: the odds ratios (ORs) were around 1.3 for the three intermediate quintiles compared with the lowest one, and 1.4 for the highest one. The association was moderate among women aged 50-59 years and 60-69 years, with ORs around 1.3 for the highest BMI quintiles, but stronger among elderly women, with ORs of 1.6 for the fourth and 2.1 for the fifth quintile. An 8-unit increase in BMI involved an OR of 1.18 at age 50-59 years, of 1.14 at age 60-69 years and of 1.59 above age 70 years. This pattern of risk is similar to that observed for post-menopausal hormone replacement treatment and is consistent with a duration-risk relationship in the exposure to high oestrogen levels and with a greater differential in oestrogen levels in overweight elderly women. In terms of population attributable risk, 19.6% of all post-menopausal breast cancer patients and 27.1% of those in women above age 70 years were attributable to overweight and obesity in this population. This has, therefore, major preventive implications as to reduce breast cancer risk late in life, it is essentially important to control weight gain in elderly women.

Age Factors↗

Margarine intake and risk of nonfatal acute myocardial infarction in Italian women.

OBJECTIVES: Since a relation between trans-fatty acids and cardiovascular diseases has been described, we examined the relationship between margarine intake and nonfatal acute myocardial infarction (AMI) in Italian women. DESIGN: Hospital-based case-control study. SETTING: Northern Italy between 1983 and 1992. SUBJECTS: Cases were 429 women, aged 18-74 y, in hospital with diagnosis of AMI and 866 controls in hospital for acute, non-cardiovascular, non-neoplastic, non-digestive, non-hormone-related conditions. ANALYSIS: Odds ratios (OR), with their 95% confidence intervals (CI), were computed by unconditional multiple logistic regression analysis, including terms for age, education, body mass index, smoking, alcohol and coffee drinking, menopausal status, hormone replacement therapy and history of diabetes, hypertension and hyperlipidemia. RESULTS: Medium or high intake of margarine was associated with an increased risk of AMI (multivariate OR 1.5, 95% CI 1.0-2.2). Analysis in separate strata of covariates indicated that the association was independent of body mass index, history of hypertension and hyperlipidemia, and was greater in older women and in current smokers. CONCLUSIONS: If real, the association with margarine could explain about 6% of AMI in this population of Italian women.

Adolescent↗

Case-control study on influence of methionine, nitrite, and salt on gastric carcinogenesis in northern Italy.

A new mutagen, 2-chloro-4-methylthiobutanoic acid, has recently been identified from a nitrite-treated Japanese salted fish. Its structure suggests that it derives from methionine in the presence of salt and nitrite. We thus considered the interaction between intake of methionine, salt, and nitrites on gastric cancer risk using data from a case-control study conducted in Northern Italy on 746 cases of incident histologically confirmed gastric cancer and 2,053 controls in hospital for acute nonneoplastic nondigestive tract disorders. Compared with subjects reporting low-methionine and low-salt intake, the odds ratios (ORs) were 2.4 [95% confidence interval (CI) = 1.5 - 4.0] for those reporting low-salt and high-methionine, 1.5 (95% CI = 1.0 - 2.2) for those with high-salt and low-methionine, and 2.8 (95% CI = 1.9 - 4.2) for those with high-salt and high-methionine intake. Likewise, with reference to nitrites, compared with subjects with low-methionine and low-nitrite intake, the ORs were 1.9 (95% CI = 1.3 - 2.6) in the high-methionine and low-nitrite stratum, 1.5 (95% CI = 1.0 - 2.1) in the low-methionine and high-nitrite stratum, and 2.5 (95% CI = 1.9 - 3.2) in the high-methionine and high-nitrite stratum. All these estimates were statistically significant. Thus the present findings from a large case-control study conducted in a relatively high-incidence area for gastric cancer suggest that a diet rich in methionine, salt, and nitrite is associated with increased gastric cancer risk.

Adult↗

Alcohol consumption and risk of pancreatic cancer.

The relation between pancreatic cancer and alcohol consumption was investigated in a case-control study conducted in Milan, Northern Italy, between 1983 and 1992 on 361 incident histologically confirmed cases and 997 controls admitted to hospital for acute nonneoplastic diseases apparently unrelated to alcohol and tobacco consumption. Compared with teetotalers, the multivariate odds ratio (OR) of pancreatic cancer, after adjustment for age, sex, education, smoking status, and history of diabetes, pancreatitis, and cholelithiasis, were 0.9 for alcohol drinkers and 0.9, 1.1, 1.4, and 1.1 for those who consumed up to four, more than four to seven, more than seven to eight, or more than eight alcoholic drinks per day; none of the estimates or the trend in risk was significant. OR were also close to unity in the separate analysis of wine, beer, and spirit intake, with no trend in risk, and no relationship was observed for duration of use (OR = 0.7 for > 40 yrs of use). No interaction was observed between pancreatic cancer and total alcohol intake in separate strata of age, sex, education, and smoking status. Thus the findings of the present study, on the basis of a population with relatively frequent and high alcohol consumption, provide epidemiologic evidence that even high alcohol intake does not appreciably modify the risk of pancreatic cancer.

Aged↗