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Biomedical subjects

E Negri

Publications and source records attributed to E Negri.

At least 253 records · Page 14Linked to original sources
PubMed1997

Diabetes mellitus and colorectal cancer risk.

The relationship between diabetes mellitus and the risk of colorectal cancer was investigated in a multicenter case-control study, conducted in Italy between 1992 and 1996 on 1225 cases of incident, histologically confirmed colon cancer, 728 cases of rectal cancer, and 4154 controls, who were in the hospital for acute, nonneoplastic diseases. Overall, 66 (5.4%) cases of colon cancer, 50 (6.9%) cases of rectal cancer, and 185 (4.4%) controls reported a history of diabetes. The corresponding multivariate odds ratios (ORs) were 1.2 [95% confidence interval (CI), 0.8-1.6] for colon, 1.5 (95% CI, 1.1-2.2) for rectal, and 1.3 (95% CI, 1.0-1.6) for all colorectal cancers. No association was observed for subjects who were diagnosed with diabetes at ages of < 40 years (7 cases and 27 controls, OR = 0.9). The OR was 1.4 (95% CI, 1.1-1.7) for subjects who were diagnosed with diabetes at ages of > or = 40 years and were likely to have non-insulin-dependent diabetes. The association was also stronger (OR = 1.6; 95% CI, 1.1-2.3) among subjects whose diabetes was diagnosed 10 or more years in advance and who were > or = 60 years old at the time of colorectal cancer diagnosis. None of the other covariates, including sex, education, body mass index, physical activity, energy intake, alcohol drinking, and fiber intake, showed any appreciable modifying effect. Thus, this uniquely large case-control study of colorectal cancer confirms that subjects with non-insulin-dependent diabetes mellitus have a slightly increased risk of colorectal cancer. More importantly, allowance for a large number of identified potential confounding factors, including body mass index, diet, and physical activity, could not explain the excess colorectal cancer risk among subjects with diabetes mellitus. These findings have plausible biological correlations because insulin-like-growth factor-I is a promoter of colon tumor cell growth in vitro.

Adult↗
PubMed1996

Lactation and the risk of breast cancer in an Italian population.

The relation between breast feeding and breast cancer was investigated in a multicentric case-control study conducted in Italy on 2,167 parous women with histologically confirmed breast cancer, diagnosed within 1 year, and 2,208 parous control women admitted to hospitals in the same catchment areas of cases for acute, non-neoplastic, non-gynecological non-hormone-related diseases. Compared with women who had never tried to lactate, those who had always failed had a multivariate odds ratio (OR; adjusted for parity, education and several other potential confounding factors) of 0.94, and those who had lactated had an OR of 1.17. The multivariate ORs of women who had breast fed 1, 2 and 3 or more children were, respectively, 1.14, 1.18 and 1.32, compared with women who had never lactated. None of these ORs was statistically significant. Compared with women who had never breast fed, the multivariate ORs were 1.19 for women reporting less than 6 months of breast feeding, 1.15 for 6-11 months, 1.34 for 12-17 months, 1.10 for 18-23 months and 0.86 for 24 months or more. No appreciable difference was evident across strata of age, menopausal status, parity and age at first birth, while there was a hint of interaction with education. Our study therefore excluded any appreciable protective role for lactation in breast cancer risk, with the patterns of lactation in this European population, aside from the protective role of parity on breast carcinogenesis.

Adult↗
PubMed1996

Body size indices and breast cancer risk before and after menopause.

The relationship between various body size indices and breast cancer risk before and after menopause was elucidated by means of a case-control study conducted between June 1991 and April 1994 in 6 Italian centers on 2,569 patients aged below 75 with histologically confirmed breast cancer, and on 2,588 controls admitted to the hospital for a wide spectrum of acute, non-neoplastic, non-hormone-related diseases. Weight and, more consistently, body mass index (BMI, kg/m2) at diagnosis were inversely related to pre-menopausal breast cancer risk and directly to post-menopausal risk. An 8-unit increase in BMI resulted in an odds ratio of 0.8 for pre-menopausal and of 1.2 (significant) for post-menopausal women. Risk seemed to increase gradually after menopause in the 7th (OR for an 8-unit BMI increase, 1.3) and 8th decades (OR, 1.6) of life. Conversely, height, waist-to-hip ratio, bra cup size and weight (or BMI) in adolescence and in young adulthood did not exert a significant or consistent influence on breast cancer risk. The apparent relationship with BMI at middle age and weight gain between age 30 years and diagnosis was eliminated by allowance for BMI at diagnosis. The age-related pattern of the association between BMI and breast cancer risk after menopause may reflect a duration-risk relationship, and resembles the effect of post-menopausal estrogen use, which seems greater among older women.

Adult↗
PubMed1996

Age at any birth and breast cancer in Italy.

To provide quantitative information on the role of age at any birth for breast cancer risk, we analyzed data from a cooperative Italian case-control study conducted between 1991 and 1994 on 2,569 incident, histologically confirmed breast cancer cases and 2,588 controls in hospital for acute, non-neoplastic, non-gynecological conditions. A single logistic model was fitted, including terms for number of births, age at each birth and at menarche, plus age and center. Age at first birth was the strongest reproductive determinant of subsequent breast cancer risk, with an estimated increase of 4.6% per year of delay of first birth. This was similar to the influence of age at menarche (4.7% decrease in risk per year of delay of menarche). Ages at subsequent births had an independent effect on breast carcinogenesis, with an estimated 0.7% increase in risk per year of delay. Multiparity showed also an independent protection on breast cancer risk, and a protective effect of parity > or = 3 was evident in all strata of age at first birth: the odds ratio was 0.81 for 3 births and 0.70 for > or = 4 births. However, the effect of parity was determined by the age of occurrence of various births.

Adolescent↗
PubMed1996

Intake of macronutrients and risk of breast cancer.

BACKGROUND: The association between risk of breast cancer and dietary fat and intakes of other energy sources remains controversial. The Italian population offers special opportunities to assess the influence of high intakes of unsaturated fat and starch and, because the population has low awareness of diet and cancer issues, there is less scope for recall bias. We have assessed the relations of various macronutrient intakes with risk of breast cancer. METHODS: In this case-control study, 2569 women with incident breast cancer (median age 55 years) and 2588 control women (median age 56 years) in hospital with acute, non-neoplastic diseases, were interviewed in six different areas of Italy between 1991 and 1994. A validated food-frequency questionnaire was used. It included questions on 78 foods and recipes grouped into six sections, as well as specific questions on individual fat intake pattern. FINDINGS: The risk of breast cancer decreased with increasing total fat intake (trend p 0.01) whereas the risk increased with increasing intake of available carbohydrates (trend p = 0.002). The odds ratios for women in the highest compared with the lowest quintile of energy-adjusted intake were 0.81 for total fat and 1.30 for available carbohydrates. Starch was the chief contributor to the positive association with available carbohydrates. High intakes of polyunsaturated and unsaturated fatty acids (i.e., polyunsaturated fatty acids plus oleic acid) were associated with a decreased risk of breast cancer (odds ratios for highest vs lowest quintile 0.70 and 0.74, respectively). Conversely, the intakes of saturated fatty acids, protein, and fibre were not significantly associated with breast-cancer risk. INTERPRETATION: This case-controls study shows that unsaturated fatty acids protect against breast cancer, possibly because intake of these nutrients is closely correlated with a high intake of raw vegetables. The findings also suggest a possible risk in southern European populations, of reliance on a diet largely based on starch.

Adult↗
PubMed1996

Attributable risks for colorectal cancer in northern Italy.

Using data from a case-control study conducted between 1985 and 1992 in northern Italy on 828 cases of colon cancer, 498 cases of rectal cancer and 2,024 controls in hospital for acute, non-neoplastic, non-digestive tract disorders, we estimated the percent population attributable risk (PAR) for colorectal cancer in relation to beta-carotene, vitamin C (as markers of a diet rich in fruit and vegetables), red meat and seasoning fat intake, daily meal frequency and family history of the disease. On the basis of multivariate odds ratios, adjusted for total calorie intake, a low intake of beta-carotene accounted for 39% of all the cases and a low intake of vitamin C for 14%. These two micronutrients together explained 43% of all colorectal cancer cases in this population. A high frequency of intake of red meat consumption explained 17% of all cases, and a high score of seasoning fats 4%. A higher daily meal frequency was responsible for 13% of the cases, and these 5 dietary factors together explained 63% of colorectal cancer cases in this population. Family history of colorectal cancer accounted for 4% of all cases. These estimates were similar for colon and rectal cancers separately, in males and females, and in younger and elderly subjects, except for seasoning fats and family history, whose PARs were apparently greater for colon cancer and at younger age. Thus, even though available dietary data were limited in several aspects, and the PAR estimates were based on somewhat arbitrary assumptions regarding the exposure distribution, about two-thirds of all colorectal cancers in this population could be explained in terms of a few risk factors or risk indicators considered. This would correspond to the avoidance of a large proportion of the over 18,000 deaths from colorectal cancer registered per year in the whole of Italy.

Adult↗
PubMed1996

Intake of selected micronutrients and the risk of endometrial carcinoma.

BACKGROUND: There is some evidence that dietary habits independent of body mass may influence endometrial carcinoma risk, but the specific aspects of this hypothesis are not yet clear. METHODS: A case-control study was conducted between 1988 and 1994 in the Swiss Canton of Vaud and Northern Italy including 368 patients with histologically confirmed endometrial carcinoma and 713 controls in hospital for acute, nonneoplastic conditions, unrelated to known or potential risk factors for endometrial carcinoma. Multiple logistic regression was used to estimate the odds rations of carcinoma of the corpus uteri according to quintile of intake of the micronutrients considered, and adjusted for potential confounding factors. RESULTS: Total energy intake was directly related to endometrial carcinoma risk. Adjustment for energy substantially modified the estimated odds ratios. After allowance for calories, the relative risk of endometrial carcinoma in the highest quintile of intake, compared with the lowest quintile of intake, was 1.2 for retinol, 0.5 for beta-carotene, 0.6 for ascorbic acid, 1.8 for vitamin D, 0.9 for vitamin E, 2.9 for methionine, 0.7 for folate, and 1.5 for calcium. Allowance for other micronutrients significantly associated with endometrial carcinoma did not substantially modify the risks estimated for beta-carotene, while associations with ascorbic acid were weaker and nonsignificant. CONCLUSIONS: This study suggests that some micronutrients, including beta-carotene, may have a protective effect against endometrial carcinoma.

Aged↗
PubMed1996

Abortion and breast cancer risk.

The relationship between spontaneous and induced abortions and breast cancer risk was analyzed using data from a case-control study conducted between June 1991 and February 1994 in 6 Italian centers 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. One or more abortions were reported by 31% of cases and 32% of controls, corresponding to a multivariate odds ratio (OR) of 1.0 (95% confidence interval [CI], 0.8-1.1). No trend in risk was observed with increasing number of total abortions or spontaneous and induced abortions separately. No significant relationship was found between the risk of breast cancer and history of spontaneous or induced or total abortions in separate strata of age at diagnosis, number of children, time of abortion in relation to first birth and family history of breast cancer. When abortion was the outcome of the first pregnancy, the OR was 1.2 for spontaneous and 1.3 for induced abortion, in relation to women with birth as outcome of the first pregnancy, and 1.0 and 1.1, respectively, when the reference category was nulligravidae. Thus, our results indicate a lack of association between induced and spontaneous abortions and breast cancer risk.

Abortion, Induced↗
PubMed1996

Intake of selected micronutrients and the risk of breast cancer.

To investigate the relation between selected micronutrients and breast cancer risk, we conducted a case-control study of breast cancer between June 1991 and April 1994 in 6 Italian areas. The study included 2569 women admitted to the major teaching and general hospitals of the study areas with histologically confirmed incident breast cancer and 2588 control women with no history of cancer, who were admitted to hospitals in the same catchment areas for acute, non-neoplastic, nongynecological conditions unrelated to hormonal or digestive tract diseases or to long-term modifications of the diet. Dietary habits, including alcoholic beverage consumption, were investigated using a validated food frequency questionnaire, including 78 foods or food groups, several types of alcoholic beverages, some "fat intake pattern" questions and some open sections for foods consumed frequently by the subject and not reported in the questionnaire. To control for potential confounding factors, several multiple logistic regression models were used. When major correlates, energy intake and the mutual confounding effect of the various micronutrients were taken into account, beta-carotene, vitamin E and calcium showed a significant inverse association with breast cancer risk. The estimated odds ratios of the 5th quintile compared to the lowest one were 0.84 for beta-carotene, 0.75 for vitamin E and 0.81 for calcium. No significant association emerged for retinol, vitamin C, thiamin, riboflavin, iron and potassium. Our results suggest that a diet rich in several micronutrients, particularly beta-carotene, vitamin E and calcium, may be protective against breast cancer.

Adult↗
PubMed1996

Nutrition and bladder cancer.

Epidemiologic evidence on the relation between nutrition and bladder cancer is reviewed. A role of diet and nutrition in bladder carcinogenisis is plausible since most substances or metabolites, including carcinogens, are excreted through the urinary tract. Ecologic studies on populations have found positive correlations between fats and oils and bladder cancer, but these are reflected only partly in the international differences in bladder cancer rates, which are systematically higher in Europe than in the United States. Ten case-control and three cohort studies of bladder cancer published in English between 1979 and 1994, and including some information on dietary factors, were reviewed. Of seven studies which considered various types and measures of fruit and vegetable consumption, six found a reduced risk with increasing consumption, which was more consistent for vegetables, with relative risk (RR) estimates between 0.5 and 0.7 for the highest cf the lowest consumption level. There is, therefore, suggestive evidence that a diet rich in fresh fruit and vegetables is a correlate--or an indicator--of reduced bladder cancer risk. No clear association emerged for other foods investigated, including meat and milk. With reference to nutrients, total fat intake was related to bladder cancer risk in three case-control studies, with relative risks between 1.4 and 1.7 for the highest cf the lowest consumption level. However, no relationship between fats and bladder cancer emerged in a cohort study on Japanese-Americans in Hawaii. No consistent association emerged between protein or carbohydrate consumption and bladder cancer risk. Among micronutrients, vitamin A, and particularly carotenoids, showed an inverse association with bladder cancer risk in four case-control studies, including one allowing for a measure of total caloric intake, but were not related consistently in two other studies. There were only scattered and inconclusive data on vitamin C and E. Finally, two studies suggested that calcium and sodium may be related to bladder cancer risk. Thus, available data on diet and bladder cancer are still inconclusive. This is at least partly attributable to the limited number of cohort studies and the paucity of case-control studies, including satisfactorily detailed and validated dietary questionnaires. Despite these limitations, available data suggest that a diet rich in fresh fruit and vegetables, and, hence, possibly in carotenoids, is a correlate of reduced bladder cancer risk.

Animals↗
PubMed1996

Correlates of oral contraceptive use in Italian women, 1991-93.

In order to understand the determinants of oral contraceptive (OC) use in Italy, we analyzed data on 1577 women aged under age 60 (median age 50 years) admitted as controls in a case-control study of breast cancer. Included in this group were women with acute, non-neoplastic, non-gynecologic, non-hormone-related diseases, admitted between 1991 and 1994 to a network of hospitals in six Italian centres. A total of 275 (17.4%) women reported ever OC use. Oral contraceptive use was strongly related to the level of education: in comparison with women reporting < 7 years of schooling, the multivariate odds ratios (OR) of ever OC use were 2.2 and 3.5, respectively, in women reporting 7-11 and > or = 12 years of schooling (chi 1(2) trend 40.87 p < 0.001). OC use was inversely related to body mass index (BMI): in comparison with leaner women (BMI, Kg/m2, < 25), the OR of being an ever OC user was 0.8 and 0.7, respectively, in women with BMI 25-< 30 and > or = 30 (chi 1(2) trend 3.36, p = 0.07). Parous women more frequently tended to be OC users than nulliparous ones, the estimated OR being 2.4 and 2.3, respectively, in women reporting 1 or 2 and 3 or more births in comparison with nulliparae. Likewise, women with history of induced abortions were more frequently ever OC users (OR for > or = 1 induced abortions vs no induced abortion, 1.8, 95% Cl 1.2-2.6). However, no relationship emerged between OC use and history of spontaneous abortions. Finally, there was no relation between pill use and history of hypertension, cholelithiasis, thyroid diseases, hyperlipidemia, family history of breast cancer, uterine fibroids and benign breast disease. Women with a history of diabetes were less likely to be OC users (OR 0.6), but the finding was not significant. The results of this analysis are comparable with those of a study conducted in the same population in the early 1980's, and suggest that sociodemographic and reproductive factors, rather than medical history, are major determinants of OC use in this population.

Adult↗
PubMed1996

Worldwide trends in cancer mortality in the elderly, 1955-1992.

Trends in age-standardised mortality for all cancers and 21 cancers or groups of cancers over the period 1955-1992 were analysed for 33 countries from four continents in a population aged 65-84 years. Mortality from all neoplasms in the elderly showed heterogeneous patterns in various countries and in the two sexes. Trends were generally more favourable for females than for males, reflecting essentially the earlier and more extensive impact of the lung cancer (and other tobacco-related neoplasms) epidemic in elderly males, in addition to the earlier decline of gastric cancer and a widespread decline of cervical cancer rates in females. In several countries, particularly from western Europe, but also Japan, cancer mortality trends were more favourable over the last two decades than in earlier calendar periods. Some countries of northern and central Europe (including Finland, Germany, Austria and Switzerland) showed stable or even downward trends over time for total cancer mortality in both sexes, particularly in males. This reflects the different patterns of the tobacco-related (lung) cancer epidemic in various countries, and the impact of a few other major neoplasms, including in particular the systematic downward trends in stomach cancer. In contrast, rates were moderately upwards in males in North America, and several countries of southern and eastern Europe, where cancer mortality in the elderly was comparatively low in the 1950s, showed appreciable upward trends, mostly in males. Thus, there was a generalised tendency towards a levelling of the differences in certified cancer mortality in the elderly population in various areas of the world. Although there are substantial limits and uncertainties in the reliability and validity of cancer death certification and their trends in the elderly, there is no widespread and generalised upward trend in cancer mortality, with a major exception of lung and other tobacco-related neoplasms. Furthermore, in several countries, cancer mortality trends over the last four decades have been favourable for elderly women.

Aged↗
PubMed1996

The role of reproductive and menstrual factors in cancer of the breast before and after menopause.

The aim of the study was to elucidate the role of reproductive and menstrual factors in the aetiology of breast cancer, overall and by menopausal status. A cooperative case-control study was conducted between 1991 and 1994 in six different Italian areas (including three from the centre and the south). The study included 2569 histologically confirmed incident cases of breast cancer (median age 55 years, range 23-78 years) and 2588 control women (median age 56 years, range 20-79 years) admitted to the same hospitals for a variety of acute conditions unrelated to the hypotheses in study. A trend of increasing risk with increasing age at menopause (odds ratio (OR) for age at menopause > or = 53 versus < 45 years = 1.8; 95% confidence interval (CI) = 1.4-2.2). High parity reduced cancer risk (OR for > or = 4 versus 1 birth = 0.7; 95% CI = 0.5-0.9). Overall, nulliparous women showed a 20% lower risk than uniparous ones (OR = 0.8; 95% CI = 0.7-1.0). Late age at first birth (or pregnancy) had an independent adverse effect (OR for first birth at > or = 32 versus < 20 years = 1.7; 95% CI = 1.3-2.1) both before and after menopause. An approximately 2-fold elevation of breast cancer risk was evident up to 10 years after the last birth. No trend in risk was evident for induced abortions (OR = 1.2 for 1 and 1.1 for > or = 2 induced abortions versus 0). Other examined menstrual and reproductive characteristics did not seem important. Multiparity, early age at first birth and early age at menopause were therefore the most important determinants of breast cancer risk. The effects of the timing of births was significantly heterogeneous in pre- and postmenopausal women because of the transient adverse effect of such events, evident only in premenopausal women.

Adult↗