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Biomedical subjects

E Negri

Publications and source records attributed to E Negri.

At least 343 records · Page 19Linked to original sources
PubMed1994

Attributable risk for laryngeal cancer in northern Italy.

Using data from a case-control study conducted between 1986 and 1992 in Northern Italy on 367 cases of laryngeal cancers (350 men and 17 women) and 1931 hospital controls (1373 men and 558 women), we estimated the relative risks (RR) and the population attributable risks (AR) for laryngeal cancer in relation to tobacco and alcohol consumption and a diet containing little fresh fruit and vegetables (low beta-carotene intake). In men, the RR and their 95% confidence interval (CI), derived from multiple logistic regression, including terms for center, age, and education, plus, simultaneously, tobacco, alcohol, and beta-carotene) were 3.3 (95% CI, 1.9 to 5.5) for ex- or moderate smokers (< 15 cigarettes/day) and 8.8 (95% CI, 5.2 to 14.8) for heavy current smokers compared to never smokers; the RR were 1.5 (95% CI, 1.0 to 2.2) for drinkers of 6 to < 8 alcoholic drinks/day and 2.2 (95% CI, 1.6 to 3.0) for drinkers of 8 or more drinks/day compared to teetotallers or moderate drinkers; with respect to carotene intake the RR were 1.4 (95% CI, 1.0 to 2.0) for the intermediate tertile and 1.8 (95% CI, 1.3 to 2.5) for the lowest tertile, as compared to the highest tertile of intake. AR were estimated assuming a multiplicative model: the single factor with the largest AR was smoking, which accounted for about 77% of laryngeal cancers in men; alcohol intake explained about 25% of cases, low beta-carotene intake accounted for about 18% of cases, and together the three factors were responsible for about 86% of laryngeal cancers in men.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Alcohol and cancers of the upper aerodigestive tract in men and women.

In order to explore the potential differences in the effect of alcohol in men and women we took advantage of a case-control study of upper aerodigestive tract tumors conducted between 1986 and 1991 in Northern Italy Five hundred forty-six incidence cases of cancer of the oral cavity and pharynx (of whom 81 were women), 410 of cancer of the esophagus (of whom 67 were women), and 388 with cancer of the larynx, (of whom 19 were women) were interviewed. The control group included 2263 inpatients (of whom 557 were women) with acute conditions unrelated to alcohol and tobacco consumption. Among alcohol drinkers, similar odds ratios were detected in men and women. In the highest, well comparable intake category (i.e., > or = 42 drinks/week in women and 42-55 drinks/week in men), odds ratios were 4.5 and 3.8 for cancer of the oral cavity and pharynx, 3.0 and 4.7 for cancer of the esophagus, and 2.6 and 2.0 for cancer of the larynx in women and men, respectively, as compared to light drinkers. However, for all cancer sites a reduced risk was found among abstaining women but not in abstaining men, when compared with light-to-moderate drinkers. The present study, therefore, does not support the hypothesis that women may be substantially more vulnerable than men to alcohol carcinogenesis, at least at the level of the upper aerodigestive tract.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Alcohol consumption and risk of prostate cancer.

Because alcohol influences metabolism and serum levels of sex hormones and specifically increases metabolic clearance of testosterone, some role of alcohol consumption in the process of prostatic carcinogenesis is biologically plausible. The relationship between prostate cancer and total alcohol consumption was therefore investigated in a case-control study conducted in Northern Italy between 1985 and 1992 on 281 cases and 599 controls admitted to hospital for acute nonneoplastic diseases apparently unrelated to alcohol and tobacco consumption. No noteworthy relationship was found for major measures of alcohol intake: compared with teetotallers, the multivariate relative risks (RRs) of prostate cancer, after adjustment for age, study center, education, marital status, body mass index, and smoking status, were 1.3, 0.9, 1.2, and 1.1, respectively, for men drinking fewer than three, three to less than five, five to less than eight, or more than eight alcoholic beverages per day. None of the estimates was significant, nor was the trend in risk significant. Multivariate risks were also close to unity in the separate analysis of intake of wine (RR = 1.2 and 0.9 for < 5 and or = 5 drinks/day, respectively, compared with wine abstainers), beer (RR = 1.1 for beer drinkers compared with beer abstainers), and spirit (RR = 0.8 for spirit intake compared with beer abstainers). No relationship was observed with duration of use (< 40 and > or = 40 yrs, multivariate RRs = 1.1 and 1.3, respectively), and the alcohol-related risk estimates were similar for men < 70 and > or = 70 years of age.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Risk factors for esophageal cancer in women in northern Italy.

BACKGROUND: The incidence of esophageal cancer in women in Italy is low, and its risk factors have not been studied extensively. METHODS: The relationship between risk of esophageal cancer and frequency of consumption of tobacco, alcohol, and a few selected dietary items was studied in 57 Italian women with histologically confirmed incident cancers of the esophagus and 344 hospital control patients, using data from a case-control study conducted in Milan, Italy, 1984-1991. RESULTS: The major risk factor for cancer of the esophagus in Italian women was cigarette smoking (relative risk [RR], 1.5 for < 15 cigarettes/day, 95% confidence interval [CI], 0.6-3.8; and RR, 4.8 for > or = 15 cigarettes/day, 95% CI, 2.2-10.3; compared with those who never smoked), followed by elevated alcohol consumption (RR, 2.3; 95% CI, 1.0-5.4 for three or more drinks/day, relative to teetotalers), which together explained more than 50% of cases. Among dietary items, high intake of fresh fruit showed a statistically significant protective effect (RR, 0.4; 95% CI, 0.2-0.9 for the highest versus the lowest tertile of intake). There was an inverse relationship with an estimate of beta-carotene intake (RR, 0.5; 95% CI, 0.2-1.0 for the highest versus the lowest level of intake). No association was evident with preformed vitamin A (retinol). CONCLUSION: On a population scale, tobacco is the major risk factor for esophageal cancer in Italian women. Although the incidence of esophageal cancer is much lower in women than in men, major risk and protective factors are similar for both sexes.

Adult↗
PubMed1993

Tar yield of cigarettes and risk of acute myocardial infarction. GISSI-EFRIM Investigators.

OBJECTIVE: To analyse the relation between tar and nicotine yield of cigarettes smoked in the recent past and the risk of myocardial infarction. DESIGN: Multicentre case-control study conducted between September 1988 and June 1989. SETTING: Over 80 coronary care units in various Italian regions. SUBJECTS: 916 patients with acute myocardial infarction without history of ischaemic heart disease and 1106 controls admitted to hospital for acute conditions not related to known or suspected risk factors for ischaemic heart disease. MAIN OUTCOME MEASURES: Relative risk of myocardial infarction according to type of cigarette smoked adjusted for identified potential confounding factors. Brands of cigarettes classified according to yield of tar and nicotine. RESULTS: Patients with acute myocardial infarction were more often smokers and among smokers they tended to smoke more cigarettes. Compared with non-smokers their estimated relative risks were 3.8, 4.3, 3.2, and 3.7 in the four categories of tar yield (< 10, 10-15, > 15-20, and > 20 mg, respectively). No trend in risk across yields was evident when analysis was restricted to smokers and allowance was made for number of cigarettes. Compared with risks in subjects in the lowest category of tar yield the relative risks were 1.2, 0.8, and 1.0 for the subsequent yields. Compared with risks in non-smokers the relative risks ranged from 9.3 to 12.6 below the age of 50 but no trend was observed with increasing yield. CONCLUSIONS: Changing to cigarettes with a lower tar yield is not an effective means of reducing tobacco related morbidity from myocardial infarction.

Adult↗
PubMed1993

Dietary factors and the risk of endometrial cancer.

BACKGROUND: Endometrial cancer is associated with overweight, but little is known on its possible relationship with specific aspects of diet. METHODS: The relationship between dietary factors and the risk of endometrial cancer was investigated in a case-control study conducted in Switzerland and Northern Italy on 274 patients with histologically confirmed endometrial cancers and 572 control subjects admitted to the hospital for acute nongynecologic disorders that were not hormone related, metabolic, or neoplastic. RESULTS: Significant direct associations were observed with (1) the total energy intake (odds ratio [OR] for the highest versus the lowest consumption tertile = 2.7) and, after allowance for energy intake, (2) the frequency of consumption of most types of meats, eggs, beans or peas, added fats (OR for total added fat = 2.5), and sugar (OR = 2.5). Significant protection, of the order of 40-60% reduction in the highest versus the lowest consumption tertile, was conferred by elevated intake of most vegetables and fresh fruit and whole grain bread and pasta. This was reflected in the low OR for the highest tertiles of intake of beta-carotene and ascorbic acid (OR for the highest versus the lowest consumption tertile after allowance for energy intake = 0.5). CONCLUSIONS: The current study suggests that, aside from the predictable adverse effects of overeating and consequent overweight, some qualitative aspects of the habitual diet may also be associated with the risk of endometrial cancer, chiefly, the intake of animal proteins and fat (directly) and of fresh fruit, vegetables, and fibers (inversely).

Adult↗
PubMed1993

Long-term impact of reproductive factors on cancer risk.

The relationship between reproductive variables (parity, age at first birth, number of induced and spontaneous abortions) and cancer risk has been analysed using data from an integrated series of case-control studies conducted in northern Italy between 1983 and 1992. The overall data-set included women below age 75 with histologically confirmed cancers of the following sites: oesophagus, 58; stomach, 280; colon, 405; rectum, 210; liver, 82; gall-bladder, 29; pancreas, 129; breast, 3,415; cervix, 742; endometrium, 725; ovary, 953; bladder, 68; kidney, 56; thyroid, 180; lymphomas, 80; myelomas, 57; and a total of 5,619 controls admitted to hospital for acute non-neoplastic, non-gynaecological, non-hormone-related conditions. Multivariate odds ratios, as estimators of relative risks (RR), were obtained after allowance for age, education, use of oral contraceptives and oestrogen replacement treatments, plus various reproductive factors. Direct significant trends with parity were observed for cancer of the liver (RR for women with > or = 4 births vs. nulliparae = 3.3) and cervix uteri (RR = 4.1). The risk of gall-bladder cancer was also elevated for multiparae (RR = 1.9). No significant inverse trend in risk emerged. However, the RRs in multiparae were significantly below unity for breast (RR = 0.8), endometrium (RR = 0.7), and ovary (RR = 0.8). With reference to age at first birth, a significant trend in risk was observed for breast cancer (RR = 1.4 for 25 to 29 and 1.5 for > or = 30 vs. < 25 years). In contrast, the risk of cervical cancer was inversely related to age at first birth. For spontaneous abortions, the only significant inverse trend was for ovarian cancer (RR = 0.7 for > or = 2 vs. 0 abortions), but also the point estimate for endometrial cancer in women with > or = 2 abortions was below unity. For induced abortions, there was a strong inverse trend in risk for endometrial cancer (RR = 0.5), and the RRs were below unity also for colon and breast cancer. In contrast, cervical cancer was directly associated with the number of spontaneous abortions. Although the underlying aetiological interpretations are different for various cancer sites, this study provides, in a large and uniform data-set, quantitative information on the long-term impact of reproductive factors on cancer risk.

Abortion, Induced↗
PubMed1993

Determinants of invasive vulvar cancer risk: an Italian case-control study.

Risk factors for vulvar cancer have been evaluated in a case-control study conducted between 1987 and 1990 in northern Italy on 73 women with histologically confirmed invasive vulvar cancer and 572 control subjects in hospital for acute nongynecological, nonneoplastic non-hormone-related conditions. The risk of vulvar cancer was inversely related to education level: with reference to women reporting less than 7 years of schooling, the relative risk estimates were 0.6 and 0.4, respectively, in those reporting 7 to 11 and 12 or more years of schooling (chi 2(1) trend = 4.91 P = 0.03). No relationship emerged between number of births and spontaneous or induced abortions. Parous women reporting late first birth tended to be at lower risk (relative risk = 0.5, 95% confidence interval 0.3 to 1.1 for < 25 vs > or = 25 years at first birth), but there was no evidence of the risk to decrease with increasing age at first birth. The risk of vulvar cancer increased with body mass index, but the trend in risk was not significant after taking into account potential confounders in the multivariate analysis. No association emerged with indicators of sexual habits, menstrual history, and smoking. The risk of the disease was lower in women reporting Pap smears during their life and diminished with increasing number of cervical smears and decreasing recency of last Pap: compared to women reporting no Pap screening, it was 0.5 in those who reported one smear and 0.3 in those with two or more.

Adult↗
PubMed1993

HPV, HIV infection, and risk of cervical intraepithelial neoplasia in former intravenous drug abusers.

The relation between human immunodeficiency virus (HIV), human papilloma virus (HPV) infection, sexual habits, reproductive history, and risk of cervical intraepithelial neoplasia (CIN) has been analyzed in a cross-sectional study conducted since 1986 among female former intravenous drug abusers attending for the first time to the Colposcopic Unit of the Ospedale Luigi Sacco of Milan and women consecutively admitted to the Community for Past Drug Abusers, S. Patrignano, Rimini. A total of 434 subjects entered the study; of those 128 (30%) had a diagnosis of CIN. Compared with HIV-negative subjects, odds ratio (OR) of CIN was 8.0 (95% confidence interval (CI) 4.6-14.1) for HIV-positive ones and the frequency of CIN 2 and 3 was higher in HIV-positive than that in HIV-negative subjects (chi 2(1), trend, 6.67, P 0.01). Compared with women without current HPV infection the OR estimate was 38.0 (95% CI 20.3-71.2) in those with current diagnosis of HPV infection. Considering HIV-positive subjects only, the frequency of CIN increased with stage of HIV infection and was higher in women with lower CD4+ values. Finally, no relation emerged between CIN risk and age, indicators of sexual habits, oral contraceptive use, parity, and history of spontaneous or induced abortions.

Adult↗
PubMed1993

Smoking habits and prostate cancer: a case-control study in northern Italy.

BACKGROUND: Cigarette smoking has been associated with increased risk for prostate cancer in 2/13 case-control studies and 4/12 cohort studies conducted on this topic. The relationship between tobacco smoking and prostate cancer was further studied in a hospital-based case-control study in northern Italy. METHODS: Two hundred seventy-one cases of histologically confirmed prostate cancer and 685 controls were interviewed during their hospital stay about smoking habits and various other covariates. Controls comprised a group of males admitted to the same hospitals as the cases, but with acute conditions exclusive of malignant tumors, urological diseases, or any condition known to be related to tobacco or alcohol consumption. Odds ratios and 95% confidence intervals from logistic regression equations were reported for all smoking characteristics. RESULTS: No increased risk was found among the current smokers (odds ratio = 0.9; 95% confidence interval, 0.6-1.4), or the ex-smokers (odds ratio = 0.8; 95% confidence interval, 0.5-1.1). No trend in risk emerged with number of cigarettes smoked per day (odds ratio = 1.0; 95% confidence interval, 0.5-2.0 for smokers of 30 or more cigarettes compared with nonsmokers). Similarly, long duration of smoking habit, early smoking onset, and consumption of high-tar cigarettes were not associated with prostate cancer. CONCLUSION: The present study did not demonstrate any association between prostate cancer and various measures of tobacco smoking.

Aged↗
PubMed1993

Descriptive epidemiology of gall-bladder cancer in Europe.

Trends in mortality from cancer of the gall-bladder and bile ducts over the period 1965-1989 were analysed for 25 European countries on the basis of official death certifications from the World Health Organization databank. A high-mortality area--i.e. with overall death certification rates, world standard, around or over 2/100,000 men and 4/100,000 women in 1985-1989--was identified in Germany and the surrounding central European countries (Austria, Czechoslovakia, Hungary and Poland). The highest rates were in Hungary (3.9/100,000 men and 7.4/100,000 women). During the two decades considered, rates increased in Czechoslovakia and Hungary, remained stable in Poland and declined in Austria and Germany. Intermediate-mortality areas included Scandinavian countries (except Norway) and Switzerland: their rates in the late 1980s were between 1.5 and 2.5/100,000 men and between 2.2 and 4.2/100,000 women. Mortality increased in Finland and Sweden, declined in the Netherlands and Switzerland, and did not change consistently in Denmark. Low-mortality countries (i.e. with rates in 1985-1989 below 2.0/100,000 men and 2.5/100,000 women) included Belgium, France, Britain, Ireland, Norway, Bulgaria and Mediterranean countries. Over the last two decades, certification rates declined in Bulgaria and Great Britain, but increased in all other countries. The ratio between the countries with the highest and lowest gall-bladder cancer mortality rates declined from 21 to 12 in women, although they remained stable around 10 for men. The pattern was similar when analysis was restricted to truncated rates from patients aged between 35 and 64 years. These trends, and particularly the exceedingly high rates in central Europe, the low rates in Mediterranean countries and the low and declining rates in Britain and Ireland are discussed in terms of known (cholelithiasis) or potential (dietary) factors in gall-bladder cancer aetiology, and of trends in cholecystectomy rates.

Adult↗
PubMed1993

Oestrogen replacement treatment and the risk of endometrial cancer: an assessment of the role of covariates.

The relationship between oestrogen replacement treatment and the risk of endometrial cancer was analysed in a case-control study of 158 histologically confirmed incident cases below the age of 75 and 468 controls in hospital for acute, non-neoplastic, non-hormone-related conditions conducted in the Swiss Canton of Vaud in 1988-1992. Overall, 60 (38%) cases vs. 93 (20%) controls had ever used oestrogen replacement treatment: the corresponding multiple logistic regression relative risk (RR) was 2.7 (95% confidence interval, CI: 1.7-4.1). The risk was directly related to duration of use, and rose to 5.1 (95% CI: 2.7-9.8) for > 5 year-use. The RR was still significantly elevated 10 or more years after stopping use (RR = 2.3, 95% CI: 1.2-4.5). When the role of covariates was considered, a significant interaction was observed with body mass index (RR for long-term oestrogen use = 6.0 for lean or normal weight women vs. 2.4 for overweight women). There was also a hint of a negative interaction with oral contraceptive (OC) use, since the RR for oestrogens was higher (or restricted) to women who had never used OC (RR = 5.4, for long-term oestrogen use), as compared with those who had used OC, who showed no significant evidence of association with oestrogens (RR = 0.9 for long-term use). There was no significant interaction with cigarette smoking. Thus, this study confirms the presence of a strong association between oestrogen replacement treatment and endometrial cancer risk, since in the late 1980s or early 1990s about 25% of cases could be attributed to oestrogen replacement treatment in this Swiss population. Further, it confirms the presence of significant negative interactions of oestrogen use with obesity, and, possibly, with OC as well.

Adult↗
PubMed1993

Trends in lung cancer mortality in three broad Italian geographical areas between 1969 and 1987.

Trends in death certification rates from lung cancer in broad Italian geographical areas (north/centre/south) were analysed over the period 1969-1987. In northern Italy, lung cancer rates in young and middle-aged males reached a peak between the mid and late 1970s, and tended to decline afterwards; only above age 60 was mortality still rising in the 1980s. A similar pattern of age-specific rates was observed in central areas, while in the South rates tended to level off in the early 1980s only below age 55, but were still upwards in subsequent age groups. Consequently, the north/south ratio for the overall age-standard rate increased slightly between the late 1960s and mid 1970s, from 1.68 (corresponding to a world standardised rate of 47.1/100,000 in the north vs. 28.1 in the south) to 1.73, but declined to 1.55 between 1985 and 1987 (for a rate of 69.1/100,000 males in the north vs. 44.6 in south). In the younger age groups a diverging pattern was observed: at ages of 25-34 rates in 1985 and 1987 were apparently higher in the south (1.0 vs. 0.9/100,000 in the north), and in the 35-44 age group the north/south ratio decreased from 1.7 to 1.2 (with rates of 12.9 and 10.7, respectively, in 1985 and 1987). Among females, lung cancer rates increased in all geographical areas and age groups except the youngest (25-34 years). Under the age of 50, the rises were proportionally similar in various geographical areas, thus widening the north/south difference in absolute terms. Above the age of 50, the north/south difference tended to be wider in relative terms too, reaching a factor of 2 in the 65-74 age group. The overall age-standardised north/south ratio for females increased from 1.51 in 1969-1974 (5.6 vs. 3.7/100,000) to 1.87 in 1985-1987 (8.4 vs. 4.5/100,000). These trends reflect changes in smoking habits in subsequent generations of Italian males and females from different areas of the country, and confirm the central role of cigarette smoking in lung cancer rates in various populations, although this does not exclude some influence by other, mainly occupational, lung carcinogens on the substantial differences in lung cancer rates in various Italian geographical areas.

Adult↗
PubMed1993

Risk factors for epithelial ovarian cancer in women under age 45.

Risk factors for ovarian cancer in young women were investigated using data from a case-control study conducted between 1983 and 1992 in Milan, northern Italy, on 194 women below age 45 with histologically confirmed incident cancers of the ovary and 710 controls admitted to the same network of hospitals for acute non-gynecological, nonhormonal and non-neoplastic diseases. An elevated relative risk (RR) of ovarian cancer was found among women reporting 12 or more years of education [RR 1.6, 95% confidence intervals (CI) 1.0-2.03] and belonging to the highest social class (RR 1.8, 95% CI 1.1-3.0). Women whose mothers had had ovarian cancer had a multivariate RR of 2.7 (95% CI 0.7-10.5) compared to those with no family history. Menarche above age 13 and irregular menstrual cycles were significantly protective against ovarian cancer (RR 0.6 for both risk factors). There was a significant inverse relationship with abortions, the RR being 0.6 both for spontaneous and for induced abortions, while protection of parity was not significant. Higher risks of ovarian cancer were observed in women having first or last birth when older than 30 years (RR 2.0 and 2.4, respectively, compared to those delivering under age 25). A significant trend toward an increased risk of ovarian cancer was also observed with decreasing time since last birth. Compared with women whose last birth occurred 10 or more years before diagnosis, the RR was 2.1 (95% CI 1.1-3.9) for those reporting a birth during the last 5 years. The RR for oral contraceptive users was 0.7 (95% CI 0.5-1.0) and the protection increased with duration, with RR of 0.3 (95% CI 0.1-0.7) for 5 or more years of use. This study indicates that, although the incidence of ovarian cancer is higher in older women, recognised risk and protective factors are similar below age 45. An excess risk in the few years after a term delivery is also suggested.

Adult↗
PubMed1993

Reproducibility of an Italian food frequency questionnaire for cancer studies: results for specific food items.

To evaluate the reproducibility of a quantitative food frequency questionnaire (FFQ) used in a case-control study on cancer of the breast, ovary and digestive tract, we compared the result of a 98-item questionnaire administered twice at an interval of 3-10 months (median = 5.4 months) to 452 volunteers (144 males and 308 females, median age = 50 years) from three Italian provinces (Pordenone, Genoa and Forlí). Spearman correlation coefficients (r) for intake frequency of 87 dietary items ranged from 0.35 ("chicken or turkey, boiled") to 0.84 ("wine"). Most coefficients were between 0.60 and 0.80, only two being below 0.40 and five equal or above 0.80 (mean r = 0.59). The concordance of the two measurements tended to be somewhat better for alcoholic and non-alcoholic beverages, bread, cereals and first courses, fruits and summary questions at the end of each section of the questionnaire than for side dishes, sweets and desserts. Also, the reproducibility of 11 subjective questions, such as those concerning the amount of fat in seasoning and the intake of garlic or salt, seemed to be high. Age, sex, educational level of the volunteers and interval between the two FFQ did not have a large or systematic impact on the concordance of the two measurements. In conclusion, the present study has shown a good level of reproducibility of our questionnaire and has provided a few important hints on ways of improving the description of various food items.

Adult↗