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E Negri

Publications and source records attributed to E Negri.

At least 415 records · Page 23Linked to original sources
PubMed1992

Trends in peptic ulcer mortality in Italy, 1955-1985.

STUDY OBJECTIVE: The aim was to analyse trends in mortality from peptic ulcer in Italy between 1955 and 1985, disentangling the role of age, cohort of birth, and period of death. DESIGN: This was a descriptive epidemiological survey. Death certification numbers from peptic ulcer and estimates of the resident population were obtained from official sources. From these data, age specific and age standardised mortality rates from peptic ulcer were computed. A log-linear age, period, and cohort model with arbitrary constraints on the parameters was applied to the matrices of age specific rates between 25 and 74 years of age. SETTING: This was a national survey. MAIN RESULTS: For males, overall peptic ulcer mortality was constant or moderately upwards (from 9.0 to 9.4/100,000, on the basis of World Standard Population) from 1955 to the mid-1970s, but declined considerably afterwards to 3.7/100,000 in 1985. Truncated (35-64 years) rates were slightly more favourable, even in earlier calendar periods, but a substantial drop was observed only from the late 1970s onwards. In 1985 the standardised rate was 3.3/100,000 compared to 18.3 in 1955-1959. For females, the time pattern was similar, although the extent of the decline was smaller in absolute terms (from 1.6 to 1.2/100,000, all ages; from 2.3 to 0.7, truncated). Age specific rates showed an earlier decline in the young, while the fall started only after the mid-1970s in older age groups. On the basis of a log-linear age, period, and cohort model, the Italian generations born in the first decade of this century had the highest risk of dying from peptic ulcer, with a substantial decline for each subsequent cohort. Period trends were stable between 1955 and the mid-1970s, but declined appreciably afterwards. CONCLUSIONS: In Italy the peak rate of peptic ulcer mortality was observed in the early 1970s, with a delay of around two decades in comparison with northern Europe and the USA. This can be related to the later process of industrialization in Italy, with the consequent changes in lifestyle habits, and to a later pattern of rise and decline of cigarette smoking. A likely explanation of the falls in mortality on a period of death basis over the last decade is the introduction of new drugs (histamine-2 receptor antagonists) for the treatment of peptic ulcer, with a reduction of complications of the disease and related mortality. This decline in mortality from peptic ulcer corresponds to the avoidance of over 1500 deaths per year in the whole of Italy.

Adult↗
PubMed1992

Determinants of sexual habits in Italian females.

OBJECTIVE: To identify characteristics of women reporting multiple sexual partners and early age at first intercourse in Italy. METHOD: Information on 1139 control women (median age 54 years) interviewed as part of a case-control study of cervical neoplasia conducted in the greater Milan area, Northern Italy were analysed using stratified analysis and multiple logistic regression. RESULTS: Overall, 81% of the study sample reported no more than one sexual partner, 10% two and 9% three or more. The proportion reporting multiple sexual partners tended to be higher among younger and more educated women (4% vs 19% of women with respectively less than 7 and 12 or more years of education reported three or more partners). Ever smokers reported a higher number of sexual partners than never smokers. The proportion of nulliparae reporting three or more sexual partners was higher than that of parous women. These findings were confirmed after taking into account in a multivariate analysis the role of potential confounding factors. Furthermore similar findings emerged from an analysis restricted to women aged 40 years or less. Always considering number of sexual partners, no relationship emerged with marital status, spontaneous or induced abortions, lifetime number of reported Pap smears and contraceptive habits. With reference to age at first intercourse, 25% of the study population reported their first intercourse at age 18 or before, 34% between 19 and 22 years, and 41% at age 23 or later. Younger women (that is, more recent cohorts) more frequently reported earlier age at first intercourse and the proportion of never married women reporting early intercourse was higher (51% vs 22% of never married vs married women). No relationship emerged between education, smoking habits, parity, history of spontaneous or induced abortions, number of Pap smears, contraceptive habits, and age at first intercourse. CONCLUSION: This study documents conservative sexual habits in Northern Italian females (at least on the basis of self reporting) but indicates that any educational compaigns towards safe sex should be focused towards younger women, particularly smokers, unmarried and nulliparae.

Abortion, Induced↗
PubMed1992

Update of trends in mortality from stroke in Italy from 1955 to 1987.

Mortality form stroke in Italy over the period 1955-1987 was analysed in terms of age-specific, age-standardised death certification rates, and by means of a log-linear model to separate the effects of age, cohort of birth and calendar period of death. In males the overall age-adjusted rate on the world standard population fell from 118.4/100,000 population in 1955-1959 to 72.0 in 1985-1987 and in females from 94.8 in 1955-1959 to 54.7 in 1985-1987. The overall decline in age-standardised rates over the 3 decades was thus 39% for males (averaging 1.7%/year) and 42% for females (averaging 1.9%/year). The declines were even greater in truncated rates from 35 to 64 years: from 80.4 to 41.2/100,000 for males (49%), and from 63.0 to 24.1/100,000 for females (62%). Inspection of age-specific rates shows comparable falls--in relative terms--in early and later middle age. For instance, male rates declined from 70.4 to 38.1/100,000 (46%) at age 50-54, and from 1,151.1 to 584.2/100,000 (50%) at age 70-74. Only above age 75 were the falls smaller. In females aged 50-54 years the decline was 63%, and for those aged 70-74 years it was 59%. In young adults, no appreciable changes were observed in either sex. Thus, the age, period and cohort model showed downwards trends in both the period and cohort effect, except for the most recent cohorts on account of an age-cohort interaction. These favourable trends are discussed in relation to better control of hypertension and the potential impact of other risk factors.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Role of family history in patients with myocardial infarction. An Italian case-control study. GISSI-EFRIM Investigators.

BACKGROUND: A family history of heart disease has been reported to increase the risk of coronary heart disease. We examined the relation between family history of myocardial infarction (MI) and risk of acute MI to establish the independency of this association, the degree of risk in relation to the number and age of relatives affected, and the possible interaction between family history and other major risk factors for MI. METHODS AND RESULTS: In a case-control study conducted in Italy within the framework of the GISSI-2 Trial, 916 cases of newly diagnosed MI and 1,106 hospital controls were identified. Using a structured questionnaire, data were collected on the history of MI in first-degree relatives and the age at which the event occurred. Compared with subjects without family history of MI in first-degree relatives, the relative risk (RR) of MI was 2.0 (95% confidence interval, CI, 1.6-2.5) in those with one and 3.0 (95% CI, 2.0-4.4) in those with two or more relatives affected (chi 2(1) test for trend, 54.1; p less than 0.001). Such an increase was not substantially affected by allowance for recognized risk factors. The risk related to family history involving at least two relatives was higher for early MI (less than 55 years) (RR, 20.0; 95% CI, 3.3-121.2) compared with later MI (less than or equal to 65 years) (RR, 3.5; 95% CI, 1.8-6.6). When known risk factors were considered for their interaction with family history, the effect on RR was approximately multiplicative for several variables, including smoking, serum cholesterol, hypertension, and hyperlipidemia but not for diabetes and body mass index. Thus, the presence of both family history and smoking and cholesterol levels greater than or equal to 226 mg/dl led to an RR of 14 (95% CI, 3.7-50.0) and 8.3 (95% CI, 1.8-38.7), respectively. CONCLUSIONS: This study indicates that a family history of MI is an independent risk factor for MI, and that the number of relatives and the age at which they were affected is related to the strength of the association. There is a multiplicative effect on RR between family history and several major risk factors for MI.

Case-Control Studies↗
PubMed1992

Trends in cancer mortality sex ratios in Europe, 1950-1989.

A study was carried out to analyse trends in cancer mortality sex differentials. This study compared age-standardized sex ratio values for mortality from 18 cancers (or groups of cancers), and total cancer mortality over the period 1950-1989 in 24 European countries, for 4 age groups (all ages, 20-44 years, 45-64 years, and 65 years and over). For lung cancer and other tobacco-related neoplasms, appreciable rises in sex ratio values were observed until the late 1970s, particularly in Southern and Eastern Europe, before levelling off in recent years, particularly among the younger age groups. In the late 1980s, the range of variation in overall age-standardized sex ratios for lung cancer was between 2 and 3 in the United Kingdom and in Nordic countries, and around or over 10 in Southern Europe. In young adults, the decline in sex ratio values observed in Denmark and Sweden (unity), and in other Nordic countries and in the United Kingdom (around or below 2) reflects a levelling of lung cancer in young males and an increase in young females. This clearly indicates that young women are a priority target group for smoking control interventions in Europe. Appreciable cohort effects were also observed for stomach cancer: rises in sex ratio values were greater in, or restricted to, middle- and older age groups, whereas in the young there was some tendency towards a levelling in sex differentials. The overall sex ratio values for stomach cancer were around 2 in most areas of Europe in the late 1980s. For intestinal cancer, sex ratio values showed some tendency to rise, reaching a level of 1.3-1.7 in the late 1980s; steady rises were also registered in sex ratio values for melanoma (skin cancer), reaching 1.5-1.8 in the late 1980s in most countries. These upward trends which were minor or inconsistent at younger ages in several countries became progressively stronger with advancing age. Sex ratio values were below unity for cancers of the gallbladder and the thyroid. Sex ratio values tended to rise also for leukaemia (from 1.2-1.5 to 1.5-1.7), but showed no noticeable trend for lymphomas or myeloma. The overall sex ratio values for total cancer mortality in the 1950s were between 1.2 and 1.4 in most European countries. Thereafter, they rose appreciably in several countries, reaching 1.9 in Czechoslovakia, Italy and Poland, and 2.3 in France.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1992

[Trends in mortality from respiratory tract tumors in Italy, 1969-1987].

Trends of Italian death certification for cancers of the lung, larynx, pleura and nasal sinuses were analyzed for both sexes in the period from 1969 to 1987. For lung and laryngeal cancer, the analyses have been conducted for broad geographical areas within Italy (North, Center and South). Mortality rates for males aged 35-44 years consistently decreased in the North; increased until the late 1970's, and then decreased in the Center; and consistently increased in the South. In the 45-54 age group, mortality rates peaked in all areas between the late 1970's and the early 1980's, subsequently decreasing. For ages over 54 years, the rates continued to increase even in the 1980's. Female lung cancer rates increased in all areas and in all age groups over 35 years. In the 25-34 years old age group the rates decreased in the North and tended to increase in the Center and in the South. Below age 50, the increases were proportional in the three areas, while for older ages the increase was greater in the North both in absolute and proportional terms. Cohort effects showed a general increase for the generations born up to 1930, in both sexes and in all geographical areas. Different trends were observed for cohorts born after 1940: decreasing for both sexes in the North, and steady for men and increasing for women in the other areas. From the mid 1970's, laryngeal cancer standardized rates for 35-64 age group decreased, or at most remained constant, in all geographical areas. The decreasing tendency was more marked in men. Larynx cancer cohort effects for men were at a maximum for cohorts born around 1990, decreasing thereafter. In women, cohort effects appeared to consistently decrease. Overall rates of pleural cancer mortality increased during the period 1969-1987, and the sex ratio was stable, from 1980 onwards, at a value of about 2.4. Cohort effects showed, for pleural cancer, a general increase for all the cohorts. The increase was particularly apparent in male cohorts born after 1930. Overall mortality rates for cancer of the nasal sinuses was rather stable in both sexes from 1975 onwards. However, in the 35-64 year age group, mortality rates increase for males and decreased for females.

Adult↗
PubMed1992

Height and the prevalence of chronic disease.

The relationship of stature with the prevalence of 18 chronic diseases or groups of diseases was analysed using data from the 1983 Italian National Health Survey, based on a sample of 63,859 individuals aged 20 or over randomly selected within strata of geographical area, size of the place of residence and of the household in order to be representative of the Italian population. Rate ratios (RR) were computed using multiple logistic regression, including terms for sex, age, geographical area, education and smoking. For 15 out of 18 diseases or groups of diseases the RR was below unity in the highest quartiles of height, and the inverse trends with stature were significant for 11 (diabetes, RR 0.90 for highest vs lowest quartile; heart disease, RR 0.92; chronic bronchitis and emphysema, RR 0.84; bronchial asthma, RR 0.70; anaemias, RR 0.70; liver cirrhosis, RR 0.62; urolithiasis, RR 0.76; renal insufficiency, RR 0.71; arthritis, RR 0.89; psychiatric and neurological disorders, RR 0.82). None of the diseases considered showed significant direct trends with height, but hypertension (RR 1.09 for the highest vs lowest quartile), haemorrhoids or varices (RR 1.09) and cancers (RR 1.22) tended to be elevated in the highest quartile of height. The generalised inverse relationship between height and prevalence of chronic disease suggests that poorer nutrition in childhood and adolescence is an unfavourable indicator for the subsequent occurrence of several diseases. Major exceptions were hypertension and varices, two conditions highly dependent on the pattern of health care utilization, and cancer.

Adult↗
PubMed1991

Pooled analysis of 3 European case-control studies: I. Reproductive factors and risk of epithelial ovarian cancer.

The role of reproductive factors in the aetiology of epithelial ovarian cancer has been re-assessed in a meta-analysis of 3 hospital-based case-control studies conducted in Europe (i.e. Italy, the United Kingdom and Greece), providing a total dataset of 1,140 cases and 2,724 controls. Multiple logistic regression models were used to obtain relative risk (RR) estimates adjusted for study centre, age, socio-cultural indicators, age at menopause, and oral contraceptive use. The risk decreased with increasing number of births and the trend in risk was significant (chi 2(1) = 7.50, p less than 0.01). In comparison to nulliparous women, those who reported 4 or more births had a 40% reduction in risk of ovarian cancer (RR = 0.6, 95% confidence interval, CI: 0.4-0.8). An RR estimate of 1.4 (95% CI: 1.1-1.7) as found, overall, for age of 35 or more at first birth compared to age of 25 or less at first birth. In each stratum and overall, nulliparous women did not appear to be at increased risk compared to those who delayed birth of their first child until age 35 or more. In each study, as well as in the overall dataset, an inverse association between number of abortions and ovarian cancer risk emerged. Overall, the inverse relationship was highly significant, RR estimates for 1 and 2 or more abortions, as compared to none, being 0.9 (95% CI: 0.8 and 1.1) and 0.7 (95% CI: 0.6-0.9) respectively. The effects of parity, age at first birth and number of abortions emerged consistently in various strata of study centre and age.

Abortion, Spontaneous↗
PubMed1991

Pooled analysis of 3 European case-control studies of ovarian cancer: II. Age at menarche and at menopause.

The role of age at menarche and at menopause on epithelial ovarian cancer risk was re-assessed in a combined analysis of 3 hospital-based case-control studies conducted in Italy, the United Kingdom and Greece, which produced a total of 1,140 cases and 2,724 controls. In the overall dataset, there was no evidence of an association with age at menarche: compared with women whose menarche occurred at age 15 or over, the relative risk (RR) estimates were 1.0 [95% confidence interval (CI) 0.8 to 1.2] for those with menarche at ages 12 to 14, and 1.0 (95% CI 0.8-1.2) for those with menarche below age 12. There was no consistent interaction between age at menarche and study centre or age at diagnosis. In relation to age at menopause, compared with women whose menopause occurred at age 44 or earlier, the RR was 1.4 between 45 and 49, 1.6 between 50 and 52 and 1.9 above 52. The strength of the association was apparently (but not significantly) greater in the British than in the Greek or Italian dataset. The effect of age at menopause tended to be long-lasting and, if anything, to increase across subsequent age-groups. The large dataset, and the replication of results in different studies, provide more definite and precise information than previously available on the absence of appreciable effect of age at menarche on subsequent ovarian cancer risk in developed countries. For age at menopause, there was a direct and consistent trend in risk, but the association was relatively weak, with RRs below 2 even between extreme categories.

Adult↗
PubMed1991

Pooled analysis of 3 European case-control studies of epithelial ovarian cancer: III. Oral contraceptive use.

The relationship between use of oral contraceptives (OCs) and other contraceptive methods and the risk of ovarian cancer was examined in a combined analysis of 3 hospital-based case-control studies conducted in Italy, the United Kingdom, and Greece, for a total of 971 ovarian cancer cases and 2,258 controls under age 65. Compared with never-users, the combined multivariate relative risk (RR) for ever-users was 0.6 (95% confidence interval, CI = 0.4-0.8) and the estimates were consistent in the 3 datasets. The protection was also similar across strata of age and parity. Considering various measures of OC use, available in the Italian and British datasets only, the protection conveyed on ovarian cancer risk increased with the duration of use and persisted in the medium-long period: the RR in women reporting their last OC use greater than or equal to 15 years prior to diagnosis was 0.5 (95% CI = 0.2-1.0). The risks in ever-users were appreciably lower in those women who reported their first OC use before 25 years of age (RR = 0.3 for first use before age 25, 0.8 for first use at age 25-34 and 0.7 at 35 years or after). Such findings emerged similarly from Italian and British data. This combined analysis, besides offering further quantitative estimates of the protective effects of OCs on ovarian cancer risk in European populations, provides useful insights into the time pattern of the relationship between OC use and ovarian carcinogenesis, suggesting that the protection persists for 15 years or more after cessation of use and may be larger for use at younger age.

Adult↗
PubMed1991

Spontaneous and induced abortions and risk of breast cancer.

The relationship between spontaneous or induced abortion and the risk of breast cancer was analyzed in a case-control study conducted in the greater Milan area on 2,394 cases of breast cancer and 2,218 controls in hospital for a spectrum of acute conditions, not gynecological, hormonal or neoplastic. No consistent relationship emerged between spontaneous or induced abortion and breast cancer: compared with women reporting no abortions (spontaneous or induced), the multivariate relative risk (RR) was 1.0 (95% confidence interval, CI, 0.9 to 1.2) in those reporting one abortion and 0.9 (95% CI 0.7 to 1.0) in those reporting two or more. This lack of association was consistent in strata of age and parity, including younger women. We further analyzed the risk of breast cancer associated with an abortion before and after full-term pregnancy. Compared with parous women reporting no induced or spontaneous abortions, those who had an abortion before their first full-term pregnancy had about a 20% higher risk of breast cancer. This finding, however, was not statistically significant (RR 1.2, 95% CI 0.9 to 1.7). No increased risk was observed in women who had had a first abortion after a full-term pregnancy (RR 0.9, 95% CI 0.8 to 1.0). This study does not support the hypothesis that spontaneous or induced abortion appreciably influences subsequent breast-cancer risk.

Abortion, Induced↗
PubMed1991

Vegetable and fruit consumption and cancer risk.

The relationship between cancer risk and frequency of consumption of green vegetables and fruit has been analyzed using data from an integrated series of case-control studies conducted in northern Italy between 1983 and 1990. The overall dataset included the following histologically confirmed cancers: oral cavity and pharynx, 119; oesophagus, 294; stomach, 564; colon, 673; rectum, 406; liver, 258; gall-bladder, 41; pancreas, 303; larynx, 149; breast, 2,860; endometrium, 567; ovary, 742; prostate, 107; bladder, 365; kidney, 147; thyroid, 120; Hodgkin's disease, 72; non-Hodgkin lymphomas, 173; myelomas, 117; and a total of 6,147 controls admitted to hospital for acute non-neoplastic conditions, unrelated to long-term dietary modifications. Multivariate relative risks (RR) for subsequent tertiles of vegetable and fruit consumption were derived after allowance for age, sex, area of residence, education and smoking. For vegetables, there was a consistent pattern of protection for all epithelial cancers, with RRs in the upper tertile ranging from 0.2 for oesophagus, liver and larynx to 0.7 for breast. All the trends in risk were in the same direction and significant for all carcinomas except gall-bladder. In contrast, no protection was afforded by high vegetable consumption against non-epithelial lymphoid neoplasms. With reference to fruit, strong inverse relationships were observed for cancers of the upper digestive and respiratory tract, with RRs in the upper tertile between 0.2 and 0.3 for oral cavity and pharynx, oesophagus and larynx relative to the lowest tertile. The lower the location of the tumour in the digestive tract, the weaker appeared to be the protection afforded. Significant inverse relationships were observed for liver, pancreas, prostate and urinary sites, but not for rectum, breast and female genital cancers or thyroid. No relationship emerged for lymphomas and myelomas. Even in the absence of a clear biological interpretation, the consistency and strength of the patterns observed indicate that, in this population, frequent green vegetable intake is associated with a substantial reduction of risk for several common epithelial cancers, and that fruit intake has a favourable effect, especially on upper digestive cancers and, probably, also on urinary tract neoplasms.

Adult↗
PubMed1991

Diet and thyroid cancer: a pooled analysis of four European case-control studies.

The relationship between frequencies of consumption of selected indicator foods and the risk of thyroid cancer was investigated in a pooled analysis of 4 case-control studies conducted in 3 areas of northern Italy and the Swiss Canton of Vaud, on a total of 385 histologically confirmed cases of thyroid cancer and 798 controls in hospital for acute, non-neoplastic, non-hormone-related diseases. Cases tended to consume significantly more frequently a number of starchy foods: the odds ratio (OR) for the highest vs. lowest tertile was 1.8 for pasta or rice, 2.1 for bread, 1.6 for pastry and 2.0 for potatoes. ORs also tended to be above unity for several types of meat and significantly so for chicken and poultry, cooked ham, salami and sausages. Raw ham and fish were significantly protective (OR = 0.7 in the highest tertile for both). Significant direct associations were observed with cheese (OR = 1.4 for the highest tertile), butter (OR = 2.1) and oils other than olive (OR = 1.6). The risk estimates were below unity for most types of vegetables and fruits, and the inverse trends were significantly for carrots (OR = 0.6 for the highest tertile), green salad (OR = 0.6) and citrus fruits (OR = 0.7). No association was observed with alcohol intake. These results were consistent and reproducible across various study centers.

Adult↗
PubMed1991

Socio-economic indicators, infectious diseases and Hodgkin's disease.

The relationship between socio-economic indicators, family size, history of tonsillectomy, infectious mononucleosis (IM) and other diseases and the risk of Hodgkin's disease (HD) was investigated in a hospital-based case-control study, conducted in the province of Pordenone, North-east Italy, between June, 1985 and March, 1990. One hundred and fifty-two HD cases (88 men and 64 women) and 613 controls (357 men and 256 women) were interviewed. Patients with 14 or more years of education had a 2-fold increased HD risk (95% confidence interval, CI: 1.0-3.9); such risk tended to be higher in patients with nodular sclerosis (NS) HD (odds ratio, OR: 4.4, 95% CI 1.8-11.0). Sibship size, birth order and tonsillectomy were not associated with HD risk. Cases and controls did not differ in the frequency or age at occurrence of common childhood infections. A history of IM, however, was found to be an important predictor of HD risk, in particular among NS HD (OR = 13.1, 95% CI 1.0-176.7). Past episodes of herpes zoster and of skin and genital warts were also associated with significantly increased HD risks. These data lend further support to the role of the IM agent (i.e., the Epstein-Barr virus) and, perhaps, of other viral infections and immunological alterations in the development of HD.

Adolescent↗
PubMed1991

Genital and urinary tract diseases and bladder cancer.

The relationship between selected urinary tract and genital diseases and the risk of bladder cancer was analyzed using data from a case-control study of 364 cases of bladder cancer and 447 controls hospitalized for acute, nonneoplastic, nongenital tract conditions, unrelated to known or suspected risk factors for bladder cancer. Cystitis was reported by 20% of the cases and 8% of the controls, corresponding to a multivariate relative risk (RR) of 3.8 (95% confidence interval, 2.4 to 5.9). No association was observed with urinary tract stones (RR = 1.2). With reference to genital diseases, the RR was elevated for gonorrhea (RR = 2.8, 95% confidence interval, 1.0 to 4.5) and condylomata acuminata (RR = 5.9, 95% confidence interval 1.0 to 3.6) but not for syphilis. The risk increased with the number of episodes of cystitis (RR = 5.0 for greater than or equal to 4 episodes, chi 2 for trend = 33.04, P less than 0.001), was higher during the last 15 years after the first episode (RR = 5.1 versus 2.3 for over 15 years), and was not heterogeneous across strata of age and sex. The interaction between urinary tract infections and tobacco appeared multiplicative, with RR = 2.4 for ever smoking, 3.2 for cystitis alone, and 10.3 for both exposures. The present study, besides providing further quantitative evidence of a relationship between urinary tract infections (and, possibly, some genital infections, too) and bladder cancer, indicates that the role of infections is probably in one of the latter (promoting) stages of the process of carcinogenesis and suggests a multiplicative interaction with smoking. In terms of prevention and public health, therefore, it is thus important to avoid at least one exposure for subjects with a history of urinary tract infections who smoke tobacco.

Carcinoma, Squamous Cell↗
PubMed1991

Oral contraceptives and the risk of endometrial cancer.

The relationship between the use of combination oral contraceptives (OCs) and the risk of endometrial cancer was assessed in a case-control study conducted in the Swiss Canton of Vaud between 1 January 1988 and 31 July 1990. Subjects included 122 women aged 75 or less with histologically confirmed endometrial cancer, and 309 control women in hospital for acute conditions unrelated to OC use. Overall, 14 percent of cases and 27 percent of controls had ever used OCs, corresponding to a multivariate relative risk (RR) of 0.5 (95 percent confidence interval [CI]: 0.3, 0.8). The risk of endometrial cancer was found to be related inversely to duration of OC use: RR = 1.0 for less than two years of OC use; 0.5 for two to five years; and 0.3 (95 percent CI: 0.1, 0.7) for more than five years. The protection appeared greater within 20 years since last use, and the RR rose to 0.8 after 20 or more years since last use; numbers are too small, however, for reliable inference from these subanalyses. No significant interaction or modifying effect was observed with other major factors related to endometrial cancer, including parity, body mass index, estrogen replacement therapy, and cigarette smoking. While this study provides further evidence for the protective effect of OCs against risk of endometrial cancer, the relationship requires continued evaluation to assess the long-term implications and public health impact of OC use.

Age Factors↗
PubMed1991

Trends in mortality from coronary heart and cerebrovascular disease in Switzerland, 1969-87.

Trends in age-specific and age-standardized death certification rates from all ischaemic heart disease and cerebrovascular disease in Switzerland have been analysed for the period 1969-87, i.e. since the introduction of the Eighth Revision of the International Classification of Diseases for coding causes of death. For coronary heart disease, overall age-standardized rates of males in the mid-late 1980's were similar to those in the late 1960's, although some upward trend was evident up to the mid 1970's (with a peak rate of 120.4/100,000, World standard, in 1978) followed by steady declines in more recent years (103.8/100,000 in 1987). These falls were larger in truncated (35 to 64 years) rates. For females, overall age-standardized rates were stable around a value of 40/100,000, while truncated rates tended to decrease, particularly over most recent years, with an overall decline of over 25%. Examination of age-specific trends showed that in both sexes declines at younger ages were already evident in the earlier calendar period, while above age 50 some fall became evident only in most recent years. Thus, in a formal log-linear age/period/cohort model, both a period and a cohort component emerged. In relation to cerebrovascular diseases, the overall declines were around 40% in males (from 67.4 to 41.2/100,000, World standard) and 45% for females (from 56.6 to 31.7/100,000), and were proportionally comparable across subsequent age groups above age 45. The estimates for the age/period/cohort model were thus downwards both for the period and the cohort component although, in such a situation, it is difficult to disentangle the major underlying component.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗