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E Negri

Publications and source records attributed to E Negri.

At least 523 records · Page 29Linked to original sources
PubMed1988

Trends in smoking and lung cancer mortality in Switzerland.

Patterns of cigarette smoking in Switzerland were analyzed on the basis of sales data (available since 1924) and national health surveys conducted in the last decade. There was a steady and substantial increase in cigarettes sales up to the early 1970s. Thereafter, the curve tended to level off around an average value of 3,000 cigarettes per adult per year. According to the 1981-1983 National Health Survey, 37% of Swiss men were current smokers, 25% were ex-smokers, and 39% were never smokers. Corresponding porportions in women were 22, 11, and 67%. Among men, smoking prevalence was higher in lower social classes, and some moderate decline was apparent from survey data over the period 1975-1981 mostly in later middle-age. Trends in lung cancer death certification rates over the period 1950-1984 were analyzed using standard cross-sectional methods and a log-linear Poisson model to isolate the effects of age, birth cohort, and year of death. Mortality from lung cancer increased substantially among Swiss men between the early 1950s and the late 1970s, and levelled off (around a value of 70/100,000 men) thereafter. Among women, there has been a steady upward trend which started in the mid-1960s, and continues to climb steadily, although lung cancer mortality is still considerably lower in absolute terms (around 8/100,000 women) than in several North European countries or in North America. Cohort analyses indicate that the peak rates in men were reached by the generation born around 1910 and mortality stabilized for subsequent generations up to the 1930 birth cohort. Among females, marked increases were observed in each subsequent birth cohort. This pattern of trends is consistent with available information on smoking prevalence in successive generations, showing a peak among men for the 1910 cohort, but steady upward trends among females. Over the period 1980-1984, about 90% of lung cancer deaths among Swiss men and about 40% of those among women could be attributed to smoking (overall proportion, 85%).

Adult↗
PubMed1988

Risk factors for adenocarcinoma of the cervix: a case-control study.

To assess risk factors for cervical adenocarcinoma data were collected in a case-control study of 39 cases and 409 controls conducted in the greater Milan area. Questions were asked about personal characteristics and habits, gynaecologic and obstetric data, history of lifetime use of oral contraceptives and other female hormones, and general indicators of sexual habits (age at first intercourse and total number of sexual partners). The relative risk of cervical adenocarcinoma increased with number of births and abortions, early age at first birth and early age at first intercourse. These estimates did not materially change after adjustment for the potential reciprocal confounding effect. Further, there was a positive association with overweight, but an apparent association with lower education was not significant. No relationship emerged with oral contraceptive use. Thus, despite the similarities with the epidemiology of squamous cell cancer, reproductive patterns and other factors related to the risk of endometrial cancer (i.e., overweight) seem to play an important role in the risk of adenocarcinoma of cervix uteri.

Abortion, Spontaneous↗
PubMed1988

Smoking and prevalence of disease in the 1983 Italian National Health Survey.

The relation between smoking habits and selected chronic diseases was evaluated from the data of the 1983 Italian National Health Survey, based on 72,284 people aged 15 or over randomly selected within strata of geographical area, size of place of residence and of the household in order to be representative of the whole Italian population. The prevalence of all the 19 diseases or groups of diseases considered was elevated among ex-smokers, thus suggesting that the presence of any chronic condition stimulates cessation of smoking. The excess prevalence among ex-smokers was particularly large for myocardial infarction and other heart diseases. Four groups of diseases were positively related with current as well as with past cigarette smoking. These were chronic bronchitis, emphysema of the lung or respiratory insufficiency, gastroduodenal ulcer and varicose veins or haemorrhoids. For all these groups of diseases the relative risks were higher in heavy cigarette smokers. Compared with never smokers, the point estimates for subjects smoking 15 cigarettes per day or more were 2.6 for chronic bronchitis, 1.7 for emphysema of the lung, 2.1 for gastroduodenal ulcer and 1.6 for varicose veins or haemorrhoids. For bronchitis, ulcer and varicose veins or haemorrhoids the relative risks tended to be higher in younger and middle age groups. From these data, it was estimated that in the whole of Italy a total of about 900,000 prevalent cases of chronic bronchitis, 270,000 of emphysema, 610,000 gastroduodenal ulcers and 380,000 varicose veins or haemorrhoids could be associated with cigarette smoking.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Socioeconomic groups and cancer risk at death in the Swiss Canton of Vaud.

Data collected by the Cancer Registry of the Canton of Vaud, Switzerland, were used to estimate proportional mortality ratios (PMR) and mortality odds ratios (MOR) for various neoplasms according to social class and sector of occupation (agriculture versus others). Mortality ratios were elevated in lower social classes for cancers of the lung (MOR = 1.18 for social class IV or V vs I or II) and other sites strictly related to tobacco (mouth or pharynx, oesophagus and larynx; MOR = 1.70), and (though not significantly) for cancers of the stomach (MOR = 1.16) and uterus (MOR = 1.30 for cervix and 1.47 for corpus uteri). Furthermore, there was a strong negative social class gradient for thyroid cancer (a neoplasm with particularly elevated incidence and mortality in Switzerland), probably attributable to higher prevalence of iodine deficiency in lower social classes (MOR = 3.17). Positive social class gradients emerged for cancers of the intestines (MOR = 0.77 for social class IV or V), skin (MOR = 0.74) and prostate (MOR = 0.87). Agricultural workers showed decreased ratios for cancers of the lung (MOR = 0.75), cervix uteri (MOR = 0.72) and prostate (MOR = 0.80), and excess mortality from cancers of the upper digestive and respiratory sites (MOR = 1.22), stomach (MOR = 1.18), testis (MOR = 2.05) and lympho-haematopoietic neoplasms, particularly myeloma (MOR = 2.14).

Adult↗
PubMed1988

Risk factors for breast cancer: pooled results from three Italian case-control studies.

The role of menstrual and reproductive factors, family history, and body weight in the epidemiology of breast cancer has been reassessed in a meta-analysis of three large case-control studies of breast cancer from several Italian regions, for a total data set of 4,072 cases and 4,099 controls. Multiple logistic regression equations were used to obtain relative risks adjusted for study, center, age, and various combinations of risk factors considered. Relative to women with menarche at age 15 or over, those with earlier menarche had a 20-30% higher breast cancer risk. However, there was no tendency for the risk to increase with lower age at menarche, and the association with menarche was stronger at younger age. The risk of breast cancer was directly related to age at menopause (relative risk (RR) = 0.7 for less than 45 years vs. greater than or equal to 50 years), age at first live birth (RR = 1.8 for greater than or equal to 28 years vs. less than 22 years), and family history of breast cancer in first-degree relatives (RR = 2.0). The effect of these factors was similar in various age strata. After allowance for age at first live birth, the risk of breast cancer did not differ among women with one to four live births, but it was significantly below unity (RR = 0.6) for those with five or more live births. Furthermore, there was a clear modifying effect of age at diagnosis on parity-related risk, since parous women had elevated breast cancer risk below age 35 and reduced risk above age 40.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Epidemiologic characteristics of women with uterine fibroids: a case-control study.

Risk factors for uterine fibroids were analyzed in a hospital-based case-control study conducted in the greater Milan area, based on 275 women with histologically confirmed fibroids and 722 controls with acute nongynecologic or hormone-related conditions. Questions were asked about menstrual and reproductive characteristics, education, history of various diseases, and lifetime use of oral contraceptives and other hormonal treatments. The risk of uterine fibroids was reduced in parous women relative to nulliparous ones (relative risk 0.6) and in those who were postmenopausal (relative risk 0.1 compared with premenopausal women of the same age). Women with fibroids tended to have an earlier age at menarche and at the last birth, to be more educated, and to use intrauterine devices and oral contraceptives more frequently, although these findings were not statistically significant. Current smoking (but not past smoking) lowered the fibroid risk by about 40%. No associations were found with body mass index, history of spontaneous or induced abortions, and age at first birth.

Adult↗
PubMed1988

Body weight and the prevalence of chronic diseases.

The relation between body mass index and prevalence of 17 chronic diseases or groups of diseases was analysed using data from the 1983 Italian National Health Survey, based on a sample of 72,284 individuals aged 15 or over randomly selected within strata of geographical area, size of place of residence and of household in order to be representative of the whole Italian population. The prevalence of diabetes was directly and strongly related to body weight (age-adjusted relative risk estimates being 1.5 for overweight and 2.7 for obese men compared with normal weight individuals; 1.6 and 2.4 for overweight and obese women). Other conditions directly related to self-reported measures of body weight were hypertension (relative risk = 1.7 for obese men and 1.9 for women), myocardial infarction (relative risk = 1.5 for obese men, 1.6 for women), other heart diseases (relative risk = 1.7 for obese men, 1.5 for women), haemorrhoids or varices (relative risk = 1.2 for obese men, 1.5 for women), cholelithiasis (relative risk = 1.2 for obese men, 1.4 for women), urolithiasis and arthritis. Chronic respiratory disorders showed a U-shaped relation to measures of body weight, since their prevalence was elevated in both under- and over-weight individuals. Anaemias and gastroduodenal ulcer showed an inverse relation to body weight, whereas no association was apparent with allergy, liver cirrhosis, and psychiatric or neurological disorders. Allowance for the two major identified covariates (education and smoking) failed to explain the observed variations between measures of body weight and disease, while separate inspection of various strata of age indicated that for most diseases the elevated risks of obesity were higher in younger and decrease steadily with advancing age. Thus, the results of this national survey indicate that overweight has a widespread and substantial impact not only on mortality but also on morbidity from different chronic conditions.

Adolescent↗
PubMed1988

Epidemiological aspects of diet and cancer: a summary review of case-control studies from northern Italy.

The major findings on dietary aspects of cancer risk are reviewed from a series of hospital-based case-control studies conducted in Northern Italy. Information collected using simple frequency questionnaires indicated that green vegetable consumption was inversely related with the risk of cancers of the breast and of the female genital tract, as well as with oesophageal and gastric neoplasms, whereas there were positive associations between fats in seasonings and other foods (e.g., meat) and cancers of the breast, ovary, endometrium and prostate. Fruits, and specifically citrus fruits, were inversely related with cancers of the oesophagus and of the stomach, and there were positive associations between various sources of starches (but not fibres) and gastric cancer risk. Thus, extremely simplified questionnaires apparently permitted identification of a number of significant and consistent differences between cancer cases and hospital-based comparison groups, which were not obviously explainable in terms of selection, confounding, information or other biases. Nonetheless, epidemiological evidence on diet and cancer from this and several other investigations is rather crude and imprecise and, hence, its implications in terms of public health policy are still open to question.

Diet↗
PubMed1988

Coffee drinking and prevalence of bronchial asthma.

The relationship between coffee consumption and the prevalence of bronchial asthma has been evaluated using data from the 1983 Italian National Health Survey, based on 72,284 individuals aged over 15 years randomly selected within strata of geographic area, size of the place of residence and of the household in order to be representative of the whole Italian population. The prevalence of bronchial asthma was inversely related with the level of coffee intake. Compared with subjects who did not drink coffee, the age- and sex-adjusted relative risks were 0.95 for one cup, 0.77 for two and 0.72 for three or more cups per day. This inverse relation was of comparable magnitude at younger and older ages, not explainable through selection, since the sample was representative of the general Italian population and the participation rate was 93.4 percent, or through confounding by several identified potential distorting factors. Thus, the results of this survey provide epidemiologic confirmation of previous clinical observations that caffeine intake has a bronchodilator effect in asthma, and indirectly suggest that long-term moderate coffee consumption may not only reduce symptoms, but also prevent the clinical manifestation of bronchial asthma. An alternative explanation of these findings is that subjects receiving treatment for asthma might tend to reduce their coffee consumption, in consequence of the side effects shared by sympathomimetics, theophylline and caffeine. Thus, further studies taking simultaneously into account methylxanthine intake from beverages and drug treatments are required before considering causal the apparent protection which emerged.

Adolescent↗
PubMed1987

A case-control study of diet and gastric cancer in northern Italy.

Dietary factors in the aetiology of stomach cancer were investigated using data from a case-control study conducted in Northern Italy on 206 histologically confirmed carcinomas and 474 control subjects in hospital for acute, non-digestive conditions, unrelated to any of the potential risk factors for gastric cancer. Dietary histories concerned the frequency of consumption per week of 29 selected food items (including the major sources of starches, proteins, fats, fibres, vitamins A and C, nitrates and nitrites in the Italian diet) and subjective scores for condiments and salt intake. Pasta and rice (the major sources of starch), polenta (a porridge made of maize) and ham were positively related with gastric cancer risk, whereas green vegetables and fresh fruit as a whole (and specifically citrus fruit) and selected fibre-rich aliments (such as whole-grain bread or pasta) showed protective effects on gastric cancer risk. Allowance for major identified potential distorting factors (chiefly indicators of socio-economic status) reduced the positive association with pasta or rice consumption, but did not appreciably modify any of the other risk estimates. When a single logistic model was fitted including all food items significant in univariate analysis, the 3 items remaining statistically significant were green vegetables (relative risk, RR = 0.27 for upper vs. lower tertile), polenta (RR = 2.32) and ham (RR = 1.60). Indices of beta-carotene and ascorbate intake were negatively and strongly related with gastric cancer risk, but the association with these micronutrients was no longer evident after simultaneous allowance for various food items. An approximately 7-fold difference in risk was found between extreme quintiles of a scale measuring major positive and negative associations.

Adult↗
PubMed1987

Coffee consumption and risk of pancreatic cancer.

The relationship between pancreatic cancer and coffee, decaffeinated coffee and tea drinking habits was evaluated using data from a hospital-based case-control study conducted in Northern Italy on 150 histologically confirmed cases and 605 controls with acute, non-neoplastic, other than digestive tract diseases unrelated to coffee consumption or to any of the known or potential risk factors for cancer of the pancreas. Compared with subjects who did not drink coffee, the multivariate relative risks were 1.7 for those who drank less than 2 cups per day, but only 1.4, and 1.1 respectively for drinkers of 3 or 4 and 5 or more cups. Likewise, there was no association with duration of consumption of coffee, decaffeinated coffee or tea. These findings were reviewed together with published evidence from other case-control studies (or cohort studies analyzed as case-control) of coffee and pancreatic cancer. When appropriate statistical methods were used to pool information, and the data from the first study which was the basis of the hypothesis were omitted, the relative risk of pancreatic cancer based on 1,464 cases was 1.2 for moderate coffee drinkers and 1.4 for heavy drinkers, and we suspect that at least part of this moderate residual association is confounded by cigarette smoking. Thus, although the present investigation and a general overview of published epidemiological evidence are compatible with a small effect of coffee on pancreatic carcinogenesis, interpretation of these findings is not obvious on account of the possibility of residual confounding and other sources of bias.

Adult↗
PubMed1987

Menstrual and reproductive factors and the risk of myocardial infarction in women under fifty-five years of age.

The relationship between menstrual and reproductive factors and subsequent risk of coronary heart disease was investigated in a hospital-based case-control study of 202 women with acute myocardial infarction and 374 control subjects admitted for a wide spectrum of acute conditions unrelated to any of the established risk factors for ischemic heart disease. No consistent association was observed with age at menarche or menopausal status, but women with a lifelong irregular menstrual cycle pattern were at significantly elevated risk of myocardial infarction (relative risk = 1.8, 95% confidence interval = 1.1 to 2.9). No clear trend in risk was evident with the number of livebirths, miscarriages, or induced abortions. However, women whose first pregnancy or livebirth occurred before age 20 years showed elevated risks of subsequent myocardial infarction compared with nulliparous ones (relative risks = 2.3; 95% confidence interval = 1.1 to 4.9), and there was a significant trend of increasing risk with earlier first birth. These associations were evident in both younger and middle-age women and were not explained by allowance for several identified potential confounding factors.

Adult↗
PubMed1987

Vitamin A and other dietary factors in the etiology of esophageal cancer.

The risk of esophageal cancer, in relation to the frequency of consumption of selected dietary items, was evaluated in a hospital-based case-control study; this study was of 105 histologically confirmed cases and 348 control subjects with acute conditions unrelated to any of the established or potential risk factors for esophageal cancer. The frequency of consumption of carrots, green vegetables, or fresh fruits was lower in cases. Further, cases tended to eat meat and fish less frequently and eggs more frequently. The estimated multivariate relative risks were 0.6 for regular (more than once a week) carrot consumption and 0.6 and 0.3, respectively, for the highest levels of vegetable or fruit consumption (compared with the lowest ones). Consequently, a strong negative association emerged between estimated beta-carotene (but not retinol) intake and esophageal cancer risk. The risk of cancer of the esophagus was not significantly related to subjective scores of fat and whole-meal food intake; however, a strong positive association did emerge with measures of alcohol consumption. Although the information collected does not allow precise definition of specific micro-nutrient(s) causally related with esophageal cancer risk, the confirmation of marked differences in reported diet between esophageal cancer cases and controls is still of interest; this is mostly in consideration of the strength and persistence of the associations after allowing for alcohol and tobacco use in addition to indicators of socioeconomic status.

Adult↗
PubMed1987

Dietary factors and the risk of breast cancer.

We evaluated the risk of breast cancer in relation to the frequency of consumption of a few selected dietary items. Data were used from a case-control study of 1,108 histologically confirmed breast cancer patients and 1,281 control subjects who were in the hospital for acute conditions unrelated to any of the established or suspected risk factors for breast cancer. Moderately elevated risk estimates were associated with higher levels of fat consumption in seasonings [butter, margarine, and oil, relative risk (RR) = 1.34, 95% confidence interval (CI) = 1.06-1.71] and meat (RR = 1.36, 95% CI = 1.12-1.65), whereas a reduced risk (RR = 0.42, 95% CI = 0.34-0.51) was associated with a more frequent green vegetable consumption. It was not possible to show that these associations were incidental, because allowance for several identified potential confounding factors, including the major identified or potential risk factors for breast cancer, did not materially modify the risk estimates. Further, no appreciable interaction emerged with age or menopausal status, because the diet-related risk estimates were similar in pre- or postmenopausal women. However, the implications of these findings in terms of specific micronutrients (e.g., retinol or beta-carotene) and biological correlates are still unclear. Alcohol consumption was significantly greater among breast cancer cases, with a multivariate risk estimate of 2.92 for the highest level. Thus, the present findings confirm that various aspects of diet may influence the risk of breast cancer, although the small amount of available knowledge does introduce serious uncertainties in any discussion of the potential implications in terms of prevention on a public health scale.

Adult↗
PubMed1987

General epidemiology of breast cancer in northern Italy.

The role of the major identified risk factors for breast cancer was assessed using data from a hospital-based case-control study conducted in Northern Italy on 1108 women with histologically confirmed breast cancer and 1281 control subjects with a spectrum of acute conditions unrelated to any of the established or potential risk factors for breast disease. With reference to nulliparous women, the risk of breast cancer was below unity for those who first gave birth below age 25, and above unity for those with later first full-term pregnancy. However, in each stratum of age at first birth, the point estimate was below unity for women with five or more births. The relative risk for greater than or equal to 5 births compared with 1 or 2 was 0.6 (95% confidence interval = 0.4-0.9) when allowance was made for age at first birth. Likewise, there was a significant and independent effect of age at last birth which was evident in various strata of parity and age at first birth. The overall relative risk for last birth at 30 years or over compared with under 30 was 1.4 (95% confidence interval = 1.1-1.8). There was little relation of breast cancer risk with abortions or miscarriages. Breast cancer cases reported earlier menarche and later menopause; further, lifelong irregularities in menstrual pattern were less common among the cases (relative risk = 0.6, 95% confidence interval = 0.5-0.8). The risk estimates were elevated in women with positive history of benign breast disease, family history of breast cancer and greater body mass index.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Induced↗
PubMed1987

Education, prevalence of disease, and frequency of health care utilisation. The 1983 Italian National Health Survey.

The relation between education, prevalence of 17 chronic diseases or groups of diseases, and pattern of health care utilisation was evaluated from data from the 1983 Italian National Health Survey, based on 58 462 individuals aged 25 or over randomly selected within strata of geographical area, size of place of residence, and size of household, in order to be representative of the whole Italian population. Most of the diseases considered, including diabetes, hypertension, myocardial infarction and other heart disease, haemorrhoids or varices, chronic respiratory disease, anaemias, gastroduodenal ulcer, cholelithiasis and liver cirrhosis, kidney and urological diseases, arthritis, and psychiatric and neurological disturbances, were consistently less prevalent among more educated individuals. The age and sex adjusted risk estimates for individuals educated in high school or university compared with those with only a primary school education or less ranged between 0.21 for liver cirrhosis and 0.80 for anaemias. The sole exception was allergy, which was more prevalent among the more educated individuals (relative risk = 1.42). General practitioner visits and hospital admissions were reported less frequently by the more educated individuals, but specialist consultations of potential preventive value were less frequent among the less well educated. The results were similar when occupation was utilised as an indicator of social class. Thus, the findings of this national survey provide confirmation and quantitative assessment of considerable differences in health and health service utilisation according to indicators of social class.

Adult↗
PubMed1987

Dietary factors and the risk of epithelial ovarian cancer.

Dietary factors in the etiology of ovarian cancer were investigated with the use of data from a case-control study conducted in Northern Italy on 455 histologically confirmed epithelial carcinomas and 1,385 control subjects in the hospital for acute conditions unrelated to any of the known or potential risk factors for cancer of the ovary. Women with ovarian cancer reported significantly elevated frequency of consumption of meat [relative risk (RR) = 1.6 for greater than or equal to 7 vs. less than 4 portions/wk], ham (RR = 1.9 for greater than or equal to 4 vs. less than 2 portions/wk), and higher subjective scores of fat intake (RR = 2.1 for highest vs. lowest scores), particularly butter. In contrast, consumptions of fish, green vegetables, carrots, and wholemeal bread or pasta were less frequent in cases; the corresponding risk estimates for highest versus lowest frequencies ranged between 0.6 and 0.8. These results were not materially modified by adjustment for indicators of socioeconomic status, parity, and other identified determinants of ovarian cancer. No relation emerged between alcohol consumption and ovarian cancer risk. The present study provides interesting indications that help to explain the considerable variations in ovarian cancer rates in different populations and, if confirmed, could, in principle, have important public health implications. Due caution, however, is required in interpreting the present results because of the limitations of available information and of the uncertainties of other published material concerning diet and ovarian cancer.

Adult↗