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Biomedical subjects

J Estève

Publications and source records attributed to J Estève.

At least 55 records · Page 3Linked to original sources

Risk factors for breast cancer by age and menopausal status: a case-control study in Singapore.

A case-control study was conducted among Singapore Chinese women, comprised of 200 histologically confirmed cases of breast cancer and 420 hospital controls. Subjects were interviewed on family history of breast cancer, social and demographic characteristics, reproductive history, and diet one year prior to interview. Differences in risk factors were observed according to menopausal status. In the premenopausal group, the most consistently significant nondietary effect was an increased risk with late age at first birth. In postmenopausal women, the most consistent nondietary effects were increased risks with nulliparity, tall stature, high educational status, and a family history of breast cancer. In premenopausal women, the strongest dietary effects were low risks with high intakes of polyunsaturated fatty acids (PUFA), beta-carotene, soya protein as a proportion of all protein, and a high risk with high red-meat intake. No dietary effects were observed in postmenopausal women. Examination of effects by 10-year age groups suggested that the differences in the effects of age at first birth, nulliparity, height, education, beta-carotene intake, and PUFA intake between premenopausal and postmenopausal women were at least partly attributable to age-related differences in the baseline distributions of these variables. The variation in the effects of red meat and soya protein appeared to be attributable mainly to menopausal status itself, which is consistent with the hypothesis that these factors operate on risk by way of hormonal mechanisms.

Adult↗

Epidemiological designs in radioepidemiological research.

Most of the information currently available on radiation effects comes from the observation of individuals who received high doses, either from one acute exposure or a series of exposures. Because of the uncertainties in extrapolating risks from these studies to the exposure circumstances of most cancers today (in particular, low-level environmental exposure), direct epidemiologic studies of populations receiving low doses chronically are needed. The effects which we want to quantify are likely to be small, however, and extreme care must therefore be put into the design of such studies if they are to be informative for risk assessment purposes. The areas of particular importance in designing risk assessment studies are reviewed. The advantages and limitations of various epidemiological study designs, and the problems and importance of dosimetry are discussed. Examples from the recent epidemiological literature are presented to illustrate the discussion.

Case-Control Studies↗

Risk factors for hepatocellular carcinoma in Catalonia, Spain.

The influence of hepatitis B virus infection, alcohol consumption, tobacco smoking and use of oral contraceptives on the risk of hepatocellular carcinoma (HCC) was evaluated in a hospital-based case-control study in Catalonia, in the Mediterranean coastal area of north-eastern Spain. A total of 96 HCC cases (86.5% of them with associated liver cirrhosis) and 190 age- and sex-matched controls were studied. The odds ratio of HCC and 95% confidence interval among hepatitis B surface antigen (HBsAg) carriers was 4.9 (1.3-21.9). The OR was not significantly elevated in smokers, and a marginally significant increased risk was found among users of oral contraceptives based on 6 female cases. There was a significant dose-response relationship between alcohol consumption and risk of HCC (chi 2 for trend: 24.3, p less than 0.001). Although hepatitis B infection was strongly associated with HCC, alcohol abuse leading to cirrhosis appears to be one of the main causes of HCC in this region.

Adult↗

Mate drinking, alcohol, tobacco, diet, and esophageal cancer in Uruguay.

A case-control study was conducted in Uruguay to investigate the role of mate drinking, alcohol, tobacco, and certain dietary factors in the etiology of esophageal cancer. The study included 261 patients with squamous cell carcinoma of the esophagus and 522 hospital controls matched by sex and age. A strong association with a clear dose-response relationship was observed with the amount of mate drunk daily and duration of the habit. The relative risk for those drinking over 2.5 liters of mate per day was 12.2 (95% confidence interval, 3.8-39.6) after adjusting for the effects of age, area of residence, alcohol, and tobacco. Strong associations were also observed with tobacco smoking and alcohol drinking which appear to act in a multiplicative way. The relative risk for those who smoke and drink heavily compared to that of light smokers and drinkers was 22.6. The risk associated with black tobacco was about three times higher than that associated with blond tobacco. A clear protective effect was found for the consumption of fruits and vegetables but a dose-response relationship was present only for fruits. Finally, an increased risk was also found for those eating barbecued meat daily.

Adult↗

Relative survival and the estimation of net survival: elements for further discussion.

The methods of calculation of survival corrected for independent cause of death are discussed, and a maximum likelihood method is proposed and illustrated by survival of colon cancer patients in Geneva. The methods which are at present favoured for doing such calculations are subject to various biases when estimating net survival if the populations are heterogeneous for life expectancy. The proposed maximum likelihood approach would eliminate these biases by enabling relevant adjustment for covariates which influence survival. The routine use of such methods would permit better comparison of survival within and between populations.

Age Factors↗

Cancer in the European Community and its member states.

The European Community (EC) mounted the "Europe Against Cancer" programme in 1987 to control cancer. Information on mortality rates is available for all member countries and the incident number of cancers was estimated for each site, for each country and for the EC as a whole. In 1980 there were 730,000 deaths from cancer and an estimated 1,222,120 [corrected] new cases (excluding non-melanoma skin cancers). Among men, cancer of the lung is the leading cancer site with some 135,000 cases per year followed by prostate, colon and bladder cancer. Breast cancer is the leading site in women, with 135,000 cases per year, followed by colon, stomach and genital cancer. Among men, melanoma of the skin, and lung, pancreas and rectum cancer are more frequent in the north in contrast to larynx, oesophagus, buccal cavity and liver cancer, which are more frequent in the south. There are additional contrasts between Southern European countries. The contrasts are less striking for women. This study provides an estimate of the true number of cases only. The establishment of a network of European cancer registries should eventually lead to more comprehensive incidence information form the EC.

Adolescent↗

Patterns of familial transmission of HBV and the risk of developing liver cancer: a case-control study in the Philippines.

The present case-control study was carried out in the Philippines to determine the risk of developing hepatocellular carcinoma (HCC) in relation to different HBV serological profiles of parents and sibs of HCC cases and controls. The HBV serological profiles of parents and sibs of 33 patients with HCC were compared with those of 2 types of community control: 33 general population controls matched for sex and age (C1 controls) and 33 asymptomatic HBsAg carriers also matched for sex and age (C2 controls). When cases were compared with C1 controls, increased risks were associated with the fact of having an HBsAg-positive mother (RR = 2.5, 95% C1 = 0.4-26.3) and older sibs positive for HBsAg (RR = 2.0, 95% C1 = 0.5-9.1), but the increased risk was not statistically significant. However, a significantly increased risk was associated with the fact of having a mother (95% C1 = 3.5-infinity) or father (RR = 11, 95% C1 = 1.6-473) who had been exposed to HBV. On the other hand, when cases were compared with C2 controls, a non-significant 2-fold increase was associated with the fact of having an HBsAg-positive mother, but no differences were observed in the HBV serological profiles of their fathers and older sibs. These results suggest that, in the Philippines, the fact of having a mother or father who has been infected in the past with HBV increases the risk of developing HCC but that the contribution of the mother to this increase in risk is not as important as hitherto believed.

Female↗

Colorectal cancer and diet in an Asian population--a case-control study among Singapore Chinese.

A hospital-based case-control study of diet and colorectal cancer was conducted among Chinese in Singapore (who constitute 77% of the population). A total of 203 cases and 425 controls were included. A history of the usual dietary intake one year prior to interview was taken using a quantitative food frequency questionnaire. Daily intakes of nutrients and selected food items were computed and stratified by tertiles of the control range, to assess risk in low-, medium- and high-intake categories. Effects were adjusted in analysis for age, sex, Chinese dialect group and occupation. For cancers of colon and rectum combined, significant observations were a protective effect of high cruciferous vegetable intake (OR = 0.50, p less than 0.01) and a predisposing effect of a high meat/vegetable consumption ratio (OR = 1.77, p less than 0.05). Similar results were observed for colon cancer alone. For rectal cancer alone (only 71 cases), significant (p less than 0.05) protective effects were observed for high intakes of protein (OR = 0.61), fibre (OR = 0.46), beta-carotene (OR = 0.54), cruciferous vegetables (OR = 0.51) and total vegetables (OR = 0.51). When further assessed by multiple logistic regression, tests for trend and assessment of risk in the extreme highest and lowest quintiles of the control range, the factors consistently significant were cruciferous vegetable intake and the meat/vegetable ratio. A particularly high relative risk was also noted in association with low coffee consumption (OR = 1.59, with p less than 0.05 for trend). No consistent trends were noted for fat or fibre intakes. For non-dietary variables investigated, a history of cholecystectomy increased the risk of both cancers combined (OR = 3.43, p less than 0.05) and colon cancer alone (OR = 4.39, p less than 0.01). This study in an Asian population of countries of Southern and Eastern Asia newly undergoing industrialization and in which rapid economic change is reflected in changing cancer patterns, suggests that the protective effects of certain dietary constituents, notably the cruciferous vegetables, may be more important than the hitherto stressed carcinogenic potential of fat and protein.

Age Factors↗

Risk factors for cancer of the cervix in a rural Chinese population.

A population-based case-control study of 109 women with invasive squamous-cell cervical cancer and 545 controls matched for age and area of residence was carried out in Jingan, China, to evaluate the importance of different risk factors and the effect of cervical cancer screening. After controlling for the protective effect of cervical cancer screening, several factors were found to make an independent contribution to risk. These included the number of sexual partners of the subjects and their husbands (OR: 3.9 for 2 or more sexual partners other than the current spouse, relative to none; 5.9 for 2 or more other partners of the husband relative to none), and poor genital hygiene (OR: 4.8 for absence of daily genital washing relative to washing every day; 0.3 for use of sanitary napkin), these are consistent with an infectious etiology. In addition, menstrual characteristics also had a strong relationship to the risk of cervical cancer (OR: 2.2 for 4 or more days' menstruation relative to shorter duration; 5.4 for irregular menstruation).

Abortion, Spontaneous↗

Cancer of the larynx/hypopharynx, tobacco and alcohol: IARC international case-control study in Turin and Varese (Italy), Zaragoza and Navarra (Spain), Geneva (Switzerland) and Calvados (France).

A case-control study on larynx and hypopharynx cancer was carried out in 6 populations including the city of Turin and the province of Varese (Italy), the provinces of Navarra and Zaragoza (Spain), the canton of Geneva (Switzerland), and the département of Calvados (France). This report presents an analysis of the risk associated with alcohol and tobacco consumption based on 1,147 male cases and 3,057 male population controls. Special attention was given to the study of the risk at various sites of larynx and hypopharynx. The effect of tobacco is similar for all sites and the risk associated with ever smoking is on the order of 10. The risks from alcohol drinking depend on site. They are similar for epilarynx and hypopharynx (RR = 4.3, for more than 80 g/day) and lower for endolarynx (RR = 2.1, for more than 80 g/day). For all sites the risk decreases after quitting (RR = 0.3 after 10 years); exclusive use of filter cigarettes is protective (RR = 0.5 relative to smokers of plain cigarettes only) as is exclusive use of blond tobacco (RR = 0.5 relative to smokers of black tobacco only). Inhalation increases the risk of endolaryngeal cancer but not that of hypopharynx or epilarynx. The relative risks for joint exposure to alcohol and tobacco are consistent with a multiplicative model.

Adult↗

A comparative study of smoking, drinking and dietary habits in population samples in France, Italy, Spain and Switzerland. II. Tobacco smoking.

This paper describes the smoking habits of six populations in France, Switzerland, Italy and Spain. A total of 2,965 men and 2,369 women have been interviewed. The proportion of ever smoking men is almost the same (75 to 80%) everywhere but in Geneva and Calvados a higher proportion of smokers quitted the habit (over 30%). In females, on the contrary, the prevalences of ever smokers is higher in Torino (42%) and Geneva (36%) than in Spain (25%) and Calvados (19%). Young females, however, tend to smoke more and intercountry differences tend to disappear. In both sexes successive generations begin to smoke earlier. Exclusive use of black tobacco is still very high in Calvados (90%) and Navarra (80%) whilst it tends to disappear in Italy (30%). Plain cigarettes decrease everywhere, especially in Spain and Varese, but they are still smoked by the majority of men in Calvados. The results suggest that the tobacco epidemic is still increasing in those areas where it began more recently.

Adult↗

A comparative study of smoking, drinking and dietary habits in population samples in France, Italy, Spain and Switzerland. I. Study design and dietary habits.

Diet, tobacco and alcohol consumption, and occupational histories have been investigated in stratified random samples of the adult population in 6 areas in France (departement of Calvados), Italy (province of Varese and city of Torino), Spain (provinces of Navarra and Zaragoza) and Switzerland (canton of Geneva), to be used as a reference group in a case-control study on cancer of the larynx and hypopharynx. Out of a total of 8,074 sampled subjects, 5,564 could be interviewed. Sampling procedures are described, and reasons for non-response are analysed. Everywhere the intake of the 4 energy providing nutrients (particularly alcohol) was much greater in men than in women. In both sexes, total caloric intake was higher in Calvados and in Italy than elsewhere. There were wide inter-area variations in the consumption of butter + milk products and oils, resulting in a polyunsaturated/saturated fatty acid ratio ranging from 0.27 in Calvados to 0.54-0.65 in Spain. Among nutrients suggested to be involved in cancer aetiology, inter-area differences in daily intake were up to 3-fold for carotene and smaller for vitamin C and fibre. The proportion of lipids, fibres, vitamin C and carotene provided by different foods varied widely between areas, thus suggesting that in etiological cancer studies consideration should be given not only to nutrients but also to foods providing them.

Adult↗

A comparative study of smoking, drinking and dietary habits in population samples in France, Italy, Spain and Switzerland. III. Consumption of alcohol.

Individual present and life time intake of aethanol has been studied in population samples of six areas of Italy (Torino, Varese), Spain (Navarra, Zaragoza), Switzerland (Geneva) and France (Calvados); 2,965 men and 2,369 women were interviewed. Abstinent men were no more than 4% except in Zaragoza (11.5%); 49 to 61% drank between 20 and 80 g. aethanol a day and 21 to 26% more than 80 g. (36% in Navarra). Women drank much less and were more often abstinent: 50 to 94% of them did not drink or drank less than 20 g. a day. Wine was the most commonly consumed beverage (over 60% of total alcohol intake), except in Calvados where cider was still largely consumed (over 30%). Such differences in drinking habits by sex and region are of major public health importance. They do not appear in national sales statistics which must be complemented by surveys on individuals.

Adult↗

Tobacco smoking, occupational exposure and bladder cancer in Argentina.

The highest rate for bladder cancer in Latin America has been reported from La Plata, Argentina. A case-control study was carried out to investigate the reasons for this high rate. A total of 117 cases, 117 hospital controls and 117 neighbourhood sex- and age-matched controls were interviewed regarding their smoking and drinking habits and occupational exposures. Cigarette smoking and coffee drinking were identified as the major risk factors, and a significant association was also found for truck and railway drivers and for oil refinery workers. The relative risks for male smokers who ever smoked cigarettes vs. non-smokers was 4.3 (95% Cl: 1.9-10.3). The risk associated with black tobacco cigarettes was 2-3 times higher than that of blond cigarettes. For male ex-smokers the risk after 5 years of no smoking is less than one third of that of current smokers. The RR for drinking coffee was 2.4 (95% Cl: 1.4-4.4) after adjusting for the effects of tobacco smoking, and the risk increased with the number of cups per day. No association was found with the use of saccharin.

Age Factors↗

Temporal aspects of bladder carcinogenesis.

A case-control study on 461 males with bladder cancer and 566 hospitalized male controls (all under age 70 and residing in the province of Turin, northern Italy) has been re-analyzed in an attempt to elucidate the role of different temporal variables. Both duration and independently cessation seem to play an important role in the carcinogenic activity of tobacco, whereas occupational exposures to aromatic amines were related to the age at first exposure. Relative risks for current smokers who have smoked less than 20, 20-29, and 40 plus years were 2.8, 6.5, and 8.2, respectively; for ex-smokers such estimates were approximately halved. In the case of occupational exposures, relative risks were 6.7, 3.1, and 1.5 for first exposure ages of less than 25, 25-34, and 35 plus years, respectively.

Adult↗

The man-made mineral fiber European historical cohort study. Extension of the follow-up.

The study concentrated on 21,967 workers producing rock wool/slag wool, glass wool or continuous filament in 13 European factories. The expected deaths and incident cancer cases were derived from multiplying the accumulated person-years by national reference rates across sex, age, and calendar-year strata, correction factors for regional lung cancer mortality also being used. Exposure assessment was based on the results of a historical environmental investigation reported elsewhere. There were 189 deaths (151.2 expected), and for rock-wool/slag-wool and glass-wool workers the standardized mortality ratios for lung cancer showed a pattern of increasing mortality with time since first exposure but not duration of employment. There was an excess of lung cancer among rock-wool/slag-wool workers employed during an early technological phase before the introduction of dust-suppressing agents, and fiber exposure, either alone on in combination with other exposures, may have contributed to the elevated risk. No excess of the same magnitude was evident for glass-wool production, and the follow-up of the continuous filament cohort was too short to allow for an evaluation of possible long-term effects. There was no evidence of an increased risk for pleural tumors or nonmalignant respiratory diseases.

Calcium Compounds↗

Prevalence of polyps in an autopsy series from areas with varying incidence of large-bowel cancer.

The results of this multicentre autopsy study emphasize the relationship between the prevalence of adenomas and the incidence of large-bowel cancer. The highest proportion of autopsies with adenomas was observed in the area with the highest incidence of large-bowel cancer. The segmental distribution of adenomas within the colon was found to be similar to the site distribution of cancer. However, the lowest proportion of adenomas was found in the rectum, the segment in which cancer is most frequent. The latter finding suggests that either the adenoma-carcinoma sequence is a less important pathway in the pathogenesis of rectal cancer, or that more rectal than colonic adenomas become malignant. The high proportion of hyperplastic polyps in the rectum, and statistically significant regional differences following the same patterns as the incidence of rectal cancer suggest that there could be at least an indirect relationship between hyperplastic polyps and cancer of the rectum. Adenomas of both colon and rectum were more frequent in men than in women, contrary to findings with colon cancer. However, as for colon cancer, the sex ratio of adenomas changed with age, from slightly below unity in persons under 65, to above unity for those aged 65 and over. A major difficulty that emerged was the histological identification of "polyps" because of the degree of autolysis of epithelial cells in the mucous membrane, and this difficulty largely contributed to the poor consistency of histological reporting. Regular consistency surveys of histological preparations should be recommended in any type of multicentre study in which histological examination is included.

Adult↗