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L Gafà

Publications and source records attributed to L Gafà.

At least 19 recordsLinked to original sources
PubMed1997

Incidence of second primary cancers in three Italian population-based cancer registries.

This is the first population-based study carried out in a southern European region to evaluate the risk of a cohort of cancer patients for developing further cancers. The Tuscany Tumour Registry, the Ragusa Cancer Registry and the Cancer Registry of Romagna, three of the 14 population-based cancer registries active in Italy, were involved in the present study. Overall, 19,252 incident cases of cancer of the female breast, and of the colon, rectum, lung and stomach were followed-up for 48 358.3 person-years. Only second metachronous cancers were considered. Controlateral breast cancers were analysed separately. Multiple primaries (MPs) were defined according to the IACR-IACR rules. The observed (O) numbers of MPs were compared with those expected (E) from age-, sex- and registry-specific incidence rates. Overall, 463 MPs were diagnosed (O/E = 0.87, P < 0.001). The O/E ratios for cancers of the colon (O/E = 0.66), rectum (O/E = 0.72) and all sites combined (O/E = 0.78) in males were significantly lower than expected. The deficit of observed MPs was significant during the first period (2-12 months) and increased over time. Patients over 65 years of age had a significant lower risk of MP, whereas young cancer patients had significantly higher risks for all cancers and for female breast cancer. Male lung cancer patients had a significantly reduced O/E ratio for stomach cancer (O/E = 0.21). Rectal cancer patients had reduced risks of developing stomach cancer and tumours of all sites combined and a 3-fold increased risk of kidney cancers. Colon cancer patients had an overall reduction in risk of MPs, but female colon cancer patients had a significantly increased risk for tumours of the ovary and small intestine; no significant results were found for primary stomach cancers. Female breast cancer patients had a significantly increased risk of rectal cancer (O/E = 1.97), and when synchronous and bilateral breast cancers were considered, significant overall increases in risk were seen for all cancer sites (O/E = 1.6) and for rectal (O/E = 2), and especially for breast cancers (O/E = 3). The cohort analysed had a lower risk of developing further independent tumours than the general population. Several artefacts may have biased these results: the exclusion of synchronous cancers greatly reduced the overall MP risk, and the age-related differences may have been due to reduced medical surveillance and diagnostic aggressiveness. We have confirmed the increased risk for kidney cancers in rectal cancer patients and the association between cancers of the colon and ovary. The significantly increased risk for rectal cancer in female breast cancer patients is probably due to hormonal and dietary factors. For female breast cancer patients, controlateral breast cancer represented the highest risk. The increased risk of cancer of the small intestine in patients with colon cancer may be due to overdiagnosis within increased medical surveillance.

Aged↗
PubMed1997

Histology of aberrant crypt foci in the human colon.

Aberrant crypt foci (ACF) have been identified in the methylene-blue stained mucosa of the human colon. Some lines of evidence suggest that ACF may be precursors of colon cancer. The objective of the present study was to establish morphological criteria able to define and classify ACF in histological sections. Twenty-four colectomy specimens were collected after operation for colorectal cancer and fixed in 10% formalin. Strips of grossly normal mucosa were stained in a 0.2% solution of methylene blue in saline for 5-10 min. The strips were measured, put on a glass slide and observed under a light microscope at x25. One hundred and fourteen ACF identified by topology were sectioned parallel to the muscularis mucosae. Eighty-four ACF were evident at histological examination and could be classified into three main groups: group A (61 ACF, 72.6%) including foci whose epithelial cells had regular nuclei, with only mild or focal crowding but no stratification, no mucin depletion and no dysplasia; group B (16 ACF, 19.1%), in which features of hyperplasia were evident; and group C (seven ACF, 8.3%) including foci with enlarged, crowded and stratified nuclei, mucin depletion, frequent mitoses, and evident dysplasia, diffuse or focal (mild in five cases, moderate in two) representing microadenomas. Finally, hyperplastic foci were significantly larger than foci of group A and C. Group B ACF were also more frequent in the rectum than in the colon. In conclusion, selected histological features allow the definition of groups of ACF, which may represent sequential steps in the development of human colorectal tumours.

Aged↗
PubMed1997

Estimation and projections of colorectal cancer trends in Italy.

BACKGROUND: Occurrence of and prognosis for tumours of the colon and rectum are thought to be changing rapidly due to simultaneous changes in risk factor prevalence, early diagnosis and treatment. In this paper time trends of morbidity, survival and mortality for colorectal cancer during the period 1970-1990 are estimated and analysed. METHODS: Mortality trends were obtained from official death certificates. Relative survival rates were computed from population-based cancer registries. Incidence and prevalence rates were estimated from mortality and survival data. RESULTS: Incidence rates were increasing during the period considered, with a lower rate of increase for the youngest birth cohorts. Relative survival rates of both colon and rectum cancers were higher for women, and for younger age groups, and were positively associated with period of diagnosis. No significant survival difference among the cancer registries used was found. A total of about 155,000 prevalent cases, 40% of which had been diagnosed > or = 7 years before, were estimated in the Italian population for the year 1990. Mortality rates were slightly increasing for men and stable for women. Projections of colorectal cancer trends to the year 2000 indicate major expected rises in both incidence and prevalence. CONCLUSION: Colorectal cancer represents a problem of growing impact for health services in Italy. This conclusion can probably be extended to many developed countries.

Adult↗
PubMed1996

The multicentre south European study 'Helios'. I: Skin characteristics and sunburns in basal cell and squamous cell carcinomas of the skin.

The aim of this study was to investigate constitutional and environmental determinants of non-melanocytic skin cancer among different populations from south Europe. Between 1989 and 1993 we interviewed incident cases and a random population sample of controls from five centres where a cancer registry was operating, whereas we selected a sample of hospital-based cases and controls from three other centres. Controls were stratified according to the age and sex distribution of cases. In all, 1549 cases of basal cell carcinoma (BCC), 228 of squamous cell carcinoma (SCC) and 1795 controls were interviewed. Both cancers affected primarily sun-exposed sites such as face, head and neck, but the prevalence of BCC on the trunk was higher than for SCC. Pigmentary traits such as hair and eye colour as well as tendency to sunburn were strong and independent indicators of risk for both BCC and SCC. In SCC, adjusted odds ratios (ORs) ranged from 1.6 for fair hair colour to 12.5 for red hair. Light-blonde hair entailed a risk of about 2 for BCC. Pale eye colour was associated with a risk of 1.8 for SCC and 1.4 for BCC. Subjects who always burn and never tan showed an adjusted OR of 2.7 for BCC and 2.0 for SCC. A history of sunburns and a young age at first sunburn were associated with an increased risk for BCC only (OR 1.7). Pigmentary traits and sun sensitivity of the skin confirmed their role as risk indicators. The effect of sunburns, as an indicator of both exposure and sun sensitivity of the skin, is less clear. Nevertheless, its association with BCC suggests, by analogy with melanoma, a relationship with intense sun exposure. Conversely, SCC would require prolonged exposure to sunlight.

Adolescent↗
PubMed1996

The multicentre south European study 'Helios'. II: Different sun exposure patterns in the aetiology of basal cell and squamous cell carcinomas of the skin.

The role of sun exposure in development of basal cell and squamous cell carcinomas among different populations from south Europe was investigated. Between 1989 and 1993 we interviewed incident cases and a random population sample of controls from five centres where a cancer registry was operating, whereas we selected a sample of hospital-based cases and controls from the other three centres. We gathered information on life-long exposure to sunlight during different activities. Results are analysed for 1549 basal cell carcinoma (BCC) cases and 228 squamous cell carcinoma (SCC) cases compared with 1795 controls. We observed a statistically significant increase of risk of SCC with increasing sun exposure beyond a threshold of 70,000 cumulated hours of exposure in a lifetime. Sun exposures during work and holidays were, however, inversely correlated. Odds ratios (ORs) of SCC were up to eight or nine times the reference for the highest exposures (200,000 cumulated hours or more). BCC exhibited a 2-fold increase of risk for lower exposure (8000-10,000 cumulated hours in a lifetime) with a plateau and a slight decrease of risk for the highest exposures (100,000 cumulated hours or more). Outdoor work showed a significantly increased risk of SCC (OR 1.6 for more than 54,000 cumulated hours of exposure in a lifetime), whereas recreational activities such as sun exposure during holidays at the beach (OR 1.6 for more than 2600 cumulated hours of exposure in a lifetime) or during water sports (OR 1.6 for more than 2600 cumulated hours of exposure in a lifetime) were associated with an increased risk of BCC. Risk patterns were different in poor or good tanners with a significant risk trend for good tanners, whereas poor tanners were on a plateau of increased risk at any level of exposure. Solar radiation is associated with a risk of BCC even for relatively short periods of exposure such as during holidays and sports, whereas SCC develops later if exposure continues. The skin's ability to tan modulates the risk of BCC; subjects who tan poorly have a steady risk increase, whereas people who tan easily develop cancer only after prolonged exposures.

Basal Cell Carcinoma↗
PubMed1996

[Survival for digestive system tumors: Italian population-based data and international comparisons].

Survival for malignant tumour of the upper digestive tract, oesophagus, stomach and pancreas are analysed from the data of 5042 cases observed during the period 1976-1985 by the Italian cancer registries (CRs) of Varese, Latina, Ragusa and Florence. Three-year relative survival rates were 42% for patients with tumours of the upper digestive tract and 7% for those tumour of the oesophagus. Five-year relative survival for patients with stomach cancer was 20%. A worse prognosis was found for cases from the Latina and Ragusa CRs. One-year relative survival for patients with pancreatitic cancer was 17%. Younger age, histologic confirmation, period of diagnosis (for upper tract, stomach and pancreatitic cancers), and female gender (for tumours of the upper tract) resulted as positively associated to survival.

Adolescent↗
PubMed1996

[Survival for tumors of the colon and the rectum in Italy].

In population based from four Italian cancer registries (Varese, Modena, Latina, Ragusa), five-years relative survival was 34% for colon cancer patients (no. = 1864) and 28% from rectum cancer patients (no. = 1117). However, rectum cancer patients showed higher survival rates in the first year of follow-up, which is possibly due to earlier diagnosis for sites more accessible to clinical examination. For colorectal cancer, age was an important prognostic factor, both in univariate and in multivariate analysis, adjusting for competitive mortality, sex, geographical area and year of diagnosis. In the same multivariate analysis, the prognosis was better for women, significantly for colon cancer and the excess death risk was reduced by 25-30% from 1978-79 to 1984-85. No significant differences were found among different geographical areas, possibly because of the low number of patients from some of the participating cancer registries.

Adult↗
PubMed1995

Familial aggregation of tumors and detection of hereditary non-polyposis colorectal cancer in 3-year experience of 2 population-based colorectal-cancer registries.

The clinical data of 2 population-based registries, located in areas with different incidence rates of colorectal cancer, were used in order to assess the role of familial factors in the pathogenesis of these tumors. The occurrence of tumors in family members was investigated in 389 subjects with colorectal cancer registered in Modena (Northern Italy, an area characterized by a high incidence of colorectal malignancies) between 1984 and 1986; similar information was obtained in 213 patients with tumors of the large bowel registered in Ragusa (Sicily, Southern Italy, an area of similar magnitude and with low incidence rates for these tumors) in the 3-year period 1988 to 1990. In both series, colorectal cancer occurred significantly more often among relatives of patients. Controls were patients of the same sex and age (+/- 5 years) hospitalized during the study periods, but not for gastrointestinal or neoplastic diseases. There were 89 cancer cases (3.1%) among 2,851 relatives of patients in Modena, vs. 17 cases among 1,744 relatives (1.0%) in Ragusa (p < 0.01). Apart from colorectal cancer, there was no excess of other types of tumors in patients' families (in both series). During the 3 years of registration, 17 cases of hereditary non-polyposis colorectal cancer (HNPCC, or Lynch syndrome) were diagnosed in Modena; in contrast, this syndrome was more rare in Ragusa (one case only during 3 years of observation). Similarly, many more families with clinical suspicion of HNPCC were recorded in Northern regions (44 vs. 10). Although incidence rates of colorectal cancer are appreciably higher in Northern than in Southern Italian regions, the excess of this cancer type among close relatives is similar. However, full-blown HNPCC or suspected Lynch syndrome were significantly more frequent in Northern Italy.

Aged↗
PubMed1995

Cancers of the female genital tract in Ragusa, Sicily.

A descriptive study of cancers of the female genital tract (cervix, endometrium, ovary, labia, vulva and vagina) in the province of Ragusa (Sicily) was carried out using incidence and mortality data of the Ragusa Cancer Registry, covering the years 1981-1987. Corpus uteri was the most frequent site of cancer, followed by cervix utery and ovary; the highest mortality rates were exhibited by ovary cancer, whose survival at five years was 18.1 percent. A comparison of incidence and mortality rates with those observed by Italian and European registries shows that while in Ragusa rates for cancers of all sites were lower, female genital tract cancers, particularly of the uterus, were more frequent in Ragusa than in other Italian and European areas. In contrast with what has been reported by cancer registries of most developed countries, incidence of cervix cancer in Ragusa has apparently not decreased between 1981 and 1987, while mortality has increased.

Age Distribution↗
PubMed1994

Kaposi's sarcoma in Italy before and after the AIDS epidemic.

The incidence of Kaposi's sarcoma (KS) in 1976-90 was assessed in Italy, taking advantage of a network of nine population-based cancer registries covering, at its maximum, approximately 5.6 million subjects. The first examined period (1976-84) substantially reflects the epidemiology of KS prior to the AIDS epidemic in the registration areas. Elevated incidence rates, standardised to the Italian population of 1981, of 1.05/100,000 men and 0.27/100,000 women emerged in 1976-84 (i.e. from two- to threefold higher than in the USA and Sweden, more than tenfold higher than in England and Wales). These high rates, especially remarkable in the Registry from the south of Italy (i.e. Ragusa, 3.01/100,000 men and 0.54/100,000 women) suggest that the prevalence of the still unknown causative agent for KS was high, at least in some parts of Italy, prior to the AIDS epidemic. In the most recent period (1985-90), an approximately twofold increase in KS incidence rates in Italian men below age 50 was observed (from 0.15 in 1976-84 to 0.47 in 1985-90). Conversely, declines in KS incidence were recorded in older men.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Descriptive epidemiology of stomach cancer in Ragusa, Sicily, 1981-1988.

An epidemiologic study was carried out on 475 incident cases of gastric cancer registered by the Ragusa Cancer Registry (Sicily) between 1981 and 1988. Distribution by sex, age, subsite, year of incidence, and survival was investigated. A reduction of incidence and mortality between 1981-84 and 1985-88 was observed in both sexes, and was more evident in males than in females. Survival was not significantly different for cancers of the various subsites.

Adult↗
PubMed1992

[Analysis of the quality of death certificates for neoplasms in the province of Ragusa].

The reliability of the death certificates issued in Ragusa for 379 of the 909 cancer patients registered in 1986 by the Ragusa Cancer Registry, who had died within 31 october 1988, was investigated. Data were available for 365 cases deceased. A consistent proportion (32.8%) of disagreements between diagnosis of the Registry and cause of death reported on death certificate was observed, concerning errors of the second and third digit of ICD-9 (21.9%) and for lack of mention of cancer in the death certificate. The main causes of the loss of information were the issuing of the certificate by a M.D. of the permanent medical ward and not by the family doctor, and the lack of the document released by the hospital upon discharge of the patient, usually containing indication on diagnosis and treatment.

Cause of Death↗
PubMed1991

Survival of patients with cancer of the stomach, colon and rectum, lung and breast in Ragusa, Sicily.

Survival of 1747 patients with cancer of the stomach, colon/rectum, lung and female breast was investigated on incident cases registered by the Ragusa Cancer Registry, covering the Province of Ragusa (275,000 inhabitants) between 1981 and 1986. Cases known from the death certificate only were excluded. Date of death was obtained by a linkage with death certificates issued for Ragusa residents. Living status was assessed directly at the Registrar's Office. Analysis was performed also by sex, age group and presence of histologic verification. Relative survival at 5 years of Ragusa cancer cases was of the same order of magnitude as that observed in the U.S.A. (1980) and in Switzerland (1970-1980). However, the slight differences observed were mostly in favor of the Swiss and American patients. Sex did not significantly influence survival, but younger patients survived longer than older ones. Lack of histologic verification was associated with poor survival.

Age Factors↗
PubMed1991

Risk factors of nonmelanoma skin cancer in Ragusa, Sicily: a case-control study.

A case-control study on 133 consecutive incident cases of nonmelanoma skin cancer registered by Cancer Registry of Ragusa (Sicily) was carried out in order to evaluate the correspondence between risk factors observed in other geographic areas with those of a Latin country with a strong solar exposure. A multivariate analysis showed that family history of skin cancer, cancer-related cutaneous diseases, fair skin color, residence more than 400 meters above sea level, and prolonged solar exposure without protection, significantly and independently increase the risk of skin cancer. Ease of suntanning was an important protective factor. Solar exposure was a stronger risk factor for squamous cell than for basal cell cancer. The results of the study enable us to identify a high risk group of people to whom simple methods of protection against solar exposure may be suggested to reduce the risk of skin cancer.

Adult↗
PubMed1989

Risk factors of female cancers in Ragusa population (Sicily)--1. Endometrium and cervix uteri cancers.

A case-control study on breast, cervix and endometrium cancer cases registered in Ragusa between January 1, 1983 and June 30, 1985 has been conducted. Information on risk factors has been obtained by means of a structured questionnaire. Risk factors for endometrium cancer were: few children (1-2 vs greater than 4 OR 15.18, 95%CL 1.96-117.64), oestrogenic treatment (OR 2.20, 95%CL 1.05-4.90), obesity (Quetelet index greater than 30 vs less than 22 OR 10.42, 95%CL 1.30-83.86), family history (OR 2.87, 95% CL 1.05-7.83). Risk factors for cervix uteri cancer were: multiple abortions (greater than 2 vs 0 OR 9.87, 95%CL 1.46-66.66), no contraception (OR 8.33, 95%CL 2.38-25.00), younger age of mother at birth (OR 6.89, 95%CL 1.71-27.70). Age at menarche, age at menopause and years of fertile life were not found to be related to either endometrium or cervix uteri cancer. The existence of influencing differences (ancestry, environment, lifestyle) has been postulated.

Case-Control Studies↗
PubMed1984

A case-control study on lip cancer risk factors in Ragusa (Sicily).

Incidence rates of lip cancer in males in Ragusa (Sicily) are amongst the highest in Europe [age-standardized rate (world) for 1980-82: 7.5 per 100,000]. A case-control study was conducted on 53 male cases and 106 controls matched for sex, age (+/- 2 1/2 years), residence and hospital from which cases had been drawn. Individual interviews were carried out for the evaluation of ethnic, environmental, pathologic and occupational risk factors. Lip cancer was significantly associated with: fair, brown, or red hair (relative odds = 2.3), blue eyes (r.o. = 5.3), fair skin (r.o. = 8.0), sensitivity to sunburns (r.o. = 4.1), working outdoors (r.o. = 4.9), coexistence of non-specific lesions of exposed body parts (r.o. = 12,2), low socioeconomic status (r.o. = 15.8), farming (r.o. = 2.6) and working in greenhouses (r.o. = 12.0). Recall of recurrent Herpes labialis was not significantly associated; also association with tobacco smoking was not significant after adjustment for socioeconomic status. Risk increased exponentially with the number of ethnic characteristics of northern European populations.

Adult↗