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M Ferraroni

Publications and source records attributed to M Ferraroni.

47 records · Page 3Linked to original sources

Socio-demographic determinants of stopping smoking from Italian population-based surveys.

Frequency and determinants of smoking cessation were analysed using data from two Italian National Health Surveys, conducted in 1983 and 1986-87 on samples of 89,753 and 77,155 individuals respectively, randomly selected within strata of region of residence, size of the municipality and of the household, in order to be representative of the general Italian population. Overall stopping ratios or "quit ratios" (i.e., ratios between ex- and ever-smokers) were 20.5% for males and 9.0% for females in the 1983 survey, and rose to 23.2 and 11.9% respectively in 1986-87. With reference to age, stopping rates were slightly higher for females than for males below age 35, but considerably higher for males in each subsequent age group, particularly in middle age. Ratios were apparently higher for the most recent survey for both sexes and each subsequent age group. After standardisation for age, "quit ratios" in both sexes were directly related with education. Cessation of smoking was more common in northern (and richer) areas of the country, and positively associated with the prevalence of smoking-related chronic diseases. The major, and most discouraging, finding from these analyses is the absolute low rate of stopping in Italy as compared to northern America or northern Europe, although some positive tendency towards increasing cessation was evident between the early and the late 1980s. These tendencies, together with some recent drops in smoking prevalence in younger women, first observed after decades of increase, indicate a change at least in attitudes towards reporting smoking, and hence social acceptance of the habit.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Smoking habits and risk of benign breast disease.

The relationship between smoking habits and the risk of benign breast disease (BBD) was analyzed using data from a case-control study conducted between 1981 and 1983 in the greater Milan area, Northern Italy. Cases (n = 288) were women with histologically confirmed BBD (203 dysplasia, 85 benign tumours) referred to the National Cancer Institute of Milan for biopsies. Controls were women (n = 291) seen on selected days for a cytological smear for cervical cancer in outpatient clinics of the same Institute. No consistent association emerged between various indicators of smoking habits (smoking status, number of cigarettes smoked per day, duration of smoking) and the risk of BBD. Compared with never smokers the relative risk (RR) of all BBD combined was 0.7 (95% confidence interval, Cl: 0.4-1.3) in exsmokers, 1.4 (95% Cl: 0.8-2.5) in smokers of less than 10 cigarettes per day, and 1.1 (95% Cl: 0.7-1.7) in smokers of 10 or more cigarettes per day. There was some suggestion that the risk may be below unity post-menopause, but the relative risks for smokers were not statistically different in pre- (RR = 1.2; 95% Cl: 0.8-1.8) and post-menopausal (RR = 0.6; 95% Cl: 0.2-1.7) women. The risk of benign tumours (chiefly fibradenoma) was higher in current smokers, but this finding was not statistically significant (RR = 1.5; 95% Cl: 0.9-2.6) and the highest risks were observed in the strata of lighter smokers and those with shorter duration of smoking. Overall these results fail to support a negative association between smoking habits and benign breast disease.

Adenofibroma↗

Alcohol and breast cancer risk: a case-control study from northern Italy.

From May 1982 to June 1985 a hospital-based case-control study of diet and breast cancer (214 cases and 215 controls) was conducted in Milan in northern Italy, an area where wine consumption is widespread. The study used a detailed diet questionnaire to obtain an estimation of total calories as well as major micro- and macro-nutrient intake. The data thus allowed an investigation of the role of alcohol in breast cancer risk, adjusting for other dietary factors, in particular total energy intake. We found positive associations between breast cancer risk and total caloric intake (chi 2 trend = 6.05, P = 0.014) but no effect for the other nutrients, when adjusted for total caloric intake. The relative risk of breast cancer, for women reporting more than 24.35 g/day of alcohol consumption (highest quintile), was 2.1 (95% confidence interval (CI): 1.1-3.9) when adjusted for non-dietary risk factors for breast cancer and 1.8 (95% CI: 1.0-3.3) when adjusted for non-alcohol caloric intake. The relative risks were moderately elevated (50% or less) for low levels of consumption and comparable to those recorded in most American studies. This finding provides further support for a moderate association between alcohol consumption and breast cancer risk, even when allowance is made for potentially relevant nutrients.

Adult↗

Reproductive and menstrual factors and risk of peritoneal and ovarian endometriosis.

OBJECTIVE: Between 1987 and 1989 data were collected to evaluate risk factors for pelvic endometriosis. DESIGN: A case-control study was conducted on 241 cases with laparoscopically or laparotomically confirmed peritoneal or ovarian endometriosis consecutively admitted to three teaching hospitals in Northern Italy. The control group consisted of 437 women admitted to hospitals for acute conditions covering similar catchment areas. RESULTS: Compared with nulliparous women, the risk of endometriosis decreased with increasing number of births: the point estimates were 0.4 and 0.3, respectively, for those with one and two or more births (X2(1) trend = 50.3, P less than 0.001). No relation emerged with age at first birth and spontaneous miscarriages. Relative to women whose menarche occurred at age 11 or younger, the risk of endometriosis was slightly lower in those who experienced later menarche, but the trend in risk was not significant. Women with irregular menstrual cycles showed a lower frequency of the disease (relative risk, 0.3; 95% confidence interval, 0.2 to 0.5). The role of various factors was largely similar for different disease locations (ovary, peritoneum, and both) and indication for diagnostic surgery (sterility, pelvic pain, and other reasons). CONCLUSIONS: This study found that parity and irregular/long menses lower the risk of endometriosis. These findings were similar in different subgroups of disease location and indication for surgery, giving strong evidence of the consistency of the general results.

Abortion, Spontaneous↗

Relative and attributable risk for cervical cancer: a comparative study in the United States and Italy.

The attributable risk for invasive cervical cancer in the US and Italian populations has been estimated in relation to main 'aetiological' factors (number of sexual partners, age at first intercourse, parity, oral contraceptive use and smoking) and history of Pap smear using data from two case-control studies conducted in the US (466 cases and 788 controls) and Italy (528 cases and 456 controls). The risk of cervical cancer increased in both studies with multiple sexual partners, decreasing age at first intercourse, higher parity, oral contraceptive use and smoking. Levels of exposure to various risk factors were markedly different in the two countries (ie number of sexual partners, frequency of oral contraceptive use and smoking were greater in the US). Multiple Pap smears and a short interval since last Pap smear strongly reduced risk of cervical cancer in both populations, although screening was much more widespread in the US study population, with only 9% of controls reporting no previous smear versus 38% of the Italian control series. The combined population attributable risk for the five 'aetiological' risk factors was slightly greater in the US study (76%) than in the Italian one (69%), chiefly because of a higher prevalence of exposure to sexual factors in US study women. A substantially larger proportion of Italian cases were due in part to deficiency in screening (46% in US and 84% in Italy). Thus, further inclusion of the effect of screening programmes (number of Pap smears and time since last Pap) led to an overall proportion of cases attributable to the examined risk factors of 87% in the US and 95% in Italy.

Adult↗

Medical history, diet and pancreatic cancer.

The relation between various aspects of medical history, selected indicator foods and the risk of pancreatic cancer was analyzed in a hospital-based case-control study conducted in Northern Italy on 247 patients with cancer of the pancreas, and 1,089 controls in hospitals for acute, nonneoplastic or digestive conditions. There was a significant association with history of pancreatitis (relative risk, RR 3.2, 95% confidence interval = 1.3-7.9), which was however reduced when the condition was first diagnosed at least 5 years previously. The point estimates were slightly, but not significantly, above unity for diabetes (RR = 1.5), gastrectomy (RR = 1.1) and cholelithiasis (RR = 1.3), and no association was found with liver disease or drug allergy. In relation to diet, there was some tendency for the risk to decrease with more frequent fruit consumption, but the results were largely inconsistent in relation to various indicators of meat, animal protein or fat intake. Although no important associations were found in this study with various aspects of medical history or diet indicators and pancreatic cancer risk, on account of the size of the dataset and the statistical power, this study contributes usefully to the debate on a common cancer whose causes are still largely undefined.

Case-Control Studies↗

Smoking in Italy, 1986-1987.

Smoking trends and patterns in Italy were evaluated using data from the 1986-87 Italian National Health Survey, based on a sample of 30,096 males and 32,176 females aged 15 or over, randomly selected within strata of geographical areas and sizes of the place of residence and of the household in order to be representative of the whole Italian population: 40.8% of Italian males and 17.3% of females described themselves as current smokers (overall estimated prevalence, 28.6%). In comparison with previous survey-based data, self-reported smoking prevalence in males has been steadily decreasing over the last three decades, whereas rates in females have been increasing up to the early 1980s, and have shown a levelling off only in more recent years. The apparent declines in self-reported smoking, however, were not reflected in official sales figures. In fact, in the mid 1980s, there were simultaneously the lowest overall prevalence of the last three decades and the highest sales figures ever reported. The inter-sex differences in smoking prevalence were smaller at younger ages. Education, but not occupation as a measure of social class, was inversely related to smoking prevalence in males. Furthermore, rates for males were lower in the northern (and richer) part of the country. The pattern was totally different in females, since smoking prevalence was higher in more educated women, of higher social class, living in North Italy. This suggests that, in the absence of adequate measures, smoking prevalence is likely to rise among Italian women in the near future. Continued monitoring of smoking patterns gives important information with which to identify the most likely future patterns in smoking and smoking-related diseases, besides providing data for targeting intervention programs.

Adolescent↗

Pattern of cervical screening utilization in Italy.

The pattern of cervical screening utilization in Italy was analyzed using data from the 1986-1987 National Health Survey on the basis of a sample of 27,455 women aged 20 to 79 randomly selected within strata of municipality of residence and age in order to be representative of the whole Italian population. Overall, about 17% of women aged 20 to 79 were screened per year, for a total of 3.5 to 4 million cervical smears per year. The highest frequency was reported in younger middle age, about one in four women being screened per year in the age groups 30 to 49, and there was a substantial decline above age 50. Cervical smear rates were higher in Northern areas (22%), where mortality from cervical cancer is lower, than in the Centre (16%) and South (11%) of the country. Further, there was a strong positive social class gradient in the utilization of cervical screening, in relation to both education and occupation. In spite of the absence of any organised mass screening program, cervical screening is a relatively common procedure among Italian women. However, this study provides further quantitative evidence of a markedly irrational utilization of non-organized cervical screening, which tends to end up selectively used by the groups in which cervical cancer is less common.

Adult↗

Coffee consumption and digestive tract cancers.

The relationship between coffee drinking and the risk of digestive tract neoplasms was analyzed in a case-control study of 50 cases of cancer of the mouth or pharynx, 209 of the esophagus, 397 of the stomach, 455 of the colon, 295 of the rectum, 151 of the liver, 214 of the pancreas, and 1944 control subjects admitted for acute, non-digestive tract disorders. There was no significant or consistent association between coffee and cancers of the mouth or pharynx, esophagus, stomach, liver, or pancreas. In particular, for pancreatic cancer, the multivariate relative risks for the intermediate and upper tertiles were 1.05 and 1.01, respectively. There were significant inverse trends in risk with measures of coffee consumption for colon and rectal cancers, the multivariate relative risks according to tertiles of coffee consumption being 0.86 and 0.64 for colon and 0.97 and 0.66 for rectum. This apparent protection is in agreement with some (but not all) previous epidemiological evidence and finds a possible biological interpretation in terms of interference on bile secretion, causing reduced bile acid and neutral sterol concentrations in the bowel. In conclusion, the results of this study, the major interest of which lies in the opportunity of drawing up an overall pattern of risk for various digestive neoplasms, offer further reassurance as regards the effects of coffee on digestive tract carcinogenesis.

Adult↗

Socioeconomic indicators, tobacco and alcohol in the aetiology of digestive tract neoplasms.

The relationship between education, social class, smoking habits, alcohol consumption and the risk of digestive tract neoplasms was analysed in a case-control study of 50 cases of cancer of the mouth or pharynx, 209 of the oesophagus, 397 of the stomach, 455 of the colon, 295 of the rectum, 151 of the liver, 214 of the pancreas, and a total of 1944 control subjects admitted for acute, non-neoplastic or digestive tract disorders. Cancers of the mouth or pharynx, oesophagus and stomach were inversely and strongly related to education, with risk estimates ranging between 0.2 and 0.4 for the highest education categories. Significant, but weaker inverse relations were evident for rectal and liver cancer, too, whereas the risk of colon cancer was elevated among more educated individuals. There was no relationship between education and pancreatic cancer. The pattern of risk was largely comparable when the head of the household's occupation was used as indicator of social class. There were strong direct associations between cigarette (as well as pipe or cigar) smoking and cancers of the mouth or pharynx and oesophagus, and a moderate one with pancreatic cancer, but none of the other sites considered was related to smoking habits. Cancers of the mouth or pharynx and oesophagus were independently and strongly related to alcohol consumption, too, while the associations between alcohol and liver or pancreatic cancer were moderate and not significant. Cancers of the stomach, colon and rectum were unrelated to measures of alcohol consumption.

Adult↗

Selected micronutrient intake and the risk of gastric cancer.

The relationship between intake of selected micronutrients and gastric cancer risk was investigated using data from a case-control study conducted in Italy between 1985 and 1992 on 723 cases of histologically confirmed, incident gastric cancer, and 2024 controls hospitalized for acute, nonneoplastic, nondigestive tract diseases. Relative risks of subsequent quintiles of intake were computed after allowance for sex, age, and other major identified potential confounding factors, including an estimate of total calorie intake. No trend in risk emerged for intake of retinol, vitamin D and vitamin E, whereas a protective pattern was observed for consumption of beta-carotene, ascorbic acid, folate, and nitrates, with risk estimates for the highest intake quintiles of 0.27, 0.40, 0.58, and 0.43, respectively. Significant direct trends in risk were found for methionine, calcium, and nitrites. When the effect of various micronutrients was taken into account, a residual protective effect was observed for beta-carotene and ascorbic acid, and a direct association with methionine remained, whereas the protective effect of folates and nitrates and the direct associations of nitrites were no longer evident. The risk estimates for the upper quintiles of beta-carotene, ascorbic acid, and methionine consumption were respectively 0.38, 0.53, and 2.40, and all the trends in risk were significant and consistent across strata of sex and age. Whether this reflects a specific effect of these micronutrients, rather than problems of collinearity or other limitations of the data, is open for discussion. Nonetheless, these data indicate that selected micronutrients may have an impact in the process of gastric carcinogenesis.

Adult↗