Is there a link between diet and esophageal cancer?
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Diet↗
Biomedical subjects
Silvano Gallus
Publications and source records attributed to Silvano Gallus.
Effects of smoking cessation on the risk of laryngeal cancer: an overview of published studies.
Epidemiological studies showed that stopping smoking substantially decreases the risk of lung cancer. With reference to laryngeal cancer, at least four cohort studies and 15 case-control studies reported information on smoking cessation. These studies indicated that the risk of laryngeal cancer is considerably reduced in ex-smokers as compared to current smokers. The relative risk steeply decreases with time since stopping smoking, with reductions by about 60% after 10-15 years since cessation, and even larger after 20 years. The favorable effect of stopping smoking is already evident within few years after cessation, thus suggesting that smoking has a relevant impact on the late stage of laryngeal carcinogenesis. However, several years after stopping smoking, ex-smokers still have elevated risks of laryngeal cancer as compared to never smokers. In conclusion, the epidemiological evidence clearly indicates that cessation of smoking is the best measure to reduce laryngeal cancer risk, the beneficial effect being evident within a few years after cessation, and steadily increasing with passing time since cessation.
Case-Control Studies↗
Smoking cessation and the risk of oesophageal cancer: An overview of published studies.
The epidemiologic studies on oesophageal cancer and smoking cessation published before December 2005 were reviewed here. The results from at least 10 cohort and 10 case-control studies indicated that former smokers had a lower risk of squamous-cell or unspecified oesophageal cancer than current smokers. Most investigations showed that the risk of oesophageal cancer remains elevated many years (at least 10) after cessation of smoking, to decline by about 40% only thereafter. Moreover, after 10 years since cessation of smoking, ex-smokers still have a twofold increased risk as compared to never smokers. A few studies investigated the effect of smoking cessation on adenocarcinoma, and did not report a clear reduction of risk. Data on oesophageal adenocarcinoma are however too limited to provide adequate inference on the relation with time since smoking cessation. In conclusion, cessation of smoking could have an appreciable impact in reducing (squamous-cell) oesophageal cancer, and represents an obvious priority for prevention and public-health purposes.
Adenocarcinoma↗
Re: Carbonated soft drink consumption and risk of esophageal adenocarcinoma.
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Adenocarcinoma↗
Number of nevi at a specific anatomical site and its relation to cutaneous malignant melanoma.
The risk of cutaneous malignant melanoma (CMM) is strongly associated with total number of nevi. Scanty information is available on the association between CMM at a specific anatomical site and number of nevi at the same site. We analyzed data from a case-control study conducted in Italy between 1992 and 1994, on 542 cases of CMM and 538 hospital controls. Cases and controls were examined by trained dermatologists who counted the number of melanocytic nevi. We derived multivariate odds ratios (ORs) and 95% confidence intervals (95% CIs) of site-specific risk of CMM for high versus low number of nevi at the corresponding site. The ORs of CMM for the highest versus the lowest tertile of number of nevi at the corresponding site was 1.4 (95% CIs: 0.7-2.8) at face and neck, 2.3 (95% CIs: 1.1-4.9) at anterior trunk, 4.9 (95% CIs: 2.9-8.4) at posterior trunk, 2.9 (95% CIs: 1.2-6.6) at upper limbs and 5.0 (95% CIs: 2.9-8.5) at lower limbs. In a case-case analysis, comparing CMM cases at a specific site and CMM cases at all other sites, the only excess risk was found for the posterior trunk, the ORs being 2.1 (95% CIs: 1.2-3.6) for the highest versus the lowest tertile of number of nevi. Our data do not support the hypothesis of a specific effect of nevi at each single anatomical site.
Adult↗
Milk, dairy products and cancer risk (Italy).
BACKGROUND: Inconclusive information is available on the potential role of milk and dairy products on the risk of cancer at several sites. METHODS: We analyzed data from a large and integrated network of hospital-based case-control studies in Italy on cancers of the oral cavity and pharynx (598 cases, 1491 controls), oesophagus (304 cases, 743 controls), colorectum (1953 cases, 4154 controls), larynx (460 cases, 1088 controls), breast (2569 cases, 2588 controls), ovary (1031 cases, 2411 controls) and prostate (1294 cases, 1451 controls). RESULTS: Multivariate odds ratio (OR) for the highest consumption level of any type of milk was 0.94 (95% confidence interval, CI: 0.61-1.33) for cancers of the oral cavity and pharynx, 1.20 (95% CI: 0.76-1.90) for oesophageal, 0.77 (95% CI: 0.62-0.96) for colon, 0.80 (95% CI: 0.60-1.05) for rectal, 0.83 (95% CI: 0.56-1.21) for laryngeal, 0.91 (95% CI: 0.76-1.10) for breast, 0.89 (95% CI: 0.68-1.15) for ovarian and 1.08 (95% CI: 0.84-1.37) for prostate cancer. A significant trend in risk was found for colon cancer only. Inverse associations were observed between consumption of skim milk and cancers of colon (OR=0.84; 95% CI: 0.73-0.97), rectum (OR=0.76; 95% CI: 0.64-0.91), breast (OR=0.87; 95% CI: 0.77-0.98) and ovary (OR=0.77; 95% CI: 0.66-0.91). Conversely, whole milk consumption was directly associated with cancer of the rectum (OR=1.22; 95% CI: 1.03-1.44) and ovary (OR=1.25; 95% CI: 1.07-1.46). High consumption of cheese was inversely related to colon cancer risk (OR=0.80; 95% CI: 0.67-0.95). CONCLUSIONS: There was a modest direct association between milk and dairy products and prostate cancer, and a moderate inverse one for colorectal cancer. However, our findings indicate that milk and dairy products are not strong risk indicators for any of the cancers considered.
Animals↗
Aspirin and cancer risk: an updated quantitative review to 2005.
Aspirin has been associated to a reduced risk of colorectal, and possibly of a few other common cancers. Epidemiological studies on aspirin and cancer risk published up to December 2005 have been reviewed, and pooled relative risks (RR) for several cancers have been provided. Besides a reduction in the risk of cancer of the colorectum (RR = 0.71, 95% confidence interval, CI: 0.67-0.75), there is evidence-although more limited, and mainly from case-control studies-that aspirin has a favourable effect on cancers of the esophagus (RR = 0.72, 95% CI: 0.62-0.84), stomach (RR = 0.84, 95% CI: 0.76-0.93), breast (RR = 0.91, 95% CI: 0.88-0.95), ovary (RR = 0.89, 95% CI: 0.78-1.02) and lung (RR = 0.94, 95% CI: 0.89-1.00). The role of aspirin on other cancers, such as pancreatic, prostate, bladder cancer, and non-Hodgkins' lymphomas is less clear, and an increase of risk has been suggested for kidney cancer. For most cancer sites, however, significant heterogeneity between studies, and particularly across study design, was found, with a reduction in risk generally stronger in case-control than in cohort studies. Further, notwithstanding the large amount of epidemiological evidence, substantial uncertainties remain about the proper aspirin dose and duration of treatment.
Anti-Inflammatory Agents, Non-Steroidal↗
Dietary iron intake and risk of non-fatal acute myocardial infarction.
OBJECTIVE: The relation between several measures of body iron and atherosclerotic disease, particularly acute myocardial infarction (AMI), is debated. This is of specific interest since iron is frequently included in supplementation and fortification of foods. We assessed the relation between dietary iron intake and the risk of non-fatal AMI. DESIGN: Case-control study. The information was collected by interviewers using a food-frequency questionnaire tested for validity and reproducibility. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were obtained by multiple unconditional logistic regression models, including terms for energy and alcohol intake, as well as for sociodemographic factors, tobacco and other major recognised risk factors for AMI. SETTING: Milan, Italy, between 1995 and 1999. SUBJECTS: Cases were 507 patients, below age 79 years, with a first episode of non-fatal AMI, and controls were 478 patients admitted to hospital for a wide spectrum of acute conditions unrelated to known or potential AMI risk factors. RESULTS: Compared with patients in the lowest tertile of total iron intake, the OR was 0.48 (95% CI 0.29-0.82) for those in the highest tertile. The corresponding value for haem iron was 0.71 (95% CI 0.48-1.06), for non-haem, non-alcohol iron was 0.80 (95% CI 0.51-1.24) and for iron derived from alcoholic beverages was 0.60 (95% CI 0.40-0.90). Sex-specific OR for total iron intake were not heterogeneous. CONCLUSIONS: In this Italian population dietary iron intake was inversely related to AMI risk. This inverse association may depend on other nutrients present in the major sources of iron in the Italian diet.
Acute Disease↗
Dietary intake of carotenoids and retinol and the risk of acute myocardial infarction in Italy.
BACKGROUND: Carotenoids may reduce the risk of coronary heart disease through their antioxidant properties, but the results of epidemiological studies are controversial. We analysed the relation between the intake of selected carotenoids and retinol and risk of acute myocardial infarction (AMI). METHODS: A case-control study was conducted in Milan, Italy, in 1995-2003. Cases were 760 patients with nonfatal AMI, and controls 682 patients admitted to hospital. RESULTS: The risk of AMI decreased with increasing intake of alpha-carotene (odds ratios, OR = 0.71, 95% confidence intervals, CI 0.51-0.98, for the highest vs the lowest quartile of intake), beta-carotene (OR = 0.71, 95% CI 0.50-1.01) and beta-criptoxanthin (OR = 0.64, 95% CI 0.46-0.88). No associations emerged for total carotenoids, lycopene, lutein plus zeaxanthin and retinol. CONCLUSIONS: Our study suggests a weak protective effect of alpha-carotene, beta-carotene and beta-criptoxanthin on the risk of AMI. It also indicates that total carotenoids, lycopene, lutein plus zeaxanthin and retinol were not related to the risk of the disease.
Adult↗
Prevalence of smoking and attitude towards smoking regulation in Italy, 2004.
AIMS AND BACKGROUND: To update trends in smoking prevalence in Italy to 2004, and describe the attitudes towards forthcoming regulation of smoking. METHODS: Population-based face-to-face survey conducted in March-April 2004 on a sample of 3050 individuals (1509 men and 1541 women) aged 15 or over, representative of the general adult Italian population in terms of age, sex, geographic area, habitat, education and working status. RESULTS: Overall, 26.2% of the Italians aged 15 or over described themselves as current cigarette smokers (30.0% of men, 22.5% of women); 19.1% of men and 11.2% of women smoked 15 or more cigarettes per day. Ex-smokers were 17.9% (24.8% of men, 11.2% of women). The difference in smoking prevalence between men and women was greater in the elderly. More educated men, and those residing in northern Italy were less frequently current smokers. Conversely, women with a low level of education (19%) were less frequently current smokers than those with higher education (24%). More than 85% of Italian adult population were in favour of restrictions of smoking in public places, such as cafes and restaurants, and to ban smoking in workplaces. CONCLUSIONS: Self-reported smoking prevalence is decreasing in men but not in females. There is widespread support for smoking restriction in public areas.
Adolescent↗
Pizza consumption and the risk of breast, ovarian and prostate cancer.
Pizza has been favourably related to the risk of prostate cancer in North America. Scanty information, however, is available on sex hormone-related cancer sites. We therefore studied the role of pizza consumption on the risk of breast, ovarian and prostate cancers using data from three hospital-based case-control studies conducted in Italy between 1991 and 2002. These included 2569 women with breast cancer, 1031 with ovarian cancer, 1294 men with prostate cancer, and a total of 4864 controls. Compared with non-pizza eaters, the multivariate odds ratios for eaters were 0.97 (95% confidence interval (CI) 0.86-1.10) for breast, 1.06 (95% CI 0.89-1.26) for ovarian and 1.04 (95% CI 0.88-1.23) for prostate cancer. Corresponding estimates for regular eaters (i.e. > or =1 portion per week) were 0.92 (95% CI 0.78-1.08), 1.00 (95% CI 0.80-1.25) and 1.12 (95% CI 0.88-1.43), respectively. Our results do not show a relevant role of pizza on the risk of sex hormone-related cancers. The difference with selected studies from North America suggests that dietary and lifestyle correlates of pizza eating vary between different populations and social groups.
Breast Neoplasms↗
Type of alcoholic beverage and the risk of laryngeal cancer.
A few studies have investigated whether the risk of laryngeal cancer depends on the types of alcoholic beverage consumed, providing conflicting results. We investigated this issue using the data from two case-control studies conducted in Italy between 1986 and 2000. These included 672 cases of laryngeal cancer and 3454 hospital controls, admitted for acute, non-neoplastic conditions, unrelated to smoking and alcohol consumption. Significant trends in risk were found for total alcohol intake, with multivariate odds ratios (ORs) of 1.12 for drinkers of 3-4 drinks/day, 2.43 for 5-7, 3.65 for 8-11, and 4.83 for > 12 drinks/day, as compared to abstainers or light drinkers. Corresponding ORs for wine drinkers were 1.12, 2.45, 3.29 and 5.91. After allowance was made for wine intake, the ORs for beer drinkers were 1.65 for 1-2 drinks/day, and 1.36 for > or = 3 drinks/day, as compared to non-beer drinkers; corresponding values for spirits drinkers were 0.88 and 1.15. This study thus indicates that in the Italian population characterized by frequent wine consumption, wine is the beverage most strongly related to the risk of laryngeal cancer.
Adult↗
Anthropometric measures and risk of cutaneous malignant melanoma: a case-control study from Italy.
Several studies have investigated the effect of various anthropometric factors on the risk of cutaneous malignant melanoma (CMM). As the results are controversial, we analysed this issue in a case-control study conducted in Italy. The roles of several body size measures were investigated in a hospital-based case-control study of CMM conducted in Italy. The cases were 542 patients with CMM and the controls were 538 subjects admitted to the same hospitals as the cases for non-dermatological and non-neoplastic diseases. The odds ratios for the highest versus the lowest quartile were 2.06 [95% confidence interval (CI), 1.39-3.05] for weight, 1.16 (95% CI, 0.80-1.68) for height, 1.90 (95% CI, 1.28-2.80) for the body mass index (BMI) and 1.87 (95% CI, 1.28-2.72) for the body surface area (BSA). When allowing for BMI and BSA in the same model, the odds ratios were 1.55 (95% CI, 0.92-2.62) for BMI and 1.41 (95% CI, 0.85-2.33) for BSA. The present findings confirm that obesity increases the risk of CMM. BSA is also related to the risk of CMM. In terms of the population attributable risk, overweight and obesity would account for 31% of the cases of CMM in this Italian population, indicating the scope of prevention.
Adolescent↗
Anthropometry and multiple myeloma.
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Adipose Tissue↗
Nutrition and cancer risk: an overview.
The role of diet in cancer is a major public health issue Foods associated with a low risk of cancer are those typically included in the so-called Mediterranean diet, which is also associated with low mortality rates from cardiovascular disease. Implementing such a diet would involve increasing the consumption of fruits, vegetables, cereals, whole-grain foods and fish, while reducing the intake of refined carbohydrates and red meat. In addition, olive oil should replace saturated fats. Omega-3 fatty acids found in fish inhibit the growth in vitro of colon, breast and prostate cancers. Fibre can bind bile acids, which produce carcinogenic metabolites, and fermented fibre produces volatile fatty acids that can protect against colon cancer. It has been hypothesized that the anti-cancer actions of olive oil may relate to the ability of its mono-unsaturated fatty acid, oleic acid, to regulate oncogenes.
Diet, Mediterranean↗
Channels of cigarette distribution, price and tobacco consumption in Italy.
BACKGROUND: Limited information is available on the role of smuggling and of perceived influence of cigarette price on tobacco consumption in Italy. To elucidate the issues, we included specific questions in a survey on smoking in Italy. METHODS: Between March and April 2004, we conducted a survey on 3050 individuals aged 15 or over, representative of the general adult Italian population. The questionnaire included the estimate of the role of various channels of cigarette distribution and information on the self-reported perception of influence of prices on cigarette consumption in the young. RESULTS: Among current smokers, 85.6% bought cigarettes from tobacco shops, 7.5% from vending machines, and 6.9% from other channels of distribution, including smuggling, and internet (plus offered cigarettes). Overall, 35.9% of ever smokers (37.9% of males and 32.8% of females) reported that the prices had an intermediate to high influence on cigarette consumption in the young. Younger and less educated smokers were not more prone to report an influence of prices. CONCLUSIONS: These data indicate that in Italy smuggling now covers a limited proportion of cigarette sales, while cigarette prices have a substantial influence on tobacco consumption in the young.
Adolescent↗
Outcome of non-variceal acute upper gastrointestinal bleeding in relation to the time of endoscopy and the experience of the endoscopist: a two-year survey.
AIM: To prospectively assess the impact of time of endoscopy and endoscopist's experience on the outcome of non-variceal acute upper gastrointestinal (GI) bleeding patients in a large teaching hospital. METHODS: All patients admitted for non-variceal acute upper GI bleeding for over a 2-year period were potentially eligible for this study. They were managed by a team of seven endoscopists on 24-h call whose experience was categorized into two levels (high and low) according to the number of endoscopic hemostatic procedures undertaken before the study. Endoscopic treatment was standardized according to Forrest classification of lesions as well as the subsequent medical therapy. Time of endoscopy was subdivided into two time periods: routine (8 a.m.-5 p.m.) and on-call (5 p.m.-8 a.m.). For each category of experience and time periods rebleeding rate, transfusion requirement, need for surgery, length of hospital stay and mortality we compared. Multivariate analysis was used to discriminate the impact of different variables on the outcomes that were considered. RESULTS: Study population consisted of 272 patients (mean age 67.3 years) with endoscopic stigmata of hemorrhage. The patients were equally distributed among the endoscopists, whereas only 19% of procedures were done out of working hours. Rockall score and Forrest classification at admission did not differ between time periods and degree of experience. Univariate analysis showed that higher endoscopist's experience was associated with significant reduction in rebleeding rate (14% vs 37%), transfusion requirements (1.8+/-0.6 vs 3.0+/-1.7 units) as well as surgery (4% vs 10%), but not associated with the length of hospital stay nor mortality. By contrast, outcomes did not significantly differ between the two time periods of endoscopy. On multivariate analysis, endoscopist's experience was independently associated with rebleeding rate and transfusion requirements. Odds ratios for low experienced endoscopist were 4.47 for rebleeding and 6.90 for need of transfusion after the endoscopy. CONCLUSION: Endoscopist's experience is an important independent prognostic factor for non-variceal acute upper GI bleeding. Urgent endoscopy should be undertaken preferentially by a skilled endoscopist as less expert staff tends to underestimate some risk lesions with a negative influence on hemostasis.
Adult↗
Alcohol consumption and risk of laryngeal cancer.
Epidemiological studies consistently showed that alcohol drinking increases the risk of laryngeal cancer. This risk increases with the amount of alcohol consumed: in recent studies conducted in North America, Europe, Japan and Korea the multivariate relative risks for the highest levels of consumption ranged between 2 and 10, and were 1.94 for 50 g/day and 3.95 for 100 g/day in a meta-analysis of 20 studies. Further, the risk increases by concomitant tobacco smoking, each agent approximately multiplying the effect of the other. In the absence of smoking the risks are small for moderate alcohol consumption. After stopping drinking, some fall in risk becomes apparent in the long term. The role of age at starting and stopping drinking is still unclear. In various studies, the most commonly used alcoholic beverage appears to be the most associated with laryngeal cancer risk, suggesting that no meaningful difference exists for different types of alcoholic beverages. The supraglottis is more closely related to alcohol consumption, as compared to the glottis/subglottis. Alcohol drinking may influence laryngeal cancer risk particularly through its direct contact or solvent action, perhaps by enhancing the effects of tobacco or other environmental carcinogens.
Alcohol Drinking↗