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Silvia Franceschi

Publications and source records attributed to Silvia Franceschi.

At least 37 records · Page 2Linked to original sources

Chapter 3: HPV type-distribution in women with and without cervical neoplastic diseases.

Geographical widespread data on human papillomavirus (HPV) type-distribution are essential for estimating the impact of HPV-16/18 vaccines on cervical cancer and cervical screening programmes. Epidemiological studies employing a variety of HPV typing protocols have been collated in meta-analyses. HPV-16/18 is estimated to account for 70% of all cervical cancers worldwide, although the estimated HPV-16/18 fraction is slightly higher in more developed (72-77%) than in less developed (65-72%) regions. About 41-67% of high-grade squamous intraepithelial lesion (HSIL), 16-32% of low-grade squamous intraepithelial lesion (LSIL) and 6-27% of atypical squamous cells of undetermined significance (ASCUS) are also estimated to be HPV-16/18-positive, thus highlighting the increasing relative frequency of HPV-16/18 with increasing lesion severity. After HPV-16/18, the six most common HPV types are the same in all world regions, namely 31, 33, 35, 45, 52 and 58; these account for an additional 20% of cervical cancers worldwide.

Female↗

Food groups and risk of non-Hodgkin lymphoma: a multicenter, case-control study in Italy.

Incidence of non-Hodgkin lymphoma (NHL) has been rising worldwide, but the reasons are undefined. Dietary habits may play a role in the etiology of NHL by influencing the metabolic pathways of several cells of the immune system. This case-control study investigated the relation between food consumption and NHL risk. Between 1999 and 2002, we conducted a hospital-based case-control study on NHL in 2 areas of Italy. Cases were 190 patients (median age 58 years) with incident NHL admitted to specialized and general hospitals. Controls were 484 patients (median age 63 years) with acute non-neoplastic conditions admitted to the same hospitals network of cases. A validated food-frequency questionnaire was used to assess habitual diet 2 years before interview. Unconditional multiple logistic regression was used to estimate the odds ratios (OR) and the corresponding 95% confidence intervals (CI), with allowance for energy intake, according to the residual model. Consumption of highest versus lowest quartile of pasta/rice (OR = 1.87, 95% CI: 1.04-3.36) and cheese (OR = 1.66, 95% CI: 0.98-2.83) were associated with a significantly increased NHL risk. Inverse association was found for vegetables (OR = 0.49, 95% CI: 0.28-0.87), fruits (OR = 0.51, 95% CI: 0.30-0.85), and egg consumption (OR = 0.59, 95% CI: 0.36-0.97). The association of pasta/rice was also supported by an increased risk of high glycemic load levels (OR = 1.86, 95% CI: 1.04-3.32). In conclusion, our results suggested that diet could affect NHL risk.

Adult↗

Lifetime occupational and recreational physical activity and risk of benign prostatic hyperplasia.

To investigate the relation between occupational and recreational physical activity (PA) in different periods of life and the risk of benign prostatic hyperplasia (BPH), we conducted a hospital-based, case-control study in Italy. The study included 1,369 histologically confirmed BPH and 1,451 controls, admitted to the same hospitals for acute, nonneoplastic diseases. Odds ratios (ORs) and 95% confidence intervals (CIs) of BPH, according to lifetime PA, were obtained by unconditional multiple logistic regression models, including terms for age, study center and education. Compared to the lowest level of occupational PA, the multivariate ORs for BPH for the heavy/strenuous level were 0.6 (95% CI, 0.4-0.8) at age 15-19, 0.6 (95% CI, 0.4-0.8) at age 30-39 and 0.7 (95% CI, 0.5-0.9) at age 50-59. Moreover, compared to <2 hr/week of recreational PA, the ORs for BPH for the highest level (>or=5 hr/week) were 0.5 (95% CI, 0.4-0.7) at age 15-19, 0.6 (95% CI, 0.5-0.8) at age 30-39, and 0.7 (95% CI, 0.5-0.8) at age 50-59. All inverse trends in risk were significant, and no heterogeneity was found by reason of BPH-diagnosis, age at diagnosis, and body mass index (BMI). The inverse association between PA and BPH risk may be due to favorable hormonal correlates of PA, but residual confounding by socioeconomic covariates cannot be excluded. A moderate PA at any ages may help reducing a sizeable number of BPH.

Adolescent↗

Diet and body mass, and oral and oropharyngeal squamous cell carcinomas: analysis from the IARC multinational case-control study.

Tobacco and alcohol use are the main risk factors for oral and oropharyngeal cancers, yet, dietary habits may also be of importance. Data from a series of case-control studies conducted in 9 countries worldwide (1,670 cases and 1,732 controls) were used to investigate the role of several food groups and body mass index (BMI). Low BMI significantly increased the odds ratio (OR) of cancer more than 2-fold among ever- and never-tobacco users and ever- and never-alcohol drinkers. After adjustment for potential confounders, high intake of fruits and vegetables significantly reduced the OR of cancer compared to low intake among ever-tobacco users (OR 0.4, 95% confidence interval [CI] 0.3-0.6), although not among never-tobacco users (OR 1.1, 95% CI 0.6-2.0). Similarly, the protective effect of high fruit and vegetable consumption was present among ever-drinkers (OR 0.4, 95% CI 0.3-0.6), but not among never-drinkers (OR 1.0, 95% CI 0.6-1.6). In conclusion, low BMI increases the risk of oral cancer, and vegetables and fruits may modulate the carcinogenic effects of tobacco and alcohol.

Alcohol Drinking↗

Gallbladder cancer worldwide: geographical distribution and risk factors.

Gallbladder cancer is a relatively rare neoplasm that shows, however, high incidence rates in certain world populations. The interplay of genetic susceptibility, lifestyle factors and infections in gallbladder carcinogenesis is still poorly understood. Age-adjusted rates were calculated by cancer registry-based data. Epidemiological studies on gallbladder cancer were selected through searches of literature, and relative risks were abstracted for major risk factors. The highest gallbladder cancer incidence rates worldwide were reported for women in Delhi, India (21.5/100,000), South Karachi, Pakistan (13.8/100,000) and Quito, Ecuador (12.9/100,000). High incidence was found in Korea and Japan and some central and eastern European countries. Female-to-male incidence ratios were generally around 3, but ranged from 1 in Far East Asia to over 5 in Spain and Colombia. History of gallstones was the strongest risk factor for gallbladder cancer, with a pooled relative risk (RR) of 4.9 [95% confidence interval (CI): 3.3-7.4]. Consistent associations were also present with obesity, multiparity and chronic infections like Salmonella typhi and S. paratyphi [pooled RR 4.8 (95% CI: 1.4-17.3)] and Helicobacter bilis and H. pylori [pooled RR 4.3 (95% CI: 2.1-8.8)]. Differences in incidence ratios point to variations in gallbladder cancer aetiology in different populations. Diagnosis of gallstones and removal of gallbladder currently represent the keystone to gallbladder cancer prevention, but interventions able to prevent obesity, cholecystitis and gallstone formation should be assessed.

Adult↗

Worldwide human papillomavirus etiology of cervical adenocarcinoma and its cofactors: implications for screening and prevention.

BACKGROUND: Most cancers of the uterine cervix are squamous cell carcinomas. Although the incidence of such carcinomas of the uterine cervix has declined over time, that of cervical adenocarcinoma has risen in recent years. The extent to which human papillomavirus (HPV) infection and cofactors may explain this differential trend is unclear. METHODS: We pooled data from eight case-control studies of cervical cancer that were conducted on three continents. A total of 167 case patients with invasive cervical adenocarcinoma (112 with adenocarcinoma and 55 with adenosquamous carcinoma) and 1881 hospital-based control subjects were included. HPV DNA was analyzed in cervical specimens with the GP5+/6+ general primer system followed by type-specific hybridization for 33 HPV genotypes. Blood samples were analyzed for chlamydial and herpes simplex virus 2 (HSV-2) serology. Multivariable unconditional logistic regression modeling was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs). All tests of statistical significance were two-sided. RESULTS: The adjusted overall odds ratio for cervical adenocarcinoma in HPV-positive women compared with HPV-negative women was 81.3 (95% CI = 42.0 to 157.1). HPV 16 and HPV 18 were the two most commonly detected HPV types in case patients and control subjects. These two types were present in 82% of the patients. Cofactors that showed clear statistically significant positive associations with cervical adenocarcinoma overall and among HPV-positive women included never schooling, poor hygiene, sexual behavior-related variables, long-term use of hormonal contraception, high parity, and HSV-2 seropositivity. Parity had a weaker association with adenocarcinoma and only among HPV-positive women. Use of an intrauterine device (IUD) had a statistically significant inverse association with risk of adenocarcinoma (for ever use of an IUD compared with never use, OR = .41 [95% CI = 0.18 to 0.93]). Smoking and chlamydial seropositivity were not associated with disease. CONCLUSIONS: HPV appears to be the key risk factor for cervical adenocarcinoma. HPV testing in primary screening using current mixtures of HPV types and HPV vaccination against main HPV types should reduce the incidence of this cancer worldwide.

Adenocarcinoma↗

Dietary acrylamide and human cancer.

Low levels of acrylamide have been found in several foods cooked at high temperatures. While there is sufficient evidence for the carcinogenicity of acrylamide in experimental animals, the few epidemiologic studies conducted to date on occupational and dietary exposure to acrylamide have found no consistent evidence of association with human cancer risk. Using data from an integrated network of Italian and Swiss hospital-based case-control studies, we analyzed the relation between dietary acrylamide intake and cancers of the oral cavity and pharynx (749 cases, 1,772 controls), esophagus (395 cases, 1,066 controls), large bowel (1,394 cases of colon, 886 cases of rectal cancer, 4,765 controls), larynx (527 cases, 1,297 controls), breast (2,900 cases, 3,122 controls), ovary (1,031 cases, 2,411 controls) and prostate (1,294 cases, 1,451 controls). All the studies included incident, histologically confirmed cancer cases and controls admitted to the same network of hospitals for acute nonneoplastic conditions. We calculated odds ratios (ORs) using multivariate logistic regression models, adjusted for energy intake and other major covariates of interest. The ORs for the highest versus the lowest quintile of acrylamide intake were 1.12 (95% CI = 0.76-1.66) for cancer of the oral cavity/pharynx, 1.10 (95% CI = 0.65-1.86) for esophageal, 0.97 (95% CI = 0.80-1.18) for colorectal, 1.23 (95% CI = 0.80-1.90) for laryngeal, 1.06 (95% CI = 0.88-1.28) for breast, 0.97 (95% CI = 0.73-1.31) for ovarian and 0.92 (95% CI = 0.69-1.23) for prostate cancer. None of the trend in risk was significant. This uniquely large and comprehensive data set does not show any consistent association between intake of acrylamide and the risk of breast and several other common cancers.

Acrylamide↗

Do childhood diseases affect NHL and HL risk? A case-control study from northern and southern Italy.

To investigate the association between non-Hodgkin lymphoma (NHL), Hodgkin lymphoma (HL), and exposure to childhood diseases, we analyzed an Italian case-control study that included 225 histologically-confirmed incident cases of NHL, 62 HL cases, and 504 controls. After adjusting for confounding factors, all examined childhood diseases were negatively associated with HL. Measles was negatively associated with NHL, particularly follicular B-cell NHL. Our findings provide additional support to the hypothesis that infections by most common childhood pathogens may protect against HL or, at least, be correlated with some other early exposure, which may lower the risk of HL in adulthood. In addition, our study shows that measles may provide a protective effect against NHL.

Adolescent↗

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↗

Genetic polymorphisms in anti-inflammatory cytokine signaling and the prevalence of gastric precancerous lesions in Venezuela.

OBJECTIVES: The aim of the study was to assess the effects of genetic polymorphisms in anti-inflammatory mediators, i.e., IL10, IL4 and IL4R on the prevalence of gastric precancerous lesions and their interactions with other environmental factors. METHODS: The study population consisted of 2,033 Venezuelan subjects known to have extremely high Helicobacter Pylori (HP) infection rates. The odds ratios (OR) and 95% confidence intervals (CI) associated with these polymorphisms were estimated by multinominal logistic regression models for gastric precursor lesions. RESULTS: We found a 60% increase in risk of intestinal metaplasia (IM) and dysplasia combined (OR 1.62, 95% CI: 1.10-2.38) among the carriers of the IL10-1082 low activity allele. This increased risk was more pronounced for dysplasia than for IM. On the other hand, homozygotes with the low activity allele of the A398G polymorphism in the IL4R gene had a modest increase in risk of atrophic gastritis (OR = 1.52, 95% CI: 1.05-2.21), compared with homozygotes of the high activity allele. There were no statistically significant synergetic interactions between these polymorphisms and environmental risk factors (low fruit intake, high starchy vegetable intake and cigarette smoking) for these lesions. CONCLUSION: While the results of the present study suggest roles of genetic variability in these anti-inflammatory mediators in different stages of gastric carcinogenesis, there is high likelihood that they were chance findings due to multiple comparisons.

Adult↗

Food groups and risk of benign prostatic hyperplasia.

OBJECTIVES: To evaluate the role of a wide range of foods on the risk of benign prostatic hyperplasia (BPH), we conducted a case-control study in Italy between 1991 and 2002. Although BPH is an extremely common condition, particularly among older men, its risk factors, including dietary ones, remain largely undefined. METHODS: Included in the study were 1369 patients younger than 75 years old surgically treated for BPH and 1451 controls younger than 75 years of age who had been admitted to the same hospitals as cases for a wide spectrum of acute, non-neoplastic conditions. A validated and reproducible food frequency questionnaire, including 78 foods and beverages, plus a separate section on alcoholic beverages, was used to assess patients' dietary habits 2 years before diagnosis or hospital admission. Multivariate odds ratios (OR) were obtained after allowance for energy intake and other major potential confounding factors. RESULTS: A significant trend of increasing risk with more frequent consumption was found for cereals (OR 1.55 for the greatest versus lowest quintile), bread (OR 1.69), eggs (OR 1.43), and poultry (OR 1.39). Inverse associations were observed for soups (OR 0.74), pulses (OR 0.74), cooked vegetables (OR 0.66), and citrus fruit (OR 0.82). No association was observed for milk and yogurt products, coffee and tea, pasta and rice, fish, cheese, row vegetables, potatoes, fruit, or desserts. CONCLUSIONS: The results of this study suggest a role for dietary habits on the risk of BPH. In particular, a diet rich in cereals and some types of meat and poor in vegetables and pulses may have an unfavorable effect in this Italian population.

Aged↗

Macronutrients, fatty acids, cholesterol, and risk of benign prostatic hyperplasia.

OBJECTIVES: To better understand the role of specific macronutrients on the risk of benign prostatic hyperplasia (BPH), we used data from an Italian case-control study. Although BPH is extremely common among the elderly, its etiology-and, particularly, the role of diet and specific macronutrients-is still unclear. METHODS: A case-control study of 1369 patients with BPH and 1451 controls, admitted to the same hospitals for a wide spectrum of acute, non-neoplastic conditions, was conducted in Italy. The subjects' usual diet was investigated through a validated and reproducible food frequency questionnaire. Multivariate odds ratios (ORs) and 95% confidence intervals (CIs) were obtained after allowance for energy intake and other potential confounding factors. RESULTS: A significant direct relation was observed between starch intake (OR 1.51, 95% CI 1.15 to 1.99 for highest quintile compared with lowest one), and an inverse relation was observed for polyunsaturated fatty acids (OR 0.72, 95% CI 0.55 to 0.93), linoleic acid (OR 0.73, 95% CI 0.56 to 0.94), and linolenic acid (OR 0.71, 95% CI 0.54 to 0.93). CONCLUSIONS: The results of this study suggest a role for specific macronutrients in the risk of BPH, including, in particular, an unfavorable effect for starch and a beneficial one for polyunsaturated fatty acids.

Aged↗

Onion and garlic use and human cancer.

BACKGROUND: Interest in the potential benefits of allium vegetables, in particular, onion (Allium cepa) and garlic (Allium sativum), has its origin in antiquity, but the details of these benefits are still open to discussion. OBJECTIVE: We investigated the role of allium vegetables in the etiology of various neoplasms. Previous data are scanty and are based mainly on Chinese studies. DESIGN: Using data from an integrated network of Italian and Swiss case-control studies, we analyzed the relation between frequency of onion and garlic use and cancer at several sites. We calculated odds ratios (ORs) by using multivariate logistic regression models that were adjusted for energy intake and other major covariates. RESULTS: Consumption of onions varied between 0-14 and 0-22 portions/wk among cases and controls, respectively. The multivariate ORs for the highest category of onion and garlic intake were, respectively, 0.16 and 0.61 for cancer of the oral cavity and pharynx, 0.12 and 0.43 for esophageal cancer, 0.44 and 0.74 for colorectal cancer, 0.17 and 0.56 for laryngeal cancer, 0.75 and 0.90 for breast cancer, 0.27 and 0.78 for ovarian cancer, 0.29 and 0.81 for prostate cancer, and 0.62 and 0.69 for renal cell cancer. CONCLUSIONS: This uniquely large data set from southern European populations shows an inverse association between the frequency of use of allium vegetables and the risk of several common cancers. Allium vegetables are a favorable correlate of cancer risk in Europe.

Administration, Oral↗

Occupational exposure to ultraviolet radiation and risk of non-Hodgkin lymphoma.

Individuals diagnosed with skin cancer have elevated risk of non-Hodgkin lymphoma, and those with non-Hodgkin lymphoma have excess rates of various types of skin cancers. Sunshine and other sources of ultraviolet radiation are major risk factors for skin cancer, and hence a potential common link between skin cancer and non-Hodgkin lymphoma. We analyzed the relationship between occupational exposure to ultraviolet radiation and the risk for non-Hodgkin lymphoma using data from a case-control study conducted in Northern Italy between 1985 and 1997. Cases were 446 patients with histologically confirmed incident non-Hodgkin lymphoma, and controls were 1295 patients admitted to hospital for acute non-neoplastic, non-immunological conditions. The multivariate odds ratios were computed after allowance for age, sex, area of residence, education and smoking. The odds ratio for patients reporting ever ultraviolet exposure at work was 1.01 (95% confidence interval 0.72-1.43) and 1.03 (95% confidence interval 0.72-1.49) for exposure longer than 10 years. The odds ratio was 1.09 for manual workers and 0.79 for farmers exposed to ultraviolet radiation, compared with those with other occupations not exposed to ultraviolet radiation. Our study found no association between occupational exposure to ultraviolet radiation and the risk of non-Hodgkin lymphoma.

Adult↗

Aspirin and the risk of prostate cancer.

Epidemiological studies have suggested that aspirin may have a protective effect against prostate cancer, but the evidence is still limited and inconsistent. The role of aspirin in prostate cancer risk was analysed in a multicentric case-control study conducted in Italy between 1991 and 2002, including 1261 incident cases of carcinoma of the prostate and 1131 hospital controls. A total of 115 (9.1%) cases versus 90 (8.0%) controls reported regular aspirin use. The multivariate odds ratio (OR) for regular aspirin users was 1.10 (95% confidence interval (95% CI) 0.81-1.50). No relation was found with duration of use (OR = 1.03 for <5 years, and 1.17 for > or =5 years) and time since first use (OR = 1.03 for <10 years, and 1.35 for > or =10 years). These findings do not support a protective role of regular aspirin use on prostate cancer risk.

Aged↗

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↗