The results of our study, show the advantages of smoke-free legislations, which may have major public health implications.
Trends in death certification rates from male breast cancer over the period 1955-89 were analysed for 25 European countries (excluding the Soviet Union and a few small countries) on the basis of official data from the World Health Organization database. In the late 1980's, about 550-600 deaths per year from male breast cancer were certified in these countries. The variation was relatively limited, most age-standardized (world standard) rates being within the range of 1.5 to 3.0 per million. The highest rates were in France, Hungary, Austria and Scotland. No clear pattern of trend was observed over the last few decades, but mortality rates in the late 1980's tended to be, for most countries, lower than those registered 3 decades earlier. Comparison was possible for 18 countries, and for 11 (including the largest ones, i.e. France, Germany, Italy and England and Wales), male breast cancer rates in 1985-89 were lower than in 1955-59. The pattern was similar when only truncated (from 35 to 64 years) mortality rates were considered and, for the largest countries, upon accurate inspection of age-specific rates. In conclusion, therefore, this overview of male breast cancer trends in Europe precludes any generalized increase in mortality from the disease over recent decades and, hence, weighs against the introduction and presence of any important new cause of this rare disease.
Diagnostic procedure, therapeutic care and degree of follow-up delivered to 1692 lung cancer patients over 2 years (1978-79) in 31 Italian hospitals were reviewed. The data show marked deficiencies in the various indicators analysed: staging by standard methods was recorded only in 13% of patients; reliable histocytologic classification in 54% of patients. A group of commonly accepted protocols was adopted as first-line therapy only in 49% of treated cases; 19% of patients were regularly followed according to standard programs, whereas 49% had been dropped without any information in the charts. Better performance, although not satisfactory, was found in hospitals with oncologic facilities and wards compared to centers without "ad hoc" organizations. The discussion focussed on the limits of organizational measures and efforts to determine widespread improvement in care for a disease such as lung cancer for which real therapeutic gains are still hard to achieve.
The relationship between frequency of consumption of whole grain food and risk of selected neoplasms has been analysed using data from an integrated series of case-control studies conducted in northern Italy between 1983 and 1996. The overall dataset included the following incident, histologically confirmed neoplasms: oral cavity and pharynx 181, oesophagus 316, stomach 745, colon 828, rectum 498, liver 428, gallbladder 60, pancreas 362, larynx 242, breast 3,412, endometrium 750, ovary 971, prostate 127, bladder 431, kidney 190, thyroid 208, Hodgkin's disease 80, non-Hodgkin's lymphomas 200, multiple myelomas 120. Controls were 7,990 patients admitted to hospital for acute, non-neoplastic conditions, unrelated to long-term modifications in diet and not likely to have been caused by tobacco or alcohol use. Odds ratios (OR) for subsequent scores (never/occasional/frequent) of whole grain food consumption were derived after allowance for age, sex, education, smoking, alcohol intake and body mass index. High intake of whole grain foods consistently reduced risk of neoplasm at all sites, except thyroid. The ORs for the highest category of consumption were 0.2–0.3 for upper digestive and respiratory tract neoplasms, 0.5 for stomach, colon and gallbladder, 0.7 for rectum, 0.6 for liver, 0.8 for pancreas and prostate, 0.9 for breast and endometrium, 0.6 for ovary, 0.4 for bladder and kidney, 1.3 for thyroid and around 0.5 for lymphomas and myeloma. The tests for trend in risks were significant for all neoplasms, except pancreas, endometrium, Hodgkin's disease and multiple myeloma. No significant heterogeneity was found across strata of age at diagnosis, sex, education, smoking habit, alcohol intake and body mass index. Thus, even in the absence of a univocal and satisfactory biological interpretation, the consistency of the patterns observed indicate that, in this population, higher frequency of whole grain food intake is an indicator of reduced risk of several neoplasms. Int. J. Cancer 77:24–28, 1998.© 1998 Wiley-Liss, Inc.
Read moreWe conducted a hospital based case-control study of 245 cases of thyroid cancer (62 males and 183 females) and 411 controls in three areas of Northern Italy. Subjects with thyroid cancer more often had a history of benign thyroid nodules (18 cases versus 0 controls, lower 95% confidence limit = 7.84), goitre (RR = 5.61, 95% confidence interval (CI): 2.13-14.77) and residence in endemic goitre areas (RR for residence longer than 20 years = 2.29, 95% CI: 1.23-4.29). Heavy (greater than 1000 rads) irradiation of the neck was reported only by seven cases (lower 95% confidence limit: 2.45). Among 31 food items considered, a few showed direct association, including starchy foods and various sources of animal fats or proteins, whereas frequent consumption of other foods, including major sources of dietary iodine (such as fish, green vegetables and fruit) gave significant protection. When analysis was restricted to various subgroups of patients (ie, different histological types, sexes and major groups of hospital controls), it yielded similar results.
Read moreFranceschi, Silvia; Favero, Adriano; Decarli, Adriano; Vecchia, Carlo La Author Information
Read moreUsing data from a case-control study conducted in Northern Italy, we analyzed the relation between alcohol drinking and risk of endometrial cancer. Cases were 726 patients, < 75 years of age, admitted to the Ospedale Maggiore (including the 4 largest teaching and general hospitals in the Greater Milan area), the University Obstetrics and Gynecology Clinics, and the National Cancer Institute of Milan with histologically confirmed endometrial cancer. Controls were 2,123 nonhysterectomized patients, < 75 years of age, admitted for acute nongynecological non-hormone-related nonneoplastic conditions to the same network of hospitals where cases had been identified. When total consumption of all alcoholic beverages was considered, 68.2% of cases and 63.9% of controls were drinkers and 12% of cases and 9.3% of controls reported > or = 2 drinks/day. Considering total alcohol drinking, the relative risk for alcohol drinkers vs. nondrinkers was 1.3 (95% confidence interval 1.1-1.5), and the RR estimates for subsequent levels of intake were 1.1, 1.4, and 1.6 for women drinking > 0 < or = 1, > 1 < or = 2 drinks/day (chi 2(1) trend 11.33, p < 0.001). The estimates were similar when wine only (which represents the large majority of all alcohol intake in Italy) was considered, whereas data were less informative for beer and spirits intake only. No relation emerged between duration of alcohol consumption and risk of endometrial cancer. These findings suggest a potential link between alcohol drinking and endometrial cancer risk and are, in any case, inconsistent with a protective role of alcohol in endometrial carcinogenesis.(ABSTRACT TRUNCATED AT 250 WORDS)
Read moreBetween 1970 and 1976, 290 patients with endometrial cancer were treated at the 1st Obstetrics and Gynecology Clinic of the University of Milan. The median age was 62 years. Surgery was completed in 262 (90.3%) patients. Abdominal hysterectomy was used in 158 (70.9%) stage I and 40 (71.4%) stage II/III) patients; vaginal hysterectomy in 55 (24.7%) stage I and nine (16.1%) stage II/III patients. Resection of the upper vagina was performed in 168 patients. Postoperative external beam radiotherapy was used in stage II/III patients and in 44 (19.7%) stage I high-risk patients. Ten-year survival, determined by the life-table method, was 84.8% in stage I (223 patients), 53.4% in stage II (37 patients), 64.4% in stage III (19 patients), and 9.1% in stage IV (11 patients). Factors associated with poorer prognosis were: late age at diagnosis (P less than 0.001); deep myometrial invasion (P less than 0.001); poorly differentiated histological grade (P = 0.11); lack of resection of the upper vagina (P = 0.13). The role and importance of surgery is discussed, with special emphasis on the selective use of the vaginal route in aged, obese and medically high-risk patients.
Read moreThe relationship of breast cancer to coffee drinking habits was evaluated in a case-control study of 616 women with breast cancer and 616 control subjects with nonmalignant disorders, apparently unrelated to coffee consumption. Compared with women who had never drunk coffee, the relative risk estimates for those women who drank less than two, two or three, and four or more cups each day were 1.5, 1.3, and 1.0, respectively. There was no apparent association with duration of consumption or use of other methylxanthine-containing beverages. The results were not modified by several potential confounding factors, including the major risk factors for breast cancer. The findings suggest that coffee consumption does not increase the risk of malignant neoplasms of the breast.
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