For our young colleagues, the relevance of this book is justified by its reference lists alone, as these include most of the papers that provided the most important achievements of epidemiology and public health from 1919 onwards. The book is easy to consult and read, because for each calendar period the main topics are separately considered—that is, infectious diseases, occupational factors, nutrition, environment, etc. Thus, for instance, under the headings tobacco or air pollution, …

This study provides additional support for an association between talc in mining and milling and non-neoplastic respiratory diseases, while showing no significant excess risk for lung cancer and mesothelioma. The results also provide additional information of interest to evaluate the potential association between silica and lung cancer.

OBJETIVO: Se realizó un estudio poblacional para conocer las actitudes relacionadas con la Nueva Ley Italiana Antitabaco y el efecto sobre el consumo. MATERIAL Y MÉTODOS: Se analizó una muestra de 3 114 individuos mayores de 15 años representativos de la población general adulta italiana. RESULTADOS: Tras la entrada en vigor de las políticas antitabaquismo, el apoyo a ellas aumentó y además contribuyeron con 8% al descenso del consumo de cigarrillos en el corto plazo. Las prohibiciones antitabaco se aceptaron casi de modo unánime y al parecer no afectaron de manera desfavorable a restaurantes y cafeterías. CONCLUSIONES: Los resultados muestran las ventajas de esta nueva legislación, que puede tener importantes implicaciones en la salud pública.<br>OBJETIVE: A population-based survey was conducted to know the attitudes towards new Italian smoke-free regulations and its impact on tobacco consumption. MATERIAL AND METHODS: We considered 3 114 subjects aged 15 or over, representative of the general adult Italian population. RESULTS: Once smoke-free policies were introduced, support for them tended to increase. Smoke-free policies accounted for 8% decrease in cigarette consumption in the short run. Tobacco bans were almost universally accepted, and do not seem to unfavourably affect the business of restaurants or cafes. CONCLUSIONS: The results of our study, show the advantages of smoke-free legislations, which may have major public health implications.

Observational studies and randomized clinical trials that have looked at the effect of hormone replacement therapy (HRT) on the risk of colorectal cancer are reviewed. Nine cohort studies in this area have included a total of over 2700 cases of colorectal cancer. Most of these studies found a relative risk (RR) of around or below unity. Of 15 case–control studies, with a total of over 7300 cases, six reported a 20–40% risk reduction among women who had ever used HRT. With reference to randomized clinical trials, in the Women's Health Initiative (WHI) study, after seven years of follow-up, 45 cases of colorectal cancer were observed in the combined HRT group versus 67 in the placebo group, corresponding to a RR of 0.63. A combined reanalysis of data from both the WHI and the Heart and Estrogen Progestin Replacement Study (HERS) included 56 cases in the com bined HRT group and 83 cases in the placebo group (pooled RR = 0.64). However, in the WHI study cancers diagnosed in the HRT group were more advanced and there were more positive lymph nodes. Furthermore, among women in the WHI who had had a hysterectomy, there was no difference at the eight-year follow-up in the incidence of colorectal cancer between those in the estrogen-only arm of the trial ( n = 61) and those in the control group ( n = 68).

To investigate the relationship between family history of cancer in first-degree relatives and the risk of endometrial cancer, we carried out a large multicentre case-control study in Italy between 1992 and 2006, including 454 endometrial cancer cases and 908 controls admitted in hospital for acute, non-neoplastic diseases. Conditional logistic regression was used to estimate odds ratios (ORs) and corresponding 95% confidence intervals (CI). Relative to women with no family history of uterine cancer, the ORs were 2.1 (95% CI: 0.7-6.4) for those reporting a family history of endometrial cancer and 1.8 (95% CI: 1.0-3.2) for a family history of any uterine cancer. A family history of intestinal cancer was directly associated with endometrial cancer risk (OR=1.6; 95% CI: 1.0-2.7). Direct associations were found for a few other cancer sites. In conclusion, a family history of endometrial, uterine or intestinal cancer in first-degree relatives is associated with an increased risk of endometrial cancer.

We analysed the prevalence of cigarette smoking among subsequent birth cohorts of Spanish males and females. Data were drawn from the Spanish NHIS conducted in 1993 ( = 26 400), 1995 ( = 8300) and 1997 ( = 8300). From the original computer files, the three surveys were pooled to obtain a single sample. A total of 33 223 subjects (16 036 men and 17 187 women) born between 1900 and 1979, >/= 16 years old, were directly interviewed and with complete information on the history of smoking included for analysis. Based on each respondent's sex and calendar year of birth, the person was classified into a particular sex-birth cohort in the decades from 1900-09 to 1970-79. For each year from date of birth to date of survey, respondents were further classified as either cigarette smoker or nonsmoker. The prevalence of cigarette smoking among successive cohorts of Spanish men and women was estimated, with correction for excess mortality of smokers. In men, the peak in smoking was reached in the 1950-59 birth cohort (prevalence rate of 68% at ages 20-29), after increases during the previous calendar years. Smoking among women was rare until 1960. Female smoking prevalence rates increased progressively among subsequent cohorts until 1980. The age distribution of smoking prevalence in women in 1990 mimics that observed in men 40 years earlier. A substantial delay in the spread of the tobacco epidemic among men is apparent. In women, the delay in the initiation of the smoking epidemic ended with a quick diffusion of the habit.

To the Editors: Having older siblings, in contrast to younger ones, is a surrogate marker of earlier exposure to common childhood pathogens ([1][1]). A Swedish case-control study reported a reduced risk of Hodgkin's disease when subjects with three or more older siblings were compared with those

Out of 6084 first breast cancers registered between 1974 and 1993 in the Cancer Registry of the Swiss Canton of Vaud, 81 (1.3%) were synchronous bilateral breast cancers (BBCs). The 5-year relative survival rates were 73% for women with unilateral breast cancer (UBC) and 65% for those with synchronous BBC. The corresponding 10-year figures were 59% and 51%. This large, population-based series indicates that women with synchronous BBC have a moderately lower long-term survival than women with UBC.

The objective of this study is to investigate the effect of menstrual and reproductive variables, breastfeeding, exogenous hormones, and gynecological conditions on endometrial cancer risk. We conducted a case-control study in Italy, including 454 women with endometrial cancer and 908 hospital controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multivariate logistic regression models. Endometrial cancer risk was inversely associated with age at menarche (OR = 0.7, 95% CI = 0.5-1.0, for > or =14 vs. <12 years), and directly associated with age at menopause (OR = 1.8, 95% CI = 1.1-2.7, for > or =55 vs. <50 years) and years of menstruation (OR = 2.4, 95% CI = 1.7-3.4, for highest vs. lowest tertile). Multiparity strongly reduced the risk among women under 60 years of age (OR = 0.3, 95% CI = 0.2-0.6, for > or =3 deliveries vs. <2). Oral contraceptive use conferred a 40% reduced risk (95% CI = 0.4-1.0), irrespective of time since cessation. Although based on small numbers, women with a history of treated infertility (OR = 2.7, 95% CI = 1.1-6.4) or endometriosis (OR = 4.0, 95% CI = 1.0-15.5) were at increased risks. No significant associations with endometrial cancer risk emerged for age at first/last birth, breastfeeding, menopausal status, hormone replacement therapy, and history of uterine fibromyomas or polycystic ovary. In conclusion, this study confirms the importance of multiparity, years of menstruation, and oral contraceptive use in endometrial cancer etiology, thus contributing to identify women at elevated risk of such neoplasm.

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