The interim results of a case-control study of myocardial infarction in women below age 55 years conducted in northern Italy since January 1983 are presented, based on 168 cases of acute myocardial infarction and 251 hospital controls. Cigarette smoking was strongly related to myocardial infarction, with risk estimates elevated more than 10-fold for heavy (more than 25 cigarettes per day) smokers. Smoking-related relative risks were of similar magnitude in younger (less than 45 years) and in perimenopausal (45-54 years) women and were largely unaffected by allowance for several potential distorting factors. Other factors independently and strongly related to the risk of myocardial infarction were diabetes, hypertension, and history of coronary heart disease in more than one first-degree relative. Relative risks were also elevated in women who gave birth to their first child earlier (below age 20 years) and in oral contraceptive users. However, these estimates were not significant. The apparent positive associations with clinical history of hyperlipidemia, hypertension in pregnancy, and heavy coffee consumption could be explained largely in terms of confounding, but the protection conveyed by moderate alcohol consumption remained after multivariate analysis. Thus, the interim results of this investigation in a low incidence population confirm the importance of several risk factors previously described in data collected in Northern Europe and the United States. Furthermore, possibly because of the low baseline risk, the proportion of cases attributable to smoking in middle-aged women in this population may be even larger than that previously reported from higher incidence areas.
A comparison of risk estimates using controls with other cancers versus controls with acute diseases unrelated to tobacco and alcohol consumption in the study of the effect of these two factors has been performed using data on tumours of the oral cavity and pharynx from an ongoing case-control surveillance programme in Northeastern Italy. Similar results were obtained using either type of controls: as compared to never smokers, moderate smokers (less than or equal to 14 cigarettes/day) showed age- and sex-adjusted odds ratio (OR) = 5.2 (95% confidence interval (CI): 2.9-9.2) when using cancer controls and 5.8 (95% CI: 3.3-10.1) when using non-cancer controls. Similarly, those who had smoked for 40 years or longer showed ORs of 7.4 (95% CI: 4.0-13.6) and 8.8 (95% CI: 4.9-15.6), respectively, using cancer and non-cancer controls. For moderate drinkers of alcoholic beverages (21-34 drinks/week) and heavy drinkers (greater than or equal to 84 drinks/week) the ORs, as compared to individuals who drank less than 21 drinks/week, were 1.9 (95% CI: 1.0-3.6) and 2.2 (95% CI: 1.2-4.0) and 10.6 (95% CI: 5.5-20.6) and 11.4 (95% CI: 6.0-21.4) using cancer and non-cancer controls, respectively. The same comparability of ORs for tobacco- and alcohol-related variables using either type of controls was observed when separate analyses of the two sexes were performed. The close similarity between cancer and non-cancer controls in studies on tobacco- and alcohol-related risks may be exploited when the choice of other types of controls would increase the costs and the feasibility of the study, and thus hamper its statistical power.(ABSTRACT TRUNCATED AT 250 WORDS)
Read moreDietary factors in the etiology of ovarian cancer were investigated with the use of data from a case-control study conducted in Northern Italy on 455 histologically confirmed epithelial carcinomas and 1,385 control subjects in the hospital for acute conditions unrelated to any of the known or potential risk factors for cancer of the ovary. Women with ovarian cancer reported significantly elevated frequency of consumption of meat [relative risk (RR) = 1.6 for greater than or equal to 7 vs. less than 4 portions/wk], ham (RR = 1.9 for greater than or equal to 4 vs. less than 2 portions/wk), and higher subjective scores of fat intake (RR = 2.1 for highest vs. lowest scores), particularly butter. In contrast, consumptions of fish, green vegetables, carrots, and wholemeal bread or pasta were less frequent in cases; the corresponding risk estimates for highest versus lowest frequencies ranged between 0.6 and 0.8. These results were not materially modified by adjustment for indicators of socioeconomic status, parity, and other identified determinants of ovarian cancer. No relation emerged between alcohol consumption and ovarian cancer risk. The present study provides interesting indications that help to explain the considerable variations in ovarian cancer rates in different populations and, if confirmed, could, in principle, have important public health implications. Due caution, however, is required in interpreting the present results because of the limitations of available information and of the uncertainties of other published material concerning diet and ovarian cancer.
Read moreThe authors assessed the relation between cigarette smoking and nonspecific inflammatory bowel disease in a case-control study of 124 cases of ulcerative colitis, 109 cases of Crohn's disease, and 250 age- and sex-matched control subjects in hospital for acute nongastric or intestinal conditions unrelated to smoking. For ulcerative colitis, the risk for current smoking compared with never smoking was 0.5, with a 95% confidence interval (Cl) of 0.3-1.0. They observed decreasing risk with increasing number of cigarettes smoked. The risk for ex-smokers, however, was greater than that for never smokers (relative risk = 2.7; 95% Cl = 1.5-4.9). The elevated risk of ulcerative colitis in ex-smoking in the presence of an overall lack of association with ever-smoking may plausibly be attributed to either 1) brief induction time of a protective effect of smoking on ulcerative colitis or 2) selective cessation of smoking due perhaps to very early symptoms of the disease. If time at first onset of bowel symptoms, instead of clinical diagnosis, is considered as the index date, the negative association between ulcerative colitis and current smoking would have weakened in men and disappeared in the overall series. There was clear evidence of a positive association between cigarette smoking and Crohn's disease (relative risk for ever smokers vs. never smokers = 4.0; 95% Cl = 2.2-7.3). The risk estimates increased with the number of cigarettes smoked per day and duration of habit. The association between current smoking and Crohn's disease was even stronger when age at first onset of bowel symptoms was considered as the index date, but the risk for ex-smokers fell below unity.
Read moreWe updated trends in breast cancer mortality in Europe up to the late 2000's. In the EU, age-adjusted (world standard population) breast cancer mortality rates declined by 6.9% between 2002 and 2006, from 17.9 to 16.7/100,000. The largest falls were in northern European countries, but more recent declines were also observed in central and eastern Europe. In 2007, all major European countries had overall breast cancer rates between 15 and 19/100,000. In relative terms, the declines in mortality were larger at younger age (-11.6% at age 20-49 years between 2002 and 2007 in the EU), and became smaller with advancing age (-6.6% at age 50-69, -5.0% at age 70-79 years). The present report confirms and further quantifies the persisting steady fall in breast cancer mortality in Europe over the last 25-30 years, which is mainly due to advancements in the therapy.
Read moreNordic nutrition recommendations and mediterranean diet in relation to prostate cancer risk in Sweden
Read moreHigh dietary GL is associated with increased risk for HCC. The positive association was most pronounced among HCC cases with HBV and/or HCV markers.
Read moreJournal Article Risk Factors for Cervical Cancer: Comments on Attributable Risk Calculations and the Evaluation of Screening in Case-Control Studies Get access FABIO PARAZZINI, FABIO PARAZZINI *Istituto di Ricerche Farmacologiche ‘Mario Negri’via Eritrea, 62, 20157 Milano, Italy. Search for other works by this author on: Oxford Academic PubMed Google Scholar ALLAN HILDESHEIM, ALLAN HILDESHEIM **Environmental Epidemiology Branch, National Cancer InstituteBethesda, MD, USA. Search for other works by this author on: Oxford Academic PubMed Google Scholar MONICA FERRARONI, MONICA FERRARONI †Istituto di Biometria e Statistica Medica, University of Milan20133 Milan, Italy. Search for other works by this author on: Oxford Academic PubMed Google Scholar CARLO LA VECCHIA, CARLO LA VECCHIA *Istituto di Ricerche Farmacologiche ‘Mario Negri’via Eritrea, 62, 20157 Milano, Italy.‡Institute of Social and Preventive Medicine, University of Lausanne1005 Lausanne, Switzerland. Search for other works by this author on: Oxford Academic PubMed Google Scholar LOUISE BRINTON LOUISE BRINTON *Istituto di Ricerche Farmacologiche ‘Mario Negri’via Eritrea, 62, 20157 Milano, Italy. Search for other works by this author on: Oxford Academic PubMed Google Scholar International Journal of Epidemiology, Volume 20, Issue 4, December 1991, Pages 1142–1143, https://doi.org/10.1093/ije/20.4.1142 Published: 01 December 1991
Read moreThe relationship between electrocoagulation diathermy and the risk of cervical neoplasia was evaluated in a case-control study of 145 women with cervical intraepithelial neoplasia compared with 145 age-matched outpatient control subjects, and 191 cases of invasive cervical cancer compared with 191 control subjects in the hospital for acute conditions unrelated to any of the identified or suspected risk factors for cervical cancer. History of electrocoagulation was associated with an apparently reduced risk of cervical intraepithelial neoplasia (relative risk = 0.50, with 95% confidence interval = 0.29-0.87), and of invasive cancer (relative risk = 0.42, 95% confidence interval = 0.22-0.82). However, this apparent protection could be largely explained in terms of a different frequency of previous Papanicolaou smears in patients and control subjects. When adjustment was made for that variable, the risk estimates of CIN and invasive cancer among women who had undergone electrocoagulation increased to 0.62 and 0.83 and became statistically nonsignificant. Further allowance for other identified potential confounding factors by means of multiple logistic regression raised these estimates to 0.73 and 0.94, respectively. Thus, these data provide evidence against the hypothesis that electrocoagulation may have an important and independent role in the prevention of cervical neoplasia.
Read moreThe study by Xu et al., reported in this issue of the Archives of Medical Science, is a large original study on breast cancer risk factors in China, a country with low breast cancer incidence [1, 2]. The study shows results from the project of breast cancer prediction (BCPC) in China, aiming to screen breast cancer risk factors among Chinese women and predict individual risk of breast cancer through established risk factors. It is a multicentric hospital-based case-control study, carried out in 14 hospitals in 8 provinces of China, and, from January to July 2008, recruited 416 women aged 30 to 65 years with incident breast cancer and 1156 heal thy women.
Read moreThe present small study does not support an involvement of HPyV or HPV infection in TCB aetiology in immunocompetent individuals. Differences in HPyV-positivity by sex and smoking may derive from differences in either acquisition or persistence of the infection.
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