Journal Article Letters to the Editor: Sociocultural influences on smoking habits in Switzerland Get access CARLO LA VECCHIA, CARLO LA VECCHIA Institut Universitaire de Médecine Sociale et PréventiveBugnon 17, CH-1005 Lausane, Switzerland Search for other works by this author on: Oxford Academic PubMed Google Scholar FELIX GUTZWILLER, FELIX GUTZWILLER Institut Universitaire de Médecine Sociale et PréventiveBugnon 17, CH-1005 Lausane, Switzerland Search for other works by this author on: Oxford Academic PubMed Google Scholar VINCENT WIETLISBACH VINCENT WIETLISBACH Institut Universitaire de Médecine Sociale et PréventiveBugnon 17, CH-1005 Lausane, Switzerland Search for other works by this author on: Oxford Academic PubMed Google Scholar International Journal of Epidemiology, Volume 16, Issue 4, December 1987, Pages 624–626, https://doi.org/10.1093/ije/16.4.624 Published: 01 December 1987

Trends in death certification rates from all motor vehicle accidents and motor-cycle accidents in Italy over the period 1955-79 were analysed. For both sexes, age-standardised mortality rates per 100,000 population increased steadily up to the early 1970's, reaching 40.08/100,000 males in 1972 and 11.05/100,000 females in 1973. Marked downward trends followed, and the 1977-79 rates were comparable with 1955 for males (around 28/100,000), though the total number of motor vehicles increased almost six-fold (and the number of cars over 14-fold). When age-specific rates were considered, the largest increases between the late 1950's and the early 1970's were for younger (under 25) and older (55 and over) males and younger (under 35) females. The decreases from 1974 onwards applied to both sexes and all age groups. Motor-cycle death rates increased in males up to the mid 1960's, mostly in younger (15-25) and older (over 55) age groups. A sudden, marked inversion of trends followed, starting from the younger age groups and spreading to all age groups in the mid 1970's. This pattern corresponds roughly to a 50% decrease in male death certification rates per registered motor-cycle. In absolute terms, the decline in the second half of the 1970's corresponds to about 4,000 fewer deaths per year. This is one of the major changes observed in mortality from any cause during the 1970's in Italy. Provisional data for the period 1980-82 suggest that further downward trends, albeit moderate, have continued.

The risk of endometrial cancer in relation to nutrition and frequency of consumption of a few selected dietary items was evaluated in a case-control study of 206 patients with endometrial cancer and 206 control subjects with acute conditions unrelated to any of the established or potential risk factors for endometrial cancer. Obesity was strongly and positively associated with the risk of endometrial cancer, and several conditions related to body weight, such as early menarche, diabetes mellitus, or hypertension were more common in cases. The risk of endometrial cancer was elevated in subjects reporting (on a subjective basis) greater fat (butter, margarine, and oil) intake (relative risk estimate for the higher compared to the lower scores equals 5.65, with 95% confidence interval of 2.76-11.55). Cases reported less frequent intake of green vegetables, fruit, and whole-grain foods: thus, the risk of endometrial cancer appeared inversely related to indices of beta-carotene and fiber intake. Furthermore, cases consumed milk, liver and fish less frequently than controls. No significant difference was noted between cases and controls in the frequency of intake of carrots, meat, eggs, ham, and cheese. Alcohol consumption was somewhat larger among the cases, but this trend in risk was not significant. Dietary information collected in this study probably is too limited and inconsistent to permit analysis of biologic correlates of these findings or discussion of their potential implications in terms of prevention on a public health scale. Nonetheless, the mere existence of differences in reported diet between endometrial cancer cases and controls is of interest, and may warrant further, more detailed investigation.

On the basis of the numbers of single and multiple births routinely collected by the Central Institute of Statistics, trends in multiple births in Italy over the period 1955-1983 were analyzed. Between 1955 and 1983 the frequency of multiple births declined by about 25% (from 12.6/1000 deliveries to 9.6/1000 deliveries). The downward trend was constant until the early 1970s when rates tended to level off and increase slightly. This finding was largely attributable to trends in dizygotic rates, monozygotic births being approximately constant over the period considered. Multiple birth rates rose till age 35-39, being more than two times higher in this age group than in teenagers, but flattened off in the subsequent strata of age: this finding was constant over the period considered. Despite the general decreasing trend, the regional differences persisted largely unchanged, multiple birth rates being about 30% higher in Southern (and less developed areas) of the country than in the North of Italy. Geographic differences were limited to dizygotic pregnancies, monozygotic rates being constant (about 4/1000 pregnancies) in various areas.

To provide an updated review of cancer mortality trends in Italy, cancer mortality and census data, from 1970 to 2007, were extracted from the WHO mortality database and analyzed using age-specific and standardized rates, and joinpoint regression. Total cancer mortality rates in men have been declining by 1.8% yearly since 1994, reaching a rate of 147 per 100 000 residents (world standard) in 2007. In women, total cancer mortality rates have been decreasing by 1.1% yearly since 1991, resulting in a standardized mortality rate of 85 per 100 000 residents in 2007. Avoided deaths, compared with rates of 1988, from lung, intestinal, stomach, and breast cancers amount to 30 646. In men, trends were driven by cancers of the lung and other tobacco-related sites, intestines, and stomach. Favorable trends for cancers of the breast, intestines, stomach, and uterus contributed to falls in mortality rate in women. Downward trends were seen in both sexes for Hodgkin's lymphoma, bone cancer, and leukemias. Lung cancer in women showed an upward trend, with mortality rates increasing by 2.6% yearly since 1997, becoming the second cause of cancer mortality in middle-aged women. Rising trends were seen in women for oral and pancreatic cancers, as well. The favorable trends in cancer mortality are related to reduced tobacco smoking and alcohol consumption in men, advancements in treatment and management for colorectal cancer, breast cancer, leukemias, and a few other rare treatable cancers, and improved diagnosis of colorectal, breast, and cervical cancers. The greater role of tobacco-related deaths in women suggests the need for targeted strategies.

Data suggest the potential importance of lignin in the prevention of endometrial cancer at Italian consumption levels.

Journal Article Letters to the Editor: Determinants of alcohol consumption in Italy Get access CARLO LA VECCHIA, CARLO LA VECCHIA *Istituto di Richerehe Farmacologiche ‘Mario Negri’Via Eritrea 62–20157. Milan. Italy Search for other works by this author on: Oxford Academic PubMed Google Scholar ROMANO PAGANO, ROMANO PAGANO Search for other works by this author on: Oxford Academic PubMed Google Scholar EVA NEGRI, EVA NEGRI Search for other works by this author on: Oxford Academic PubMed Google Scholar ADRIANO DECARLI ADRIANO DECARLI Search for other works by this author on: Oxford Academic PubMed Google Scholar International Journal of Epidemiology, Volume 16, Issue 2, June 1987, Pages 295–296, https://doi.org/10.1093/ije/16.2.295 Published: 01 June 1987

This quantitative analysis of mouthwash use and oral malignancy revealed no statistically significant associations between mouthwash use and risk of oral cancer, nor any significant trend in risk with increasing daily use; and no association between use of mouthwash containing alcohol and oral cancer risk.

Incidence and prevalence of renal cell cancer are likely to remain approximately stable between 2002 and 2007. Increased diagnostic attention due to widespread use of echography and other diagnostic techniques may, however, lead to earlier detection of kidney neoplasms and consequently to an apparent increase in the incidence of renal cell cancer.

Italian death certification data from 1955 to 1979 for total cancer mortality and 30 cancer sites in the population aged 25 to 74, were analyzed using a log-linear Poisson model to isolate the effects of birth cohort, calendar period of death, and age. The most frequent cohort pattern was characterized by increases up to the generations born between 1920 and 1930, followed by stabilization or a slight decrease. This pattern was evident for total cancer mortality in men, and for several common sites, including larynx, lung, esophagus, bladder, female breast, and ovary. Only four sites (pancreas, pleura, intestines in both sexes, and kidney in men) showed cohort values still rising in more recent generations. Stable cohort and period of death curves were observed for cancers of the prostate and testis, whereas trends were steadily going down for neoplasms of the stomach, and (cervix) uteri. Finally, there were a few discontinuous trends (e.g., in the case of brain neoplasms, leukemias, and lymphomas), which probably reflect different effects of improvements in diagnosis and/or treatment. Period of death values increased for lung and other tobacco related sites (chiefly in males) and, up to the early 1970s, for a few other common sites, including intestines, and the female breast. Downward trends over the calendar period were evident for cancers of the stomach and of the (cervix) uteri. Therefore, total cancer mortality trends over the calendar period of death were moderately increasing for men, and slightly decreasing for women.

The relationship between socio-economic indicators, family size, history of tonsillectomy, infectious mononucleosis (IM) and other diseases and the risk of Hodgkin's disease (HD) was investigated in a hospital-based case-control study, conducted in the province of Pordenone, North-east Italy, between June, 1985 and March, 1990. One hundred and fifty-two HD cases (88 men and 64 women) and 613 controls (357 men and 256 women) were interviewed. Patients with 14 or more years of education had a 2-fold increased HD risk (95% confidence interval, CI: 1.0-3.9); such risk tended to be higher in patients with nodular sclerosis (NS) HD (odds ratio, OR: 4.4, 95% CI 1.8-11.0). Sibship size, birth order and tonsillectomy were not associated with HD risk. Cases and controls did not differ in the frequency or age at occurrence of common childhood infections. A history of IM, however, was found to be an important predictor of HD risk, in particular among NS HD (OR = 13.1, 95% CI 1.0-176.7). Past episodes of herpes zoster and of skin and genital warts were also associated with significantly increased HD risks. These data lend further support to the role of the IM agent (i.e., the Epstein-Barr virus) and, perhaps, of other viral infections and immunological alterations in the development of HD.