Overweight and obesity are associated with increased mortality and morbidity, and human weight is influenced by multiple factors, both genetically and environmentally determined. We investigated the influence of some socioeconomic, behavioral, dietary and reproductive factors on body mass index (BMI). Data were obtained from a comparison group of a case-control study of gastrointestinal cancers from the four largest teaching and general hospitals in Milan, northern Italy. The subjects were 1,188 men and 832 women admitted between January 1985 and June 1992 to the hospitals under study for diseases other than malignant or digestive and not known or suspected to be related to alcohol or tobacco. The following were measured: BMI (Quetelet's index, weight, kg/height, m2) and the corresponding standard errors (s.e.) in strata of selected variables, linear regression coefficients (beta) and correlation coefficients between BMI and each variable. Mean BMI increased with age until 35-44 years in men and 45-54 years in women. In both sexes BMI was inversely associated with education and social class. Smokers tended to be leaner than non-smokers, but no consistent trend was observed with increasing numbers of cigarettes. Alcohol drinkers had mean BMI similar to non-drinkers, except heavy drinking women who were lighter. BMI was not significantly associated with coffee, decaffeinated coffee, tea, bread, vegetable and fruit consumption. No relation was observed between total estimated caloric intake and BMI. In women BMI was directly associated with marriage and number of children, and inversely with oral contraceptive use.(ABSTRACT TRUNCATED AT 250 WORDS)
The relationship between brassière size, as an indicator of breast size, and breast cancer risk was considered in a case--control study conducted between 1991 and 1994 in six Italian centres. Cases were 2,557 women, below age 75, with histologically confirmed breast cancer, and controls were 2,566 women admitted to hospital for a wide spectrum of acute, non-neoplastic, non-hormone-related diseases. Odds ratio (ORs) of breast cancer and their 95% confidence intervals (CIs) were obtained from multiple logistic regression equations including terms for study centre and age, as well as main breast cancer risk factors. A slight inverse relationship was observed between breast size and the risk of breast cancer, with an OR of 1.37 (95% CI 1.05-1.80) for the smallest brassière size compared with the largest; the increase in risk disappeared after adjustment for main recognized breast cancer risk factors, with an OR of 1.16 (95% CI 0.87-1.54) for brassière size < or = 1 compared with > or = 5. No significant heterogeneity in risk of breast cancer with breast size was found in strata of age at diagnosis, parity, age at first birth, age at menopause, family history of breast cancer, benign breast disease, ever use of oral contraceptives and/or hormone replacement therapy. Thus, this study, based on large number of caucasian women, provides conclusive evidence of a lack of appreciable association between breast size and breast cancer risk in this Italian population.
To compare the separate and combined effects of alcohol drinking and smoking between the 2 sites, we evaluated 274 men with oral cancer, 364 with pharyngeal cancer and 1,254 controls, frequency-matched for age and area of residence, from Italy and Switzerland. Extremely elevated risk increases for oral cancer (odds ratio, OR = 228) and pharyngeal cancer (OR = 100) were found for the highest joint level of drinking (≥77 drinks/week) and smoking (≥25 cigarettes/day). Ratios of ORs between oral cancer and pharyngeal cancer vs. controls, obtained by polytomous logistic regression, suggested that the risk increase for oral cancer was about 2-fold greater than that for pharyngeal cancer at each combined level of smoking and drinking, except at low levels of drinking in smokers. A clear departure from risk difference additivity was present for both oral and pharyngeal cancer in individuals heavily exposed to both factors versus non-smoking abstainers/light drinkers. Our findings thus help explain observations from descriptive epidemiology that, if smoking level in a population does not change substantially, but alcohol consumption increases, increase in oral cancer would be greater than at any other site in the upper aero-digestive tract, including cancer of the pharynx. Int. J. Cancer 83: 1–4, 1999. © 1999 Wiley-Liss, Inc.
1Cancer Epidemiology Unit and Cancer Registries of Vaud and Neuchâtel, Institut Universitaire de Médecine Sociale et Préventive, CHUV-Falaises 1, 1011 Lausanne, Switzerland. 2Laboratory of Epidemiology, Istituto di Ricerche Farmacologiche ‘Mario Negri’, Via Eritrea 62, 20157 Milano, Italy. 3Istituto di Statistica Medica e Biometria, Università degli Studi di Milano, Via Venezian 1, 20133 Milano, Italy. 4Division of Epidemiology and Biostatistics, European Institute of Oncology, Via Ripamonti 435, 20141 Milano, Italy. Correspondence to: Fabio Levi, Registre Vaudois des Tumeurs, CHUV-Falaises 1, 1011 Lausanne, Switzerland. Fax: (+41) 21 323 0303. E-mail: [email protected] Received 4 August 2000 Accepted 14 August 2000
Read moreWe have investigated the relation between alcohol, tobacco and dietary habits and risk of adenocarcinoma of the small intestine using data from 2 hospital-based case-control studies on intestinal cancers conducted in 6 Italian centres between 1985 and 1996. Cases were 23 patients below age 75 years with adenocarcinoma of the small intestine. Controls were 230 patients admitted to hospital for a wide spectrum of acute, non-neoplastic, non-digestive tract diseases, matched to cases on sex, age, study and centre. Odds ratios (ORs) were estimated using conditional logistic regression. Alcohol and tobacco consumption did not increase the risk of adenocarcinoma of the small intestine. The risk appeared to be directly related to intake of bread, pasta or rice (OR = 3.8), sugar (OR = 2.9) and red meat (OR = 4.6), and inversely to coffee (OR = 0.4), fish (OR = 0.3), vegetables (OR = 0.3) and fruit (OR = 0.6). Our results suggest that dietary correlates of adenocarcinoma of the small intestine are similar to those of colon cancer and at least of the same magnitude. While the present data are inconsistent with a major effect of tobacco or alcohol, a moderate association between these factors and small bowel cancer may have been obscured by the play of chance.
Read moreIn order to explore the potential differences in the effect of alcohol in men and women we took advantage of a case-control study of upper aerodigestive tract tumors conducted between 1986 and 1991 in Northern Italy Five hundred forty-six incidence cases of cancer of the oral cavity and pharynx (of whom 81 were women), 410 of cancer of the esophagus (of whom 67 were women), and 388 with cancer of the larynx, (of whom 19 were women) were interviewed. The control group included 2263 inpatients (of whom 557 were women) with acute conditions unrelated to alcohol and tobacco consumption. Among alcohol drinkers, similar odds ratios were detected in men and women. In the highest, well comparable intake category (i.e., > or = 42 drinks/week in women and 42-55 drinks/week in men), odds ratios were 4.5 and 3.8 for cancer of the oral cavity and pharynx, 3.0 and 4.7 for cancer of the esophagus, and 2.6 and 2.0 for cancer of the larynx in women and men, respectively, as compared to light drinkers. However, for all cancer sites a reduced risk was found among abstaining women but not in abstaining men, when compared with light-to-moderate drinkers. The present study, therefore, does not support the hypothesis that women may be substantially more vulnerable than men to alcohol carcinogenesis, at least at the level of the upper aerodigestive tract.(ABSTRACT TRUNCATED AT 250 WORDS)
Read moreBACKGROUND Protection from thyroid carcinoma due to certain dietary factors was suggested by several studies, but the findings were relatively inconsistent. The role of micronutrients has not yet been systematically analyzed. To investigate the relationship between micronutrient intake and thyroid carcinoma risk, the authors used data from a case-control study conducted in northern Italy between 1986 and 1992. METHODS The study included 399 incident, histologically confirmed thyroid carcinoma cases and 617 controls admitted to the hospital for acute, nonneoplastic, nonhormone-related diseases. RESULTS Retinol intake showed a direct association with thyroid carcinoma risk, with odds ratios (ORs) of 1.39 (95% confidence interval [CI], 0.9-2.0) in the third quartile of consumption and 1.52 (95% CI, 1.0-2.3) in the highest quartile, whereas beta-carotene had an inverse relationship, with ORs of 0.63 (95% CI, 0.4-0.9) in the third quartile of consumption and 0.58 (95% CI, 0.4-0.9) in the highest quartile compared with the lowest quartile. Some protection was observed for measures of vitamin C intake (with an OR of 0.72) and vitamin E (with an OR of 0.67) for the highest quartile of consumption, although the estimates were not statistically significant, and were reduced after adjustment for beta-carotene intake. No clear pattern in risk appeared for vitamin D, folate, calcium, thiamin, or riboflavin. The inverse relationship between beta-carotene and thyroid carcinoma was observed in both papillary and follicular carcinomas. CONCLUSIONS In this study, a significant inverse association between beta-carotene and thyroid carcinoma was observed, and some protection against thyroid carcinoma from vitamins C and E was also suggested. Cancer 1997; 79:2186-92. © 1997 American Cancer Society.
Read moreTo assess the dietary correlates of cancer of the ovary, the consumption of a wide range of food groups has been investigated in a case-control study conducted between January 1992 and September 1999 in 4 Italian areas. Cases were 1,031 women with incident, histologically confirmed epithelial ovarian cancer; controls were 2,411 women admitted to the same network of hospitals as the cases for acute, non-malignant and non-gynecological conditions, unrelated to hormonal or digestive tract diseases or to long-term modifications of diet. The subjects' usual diet was investigated through a validated food frequency questionnaire including 78 foods and recipes, then grouped into 18 food groups. Odds ratios (OR), and the corresponding 95% confidence intervals (CI) were estimated using unconditional multiple logistic regression models including terms for age, study center, education, year at interview, parity, oral contraceptive use and energy intake. Significant trends of increasing risk emerged for red meat (OR = 1.53 for the highest compared with the lowest quintile of consumption), whereas inverse associations were observed for consumption of fish (OR = 0.51), raw (OR = 0.47) and cooked vegetables (OR = 0.65), and pulses (OR = 0.77).
Read moreTo evaluate the understandability and the validity of information included in package inserts of the 20 main oral contraceptive (OC) preparations sold in Italy, we systematically tabulated the indications, contraindications and side-effects listed in their patient information leaflets. OC information leaflets included, in their vast majority, only contraception as indication, with no mention of endometriosis, dysmenorrhea, or other menstrual cycle disorders, which are potential indications for OC use. In contrast, information leaflets included an extremely detailed, but largely acritical, list of contraindications and side-effects, in the absence of any quantitative indication on their frequency and importance. These include, among others, depressive symptoms, visual impairments, or endometrial hyperplasia, which is indeed an indication for combined OC use. Such acritical and poorly explained information on potential, but often unproven, side-effects may cause confusion and lead to withdrawal from OC use for some women, in the absence of any real contraindication. In contrast, some real contraindications or serious side-effects, including cervical neoplasia, hepatomas, liver cancer or myocardial infarction, were not reported in OC leaflets. The incomplete data, and particularly the absence of quantitative information on OC leaflets, may cause negative attitudes of women towards their use, decreased compliance, and, however indirectly, be a determinant of the low prevalence of OC use among Italian women.
Read moreExposure to airborne polycyclic aromatic hydrocarbons (PAHs) in 65 employees (40 sampled both in summer and winter, 15 sampled in summer only, and 10 sampled in winter only) with no occupational exposure to PAHs was assessed by measuring: personal exposure to pyrene, urinary excretion of 1-hydroxypyrene (1-OHP), and benzo(a)pyrene diol epoxide adducts to hemoglobin (BPDE-Hb). Overall, office employees were exposed to significantly higher levels of pyrene in winter (4.54 +/- 2.35 ng/m3, mean +/- SD) than in summer (1.67 +/- 1.92 ng/m3, mean +/- SD; P < 0.001), but no such seasonal variability was observed in 1-OHP excretion. Tobacco smoking was the major determinant of 1-OHP excretion. BPDE-Hb adducts were measured by gas chromatography-mass spectrometry as benzo(a)pyrene tetrols (BPT) released from adducted hemoglobin. In the 65 employees analyzed, mean BPT levels +/- SD were higher in winter (0.14 +/- 0.38 fmol/mg Hb) than summer (0.031 +/- 0.022 fmol/mg Hb). This difference was not statistically significant, probably because of the small proportion of subjects with detectable adducts (11% in summer and 16% in winter). BPDE-Hb adducts were not significantly associated with sex, age, diet, smoking habits, or with pyrene levels and 1-OHP excretion. This is the first report providing reference BPDE-Hb adduct values for the general population not occupationally exposed to environmental PAHs and shows a tendency to seasonal variability, with higher BPT levels in winter when environmental PAHs are also high.
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