RiassuntoIn questo rapporto vengono presentati e brevemente commentati dati e statistiche di mortalità per tumori in Italia nel 1982, sulla base dei dati di certificazione di morte pubblicati dall'Istituto Centrale di Statistica (ISTAT). Il numero totale di morti per tumore è salito ad oltre 127.000, e vi è stato un incremento medio nei tassi standardizzati del 2 % nei maschi (e del 4 % nei tassi troncati dai 35 ai 64 anni), mentre la mortalità globale per tumori è rimasta stabile nelle donne. Questo ulteriore ampliarsi del differenziale nella mortalità per tumori tra i due sessi è dovuto essenzialmente al persistente incremento del cancro del polmone nei maschi al disopra dei 55 anni. Il tumore del polmone ha rappresentato più del 29 % della mortalità globale per tumore nei maschi, ed un numero globale di oltre 25.000 morti nell'insieme dei due sessi. Tra gli altri tumóri legati al tabacco, i tassi erano superiori rispetto all'anno precedente per i tumori di cavo orale e faringe nei maschi, e per il pancreas e la vescica in entrambi i sessi. Si sono registrati aumenti anche per il tumore del polmone nelle donne, seppur in maniera limitata rispetto agli Stati Uniti e diversi Paesi del Nord Europa. Tra i tumori non associati al tabacco, si è osservato qualche ulteriore diminuzione per lo stomaco e qualche aumento per l'intestino in entrambi i sessi: per la prima volta nel 1982 l'intestino è così divenuto la seconda causa di morte per tumore in Italia. Moderati aumenti si sono anche registrati per il tumore della mammella nelle donne (che ha raggiunto i massimi tassi assoluti), per l'ovaio in diverse classi d'età, mentre è continuata a diminuire la mortalità per tumore del collo dell'utero, senza che si sia osservata alcuna tendenza ad un'inversione di tendenza nelle giovani. Ulteriori aumenti si sono avuti per il melanoma della pelle soprattutto nei giovani uomini, mentre gli incrementi per altre neoplasie, quali la prostata, il cervello od il mieloma erano più diffusi, o concentrati, tra i più anziani, indicando pertanto come siano prevalentemente o largamente da attribuirsi a miglior diagnosi e certificazione.

Official Italian data on fetal and infant mortality are used to present comparative data for the regions of Italy for the period 1959-1979. The data are presented separately by sex for stillbirths perinatal mortality and mortality on the 1st day 2nd to 7th day 8th to 28th day 29th to 365th day and 1st to 365th day of life. Consideration is given to differences by maternal age and education and by paternal occupation. (SUMMARY IN ENG) (ANNOTATION)

Trends in death rates from all suicides and specific methods of suicide in Italy over the period 1955-79 were analysed on the basis of age-specific and age-standardised rates, and through a log-linear Poisson model to isolate the effects of age, birth cohort and calendar period. In both sexes, a large decrease in mortality from suicide was evident in the late 1950's and early 1960's. Thereafter, death certification rates showed fluctuating trends up to the mid 1970's, when steady increases became evident for both sexes. Nevertheless, overall age-standardized mortality rates from suicide in the late 1970's were still considerably lower than in the two previous decades (15% in males, 7% in females). The observed variations in suicide mortality, mostly in males, can be explained in terms of period of death effect and be related to changes in the Italian economic situation. This view finds further support from analysis of age-specific trends (e.g. mortality rates in the younger age groups started rising in the early 1970's, together with a rise in unemployment rates among the young). Cohort curves for males born in the current century were U-shaped as well, with marked declines for generations born between 1905 and 1930, and moderate increases for more recent cohorts. For females, the cohort curve was remarkably flat. Some of the changes in the various methods of suicide can be explained in terms of well-defined exogenous factors (e.g., the large fall in poisoning by domestic gas is obviously attributable to domestic gas detoxification).

The relation between body mass index and prevalence of 17 chronic diseases or groups of diseases was analysed using data from the 1983 Italian National Health Survey, based on a sample of 72,284 individuals aged 15 or over randomly selected within strata of geographical area, size of place of residence and of household in order to be representative of the whole Italian population. The prevalence of diabetes was directly and strongly related to body weight (age-adjusted relative risk estimates being 1.5 for overweight and 2.7 for obese men compared with normal weight individuals; 1.6 and 2.4 for overweight and obese women). Other conditions directly related to self-reported measures of body weight were hypertension (relative risk = 1.7 for obese men and 1.9 for women), myocardial infarction (relative risk = 1.5 for obese men, 1.6 for women), other heart diseases (relative risk = 1.7 for obese men, 1.5 for women), haemorrhoids or varices (relative risk = 1.2 for obese men, 1.5 for women), cholelithiasis (relative risk = 1.2 for obese men, 1.4 for women), urolithiasis and arthritis. Chronic respiratory disorders showed a U-shaped relation to measures of body weight, since their prevalence was elevated in both under- and over-weight individuals. Anaemias and gastroduodenal ulcer showed an inverse relation to body weight, whereas no association was apparent with allergy, liver cirrhosis, and psychiatric or neurological disorders. Allowance for the two major identified covariates (education and smoking) failed to explain the observed variations between measures of body weight and disease, while separate inspection of various strata of age indicated that for most diseases the elevated risks of obesity were higher in younger and decrease steadily with advancing age. Thus, the results of this national survey indicate that overweight has a widespread and substantial impact not only on mortality but also on morbidity from different chronic conditions.

Determinants of stopping smoking: Italian National Health Survey. E Negri, and C La VecchiaCopyRight https://doi.org/10.2105/AJPH.79.9.1307-b Published Online: October 07, 2011

The relation between age of parents and the risk of complete and partial hydatidiform mole was examined using data from a case-control study conducted in Northern Italy of 149 histologically confirmed complete moles, 45 partial moles and 306 controls subjects who delivered normal babies. Compared to women aged 21 to 35, the relative risk (RR) of complete mole was elevated for teenage women (RR = 1.9) and for those aged 36-40 (RR = 1.9) or over 40 (RR = 7.5). There was no association between women's age and partial mole. Likewise, older paternal age (greater than 45) was related with the risk of complete mole (RR = 4.9, though allowance for women's age reduced this point estimate to 2.9), but not of partial mole. The present findings indicate that there are important differences in the epidemiology of complete and partial hydatidiform mole.

The relationship between preference for food temperature and the risk of stomach cancer was analysed using data from a case-control study conducted in Northern Italy on 563 histologically confirmed incident gastric cancers and 1,501 controls admitted to hospital for acute, non-neoplastic, non-digestive tract disorders. A specific question was related to food temperature, subjectively defined as "warm", "hot" or "very hot". Compared with subjects indicating preference for "warm" foods, the relative risk (RR) was 1.1 (95% confidence interval, CI, 0.9-1.4) for "hot" and 1.8 (95% CI = 1.3-2.4) for "very hot". The test for trend in risk was statistically significant, and the results were not appreciably modified by allowance for a number of identified potential distorting factors. The elevated risk, however, appeared to be restricted to the 17% of cases reporting a preference for "very hot" foods. This may be due to an absence of substantial misclassification between "warm" and "very hot", but also to the existence of a threshold temperature, below which no appreciable thermal irritation is evident. Thus, although the difficulties and uncertainties on measures of food temperature are substantial, these data suggest that thermal irritation may have a role in gastric carcinogenesis.

Journal Article THE AUTHORS REPLY Get access Silvia Franceschi, Silvia Franceschi 1Servizio di Epidemiotogia Centra di Riferimento Oncologico via Pedemontana Occ33081 Aviano (PN) Italy Search for other works by this author on: Oxford Academic PubMed Google Scholar Carlo La Vecchia Carlo La Vecchia 2Istituto Ricerche Farmacologiche “M. Negri”Via Eritrea, 62 20157 Milano Italy Search for other works by this author on: Oxford Academic PubMed Google Scholar American Journal of Epidemiology, Volume 127, Issue 3, March 1988, Pages 697–698, https://doi.org/10.1093/oxfordjournals.aje.a114848 Published: 01 March 1988

The role of socio-demographic factors, lifestyle habits and selected dietary factors on the risk of hepatocellular carcinoma was evaluated in a hospital-based case-control study conducted in Northern Italy on 151 patients with hepatocellular carcinoma and 1,051 controls in hospital for acute, non-neoplastic or digestive conditions, unrelated to any of the known or potential risk factors for primary liver cancer. There were significant inverse relationships with levels of education and social class (relative risk, RR = 1.9 and 2.4 for lower vs. upper categories), and positive associations with clinical history of hepatitis (RR = 3.5, 95% confidence interval = 2.0-6.0) or liver cirrhosis (RR = 15.6, 95% CI = 8.3-29.4). The relative risk was not elevated in smokers and light or moderate alcohol drinkers, but the point estimate was above unity among heavy drinkers (RR = 1.5, 95% CI = 1.0-2.4). Among 14 food items considered, including important sources of vitamin A, protein and fats in the Italian diet, 5 were inversely and significantly related to liver cancer risk. This suggests that a diet deficient in several aspects may be related to hepatocellular carcinoma.

Death certification rates from 17 non-sexual and 4 sexual cancers were used to examine patterns of correlation between various cancers within the 20 Italian regions. A large number of strongly positive correlations emerged, reflecting the geographical distribution of cancer mortality in Italy which shows substantially higher rates for several common sites in northern areas. The most notable findings were the high positive correlations between various tobacco-related cancers in both sexes (however somewhat higher in males), the positive correlations between most intestinal sites and between a well defined group of other cancers including intestines in both sexes, breast and ovary in females and prostate in males, previously described in several widely heterogeneous populations. Various alcohol-related cancers showed high positive coefficients in males but not in females. Several suggestions which emerged from previous correlation studies but which generally lacked convincing biological or epidemiological consistency were not confirmed by the present data. Conversely, a few strong correlations emerged in the present study which are not explainable in terms of available knowledge of the causes of cancer, or obvious confounding. Though probably incidental, the existence of these correlations between cancers with widely heterogeneous or largely undefined etiology is still an indirect indication that these neoplasms are largely avoidable, since it is unlikely that the same genetic determinants are strongly associated with such different malignancies.

The relation between reproductive and menstrual factors and the risk of colorectal cancer was investigated in a case-control study conducted in Northern Italy on 279 women with colon cancer, 153 with rectal cancer and 386 controls admitted to hospital for a wide spectrum of acute, nonneoplastic, nondigestive disorders. Compared with nulliparous women, the relative risks (RR) of colon cancer were 1.1 for one and two births, 1.3 for three or four, and 1.1 for five or more. Corresponding values for rectal cancer were 0.9 for one, 1.1 for two, 1.4 for three or four, and 0.8 for five or more births. No significant association emerged with number of abortions, and no consistent pattern of trends for both colon and rectum cancer was observed in relation to age at first or last birth. Women whose menarche occurred at age 15 or over were at significantly lower risk of colon cancer (RR 0.5, 95% confidence interval = 0.3-0.9), and the point estimate was below unity, though nonsignificantly, for rectal cancer too (RR = 0.7). There was no relation between age at menopause, duration of menstrual cycles, and cancers of the colon and rectum. The present study produced no evidence that reproductive factors are related to colorectal cancer in this population. With this sample size, it was possible to exclude relative risks below 0.8 for colon and 0.7 for rectal cancer among multiparous women versus nulliparous ones. These findings are thus inconsistent with the epidemiological evidence on reproductive and menstrual factors and breast cancer in this and other populations, with the sole potential exception of the reduced risk of colorectal cancer among women whose menarche occurred at age 15 or over.

The relation between calcium intake, estimated from frequency of use of 29 food items, and colorectal cancer risk was analyzed using data from a case-control study conducted in Northern Italy. The study was conducted on 558 cases of colon cancer, 352 cases of rectal cancer, and 1,032 controls admitted to the hospital for acute, nonneoplastic, nondigestive tract disorders (39% with traumas, 17% nontraumatic orthopedic diseases, 25% acute surgical conditions, 19% other miscellaneous disorders). There was no appreciable trend in risk of colon or rectal cancer in relation to measures of calcium intake. The multivariate relative risk (adjusted for age, sex, education, area of residence, and consumption of selected indicator foods) for highest versus lowest quintile was 1.1 for colon and 1.0 for rectum. Likewise, there was no appreciable difference between cases and controls with reference to frequency of consumption of the two major calcium-containing foods (milk and cheese), with relative risk for the highest level of intake between 0.9 and 1.2. This study indicates that little or no protection on large bowel cancer risk is provided by dairy products or calcium intake in a range of 0.5-1.5 g per day.