Trends in age-specific and age-standardized cancer death certification rates in Italy from 1955 to 1978 were analyzed. In males total cancer mortality rates increased in all age groups. However, when respiratory and other tobacco-related neoplasms were excluded, death certification rates were roughly stable up to age 64. Moderate decreases in overall cancer mortality have been apparent at younger ages (35-44) since the early 1970's. In females, all the age-specific and the age standardized, under-65 death certification rates decreased; the downward trends were more pronounced (-18.5%) in the younger age group considered (35-44 years). Respiratory cancer mortality increased sharply in males: lung cancer death rates reached a plateau in the early 1970's in the 35-44-year age group, but increased at all subsequent ages. In females, the increase in lung cancer mortality was about 50% in the 45-54 and 55-64-year age groups, but no upward trend was evident in younger women. Other tobacco-related cancers (mouth or pharynx, larynx, esophagus, pancreas, kidney and bladder) also rose considerably. In both sexes, gastric cancer mortality dropped about 50% below age 65, but mortality rates from cancer of the stomach were still considerably higher than in other Western countries. Likewise, mortality from cancer of the (cervix) uteri decreased markedly, mostly in younger age groups. Upward trends in death certification rates were evident for cancers of the bowel (colon and rectum, about 50% in males, and 35% in females below age 65), and of the breast in females. However, these trends have levelled off since the late 1960's, at least in the younger age groups. Certified death rates from cancer of the skin (melanoma) increased over all the periods considered in the young of both sexes. Cancer mortality rates showed marked increases in older (greater than or equal to 65) males, but this can be partially explained in terms of better case ascertainment and more accurate death certification.
Numerical and graphical data are presented on certified cancer mortality in Italy from 1955 to 1978. The data are provided for cancer mortality as a whole and for 32 cancer sites. Breakdowns by age group and sex are included. (ANNOTATION)
Trends in childhood cancer death rates in Italy from 1955 to 1978 were analyzed. All cancer age-standardized mortality below age 15 fell about 20%, with a clear downward trend since the early 1970's. Declines were evident for leukemias (-25%), Hodgkin's disease (-56%), non-Hodgkin's lymphomas (-27%), kidney cancer (-25%), retinoblastoma (-50%), and bone sarcomas (-31%), for a total number of about 200-250 fewer deaths per year in the late 1970's compared to the expected values using rates of the 1950's. The observed fall was apparently confined within the first age group considered (0-4 years), but the age-specific patterns of trend were partly influenced by simple postponement of some deaths to older age groups. Comparisons with similar data in other developed countries suggest that, although there has undoubtedly been some progress, there is still wide scope for further reduction in childhood cancer mortality in Italy, simply through more rational use of currently available diagnostic and therapeutic knowledge.
Breast cancer death certification rates in Italy showed a consistent geographic variation, with approximately a 2-fold ratio between the highest rates registered in Northern (and richer) regions, and the lowest ones in the South. This variation in breast cancer mortality was positively and strongly correlated with mean age at first birth (r = +0.73). This positive correlation could not be totally explained by several other economic or dietary variables considered, though some of them substantially reduced the strength of the association. Breast cancer mortality rates were found to be positively correlated with milk, meat and sugar consumption, and negatively with pasta, thus confirming previous studies on national or international scales. These correlation coefficients, however, were considerably reduced after controlling for mean age at first birth. Further, when allowance was made for economic variables and age at first birth, only the correlation coefficients for milk and cheese remained significantly positive. Thus, the evidence from this study suggests that the Italian geographical correlations between breast cancer mortality and dietary variables may be largely explained in terms of reproductive factors, though there may be some effect of dietary variables on breast cancer risk as well.
To determine whether there is a short term increase in the risk of breast cancer after a full term birth data from two hospital based, case-control studies in Italy were pooled. Analysis was restricted to women aged under 50 with two or more children (573 women with cancer and 570 controls). A relative risk for breast cancer of 2.66 was seen in women who had given birth during the three years preceding the interview compared with women whose last birth had occurred 10 or more years before, after adjustment for age, age at first birth, and parity. The relative risk slowly decreased for women who had last given birth three to 10 years before. Multivariate analyses confirmed the protective effect of an early age at first birth and the age dependent effect of parity on the risk of breast cancer--that is, a direct relation below age 40 and an inverse one in older women. These data provide epidemiological evidence that a full term birth is followed by a transient increase in the risk of breast cancer, which for some time contrasts with and overcomes the long term protection of pregnancy at an early age. They therefore confirm predictions from animal studies and theoretical models that pregnancy prevents the early stages of breast carcinogenesis but promotes the late stages of the process.
Read moreThe relationship of benign breast disease (BBD) and oral contraceptive (OC) use was analyzed in a case-control study conducted in Milan on 288 women with clinically relevant and histologically confirmed BBD (cases) and 285 age matched controls with a spectrum of acute conditions apparently unrelated to OC use. Compared to women who had never used OCs, the relative risk (RR) for users was 1.0 (95% confidence interval: 0.6-1.5). Likewise, there was no siginficant association with duration of use; however, a significantly lower relative risk emerged in women taking OCs during the year before breast biopsy (RR=0.4; 95% confidence interval: 0.2-0.8). The protection in current users increased with increasing duration of use. In spite of this finding, the overall results of the study do not support the hypothesis that OC use protects against development of histologically confirmed and clinically relevant benign breast disease.
Read moreJournal Article Changes in diagnostic procedure utilization in Italy, 1980–83 Get access ROMANO PAGANO, ROMANO PAGANO Central Institute of Statistics00100 Rome, Italy Search for other works by this author on: Oxford Academic PubMed Google Scholar CARLO LA VECCHIA CARLO LA VECCHIA Central Institute of Statistics00100 Rome, Italy Search for other works by this author on: Oxford Academic PubMed Google Scholar International Journal of Epidemiology, Volume 17, Issue 2, June 1988, Pages 473–474, https://doi.org/10.1093/ije/17.2.473 Published: 01 June 1988
Read moreThe relation between ovarian cancer and coffee drinking habits was evaluated in a case-control study of 247 histologically confirmed epithelial ovarian cancers and 494 age-matched controls, admitted to hospital for acute conditions apparently unrelated to coffee consumption. Compared to rates for women who had never drunk coffee, the crude relative risk estimates for those who drank less than two, two or three, and four or more cups per day were 1.3, 1.5 and 1.4 respectively; however, when allowance was made for smoking habits, these risk estimates became 1.3, 1.7 and 1.8 respectively, and a significant linear trend of increasing risk with more elevated coffee consumption was evident. These results were not explained by various other potential confounding factors, including the major risk factors for ovarian cancer, but we had no information on dietary variables. The relative risk, however, did not increase with increasing duration of use. The findings of this study give apparent support in favour of the hypothesis that coffee consumption, or related dietary variables, may be associated with the risk of epithelial ovarian cancer. Further studies in different settings, however, are required in order to establish whether this association is real, and if so, whether it is causal.
Read moreIn this volume we present and discuss the findings derived from the application of a standard age-period-cohort model to Swiss cancer death certifications over the period 1951-1984 with the aim of assisting the interpretation of trends and the search for aetiological correlates or hypotheses. Data are from official sources. An attempt is also made to forecast future trends in Swiss mortality. (EXCERPT)
Read moreCigarette consumption has increased steadily throughout this century in Italy. There were marked increases in three periods: in the 1920s, in the 1950s possibly due to the spread of smoking among young men, and in the 1970s in part due to smoking among women. The average number of cigarettes per adult per day sold legally in 1980 was 6.9 but, taking smuggling into account, the actual average number of cigarettes smoked per day is likely to range between eight and nine. Data from a national sample-based survey conducted in 1980 showed that smoking prevalence in men was broadly similar within age groups, geographical area, education, and socioeconomic groups. Smoking in women, on the other hand, was concentrated in younger and more educated women living in larger towns and in richer areas of the country. This pattern is typical of a recent rapid spread of smoking among women. The average tar yield of Italian cigarettes in 1983-4 was about 17 mg. Tar yield was strongly and negatively correlated with price (r = -0.55). This abnormality should be urgently reversed by government intervention. No material increase in lung cancer mortality in young women was evident up to the lat 1970s. Lung cancer death rates in men correlated closely with the observed changes in cigarette consumption. The highest mortality rates (about 7, 20, and 50/100 000 respectively in the age groups 35-39, 40-44, and 45-49) were reached by the generation born around 1927-30, and the rates have remained fairly constant around these maximum levels for those born up to 1940. As a consequence, Italian lung cancer death rates in middle-aged men (45 to 54) are currently the highest registered in developed countries, and large upward trends are currently detectable in older men.
Read moreRisk factors for uterine fibroids were analyzed in a hospital-based case-control study conducted in the greater Milan area, based on 275 women with histologically confirmed fibroids and 722 controls with acute nongynecologic or hormone-related conditions. Questions were asked about menstrual and reproductive characteristics, education, history of various diseases, and lifetime use of oral contraceptives and other hormonal treatments. The risk of uterine fibroids was reduced in parous women relative to nulliparous ones (relative risk 0.6) and in those who were postmenopausal (relative risk 0.1 compared with premenopausal women of the same age). Women with fibroids tended to have an earlier age at menarche and at the last birth, to be more educated, and to use intrauterine devices and oral contraceptives more frequently, although these findings were not statistically significant. Current smoking (but not past smoking) lowered the fibroid risk by about 40%. No associations were found with body mass index, history of spontaneous or induced abortions, and age at first birth.
Read moreTrends in the death rates from cancers of the intestine (including colon and rectum) in Italy from 1956 to 1981 were analyzed with a standard cross-sectional approach and a log-linear age/period/cohort model. In both sexes there were steady increases in mortality rates between the middle 1950s and the middle 1970s, chiefly explainable in terms of cohort effects. This was followed by a leveling off and stabilization, starting from the younger age groups and more evident in women. The analyses of the geographic distribution of intestinal cancer mortality in the 95 Italian provinces during 1975 to 1977 showed higher rates in the north of the country and in large urban concentrations, and a bimodal distribution of mortality rates, whose minimum corresponded to a distinct north/south separation. Trend surface models fitted to intestinal cancer standardized mortality ratios showed a high determination coefficient even for the simplest models. Residuals, corresponding to outliers, were scattered in a few northern and central areas. In addition, mortality rates for cancers of the intestine in middle age people were considered according to geographic area of birth and residence at death. In both sexes rates of migrant populations were influenced both by area of birth and residence, and, in particular, there was a wide-spread unfavorable effect of residence on migrants from the South to the North (the major migrant flux in Italy). The temporal and geographic variations in intestinal cancer rates observed in this study indicate that Italy may well be a particularly interesting situation for etiologic investigations of colorectal cancers.
Read morePrevalence and determinants of HIV infection were assessed in 313 parenteral drug addicts admitted to five Centers for Drug-Addict Assistance and two prisons located in the northeast of Italy (Friuli Venezia-Giulia), an area some distance from the major Italian cities first reached by the AIDS epidemic. The overall prevalence of HIV positivity was also rather high in this area, ie 30% with 24-36% confidence interval. The most important risk factors (besides syringe sharing applicable to all drug addicts), turned out to be of a geographical nature, ie living in Pordenone province (where a US military base is located) or coming from other endemic areas and having travelled long distances in the past three years. Prostitution also seemed to increase the risk of infection, but duration of drug addiction had little effect. In addition to persistent generalized lymphadenopathy (closely linked to HIV infection), reversal of helper:suppressor T-cell ratio was found in 67% of HIV positive individuals, but also in 31% of HIV negative ones. Clinical signs and symptoms strongly linked with HIV positivity were fatigue, weight loss, splenomegaly, fever and nocturnal sweats.
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