A critical overview is presented of selected findings from a series of case-control studies conducted in the greater Milan area on cancers of the digestive tract, breast, female genital tract, prostate and bladder. Even using very simple data collection instruments (based on the frequency of use of a restricted number of food items), a number of consistent and strong associations emerged. In particular, frequent green vegetable consumption appeared to exert substantial protection against most of the cancer sites considered, which could not be explained in terms of information, selection or confounding bias. Other interesting clues, such as a moderately positive relation between fats and breast cancer, and a positive association between maize and esophageal or gastric cancer are discussed in order to illustrate the potential scope of studies of diet and cancer risk based on populations with considerable heterogeneity and modifications in dietary patterns, and recent changes in mortality from various common cancers.

Journal Article Recent decline of smoking in younger Italian women Get access CARLO LA VECCHIA, CARLO LA VECCHIA *Istituto di Ricerche Farmacologiche ‘Mano Negri’20157-Milan,Italy Search for other works by this author on: Oxford Academic PubMed Google Scholar EVA NEGRI, EVA NEGRI *Istituto di Ricerche Farmacologiche ‘Mano Negri’20157-Milan,Italy Search for other works by this author on: Oxford Academic PubMed Google Scholar ROMANO PAGANO ROMANO PAGANO †lstituto Ccntrale di Statistica (ISTAT)00100-Rome,Italy Search for other works by this author on: Oxford Academic PubMed Google Scholar International Journal of Epidemiology, Volume 19, Issue 1, March 1990, Page 221, https://doi.org/10.1093/ije/19.1.221 Published: 01 March 1990

The characteristics of women reporting cervical cytology screening has been evaluated using data from control subjects collected in the framework of a case-control study on invasive cervical cancer conducted since 1981 in the greater Milan area. A total of 515 women admitted for nonneoplastic, non-gynecologic, nonendocrine-related acute conditions to a network of general and university hospitals were interviewed. The frequency of cervical screening utilization decreased with age: regular screening (≥ 3 lifetime Pap smears) was reported by 46% of women aged 44 years or less, but only 11% of those aged 65 or more. Married women reported about 50% more frequently occasional (1 or 2) and about three times regular (≥ 3) cervical screening than unmarried ones. Parous women were more frequently screened, but no trend emerged with number of births. Similarly number of medical consultations in the year before the interview was associated with an increased number of Pap smears. There was no consistent association between number or recency of Pap smears and smoking, sexual habits or education, but women in low social classes tended to be less frequently screened. Ever contraceptive users (oral contraceptives or barrier methods) reported an increased probability to be screened regularly and within two years before the interview.

Trends in the number of sexual partners and in age at first intercourse were analyzed using data on 706 men and 1206 women drawn from the hospital control groups of two case-control studies conducted since 1981 in Northern Italy. The overall lifelong mean number of sexual partners was 7.5 +/- 12.8 for men and 1.4 +/- 1.8 for females. The mean number of sexual partners was 6.0 for men born between 1910 and 1919, and 7.3, 9.0, 6.3 and 5.5 for subsequent 10 year birth cohorts. Mean age at first intercourse was 20.7 for the cohort born in 1910-19 and was fairly stable in men born after 1919, ranging from 18.4 to 18.8. Women had a substantially lower number of sexual partners than men in each subsequent birth cohort. However, the mean number of sexual partners increased from 1.1 in the 1910-19 cohort to 1.2, 1.2, 1.4 and 2.3 in subsequent birth cohorts, and the mean age at first intercourse decreased from 23.6 years to 23.1, 22.7, 21.3 and 19.7. These figures should be considered with caution, on account of the non-representativeness of the sample and of a possible under-reporting of number of partners by women. Still, Italian women, although not necessarily men, report substantially fewer sexual partners than northern European on American ones.

The role of age at first and at second birth on subsequent breast cancer risk was analyzed using pooled data from 2 hospital-based case-control studies conducted in Italy, for a total of 1,200 biparous cases and 987 controls. Compared with women who gave birth for the first time below age 20, the relative risks were above unity for those with later first birth, even after allowance for age at second birth, although the trend was inconsistent across subsequent strata. A similar direct trend in risk was observed in relation to age at second birth: compared with less than 25 years and after allowance for age at first birth, the point estimates were 1.2, 1.4 and 1.4 for 25-29, 30-34 and greater than or equal to 35 (p for linear trend = 0.04). The results for age at first and at second birth were similar in the 2 studies pooled in this analysis. A significant interaction with age was observed in relation to age at first and at second birth. In younger women (below age 50) a strong and direct association with age at first birth was found, while no apparent protection was conveyed by earlier second birth. Among older women (aged 50 or over), there was no apparent relationship with age at first birth after allowance for age at second, but the role of age at second birth was independent and statistically significant. Thus, our study confirms an independent and significant role of age at second birth in biparous women, after allowance for age at first birth, and indicates that, after reciprocal allowance, the role of first and second birth was not apparently different. The relative risks for both variables were quantitatively moderate, and may be influenced by age or other temporal variables.

This meta-analysis provides reassuring evidence on the absence of any major risk of adverse pregnancy outcome as a result of exposure to a VDT. With the number of cases reviewed, it was possible to exclude excess risk of 20% for spontaneous abortion, low birth weight, and congenital malformations.