The association between oral contraceptives (o.c.) and disease risk was reviewed on the basis of data from a network of a case-control studies conducted in northern Italy since the early 1980's on about 150 cases below age 55 with acute myocardial infarction, 150 with gallstone disease, 350 with uterine fibromyoma, 170 with endometrial cancer, 700 with benign or malignant ovarian tumours, 2000 with breast cancer, 360 with intraepithelial and 370 with invasive cervical cancer, 20 with liver cancer plus over 2000 control women admitted to hospital for acute, non hormone-related non neoplastic diseases. The relative risk (RR) of myocardial infarction was 2.1 (95% confidence interval from 0.7 to 7.1) among current o.c. users, but only 4% of women were current users. There was no association between gallstone disease, uterine fibromyoma and o.c. use. Significant protections were observed with reference to endometrial cancer and benign, borderline and malignant ovarian tumours, while the RR was above unity (RR = 1.9) for invasive cervical cancer, but not for intraepithelial cervical neoplasia. A significantly increased risk was observed for primary liver cancer, which is however extremely rare in young women. With reference to breast cancer, there was no consistent duration-risk relationship, and the RR was 0.8 for use for 5 or more years. Thus, these data provide reassuring information on the relationship between o.c. use and the risk of several important diseases in a Southern European population.

Available evidence concerning oral contraceptives and their potential interaction with reproductive history on breast cancer risk is reviewed. The relative risks in 15 out of 15 studies were above unity among younger women (i.e., below age 35 and perhaps up to 45) for long-term oral contraceptive use, although apparent heterogeneities emerged in the risk estimates. The overall evidence is reassuring in subsequent age groups, whereas the modifying effects or interactions between oral contraceptives, reproductive factors and breast cancer risk are still largely undefined. Thus we suggest that, besides chance and bias, the apparent discrepancies between various studies should be considered within the framework of the complex time- and age-effects of hormone-related risk factors on breast carcinogenesis.

The aim of this report is to update data and statistics on cancer mortality in Italy which were published from 1955 to 1984 in strata of sex age group and calendar period. Cancer mortality statistics for 1989 alone are presented together with aggregate death certification data and statistics for the quinquennia 1985-89 and with figures summarizing trends in age-standardized mortality from major cancers since 1955. (EXCERPT)

Suicide mortality in Italy over the period 1955-87 has been analysed in terms of age-specific and age-standardised death certification rates, and using a log-linear model to disentangle the effects of age, cohort of birth and calendar period at death. In males, the overall age-adjusted rate (on the World Standard population) was 8.6/100,000 in 1955-59, decreased to 6.7/100,000 in 1965-69, but steadily increased thereafter to reach 9.2/100,000 in 1985-87. In women, overall suicide mortality was 3.3/100,000 in 1955-59, decreased to 2.7/100,000 in 1965-69, and increased to 3.2/100,000 in the late 1980's. The percent rise over the last two decades was approximately 35% for males and over 15% for females, corresponding to an excess of over 1,000 deaths per year. The rise in males was attributable to both a period and a cohort effect, and appreciable increases were evident among younger generations over most recent periods. For females, trends at younger ages were more favourable, and the recent increases were essentially on a period of death basis. Recent unfavourable trends are discussed in relation to increased unemployment in Italy during the early 1970's, and to changes in psychiatric care delivery, since a radical psychiatric reform was implemented in Italy in 1978. Differences of trends for males and females, and comparison with suicide trends in other Western countries, however, would not support any simple relationship between these factors and national suicide rates.

This study documents conservative sexual habits in Northern Italian females (at least on the basis of self reporting) but indicates that any educational compaigns towards safe sex should be focused towards younger women, particularly smokers, unmarried and nulliparae.