Tomatoes have been estimated as the second most important source of vitamin C, after oranges, in an Italian population. We have therefore considered the relationship between tomato intake and the risk of digestive tract cancers using data from a series of case-control studies conducted in Italy between 1983 and 1992, and including 317 histologically confirmed, incident cases of cancer of the oral cavity and pharynx, 85 of the esophagus, 723 of the stomach, 955 of the colon, and 629 of the rectum, and a total of 2879 controls admitted for acute, non-neoplastic conditions, unrelated to long-term modifications of diet. Multivariate odds ratios (OR) and 95% confidence intervals (CI) for subsequent quartiles of intake of tomatoes were derived, after allowance for age, sex, study center, education, smoking, alcohol drinking, and total calorie intake. There was a consistent pattern of protection for all sites. The ORs for the highest consumption quartile were 0.65 (95% CI 0.4-1.0) for oral cavity, pharynx, and esophagus, 0.43 (95% CI 0.3-0.6) for stomach, 0.39 (95% CI 0.3-0.5) for colon, and 0.42 (95% CI 0.3-0.6) for rectum. Another study of colorectal cancer, based on 1,953 cases and 4,154 controls, conducted between 1992 and 1996 and using a more detailed food frequency questionnaire, confirmed that tomato intake was significantly protective on colorectal cancer risk, even after allowance for several potential confounding factors, including measures of body mass index, calorie intake, and physical activity. The ORs for the highest consumption quintile were 0.79 (95% CI 0.6-0.9) for colon, and 0.71 (95% CI 0.5-0.9) for rectal cancer. The beneficial effect of tomatoes observed in these epidemiological studies may be due to the fact that they constitute one of the most specific features of the Mediterranean diet. This has both a scientific and a public health relevance.
The spectrum of HIV-related lymphoid malignancies certainly includes non-Hodgkin's lymphoma (NHL; i.e., chiefly large-cell lymphoma and Burkitt's lymphoma), primary lymphoma of the brain (PBL) and, possibly, Hodgkin's disease (HD). Since the mid-1990s, several epidemiological studies have led to better quantification of the burden of lymphomas in HIV-infected populations. AIDS surveillance data from 17 western European countries show that between 1988 and 1997 a total of 7,148 AIDS cases had NHL as the AIDS-defining illness. The yearly number of cases rose steadily from 1988 to 1995 but declined thereafter. As a percentage of AIDS-defining illnesses, NHL increased from 3.6% in 1994 to 4.9% in 1997. Percent increases were observed in different strata by area, age group, sex and HIV-transmission group. To estimate relative risk (RR) of NHL and other lymphoid neoplasms in unselected HIV-seropositive populations, records of population-based cancer registries and AIDS registries were linked in the United States, Italy and Australia. RRs for NHL in adults with HIV/AIDS ranged between 14 (for low-grade NHL) to over 300 (for high-grade NHL). For HD, the RR was approximately 10. Limited findings from studies based on death certificates and cohorts of HIV-seropositive persons were consistent with those from registry linkage studies. In developing countries, the risk of HIV-associated NHL appears to be much lower than in developed countries, but under-ascertainment and earlier death from other AIDS manifestations may explain the lack of HIV-associated lymphomas in Africa.
Individuals whose energy intake exceeds expenditure are at increased risk of colorectal cancer. To determine whether body-size measurements at different ages were risk factors for cancer of the colon-rectum, we carried out a hospital-based case-control study in 6 Italian areas, 2 of which were in the South. Interviews were conducted with 1,217 subjects of both genders with incident histologically confirmed cancer of the colon, 726 with cancer of the rectum, and 4,136 controls hospitalized for acute, non-neoplastic, non-digestive conditions. The questionnaire included information on sociodemographic factors, and physical activity, a validated dietary history, height, weight at diagnosis and at 12, 30 and 50 years of age and waist-to-hip ratio (WHR). After allowance for education, physical activity, energy intake, family history of colorectal cancer and recent change in weight, the body-mass index (BMI) was significantly associated with colorectal-cancer-risk in men (odds ratio, OR, in highest vs. lowest quintile = 1.7; 95% confidence interval, CI, 1.3-2.3), but not in women (corresponding OR = 0.9; 95% CI, 0.7-1.2). Cases of both gender tended to have higher BMI than controls in adolescence, young adulthood and middle age. Height appeared unrelated to risk. In women, but not in men, WHR was positively associated with risk, independently of BMI (OR for > or = 0.90 vs. < or = 0.81 = 1.6; 95% CI; 1.2-2.1). Thus, excessive weight predicts colorectal-cancer risk in men, whereas abdominal obesity (i.e., a high WHR) represents a more reliable risk indicator in women.
These findings suggest that exogenous oestrogens do not increase the risk of cervical cancer and may decrease the risk.
Read moreThe relation between pancreatic cancer and alcohol consumption was investigated in a case-control study conducted in Milan, Northern Italy, between 1983 and 1992 on 361 incident histologically confirmed cases and 997 controls admitted to hospital for acute nonneoplastic diseases apparently unrelated to alcohol and tobacco consumption. Compared with teetotalers, the multivariate odds ratio (OR) of pancreatic cancer, after adjustment for age, sex, education, smoking status, and history of diabetes, pancreatitis, and cholelithiasis, were 0.9 for alcohol drinkers and 0.9, 1.1, 1.4, and 1.1 for those who consumed up to four, more than four to seven, more than seven to eight, or more than eight alcoholic drinks per day; none of the estimates or the trend in risk was significant. OR were also close to unity in the separate analysis of wine, beer, and spirit intake, with no trend in risk, and no relationship was observed for duration of use (OR = 0.7 for > 40 yrs of use). No interaction was observed between pancreatic cancer and total alcohol intake in separate strata of age, sex, education, and smoking status. Thus the findings of the present study, on the basis of a population with relatively frequent and high alcohol consumption, provide epidemiologic evidence that even high alcohol intake does not appreciably modify the risk of pancreatic cancer.
Read moreThe relationship between social class indicators, body mass index (BMI), selected life-style habits (alcohol, coffee, maté and tea drinking) and colorectal cancer was investigated in a case-control study conducted between 1993 and 1997 in Córdoba, Argentina, a relatively high mortality area of colorectal cancer. Cases were 190 patients below age 80 years with incident, histologically confirmed colorectal adenocarcinomas, and controls were 393 patients admitted to hospital for a wide spectrum of acute, non-neoplastic disorders. Higher social class, based on occupation of the head of the household, was significantly associated with colorectal cancer risk: the odds ratios (OR) and 95% confidence intervals (95% CI) were 1.9 (1.2-2.9) for intermediate and 2.0 (1.2-3.4) for the highest as compared to the lowest social class individuals. When compared with subjects whose BMI was < 25 kg/m2, the OR was 1.1 (0.7-1.6) for those with BMI 25 to 29 kg/m2, and 1.3 (0.7-2.3) for those > or = 30. In comparison with alcohol abstainers, the OR was 2.8 (1.6-5.1) for drinkers, and there was a significant trend in risk with dose. The association was observed with wine (the most common alcoholic beverage in Argentina), as well as for beer and spirits. The consumption of coffee, maté and tea was not significantly related to colorectal cancer, but the ORs were below unity (0.9 (0.7-1.3) for coffee, 0.9 (0.6-1.2) for maté and 0.8 (0.6-1.2) for tea drinkers). The relationship between social class, alcohol drinking and colorectal cancer were consistent across strata of sex and age. This study confirms that colorectal cancer has positive social class correlates. The association with alcohol drinking is apparently stronger than previously reported, and may be due to the role of chance and/or peculiar correlates of alcohol drinking in this Argentinean population.
Read moreAlthough changes in diagnostic practices may have played a role, the incidence data presented in this study suggest that adenocarcinoma is sustaining a new lung carcinoma epidemic, chiefly attributable to the switch to low-tar, filtered cigarettes. Its pattern seems remarkably similar in the two genders. Thus, the authors conclude that similar exposure to tobacco-related carcinogens leads to similar rates of histologic type-specific lung carcinoma incidence in males and females.
Read moreThe relationship between breast cancer risk and family history of cancer in first-degree relatives was investigated using data from a multicentric case-control study conducted in Italy between June 1991 and April 1994 on 2,569 women aged less than 75 years, with histologically confirmed incident breast cancer, and 2,588 control women admitted to hospital for acute, non-neoplastic, non-gynaecological conditions. Relative to women with no history, those with a family history of breast cancer had an odds ratio (OR) of 2.4 [95% confidence interval (CI) 1.9-3.0], and those with family history of intestinal cancer had an OR of 1.3 (95% CI 1.0-1.7). No significant relations emerged between breast cancer risk and family history of prostate (OR 1.1), ovarian (OR 1.3), cervical or endometrial (OR 1.2) or other cancers, except gallbladder (OR 8.6). The OR for family history of any type of cancer except breast cancer was 1.1. For family history of breast cancer the ORs were similar across strata of age of the proband, being 2.4 below age 45, 2.2 at age 45-59 and 2.7 above age 60, and whether the relative affected was the mother, sister(s) or both, while the risk appeared higher if the age at onset of breast cancer in the relative was lower than 40 years (OR 3.5), rather than higher (OR 2.2). Thus, our results, based on the investigation of all neoplasms in first-degree relatives, confirm that breast cancer risk is increased in women with a family history of breast cancer, while there was no material association with family history of cancer in general, excluding breast cancer.
Read moreUntil now, it has been unclear whether there are differences in various risk factor profiles for familial gastric cancer, i.e., gastric cancer among subjects with a family history of the disease. A total of 722 gastric cancer patients and 2024 controls were admitted between 1985 and 1992 to a network of hospitals in the Greater Milan area. Of these, 88 cases and 103 controls who reported a family history of gastric cancer in first degree relatives were considered in the present analysis. There was no relationship between gastric cancer risk and tobacco smoking or alcohol drinking. Shorter duration of electrical refrigerator use was related to a nonsignificant increased risk and a high daily meal frequency was associated with an increased gastric cancer risk. Significant direct trends of risk were observed for pasta (odds ratio, OR = 4.20 for the highest versus the lowest tertile), bread (OR, 2.86), red meat (OR, 3.38), and preserved meat (OR, 1.90). Inverse associations were observed for increasing consumption of selected vegetables and fruits, chiefly peppers (OR = 0.31), total fruits (OR, 0.47), and citrus fruits (OR, 0.38). With reference to selected micronutrients, a significant inverse trend in risk with increasing consumption for beta-carotene (OR, 0.27) and ascorbic acid (OR, 0.20) was observed. These results suggest that dietary risk factors for subjects with a family history of gastric cancer in first-degree relatives are not appreciably different from well-established risk factors of the disease in the general population.
Read moreIn this study, seasoning fats did not appear to increase the risk of colorectal carcinoma, and there was little evidence for a differential effect by fat type. If such a differential effect exists, it is minor and could favor olive oil.
Read moreTo evaluate the relation between oral contraceptives and colon and rectal cancer, we analyzed combined data from two case-control studies conducted in six Italian regions between 1985 and 1996. The studies included 803 women with incident colon cancer, 429 with rectal cancer, and 2,793 controls with acute, nonneoplastic, nondigestive, non-hormone-related disorders. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) from unconditional multiple logistic regression equations, including terms for age, center/study period, education, family history of colorectal cancer, menopausal status, age at menopause, parity, use of hormone replacement therapy, body mass index [weight (kg) per height squared (m2)], and total energy intake. Ever-use of oral contraceptives was inversely associated with colon cancer (OR = 0.63; 95% CI = 0.45-0.87) and rectal cancer (OR = 0.66; 95% CI = 0.43-1.01). Duration of use of oral contraceptives was inversely related to risk of colon but not rectal cancer. This study suggests that women who have ever used oral contraceptives are at lower risk of colon and rectal cancer.
Read moreThe relationship between frequency of intake of selected indicator foods, lymphoid neoplasms, and soft tissue sarcomas was investigated in an updated case-control study conducted in Northern Italy between 1983 and 1992 on 158 incident, histologically confirmed cases of Hodgkin's disease (HD), 429 cases of non-Hodgkin's lymphoma (NHL), 141 cases of multiple myelomas, 101 cases of soft tissue sarcomas, and 1,157 controls admitted to hospital for acute, nonneoplastic diseases unrelated to long-term modifications of diet. Compared with the lowest tertile, the odds ratio (OR) for the highest tertile of milk intake was 1.8 for NHL and 1.9 for sarcomas. Liver intake was an indicator of the risk of HD (OR = 1.8), NHL (OR = 1.6), and myelomas (OR = 2.0), ham an indicator of HD (OR = 1.7), and butter an indicator of myelomas (OR = 2.8). A high consumption of green vegetables was inversely related to myelomas (OR = 0.4), and frequent use of whole-grain foods was inversely related to NHL (OR = 0.4) and soft tissue sarcomas (OR = 0.2). No material association with meat was observed for any of the neoplasms considered. Likewise, coffee and alcohol intakes were not associated with lymphoid neoplasms and soft tissue sarcomas. The OR for the highest tertile of intake of beta-carotene ranged between 0.5 and 0.7, whereas the OR for retinol ranged between 1.5 and 2.3. Although available data do not point to any specific inference, this study suggests that certain aspects of diet are a correlate or an indicator of the risk of lymphoid neoplasms and soft tissue sarcomas.
Read moreLack of significant correlation between the incidence of bloodborne AIDS and that of all AIDS in Western Europe points to important, but little-quantified sources of variation by country in the safety of blood and blood derivatives. Higher rates of TA-AIDS in the elderly and in males in some countries suggest international differences in transfusion practices by age and sex.
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