In Costa Rica, like elsewhere, inducing smokers to stop is a public health priority.

Our results support that cessation of tobacco smoking and cessation of alcohol drinking protect against the development of head and neck cancer.

To evaluate the association between diet and cancer risk in Mediterranean countries, data presented from a series of case-control studies conducted in Italy were reviewed. The series comprised over 20,000 cases affecting 20 cancer sites and included 18,000 controls. For most epithelial cancers, risk decreased with increasing vegetable and fruit consumption. Fish and whole grains (but not refined grains) were also favorable diet indicators. Olive oil and other monounsaturated and unsaturated fats were inversely related to cancer risk at several sites. A Mediterranean diet pattern appears to be favorable for a reduced cancer risk, indicating the importance of dietary patterns.

We considered flavonoids and proanthocyanidins in a network of multicentric Italian case-control studies including about 10,000 incident, histologically confirmed cases of selected cancers and over 16,000 controls. Odds ratios (ORs) for the highest vs. the lowest quintile of 6 classes of flavonoids and proanthocyanidins were estimated by multiple logistic regression models. Total flavonoids, flavanones, and flavonols were inversely related to oral and laryngeal cancers (ORs, respectively 0.56 and 0.60 for total flavonoids; 0.51 and 0.60 for flavanones; and 0.62 and 0.32 for flavonols). Flavanols were also inversely related to laryngeal cancer (OR = 0.64), whereas flavanones were inversely related to esophageal cancer (OR = 0.38). A reduced risk of colorectal cancer was found for high intake of anthocyanidins (OR = 0.67), flavonols (OR = 0.64), flavones (OR = 0.78), and isoflavones (OR = 0.76). Inverse relations with breast cancer were found for flavones (OR = 0.81) and flavonols (OR = 0.80). Flavonols (OR = 0.63) and isoflavones (OR = 0.51) were inversely associated to ovarian cancer, whereas flavonols (OR = 0.69) and flavones (OR = 0.68) were inversely associated to renal cancer. No association between flavonoids and prostate cancer emerged. We found inverse associations between proanthocyanidins and colorectal cancer. These associations appeared stronger for proanthocyanidins with a higher degree of polymerization (OR = 0.69 for ≥ 10 mers).

This meta-analysis estimates the excess of esophageal and gastric cardia adenocarcinoma risk for smokers. This risk was similar for the 2 cancer sites.

Our study found a moderate protective role of allium vegetables on the risk of endometrial cancer.

<i>Background/Aims:</i> To evaluate the association of psoriasis with selected medical conditions and a number of drugs used before diagnosis. <i>Methods:</i> Multicenter case-control study involving outpatient services of 20 general and teaching hospitals. Entry criteria for cases were a first diagnosis of psoriasis made by a dermatologist and a history of skin manifestations of no more than 2 years after the reported onset of the disease. Controls were the first eligible dermatological patients observed on randomly selected days in the same centers as cases. A total of 560 cases and 690 controls were recruited. <i>Results:</i> The odds ratio (OR) of psoriasis was 0.8 (95% confidence interval, CI, 0.5–1.3) in hypertensive subjects, 1.1 (95% CI 0.6–2.0) in diabetics and 1.1 (95% CI 0.7–1.7) in hyperlipidemic subjects. Histamine 2 receptor antagonist exposure was negatively associated with psoriasis: OR 0.3 (95% CI 0.1–0.8). <i>Conclusion:</i> Our study rules out a strong association of psoriasis at its first ever diagnosis with common chronic conditions. The reported associations of psoriasis with relatively common conditions such as diabetes mellitus, hypertension and hyperlipidemia may represent a late effect of well-known risk factors for psoriasis such as smoking and overweight or reflect factors related to the long course of psoriasis itself.

Janssens, Jaak Ph La Vecchia, Carlo eng Editorial Research Support, Non-U.S. Gov't England ECP 2011/12/14 06:00 Eur J Cancer Prev. 2012 Jul;21(4):317-22. doi: 10.1097/CEJ.0b013e32834ef1de.

These data provide additional evidence that major characteristics of the Mediterranean diet favourably affect cancer risk.

Within the EURopean micronutrient RECommendations Aligned Network of Excellence (EURRECA), a scoring system was developed to assess the quality of dietary intake validation studies. The scoring system included three steps. The first step was to give each study a quality score, which included five components: sample size, statistics used, data collection procedure, consideration of seasonality and supplement use. Scores ranged from 0 to 7, and validation studies classified as very good ( > or = 5), good (5-3.5), acceptable/reasonable (3.5-2.5) and poor ( < 2.5). The second and third steps included an adjustment/weighting of the correlation coefficient according to the quality score and moreover a rating of the adjusted/weighted correlation. The scoring system was tested in 124 validation studies that included at least one vitamin. Only 5.6 % of the 124 studies were judged to be of very good quality according to the quality score, 41.9 % of good quality and 16.9 % had a poor rating. When adjusting for the study quality scores, crude and adjusted mean correlations of vitamins A, C, D and E intakes were similar, but the percentage of correlation values classified as poor or very good was higher after adjustment. These results show the importance of considering the quality of studies validating dietary assessment methods and the correlations obtained for the micronutrient of interest when interpreting effects observed in epidemiological studies using dietary assessment methods. Without a doubt, this subject constitutes a key topic for research in nutritional epidemiology.

Data on the role of aspirin on endometrial cancer risk are scanty. Here we provide additional information on the issue, using data from a multicentric Italian case-control study. The study was conducted between 1992 and 2006 in three Italian areas, on 442 cases with histologically confirmed endometrial cancer and 676 control women admitted to the same hospitals as cases for a wide spectrum of acute, non-neoplastic, non-gynaecological, non-hormone-related conditions, providing information on aspirin use. Odds ratios (OR) of endometrial cancer and corresponding 95% confidence intervals were calculated using multiple logistic regression models, including terms for sociodemographic characteristics, body mass index and hormonal and reproductive factors. Regular aspirin use was reported by 28 (6.3%) cases and 46 (6.8%) controls, corresponding to a multivariate OR of 0.65 (95% confidence interval 0.37-1.11). There was no consistent pattern of risk with duration of use, nor with age at first use, time since first use or time since last use. Further, there was no difference in risk estimates across strata of body mass index. This study--the first one from a population outside North America--adds relevant information on the absence of a consistent association between aspirin use and endometrial cancer risk, even in high-risk overweight and obese women.

FIGURES 1–9. Philosepedon dumosum Omelková &amp; Ježek sp. nov., male. 1. Head, 2. Basal antennomeres, 3. Middle flagellomere with one ascoid (the second ascoid is omitted), 4. Terminal lobe of labium, 5. Maxilla and first palpomere, in detail, 6. Gonocoxite and gonostyle, lateral view, 7. Epandrium and surstylus, lateral view, 8. Surstylus, dorsal view, 9. Aedeagal complex and gonopods, caudal view. [Scale: 4–5, 9 = 0.05 mm; 1, 3, 6–8 = 0.1 mm; 2 = 0.2 mm]

A recent systematic review and meta-analysis of studies on physical activity and pancreatic cancer,1 based on 22 prospective and six case-control investigations, reported no strong evidence for association. There was a modest inverse association with total and occupational physical activity, recreational activity showed inconsistent relations, whereas no association was found with high intensity activity. Several aspects of physical activity, including the role of activity in early life, have been scarcely considered to date.2 To provide further information on the issue, we analyzed data on physical activity in a case-control study of pancreatic cancer conducted in two areas of Northern Italy. The characteristics of this study have been described elsewhere.3 Briefly, cases were 326 patients (174 men and 152 women, median age 63 years) with histologically confirmed incident cancer of the pancreas, admitted to the major teaching and general hospitals in the study areas, and with no previous cancer diagnosis. Histologically confirmed neuroendocrine tumors of the pancreas were excluded. Controls were 652 patients (348 men and 304 women, median age 63 years) admitted to the same hospitals as cases for a wide spectrum of acute, non-neoplastic conditions, unrelated to smoking, alcohol consumption, or long-term modifications of diet. Controls were frequency-matched to cases by sex, age, and study center. For both cases and controls, data were collected during the hospital stay by trained interviewers using a standardized, structured questionnaire. The section on physical activity included questions on self-reported intensity of activity at work and during leisure time separately, in different periods of life. For occupational physical activity, patients were asked whether their jobs were “very heavy,” “heavy,” “average,” “standing,” or “mainly sitting,” according to a structured scale classified into five categories. Physical activity during leisure time was defined on the basis of the number of hours per week of sport or activity, such as walking, gardening, cycling, etc. Scores ranged between 1 and 4, corresponding respectively to <2, 2–4, 5–7, and >7 hours of physical activity per week. The scores of the two lowest and the two highest levels of occupational physical activity and the scores of the two highest levels of recreational physical activity were combined together, since there were too few subjects in these categories. Odds ratios (OR) and the corresponding 95% confidence intervals (CI) were derived using conditional multiple logistic regression. All regression models were stratified on age, sex, and study center, and adjusted for year of interview, education, smoking habit, alcohol drinking, diabetes, body mass index, and energy intake. Table 1 shows the distribution of cases and controls and the corresponding ORs and 95% CI according to occupational and recreational physical activity at various ages. For the highest vs. the lowest level of occupational physical activity, the ORs were 1.24 (95% CI, 0.79–1.95) at age 15–19, 1.21 (95% CI, 0.80–1.85) at age 30–39 and 1.41 (95% CI, 0.90–2.22) at age 50–59, with no significant trend in risk at any age considered. The corresponding ORs for recreational physical activity were 1.44 (95% CI, 0.97–2.13) at age 15–19, 1.52 (95% CI, 1.03–2.24) at age 30–39 and 1.39 (95% CI, 0.91–2.14) at age 50–59. A significant positive trend in risk emerged only for recreational physical activity at age 30–39 (p = 0.02). Therefore, occupational and recreational physical activity were not associated to a decreased risk of pancreatic cancer in our study. Results for physical activity during the teenage period were comparable to those at older ages, indicating a lack of association or, if any, a modest increase in risk of pancreatic cancer for high recreational physical activity in early life. Previous case-control studies were conducted in North America and generally reported inconsistent results. In a Canadian study,4 men with the highest index of total physical activity had an almost halved risk of pancreatic cancer as compared to those in the lowest level, whereas no association was found in women. A study from the San Francisco Bay area5 found a nonsignificant roughly 20% decreased risk in both sexes for subjects with high activity level as compared to inactive ones. A recent investigation from the Upper Midwest of the United States6 reported a decreased pancreatic cancer risk associated to physical activity; however, this association was limited to light and moderate activity, in the absence of any trend in risk. However, a study conducted in Missouri7 showed that men with moderate occupational activity level had a slightly increased risk of pancreatic cancer as compared to those with both high and low levels of occupational activity. In conclusion, our data do not indicate a major role of physical activity on pancreatic cancer risk. Although our point estimates of risk were somewhat higher as compared with previous investigations, the results were in broad agreement with other reports when considering the whole range of the CIs. The evidence from cohort and case-control studies, therefore, weighs against a relevant role of physical activity in pancreatic cancer risk. Claudio Pelucchi*, Antonella Zucchetto , Alessandra Tavani*, Luigino Dal Maso , Diego Serraino , Carlo La Vecchia* , * Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy, Struttura Operativa Complessa di Epidemiologia e Biostatistica, Centro di Riferimento Oncologico, Aviano (PN), Italy, Dipartimento di Medicina del Lavoro, Clinica del Lavoro Luigi Devoto, Sezione di Statistica Medica e Biometria Giulio, A. Maccacaro, Università degli Studi di Milano, Milan, Italy.