2,971 publications from this institution
The objective of this study was to assess the association between alcohol drinking before and during pregnancy and the risk of spontaneous abortion using data from a case-control study conducted in Milan, Italy. A total of 462 women (median age 30 years) were admitted for spontaneous abortion (within the 12th week of gestation) to a network of obstetrics departments in the greater Milan area. Of these, 148 (32%) were between the fourth and the eighth week of gestation and 314 (68%) between the ninth and the 12th week. A control group was made up of 814 women (median age 29 years) who gave birth at term (> 37 weeks gestation) to healthy infants (Apgar 5th minute > or = 8, weight > or = 3000 g) on randomly selected days at the same hospitals where cases had been identified. A total of 212 cases (46%) and 355 controls (47%) reported alcohol drinking before conception. Considering non-drinkers as the reference category, the relative risks (RR) of spontaneous abortion were 1.2 [95% confidence interval (CI), 0.9-1.6] and 0.8 (95% CI, 0.6-1.1), respectively, in drinkers of one to seven and more than seven drinks per week before conception. No association emerged between the duration of alcohol drinking and the risk of spontaneous abortion. A total of 166 cases (35.9%) and 263 (32.3%) controls reported any alcohol drinking during the first trimester of pregnancy. The corresponding relative risk was 1.1 (95% CI, 0.9-1.4) and no relationship emerged between the number of drinks per week and the risk of abortion.(ABSTRACT TRUNCATED AT 250 WORDS)
The impact of oral contraceptive (OC) use on cardiovascular diseases and carcinogenesis is a major issue in clinical practice and research in developing countries. Overall the most recent research suggests that OCs lower the risk of endometrial and ovarian cancer and this protection is long-lasting. There is no association with skin melanoma and breast cancer risk although there is a moderately increased risk of breast cancer among current OC users. The relative risk of both cardiovascular and cerebrovascular disease is increased about 2-fold in current OC users but no such association has been found in ex-users. Despite these generally favorable findings OC prescribing literature focuses heavily on contraindications and adverse side effects. This distortion may result in the unnecessary avoidance or termination of OCs by many women in need of an effective reversible contraceptive method.
Abstract The role of age at menarche and at menopause on epithelial ovarian cancer risk was re‐assessed in a combined analysis of 3 hospital‐based case‐control studies conducted in Italy, the United Kingdom and Greece, which produced a total of 1, 140 cases and 2,724 controls. In the overall dataset, there was no evidence of an association with age at menarche: compared with women whose menarche occurred at age I5 or over, the relative risk (RR) estimates were 1.0[95% confidence interval (CI) 0.8 to 1.2] for those with menarche at ages 12 to 14, and 1.0 (95% CI 0.8‐1.2) for those with menarche below age 12. There was no consistent interaction between age at menarche and study centre or age at diagnosis. In relation to age at menopause, compared with women whose menopause occurred at age 44 or earlier, the RR was 1.4 between 45 and 49, 1.6 between 50 and 52 and 1.9 above 52. The strength of the association was apparently (but not significantly) greater in the British than in the Greek or Italian dataset. The effect of age at menopause tended to be long‐lasting and, if anything, to increase across subsequent age‐groups. The large dataset, and the replication of results in different studies, provide more definite and precise information than previously available on the absence of appreciable effect of age at menarche on subsequent ovarian cancer risk in developed countries. For age at menopause, there was a direct and consistent trend in risk, but the association was relatively weak, with RRs below 2 even between extreme categories.
An innovative approach was used to define a low-risk diet for colorectal cancer from a multicentric case-control study of 1953 incident cases and 4154 hospital controls from Italy. A logistic regression model was fitted on the reported intake of five macronutrients, and the estimated coefficients were used to compute a diet-related logistic risk score (LRS). The mean of LRS within risk decile ranged from 0.89 to 1.86. Total energy intake and absolute consumption of each macronutrient increased with increasing LRS. In relative terms, however, starch intake showed an almost threefold increase across subsequent score levels, while a decline was observed for unsaturated fat, sugar and protein. Saturated fat consumption remained fairly stable in relative terms. When food groups were considered, bread and cereals dishes, cakes and desserts and refined sugar were positively associated, while the consumption of vegetables, fruit, fish, poultry and olive oils was inversely associated with LRS.
Controversial topics in the epidemiology of cervical neoplasia are reviewed, in the light of data from studies conducted in Italy and indications from the literature. The downward trends registered over the last three decades in mortality from cervical cancer seem to be levelling off in the younger age groups (below age 45). This may be partly due to changes in sexual habits in younger women, but is certainly attributable to deficiencies in cervical screening. Pap smear, in fact, strongly reduces the risk of cervical neoplasia, the protection (as suggested by data from a case control study), being long lasting (over five years and perhaps around 10-15 years) for invasive cancers. The results of the same case-control study indicate that, although women with pre-invasive and invasive conditions seem to share several unspecific indicators of sexual habits (i.e., total number of partners and age at first intercourse), they appear to differ with regard to clinical history of specific venereal disease. In fact, genital warts, herpes genitalis and trichomoniasis were more frequent in cases of intraepithelial neoplasia, but not of invasive cancer. The implications of these findings, and of other controversial points in the epidemiology of cervical neoplasia, such as oral contraceptives, cigarette smoking and diet, are discussed with regard to indications from other disciplines (chiefly molecular hybridization and stochastic models of carcinogenesis).
1Servizio di Epidemiologia, Centro di Riferimento Oncologico, Via Pedemontana Oce, 33081 Avtano, Italy 2Registre Vaudois des Tumeurs, Institut Universitaire de Médecine Sociale et Préventive, Centre Hospitalier Universitaire Vaudois. Lausanne, Switzerland 3Istituto di Ricerche Farmacologiche 'Mario Negri', and 4Istituto di Statistica Medica e Biometria. Università di Milano, Milan, Italy Correspondence to S Franceschi Fax: (+39) 434 659 222.
