Publications

The relationship between various body size indices and breast cancer risk before and after menopause was elucidated by means of a case-control study conducted between June 1991 and April 1994 in 6 Italian centers on 2,569 patients aged below 75 with histologically confirmed breast cancer, and on 2,588 controls admitted to the hospital for a wide spectrum of acute, non-neoplastic, non-hormone-related diseases. Weight and, more consistently, body mass index (BMI, kg/m2) at diagnosis were inversely related to pre-menopausal breast cancer risk and directly to post-menopausal risk. An 8-unit increase in BMI resulted in an odds ratio of 0.8 for pre-menopausal and of 1.2 (significant) for post-menopausal women. Risk seemed to increase gradually after menopause in the 7th (OR for an 8-unit BMI increase, 1.3) and 8th decades (OR, 1.6) of life. Conversely, height, waist-to-hip ratio, bra cup size and weight (or BMI) in adolescence and in young adulthood did not exert a significant or consistent influence on breast cancer risk. The apparent relationship with BMI at middle age and weight gain between age 30 years and diagnosis was eliminated by allowance for BMI at diagnosis. The age-related pattern of the association between BMI and breast cancer risk after menopause may reflect a duration-risk relationship, and resembles the effect of post-menopausal estrogen use, which seems greater among older women.

The aim of this report is to update data and statistics on cancer mortality in Switzerland from 1950 to 1984 by sex, age group and calendar period 1. Aggregate death certification data for the five-year period 1985- 89 are now presented. The materials and methods are similar to those previously utilized 1. Briefly, death certification numbers by cause and estimates of the resident population, stratified by sex and quinquennia of age, were abstracted from registries provided by the Swiss Federal Statistical Office. All cancers or groups of cancers, originally classified according to the standard International Classification of Diseases (ICD), Eighth Revision/, were grouped in the same 30 categories adopted for previous reports, besides total cancer mortality and a broad group including other and unspecified. In particular, we grouped together all intestinal sites, melanomas and non-melanomatous skin neoplasms, all uterine neoplasms (cervix and corpus), all the neoplasms of the brain and nerves

Mortality form stroke in Italy over the period 1955-1987 was analysed in terms of age-specific, age-standardised death certification rates, and by means of a log-linear model to separate the effects of age, cohort of birth and calendar period of death. In males the overall age-adjusted rate on the world standard population fell from 118.4/100,000 population in 1955-1959 to 72.0 in 1985-1987 and in females from 94.8 in 1955-1959 to 54.7 in 1985-1987. The overall decline in age-standardised rates over the 3 decades was thus 39% for males (averaging 1.7%/year) and 42% for females (averaging 1.9%/year). The declines were even greater in truncated rates from 35 to 64 years: from 80.4 to 41.2/100,000 for males (49%), and from 63.0 to 24.1/100,000 for females (62%). Inspection of age-specific rates shows comparable falls--in relative terms--in early and later middle age. For instance, male rates declined from 70.4 to 38.1/100,000 (46%) at age 50-54, and from 1,151.1 to 584.2/100,000 (50%) at age 70-74. Only above age 75 were the falls smaller. In females aged 50-54 years the decline was 63%, and for those aged 70-74 years it was 59%. In young adults, no appreciable changes were observed in either sex. Thus, the age, period and cohort model showed downwards trends in both the period and cohort effect, except for the most recent cohorts on account of an age-cohort interaction. These favourable trends are discussed in relation to better control of hypertension and the potential impact of other risk factors.(ABSTRACT TRUNCATED AT 250 WORDS)

In the prospect of a political and economic 'harmonization' of the European Economic Community (EEC) and, possibly, all Europe, the identification of differences in cancer frequencies and trends in major European areas (ie EEC, non-EEC western countries, and eastern European countries) can help to set health priorities. From 1960-64 to 1985-89 all-age mortality rates of some common cancers (mouth or pharynx, pancreas, lung, kidney, prostate and skin) increased substantially especially in East Europe. Conversely, mortality rates from cancer of the stomach, uterus, testis and from Hodgkin's disease declined, but, again, trends in East Europe were less favourable. Some elevations in rare malignancies (non-Hodgkin's lymphomas, multiple myeloma and connective and soft-tissue sarcomas) emerged rather uniformly in Europe, especially in elderly people. Most favourable trends in total cancer mortality were apparent among females in the EEC (minus 7%) and non-EEC western countries (minus 14%). The picture becomes gradually less favourable with respect to non-EEC western European males and eastern European females (virtually no change) and EEC males (plus 13%). With a 25% increase in total cancer mortality rates in the past 30 years, males in East Europe emerge as the 'problem' group. The even wider gap between West and East Europe in cancer rates in young males leaves no hope for future improvements in the absence of effective interventions. Raising public awareness (especially with respect to smoking and alcohol consumption), and increasing motivation and quality controls among health professionals are badly needed in disadvantaged European areas.

The risk of endometrial cancer in relation to nutrition and frequency of consumption of a few selected dietary items was evaluated in a case-control study of 206 patients with endometrial cancer and 206 control subjects with acute conditions unrelated to any of the established or potential risk factors for endometrial cancer. Obesity was strongly and positively associated with the risk of endometrial cancer, and several conditions related to body weight, such as early menarche, diabetes mellitus, or hypertension were more common in cases. The risk of endometrial cancer was elevated in subjects reporting (on a subjective basis) greater fat (butter, margarine, and oil) intake (relative risk estimate for the higher compared to the lower scores equals 5.65, with 95% confidence interval of 2.76-11.55). Cases reported less frequent intake of green vegetables, fruit, and whole-grain foods: thus, the risk of endometrial cancer appeared inversely related to indices of beta-carotene and fiber intake. Furthermore, cases consumed milk, liver and fish less frequently than controls. No significant difference was noted between cases and controls in the frequency of intake of carrots, meat, eggs, ham, and cheese. Alcohol consumption was somewhat larger among the cases, but this trend in risk was not significant. Dietary information collected in this study probably is too limited and inconsistent to permit analysis of biologic correlates of these findings or discussion of their potential implications in terms of prevention on a public health scale. Nonetheless, the mere existence of differences in reported diet between endometrial cancer cases and controls is of interest, and may warrant further, more detailed investigation.