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Excluding Sweden, current oral tobacco use was not commonly reported in the European countries surveyed and was similarly rare both in men and in women. In Sweden, however, use of smokeless tobacco was about 10-fold higher than the rest of Europe and more prevalent in men than in women.

Abstract Neoplasms continue to dominate globally as one of the major sources of human disease and death. From a biological, clinical, and public health point of view, it is important to differentiate between a malignant and benign neoplasm. There are multiple causes of cancer and understanding the attributable risk factors for each cancer is important. This chapter covers the role of cellular and molecular mechanisms as well as the experimental and epidemiological approaches as determinants of select, common cancers. Promising approaches focused on prevention of the known causes, reducing its consequences, and notably in resource-constrained settings are highlighted.

ABSTRACT Introduction Migrants and refugees in Europe carry a disproportionate burden of chronic hepatitis B and C and face barriers accessing formal health systems. Community-based interventions can improve screening, prevention, and care, yet no framework exists to track the performance of these programmes. This study aimed to generate a consensus set of indicators for monitoring and evaluating such interventions. Methods A scoping review (PubMed, January 2005□June 2024) identified 70 studies and 275 candidate indicators. After removing redundancies, we submitted 38 primary and 17 additional indicators to a two□round online Delphi panel. Fourteen experts in viral hepatitis, migrant health and community programmes rated each indicator on relevance, measurability, accuracy, ethics and clarity (4□point Likert scale). Items with >67 % combined “agree/somewhat agree” advanced. In Round 2, revised indicators were re□rated and all accepted indicators domain□ranked. Agreement grades (U, A, B, C) reflected the final proportion of positive votes; mean ranks identified domain priorities. Results All 38 primary indicators and 10 of 17 additional indicators surpassed the Round 1 threshold. After expert feedback, 15 indicators were re□rated in Round 2; none were rejected. The final set comprised 50 indicators distributed across six domains: Prevention (6), Testing (9), Linkage to care (6), Treatment & Care (9), Morbidity (7) and Health System (13). Overall combined agreement averaged 95.3% (SD 7.0), with 29 indicators achieving unanimous support. Testing and Morbidity domains showed the strongest consensus. Ranking highlighted screening acceptability, infection prevalence, rapid testing results, referral success and treatment initiation as highest priorities. An 18□indicator core subset (top three per domain) was proposed for routine use. Conclusion This Delphi study delivers the first consensus□driven indicator suite for monitoring and evaluating community hepatitis B/C services targeting migrants and refugees. Adoption of the 50□indicator framework, and its streamlined core set, can harmonise monitoring, guide resource allocation and strengthen data□driven progress toward elimination goals. KEY MESSAGES What is already known on this topic Community□based HBV/HCV initiatives can reach migrants and refugees who face barriers to facility□based care, yet there is no agreed set of indicators to gauge the performance of these programmes, hindering comparability and quality improvement. What this study adds Using a two□round Delphi process, experts reached high consensus on 50 monitoring indicators (of which 18□indicator form a core subset) covering prevention, testing, linkage, treatment, morbidity and health□system support specifically for migrant□ and refugee□focused community services. How this study might affect research, practice or policy Adopting these indicators can standardise evaluation, guide resource allocation and enable data□driven adjustments to accelerate progress toward viral hepatitis elimination targets among underserved mobile populations.

cancer diagnosed within the year preceding the interview.Controls included 1787 women residing in the same area, who had been admitted for acute non-neoplastic, non-gynaecological conditions to the same network of hospitals.Two (0.4%) cases and eight (0.4%) controls reported ever use of fertility drugs: the corresponding odds ratio, after allowance for age, education, parity, body mass index, oral contraceptive and hormonal replacement therapy use was 0.8 (95% confidence interval 0.2-4.3).The two cases reporting fertility drug use were treated Ͼ10 years before diagnosis of endometrial cancer.Consequently, our data do not provide meaningful information on the time-risk relation, nor on type of treatment.Despite the low frequency of use, and hence the wide confidence interval, our findings indicate that fertility drugs are not a major risk factor for endometrial cancer in Italy.

Bertuccio, Paola; Bravi, Francesca; Bosetti, Cristina; Negri, Eva; La Vecchia, Carlo Author Information

<b><i>Background:</i></b> Limited, outdated, and poor quality data are available on the prevalence of tinnitus, particularly in Italy. <b><i>Methods:</i></b> A face-to-face survey was conducted in 2014 on 2,952 individuals, who represented the Italian population aged 18 or more (50.6 million). Any tinnitus was defined as the presence of ringing or buzzing in the ears lasting for at least 5 min in the previous 12 months. <b><i>Results:</i></b> Any tinnitus was reported by 6.2% of Italian adults, chronic tinnitus (i.e. for more than 3 months) by 4.8%, and severe tinnitus (i.e. which constitutes a big or very big problem) by 1.2%. The corresponding estimates for the population aged ≥45 years were 8.7, 7.4 and 2.0%, respectively. Multivariable analysis on population aged ≥45 years revealed that old age (odds ratio (OR) = 4.49 for ≥75 vs. 45-54 years) and obesity (OR = 2.14 compared to normal weight) were directly related to any tinnitus, and high monthly family income (OR = 0.50) and moderate alcohol consumption (OR = 0.59 for &lt;7 drinks/week vs. non-drinking) were inversely related. <b><i>Conclusions:</i></b> This is the first study on tinnitus prevalence among the general Italian adult population. It indicates that in Italy tinnitus affects more than 3 million adults and is felt as a major problem by more than 600,000 Italians, mostly aged 45 years or more.

To monitor recent trends in oral and pharyngeal cancer mortality in 38 European countries, we analyzed data provided by the World Health Organization over the period 1975-2004. Joinpoint analysis was used to identify significant changes in trends. In the European Union (EU), male mortality rates rose by 2.1% per year between 1975 and 1984, by 1.0% between 1984 and 1993, and declined by 1.3% between 1993 and 2004, to reach an overall age-standardized rate of 6.1/100,000 in 2000-2004. Mortality rates were much lower in women, and the rate in the EU rose by 0.9% per year up to 2000, and levelled off to 1.1/100,000 in 2000-2004. In France and Italy-which had the highest rates in the past-male rates have steadily declined during the last two decades (annual percent change, APC = -4.8% in 1998-2004 in France and -2.6% in 1986-2003 in Italy). Persisting rises were, however, observed in several central and eastern European countries, with exceedingly high rates in Hungary (21.1/100,000; APC = 6.9% in 1975-1993 and 1.4% in 1993-2004) and Slovakia (16.9/100,000; APC = 0.14% in 1992-2004). In middle aged (35 to 64) men, oral and pharyngeal cancer mortality rates in Hungary (55.3/100,000) and Slovakia (40.8/100,000) were comparable to lung cancer rates in several major European countries. The highest rates for women were in Hungary (3.3/100,000; APC = 4.7% in 1975-2004) and Denmark (1.6/100,000; APC = 1.3% in 1975-2001). Oral and pharyngeal cancer mortality essentially reflects the different patterns in tobacco smoking and alcohol drinking, including drinking patterns and type of alcohol in central Europe.

Abstract Background Aspirin and statins have been suggested to have potential chemopreventive effects against gastric cancer (GC), although results of previous studies have been inconsistent. Therefore, we aimed to investigate the association between the use of aspirin and statins, alone or in combination, and GC. Methods We conducted a pooled analysis of seven case-control studies within the Stomach cancer Pooling (StoP) Project, including 3220 cases and 9752 controls. Two-stage modelling analyses were used to estimate the associations between aspirin use, statin use, and combined use of the two drugs, and GC after adjusting for potential confounders. Results The pooled odds ratio (OR) of GC for aspirin users versus non-users was 0.72 (95% confidence interval [CI] = 0.54–0.95). The protective effect of aspirin appeared stronger in individuals without a GC family history (OR: 0.60, 95% CI: 0.37–0.95). The OR of GC decreased with increasing duration of aspirin use, with an OR of 0.41 (95% CI: 0.18–0.95) for durations ≥ 15 years. An inverse, non-statistically significant association with risk of GC was observed for use of statins alone (OR: 0.79, 95% CI: 0.52–1.18). Conclusions Our findings suggest that aspirin use, particularly long-term use, is associated with a reduced risk of GC, while a similar association was not observed with statins, possibly due to low frequency of use.