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Until 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.
In 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.
The relation between ovarian cancer and coffee drinking habits was evaluated in a case-control study of 247 histologically confirmed epithelial ovarian cancers and 494 age-matched controls, admitted to hospital for acute conditions apparently unrelated to coffee consumption. Compared to rates for women who had never drunk coffee, the crude relative risk estimates for those who drank less than two, two or three, and four or more cups per day were 1.3, 1.5 and 1.4 respectively; however, when allowance was made for smoking habits, these risk estimates became 1.3, 1.7 and 1.8 respectively, and a significant linear trend of increasing risk with more elevated coffee consumption was evident. These results were not explained by various other potential confounding factors, including the major risk factors for ovarian cancer, but we had no information on dietary variables. The relative risk, however, did not increase with increasing duration of use. The findings of this study give apparent support in favour of the hypothesis that coffee consumption, or related dietary variables, may be associated with the risk of epithelial ovarian cancer. Further studies in different settings, however, are required in order to establish whether this association is real, and if so, whether it is causal.
The relation between breast feeding and breast cancer was investigated in a multicentric case-control study conducted in Italy on 2,167 parous women with histologically confirmed breast cancer, diagnosed within 1 year, and 2,208 parous control women admitted to hospitals in the same catchment areas of cases for acute, non-neoplastic, non-gynecological non-hormone-related diseases. Compared with women who had never tried to lactate, those who had always failed had a multivariate odds ratio (OR; adjusted for parity, education and several other potential confounding factors) of 0.94, and those who had lactated had an OR of 1.17. The multivariate ORs of women who had breast fed 1, 2 and 3 or more children were, respectively, 1.14, 1.18 and 1.32, compared with women who had never lactated. None of these ORs was statistically significant. Compared with women who had never breast fed, the multivariate ORs were 1.19 for women reporting less than 6 months of breast feeding, 1.15 for 6–11 months, 1.34 for 12–17 months, 1.10 for 18–23 months and 0.86 for 24 months or more. No appreciable difference was evident across strata of age, menopausal status, parity and age at first birth, while there was a hint of interaction with education. Our study therefore excluded any appreciable protective role for lactation in breast cancer risk, with the patterns of lactation in this European population, aside from the protective role of parity on breast carcinogenesis. © 1996 Wiley-Liss, Inc.
Trends of mortality from cutaneous malignant melanoma (CMM) between 1960 and 1999 in several European countries and the European Union (EU) as a whole have been reviewed, using death certification data for skin cancer available from the World Health Organization. Separate analyses were performed for young (i.e., age 20-44 years) and middle-aged (i.e., age 45-64 years) adults, among whom around 80-90% of skin cancer deaths are attributable to CMM. After steady rises between 1960 and 1990, skin cancer rates among young adults have tended to decline since the mid-1990s in several European countries, with a fall of 14% in men and of 11% in women in the EU as a whole. In middle-aged adults, the trends were less favourable, although mortality started to level off since the mid-1990s. Thus, our data provide further evidence of an improvement of CMM mortality trends in recent years in several European countries. The particularly favourable trends in young people suggest that a further decline in mortality from CMM in Europe is likely to occur within the next few years.
Trends in age-specific and age-standardized death certification rates from all cerebrovascular diseases and various diagnostic subcategories in Italy during the period 1955-78 have been analysed. In both sexes, a decrease in excess of 25% was evident in the overall age-standardized cerebrovascular disease mortality. However, rates were roughly stable in males up to age 50 and in females up to age 45, and slightly but consistently increasing in the younger age groups (under 40), mostly in females. The largest downward trends were for both sexes in the 55 to 74 age groups, and the declines were more marked in females, averaging 3% per year. Since death certification is most reliable in the younger age groups and it is difficult to imagine any modification of risk factors which should affect mortality in later middle age but not in younger age groups, there is no obvious and simple interpretation of this pattern of trends. A comparison with similar trends in ischemic heart disease and other causes of death suggests that the decline in overall cerebrovascular disease mortality might be partially or largely artefactual, though a between-sexes comparison indicates that at least part of the decrease registered in females may well be real. The extent of the decline, however, has been almost certainly more limited in Italy than in most other Western countries. Only in the younger age group (30-34) did rates show a larger increase in females, which might be related to increased prevalence of cigarette smoking, or the use of oral contraceptives.