Publications

Alcohol consumption is not related to fertility in Italian women

EDITOR—Jensen et al observed decreased fecundability among women who drank alcohol compared with those who did not.1 The decrease was found even among women reporting a weekly intake of five or fewer drinks. The authors call for further corroboration of their findings. View this table: Number (percentage) of women having difficulty in conception according to alcohol consumption, Milan, Italy We analysed the relation between alcohol intake and difficulties in …

Interstitial lung diseases in a lung cancer screening trial

We assessed the prevalence of interstitial lung disease (ILD) in a cohort of smokers included in a lung cancer screening trial. Two observers independently reviewed, for the presence of findings consistent with ILD, the computed tomography (CT) examinations of 692 heavy smokers recruited by the Multicentric Italian Lung Detection (MILD) trial. Four CT patterns were considered: usual interstitial pneumonia (UIP), other chronic interstitial pneumonia (OCIP), respiratory bronchiolitis (RB) and indeterminate. Subsequently, the evolution of ILD in those subjects who had undergone a repeat CT examination after 3 yrs was assessed. The UIP pattern and the OCIP pattern were identified in two (0.3%) out of 692 and 26 (3.8%) out of 692 patients, respectively; 109 (15.7%) out of 692 patients showed CT abnormalities consistent with RB, while an indeterminate CT pattern was reported in 21 out of 692 (3%) patients. Age, male sex and current smoking status were factors associated with the presence of OCIP and UIP (combined) pattern, although the relationship did not attain statistical significance. A progression of the disease was observed in three (25%) out of 12 subjects with OCIP who underwent repeat CT after 3 yrs. Thin-section CT features of ILD, probably representing smoking-related ILD, are not uncommon in a lung cancer screening population and should not be overlooked.

Second neoplasms after invasive and borderline ovarian cancer

Excess risk of subsequent cancers has been documented in women diagnosed with ovarian cancer. We updated to 2006 data on second cancers in women diagnosed with invasive and borderline ovarian cancer in the Swiss canton of Vaud. Between 1974 and 2006, 304 borderline and 1530 invasive first ovarian tumours were abstracted from the Vaud Cancer Registry database and followed up till the end of 2006. Calculation of expected numbers of tumours in the cohorts was based on site-specific, age-specific and calendar-year-specific incidence rates. We computed the standardized incidence ratios (SIRs) of second cancers, and the corresponding 95% confidence intervals (CI). There was no change in the incidence of malignant cancers, but that of borderline tumours increased over more recent years. Overall, 110 second neoplasms were observed versus 49.7 expected after invasive ovarian cancer (SIR 2.21; 95% CI: 1.82-2.67). Significant excess risks were observed for cancers of the breast, corpus uteri and leukaemias. When synchronous cancers were excluded, the overall SIR for all sites declined to 1.05. Thirty-one second neoplasms were observed after borderline tumours compared with 21.1 expected (SIR=1.47; 95% CI: 1.00-2.09). SIRs were above unity for ovary, colorectum and uterus. After exclusion of synchronous neoplasms, SIR for all neoplasms declined to 1.09, and remained significant only for second ovarian cancers (SIR=4.93). The present record linkage cohort study shows an excess risk for selected synchronous neoplasms in women diagnosed with both borderline and invasive ovarian cancer, likely because of shared genetic and perhaps environmental factors.

Risk factors for vulvar lichen sclerosus

Central Obesity, Body Mass Index, Metabolic Syndrome and Mortality in Mediterranean Breast Cancer Patients

Abstract Background: Obesity and metabolic disorders have been associated with poorer outcomes in many cohorts of breast cancer (BC) patients, with poor evidence from Mediterranean cohorts. The purpose of this study is to investigate the prognostic potential of anthropometric variables in early BC patients living in a Southern region of Italy. Methods: This prospective cohort study enrolled 955 consecutive early BC patients treated at the Istituto Nazionale dei Tumori “G. Pascale” and at the University Hospital “Federico II”, Naples, Italy, between January 2009 and December 2013. Median follow-up was 11.8 years and ended on June 15 th 2022. Anthropometric measurements and indices namely body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), as well as Metabolic Syndrome (MetS) and its components, were collected. All-cause and BC-specific mortality were calculated. Results: Mean age was 55.3 years (±12.5 years); 61% of patients were post-menopausal. At data cut-off, 208 (22%) patients had died, 131 (14%) of whom from BC. Obesity was found in 29% of patients. High WC or WHR and the presence of MetS were associated with a moderately increased risk of all-cause mortality (WC ≥ 88 cm, HR=1.39, 95%CI:1.00-1.94; WHR > 0.85, HR=1.62, 95%CI:1.12-2.37; MetS, HR=1.61, 95%CI:1.12-2.32). An increased BC-specific mortality risk was found in obese patients (HR=1.72, 95%CI:1.06-2.78), in those with WC ≥88 (HR=1.71, 95%CI:1.12-2.61)and in those with high WHR, both when evaluated as a categorical variable (WHR>0.85, HR=1.80, 95%CI:1.13-2.86) and as a continuous variable (for each 0.1-U increase in WHR, HR=1.33, 95%CI:1.08-1.63) as well as the presence of MetS (HR=1.81, 95%CI:1.51-2.85). These associations varied according to menopausal status and BC subtype. Conclusions: Central obesity significantly increased total and BC-specific mortality particularly in pre-menopausal women, while in post-menopause the MetS was a stronger risk factor. These associations were significant mainly in luminal subtypes while no relevant findings were observed in TNBC. The magnitude of risk suggests that obesity and the presence of the MetS or its single components may nullify the benefit of effective BC therapies. Active lifestyle intervention studies should be encouraged for several expected beneficial effects.

Re: Evaluating Gastric Cancer Misclassification: a Potential Explanation for the Rise in Cardia Cancer Incidence

Increased incidence of adenocarcinoma of the gastric cardia has been reported over the last few decades from several areas of North America and Europe (1–2). A mortality study from the Swedish Cancer Registry, however, suggested that the observed upward trends can be, partly or largely, accounted for by changed accuracy of registration within gastric subsites (3). We considered, therefore, trends in incidence rates for various gastric subsites in the Cancer Registry of the Swiss Canton of Vaud (covering approximately 600 000 inhabitants in 1990 from the French-speaking part of Switzerland) over the period from 1976 through 1997. In this area, uniform criteria of classification have been adopted, and traditional attention has been focused on careful endoscopic and histopathologic examination of gastric lesions (4–6). Table 1 gives average age-adjusted (on the world standard population) incidence rates for various subsites of gastric cancer during three separate calendar periods. In both sexes, no appreciable change in incidence of adenocarcinoma of the gastric cardia was observed (3.1 cases per 100 000 males, and 0.5 cases per 100 000 females from 1976 through 1979 versus 3.2 and 0.1, respectively, from 1995 through 1997), while appreciable downward trends were observed for distal and other or unspecified gastric cancer sites. These data, from a carefully surveyed European population, therefore do not support the existence of a systematic and major rise in incidence of cardiac adenocarcinomas (3,7), confirming that—in proportional terms—the cancers of the gastric cardia have become

Artificial sweeteners and cancer risk in a network of case–control studies

PLC-γ2 is essential for formation and maintenance of memory B cells

Resting antigen-experienced memory B cells are thought to be responsible for the more rapid and robust antibody responses after antigen reencounter, which are the hallmark of memory humoral responses. The molecular basis for the development and survival of memory B cells remains largely unknown. We report that phospholipase C (PLC) γ2 is required for efficient formation of germinal center (GC) and memory B cells. Moreover, memory B cell homeostasis is severely hampered by inducible loss of PLC-γ2. Accordingly, mice with a conditional deletion of PLC-γ2 in post-GC B cells had an almost complete abrogation of the secondary antibody response. Collectively, our data suggest that PLC-γ2 conveys a survival signal to GC and memory B cells and that this signal is required for a productive secondary immune response.

Risk Factors for HIV Infection in Drug Addicts from the Northeast of Italy

Prevalence and determinants of HIV infection were assessed in 313 parenteral drug addicts admitted to five Centers for Drug-Addict Assistance and two prisons located in the northeast of Italy (Friuli Venezia-Giulia), an area some distance from the major Italian cities first reached by the AIDS epidemic. The overall prevalence of HIV positivity was also rather high in this area, ie 30% with 24-36% confidence interval. The most important risk factors (besides syringe sharing applicable to all drug addicts), turned out to be of a geographical nature, ie living in Pordenone province (where a US military base is located) or coming from other endemic areas and having travelled long distances in the past three years. Prostitution also seemed to increase the risk of infection, but duration of drug addiction had little effect. In addition to persistent generalized lymphadenopathy (closely linked to HIV infection), reversal of helper:suppressor T-cell ratio was found in 67% of HIV positive individuals, but also in 31% of HIV negative ones. Clinical signs and symptoms strongly linked with HIV positivity were fatigue, weight loss, splenomegaly, fever and nocturnal sweats.

Dietary inflammatory index and non-Hodgkin lymphoma risk in an Italian case–control study

Pooled analysis of 3 european case‐control studies of epithelial ovarian cancer: III. Oral contraceptive use

The relationship between use of oral contraceptives (OCs) and other contraceptive methods and the risk of ovarian cancer was examined in a combined analysis of 3 hospital-based case-control studies conducted in Italy, the United Kingdom, and Greece, for a total of 971 ovarian cancer cases and 2,258 controls under age 65. Compared with never-users, the combined multivariate relative risk (RR) for ever-users was 0.6 (95% confidence interval, CI = 0.4-0.8) and the estimates were consistent in the 3 datasets. The protection was also similar across strata of age and parity. Considering various measures of OC use, available in the Italian and British datasets only, the protection conveyed on ovarian cancer risk increased with the duration of use and persisted in the medium-long period: the RR in women reporting their last OC use greater than or equal to 15 years prior to diagnosis was 0.5 (95% CI = 0.2-1.0). The risks in ever-users were appreciably lower in those women who reported their first OC use before 25 years of age (RR = 0.3 for first use before age 25, 0.8 for first use at age 25-34 and 0.7 at 35 years or after). Such findings emerged similarly from Italian and British data. This combined analysis, besides offering further quantitative estimates of the protective effects of OCs on ovarian cancer risk in European populations, provides useful insights into the time pattern of the relationship between OC use and ovarian carcinogenesis, suggesting that the protection persists for 15 years or more after cessation of use and may be larger for use at younger age.

Energy, macronutrients and laryngeal cancer risk

Alcohol drinking and bladder cancer

Coffee consumption and colorectal cancer risk: a multicentre case-control study from Italy and Spain

This large pooled analysis of two studies shows no association of coffee and decaffeinated coffee with colorectal cancer risk.

Glycemic index, glycemic load and renal cell carcinoma risk

Basi scientifiche per la definizione delle linee guida in ambito clinico per l’epatocarcinoma.

Occupational exposure to ultraviolet radiation and risk of non-Hodgkin lymphoma

Individuals diagnosed with skin cancer have elevated risk of non-Hodgkin lymphoma, and those with non-Hodgkin lymphoma have excess rates of various types of skin cancers. Sunshine and other sources of ultraviolet radiation are major risk factors for skin cancer, and hence a potential common link between skin cancer and non-Hodgkin lymphoma. We analyzed the relationship between occupational exposure to ultraviolet radiation and the risk for non-Hodgkin lymphoma using data from a case-control study conducted in Northern Italy between 1985 and 1997. Cases were 446 patients with histologically confirmed incident non-Hodgkin lymphoma, and controls were 1295 patients admitted to hospital for acute non-neoplastic, non-immunological conditions. The multivariate odds ratios were computed after allowance for age, sex, area of residence, education and smoking. The odds ratio for patients reporting ever ultraviolet exposure at work was 1.01 (95% confidence interval 0.72-1.43) and 1.03 (95% confidence interval 0.72-1.49) for exposure longer than 10 years. The odds ratio was 1.09 for manual workers and 0.79 for farmers exposed to ultraviolet radiation, compared with those with other occupations not exposed to ultraviolet radiation. Our study found no association between occupational exposure to ultraviolet radiation and the risk of non-Hodgkin lymphoma.

An examination of male and female odds ratios by BMI, cigarette smoking, and alcohol consumption for cancers of the oral cavity, pharynx, and larynx in pooled data from 15 case–control studies

Greater tobacco smoking and alcohol consumption and lower body mass index (BMI) increase odds ratios (OR) for oral cavity, oropharyngeal, hypopharyngeal and laryngeal cancers; however, there are no comprehensive sex-specific comparisons of ORs for these factors.