Publications

BPH rates have been steadily declining in developed countries. The excess BPH mortality in Eastern Europe indicates the scope for further reduction too.

1529 Background: The efficacy of low-dose computed tomography (LDCT) screening is currently being tested in prospective randomized trials worldwide. Some of these trials are also investigating the value of non-invasive biomarkers, to improve the cost-benefit ratio of LDCT by individual risk assessment. In the present study, we have analyzed the capacity of a miRNA signature classifier (MSC) based on 24 previously refined microRNAs circulating in plasma to predict the outcome of lung cancer patients within the LDCT screening program. Methods: Between 2000 and 2010, 3411 heavy smokers were enrolled in a screening program, with annual (2225) or biennial (1186) LDCT. During the first five years of screening, a total of 111 consecutive subjects developed lung cancer. The actuarial five-year survival according to clinical and pathological characteristics was calculated for all patients, and for the subset of 76 patients suitable for plasma MSC analysis, according to three different risk groups (High, Intermediate or Low). Median follow-up of the alive patients was 4.5 years (Inter Quartile Range = 6.5). Results: Five-year survival was 55% in overall (median 7.9 yrs), 63% for LDCT-detected cases (median nc), 90% for pStage I (median nc), 9% for pStage II-IV (median 1.5 yrs, p<0.001), 68% for cancers detected in the initial two years of screening (median nc), and 38% for years 3 to 5 (median 3.0 yrs, p<0.004). None of the 13 interval cancers survived 4 years (median 0.8 yrs, p<0.001). In the subset suitable for plasma MSC analysis , survival was 76% for low- to intermediate risk MSC (median nc), and 35% for High risk MSC (median 2.9 yrs, p=0.002). The prognostic power of MSC persisted when the analysis was restricted to LDCT-detected cases after exclusion of interval cancers (85 vs. 38% respectively, p<0.001). No cancer deaths were observed in the subset of 28 patients with pStage I and low- to intermediate risk MSC. Conclusions: Patients developing interval lung cancer or with a Stage higher than I had a very poor outcome, despite LDCT monitoring. Plasma MSC predicted lung cancer outcome effectively, and might improve the individual risk assessment and performance of LDCT screening in the near future. Clinical trial information: INT 05-53.

The role of various micronutrients on the risk of renal cell cancer (RCC) was examined in a multicentric case-control study from Italy, in which information on dietary habits were collected using a validated food-frequency questionnaire. Cases were 767 patients (494 men and 273 women) with incident, histologically confirmed RCC; controls were 1,534 subjects (988 men and 546 women) admitted to the same hospitals as cases for a wide spectrum of acute, nonneoplastic conditions. After allowing for energy and other major covariates, a significant inverse association was found for vitamin E (odds ratio, OR, for the highest quintile of intake versus the lowest one 0.56, 95% confidence interval, CI 0.41-0.75), and vitamin C (OR = 0.72, 95% CI = 0.54-0.96), although the trend in risk for vitamin C was of borderline significance. No significant trend of decreasing risk was found for other micronutrients analyzed, although for most of them the risk estimates were below unity for intakes above the lowest. The ORs for the upper quintile of intake when compared with the lowest one were 0.80 (95% confidence interval, CI = 0.59-1.08) for retinol, 0.82 (95% CI = 0.61-1.10) for alpha-carotene, 0.90 (95% CI = 0.68-1.20) for beta-carotene, 0.94 (95% CI = 0.73-1.21) for beta-criptoxanthin, 0.85 (95% CI = 0.63-1.14) for lutein/zeaxanthin, 0.76 (95% CI = 0.57-1.01) for vitamin D, 0.75 (95% CI = 0.55-1.01) for thiamine, 0.88 (95% CI = 0.66-1.19) for riboflavin, 0.85 for vitamin B6 (95% CI = 0.64-1.13), 0.85 (95% CI = 0.64-1.12) for folate and 0.80 (95% CI = 0.60-1.07) for niacin. No meaningful associations emerged for lycopene (OR = 1.11). The present findings support a possible beneficial effect of vitamin E and C on RCC.

The relationship between occupation and exposure to several occupational agents and Hodgkin's disease (HD) was investigated in a case-control study of 152 cases and 613 controls with acute diseases admitted to all hospitals in Pordenone province, north-east Italy. Among cases, there was a significant excess of individuals occupied in agriculture (odds ratio, OR for greater than 10 years = 2.2, 95% confidence interval, CI:1.3-3.7), who were exposed to livestock and meat processing (OR = 3.4, 95% CI:1.7-6.6), herbicides and pesticides (OR = 3.2, 95% CI:1.6-6.5). When the relationship between agriculture and specific exposures was assessed, it appeared that contact with some still unidentified animal-related agent involved in livestock farming and meat processing may be at least as important in determining HD risk as exposure to herbicides and pesticides and, probably, more important than occupation in agriculture per se.

The beneficial association of the Mediterranean diet (MedDiet) with longevity has been consistently demonstrated, but the associations of MedDiet components have not been accordingly evaluated. We performed an updated meta-analysis of prospective cohort studies published up to 31 December 2017, to quantify the association of adherence to MedDiet, expressed as an index/score (MDS) and of its components with all-cause mortality. We estimated summary relative risks (SRR) and 95 % CI using random effects models. On the basis of thirty studies (225 600 deaths), SRR for the study-specific highest/lowest and per 1sd MDS increment were 0·79 (95 % CI 0·77, 0·81, Ι 2=42 %, P-heterogeneity 0·02) and 0·92 (95 % CI 0·90, 0·94, Ι 2 56 %, P-heterogeneity <0·01), respectively. Inversely, statistically significant associations were evident in stratified analyses by country, MDS range and publication year, with some evidence for heterogeneity across countries overall (P-heterogeneity 0·011), as well as across European countries (P=0·018). Regarding MDS components, relatively stronger and statistically significant inverse associations were highlighted for moderate/none-excessive alcohol consumption (0·86, 95 % CI 0·77, 0·97) and for above/below-the-median consumptions of fruit (0·88, 95 % CI 0·83, 0·94) and vegetables (0·94, 95 % CI 0·89, 0·98), whereas a positive association was apparent for above/below-the-median intake of meat (1·07, 95 % CI 1·01, 1·13). Our meta-analyses confirm the inverse association of MedDiet with mortality and highlight the dietary components that influence mostly this association. Our results are important for better understanding the role of MedDiet in health and proposing dietary changes to effectively increase adherence to this healthy dietary pattern.