These findings indicate that the expression of familial susceptibility can be substantially modified by adult life risk factors.
The onset of decline in ischemic heart disease in Italy. C La Vecchia, E Negri, and A DecarliCopyRight https://doi.org/10.2105/AJPH.80.4.502 Published Online: October 07, 2011
The relationship between family history of breast, ovarian and endometrial cancer and risk of breast cancer was analysed using data from a case-control study of breast cancer conducted in the greater Milan area, Northern Italy. The cases studied were 3415 women (median age 52 years, range 23-74) who had histologically confirmed breast cancer diagnosed within the year preceding the interview. The controls were 2916 women (median age 54 years; range 21-74) in hospital for a spectrum of acute illnesses excluding gynaecological, hormonal or neoplastic conditions. A total of 375 cases (11.0%) and 128 controls (4.4%) reported a history of breast cancer in first degree relatives. Compared with women with no family history of breast cancer, the RR was 2.7 (95% confidence interval [CI] : 2.2-3.3) in those with one first degree relative affected and 2.8 (95% CI : 1.3-5.7) in those with two or more affected relatives. In comparison with women without family history of ovarian cancer the RR of breast cancer was 1.4 (95% CI : 0.9-2.3) for those reporting one or more first degree relatives with ovarian cancer. However, the multivariate estimate for family history of ovarian cancer, including a term for familial breast cancer, decreased to 0.8 (95% CI : 0.5-1.4). The risk of breast cancer was similar in women reporting a family history of breast cancer (RR = 2.2) and in those reporting a family history of both breast and ovarian cancer (RR = 2.5), in comparison with women reporting no family history of breast and/or ovarian cancer.(ABSTRACT TRUNCATED AT 250 WORDS)
The relationship between diabetes mellitus and primary liver cancer was investigated in a case-control study conducted in Italy between 1984 and 1996 on 428 cases with incident, histologically confirmed hepatocellular carcinoma, 59 with gallbladder and bile duct cancer, and 1,502 control subjects in the hospital for acute non-neoplastic diseases. Sixty-four cases of hepatocellular carcinoma vs. 87 controls reported a history of diabetes, corresponding to an odds ratio (OR) of 2.3 after allowance for age, sex and area of residence, and of 2.1 [95% confidence interval (CI) = 1.4–3.2] after further allowance for alcohol and tobacco consumption, history of hepatitis and liver cirrhosis, body mass index and history of liver cancer in first-degree relatives. The ORs were similar both for subjects diagnosed with diabetes below age 45, who most likely had insulin-dependent diabetes, and for those diagnosed later, who were likelier to have non-insulin-dependent diabetes. The OR was 2.3 for subjects whose diabetes was diagnosed <5 years before diagnosis of liver cancer, 1.9 for those diagnosed 5–9 years in advance and 2.2 for those diagnosed since 10 years or more. Five cases of gallbladder and bile duct cancer reported a history of diabetes: the corresponding OR was 1.2 (95% CI 0.5–2.9). The OR of hepatocellular carcinoma was 2.4 for males and 2.0 for females, 3.0 for subjects diagnosed with liver cancer under age 60 and 1.8 for those diagnosed at age 60 or over. None of the other covariates considered, including education, history of hepatitis, liver cirrhosis and alcohol drinking showed any meaningful modifying effect or interaction. The potential pathogenic mechanisms include liver alteration—and consequent cell proliferation—in subjects with diabetes. Thus a history of diabetes mellitus could explain about 8% (95% CI 5–11) of cases of liver cancer in this population. Int. J. Cancer 73:204–207, 1997. © 1997 Wiley-Liss, Inc.
ALcOHOL AND cANcER RIsk, wITH fOcus ON mODERATE DRINkERs Alcohol and cancer risk, with focus on moderate drinkers Carlo La Vecchia (1) , Claudio Pelucchi (2) A Alcohol substantially increases the risk of head and neck and oesophageal cancers.The risks are essentially due to total ethanol intake.Alcohol drinking has also been associated with primary liver cancer, with cancers of the large bowel in both sexes, of the female breast, and -at high doses only-of the pancreas [1].To evaluate the strength of the evidence provided by the epidemiological literature on the association between alcohol consumption and the risk of 18 known or potentially alcohol-related neoplasms, we performed a search of the epidemiological literature from 1966 to 2012 using major bibliographic data-bases.We fitted meta-regression models considering linear and non-linear effects of alcohol intake.We also investigated the effects of selected characteristics of the studies (e.g., allowance for tobacco) and of individuals included in the studies (e.g., gender, age, etc.), as possible sources of heterogeneity of the estimates.A total of approximately 600 studies including 200,000 cases were considered.Strong trends in risk were observed for cancers of the oral cavity, oesophagus and larynx, the strongest one being for oral cancer, with a relative risk (RR) around 5 for 50 g/day of alcohol.Direct relations were also observed for cancers of the colon and rectum, liver, breast, and (for high doses only) pancreas [2].We also specifically considered the association between light alcohol consumption and cancer risk for those sites for which there is sufficient or limited evidence for carcinogenicity of alcohol [1,3].Thus, we considered cancers of the upper digestive and respiratory tract (oral and pharyngeal cancer, esophageal squamous cell carcinoma -but not adenocarcinoma of the esophagus, that is not associated to alcohol drinking [4] -and laryngeal cancer), liver, colorectum, pancreas and breast.Quantification of the association between low doses of alcohol consumption and cancers known to be alcohol-related is particularly important, as it is still unclear
