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
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.
Mortality rates for 21 cancer sites in 20 Italian regions have been correlated with several economic and dietary variables (including alcohol and coffee consumption), patterns of cigarette smoking and reproductive habits. In both sexes, a large number of strong correlations emerged, the most notable ones being the strong positive coefficients between cigarettes sold in the early 1950s and lung cancer mortality in middle-aged males in the early 1970s, between gross internal product or meat consumption and cancer of the intestines in both sexes, between total per caput consumption and cancer of the prostate and between mean age at first birth, gross internal product and milk consumption and cancer of the breast. Cancer of the ovary was positively correlated with mean age at the first birth, and negatively with average number of births. Among the unexpected correlations observed, the most remarkable ones were the strong positive coefficient between skin cancer mortality and latitude (which can however be explained in terms of different constitutional characteristics of skin color in various Italian regions), and the pattern of coefficients emerging for gastric cancer, showing positive correlations with gross internal product or meat and negative ones with bread, pasta or fish. These and other results (including the analysis of several first-order partial correlation coefficients) are discussed with regard to their limitations and major points of interest, and in comparison with similar studies conducted on different populations.
Trends in the death rates from cancers of the intestine (including colon and rectum) in Italy from 1956 to 1981 were analyzed with a standard cross-sectional approach and a log-linear age/period/cohort model. In both sexes there were steady increases in mortality rates between the middle 1950s and the middle 1970s, chiefly explainable in terms of cohort effects. This was followed by a leveling off and stabilization, starting from the younger age groups and more evident in women. The analyses of the geographic distribution of intestinal cancer mortality in the 95 Italian provinces during 1975 to 1977 showed higher rates in the north of the country and in large urban concentrations, and a bimodal distribution of mortality rates, whose minimum corresponded to a distinct north/south separation. Trend surface models fitted to intestinal cancer standardized mortality ratios showed a high determination coefficient even for the simplest models. Residuals, corresponding to outliers, were scattered in a few northern and central areas. In addition, mortality rates for cancers of the intestine in middle age people were considered according to geographic area of birth and residence at death. In both sexes rates of migrant populations were influenced both by area of birth and residence, and, in particular, there was a wide-spread unfavorable effect of residence on migrants from the South to the North (the major migrant flux in Italy). The temporal and geographic variations in intestinal cancer rates observed in this study indicate that Italy may well be a particularly interesting situation for etiologic investigations of colorectal cancers.
The relationship of stature with the prevalence of 18 chronic diseases or groups of diseases was analysed using data from the 1983 Italian National Health Survey, based on a sample of 63,859 individuals aged 20 or over randomly selected within strata of geographical area, size of the place of residence and of the household in order to be representative of the Italian population. Rate ratios (RR) were computed using multiple logistic regression, including terms for sex, age, geographical area, education and smoking. For 15 out of 18 diseases or groups of diseases the RR was below unity in the highest quartiles of height, and the inverse trends with stature were significant for 11 (diabetes, RR 0.90 for highest vs lowest quartile; heart disease, RR 0.92; chronic bronchitis and emphysema, RR 0.84; bronchial asthma, RR 0.70; anaemias, RR 0.70; liver cirrhosis, RR 0.62; urolithiasis, RR 0.76; renal insufficiency, RR 0.71; arthritis, RR 0.89; psychiatric and neurological disorders, RR 0.82). None of the diseases considered showed significant direct trends with height, but hypertension (RR 1.09 for the highest vs lowest quartile), haemorrhoids or varices (RR 1.09) and cancers (RR 1.22) tended to be elevated in the highest quartile of height. The generalised inverse relationship between height and prevalence of chronic disease suggests that poorer nutrition in childhood and adolescence is an unfavourable indicator for the subsequent occurrence of several diseases. Major exceptions were hypertension and varices, two conditions highly dependent on the pattern of health care utilization, and cancer.
Patients with histologically confirmed first diagnosis of superficial bladder carcinoma notified to the population-based cancer registry of the Swiss Canton of Vaud during the calendar period 1974-90 were actively followed-up to December 31, 1990 for the occurrence of a subsequent invasive tumour of the urinary bladder. Among 1,012 incident cases of superficial bladder neoplasms, followed for a total of 6,286 person/years at risk, 93 infiltrating tumours of the urinary bladder were diagnosed. Only 5.3 cases were expected on the basis of the general population of the canton. The overall standardized incidence ratio (SIR) was 17.5 (95% confidence interval, CI: 14.2-21.7). The SIR was significantly greater for females than for males. The SIR was highest between 1 and 4 years following registration of non-infiltrating cancer, and declined thereafter. The cumulative risk of invasive bladder cancer was 7%, 13%, and 16%, after 5, 10 and 15 years, respectively. This work provides population-based, accurate and reliable estimates of the risk of invasive bladder cancer following non-infiltrating cancers. Although the overall relative risk was almost 20-fold higher than in the general population, the cumulative risk of developing an invasive bladder cancer was only 16% at 15 years.
