Publications

The relation between 17 micronutrients and breast-cancer risk was analyzed in a case-control study conducted between 1993 and 1999 in the Swiss Canton of Vaud. Cases were 289 women with incident, histologically confirmed breast cancer, and controls were 442 women admitted to the same hospital for a wide spectrum of acute non-neoplastic conditions unrelated to long-term modifications of diet. Dietary habits were investigated using a validated food-frequency questionnaire. Odds ratios (ORs) were obtained after allowance for age, education, parity, menopausal status, body mass index, total energy intake and alcohol drinking. For several micronutrients, the ORs tended to decline with increasing tertile of intake, with significant inverse trends in risk for potassium (OR for the highest tertile = 0.21), total carotenoids (OR = 0.42), lycopene (OR = 0.43), folic acid (OR = 0.45), vitamin C (OR = 0.19), vitamin E (OR = 0.37) and vitamin B(6) (OR = 0.54). In a model including a continuous term for the 7 micronutrients significantly related to breast cancer, the only persisting significant inverse relations were for vitamin C (OR = 0.23) and lycopene (OR = 0.64).

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.

<p>Supplementary Table 3: History of exposure to proton-pump inhibitors (PPIs) among cases and controls, according to different exposure definitions.</p>

Long-term health risks in patients with WHO group 2 anovulation demand their general health be monitored, even after their reproductive needs have been fulfilled. Metabolic and cardiovascular risk prevention in women with PCOS should start as early as possible. It is not easy to analyse the possible role of PCOS, independent of obesity, metabolic syndrome, insulin resistance and diabetes, on long-term health.

On a population scale, tobacco is the major risk factor for esophageal cancer in Italian women. Although the incidence of esophageal cancer is much lower in women than in men, major risk and protective factors are similar for both sexes.

Mortality rates of hepatocellular carcinoma (HCC) are high in Italy compared with other Western countries. To elucidate further the role of hepatitis B virus (HBV), hepatitis C virus (HCV), alcohol drinking, and tobacco smoking in the etiology of HCC, we carried out a hospital-based case-control study in two areas of Italy: the province of Pordenone in the Northeast and the town of Naples in the South. A total of 229 HCC cases (median age, 66 years) and 431 controls (median age, 65 years) answered a questionnaire and provided blood samples between 1999 and 2002. Odds ratios (OR), percent attributable risks, and corresponding 95% confidence intervals were computed using unconditional multiple logistic regression. ORs for hepatitis B surface antigen (HBsAg) positive versus HBsAg negative and for anti-HCV antibody positive versus anti-HCV antibody negative were 20.2 and 15.6, respectively. Positivity for both markers was associated with an OR of 51.6. Sensitive molecular techniques applied to sera in a subset of HCC cases disclosed a very small number of occult hepatites. Maximal lifetime alcohol intake of > or =35 versus <7 drinks/wk was associated with an HBV/HCV adjusted OR of 5.9. Tobacco smoking was unrelated to HCC risk overall but seemed to enhance HCC risk among virus carriers. Overall, 61% of HCC were attributable to HCV, 13% to HBV, and 18% to heavy alcohol drinking. In conclusion, our study confirms the importance of HCV in HCC etiology in Italy where the widespread dissemination of the virus dates back four or five decades.