2,971 publications from this institution
We evaluated the risk of breast cancer in relation to the frequency of consumption of a few selected dietary items. Data were used from a case-control study of 1,108 histologically confirmed breast cancer patients and 1,281 control subjects who were in the hospital for acute conditions unrelated to any of the established or suspected risk factors for breast cancer. Moderately elevated risk estimates were associated with higher levels of fat consumption in seasonings [butter, margarine, and oil, relative risk (RR) = 1.34, 95% confidence interval (CI) = 1.06-1.71] and meat (RR = 1.36, 95% CI = 1.12-1.65), whereas a reduced risk (RR = 0.42, 95% CI = 0.34-0.51) was associated with a more frequent green vegetable consumption. It was not possible to show that these associations were incidental, because allowance for several identified potential confounding factors, including the major identified or potential risk factors for breast cancer, did not materially modify the risk estimates. Further, no appreciable interaction emerged with age or menopausal status, because the diet-related risk estimates were similar in pre- or postmenopausal women. However, the implications of these findings in terms of specific micronutrients (e.g., retinol or beta-carotene) and biological correlates are still unclear. Alcohol consumption was significantly greater among breast cancer cases, with a multivariate risk estimate of 2.92 for the highest level. Thus, the present findings confirm that various aspects of diet may influence the risk of breast cancer, although the small amount of available knowledge does introduce serious uncertainties in any discussion of the potential implications in terms of prevention on a public health scale.
Overweight and obesity are associated with several important diseases, including diabetes, cardio- and cerebrovascular diseases, digestive disorders and cancer. We decided, therefore, to present estimates of the prevalence of overweight and obesity in the general Italian population. The prevalence of overweight and obesity in Italy was evaluated using data from the 1990-91 Italian National Health Survey. 25,818 households were surveyed, representing the whole Italian population. A sample of 24,602 males and 26,090 females aged 15 or over was randomly selected, within strata of geographical area, size of municipality and size of household, in order to be fully representative. Quetelet's index was considered as a measure of body mass index, on the basis of self reported height and weight, and was a priori divided into four levels: underweight (< 20 kgm-2), normal weight (20 to 24.9 kgm-2), overweight (25 to 29.9 kgm-2), and obese (> or = 30 kgm-2). In the overall national sample, 11.0% of subjects were underweight (4.4% males, 12.2% females), 50.8% normal weight (49.4% males, 52.2% females), 31.6% overweight (39.2% males, 24.5% females), and 6.5% obese (7.0% males, 6.1% females). The prevalence of overweight and obesity was higher in middle age and in the South of the country, and was directly related to history of diabetes, hypertension, heart diseases, gallbladder disease and chronic respiratory disorders. These data quantify the importance of overweight and obesity as a public health issue in the general Italian population.
The cohort trend suggests that long term improvements in socioeconomic and general health conditions may be important factors in the diminishing stillbirth rates, as well as short term advances in obstetric care. Alternatively the cohort effect could be attributed, at least in part, to an age-period interaction, since the downward trends were more pronounced in younger women.
It has been suggested that the risk of stomach cancer is increased when there is a history of gastric ulcer, but decreased in those with a history of duodenal ulcer. To provide further information on the issue, data from a case-control study of gastric cancer conducted in greater Milan, northern Italy, between 1985 and 1993, were examined. There were 746 cases of gastric cancer below the age of 75 and 2,053 controls admitted to hospital for acute, non-neoplastic, non-hormone-related diseases. A total of 76 (10.2%) cases and 84 (4.1%) controls reported a history of gastric ulcer, corresponding to a multivariate odds ratio (OR) of 2.6 (95% confidence interval, CI = 1.8-3.6). Fifty nine cases (7.9%) and 111 (5.4%) controls reported a history of duodenal ulcer, corresponding to an OR of 1.3 (95% CI = 0.9-1.8). The OR of gastric cancer was significantly above unity for the first five years after diagnosis of gastric ulcer (OR = 7.4, 95% CI 3.7-14.8), and declined thereafter. No consistent pattern of risks was observed after duodenal ulcer. The present data therefore confirm that the risk of gastric cancer is increased after gastric ulcer. They do not support, however, a reduced risk after duodenal ulcer. This may be due to variable baseline characteristics of the populations studied, or to the different role and impact of Helicobacter pylori and other determinants of duodenal ulcer and gastric cancer in various countries.
ItalianIn questo rapporto tecnico vengono presentati e brevemente commentati dati e statistiche di mortalità per tumori in Italia nel 1983, sulla base dei dati di certificazione di morte pubblicati dall'Istituto Centrale di Statistica. Il numero totale di morti per tumore registrati nel 1983 in Italia è stato di oltre 131.000, con un aumento di oltre il 2% rispetto all'anno precedente nel tasso standardizzato per età dei maschi, mentre i tassi sono rimasti stabili nelle donne. Come in passato, la proporzione maggiore dell'aumento nei maschi era dovuta al cancro del polmone, che rappresentava da solo 22.400 morti nei maschi (il 29% della mortalità totale per tumori), ed oltre 25.000 morti nei due sessi. Nei maschi i tassi erano superiori rispetto all'anno precedente per le neoplasie dell'esofago, colon-retto e fegato nella mezza età come in età più avanzata, mentre gli apparenti aumenti erano concentrati tra i più anziani per prostata, cervello e sistema nervoso, linfomi e mieloma. Nelle donne, si sono registrati persistenti ma modesti aumenti per il polmone (ancora al quinto posto nella mortalità per tumori nelle donne con 3435 morti od il 6,3% del totale) e della mammella (9570 morti o il 17,7% del totale) nella mezza età come in età più avanzata, sebbene gli andamenti di lungo periodo per la mammella siano stati più sfavorevoli al di sopra dei 70 anni. I tassi nelle donne erano costanti per l'intestino (una stabilità che dura da oltre un decennio), mentre sono continuate le diminuzioni per il cancro dello stomaco e del (collo) dell'utero, anche nelle classi di età più giovani. La principale (e probabilmente la sola) evidenza incoraggiante è stato il persistente declino della mortalità per tumori al di sotto dei 20 anni, che riflette evidentemente i sostanziali miglioramenti nel trattamento dei tumori in età pedliatrica.
The relationship between frequency of consumption of whole grain food and risk of selected neoplasms has been analysed using data from an integrated series of case-control studies conducted in northern Italy between 1983 and 1996. The overall dataset included the following incident, histologically confirmed neoplasms: oral cavity and pharynx 181, oesophagus 316, stomach 745, colon 828, rectum 498, liver 428, gallbladder 60, pancreas 362, larynx 242, breast 3,412, endometrium 750, ovary 971, prostate 127, bladder 431, kidney 190, thyroid 208, Hodgkin's disease 80, non-Hodgkin's lymphomas 200, multiple myelomas 120. Controls were 7,990 patients admitted to hospital for acute, non-neoplastic conditions, unrelated to long-term modifications in diet and not likely to have been caused by tobacco or alcohol use. Odds ratios (OR) for subsequent scores (never/occasional/frequent) of whole grain food consumption were derived after allowance for age, sex, education, smoking, alcohol intake and body mass index. High intake of whole grain foods consistently reduced risk of neoplasm at all sites, except thyroid. The ORs for the highest category of consumption were 0.2-0.3 for upper digestive and respiratory tract neoplasms, 0.5 for stomach, colon and gallbladder, 0.7 for rectum, 0.6 for liver, 0.8 for pancreas and prostate, 0.9 for breast and endometrium, 0.6 for ovary, 0.4 for bladder and kidney, 1.3 for thyroid and around 0.5 for lymphomas and myeloma. The tests for trend in risks were significant for all neoplasms, except pancreas, endometrium, Hodgkin's disease and multiple myeloma. No significant heterogeneity was found across strata of age at diagnosis, sex, education, smoking habit, alcohol intake and body mass index. Thus, even in the absence of a univocal and satisfactory biological interpretation, the consistency of the patterns observed indicate that, in this population, higher frequency of whole grain food intake is an indicator of reduced risk of several neoplasms.
Histograms of all age-standardized death certification rates from 26 cancers or groups of cancers and total cancer mortality for the most recent calendar quinquennium (generally 1985–89) were produced for 55 countries: 26 in Europe, the former Soviet Union (USSR), three in North America, 13 in Latin America and the Caribbean, two in Africa, eight in Asia and two in Oceania, providing interpretable data to the World Health Organization database. Major differences were observed for all common cancer sites, including stomach (49 100.000 males in Costa Rica, 38 in the USSR and Japan vs 5/100,000 in the United States), intestines (over 25 100.000 males in Czechoslovakia, Hungary and New Zealand vs 10–15/100,000 in Japan and Southern Europe and less than 5/100,000 in most Latin American and Asian countries), lung (over 70/100,000 in Belgium, Scotland, The Netherlands, Czechoslovakia and Hungary, and less than 20/100,000 in most Latin American and Asian countries; over 20/100,000 females in Britain, Hong Kong, the United States and Denmark vs less than 5/100,000 in France, Spain and again most areas of Asia and Africa providing data; breast (over 25 100.000 females in Great Britain, New Zealand, Belgium, The Netherlands and Uruguay, vs less than 10 100,000 in Japan, Hong Kong and most Latin American countries). Thus, there was over a fivefold variation in total cancer mortality for both sexes, the highest rates being in Hungary (237/100,000) and Czechoslovakia (229/100.000) for males, and in Denmark (142/100,000) and Scotland (138/100,000) for females. Although problems of validity and reliability of cancer death certification, mostly in developing countries, may in part explain this variation, these substantial differences are at least in part real and essentially reflect, besides the impact of breast cancer in females and of stomach and colorectal cancer in both sexes, the different spectrum of the tobacco-related lung cancer epidemic in the two sexes and in various areas of the world.
The relationship between lifelong menstrual pattern and the risk of breast cancer has been analyzed using data from a large case-control study conducted since 1983 in the greater Milan area including 3,037 cases, aged 74 years or less, with histologically confirmed breast cancer and 2,569 control subjects admitted for acute nongynecological, nonneoplastic nonhormone-related conditions to the same network of hospitals where cases had been identified. Compared with women reporting lifelong regular cycles, those reporting irregularities were at significantly reduced risk of breast cancer, relative risk estimate being 0.6, with 95% confidence interval (CI) ranging from 0.5 to 0.8. This protection was restricted to women reporting totally irregular menstrual cycles; compared to women reporting menstrual cycles lasting 25 days or less, the estimated relative risks were 1.0 and 1.2 in those reporting cycles lasting 26-30 days or 31 days or more, respectively, but 0.6 (95% CI 0.5-0.8) for those reporting totally irregular cycles. The effect of irregular menstrual cycles was similar in different strata of age and main risk factors for breast cancer.
