Publications

Nutrition, social factors and prostatic cancer in a Northern Italian population

Body mass at different ages and subsequent endometrial cancer risk

The relationship between body mass index (BMI) at different ages and subsequent endometrial-cancer risk was investigated in a multicentre case-control study conducted between 1988 and 1991 in Vaud, Switzerland, and Northern Italy on 272 histologically confirmed incident cases of endometrial cancer and 571 controls admitted to hospital for acute, non-neoplastic conditions, unrelated to known or potential risk factors for endometrial cancer. The risk of endometrial cancer increased with increasing BMI in the 3rd decade of age (20 to 29 years), in the 5th decade (40 to 49 years) and in the 7th decade (60 to 69 years), although the risk estimates tended to be substantially higher at older ages: compared with women whose BMI (kg m-2) was less than 20, the relative risks (RR) were 1.8 for BMI greater than or equal to 25 at age 20 to 29, 2.7 for BMI greater than or equal to 30 at age 40 to 49 and 3.8 at age 60 to 69. All the trends in risk were significant, except that for BMI at age 25 after allowance for current BMI. When data were examined in separate strata of current BMI, among women of normal body mass at diagnosis no significant effect of past overweight was observed. In contrast, among subjects over-weight at diagnosis, there were significant direct relationships with BMI at ages 20 to 29 and 40 to 49. To reduce endometrial cancer risk, it is therefore important to avoid obesity in later middle and older age, and the benefit can be even greater for women who were overweight at younger age.

Disparities in breast cancer mortality trends between 30 European countries: retrospective trend analysis of WHO mortality database

Changes in breast cancer mortality after 1988 varied widely between European countries, and the UK is among the countries with the largest reductions. Women aged <50 years showed the greatest reductions in mortality, also in countries where screening at that age is uncommon. The increasing mortality in some central European countries reflects avoidable mortality.

The telomerase reverse transcriptase elongates reversed replication forks at telomeric repeats

The telomerase reverse transcriptase elongates telomeres to prevent replicative senescence. This process requires exposure of the 3'-end, which is thought to occur when two sister telomeres are generated at replication completion. Using two-dimensional agarose gel electrophoresis (2D-gels) and electron microscopy, we found that telomeric repeats are hotspots for replication fork reversal. Fork reversal generates 3' telomeric ends before replication completion. To verify whether these ends are elongated by telomerase, we probed de novo telomeric synthesis in situ and at replication intermediates by reconstituting mutant telomerase that adds a variant telomere sequence. We found variant telomeric repeats overlapping with telomeric reversed forks in 2D-gels, but not with normal forks, nontelomeric reversed forks, or telomeric reversed forks with a C-rich 3'-end. Our results define reversed telomeric forks as a substrate of telomerase during replication.

Alcohol Consumption and Cancer Risk

This review focuses on selected aspects of the relation between alcohol consumption and cancer risk. Heavy alcohol consumption (i.e., ≥4 drinks/day) is significantly associated with an increased risk of about 5-fold for oral and pharyngeal cancer and esophageal squamous cell carcinoma, 2.5-fold for laryngeal cancer, 50% for colorectal and breast cancers, and 30% for pancreatic cancer. These estimates are based on a large number of epidemiological studies and are generally consistent across strata of several covariates. The evidence suggests that at low doses of alcohol consumption (i.e., ≤1 drink/day) the risk is also increased by about 20% for oral and pharyngeal cancer and 30% for esophageal squamous cell carcinoma. Thus, for these sites there is little evidence of a threshold effect. While consumption of fewer than 3 alcoholic drinks/wk is not associated with an increased risk of breast cancer, an intake of 3 to 6 drinks/wk might already yield a (small) increase in risk. On the other hand, intakes up to 1 drink/day are not associated to the risk of laryngeal, colorectal, and pancreatic cancer. The positive association between alcohol consumption and the risk of head and neck cancers is independent from tobacco exposure.

Mortalidad infantil en Europa central: efectos de la transición

Trends in gastric cancer mortality 1990–2019 in 36 countries worldwide, with predictions to 2025, and incidence, overall and by subtype

Observed and predicted GC mortality trends declined in most countries in both sexes, with few exceptions, likely due to the control of GC risk factors, in particular Hp infection.

Alcohol intake and gastric cancer: Meta-analyses of published data versus individual participant data pooled analyses (StoP Project)

Diverging trends in lung cancer: a 26-year analysis of sex-specific patterns and histological shifts in Northern Italy

Lung cancer is the leading cause of cancer-related mortality worldwide, and understanding its pathological patterns and trends is of interest for clinical and public health interventions. This study investigates the trends in lung cancer incidence rates from 1995 to 2021 in the Friuli Venezia Giulia (FVG) region in northeastern Italy, focusing on histological subtypes and sex-specific differences. Data were obtained from the population-based FVG Cancer Registry. Data on histological types of lung cancer were analyzed. Using census-based population estimates, age-standardized incidence rates (ASIRs) were calculated for three calendar periods (1995-2003, 2004-2012, 2013-2021). Joinpoint regression analysis was used to assess significant changes in trends, estimating annual percent change and average annual percent change (AAPC). A total of 24 519 lung cancer cases were recorded between 1995 and 2021, 70% in males. During 2013-2021, ASIRs were 31.9/100 000 males and 16.9/100 000 females. Adenocarcinoma accounted for the highest ASIRs in both sexes (15.2/100 000 males and 9.9/100 000 females). Over the 1995-2021 period, the overall incidence of lung cancer decreased in males (AAPC: -3.2%), whereas it increased in females (AAPC: +1.0%). Trends in adenocarcinoma were inconsistent formales but continued to rise in females. Squamous and small cell lung cancer incidence declined in males, while both increased in females. These trends underscore the importance of targeted prevention strategies, especially addressing smoking cessation in middle-aged females.

Relations between vegetable, fruit and micronutrient intake. Implications for odds ratios in a case–control study

Supplementary Table 1 from Intake of Proton-Pump Inhibitors and Gastric Cancer within the Stomach Cancer Pooling (StoP) Project

&lt;p&gt;Supplementary Table 1: Main characteristics of the studies included in the analysis.&lt;/p&gt;

Bronchial diverticula in smokers on thin-section CT

Laryngeal cancer in women: tobacco, alcohol, nutritional, and hormonal factors.

Laryngeal cancer is the neoplasm with the largest male to female sex ratio in most populations. Thus, inadequate data are available on women. We analyzed several risk factors in the combined dataset from two case-control studies conducted between 1986 and 2000 in northern Italy and Switzerland. Cases were 68 women under age 79 years, with incident, histologically confirmed cancer of the larynx. Controls were 340 women, admitted to the same network of hospitals as cases, for acute, nonmalignant conditions, unrelated to tobacco and alcohol consumption. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated by logistic regression models, conditioned by age, study center and year of interview, and including terms for education, body mass index, tobacco, alcohol drinking, and nonalcohol energy intake. Laryngeal cancer was strongly associated with cigarette smoking (OR = 435.7, 95% CI: 38.2-4964.4 for smokers of >/=25 cigarettes/day) and alcohol drinking (OR = 4.3, 95% CI: 0.8-24.1 for >/=5 drinks/day). An inverse relation was found for vegetables (OR = 0.3, 95% CI: 0.1-0.9 for the highest level of consumption), fruit (OR = 0.5, 95% CI: 0.2-1.3), and olive oil (OR = 0.3, 95% CI: 0.1-0.9). Reproductive and hormonal factors were not consistently associated to laryngeal cancer risk. This investigation, based on a uniquely large number of laryngeal cancers in women, provides definite evidence that cigarette smoking is the prominent risk factor for laryngeal cancer in women, accounting for 78% of cases in this population. Alcohol and selected dietary aspects account for approximately 30% of cases, whereas menstrual and hormonal factors do not appear to have a consistent role in laryngeal carcinogenesis.

Italian study on colorectal cancer with emphasis on influence of cereals

To elucidate the influence of diet on colorectal carcinogenesis, 1225 subjects with cancer of the colon, 728 with cancer of the rectum and 4154 controls, hospitalized with acute non-neoplastic diseases, were interviewed between 1992 and 1996 in six Italian areas. The validated food frequency questionnaire included 79 questions on food items and recipes which were grouped into 16 food groups. After allowing for nondietary confounding factors and total energy intake, a significant trend towards an increasing risk of colorectal cancer with increasing intake was found for bread and cereal dishes (odds ratio for increase of one daily serving 1.11), cakes and desserts (odds ratio 1.02) and refined sugar (odds ratio 1.11). The intake of fish (odds ratio 0.53), raw and cooked vegetables (odds ratios 0.79 and 0.65, respectively) and fruit (odds ratio 0.93) showed an inverse association with risk. Wholemeal bread was consumed by only 12.5% of cases and 13.9% of controls and, at variance with refined bread, did not show a significant direct association with colorectal cancer risk (odds ratio 0.88). In view of these findings, current hypotheses on the carcinogenic effects of refined starchy foods and refined sugar should be revised to take into account the digestive physiology of carbohydrates and the possible relationship between insulin and colon cancer. The beneficial influence of most vegetables is confirmed, and a possible difference between refined and wholemeal bread is suggested.

Alcohol and the Risk of Cancers of the Stomach and Colon-Rectum

Alcohol drinking is strongly related to cancer of the upper digestive tract, but the pattern of risk with alcohol drinking is clearly different for cancer of the stomach and colon-rectum. All twelve cohort studies and three-quarters of 40 case-control investigations on the topic weigh against the possibility of a substantial effect of alcohol consumption on the risk of stomach cancer. Evidence is still insufficient to establish whether cancer of the cardiac region of the stomach is related to alcohol intake to any different extent than the rest of the stomach. With reference to colorectal cancer, different types of epidemiological studies are consistent in suggesting some direct relations with alcohol drinking. The association, however, is moderate, and an elevated risk of a factor 2--or even of a factor 1.5--for both cancers of the colon and rectum can now be excluded even for the highest levels of alcohol consumption.

Flavonoid intake and liver cancer: a case–control study in Greece

Supplementary figure S3 from B-cell Receptor Silencing Reveals the Origin and Dependencies of High-Grade B-cell Lymphomas with &lt;i&gt;MYC&lt;/i&gt; and &lt;i&gt;BCL2&lt;/i&gt; Rearrangements

&lt;p&gt;AID expression in IGH&lt;sup&gt;+&lt;/sup&gt; and IGH&lt;sup&gt;UND&lt;/sup&gt; HGBCL-DH-&lt;i&gt;BCL2&lt;/i&gt;&lt;/p&gt;

Family history and the risk of endometrial cancer

The association between a family history of endometrial, breast and ovarian cancer and the risk of endometrial cancer was analyzed on the basis of data from a case-control study conducted in northern Italy between 1983 and 1993. A total of 726 histologically confirmed endometrial-cancer patients (median age 61) admitted to a network of general and teaching hospitals in the Greater Milan area were interviewed. The controls were 2,123 women (median age 59), admitted for acute, non-neoplastic, non-hormone-related diseases to the same network of hospitals where the cases had been identified, with admission diagnoses unrelated to any of the known or suspected risk factors for endometrial cancer. Among cases, 37 (5.1%) reported a history of endometrial cancer in first-degree relatives. The corresponding figure among controls was 77 (3.6%). In comparison with women with no family history of endometrial cancer, the odds ratio (OR) of endometrial cancer was 1.5 (95% CI [confidence interval], 1.0-2.3) in women with a history of endometrial cancer in first-degree relatives. No relation emerged between endometrial cancer and a family history of breast or ovarian cancer. These results suggest that a family history of endometrial cancer increases the risk of contracting the same disease. However, the proportion of cases attributable to this factor was small: less than 1% of endometrial cancers in this population were attributable to familial (and hence potentially genetic) factors.