Publications

Progestins have become normal medical practice in the treatment of endometrial carcinoma. An accurate review of the literature on the subject, involving about 1500 treated cases since 1951, reveals that a positive response is obtained in about 30% of cases. However, authors differ greatly as to the kind of progestin to be administered, and especially as to the dosage, which can go from 0.2 to 5.6 gr. According to the authors of this article great importance must be given to plasmatic levels and to the analysis of hormonal receptors before deciding on the type of therapy. Results from their personal observations of 45 cases show that some patients would benefit more from progestin thersapy, and others from traditional chemothersapy.

The relationship between selected foods and nutrients and breast cancer risk was investigated in strata of age and menopausal status using data from a case-control study on breast cancer conducted between June 1991 and April 1994 in six Italian areas. Cases were 2,569 women with histologically confirmed incident breast cancer admitted to the major teaching and general hospitals of the study areas; controls were 2,588 women with no history of cancer admitted to hospitals in the same catchment area as cases for acute, nonneoplastic, nongynecological conditions unrelated to hormonal or digestive tract diseases or to long-term modifications of diet. Dietary habits were investigated using a validated food frequency questionnaire, including 78 foods or food groups. Among food groups, bread was directly and significantly related to breast cancer risk in older women and, consequently, in postmenopause, whereas the protection conferred by fish consumption was stronger in postmenopause and that exerted by raw vegetables was stronger in premenopause. Among nutrients, unsaturated fatty acids were inversely related to breast cancer risk, the association being stronger in postmenopausal and elderly women. The pattern was similar for total fats. For starch, available carbohydrates, and total proteins, no heterogeneity emerged across strata of age and menopausal status. Among micronutrients, protection diminished with increasing age for beta-carotene and calcium, whereas no heterogeneity emerged for vitamin E. Thus this age-specific analysis of the largest investigation to date on diet and breast cancer did not show any consistent pattern of breast cancer risk in relation to selected dietary factors across strata of age and menopausal status.

1Istituto di Ricerche Farmacologiche “Mario Negri” Via Eritrea 62 20157 Milano, Italy 2Istituto di Statistica Medica e Biometria Università di Milano Via Venezian 1 20133 Milano, Italy Correspondence to: C La Vecchia Fax: (+39-02-33200231/39001916)

The possible relation between low-calorie sweeteners (as well as sugar-sweetened beverages) and unfavourable pregnancy outcomes, in particular preterm delivery and low birth weight, has recently become of considerable interest, given the widespread use of low-calorie sweeteners, and the high frequency of preterm deliveries in high-income countries. In a study from Norway, Englund-Ogge et al. 1 considered the possible relation between low-calorie-sweetened and sugar-sweetened beverages and preterm delivery using data from 60 761 women in the Norwegian Mother and Child Study cohort. Overall, 3281 preterm deliveries (<37 weeks) were observed, corresponding to 5.4% of all deliveries. Of these, 3.9% were late preterm deliveries (34 to <37 weeks), 0.8% moderately preterm deliveries (32 to <34 weeks) and 0.7% early preterm (<32 weeks) deliveries. There was a moderate association between frequency of use of sugar-sweetened beverages during pregnancy and the risk of preterm deliveries. As compared to women who did not drink sugar-sweetened beverages, the relative risk (RR) was 1.15 for <1 serving/week, 1.15 for 1–6 servings/week, 1.25 for 1 serving/day, 1.19 for 2–3 servings/day and 1.41 for ≥4 servings/day. Allowance was made for age, education, obstetric history and tobacco but not for alcohol. Women …

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.

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.