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In this study, a significant inverse association between beta-carotene and thyroid carcinoma was observed, and some protection against thyroid carcinoma from vitamins C and E was also suggested.
Abstract In a cohort mortality study, a few basic rules must be respected for risk estimation including: (1) the definition of the criteria of entry in the cohort; (2) the time period of observation; (3) the outcome, which must be the same for observed and expected events [Breslow and Day, 1987; MacMahon and Trichopoulos, 1996]. In their letter to the Editor referring to our article "Mortality Among Workers in the Geothermal Power Plants at Larderello, Italy" [Pira et al., 1999], Merler et al. appear to ignore these basic principles, since they extend the observation period from 1990 to 1998 for observed but not for expected events and do not distinguish between incidence and mortality. Consequently, their relative risk estimates are simply not interpretable. Anyway, an update of the follow‐up to the end of 2000 has already been planned.
The risk of breast cancer is moderately elevated in current and recent hormone replacement therapy users, with an approximate 2.3% excess risk per year of use. Some excess risk has also been reported for ovarian cancer in long-term users. Unopposed oestrogens are strongly related to endometrial cancer risk, but cyclic progestogen addition appears to reduce this side effect, possibly further increasing the risk of breast cancer. There is a moderate inverse association between colorectal cancer and hormone replacement therapy. Most potential favourable and adverse effects of hormone replacement therapy on cancer risk are restricted to current users. Selective oestrogen receptor modulators may offer advantages in reducing breast cancer risk. Regular aspirin use and high levels of physical activity induce a moderate reduction of risk for colorectal, and possibly for breast, ovarian and endometrial cancer. Overweight and obesity are strongly related to gallbladder, endometrial and breast cancer, and appear to be also related to colorectal, renal, pancreatic and ovarian cancer.
Changing to cigarettes with a lower tar yield is not an effective means of reducing tobacco related morbidity from myocardial infarction.
We used data from the 1993 Italian Household Multipurpose Survey, based on a sample of 46,693 subjects ages 15 years or over, to analyze the relation between frequency of vegetable consumption and prevalence of 12 chronic diseases. We observed little association with diabetes mellitus, hypertension, and allergy. There were inverse relations between vegetable consumption and myocardial infarction [odds ratio (OR) = 0.79 for the highest tertile], angina pectoris (OR = 0.89), chronic bronchitis (OR = 0.69), bronchial asthma (OR = 0.70), peptic ulcer (OR = 0.74), gallstones (OR = 0.92), liver cirrhosis (OR = 0.71), kidney stones (OR = 0.68), and arthritis (OR = 0.84). Adjustment for alcohol and tobacco use made little difference.
There is no consistent evidence from epidemiological studies, although a modest excess risk emerged in case-control studies, that added sugars, dietary glycemic index and glycemic load are associated with increased risk of colon cancer, independently from their effect on energy intake, overweight, obesity and diabetes, which are related to excess colon cancer risk.