Publications

DEAR EDITOR, We read with interest the letter by Drs Chen and Zhang1 about our recent investigation, ‘Alcohol drinking and cutaneous melanoma risk: a systematic review and dose–risk meta-analysis’, published in the British Journal of Dermatology.2 With reference to the literature search, excluding studies published in languages other than English has generally little effect on summary effect estimates of meta-analyses.3–5 In our meta-analysis, we considered for inclusion only articles published as originals in English up to 30 April 2012. The contribution by Kvaskoff et al.6 was published in French as a conference abstract, and thus it did not satisfy our inclusion criteria. The article by Asgari et al.7 reported the results of the American VITamins And Lifestyle (VITAL) cohort study. It was published in the June 2012 issue of the Journal of Investigative Dermatology, and appeared online ahead of print on 1 March 2012. Unfortunately, our literature search did not retrieve this article, probably because it was fully indexed in Medline only on 18 July 2012. Still, for the sake of completeness, we have updated our meta-analysis by including it. None of the results materially change; in particular, the overall pooled relative risks (RRs) are 1.20 [95% confidence interval (CI) 1.07–1.35], 1.11 (95% CI 0.99–1.25) and 1.20 (95% CI 1.04– 1.38) for any (Fig. 1), light and moderate-to-heavy alcohol drinking, respectively, vs. no/occasional drinking. With the addition of the Asgari et al. study,7 stratified analyses from studies (n = 8) conducted in America showed an RR of 1.34 (95% CI 1.18–1.52), while no differences appeared in the RR of studies that did not adjust for sun exposure (RR 1.27, 95% CI 1.20–1.35), as in the study of Asgari et al.7 We disagree with the existence of a relevant bias by study quality. In fact, large cohort studies such as the U.K. Million Women Study8 and the U.S. Women’s Health Initiative9 reported an increased risk of cutaneous malignant melanoma (CMM) in alcohol drinkers, and the pooled risk estimates of our meta-analysis were similar for case–control and cohort studies. We agree with Drs Chen and Zhang that current evidence is insufficient to conclude for a causal association of CMM with alcohol consumption. As we pointed out in our review,2 caution in interpreting our results is required, as residual confounding by sun ultraviolet exposure cannot be ruled out. Future well designed studies with specific control for this potential confounder are needed to confirm, or not, our findings.

Time trends of mortality from digestive cancers in Italy during the period 1970-1989 were here studied either at the national level and for wide geographical areas (North, Center and South). Cancers of oral cavity and pharynx, of colon and rectum, of gallbladder and of the pancreas presented, during the considered period a generalized increasing trend. Stomach cancer mortality was decreasing in both sexes and in all areas, but a less marked rate of decrease appeared for younger cohorts, particularly for women. Trends almost stable, or contrasting across sexes and age classes, were observed for malignant tumours of the oesophagus and of the liver.

B‐cell development is a multistep process sustained by a highly coordinated transcriptional network under the control of a limited set of transcription factors. Epigenetic mechanisms, including DNA methylation, histone posttranslational modifications and microRNAs act in concert with transcription factors to promote lineage commitment, define and sustain cell identity and establish heritable cell‐type‐ and stage‐specific gene expression profiles. Epigenetic modifiers have recently emerged as key regulators of B‐cell development and activation. Central to B‐cell‐mediated immunity are germinal centers, transient structures formed in secondary lymphoid organs where antigen‐specific B cells undergo intense proliferation, immunoglobulin somatic hypermutation and isotype switching, to generate ultimately long‐lived memory B cells and terminally differentiated plasma cells expressing high‐affinity antibodies. Deregulation of one or more epigenetic axes represents a common feature of several B‐cell disorders arising from germinal center B cells, including autoimmunity and lymphoma. Moreover, the hijacking of epigenetic determinants is central to the ability of the B‐lymphotropic Epstein–Barr virus (EBV) to establish, via the germinal center reaction, life‐long latency and occasionally contribute to malignant B‐cell transformation. In the light of recent findings, this review will discuss the relevance of epigenetic deregulation in the pathogenesis of B‐cell diseases. Understanding how specific epigenetic alterations contribute to the development of lymphomas, autoimmunity and EBV‐associated disorders is instrumental to develop novel therapeutic interventions for the cure of these often fatal pathologies.

High-GI and high-GL diets are related to moderately increased risk of cancer at several common sites.

The difference in cigarette consumption between legal sale and self-reported data has substantially increased over the last two decades in Italy, reflecting increasing under-reporting of cigarette consumption mainly due to a decreasing social acceptability of smoking. Comparisons between interview-based and legal sale data are complicated by factors such as smuggling control and changes in the population (eg, increased proportion of immigrants); however these are able to justify only a small proportion of the gap found in Italy.

The relation between various measures of physical activity and colorectal cancer risk was considered in a case-control study conducted between 1992 and 1997 in the Swiss canton of Vaud. Cases were 223 patients (142 men, 81 women) below age 75, with colon (n = 119) or rectal (n = 104) cancer; controls were 491 patients (211 men, 280 women) admitted to hospital for acute, non-neoplastic conditions. Compared with the lowest level of physical activity at age 30-39 years, the odds ratios (OR) of colorectal cancer for the highest level were 0.44 (95% confidence interval, CI, 0.26-0.73) for occupational and 0.53 (95% CI 0.33-0.86) for leisure-time activity. An inverse association was also observed for physical activity at age 15-19 and 50-59 years. The inverse relation between physical activity and colorectal cancer was observed across strata of sex, age, education, body mass index and alcohol drinking; was somewhat stronger in subjects reporting high total energy, and low vegetable and fibre intakes; and was observed across various colon subsites and rectum. In terms of population attributable risk, increasing physical activity would avoid one-fifth to one-third of incident colorectal cancer cases.

<p>Metagenomic raw data at visit 1.</p>

The established risk factors for PC, including smoking, diabetes, family history of PC, and obesity, also apply to EOPC. Alcohol intake appeared to have an age-dependent effect; the strongest association was with VEOPC.

OBJETIVO: Se realizó un estudio poblacional para conocer las actitudes relacionadas con la Nueva Ley Italiana Antitabaco y el efecto sobre el consumo. MATERIAL Y MÉTODOS: Se analizó una muestra de 3 114 individuos mayores de 15 años representativos de la población general adulta italiana. RESULTADOS: Tras la entrada en vigor de las políticas antitabaquismo, el apoyo a ellas aumentó y además contribuyeron con 8% al descenso del consumo de cigarrillos en el corto plazo. Las prohibiciones antitabaco se aceptaron casi de modo unánime y al parecer no afectaron de manera desfavorable a restaurantes y cafeterías. CONCLUSIONES: Los resultados muestran las ventajas de esta nueva legislación, que puede tener importantes implicaciones en la salud pública.<br>OBJETIVE: A population-based survey was conducted to know the attitudes towards new Italian smoke-free regulations and its impact on tobacco consumption. MATERIAL AND METHODS: We considered 3 114 subjects aged 15 or over, representative of the general adult Italian population. RESULTS: Once smoke-free policies were introduced, support for them tended to increase. Smoke-free policies accounted for 8% decrease in cigarette consumption in the short run. Tobacco bans were almost universally accepted, and do not seem to unfavourably affect the business of restaurants or cafes. CONCLUSIONS: The results of our study, show the advantages of smoke-free legislations, which may have major public health implications.