Cancer mortality among children in Switzerland was analysed using (1) age-specific and age-standardized (0-14) rates from 1951 to 1984 and (2) comparison of observed numbers of deaths over the period 1960-1984 with expected one obtained by application of age-specific rates for the period 1951-1959 to the population structure of subsequent 5-year calendar periods. Certified mortality fell about 60% for leukaemias, 21% for lymphomas, 66% for Wilms' tumours, 40% for bone sarcomas and 30% for other and unspecified sites. Thus, the overall decline in childhood cancer mortality in Switzerland was around 45%, slightly more marked in females (-48%) than in males (-42%), and more pronounced in younger children (over 50% before age 5). This corresponds to an absolute number of about 50 deaths from childhood cancer per year avoided in the early 1980s as compared with expected numbers computed on the basis of rates registered in the 1950s (30 deaths per year for leukaemias alone). The estimated total number of deaths avoided during the whole period 1960-1980 was 820 (430 leukaemias alone). Trends in childhood cancer mortality persisted steadily downwards in the early 1980s, suggesting that further progress is being achieved in the treatment of these neoplasms.
To evaluate the risk factors for serous, mucinous and endometrioid ovarian cysts, data were collected in a case-control study conducted in the greater Milan area based on 202 women with benign cysts (114 endometrioid and 88 serous or mucinous) of the ovary and 1127 controls. Questions were asked about menstrual and reproductive characteristics, marital status, education, history of various diseases, and lifetime use of oral contraceptives and other hormonal treatments. Higher social class, earlier menarche and longer interval between age at first marriage and first birth, a likely indicator of subfertility, were associated with an increased risk of serous, mucinous and endometrioid cysts. Women with endometrioid cyst were characterized by low parity, less frequent irregular or long menses, more frequent oral contraceptive use and low body mass index, while the most relevant risk factor associated with serous and mucinous cysts was greater age at first birth. The present data point out the epidemiological differences between endometrioid and serous or mucinous cysts. Further, they suggest that analyses of risk factors for epithelial ovarian cancer subdivided by various histotypes may be of interest in order to confirm possible heterogeneities in the aetiology of ovarian epithelial neoplasms.
The decline in childhood cancer mortality in Italy from 1955 to 1980 has been evaluated through (1) comparison of age-specific and age-standardized (0-14 years) rates for the periods 1955-1960 and 1979-1980 and (2) computation of expected numbers of deaths by application of the age-specific rates for the period 1955-1960 to the population structure of subsequent periods. Certified mortality fell by 35% for leukaemias, 90% for Hodgkin's disease, 30% for non-Hodgkin's lymphomas, 40% for bone sarcomas, 30% for kidney (Wilms') tumours, 65% for retinoblastoma. No clear trend was reported for other neoplasms, including neuroblastoma. About 300 cancer deaths per year were avoided in the period 1979-1980 compared with the expected number based on the 1955-1960 rates (170 for leukaemias alone). Although clearly encouraging, these trends are substantially less favourable than those from several other developed countries. It is therefore likely that several dozen other deaths from childhood cancer could be avoided each year through earlier (or more accurate) application of effective therapies, particularly for neoplasms requiring radiotherapy or surgical treatment.
The interim results of a case-control study of myocardial infarction in women below age 55 years conducted in northern Italy since January 1983 are presented, based on 168 cases of acute myocardial infarction and 251 hospital controls. Cigarette smoking was strongly related to myocardial infarction, with risk estimates elevated more than 10-fold for heavy (more than 25 cigarettes per day) smokers. Smoking-related relative risks were of similar magnitude in younger (less than 45 years) and in perimenopausal (45-54 years) women and were largely unaffected by allowance for several potential distorting factors. Other factors independently and strongly related to the risk of myocardial infarction were diabetes, hypertension, and history of coronary heart disease in more than one first-degree relative. Relative risks were also elevated in women who gave birth to their first child earlier (below age 20 years) and in oral contraceptive users. However, these estimates were not significant. The apparent positive associations with clinical history of hyperlipidemia, hypertension in pregnancy, and heavy coffee consumption could be explained largely in terms of confounding, but the protection conveyed by moderate alcohol consumption remained after multivariate analysis. Thus, the interim results of this investigation in a low incidence population confirm the importance of several risk factors previously described in data collected in Northern Europe and the United States. Furthermore, possibly because of the low baseline risk, the proportion of cases attributable to smoking in middle-aged women in this population may be even larger than that previously reported from higher incidence areas.
Background: Factors linked to glucose metabolism play an impor-tant role in the development of cancers, and both glycemic index (GI) and glycemic load (GL) have been investigated as potential etiologic factors. Objective: A meta-analysis was performed to explore the associa-tion between GI and GL and cancer risk from published studies. Design: A comprehensive, systematic bibliographic search of the medical literature was conducted to identify relevant studies. Case-control and cohort studies published before October 2007 that re-ported cancer risk estimates for GI and GL were included. Pooled relative risks (RRs) were estimated for breast, colorectal, endome-trial, and pancreatic cancer. Results: Thirty-nine studies were included in the meta-analysis. The interquantile ranges of GL were significantly wider in case-control studies, most of which were conducted in European countries, than in cohort studies. Cohort studies that presented lower ranges of GL also reported lower risk estimates. Overall, both GL and GI were significantly associated with a greater risk of colorectal (summary RR 1.26; 95 % CI: 1.11, 1.44 and RR 1.18; 95 % CI: 1.05, 1.34, respectively) and endometrial (RR 1.36; 95 % CI: 1.14, 1.62 and RR 1.22; 95 % CI: 1.01, 1.49) cancer than of breast and pancreatic cancer. There was, however, a significant between-study heteroge-neity for colorectal cancer (P 0.0001). The association between GL and breast cancer disappeared when publication bias was taken into account. No association was found for pancreatic cancer. Conclusion: This comprehensive meta-analysis of GI and GL and cancer risk suggested an overall direct association with colorectal and endometrial cancer. Am J Clin Nutr 2008;87:1793–801.
The relationship between the consumption of salt and the risk of gastrointestinal cancer was examined using data from a case-control study conducted in northern Italy. The study was conducted on 526 incident cases of gastric cancer, 621 of colon cancers, 382 of rectal cancers, and 1,223 controls admitted to hospital for acute, nonneoplastic, nondigestive tract disorders. Compared with those for people with low salt intakes, the relative risks (and 95% confidence intervals) for those with intermediate and high salt intakes were 1.3 (1.0-1.8) and 1.2 (0.8-1.7) for stomach, 1.0 (0.8-1.3) and 1.1 (0.8-1.5) for colon, and 1.2 (0.9-1.6) and 0.9 (0.6-1.3) for rectum. None of the trends in risk were statistically significant, and the risk estimates were not materially modified by allowance for major identified potential confounding factors. Thus, this study gives little support to the existence of any strong association between salt intake and gastrointestinal cancers. However, in view of the results obtained and of the uncertainties of salt intake measurement, the possibility exists of a real, although moderate, association of salt intake with gastric cancer.
