2,971 publications from this institution
This pooled analysis shows that long duration/low intensity smoking is associated with a greater increase in bladder cancer risk than short duration/high intensity smoking within equal pack-year categories, thus confirming studies in other smoking-related cancers and demonstrating that reducing exposure history to a single metric such as pack-years was too restrictive.
Most associations between PCBs and STS risk were not significant, but, given the limited sample size, we cannot exclude moderate associations.
The incidence of contralateral breast cancer is high and constant with age, around five per 1000 women who had a primary breast cancer. For other neoplasms, the pattern of incidence of second primary neoplasms with age is less known, particularly as for only a few neoplasms the site of origin is not totally removed, and hence remains at risk of a second primary. Using the dataset from the Cancer Registry of the Swiss Canton of Vaud, we show that the incidence of second neoplasms is constant with age also after oral and pharyngeal, colorectal cancers, cutaneous malignant melanoma (CMM) and basal cell carcinoma. The incidence of first primary oral and pharyngeal cancer increased 20-fold between age 30-39 and 70-89 years, whereas the incidence of second neoplasms did not increase with age. Rates of second colorectal cancer remained relatively constant with age, between 2.5 per 1000 at age 40-59 years and 3.8 per 1000 at 70 years and above. Likewise, for CMM, the age-specific incidence rates of second primary CMM did not vary, ranging between 1 and 2.5 per 1000 in various subsequent age groups. The pattern of incidence for second basal cell carcinoma was similar, with no clear rise with age. These patterns are compatible with the occurrence of a single mutational event in a population of susceptible individuals. A possible implication of these observations is that a variable, but potentially large, proportion of cancers arise in very high-risk individuals and the incidence, on average, increases at a high constant level at a predetermined age.
<h3>Background</h3> Knowledge on the role of the temporal pattern of exposure to asbestos in determining mortality from asbestosis is limited. We aim at investigating how the risk of death due to asbestosis changes according to the duration of employment and the time since the last employment (TSLE). <h3>Methods</h3> An historical cohort of workers from a former asbestos textile factory (active between 1946 and 84) was followed up until November 2013. For each subjects, we collected information on duration of the employment, TSLE, age and year of first employment, and sex. We estimated hazard ratios (HR) and 95% confidence intervals (CI) of death from asbestosis by fitting multivariable Cox regression models with age specified as the main temporal axis. <h3>Results</h3> We identified 51 deaths from asbestosis that occurred among 1823 workers (incidence rate of 74 cases per 1 00 000 person-years). The risk of death from asbestosis increased with increasing exposure duration (HR 3.0 [95%CI 1.3–7.6] for duration of employment ≥15 years compared to duration <5 years) and declined with TSLE (HR 0.3 [95%CI 0.1–0.9] for TSLE ≥25 compared to TSLE <5 years). We observed a strong decline of mortality due to asbestosis among workers firstly employed after 1968. <h3>Conclusions</h3> Information on the temporal pattern of exposure to asbestos is fundamental to estimate the individual risk of asbestosis. On the opposite of what overserved in ecological studies, the risk of death due to asbestosis declines steadily after cessation of exposure to asbestos.
The authors assessed the relation between cigarette smoking and nonspecific inflammatory bowel disease in a case-control study of 124 cases of ulcerative colitis, 109 cases of Crohn's disease, and 250 age- and sex-matched control subjects in hospital for acute nongastric or intestinal conditions unrelated to smoking. For ulcerative colitis, the risk for current smoking compared with never smoking was 0.5, with a 95% confidence interval (Cl) of 0.3-1.0. They observed decreasing risk with increasing number of cigarettes smoked. The risk for ex-smokers, however, was greater than that for never smokers (relative risk = 2.7; 95% Cl = 1.5-4.9). The elevated risk of ulcerative colitis in ex-smoking in the presence of an overall lack of association with ever-smoking may plausibly be attributed to either 1) brief induction time of a protective effect of smoking on ulcerative colitis or 2) selective cessation of smoking due perhaps to very early symptoms of the disease. If time at first onset of bowel symptoms, instead of clinical diagnosis, is considered as the index date, the negative association between ulcerative colitis and current smoking would have weakened in men and disappeared in the overall series. There was clear evidence of a positive association between cigarette smoking and Crohn's disease (relative risk for ever smokers vs. never smokers = 4.0; 95% Cl = 2.2-7.3). The risk estimates increased with the number of cigarettes smoked per day and duration of habit. The association between current smoking and Crohn's disease was even stronger when age at first onset of bowel symptoms was considered as the index date, but the risk for ex-smokers fell below unity.
The relation between breast feeding and breast cancer was investigated in a multicentric case-control study conducted in Italy on 2,167 parous women with histologically confirmed breast cancer, diagnosed within 1 year, and 2,208 parous control women admitted to hospitals in the same catchment areas of cases for acute, non-neoplastic, non-gynecological non-hormone-related diseases. Compared with women who had never tried to lactate, those who had always failed had a multivariate odds ratio (OR; adjusted for parity, education and several other potential confounding factors) of 0.94, and those who had lactated had an OR of 1.17. The multivariate ORs of women who had breast fed 1, 2 and 3 or more children were, respectively, 1.14, 1.18 and 1.32, compared with women who had never lactated. None of these ORs was statistically significant. Compared with women who had never breast fed, the multivariate ORs were 1.19 for women reporting less than 6 months of breast feeding, 1.15 for 6-11 months, 1.34 for 12-17 months, 1.10 for 18-23 months and 0.86 for 24 months or more. No appreciable difference was evident across strata of age, menopausal status, parity and age at first birth, while there was a hint of interaction with education. Our study therefore excluded any appreciable protective role for lactation in breast cancer risk, with the patterns of lactation in this European population, aside from the protective role of parity on breast carcinogenesis.
ItalianIn questo rapporto vengono presentati e discussi i tassi di mortalità per tumori in Italia nel 1979 sulla base dei dati di certificazione di morte pubblicati dall'Istituto Centrale di Statistica (ISTAT). Un modesto incremento si è registrato nei tassi globali standardizzati per età di mortalità per tutti i tumori non soltanto per i maschi (275,82 vs 271,71/100.000 del 1978 nel tasso troncato 35-64), ma anche per le femmine (161,82 vs 160,02/100.000 donne dai 35 ai 64 anni), dopo sei anni di continue diminuzioni della mortalità globale per tumori nelle donne giovani e di mezza età. Questi andamenti piuttosto sfavorevoli sono in larga misura attribuibili ad un diminuito tasso di decremento per quelle neoplasie che sono state in costante diminuzione nel corso degli ultimi tre decenni. In particolare, i tassi di certificazione di morte per i tumori del (collo) dell'utero sono rimasti totalmente stabili nelle donne giovani e di mezza età e la mortalità per carcinoma gastrico nelle femmine dai 35 ai 64 anni ha addirittura mostrato un leggero incremento. Analogamente, moderati aumenti si sono osservati nella mortalità per leucemie in giovane età in entrambi i sessi. Tra i tumori « altamente curabili », l'unico a mostrare consistenti diminuzioni è stato il morbo di Hodgkin. D'altra parte, sono continuate le tendenze all'aumento nella mortalità per tumori del polmone e degli altri organi associati al tabacco (cavo orale e faringe, laringe, esofago, rene e vescica), quantomeno negli uomini di mezza età o di età più avanzata, e, seppur in misura più limitata, anche nelle donne. Inoltre, nessun accenno a diminuzioni nella mortalità per carcinoma del polmone è per ora evidente neppure nei maschi più giovani (dai 35 ai 44 anni), il che appare in netto contrasto rispetto ai recenti andamenti in molti altri Paesi sviluppati. Aumenti si sono anche registrati per le neoplasie del fegato, dell'intestino e della pleura (i quali tuttavia non sono facilmente interpretabili a causa dei cambiamenti introdotti nella Nona Revisione della Classificazione Internazionale delle Malattie, entrata in uso nel 1979), e per i tumori della cute (melanomi) in giovane età per le femmine, mentre i tassi di mortalità sono rimasti praticamente stabili nel 1979 per le neoplasie della mammella, dell'ovaio e della prostata, quantomeno al di sotto dei 65 anni quando la certificazione di morte è più accurata.
