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<p>Supplementary Table 1. Characteristics of the Studies Included in the Male Breast Cancer Pooling Project</p>
<p>Supplementary Table 3: History of exposure to proton-pump inhibitors (PPIs) among cases and controls, according to different exposure definitions.</p>
The number of siblings is an indirect indicator of living and, possibly, dietary conditions in childhood and adolescence. The relationship between the number of siblings and subsequent gastric cancer risk was analysed using data from a case--control study conducted in Italy between 1985 and 1992 on 723 cases of incident, histologically confirmed gastric cancer and 2,024 controls in hospital for acute, non-neoplastic, non-digestive tract disorders. After allowance for age and sex, there was a significant trend of increasing gastric cancer risk with increasing number of siblings (P < 0.01). Compared with subjects with no siblings, the relative risk (RR) was 1.1 for those with one, 1.3 for 2, 1.4 for 3-6 and 1.7 for 7 or more siblings. The association was stronger in subjects above the age of 60: the RR for > or = 5 siblings was 1.8, as compared with 1.2 for younger subjects. These patterns of trends are consistent with the hypothesis that domestic crowding and deprivation in childhood and adolescence is a correlate of subsequent gastric cancer risk, and offer therefore interesting clues to our understanding of the process of gastric carcinogenesis.
The total duration of 'ovulatory activity' or 'ovulatory age' has been reported to be the strongest indicator of the risk of ovarian cancer. In the case-control study examined in this paper this variable was found to be a strong correlate of the risk of ovarian cancer. However, the finding that in older women the major determinant of 'ovulatory age' was age at menopause (which is a very unreliable indicator of 'ovarian activity'), and that age at menopause by itself was related to the risk of ovarian cancer as strongly as the total duration of ovulatory age, threw doubt on the biological consistency of that model. Furthermore, the protection conferred by pregnancies was different at different ages, and age at first pregnancy was more strongly associated with the risk of ovarian cancer than the actual number of pregnancies. The model of carcinogenesis for epithelial ovarian cancer appears, therefore, to be more complex than is indicated simply by the total duration of 'ovarian activity.'
We considered epidemiological data on overweight, diabetes, insulin, and breast cancer. Overweight is inversely related to premenopausal breast cancer, but there is definite evidence that, as compared with normal weight women, the relative risk (RR) for postmenopausal breast cancer is around 1.5 for overweight women and >2 for obese women, and that the association is stronger in elderly women. Overweight and obesity are strongly related to diabetes. Diabetes is associated with postmenopausal breast cancer, too, with summary RRs from meta-analyses of 1.15-1.20, but not with premenopausal breast cancer (RR, 0.9). There is no consistent evidence that fasting insulin is related to breast cancer risk. Thus, although overweight and obesity are strongly related to postmenopausal breast cancer, diabetes is only moderately related to it. Given the extent of the association, and the likely residual confounding by overweight, inference on causality for the diabetes-breast cancer relation remains open to discussion.
Letters7 October 2003Alcohol, Postmenopausal Hormones, and Breast CancerSilvano Gallus, ScD, Silvia Franceschi, MD, and Carlo La Vecchia, MDSilvano Gallus, ScDFrom Istituto di Ricerche Farmacologiche Mario Negri; 20157 Milan, Italy; International Agency for Research on Cancer; 69372 Lyon Cedex, France; and Istituto di Statistica Medica e Biometria, Universit degli Studi di Milano; 20133 Milan, Italy.Search for more papers by this author, Silvia Franceschi, MDFrom Istituto di Ricerche Farmacologiche Mario Negri; 20157 Milan, Italy; International Agency for Research on Cancer; 69372 Lyon Cedex, France; and Istituto di Statistica Medica e Biometria, Universit degli Studi di Milano; 20133 Milan, Italy.Search for more papers by this author, and Carlo La Vecchia, MDFrom Istituto di Ricerche Farmacologiche Mario Negri; 20157 Milan, Italy; International Agency for Research on Cancer; 69372 Lyon Cedex, France; and Istituto di Statistica Medica e Biometria, Universit degli Studi di Milano; 20133 Milan, Italy.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-139-7-200310070-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In the Nurses' Health Study cohort, Chen and colleagues (1) found an approximately 2-fold excess risk for breast cancer in women who currently used postmenopausal hormones and drank alcohol. However, the researchers were unable to consider high alcohol consumption. To address this issue, we analyzed data from 2 Italian case–control studies. The first was conducted between 1983 and 1991 in greater Milan (2), and the second was conducted between 1991 and 1994 in 6 centers in various regions of Italy (3). The studies involved 3573 postmenopausal women (median age, 61 years [range, 31 to 74 years]) with ...References1. Chen WY, Colditz GA, Rosner B, Hankinson SE, Hunter DJ, Manson JE, . Use of postmenopausal hormones, alcohol, and risk for invasive breast cancer. Ann Intern Med. 2002;137:798-804. [PMID: 12435216] LinkGoogle Scholar2. La Vecchia C, Negri E, Parazzini F, Boyle P, Fasoli M, Gentile A, . Alcohol and breast cancer: update from an Italian case–control study. Eur J Cancer Clin Oncol. 1989;25:1711-7. [PMID: 2632254] CrossrefMedlineGoogle Scholar3. Ferraroni M, Decarli A, Franceschi S, La Vecchia C. Alcohol consumption and risk of breast cancer: a multicentre Italian case–control study. Eur J Cancer. 1998;34:1403-9. [PMID: 9849424] CrossrefMedlineGoogle Scholar4. La Vecchia C, Pagano R, Negri E, Decarli A. Determinants of alcohol consumption in Italy [Letter]. Int J Epidemiol. 1987;16:295-6. [PMID: 3610459] CrossrefMedlineGoogle Scholar5. Ferraroni M, Decarli A, Franceschi S, La Vecchia C, Enard L, Negri E, . Validity and reproducibility of alcohol consumption in Italy. Int J Epidemiol. 1996;25:775-82. [PMID: 8921456] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Silvano Gallus, ScD; Silvia Franceschi, MD; Carlo La Vecchia, MDAffiliations: From Istituto di Ricerche Farmacologiche Mario Negri; 20157 Milan, Italy; International Agency for Research on Cancer; 69372 Lyon Cedex, France; and Istituto di Statistica Medica e Biometria, Universit degli Studi di Milano; 20133 Milan, Italy.Grant Support: By the Italian Association for Cancer Research, Milan, Italy. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoUse of Postmenopausal Hormones, Alcohol, and Risk for Invasive Breast Cancer Wendy Y. Chen , Graham A. Colditz , Bernard Rosner , Susan E. Hankinson , David J. Hunter , JoAnn E. Manson , Meir J. Stampfer , Walter C. Willett , and Frank E. Speizer Metrics Cited byHormone therapy and breast cancer: what factors modify the association? 7 October 2003Volume 139, Issue 7Page: 601-602KeywordsAlcohol consumptionAlcoholsBreast cancerCohort studiesEthanolHabitsHormonesMenopauseOdds ratioWine ePublished: 7 October 2003 Issue Published: 7 October 2003 Copyright & PermissionsCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Epidemiological studies on the relation between coffee consumption and cancer risk have been mainly focused on cancers of the urinary bladder, pancreas and colorectum. The relation between coffee and bladder cancer is controversial, despite a large number of studies published over the last three decades. In most studies, the risk tends to be higher in coffee drinkers than in those who do not drink coffee, but the excess risk is generally moderate and is neither dose- nor duration-related. Thus, a strong association between coffee drinking and bladder cancer can be excluded, although it is still unclear whether the weak association is causal or nonspecific and due to some bias or confounding. For pancreatic cancer, a possible association with coffee consumption has been postulated in a large case-control study published in 1981; since then, however, most studies have shown no substantial association, and overall evidence suggests that coffee is not materially related to pancreatic cancer risk. Overall evidence on the coffee-colorectal cancer relation suggests an inverse association, since most case-control studies found odds ratios below unity, particularly for colon cancer. The pattern of risk is less clear for cohort studies. A plausible biological explanation has been given in terms of coffee-related reduction of bile acids and neutral sterol secretion in the colon. For other cancer sites, including oral cavity, oesophagus, stomach, liver, breast, ovary, kidney and lymphoid neoplasms, the relation of coffee drinking with cancer risk has been less extensively investigated, but the evidence is largely reassuring.
aDepartment of Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri bOccupational Health, Universita` di Milano, Italy Correspondence to Professor Carlo La Vecchia, MD, Istituto Mario Negri, Via G. La Masa, 19, Milano 20156, Italy Tel: +39 02 3901 4527; fax: +39 02 3320 02321; e-mail: [email protected] Received June 20, 2011 Accepted June 24, 2011
