Nutrition, social factors and prostatic cancer in a Northern Italian population.

The relationship between prostate cancer and indicators of nutrition, diet and social factors was evaluated in a case-control study of 166 patients with histologically confirmed prostatic carcinoma and 202 control subjects hospitalized for acute diseases other than malignant, hormonal or urogenital. The relative risk increased with increasing body mass index, men being moderately overweight showing a 2.3 elevated risk, and those grossly overweight an over four-fold higher risk of prostate cancer, when allowance was made for several identified potential confounding factors. Cases also reported more frequent consumption of milk and other dairy products and meat, but no significant difference was noted for vegetable intake. The risk of prostate cancer was unrelated to marital status or indicators of social class based on occupation

Trends in mortality from Hodgkin's disease in western and eastern Europe

Hodgkin's disease mortality rates steadily declined by about 75% between the late 1960's and the late 1990's in the current European Union countries and the USA, and Japan. Eastern European countries, however, showed only an approximately 40% decline between the late 1960's and the early 1990's, and no further fall thereafter

Genital warts and cervical neoplasia: an epidemiological study.

Cervical carcinoma and cervical intra-epithelial neoplasia (CIN) are likely to be associated with all sexually transmitted diseases (STDs). To help discover which (if any) of the recognised STDs might actually cause these conditions, a key question is whether one particular such association is much stronger than the others. The present study is therefore only of women newly attending an STD clinic, and compares the prevalences of cytological abnormalities of the cervix among 415 women attending with genital warts, 135 with genital herpes, and 458 with trichomoniasis or gonorrhoea. Significantly more genital wart patients (8.1%) than trichomoniasis or gonorrhoea patients (1.9%) showed dyskaryotic changes (adjusted relative risk (RR) = 5.8 with 95% limits 2.5-13.5) at, or a few months before, first attendance, while no excess whatever was seen in women with genital herpes. Moreover, half the women had a subsequent smear (at an average of 3-4 years after first attendance) and, although the diagnosis at first attendance was not related to the onset rate of dyskaryotic changes observed in these subsequent smears, it was related to the onset rate of grade III cervical intra-epithelial neoplasia (CIN III), which was found in 7 previous genital wart patients, in 2 previous trichomonas patients, but in 0 previous genital herpes patients. Thus, our findings suggest that herpes is not directly relevant to dyskaryotic change, but that one or more of the human papilloma viruses that cause genital warts may be

Selected medical conditions and risk of breast cancer.

Several diseases are known or suspected to be associated with altered levels of hormones and growth factors that may influence breast cancer risk. To elucidate this possibility, we studied the relationship between 23 medical conditions or procedures and breast cancer risk by means of data from a multicentric case-control study conducted between 1991 and 1994 in six Italian areas. The study included 2569 histologically confirmed incident cases of breast cancer (median age 55 years, range 23-74 years) and 2588 control women (median age 56 years, range 20-74 years) admitted to the same hospitals as cases for a variety of acute conditions unrelated to known or suspected risk factors for breast cancer. After allowance for education, parity and body mass index, elevated odds ratios (ORs) emerged for history of diabetes mellitus in post-menopausal women (OR = 1.5, 95% CI 1.1-2.0), hypertension in pregnancy (OR = 1.8, 95% CI 1.0-3.4) and breast nodules (OR = 1.3, 95% CI 1.0-1.7). Risk decreases were associated with ovarian ablation for ovarian cysts (OR = 0.5, 95% CI 0.3-0.7) and with thyroid nodules (OR = 0.7, 95% CI 0.5-0.9) but not with the combination of any type of benign thyroid disease. While most examined conditions seemed unrelated to breast cancer risk, the association with late-onset diabetes is of special interest as it suggests a role of hyperinsulinaemia and insulin resistance in breast cancer promotion. It also points to preventive lifestyle modifications

Smoking and drinking cessation and the risk of oesophageal cancer

In a case–control study from Italy and Switzerland with 404 oesophageal cancer cases and 1070 hospital controls, the risk of oesophageal cancer declined with time since cessation of smoking or drinking, and was significantly reduced (odds ratio = 0.11) 10 or more years after cessation of both habits. © 2000 Cancer Research Campaig

Aspirin use and cancers of the upper aerodigestive tract

The role of aspirin on the risk of cancers of the upper aerodigestive tract was investigated in the combined data of three Italian case-control studies, including 965 cases and 1779 hospital controls. The odds ratio was 0.33 for users of 65 5 years, and 0.51 for 65 5 years since first use

Effectiveness and healthcare cost of adding trastuzumab to standard chemotherapy for first-line treatment of metastatic gastric cancer: A population-based cohort study

A randomized clinical trial showed that trastuzumab, added to traditional chemotherapy, significantly improved overall survival in human epidermal growth factor receptor 2 (HER2)-overexpressing metastatic gastric cancer patients. This population-based study aimed at evaluating both the clinical and economic impact of trastuzumab in a real-world setting. By using the healthcare utilization databases of Lombardy, Italy, a cohort of patients newly diagnosed with metastatic gastric cancer during the period 2011–2016 was selected. Among these, patients initially treated with either trastuzumab-based chemotherapy or standard chemotherapy alone were followed up until death, migration in other regions or June 2018. Overall survival and average cumulative costs were estimated and compared between the two treatment arms. Among the 1198 metastatic gastric cancer patients who started therapy within six months after metastasis detection, 87 were initially treated with trastuzumab-based chemotherapy and 1111 with standard chemotherapy. Median overall survival and restricted mean survival were 10.2 and 7.4 months, and 14.9 and 11.4 months, respectively, in the two treatment arms. The adjusted hazard ratio of death was 0.73 (95% CI 0.57–0.93). The average per capita cumulative healthcare costs were, respectively, EUR 39,337 and 26,504, corresponding to an incremental cost-effectiveness ratio of EUR 43,998 for each year of survival gained. Our study shows that adding trastuzumab to conventional chemotherapy is effective and cost-effective

Monitoring falls in gastric cancer mortality in Europe

We have considered trends in age-standardized mortality from gastric cancer in 25 individual European countries, as well as in the European Union (EU) as a whole, in six selected central-eastern European countries and in the Russian Federation over the period 1950-1999. Steady and persisting falls in rates were observed, and the fall between 1980 and 1999 was ∼50% in the EU, 45% in eastern Europe and 40% in Russia. However, the declines were greater in Russia and eastern Europe, since rates were much higher, in absolute terms. Joinpoint regression analysis indicated that the falls were proportionally greater in the last decade for men (-3.83% per year in the EU) and in the last 25 years for women (-3.67% per year in the EU) than in previous calendar years. Moreover, steady declines in gastric cancer mortality were observed in the middle-aged and the young population as well, suggesting that they are likely to persist in the near future. In terms of number of deaths avoided, however, the impact of the decline in gastric cancer mortality will be smaller, particularly in the E