Oral contraceptives and primary liver cancer.

The relative risk for developing primary liver cancer in northern Italian users of oral contraceptives, compared to matched controls was calculated based on reported cases in hospitals in the greater Milan area from 1984-1987. The incidence of and mortality from primary liver cancer, as well as the prevalence of oral contraceptive usage, have both been rising to Italy since the late 1950s. 21 cases of liver cancer, in women aged 32-59 (median 50), occurred in the Milan area during the study period. These women, and 145 controls matched for age but admitted to hospitals for a variety of non-neoplastic diseases, were interviewed with a structured questionnaire covering socio-demographics, life style, diet, medical history, and history of use of oral contraceptives and other drugs. 19.0% of the cases had used oral contraceptives compared to 7.6% of controls, a relative risk of 1.8 for up to 5 years' use, and 8.3 for 5 years. History of hepatitis was associated with 14% of cases and 7% of controls. Italians have a higher incidence of liver neoplasms that northern Europeans and Americans, probably because of higher incidence of risk factors, such as hepatitis and alcohol use. The attributable risk for oral contraception, however, is lower in this population

Prevalence of COVID 19 like symptoms in Italy and Lombardy, March-April 2020, and their implications on cancer prevention, diagnosis and management

Two population-based surveys on coronavirus disease-2019 (Covid-19)-like symptoms were conducted by BVA-Doxa on representative samples of the general population from Italy and its largest region, Lombardy, with over 10 million inhabitants and heavily struck by Covid-19, on 27-30 March and 3-7 April, on a total of 2000 individuals - 353 from Lombardy. Overall, 14.2% of Italians - and 19.6% in Lombardy - reported Covid-19-like symptoms. The estimated prevalence was higher in the young, in smokers, and in Lombardy over the period 20 March to 7 April. Although the influenza season was ended by mid-March, at least part of the symptoms may be not Covid-19 related. Even assuming that only half are, at least 7% of Italians and 10% in Lombardy had been affected by Covid-19. To these, asymptomatic or paucisymptomatic cases have to be added. These estimates are at least one or two orders of magnitude larger than official registered cases. This has major implications for cancer prevention, management and treatment

Declining mortality from kidney cancer in Europe

Mortality rates from kidney cancer increased throughout Europe up until the late 1980s or early 1990s. Trends in western European countries, the European Union (EU) and selected central and eastern European countries have been updated using official death certification data for kidney cancer abstracted from the World Health Organisation (WHO) database over the period 1980-1999. In EU men, death rates increased from 3.92 per 100 000 (age standardised, world standard) in 1980-81 to 4.63 in 1994-95, and levelled off at 4.15 thereafter. In women, corresponding values were 1.86 in 1980-81, 2.04 in 1994-95 and 1.80 in 1998-99. Thus, the fall in kidney cancer mortality over the last 5 years was over 10% for both sexes in the EU. The largest falls were in countries with highest mortality in the early 1990s, such as Germany, Denmark and the Netherlands. Kidney cancer rates levelled off, but remained very high, in the Czech Republic, Baltic countries, Hungary, Poland and other central European countries. Thus, in the late 1990s, a greater than three-fold difference in kidney cancer mortality was observed between the highest rates in the Czech Republic, the Baltic Republics and Hungary, and the lowest ones in Romania, Portugal and Greece. Tobacco smoking is the best recognised risk factor for kidney cancer, and the recent trends in men, mainly in western Europe, can be related to a reduced prevalence of smoking among men. Tobacco, however, cannot account for the recent trends registered in wome

Continuing declines in cancer mortality in the European Union

Background: From 1988 to 1997 age-standardised total cancer mortality rates in the European Union (EU) fell by around 9% in both sexes. Available cancer mortality data in Europe up to 2002 allow a first check of the forecast of further declines in cancer mortality. Patients and methods: We considered trends in age-standardised mortality from major cancer sites in the EU during the period 1980-2002. Results: For men, total cancer mortality, after a peak of 191.1/100 000 in 1987 declined to 177.8 in 1997 (−7%), and to 166.5 in 2002. Corresponding figures for females were 107.9/100 000, 100.5 and 95.2, corresponding to falls of 7% from 1987 to 1997, and to 5% from 1997 to 2002. Over the last 5 years, lung cancer declined by 1.9% per year in men, to reach 44.4/100 000, but increased by 1.7% in women, to reach 11.4. In 2002, for the first year, lung cancer mortality in women was higher than that for intestinal cancer (11.1/100 000), and lung cancer became the second site of cancer deaths in women after breast (17.9/100 000). From 1997 to 2002, appreciable declines were observed in mortality from intestinal cancer in men (−1.6% per year, to reach 18.8/100 000), and in women (−2.5%), as well as for breast (−1.7% per year) and prostate cancer (−1.4%). Conclusions: Despite the persisting rises in female lung cancer, the recent trends in cancer mortality in the EU are encouraging and indicate that an 11% reduction in total cancer mortality from 2000 to 2015 is realistic and possibl

Lung cancer mortality in European women: recent trends and perspectives

Background: Lung cancer mortality in men has been declining since the late 1980s in most European countries. In women, although rates are still appreciably lower than those for men, steady upward trends have been observed in most countries. To quantify the current and future lung cancer epidemic in European women, trends in lung cancer mortality in women over the last four decades were analyzed, with specific focus on the young. Patients and methods: Age-standardized (world standard) lung cancer mortality rates per 100 000 women—at all ages, and truncated 35-64 and 20-44 years—were derived from the WHO for the European Union (EU) as a whole and for 33 separate European countries. Joinpoint regression analysis was used to identify points where a significant change in trends occurred. Results: In the EU overall, female lung cancer mortality rates rose by 23.8% between 1980-1981 and 1990-1991 (from 7.8 to 9.6/100 000), and by 16.1% thereafter, to reach the value of 11.2/100 000 in 2000-2001. Increases were smaller in the last decade in several countries. Only in England and Wales, Latvia, Lithuania, Russia and Ukraine did female lung cancer mortality show a decrease over the last decade. In several European countries, a decline in lung cancer mortality in young women (20-44 years) was observed over the last decade. Conclusions: Although female lung cancer mortality is still increasing in most European countries, the more favorable trends in young women over recent calendar years suggest that if effective interventions to control tobacco smoking in women are implemented, the lung cancer epidemic in European women will not reach the levels observed in the US

Selected physical activities and the risk of endometrial cancer.

The relationship between various indicators of physical activity and endometrial cancer risk was analysed using data of a case-control study conducted in 1988-1991 in Switzerland and Italy on 274 histologically confirmed cases and 572 controls admitted to hospital for acute, non neoplastic, non hormone-related diseases. Using a self-rated assessment of total physical activity, there was a systematic tendency for the cases to report more frequently 'low' or 'very low' physical activity. The relative risks were similar for 'very high' or 'moderately high' physical activity, but increased in the two lowest levels, with point estimates, in various decades of age, between 1.3 and 2.3 for 'moderately low' and over 2.5 for 'very low' physical activity. Although the association was apparently stronger at older ages, all the trends in risk were significant. Allowance for major identified potential distorting factors, including body mass index and a measure of total energy intake, could explain only in part the association, and the inverse trends in risk remained statistically significant. When selected types of physical activity were analysed, no association was observed with climbing stairs or walking, but the risk estimates for the lowest level of activity was over 4 for housework, and between 1.5 and 1.9 for sport and leisure and occupational activity. Thus, the present findings suggest that a moderate or high physical activity is an indicator of reduced endometrial cancer risk, although this observation still requires epidemiologic confirmation and clearer definition from a pathogenic point of view

Risk factors for colorectal cancer in subjects with family history of the disease.

The relationship between lifestyle factors, past medical conditions, daily meal frequency, diet and the risk of 'familial' colorectal cancer has been analysed using data from a case-control study conducted in northern Italy. A total of 1584 colorectal cancer patients and 2879 control subjects were admitted to a network of hospitals in the Greater Milan area and the Pordenone province. The subjects included for analysis were the 112 cases and the 108 control subjects who reported a family history of colorectal cancer in first-degree relatives. Colorectal cancer cases and control subjects with family history were similarly distributed according to sex, age, marital status, years of schooling and social class. Familial colorectal cancer was associated with meal frequency, medical history of diabetes (relative risk, RR = 4.6) and cholelithiasis (RR = 5.2). Significant positive trends of increasing risk with more frequent consumption were observed for pasta (RR = 2.5, for the highest vs the lowest intake tertile), pastries (RR = 2.4), red meat (RR = 2.9), canned meat (RR = 1.9), cheese (RR = 3.5) and butter (RR = 1.9). Significant inverse associations and trends in risk were observed for consumption of poultry (RR = 0.4), tomatoes (RR = 0.2), peppers (RR = 0.3) and lettuce (RR = 0.3). Significant inverse trends in risk with increasing consumption for beta-carotene and ascorbic acid were observed (RR = 0.5 and 0.4 respectively, highest vs lowest intake tertile). These results suggest that risk factors for subjects with a family history of colorectal cancer in first-degree relatives are not appreciably different from recognized risk factors of the disease in the general population