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Find video protocols related to scientific articles indexed in Pubmed.
Association between dietary inflammatory index and prostate cancer among Italian men.
Br. J. Nutr.
PUBLISHED: 11-18-2014
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Previous studies have shown that various dietary components may be implicated in the aetiology of prostate cancer, although the results remain equivocal. The possible relationship of inflammation derived from dietary exposures with prostate cancer risk has not been investigated. We examined the ability of a newly developed dietary inflammatory index (DII) to predict prostate cancer risk in a case-control study conducted in Italy between 1991 and 2002. A total of 1294 patients aged < 75 years with incident, histologically confirmed carcinoma of the prostate served as cases. A total of 1451 subjects aged < 75 years who were admitted to the same hospitals as cases for a wide spectrum of acute, non-neoplastic conditions served as controls. The DII was computed based on dietary intake assessed using a previously validated seventy-eight-item FFQ. Logistic regression models were used to estimate multivariable OR adjusted for age, study centre, years of education, social class, BMI, smoking status, family history of prostate cancer and total energy intake. Men with higher DII scores had a higher risk of prostate cancer when analysed using the DII as both continuous (OR 1·06, 95 % CI 1·00, 1·13) and categorical, i.e. compared with men in the lowest quartile of the DII, men in the third and fourth quartiles were at elevated risk (ORQuartile 3 v. 1 1·32, 95 % CI 1·03, 1·69 and ORQuartile 4 v. 1 1·33, 95 % CI 1·01, 1·76; P trend= 0·04). These data suggest that a pro-inflammatory diet, as indicated by the increasing DII score, is a risk factor of prostate cancer in Italian men.
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Effectiveness of Trastuzumab in First-Line HER2+ Metastatic Breast Cancer After Failure in Adjuvant Setting: A Controlled Cohort Study.
Oncologist
PUBLISHED: 10-31-2014
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The evidence supporting the use of trastuzumab (T) in a metastatic setting comes from studies that included (almost) only patients who never received prior T. We investigated the effectiveness of T as first-line therapy for metastatic breast cancer (mBC) in women previously treated with T in the adjuvant setting.
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Sarcoidosis and cancer risk: systematic review and meta-analysis of observational studies.
Chest
PUBLISHED: 10-24-2014
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Background.An increased cancer risk in sarcoidosis patients has been suggested, although results are conflicting in a number of case-control and cohort studies. We conducted a systematic review of all available data and performed a meta-analysis to better define and quantify the association between sarcoidosis and cancer. Methods.We searched Medline and Embase for all original articles on cancer and sarcoidosis published up to January 2013. Two independent authors reviewed all titles/abstracts to identify studies according to predefined selection criteria. We derived summary estimates using random effects model and reported as relative risk (RR). Publication bias was evaluated by using funnel plot and was quantified by Egger's test. Results.Sixteen original studies, involving more than 25,000 patients, were included in the present review. The summary RR to develop all invasive cancers was 1.19 (95% CI, 1.07-1.32). The results for selected cancer sites indicated a significant increased risk of skin (RR 2.00; 95% CI, 1.69-2.36), haematopoietic (RR 1.92; 95% CI, 1.41-2.62), upper digestive tract (RR 1.73; 95% CI, 1.07-2.79), kidney (RR 1.55; 95% CI, 1.21-1.99), liver (RR 1.79; 95% CI, 1.03-3.11) and colorectal cancers (1.33; 95% CI, 1.07-1.67). There was no evidence of publication bias for all cancers (p=0.8), nor for any specific cancer site. Conclusions.The present meta-analysis suggests a significant, though moderate, association between sarcoidosis and malignancy.
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Relation between national-level tobacco control policies and individual-level voluntary home smoking bans in Europe.
Tob Control
PUBLISHED: 10-23-2014
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Little is known about the relationship between national tobacco control policies and implementation of private home smoking bans.
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Mediterranean diet and non-fatal acute myocardial infarction: a case-control study from Italy.
Public Health Nutr
PUBLISHED: 10-21-2014
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To add epidemiological data on the association of adherence to the Mediterranean diet with non-fatal acute myocardial infarction (AMI) in a Southern European population.
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Prevention and early detection of prostate cancer.
Lancet Oncol.
PUBLISHED: 10-05-2014
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Prostate cancer is a common malignancy in men and the worldwide burden of this disease is rising. Lifestyle modifications such as smoking cessation, exercise, and weight control offer opportunities to reduce the risk of developing prostate cancer. Early detection of prostate cancer by prostate-specific antigen (PSA) screening is controversial, but changes in the PSA threshold, frequency of screening, and the use of other biomarkers have the potential to minimise the overdiagnosis associated with PSA screening. Several new biomarkers for individuals with raised PSA concentrations or those diagnosed with prostate cancer are likely to identify individuals who can be spared aggressive treatment. Several pharmacological agents such as 5?-reductase inhibitors and aspirin could prevent development of prostate cancer. In this Review, we discuss the present evidence and research questions regarding prevention, early detection of prostate cancer, and management of men either at high risk of prostate cancer or diagnosed with low-grade prostate cancer.
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Model-based patterns in stomach cancer mortality worldwide.
Eur. J. Cancer Prev.
PUBLISHED: 09-27-2014
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The decrease in stomach cancer mortality was not because of specific interventions, and is likely that different countries follow a similar model of variation. Here, we aimed to identify model-based patterns in the time trends of stomach cancer mortality worldwide. Stomach cancer mortality rates were retrieved for 62 countries from the WHO mortality database. Sex-specific mixed models were used to describe time trends in age-standardized rates between 1980 and 2010 (age group 35-74 years; World standard population). Three patterns, similar for men and women, were identified through model-based clustering. Pattern 1 presented the highest mortality rates in 1980 (median: men, 81.5/100 000; women, 34.4/100 000) and pattern 3 the lowest ones (median: men, 24.4/100 000; women, 12.4/100 000). The decrease in mortality rates was greater in 1980-1995 than during 1996-2010. Assuming that the patterns characterized by the highest rates precede temporally those with lower mortality, the overlap of model predictions supports a 20-year lag between adjacent patterns. We propose a model for the variation in stomach cancer mortality with three stages that develop sequentially through a period of ?70 years. The countries with the lowest mortality had the highest proportional decrease in mortality rates.
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MEDITERRANEAN WAY OF DRINKING AND LONGEVITY.
Crit Rev Food Sci Nutr
PUBLISHED: 09-11-2014
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ABSTRACT The relation between alcohol consumption and mortality is a J-shaped curve in most of the many studies published on this topic. The Copenhagen Prospective Population Studies demonstrated in the year 2000 that wine intake may have a beneficial effect on all cause mortality that is additive to that of alcohol. Wine contains various poliphenolic substances which may be beneficial for health and in particular flavonols (such as myricetin and quercetin), catechin and epicatechin, proanthocyanidins, anthocyanins, various phenolic acids and the stilbene resveratrol. In particular, resveratrol seems to play a positive effect on longevity because it increases the expression level of Sirt1, besides its antioxidant, anti-inflammatory and anticarcinogenic properties. Moderate wine drinking is part of the Mediterranean diet, together with abundant and variable plant foods, high consumption of cereals, olive oil as the main (added) fat and a low intake of (red) meat. This healthy diet pattern involves a "Mediterranean way of drinking", that is a regular, moderate wine consumption mainly with food (up to two glasses a day for men and one glass for women). Moderate wine drinking increases longevity, reduces the risk of cardiovascular diseases and does not appreciably influence the overall risk of cancer.
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Etiologic heterogeneity among non-Hodgkin lymphoma subtypes: the InterLymph Non-Hodgkin Lymphoma Subtypes Project.
J. Natl. Cancer Inst. Monographs
PUBLISHED: 09-01-2014
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Non-Hodgkin lymphoma (NHL) comprises biologically and clinically heterogeneous subtypes. Previously, study size has limited the ability to compare and contrast the risk factor profiles among these heterogeneous subtypes.
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Rationale and Design of the International Lymphoma Epidemiology Consortium (InterLymph) Non-Hodgkin Lymphoma Subtypes Project.
J. Natl. Cancer Inst. Monographs
PUBLISHED: 09-01-2014
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Non-Hodgkin lymphoma (NHL), the most common hematologic malignancy, consists of numerous subtypes. The etiology of NHL is incompletely understood, and increasing evidence suggests that risk factors may vary by NHL subtype. However, small numbers of cases have made investigation of subtype-specific risks challenging. The International Lymphoma Epidemiology Consortium therefore undertook the NHL Subtypes Project, an international collaborative effort to investigate the etiologies of NHL subtypes. This article describes in detail the project rationale and design.
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Support for a tobacco endgame strategy in 18 European countries.
Prev Med
PUBLISHED: 08-10-2014
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The feasibility of a tobacco endgame strategy, aiming to bring smoking prevalence to near-zero levels, is currently under debate. We provide information on public support for such a strategy in Europe.
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Thyroid cancer mortality and incidence: A global overview.
Int. J. Cancer
PUBLISHED: 08-01-2014
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In most areas of the world, thyroid cancer incidence has been appreciably increasing over the last few decades, whereas mortality has steadily declined. We updated global trends in thyroid cancer mortality and incidence using official mortality data from the World Health Organization (1970-2012) and incidence data from the Cancer Incidence in Five Continents (1960-2007). Male mortality declined in all the major countries considered, with annual percent changes around -2/-3% over the last decades. Only in the United States mortality declined up to the mid 1980s and increased thereafter. Similarly, in women mortality declined in most countries considered, with APCs around -2/-5% over the last decades, with the exception of the UK, the United States and Australia, where mortality has been declining up to the late 1980s/late 1990s to level off (or increase) thereafter. In 2008-2012, most countries had mortality rates (age-standardized, world population) between 0.20 and 0.40/100,000 men and 0.20 and 0.60/100,000 women, the highest rates being in Latvia, Hungary, the Republic of Moldova and Israel (over 0.40/100,000) for men and in Ecuador, Colombia and Israel (over 0.60/100,000) for women. In most countries, a steady increase in the incidence of thyroid cancer (mainly papillary carcinomas) was observed in both sexes. The declines in thyroid cancer mortality reflect both variations in risk factor exposure and changes in the diagnosis and treatment of the disease, while the increases in the incidence are likely due to the increase in the detection of this neoplasm over the last few decades.
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E-Cigarette Awareness, Use, and Harm Perception in Italy: A National Representative Survey.
Nicotine Tob. Res.
PUBLISHED: 07-31-2014
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Only a few studies provided information on awareness, use, and harm perception of e-cigarettes in Europe. We fill the knowledge gap in Italy.
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Age-specific incidence of all neoplasms after colorectal cancer.
Ann Epidemiol
PUBLISHED: 07-30-2014
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Patients diagnosed with a specific neoplasm tend to have a subsequent excess risk of the same neoplasm. The age incidence of a second neoplasm at the same site is approximately constant with age, and consequently the relative risk is greater at younger age. It is unclear whether such a line of reasoning can be extended from a specific neoplasm to the incidence of all neoplasms in subjects diagnosed with a defined neoplasm.
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Overweight and obesity in 16 European countries.
Eur J Nutr
PUBLISHED: 07-22-2014
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In Europe, only a few population-based studies have been conducted on obesity in different countries at the same time using homogeneous methodologies. We provide updated information on the prevalence of overweight and obesity in Europe, using data from a pan-European survey.
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Hepatocellular carcinoma epidemiology.
Best Pract Res Clin Gastroenterol
PUBLISHED: 06-26-2014
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Primary liver cancer (namely hepatocellular carcinoma, HCC) is worldwide the fifth most common cancer in men and the seventh one in women, and it represents the third most frequent cause of cancer death. HCC rates are particularly high in eastern/south-eastern Asia and in Africa, intermediate in Southern Europe, and low in most high-income countries. Persistent infections by HBV or HCV are the main recognized risk factors for HCC. Aflatoxin exposure is also an important risk factor for HCC development in Africa and eastern Asia. In high-income countries heavy alcohol drinking, tobacco smoking, overweight, diabetes, familial/genetic factors, and selected dietary aspects, have a relevant role. Updated geographic patterns and time trends in mortality from HCC in Europe, USA, Japan, and Australia are provided in the present review, together with an overview of relevant etiologic factors for HCC and main measures for the prevention of this neoplasm.
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The weekend effect in patients hospitalized for upper gastrointestinal bleeding: a single-center 10-year experience.
Eur J Gastroenterol Hepatol
PUBLISHED: 05-23-2014
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This study was conducted to assess the possible weekend effect in patients with upper gastrointestinal bleeding (UGIB) on the basis of a 10-year single-center experience in Serbia.
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Spectrum of pediatric cancers in Mozambique: an analysis of hospital and population-based data.
Pediatr Hematol Oncol
PUBLISHED: 05-22-2014
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The existing data provide little detail about the epidemiology of pediatric cancers in Mozambique. We aimed at characterizing the spectrum of pediatric cancers (0-14 years) diagnosed in Mozambique in two different calendar periods. Data were obtained from the Pathology Department of the Maputo Central Hospital (DP-HCM) (1999-2000 and 2009-2010), which receives virtually all samples for histopathological diagnosis in Maputo, with the exception of leukemia, and from the population-based Cancer Registry of Beira (2009-2010). In 1999-2000, the DP-HCM diagnosed 61 cancers. Burkitt lymphoma, malignant bone tumors, and rhabdomyosarcomas accounted for 24.6%, 11.5%, and 9.8% of all cases, respectively. In 2009-2010, the number of cancers increased to 150, reflecting a two- to threefold increase in the proportion of Kaposi sarcomas, non-Hodgkin lymphomas, nephroblastomas, and neuroblastomas. In 2009-2010, the Cancer Registry of Beira registered 34 cases, corresponding to an incidence rate of 9.7/100,000 inhabitants in this age group; Kaposi sarcomas, lymphomas, retinoblastomas, and nephroblastomas accounted for 29.4%, 23.5%, 8.8%, and 8.8% of all cases, respectively. These data show that pediatric cancers account for an appreciable burden in Mozambique, probably reflecting a high frequency of HIV-associated cancers and improved access to diagnosis, and highlight the potential for improving surveillance in this low resource setting.
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Gastric cancer and allium vegetable intake: a critical review of the experimental and epidemiologic evidence.
Nutr Cancer
PUBLISHED: 05-12-2014
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There are suggestions of an anticancerogenic effect of allium vegetables and their associated organosulfur components against several cancer types, including gastric cancer, but the issue remains open to discussion and quantification. The present critical review discussed the history, the health properties, the chemistry, the anticancerogenic evidences from experimental studies, and the anticancer mechanisms of allium vegetables. We also summarized findings from epidemiological studies concerning the association between different types of allium vegetables and gastric cancer risk, published up to date. Available data, derived mainly from case-control studies, suggested a favorable role of high intakes of allium vegetables, mainly garlic and onion, in the etiology of gastric cancer. In particular, of 10 studies, 7 suggested a favorable role of high intake of total allium vegetables and gastric cancer. All 14 studies on garlic and most studies on onion (more than 80%) reported a beneficial role of these allium types against gastric cancer. However several limitations, including possible publication bias and the difficulty to establish a dose-risk relationship, suggest caution in the interpretation. Evidences on other types of allium vegetables, as well as on the influence of different gastric cancer anatomical and histological types, are less consistent.
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Chinchón declaration; decalogue on low- and no-calorie sweeteners (LNCS).
Nutr Hosp
PUBLISHED: 04-01-2014
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Multidisciplinary experts in the areas of nutrition and health met in Chinchón, Madrid, on November 25-26, 2013 under the auspices of the Fundación para la Investigación Nutricional (Nutrition Research Foundation) and with the collaboration of the Madrid Regional Government's Health Ministry, the International Sweeteners Association and the Carlos III Health Institute CIBER of Physiopathology of Obesity and Nutrition. They analyzed the current status of scientific knowledge on low- and no-calorie sweeteners (LNCS) and developed a consensus Decalogue on their use; this constitutes the Chinchón Declaration. Sweeteners, including sugar, represent a subject of undeniable interest and are currently a popular topic, although areas relating to their safety and benefits remain unknown to segments of academia and the general public. The nature of LNCS makes them vulnerable to biased and even contradictory information. They are food additives that are broadly used as sugar substitutes to sweeten foods, medicines and food supplements when non-nutritional or non-caloric alternatives are needed. The Chinchón Decalogue is the outcome of a meeting for reflection and consensus by a group of experts with backgrounds in different scientific disciplines (toxicology, clinical nutrition, community nutrition, physiology, food science, public health, pediatrics, endocrinology and nutrition, nursing, pharmaceutical care and food legislation). The Decalogue includes different aspects of LNCS related to regulation, use, benefits and safety. In general, benefits of LNCS have been traditionally neglected in comparison with the tendency for emphasising unexisting or unproven possible risks. The need to strengthen research on LNCS in Spain was emphasized, as well as the need to educate both professionals and the public.
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Alcohol drinking and risk of leukemia-a systematic review and meta-analysis of the dose-risk relation.
Cancer Epidemiol
PUBLISHED: 03-25-2014
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The association between alcohol and leukemia risk has been addressed in several studies in the past two decades, but results have been inconsistent. Therefore, we conducted a systematic review and meta-analysis to quantify the dose-risk relation. Through the literature search up to August 2013, we identified 18 studies, 10 case-control and 8 cohorts, carried out in a total of 7142 leukemia cases. We derived pooled meta-analytic estimates using random-effects models, taking into account the correlation between estimates, and we performed a dose-risk analysis using a class of nonlinear random-effects meta-regression models. Stratified analyses were carried out on leukemia subtypes and groups, in order to identify possible etiologic differences. Compared with nondrinkers, the relative risks (RRs) for all leukemia were 0.94 [95% confidence interval (CI), 0.85-1.03], 0.90 (95% CI, 0.80-1.01) and 0.91 (95% CI, 0.81-1.02) for any, light (? 1 drink/day) and moderate to heavy (>1 drink/day) alcohol drinking, respectively. The summary RRs for any alcohol drinking were 1.47 (95% CI, 0.47-4.62) for acute lymphoblastic leukemia, 0.94 (95% CI 0.77-1.15) for chronic lymphocytic leukemia, 1.02 (95% CI, 0.86-1.21) for acute myeloid leukemia and 0.93 (95% CI 0.75-1.14) for chronic myeloid leukemia. The subgroup analysis on geographical area for all leukemia combined showed RRs of 0.84 (95% CI, 0.76-0.93), 0.92 (95% CI, 0.83-1.01) and 1.32 (95% CI, 1.02-1.70) for studies conducted in America, Europe and Asia, respectively. We did not find an increased risk of leukemia among alcohol drinkers. If any, a modest favorable effect emerged for light alcohol drinking, with a model-based risk reduction of approximately 10% in regular drinkers.
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Long term survival of HER2-positive early breast cancer treated with trastuzumab-based adjuvant regimen: A large cohort study from clinical practice.
Breast
PUBLISHED: 03-18-2014
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Trastuzumab-based regimens for the adjuvant treatment of HER2-positive early breast cancer significantly prolonged overall survival (OS) and disease free survival (DFS) in large randomized trials, with sustained benefits at four-year follow-up. We assessed long-term survival estimates and predictors in a large cohort of Italian women with early breast cancer treated with trastuzumab in clinical practice. Through a record linkage between five regional healthcare databases, we identified women treated with trastuzumab for early breast cancer in Lombardy (2006-2009). DFS and OS were estimated using the Kaplan-Meier method, and independent predictors were assessed using proportional hazard models. 2046 women received trastuzumab in early breast cancer adjuvant setting. Overall, the proportion of patients surviving free of disease was 93.9% at one year, 85.8% at 2 years, 79.4% at 3 years, and 75.0% at 4 years. OS estimates were 98.7%, 95.4%, 91.5% and 89.4% at 1, 2, 3 and 4 years, respectively. Significant independent predictors of worse survival outcomes were age <40 or ?70 years compared to age 40-69 years, positive nodal status, radical breast surgery, combination therapy with paclitaxel, having at least one comorbidity (i.e. diabetes, cardiovascular disease), and a trastuzumab-based regimen lasting less than six months. Long term survival rates of women treated with trastuzumab for early breast cancer in clinical practice were consistent with estimates from clinical trials testing the drug in the adjuvant setting.
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Use of trastuzumab for breast cancer: the role of age.
Curr. Pharm. Des.
PUBLISHED: 03-12-2014
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Indication for the use of trastuzumab was given in Italy in 2000 for the treatment of HER-2 metastatic breast cancer and in 2006 for early stage breast cancer. Information on trastuzumab use and on its possible variation with age in Italy is however limited. Using health care administrative databases, we evaluated the prevalence of the use of trastuzumab, and the probability for administration since the first hospitalization for breast cancer in various age groups, in two series of Italian women diagnosed with breast cancer in the Lombardy region (2004-2009) and in the Palermo district. The ratio between trastuzumb users and patients with a hospitalization for breast cancer increased from 2.9% in 2004 up to 17.2% in 2009 in Lombardy. Patients aged <65 years were more frequent users (9.6%) compared to those aged ? 75 years (1.3%). Similarly, in the Palermo district the ratio increased from 10.6% in 2006 to 28.5% in 2008, with subjects aged <65 years more frequently using trastuzumab (19.1%), than subjects aged ? 75 years (6.2%). The age ratio between younger and older patients decreased over time in both settings (from 15 in 2004 to 10.2 in 2006, and 5.2 in 2009 in Lombardy, and from 4.0 in 2006 to 2.3 in 2009 in the Palermo district). The proportion of breast cancer patients using trastuzumab increased over time both in Lombardy and in Palermo district, though geographical differences persisted. Younger breast cancers patients were more likely to receive a trastuzumab treatment than elderly ones, but the difference declined over calendar period.
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Colorectal cancer and adenomatous polyps in relation to allium vegetables intake: a meta-analysis of observational studies.
Mol Nutr Food Res
PUBLISHED: 03-10-2014
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To provide updated quantitative estimates of the associations between allium vegetables intake and risk of colorectal cancer and colorectal adenomatous polyps.
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Dietary glycemic index, glycemic load and risk of age-related cataract extraction: a case-control study in Italy.
Eur J Nutr
PUBLISHED: 03-07-2014
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Although a role of glycemic index (GI) and glycemic load (GL) in age-related cataract development is plausible, a few studies, all conducted in USA or Australia, provided results on this issue. The aim of the present study was to provide new original data from a Mediterranean population.
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Mortality from lymphohematopoietic neoplasms and other causes in a cohort of laminated plastic workers exposed to formaldehyde.
Cancer Causes Control
PUBLISHED: 03-04-2014
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A possible relationship between exposure to formaldehyde and leukemia-particularly myeloid leukemia-as well as of lymphoid neoplasms has been debated and is still controversial. We thus examined the issue using data from a cohort of workers of a laminated plastic factory sited in Piedmont, northern Italy.
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Medication persistence and the use of generic and brand-name blood pressure-lowering agents.
J. Hypertens.
PUBLISHED: 02-27-2014
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Because of their lower cost, healthcare systems recommend physicians to prefer generic products, rather than brand-name medicaments. There is then considerable interest and debate concerning safety and effectiveness of generic products. Few studies have compared patients treated with brand-name and generic drugs for adherence to treatment, with somewhat inconsistent results. The primary objective of this study was to compare the risk of discontinuing antihypertensive drug therapy in patients treated with generic or brand-name agents.
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Duration and intensity of tobacco smoking and the risk of papillary and non-papillary transitional cell carcinoma of the bladder.
Cancer Causes Control
PUBLISHED: 02-26-2014
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To evaluate the impact of tobacco smoking on specific histological subtypes of transitional cell carcinoma of the bladder (TCC).
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Regular use of aspirin for cardiovascular disease prevention in Italy.
Prev Med
PUBLISHED: 02-25-2014
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Only a few European studies focused on aspirin use in the general population. We provide updated information on the prevalence and determinants of regular aspirin use for the prevention of cardiovascular disease (CVD) in the Italian adult population.
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Estimating and explaining the effect of education and income on head and neck cancer risk: INHANCE consortium pooled analysis of 31 case-control studies from 27 countries.
Int. J. Cancer
PUBLISHED: 02-21-2014
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Low socioeconomic status has been reported to be associated with head and neck cancer risk. However, previous studies have been too small to examine the associations by cancer subsite, age, sex, global region and calendar time and to explain the association in terms of behavioral risk factors. Individual participant data of 23,964 cases with head and neck cancer and 31,954 controls from 31 studies in 27 countries pooled with random effects models. Overall, low education was associated with an increased risk of head and neck cancer (OR = 2.50; 95% CI = 2.02 - 3.09). Overall one-third of the increased risk was not explained by differences in the distribution of cigarette smoking and alcohol behaviors; and it remained elevated among never users of tobacco and nondrinkers (OR = 1.61; 95% CI = 1.13 - 2.31). More of the estimated education effect was not explained by cigarette smoking and alcohol behaviors: in women than in men, in older than younger groups, in the oropharynx than in other sites, in South/Central America than in Europe/North America and was strongest in countries with greater income inequality. Similar findings were observed for the estimated effect of low versus high household income. The lowest levels of income and educational attainment were associated with more than 2-fold increased risk of head and neck cancer, which is not entirely explained by differences in the distributions of behavioral risk factors for these cancers and which varies across cancer sites, sexes, countries and country income inequality levels.
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Making prospective registration of observational research a reality.
Sci Transl Med
PUBLISHED: 02-21-2014
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The vast majority of health-related observational studies are not prospectively registered and the advantages of registration have not been fully appreciated. Nonetheless, international standards require approval of study protocols by an independent ethics committee before the study can begin. We suggest that there is an ethical and scientific imperative to publicly preregister key information from newly approved protocols, which should be required by funders. Ultimately, more complete information may be publicly available by disclosing protocols, analysis plans, data sets, and raw data.
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The stomach cancer pooling (StoP) project: study design and presentation.
Eur. J. Cancer Prev.
PUBLISHED: 02-20-2014
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Gastric cancer affects about one million people per year worldwide, being the second leading cause of cancer mortality. The study of its etiology remains therefore a global issue as it may allow the identification of major targets, besides eradication of Helicobacter pylori infection, for primary prevention. It has however received little attention, given its comparatively low incidence in most high-income countries. We introduce a consortium of epidemiological investigations named the 'Stomach cancer Pooling (StoP) Project'. Twenty-two studies agreed to participate, for a total of over 9000 cases and 23 000 controls. Twenty studies have already shared the original data set. Of the patients, 40% are from Asia, 43% from Europe, and 17% from North America; 34% are women and 66% men; the median age is 61 years; 56% are from population-based case-control studies, 41% from hospital-based ones, and 3% from nested case-control studies derived from cohort investigations. Biological samples are available from 12 studies. The aim of the StoP Project is to analyze the role of lifestyle and genetic determinants in the etiology of gastric cancer through pooled analyses of individual-level data. The uniquely large data set will allow us to define and quantify the main effects of each risk factor of interest, including a number of infrequent habits, and to adequately address associations in subgroups of the population, as well as interaction within and between environmental and genetic factors. Further, we will carry out separate analyses according to different histotypes and subsites of gastric cancer, to identify potential different risk patterns and etiological characteristics.
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Aspirin and prostate cancer prevention.
Recent Results Cancer Res.
PUBLISHED: 02-18-2014
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Aspirin has been associated to a reduced risk of colorectal, and possibly of other cancers. Data from at least 25 observational studies also suggest a modest reduced risk of prostate cancer in regular aspirin users, with a summary relative risk, RR, of 0.91 (95 % confidence interval, CI, 0.86-0.96) overall, 0.87 (95 % CI 0.74-1.02) from nine case-control studies, and 0.92 (95 % CI 0.87-0.97) from 16 cohort studies. However, risk estimates are heterogeneous and there is no relation with frequency, dose, or duration of aspirin use. Data from randomized controlled trials of aspirin for the prevention of vascular events showed a nonsignificant reduced risk of death from prostate cancer after a latent period of five or more years (RR 0.52, 95 % CI 0.20-1.24) based on 37 deaths from prostate cancer from seven trials. The RR was 0.81 (95 % CI 0.61-1.06) after 20 years of follow-up, based on 210 cases from three trials with long-term follow-up. Thus, data from observational studies and clinical trials are compatible with a modest favorable effect of aspirin on prostate cancer. Inference for causality and public health implications are, however, far from conclusive given the heterogeneity of results and the lack of dose and duration-risk relationships. Data on prostate cancer survival are still limited and inconsistent.
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Roll-your-own cigarettes in Europe: use, weight and implications for fiscal policies.
Eur. J. Cancer Prev.
PUBLISHED: 02-07-2014
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Excise duties on roll-your-own (RYO) tobacco, which are generally based on RYO cigarettes containing 1 g of tobacco, are lower than duties on factory-made (FM) cigarettes. This provides a price incentive for smokers to switch to RYO, the use of which is increasing across Europe. To effectively approximate duties on the two types of products, accurate data on the weight of RYO cigarettes are required. We provide updated information on RYO use and RYO cigarette weight across Europe. From a representative face-to-face survey conducted in 2010 in 18 European countries (Albania, Austria, Bulgaria, Czech Republic, Croatia, England, Finland, France, Greece, Hungary, Ireland, Italy, Latvia, Poland, Portugal, Romania, Spain and Sweden), we considered data from 5158 current smokers aged 15 years or above, with available information on daily consumption of FM and RYO cigarettes separately. In Europe, 10.4% of current smokers (12.9% of men and 7.5% of women) were 'predominant' RYO users (i.e. >50% of cigarettes smoked). This proportion was highest in England (27.3%), France (16.5%) and Finland (13.6%). The median weight of one RYO cigarette is 0.75 g (based on 192 smokers consuming exclusively RYO cigarettes). The proportion of RYO smokers is substantial in several European countries. Our finding on the weight of RYO cigarettes is consistent with the scientific literature and industry documents showing that the weight of RYO cigarettes is substantially lower than that of FM ones. Basing excise duties on RYO on an average cigarette weight of 0.75 g rather than 1 g would help increase the excise levels to those on FM cigarettes.
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Occupational exposures to polycyclic aromatic hydrocarbons and respiratory and urinary tract cancers: an updated systematic review and a meta-analysis to 2014.
Arch. Toxicol.
PUBLISHED: 02-05-2014
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Exposure to polycyclic aromatic hydrocarbons (PAHs) has been associated with an excess risk of respiratory tract and bladder cancers in several industries, but the issue requires further quantification. We updated a previous systematic review by reviewing in details cohort studies on workers employed in selected industries with potential PAH exposure published between 2006 and 2014, and we summarized through a meta-analytic approach the main results of all available cohort studies published between 1958 and 2014 investigating cancers of the respiratory and urinary tracts. Thirteen papers on cohort studies investigating cancer risk in workers exposed to PAHs were retrieved through the literature search. These included workers from aluminum production industries (seven studies), iron and steel foundries (two studies), asphalt workers (two studies), and carbon black production (two studies). In the meta-analysis, an excess risk of respiratory tract cancers (mainly lung cancer) was found in iron and steel foundries [pooled relative risk (RR) 1.31, 95 % confidence interval (CI) 1.08-1.59 from 14 studies], while a weak excess risk (pooled RR 1.08, 95 % CI 0.95-1.23 from 11 studies) emerged for aluminum production. A borderline increase risk was also observed for cancer of the bladder in the aluminum production (pooled RR 1.28, 95 % CI 0.98-1.68 from 10 studies) and in iron and steel foundries (pooled RR 1.38, 95 % CI 1.00-1.91 from 9 studies). This updated review and meta-analysis confirm the increased risk from respiratory tract and bladder cancers in selected PAH-related occupations. It cannot be ruled out whether such excesses are due, at least in part, to possible bias or residual confounding.
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Nutrient-based dietary patterns and prostate cancer risk: a case-control study from Italy.
Cancer Causes Control
PUBLISHED: 01-31-2014
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The role of various foods and nutrients, and their combinations, on prostate cancer risk remains largely undefined. We addressed therefore the issue of complex dietary patterns.
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Folate intake and the risk of oral cavity and pharyngeal cancer: A pooled analysis within the International Head and Neck Cancer Epidemiology Consortium.
Int. J. Cancer
PUBLISHED: 01-29-2014
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There are suggestions of an inverse association between folate intake and serum folate levels and the risk of oral cavity and pharyngeal cancers (OPCs), but most studies are limited in sample size, with only few reporting information on the source of dietary folate. Our study aims to investigate the association between folate intake and the risk of OPC within the International Head and Neck Cancer Epidemiology (INHANCE) Consortium. We analyzed pooled individual-level data from ten case-control studies participating in the INHANCE consortium, including 5,127 cases and 13,249 controls. Odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) were estimated for the associations between total folate intake (natural, fortification and supplementation) and natural folate only, and OPC risk. We found an inverse association between total folate intake and overall OPC risk (the adjusted OR for the highest vs. the lowest quintile was 0.65, 95% CI: 0.43-0.99), with a stronger association for oral cavity (OR?=?0.57, 95% CI: 0.43-0.75). A similar inverse association, though somewhat weaker, was observed for folate intake from natural sources only in oral cavity cancer (OR?=?0.64, 95% CI: 0.45-0.91). The highest OPC risk was observed in heavy alcohol drinkers with low folate intake as compared to never/light drinkers with high folate (OR?=?4.05, 95% CI: 3.43-4.79); the attributable proportion (AP) owing to interaction was 11.1% (95% CI: 1.4-20.8%). Lastly, we reported an OR of 2.73 (95% CI:2.34-3.19) for those ever tobacco users with low folate intake, compared with nevere tobacco users and high folate intake (AP of interaction =10.6%, 95% CI: 0.41-20.8%). Our project of a large pool of case-control studies supports a protective effect of total folate intake on OPC risk.
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Worldwide trends in gastric cancer mortality (1980-2011), with predictions to 2015, and incidence by subtype.
Eur. J. Cancer
PUBLISHED: 01-27-2014
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Gastric cancer incidence and mortality decreased substantially over the last decades in most countries worldwide, with differences in the trends and distribution of the main topographies across regions. To monitor recent mortality trends (1980-2011) and to compute short-term predictions (2015) of gastric cancer mortality in selected countries worldwide, we analysed mortality data provided by the World Health Organization. We also analysed incidence of cardia and non-cardia cancers using data from Cancer Incidence in Five Continents (2003-2007). The joinpoint regression over the most recent calendar periods gave estimated annual percent changes (EAPC) around -3% for the European Union (EU) and major European countries, as well as in Japan and Korea, and around -2% in North America and major Latin American countries. In the United States of America (USA), EU and other major countries worldwide, the EAPC, however, were lower than in previous years. The predictions for 2015 show that a levelling off of rates is expected in the USA and a few other countries. The relative contribution of cardia and non-cardia gastric cancers to the overall number of cases varies widely, with a generally higher proportion of cardia cancers in countries with lower gastric cancer incidence and mortality rates (e.g. the USA, Canada and Denmark). Despite the favourable mortality trends worldwide, in some countries the declines are becoming less marked. There still is the need to control Helicobacter pylori infection and other risk factors, as well as to improve diagnosis and management, to further reduce the burden of gastric cancer.
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Relation of dietary glycemic load with ischemic and hemorrhagic stroke: a cohort study in Greece and a meta-analysis.
Eur J Nutr
PUBLISHED: 01-09-2014
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High glycemic load (GL) has been associated with excess stroke risk. Data suggest a different role of diet in the etiology of ischemic and hemorrhagic stroke.
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Family history and the risk of cancer: genetic factors influencing multiple cancer sites.
Expert Rev Anticancer Ther
PUBLISHED: 12-02-2013
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A number of co-aggregations of cancers at different sites has been reported, including recognized syndromes (e.g., Li-Fraumeni), and aggregations between cancers at breast, stomach and ovary, between cancers at prostate, urinary tract and other sites, as well as between several tobacco-related neoplasms. In a network of case-control studies from Italy and Switzerland, including more than 12,000 cases of 13 different cancers, after controlling for multiple testing, significant associations emerged between oral and pharyngeal cancer and family history of laryngeal cancer (relative risk (RR): 3.3); esophageal cancer and family history of oral and pharyngeal cancer RR: 4.1; breast cancer and family history of colorectal cancer (RR: 1.5) and of hemolymphopoietic cancers (RR: 1.7); ovarian cancer and family history of breast cancer (RR: 2.3); and prostate cancer and family history of bladder cancer (RR: 3.4). Shared exposures to environmental factors within families account for some of the observed aggregations, together with heritable, and hence, genetic factors.
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Fiber intake and risk of nasopharyngeal carcinoma: a case-control study.
Nutr Cancer
PUBLISHED: 10-07-2013
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Some studies examined the inverse relation between nasopharyngeal carcinoma (NPC) risk and dietary fibers in endemic populations. By means of a hospital-based case-control study, we verified whether this association was also present in Italy in connection with various types of dietary fibers. Cases were 198 patients with incident, histologically confirmed, NPC admitted to major teaching and general hospitals during 1992-2008. Controls were 594 patients admitted for acute, nonneoplastic conditions to the same hospital network of cases. Information was elicited using a validated food frequency questionnaire including 78 foods, food groups, or dishes. Odds ratios (OR) and corresponding 95% confidence intervals (CI) were estimated for quartiles of intake of different types of fiber after allowance for energy intake and other potential confounding factors. Total fiber intake was inversely related to risk of NPC (OR = 0.58 for the highest vs. the lowest quartile of intake; 95% CI: 0.34-0.96). We found an inverse association for total soluble (OR = 0.58; 95% CI: 0.35-0.96) and total insoluble fiber (OR = 0.56; 95% CI: 0.33-0.95), in particular cellulose (OR = 0.57; 95% CI: 0.33-0.96), and lignin (OR = 0.51; 95% CI: 0.31-0.85). In conclusion, this study suggests that dietary intake of soluble and insoluble fibers is inversely related to NPC risk in a nonendemic southern population.
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Adherence to the Mediterranean diet and gastric cancer risk in Italy.
Int. J. Cancer
PUBLISHED: 09-10-2013
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We investigated gastric cancer risk in relation to the adherence to the Mediterranean diet using data from two case-control studies conducted in Italy between 1985 and 2007, including 999 incidents, histologically confirmed gastric cancers and 2,628 controls admitted to hospital for acute non-neoplastic diseases. Adherence to the Mediterranean diet was assessed using the Mediterranean Diet Score (MDS) based on nine of the major characteristics of the Mediterranean diet in the overall dataset. The Mediterranean Dietary Pattern adherence index (MDP) and the Mediterranean Adequacy Index (MAI) were considered in the second study only. We estimated odds ratios (OR) and corresponding 95% confidence intervals (CI) of gastric cancer for categories of the three scores using multiple logistic regression models. We found a reduced risk of gastric cancer for increasing levels of the MDS: as compared to subjects in the lowest category of the MDS, the ORs were 0.78, 0.61 and 0.57 in subsequent levels of MDS, with a significant trend in risk. Risk estimates were consistent across strata of age, sex, education, smoking, body mass index, and family history of gastric cancer. We also observed a decreased risk of gastric cancer for the highest versus the lowest quintile for MDP and MAI, with OR of 0.58 and 0.71, respectively. Our study provides convincing evidence of a beneficial role of the Mediterranean diet on gastric cancer.
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Trends in cardiovascular diseases and cancer mortality in 45 countries from five continents (1980-2010).
Eur J Prev Cardiol
PUBLISHED: 07-24-2013
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Cardiovascular diseases (CVD) and cancer are worldwide main causes of death with mortality trends varying across countries with different levels of economic development.
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Trastuzumab-related cardiotoxicity in early breast cancer: a cohort study.
Oncologist
PUBLISHED: 07-03-2013
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Concerns have been raised about the cardiac safety profile of trastuzumab for the adjuvant treatment of early stage breast cancer in clinical practice. We assessed trastuzumab-related cardiotoxicity and its predictors in a large cohort of Italian women.
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Allergies and risk of pancreatic cancer: a pooled analysis from the Pancreatic Cancer Case-Control Consortium.
Am. J. Epidemiol.
PUBLISHED: 07-02-2013
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In order to quantify the risk of pancreatic cancer associated with history of any allergy and specific allergies, to investigate differences in the association with risk according to age, gender, smoking status, or body mass index, and to study the influence of age at onset, we pooled data from 10 case-control studies. In total, there were 3,567 cases and 9,145 controls. Study-specific odds ratios and 95% confidence intervals were calculated by using unconditional logistic regression adjusted for age, gender, smoking status, and body mass index. Between-study heterogeneity was assessed by using the Cochran Q statistic. Study-specific odds ratios were pooled by using a random-effects model. The odds ratio for any allergy was 0.79 (95% confidence interval (CI): 0.62, 1.00) with heterogeneity among studies (P < 0.001). Heterogeneity was attributable to one study; with that study excluded, the pooled odds ratio was 0.73 (95% CI: 0.64, 0.84) (Pheterogeneity = 0.23). Hay fever (odds ratio = 0.74, 95% CI: 0.56, 0.96) and allergy to animals (odds ratio = 0.62, 95% CI: 0.41, 0.94) were related to lower risk, while there was no statistically significant association with other allergies or asthma. There were no major differences among subgroups defined by age, gender, smoking status, or body mass index. Older age at onset of allergies was slightly more protective than earlier age.
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Cigarette, cigar, and pipe smoking and the risk of head and neck cancers: pooled analysis in the International Head and Neck Cancer Epidemiology Consortium.
Am. J. Epidemiol.
PUBLISHED: 06-30-2013
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Cigar and pipe smoking are considered risk factors for head and neck cancers, but the magnitude of effect estimates for these products has been imprecisely estimated. By using pooled data from the International Head and Neck Cancer Epidemiology (INHANCE) Consortium (comprising 13,935 cases and 18,691 controls in 19 studies from 1981 to 2007), we applied hierarchical logistic regression to more precisely estimate odds ratios and 95% confidence intervals for cigarette, cigar, and pipe smoking separately, compared with reference groups of those who had never smoked each single product. Odds ratios for cigar and pipe smoking were stratified by ever cigarette smoking. We also considered effect estimates of smoking a single product exclusively versus never having smoked any product (reference group). Among never cigarette smokers, the odds ratio for ever cigar smoking was 2.54 (95% confidence interval (CI): 1.93, 3.34), and the odds ratio for ever pipe smoking was 2.08 (95% CI: 1.55, 2.81). These odds ratios increased with increasing frequency and duration of smoking (Ptrend ? 0.0001). Odds ratios for cigar and pipe smoking were not elevated among ever cigarette smokers. Head and neck cancer risk was elevated for those who reported exclusive cigar smoking (odds ratio = 3.49, 95% CI: 2.58, 4.73) or exclusive pipe smoking (odds ratio = 3.71, 95% CI: 2.59, 5.33). These results suggest that cigar and pipe smoking are independently associated with increased risk of head and neck cancers.
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Patterns of smoking prevalence among the elderly in Europe.
Int J Environ Res Public Health
PUBLISHED: 06-28-2013
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Scant information is available on determinants of smoking prevalence in the vulnerable population of the elderly, particularly in Europe. Therefore, we analyzed smoking patterns among older adults (?65 years old), using data from a representative survey based on 3,071 elderly, conducted in 17 European countries in 2010, within the Pricing Policies And Control of Tobacco in Europe (PPACTE) project. Overall smoking prevalence in 17 European countries was 11.5% (15.3% in men and 8.6% in women). An inverse relation with level of education was observed among men, while no specific pattern was evident among women. Smoking prevalence was highest in eastern/central Europe for men (20.3%) and northern Europe for women (13.1%). In both sexes combined, smokers were more frequent in countries with low implementation of tobacco control activities (14.9%). Anti-tobacco campaigns and smoking cessation interventions specifically targeted to the elderly are urgently needed in Europe.
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Mediterranean diet and hepatocellular carcinoma.
J. Hepatol.
PUBLISHED: 06-14-2013
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Hepatocellular carcinoma (HCC) has a very poor prognosis and any effort to identify additional risk factors, besides those already established, would be important for the prevention of the disease. Data on the role of diet on HCC risk are still controversial.
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Sociodemographic determinants of prevalence and incidence of Helicobacter pylori infection in Portuguese adults.
Helicobacter
PUBLISHED: 06-03-2013
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Understanding the determinants of Helicobacter pylori infection in adults is essential to predict the burden of H. pylori-related diseases. We aimed to estimate the prevalence and incidence of H. pylori infection and to identify its major sociodemographic correlates in an urban population from the North of Portugal.
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Multicentric cohort study on the long-term efficacy and safety of electronic cigarettes: study design and methodology.
BMC Public Health
PUBLISHED: 05-27-2013
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While electronic cigarettes are forbidden in several countries, their sales are exploding in many others. Although e-cigarettes have been proposed as long-term substitutes for traditional smoking or as a tool for smoking cessation, very scarce data are available on their efficacy and safety.We describe the protocol of a 5-year multicentric prospective study aimed to evaluate short- and long-term adherence to e-cigarette smoking and the efficacy of e-cigarettes in reducing and/or quitting traditional cigarette smoking. The study will also compare the health effects of electronic vs traditional vs mixed cigarette smoking.
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Personal hair dye use and bladder cancer: a meta-analysis.
Ann Epidemiol
PUBLISHED: 05-17-2013
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Despite considerable research, the issue of hair dyes and bladder cancer is still open to discussion. In January 2013, we searched in PubMed/EMBASE to identify observational studies investigating the association between personal use of hair dyes and bladder cancer incidence/mortality. Pooled relative risks (RRs) and corresponding 95% confidence intervals (CIs) were calculated using random-effects models. Fifteen case-control and two cohort studies were available for meta-analysis (8504 cases/deaths, 14,102 controls, and 617,937 persons at risk). Compared with no use, the pooled RR of bladder cancer for personal use of any type of hair dyes was 0.93 (95% CI, 0.82-1.05), with moderate heterogeneity among studies (I(2) = 34.1%, P = .07). Similar RRs were found for females (RR = 0.95) and males (RR = 0.81). Based on seven studies, the pooled RR for personal use of permanent hair dyes was 0.92 (95% CI, 0.77-1.09). Compared with no use, no association was observed for the highest categories of duration of use and lifetime frequency of use of both any type of dyes and permanent dyes. The pooled RR from four studies reporting results for use of dark-colored dyes was 1.29 (95% CI, 0.98-1.71). This meta-analysis allows to definitively exclude any appreciable excess risk of bladder cancer among personal hair dye users.
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Aspartame, low-calorie sweeteners and disease: regulatory safety and epidemiological issues.
Food Chem. Toxicol.
PUBLISHED: 04-05-2013
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Aspartame is a synthetic sweetener that has been used safely in food for more than 30 years. Its safety has been evaluated by various regulatory agencies in accordance with procedures internationally recognized, and decisions have been revised and updated regularly. The present review summarizes the most relevant conclusions of epidemiological studies concerning the use of low-calorie sweeteners (mainly aspartame), published between January 1990 and November 2012. In the Nurses Health study and the Health Professionals Followup study some excess risk of Hodgkin lymphoma and multiple myeloma was found in men but not in women; no association was found with leukemia. In the NIH-AARP Diet and Health Study, there was no association between aspartame and haematopoietic neoplasms. US case-control studies of brain and haematopoietic neoplasms also showed no association. The NIH-AARP Diet and Health Study and case-control studies from California showed no association with pancreatic cancer, and a case-control study from Denmark found no relation with breast cancer risk. Italian case-control studies conducted in 1991-2008 reported no consistent association for cancers of the upper aerodigestive tract, digestive tract, breast, endometrium, ovary, prostate, and kidney. Low calorie sweeteners were not consistently related to vascular events and preterm deliveries.
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A meta-analysis of prospective studies of coffee consumption and mortality for all causes, cancers and cardiovascular diseases.
Eur. J. Epidemiol.
PUBLISHED: 04-02-2013
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Several prospective studies considered the relation between coffee consumption and mortality. Most studies, however, were underpowered to detect an association, since they included relatively few deaths. To obtain quantitative overall estimates, we combined all published data from prospective studies on the relation of coffee with mortality for all causes, all cancers, cardiovascular disease (CVD), coronary/ischemic heart disease (CHD/IHD) and stroke. A bibliography search, updated to January 2013, was carried out in PubMed and Embase to identify prospective observational studies providing quantitative estimates on mortality from all causes, cancer, CVD, CHD/IHD or stroke in relation to coffee consumption. A systematic review and meta-analysis was conducted to estimate overall relative risks (RR) and 95 % confidence intervals (CI) using random-effects models. The pooled RRs of all cause mortality for the study-specific highest versus low (?1 cup/day) coffee drinking categories were 0.88 (95 % CI 0.84-0.93) based on all the 23 studies, and 0.87 (95 % CI 0.82-0.93) for the 19 smoking adjusting studies. The combined RRs for CVD mortality were 0.89 (95 % CI 0.77-1.02, 17 smoking adjusting studies) for the highest versus low drinking and 0.98 (95 % CI 0.95-1.00, 16 studies) for the increment of 1 cup/day. Compared with low drinking, the RRs for the highest consumption of coffee were 0.95 (95 % CI 0.78-1.15, 12 smoking adjusting studies) for CHD/IHD, 0.95 (95 % CI 0.70-1.29, 6 studies) for stroke, and 1.03 (95 % CI 0.97-1.10, 10 studies) for all cancers. This meta-analysis provides quantitative evidence that coffee intake is inversely related to all cause and, probably, CVD mortality.
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Coffee reduces risk for hepatocellular carcinoma: an updated meta-analysis.
Clin. Gastroenterol. Hepatol.
PUBLISHED: 03-30-2013
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Coffee consumption has been suggested to reduce the risk for hepatocellular carcinoma (HCC). We performed a meta-analysis of epidemiological studies to provide updated information on how coffee drinking affects HCC risk.
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Adult height and head and neck cancer: a pooled analysis within the INHANCE Consortium.
Eur. J. Epidemiol.
PUBLISHED: 02-28-2013
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Several epidemiological studies have shown a positive association between adult height and cancer incidence. The only study conducted among women on mouth and pharynx cancer risk, however, reported an inverse association. This study aims to investigate the association between height and the risk of head and neck cancer (HNC) within a large international consortium of HNC. We analyzed pooled individual-level data from 24 case-control studies participating in the International Head and Neck Cancer Epidemiology Consortium. Odds ratios (ORs) and 95 % confidence intervals (CIs) were estimated separately for men and women for associations between height and HNC risk. Educational level, tobacco smoking, and alcohol consumption were included in all regression models. Stratified analyses by HNC subsites were performed. This project included 17,666 cases and 28,198 controls. We found an inverse association between height and HNC (adjusted OR per 10 cm height = 0.91, 95 % CI 0.86-0.95 for men; adjusted OR = 0.86, 95 % CI 0.79-0.93 for women). In men, the estimated OR did vary by educational level, smoking status, geographic area, and control source. No differences by subsites were detected. Adult height is inversely associated with HNC risk. As height can be considered a marker of childhood illness and low energy intake, the inverse association is consistent with prior studies showing that HNC occur more frequently among deprived individuals. Further studies designed to elucidate the mechanism of such association would be warranted.
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Pet exposure and risk of atopic dermatitis at the pediatric age: a meta-analysis of birth cohort studies.
J. Allergy Clin. Immunol.
PUBLISHED: 02-26-2013
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Findings on pet exposure and the risk of atopic dermatitis (AD) in children are inconsistent.
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Nutritional factors, physical activity, and breast cancer by hormonal receptor status.
Breast
PUBLISHED: 02-22-2013
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To investigate the association between food and nutrient intake, occupational and leisure-time physical activity, and body mass index and breast cancer risk by estrogen receptor (ER) and progesterone receptor (PR) status.
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Bevacizumab in clinical practice: prescribing appropriateness relative to national indications and safety.
Oncologist
PUBLISHED: 12-30-2011
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The aim of this study was to describe the clinical use of bevacizumab in Lombardy (9.5 million inhabitants), Italy, during 2006-2007 in patients with metastatic colorectal cancer (mCRC) to evaluate compliance with the Italian Medicine Agency (AIFA) indications, the incidence of adverse events, and the survival rate. We performed computerized record linkage among three different Lombardy health care databases: File F registry, Regional discharge database, and Registry Office records. Patients were classified into approved and off-label uses according to the AIFA indications. Treatment with bevacizumab was administered to 780 patients, of whom 81.7% (n = 637) had mCRC. Among these, 37.8% (n = 241) of patients received the drug in observance of AIFA indications. Overall, ?10% of patients had serious treatment-related toxicities (fistula, 3.5%; venous thromboembolism, 2.8%; hemorrhage, 1.9%; intestinal perforation and arterial thromboembolism, <1%). The 1-year survival rate was 74.3% and the 2-year survival rate was 39.2%. The median survival time was 20.5 months, and there were no meaningful differences between gender and age groups. There was a gap between the bevacizumab approved indication and clinical practice pattern: overall, less than one half of the patients received bevacizumab in observance with the regulatory indication. The main reason for nonadherence to the indication was use as a second-line or advanced line of therapy. The incidence of serious adverse events and the survival rates of mCRC patients were similar to those reported in clinical trials.
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Dietary habits and prostate cancer prevention: a review of observational studies by focusing on South America.
Nutr Cancer
PUBLISHED: 12-02-2011
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There exist several works considering the association between diet and prostate cancer (PC) risk, but the issue is largely unsettled. This article systematically reviews the epidemiological studies on diet and risk of PC focusing on those carried out in countries of South America. There is some suggestion that dairy products, red meat, processed meat, ?-linolenic fatty acids, as well as dietary patterns characterized by higher intakes of red and processed meat, eggs, and grains may play some role in the development of PC. There is no clear association with the intake of vegetables and fruits, lycopene, fats, and different types of fatty acids. The evidence on diet and PC is therefore inconclusive in general and specifically in South America. Particular attention must be paid to the study of cancer risk in some countries of South America because of the singularly risky dietary pattern consumed by its population.
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Exposure to secondhand smoke in Italian non-smokers 5 years after the Italian smoking ban.
Eur J Public Health
PUBLISHED: 11-23-2011
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No data on secondhand smoke (SHS) exposure are available on a national level in Italy. To assess the prevalence of exposure to SHS in indoor public places, home and cars in non-smoking Italian population, we conducted a survey 5 years after the national smoking ban.
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Relationship and prognostic value of modified coronary artery calcium score, FEV1, and emphysema in lung cancer screening population: the MILD trial.
Radiology
PUBLISHED: 11-23-2011
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To assess the relationship between a modified coronary artery calcium (mCAC) score and both forced expiratory volume in 1 second (FEV1) and pulmonary emphysema and the associations of such factors with all-cause mortality and cardiovascular events (CVEs) in a lung cancer computed tomographic (CT) screening trial.
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Smoking in young and adult population, Italy 2009.
Tumori
PUBLISHED: 10-13-2011
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To monitor smoking prevalence and trends of young and adult populations in Italy. METHOD AND STUDY DESIGN: A survey on smoking was conducted during March-April 2009 on a sample of 3213 participants (1546 men and 1667 women), representative of the Italian population aged 15 years or over. Data from a simplified questionnaire were collected in an over-sample of 1010 young individuals, reaching a total of 1390 participants aged 15-24 years (713 males and 677 females).
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Alcohol consumption and cancer risk.
Nutr Cancer
PUBLISHED: 08-24-2011
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This review focuses on selected aspects of the relation between alcohol consumption and cancer risk. Heavy alcohol consumption (i.e., ?4 drinks/day) is significantly associated with an increased risk of about 5-fold for oral and pharyngeal cancer and esophageal squamous cell carcinoma, 2.5-fold for laryngeal cancer, 50% for colorectal and breast cancers, and 30% for pancreatic cancer. These estimates are based on a large number of epidemiological studies and are generally consistent across strata of several covariates. The evidence suggests that at low doses of alcohol consumption (i.e., ?1 drink/day) the risk is also increased by about 20% for oral and pharyngeal cancer and 30% for esophageal squamous cell carcinoma. Thus, for these sites there is little evidence of a threshold effect. While consumption of fewer than 3 alcoholic drinks/wk is not associated with an increased risk of breast cancer, an intake of 3 to 6 drinks/wk might already yield a (small) increase in risk. On the other hand, intakes up to 1 drink/day are not associated to the risk of laryngeal, colorectal, and pancreatic cancer. The positive association between alcohol consumption and the risk of head and neck cancers is independent from tobacco exposure.
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The decline in breast cancer mortality in Europe: an update (to 2009).
Breast
PUBLISHED: 06-29-2011
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We updated trends in breast cancer mortality in Europe up to the late 2000s. In the EU, age-adjusted (world standard population) breast cancer mortality rates declined by 6.9% between 2002 and 2006, from 17.9 to 16.7/100,000. The largest falls were in northern European countries, but more recent declines were also observed in central and eastern Europe. In 2007, all major European countries had overall breast cancer rates between 15 and 19/100,000. In relative terms, the declines in mortality were larger at younger age (-11.6% at age 20-49 years between 2002 and 2007 in the EU), and became smaller with advancing age (-6.6% at age 50-69, -5.0% at age 70-79 years). The present report confirms and further quantifies the persisting steady fall in breast cancer mortality in Europe over the last 25-30 years, which is mainly due to advancements in the therapy.
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Dietary transfatty acids and cancer risk.
Eur. J. Cancer Prev.
PUBLISHED: 06-25-2011
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This study assesses the association between dietary transfatty acid (TFA) intake and the risk of selected cancers. Mailed questionnaires were completed between 1994 and 1997 in eight Canadian provinces by 1182 incident, histologically confirmed cases of the stomach, 1727 of the colon, 1447 of the rectum, 628 of the pancreas, 3341 of the lung, 2362 of the breast, 442 of the ovary, 1799 of the prostate, 686 of the testis, 1345 of the kidney, 1029 of the bladder, 1009 of the brain, 1666 non-Hodgkins lymphomas, 1069 leukemias, and 5039 population controls. Information on dietary habits and nutrition intake was obtained using a food frequency questionnaire, which provided data on eating habits 2 years before the study. Odds ratios (OR) and 95% confidenc530e intervals (CI) were derived by unconditional logistic regression to adjust for total energy intake and other potential confounding factors. Dietary TFA were positively associated with the risk of cancers of the colon (OR: 1.38 for the highest vs. the lowest quartile), breast in premenopause (OR: 1.60), and prostate (OR: 1.42). There were a borderline association for pancreas cancer (OR: 1.38; P=0.06). No significant association was observed for cancers of the stomach, rectum, lung, ovary, testis, kidney, bladder, brain, non-Hodgkins lymphomas, and leukemia, although the ORs for the highest quartile were above unity for all neoplasms considered, except testis. Our findings add evidence that high TFA is associated with an increased risk of various cancers. Thus, a diet low in transfat may play a role in the prevention of several cancers.
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Nutrient-based dietary patterns, family history, and colorectal cancer.
Eur. J. Cancer Prev.
PUBLISHED: 06-25-2011
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The effect of dietary habits on colorectal cancer (CRC) risk may be modified by a family history of CRC. We analyzed data from an Italian case-control study, including 1953 CRC cases and 4154 controls. Odds ratios (OR) and 95% confidence intervals (CI) for combined categories of family history and tertiles of two a posteriori dietary patterns were derived using multiple logistic regression models. Compared with individuals without family history and in the lowest tertile category of the starch-rich pattern, the ORs of CRC were 1.38 (95% CI: 1.19-1.61) for the group without family history and in the highest tertile, 2.89 (95% CI: 2.30-3.64) for the one with family history and in the lowest tertile, and 4.00 (95% CI: 3.03-5.27) for the one with family history and in the highest tertile. Compared with individuals without family history and in the highest tertile of the vitamins and fiber pattern, the ORs were 1.29 (95% CI: 1.12-1.48) for the group without family history and in the lowest tertile, 2.89 (95% CI: 2.30-3.64) for the one with family history and in the highest tertile, and 3.74 (95% CI: 2.85-4.91) for the one with family history and in the lowest tertile. Family history of CRC and starch-rich or vitamins and fiber patterns has an independent effect on CRC risk in our population. However, as having a family history plausibly implies shared environmental and/or genetic risk factors, our results could not exclude that dietary habits can modify genetic susceptibility to CRC.
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Overweight, obesity, diabetes, and risk of breast cancer: interlocking pieces of the puzzle.
Oncologist
PUBLISHED: 05-31-2011
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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.
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