1
|
Dal Maso L, Panato C, De Paoli A, Mattioli V, Serraino D, Elisei R, Zoppini G, Gobitti C, Borsatti E, Di Felice E, Falcini F, Ferretti S, Francisci S, Giorgi Rossi P, Guzzinati S, Mazzoleni G, Pierannunzio D, Piffer S, Vaccarella S, Vicentini M, Zorzi M, Franceschi S, Fedeli U. Trends in thyroid function testing, neck ultrasound, thyroid fine needle aspiration, and thyroidectomies in North-eastern Italy. J Endocrinol Invest 2021; 44:1679-1688. [PMID: 33460012 PMCID: PMC8285305 DOI: 10.1007/s40618-020-01475-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 11/24/2020] [Indexed: 11/04/2022]
Abstract
PURPOSE Evidence of an increased diagnostic pressure on thyroid has emerged over the past decades. This study aimed to provide estimates of a wide spectrum of surveillance indicators for thyroid dysfunctions and diseases in Italy. METHODS A population-based study was conducted in North-eastern Italy, including 11.7 million residents (20% of the total Italian population). Prescriptions for TSH testing, neck ultrasound or thyroid fine needle aspiration (FNA), surgical procedures, and drugs for hypo- or hyperthyroidism were extracted from regional health databases. Proportions and rates of selected examinations were calculated from 2010 to 2017, overall and by sex, calendar years, age, and region. RESULTS Between 2010 and 2017 in North-eastern Italy, 24.5% of women and 9.8% of men received at least one TSH test yearly. In 2017, 7.1% of women and 1.5% of men were prescribed drugs for thyroid dysfunction, 94.6% of whom for hypothyroidism. Neck ultrasound examinations were performed yearly in 6.9% of women and 4.6% of men, with a nearly two-fold variation between areas. Thyroid FNA and thyroidectomies were three-fold more frequent in women (394 and 85 per 100,000) than in men (128 and 29 per 100,000) with a marked variation between areas. Both procedures decreased consistently after 2013. CONCLUSIONS The results of this population-based study describe recent variations over time and between surrounding areas of indicators of 'diagnostic pressure' on thyroid in North-eastern Italy. These results emphasize the need to harmonize practices and to reduce some procedures (e.g., neck ultrasound and total thyroidectomies) in certain areas.
Collapse
Affiliation(s)
- L Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Via Franco Gallini 2, 33081, Aviano, PN, Italy.
| | - C Panato
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Via Franco Gallini 2, 33081, Aviano, PN, Italy
| | - A De Paoli
- Epidemiological Department, Azienda Zero, Via J. Avanzo, 35, 35132, Padua, Italy
| | - V Mattioli
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Via Franco Gallini 2, 33081, Aviano, PN, Italy
| | - D Serraino
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Via Franco Gallini 2, 33081, Aviano, PN, Italy
| | - R Elisei
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy
| | - G Zoppini
- Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Hospital Trust of Verona, Verona, Italy
| | - C Gobitti
- Radiation Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081, Aviano, Italy
| | - E Borsatti
- Nuclear Medicine Unit, CRO Aviano National Cancer Institute, Via Franco Gallini, 2, 33081, Aviano, Italy
| | - E Di Felice
- Authority for Healthcare and Welfare, Emilia Romagna Regional Health Service, Bologna, Italy
| | - F Falcini
- Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, Italy
- Azienda Usl della Romagna, Forlì, Italy
| | - S Ferretti
- Ferrara Cancer Registry, University of Ferrara, Azienda USL Ferrara, Ferrara, Italy
| | - S Francisci
- National Centre for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - P Giorgi Rossi
- Reggio Emilia Cancer Registry, Epidemiology Unit, AUSL ASMN-IRCCS, Azienda USL di Reggio Emilia, Reggio Emilia, Italy
| | - S Guzzinati
- Epidemiological Department, Azienda Zero, Via J. Avanzo, 35, 35132, Padua, Italy
| | | | - D Pierannunzio
- National Centre for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - S Piffer
- Trento Province Cancer Registry, Unit of Clinical Epidemiology, Trento, Italy
| | - S Vaccarella
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - M Vicentini
- Reggio Emilia Cancer Registry, Epidemiology Unit, AUSL ASMN-IRCCS, Azienda USL di Reggio Emilia, Reggio Emilia, Italy
| | - M Zorzi
- Epidemiological Department, Azienda Zero, Via J. Avanzo, 35, 35132, Padua, Italy
| | - S Franceschi
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Via Franco Gallini 2, 33081, Aviano, PN, Italy
| | - U Fedeli
- Epidemiological Department, Azienda Zero, Via J. Avanzo, 35, 35132, Padua, Italy.
| |
Collapse
|
2
|
Mattioli V, Crocetti E, Dal Maso L, Buzzoni C, Franceschi S, Serraino D, Vaccarella S, Ferretti S, Busco S, Fedeli U, Varvarà M, Falcini F, Zorzi M, Carrozzi G, Mazzucco W, Gasparotti C, Iacovacci S, Toffolutti F, Cavallo R, Stracci F, Russo AG, Caldarella A, Rosso S, Musolino A, Mangone L, Casella C, Fusco M, Tagliabue G, Piras D, Tumino R, Guarda L, Dinaro YM, Piffer S, Pinna P, Mazzoleni G, Fanetti AC. RISK OF HEMOLYMPHOPOIETIC NEOPLASM BEFORE AND AFTER THYROID CANCER. A POPULATION‐BASED STUDY IN ITALY, 1998‐2012. Hematol Oncol 2021. [DOI: 10.1002/hon.104_2881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | | | | | | | | | | | - S. Vaccarella
- International Agency for Research on Cancer Section of Cancer Surveillance Lyon France
| | - S. Ferretti
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori" Meldola, Italy‐Azienda Usl della Romagna, Romagna Cancer Registry Forlì Italy
| | - S. Busco
- ASL Latina Cancer Registry of Latina Province Latina Italy
| | - U. Fedeli
- Azienda Zero Epidemiological Department Padua Italy
| | - M. Varvarà
- Università degli Studi di Catania Registro Tumori Integrato Catania‐Messina‐Siracusa‐Enna Catania Italy
| | - F. Falcini
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS Romagna Cancer Registry Meldola Italy
| | - M. Zorzi
- Veneto Region Veneto Tumor Registry Padua Italy
| | - G. Carrozzi
- Modena Cancer Registry AUSL Modena Public Health Department Modena Italy
| | - W. Mazzucco
- Palermo and Province Cancer Registry Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone" University of Palermo Clinical Epidemiology Unit with Cancer Registry Palermo Italy
| | - C. Gasparotti
- Brescia Health Protection Agency Epidemiology Unit Brescia Cancer Registry Brescia Italy
| | - S. Iacovacci
- ASL Latina Cancer Registry of Latina Province Latina Italy
| | | | - R. Cavallo
- ASL Salerno Cancer Registry Salerno Italy
| | - F. Stracci
- University of Perugia Public Health Section ‐ Dept. of Medicine and Surgery Perugia Italy
| | - A. G. Russo
- Agency for Health Protection of Milan Cancer Registry of Milan Epidemiology Unit Milan Italy
| | - A. Caldarella
- Institute for Cancer Research Prevention and Clinical Network (ISPRO) Tuscany Cancer Registry Clinical Epidemiology Unit Florence Italy
| | - S. Rosso
- Azienda Ospedaliera‐Universitaria Città della Salute e della Scienza di Torino Piedmont Cancer Registry Torino Italy
| | - A. Musolino
- Azienda Ospedaliera Universitaria di Parma Parma Cancer Registry Oncology Unit Parma Italy
| | - L. Mangone
- AUSL ASMN‐IRCCS Azienda USL di Reggio Emilia Reggio Emilia Cancer Registry Epidemiology Unit Reggio Emilia Italy
| | - C. Casella
- IRCCS Ospedale Policlinico San Martino Liguria Cancer Registry Clinical Epidemiology Genova Italy
| | - M. Fusco
- ASL Napoli 3 Sud Cancer Registry Napoli Italy
| | - G. Tagliabue
- Fondazione IRCCS Istituto Nazionale dei Tumori Lombardy Cancer Registry Varese Province Cancer Registry Unit Department of Research Milan Italy
| | - D. Piras
- Azienda Regionale per la Tutela della Salute North Sardinia Cancer Registry Sassari Italy
| | - R. Tumino
- Provincial Health Authority (ASP 7) Cancer Registry and Histopathology Department Ragusa Italy
| | - L. Guarda
- Agenzia di Tutela della Salute (ATS) della Val Padana Mantova Cancer Registry Epidemilogy Unit Mantova Italy
| | - Y. M. Dinaro
- Siracusa Cancer Registry Health Unit of Siracusa Siracusa Italy
| | - S. Piffer
- Trento Province Cancer Registry Unit of Clinical Epidemiology Trento Italy
| | - P. Pinna
- ASSL Nuoro/ATS Sardegna Nuoro Cancer Registry RT Nuoro Nuoro Italy
| | | | - A. C. Fanetti
- Health Protection Agency Sondrio Cancer Registry Sondrio Italy
| |
Collapse
|
3
|
Lortet-Tieulent J, Vaccarella S. International and subnational variation thyroid cancer incidence and mortality over 2008–2012. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.05.053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
4
|
Vaccarella S, Laversanne M, Ferlay J, Bray F. Cervical cancer in Africa, Latin America and the Caribbean and Asia: Regional inequalities and changing trends. Int J Cancer 2017; 141:1997-2001. [PMID: 28734013 DOI: 10.1002/ijc.30901] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 07/11/2017] [Accepted: 07/13/2017] [Indexed: 01/04/2023]
Abstract
The vast majority (86% or 453,000 cases) of the global burden of cervical cancer occurs in Africa, Latin America and the Caribbean and Asia, where one in nine new cancer cases are of the cervix. Although the disease has become rare in high-resource settings (e.g., in North America, parts of Europe, Japan) that have historically invested in effective screening programs, the patterns and trends are variable elsewhere. While favourable incidence trends have been recorded in many populations in Asia and Latin America and the Caribbean in the past decades, rising rates have been observed in sub-Saharan African countries, where high quality incidence series are available. The challenge for countries heavily affected by the disease in these regions is to ensure resource-dependent programmes of screening and vaccination are implemented to transform the situation, so that accelerated declines in cervical cancer are not the preserve of high-income countries, but become the norm in all populations worldwide.
Collapse
Affiliation(s)
- S Vaccarella
- Infections and Cancer Epidemiology group, International Agency for Research on Cancer, Lyon, France
| | - M Laversanne
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - J Ferlay
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - F Bray
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| |
Collapse
|
5
|
Vaccarella S, Franceschi S, Engholm G, Lönnberg S, Khan S, Bray F. 50 years of screening in the Nordic countries: quantifying the effects on cervical cancer incidence. Br J Cancer 2014; 111:965-9. [PMID: 24992581 PMCID: PMC4150271 DOI: 10.1038/bjc.2014.362] [Citation(s) in RCA: 139] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Revised: 05/22/2014] [Accepted: 06/04/2014] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Nordic countries' data offer a unique possibility to evaluate the long-term benefit of cervical cancer screening in a context of increasing risk of human papillomavirus infection. METHODS Ad hoc-refined age-period-cohort models were applied to the last 50-year incidence data from Denmark, Finland, Norway and Sweden to project expected cervical cancer cases in a no-screening scenario. RESULTS In the absence of screening, projected incidence rates for 2006-2010 in Nordic countries would have been between 3 and 5 times higher than observed rates. Over 60,000 cases or between 41 and 49% of the expected cases of cervical cancer may have been prevented by the introduction of screening in the late 1960s and early 1970s. CONCLUSIONS Our study suggests that screening programmes might have prevented a HPV-driven epidemic of cervical cancer in Nordic countries. According to extrapolations from cohort effects, cervical cancer incidence rates in the Nordic countries would have been otherwise comparable to the highest incidence rates currently detected in low-income countries.
Collapse
Affiliation(s)
- S Vaccarella
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon cedex 08, France
| | - S Franceschi
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon cedex 08, France
| | - G Engholm
- Department of Documentation & Quality, Danish Cancer Society, Strandboulevarden 49, 2100 Copenhagen, Denmark
| | - S Lönnberg
- Cancer Registry of Norway, P.O. box 5313 Majorstuen, Oslo N-0304, Norway
| | - S Khan
- Swedish Cancer Registry, National Board of Health and Welfare, S-106 30 Stockholm, Sweden
| | - F Bray
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon cedex 08, France
| |
Collapse
|
6
|
|
7
|
Marchetti A, Pinto C, Taddei GL, Troncone G, Russo A, Fontanini G, Larocca LM, Mottolese M, Giannini G, Ruco L, Roz E, Scarpa A, Calabrese G, Bortesi B, Vaccarella S, Cossu A, Ludovini V, Normanno N. KRAS mutations in colorectal cancer patients in Italy: Results from the KRAS aKtive program. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e14000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
8
|
Franceschi S, Plummer M, Clifford G, de Sanjose S, Bosch X, Herrero R, Muñoz N, Vaccarella S. Differences in the risk of cervical cancer and human papillomavirus infection by education level. Br J Cancer 2009; 101:865-70. [PMID: 19654578 PMCID: PMC2736843 DOI: 10.1038/sj.bjc.6605224] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Cervical cancer risk is associated with low education even in an unscreened population, but it is not clear whether human papillomavirus (HPV) infection follows the same pattern. METHODS Two large multicentric studies (case-control studies of cervical cancer and HPV prevalence survey) including nearly 20 000 women. GP5+/GP6+ PCR was used to detect HPV. RESULTS Education level was consistently associated with cervical cancer risk (odds ratio (OR) for 0 and >5 years vs 1-5 years=1.50, 95% confidence interval (CI): 1.25-1.80 and 0.69, 95% CI: 0.57-0.82, respectively, P for trend <0.0001). In contrast, no association emerged between education level and HPV infection in either of the two IARC studies. A majority of the women studied had never had a Pap smear. The association between low education level and cervical cancer was most strongly attenuated by adjustment for age at first sexual intercourse and first pregnancy. Parity and screening history (but not lifetime number of sexual partners, husband's extramarital sexual relationships, and smoking) also seemed to be important confounding factors. CONCLUSION The excess of cervical cancer found in women with a low socio-economic status seems, therefore, not to be explained by a concomitant excess of HPV prevalence, but rather by early events in a woman's sexually active life that may modify the cancer-causing potential of HPV infection.
Collapse
Affiliation(s)
- S Franceschi
- International Agency for Research on Cancer, 69372 Lyon cedex 08, France.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Heck J, Berthiller J, Vaccarella S, Winn D, Smith E, Shangina O, Schwartz S, Purdue M, Eluf-Neto J, Menezes A, McClean M, Matos E, Koifman S, Kelsey K, Herrero R, Hayes R, Franceschi S, Wünsch-Filho V, Fernandez L, Daudt A, Curado M, Chen C, Castellsagué X, Ferro G, Brennan P, Boffetta P, Hashibe M. Sexual behaviors and the risk of head and neck cancers. EJC Suppl 2008. [DOI: 10.1016/s1359-6349(08)71863-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
10
|
Bardin A, Vaccarella S, Clifford G, Lissowska J, Rekosz M, Bobkiewicz P, Kupryjańczyk J, Krynicki R, Jonska-Gmyrek J, Danska-Bidzinska A, Snijders P, Meijer C, Zatonski W, Franceschi S. Human papillomavirus infection in women with and without cervical cancer in Warsaw, Poland. Eur J Cancer 2008; 44:557-64. [DOI: 10.1016/j.ejca.2007.12.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2007] [Revised: 11/16/2007] [Accepted: 12/06/2007] [Indexed: 11/28/2022]
|
11
|
Dai M, Bao YP, Li N, Clifford GM, Vaccarella S, Snijders PJF, Huang RD, Sun LX, Meijer CJLM, Qiao YL, Franceschi S. Human papillomavirus infection in Shanxi Province, People's Republic of China: a population-based study. Br J Cancer 2006; 95:96-101. [PMID: 16773069 PMCID: PMC2360486 DOI: 10.1038/sj.bjc.6603208] [Citation(s) in RCA: 122] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
To investigate the prevalence of, and risk factors for, cervical infection with human papillomavirus (HPV) in the rural province of Shanxi, People's Republic of China, which has relatively high cervical cancer mortality rates, we interviewed and obtained cervical cell samples from 662 women aged 15–59 years. A total of 24 different HPV types were identified using a GP5+/6+-based PCR assay able to detect 44 different HPV types. Human papillomavirus prevalence was 14.8% overall and 9.6% among women without cervical abnormalities (14.2 and 8.9%, respectively, age standardised to the world standard population). Multiple-type infections accounted for 30.6% of all infections. By far the most commonly found type was HPV16 (5.7% of all women and 38.8% of HPV-positive women), followed by HPV 58, 52, 33 and 18. Unlike most previous studies published, HPV prevalence was lower among women younger than 35 years (8.7%) than those older than 35 years (17.8%). High-risk HPV types predominated in all age groups. Although low-risk HPV types were rare in young women, they became more common with increasing age. 92.3% of women with cervical intraepithelial neoplasia grade 3 were infected with high-risk HPV types, but none with low-risk types only. No significant difference in HPV positivity was observed by educational level, sexual habits, reproductive history or use of contraceptive methods in this rural low-income Chinese population.
Collapse
Affiliation(s)
- M Dai
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon cedex 08, France
| | - Y P Bao
- Cancer Institute/Hospital, Chinese Academy of Medical Sciences, 17, South Pan Jia Yuan LN, PO Box 2258, Beijing 100021, China
| | - N Li
- Cancer Institute/Hospital, Chinese Academy of Medical Sciences, 17, South Pan Jia Yuan LN, PO Box 2258, Beijing 100021, China
| | - G M Clifford
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon cedex 08, France
| | - S Vaccarella
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon cedex 08, France
| | - P J F Snijders
- Vrije University Medical Center, Postbus 7057, 1007 MB, Amsterdam, The Netherlands
| | - R D Huang
- Yangcheng Tumor Hospital, 4 Qiaodong Road, Yangcheng 048100, Shanxi, China
| | - L X Sun
- Department of Gynecological Oncology, Shanxi Provincial Tumor Hospital, 3 Zhigongxincun, Taiyuan 030013, Shanxi, China
| | - C J L M Meijer
- Vrije University Medical Center, Postbus 7057, 1007 MB, Amsterdam, The Netherlands
| | - Y L Qiao
- Cancer Institute/Hospital, Chinese Academy of Medical Sciences, 17, South Pan Jia Yuan LN, PO Box 2258, Beijing 100021, China
- Department of Cancer Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences, 17, South Pan Jia Yuan LN, PO Box 2258, Beijing 100021, China. E-mail:
| | - S Franceschi
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon cedex 08, France
| |
Collapse
|
12
|
Aguilar LV, Lazcano-Ponce E, Vaccarella S, Cruz A, Hernández P, Smith JS, Muñoz N, Kornegay JR, Hernández-Avila M, Franceschi S. Human papillomavirus in men: comparison of different genital sites. Sex Transm Infect 2006; 82:31-3. [PMID: 16461598 PMCID: PMC2563819 DOI: 10.1136/sti.2005.015131] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To elucidate which anatomical sites need to be sampled to detect human papillomavirus (HPV) infection in the lower male genital tract. METHOD In an HPV survey of Mexican soldiers (median age 24 years; range 16-50 years), a cell sample from 2 cm deep into the distal urethra (group 1; n = 168 men), or 0.5 cm deep into the meatus urethralis (group 2; n = 414 men) was collected, along with a sample from the external genitalia. The different samples were tested for 27 HPV types using a polymerase chain reaction based strip assay. RESULTS HPV DNA was detected more frequently in external genitalia samples (46.4%) than in the urethra (20.8%) or meatus samples (12.1%). Lack of samples from the urethra or meatus would have led to 5.1% and 1.5% false HPV negative results, respectively. The most frequently detected high risk HPV types (HPV 59, 52, 51, and 16) were similar in different sites, whereas low risk types were found rarely in urethra samples. CONCLUSIONS The addition of cell samples from the meatus to those from external genitalia contributed negligibly to the evaluation of the prevalence of HPV in men. HPV detection was slightly improved by the addition of urethra samples, but the gain may not justify the discomfort of the procedure in large epidemiological studies.
Collapse
Affiliation(s)
- L V Aguilar
- Escuela Militar de Graduados de Sanidad, Universidad del Ejército y Fuerza Aérea Mexicanos, Mexico DF, Mexico
| | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Clifford GM, Gallus S, Herrero R, Muñoz N, Snijders PJF, Vaccarella S, Anh PTH, Ferreccio C, Hieu NT, Matos E, Molano M, Rajkumar R, Ronco G, de Sanjosé S, Shin HR, Sukvirach S, Thomas JO, Tunsakul S, Meijer CJLM, Franceschi S. Worldwide distribution of human papillomavirus types in cytologically normal women in the International Agency for Research on Cancer HPV prevalence surveys: a pooled analysis. Lancet 2005. [PMID: 16168781 DOI: 10.1016/s0140-6736(05)] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The proportion of women infected with human papillomavirus (HPV) varies greatly across populations, as might the distribution of HPV types. We aimed to compare HPV-type distribution in representative samples of women from different world regions. METHODS Women were randomly selected from the general population of 13 areas from 11 countries (Nigeria, India, Vietnam, Thailand, Korea, Colombia, Argentina, Chile, the Netherlands, Italy, and Spain). A standardised protocol was used for cervical specimen collection. All HPV testing was by GP5+/6+ PCR-based EIA. The proportion of HPV-positive women infected with different HPV types was compared by study area and between pooled regions with age-adjusted odds ratios (ORs) with corresponding 95% floating CIs. FINDINGS 15 613 women aged 15-74 years without cytological abnormalities were included in a pooled analysis. Age-standardised HPV prevalence varied nearly 20 times between populations, from 1.4% (95% CI 0.5-2.2) in Spain to 25.6% (22.4-28.8) in Nigeria. Although both overall HPV prevalence and HPV16 prevalence were highest in sub-Saharan Africa, HPV-positive women in Europe were significantly more likely to be infected with HPV16 than were those in sub-Saharan Africa (OR 2.64, p=0.0002), and were significantly less likely to be infected with high-risk HPV types other than HPV16 (OR 0.57, p=0.004) and/or low-risk HPV types (OR 0.44. p=0.0002). Women from South America had HPV-type distribution in between those from sub-Saharan Africa and Europe. Heterogeneity between areas of Asia was significant. INTERPRETATION Heterogeneity in HPV type distribution among women from different populations should be taken into account when developing screening tests for the virus and predicting the effect of vaccines on the incidence of infection.
Collapse
Affiliation(s)
- G M Clifford
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon cedex 08, France.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Clifford GM, Gallus S, Herrero R, Muñoz N, Snijders PJF, Vaccarella S, Anh PTH, Ferreccio C, Hieu NT, Matos E, Molano M, Rajkumar R, Ronco G, de Sanjosé S, Shin HR, Sukvirach S, Thomas JO, Tunsakul S, Meijer CJLM, Franceschi S. Worldwide distribution of human papillomavirus types in cytologically normal women in the International Agency for Research on Cancer HPV prevalence surveys: a pooled analysis. Lancet 2005; 366:991-8. [PMID: 16168781 DOI: 10.1016/s0140-6736(05)67069-9] [Citation(s) in RCA: 685] [Impact Index Per Article: 36.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND The proportion of women infected with human papillomavirus (HPV) varies greatly across populations, as might the distribution of HPV types. We aimed to compare HPV-type distribution in representative samples of women from different world regions. METHODS Women were randomly selected from the general population of 13 areas from 11 countries (Nigeria, India, Vietnam, Thailand, Korea, Colombia, Argentina, Chile, the Netherlands, Italy, and Spain). A standardised protocol was used for cervical specimen collection. All HPV testing was by GP5+/6+ PCR-based EIA. The proportion of HPV-positive women infected with different HPV types was compared by study area and between pooled regions with age-adjusted odds ratios (ORs) with corresponding 95% floating CIs. FINDINGS 15 613 women aged 15-74 years without cytological abnormalities were included in a pooled analysis. Age-standardised HPV prevalence varied nearly 20 times between populations, from 1.4% (95% CI 0.5-2.2) in Spain to 25.6% (22.4-28.8) in Nigeria. Although both overall HPV prevalence and HPV16 prevalence were highest in sub-Saharan Africa, HPV-positive women in Europe were significantly more likely to be infected with HPV16 than were those in sub-Saharan Africa (OR 2.64, p=0.0002), and were significantly less likely to be infected with high-risk HPV types other than HPV16 (OR 0.57, p=0.004) and/or low-risk HPV types (OR 0.44. p=0.0002). Women from South America had HPV-type distribution in between those from sub-Saharan Africa and Europe. Heterogeneity between areas of Asia was significant. INTERPRETATION Heterogeneity in HPV type distribution among women from different populations should be taken into account when developing screening tests for the virus and predicting the effect of vaccines on the incidence of infection.
Collapse
Affiliation(s)
- G M Clifford
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon cedex 08, France.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Rajkumar T, Franceschi S, Vaccarella S, Gajalakshmi V, Sharmila A, Snijders PJF, Muñoz N, Meijer CJLM, Herrero R. Role of paan chewing and dietary habits in cervical carcinoma in Chennai, India. Br J Cancer 2003; 88:1388-93. [PMID: 12778066 PMCID: PMC2741039 DOI: 10.1038/sj.bjc.6600902] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2002] [Revised: 02/14/2003] [Accepted: 02/14/2003] [Indexed: 11/29/2022] Open
Abstract
Non-viral factors contribute to human papillomavirus (HPV)-related cervical carcinogenesis. We investigated the role of paan chewing and dietary habits among 205 women with invasive cervical cancer (ICC) and 213 age-matched control women in Chennai, India. Odds ratios (OR) and 95% confidence intervals (CI) were computed by means of unconditional multiple regression, taking into account major correlates of ICC risk. Paan chewing showed a dose-dependent direct association with ICC (OR for >/=5 paan day(-1)=4.0; 95% CI 1.2-13.3). Among dietary habits, the highest vs lowest intake tertile for vegetables and fruit was associated with an OR of 0.5 (95% CI 0.2-1.0). Low education level and low body weight were also risk factors for ICC, but they did not account for the associations of paan chewing and low vegetable and fruit intake. In the analyses restricted to HPV-positive cases and controls, the inverse association with vegetable and fruit intake was confirmed. Conversely, the adverse influence of paan chewing on ICC risk seemed to be attributable to a higher prevalence of cervical HPV infection in women who chewed.
Collapse
Affiliation(s)
- T Rajkumar
- Cancer Institute (WIA), 18 Sardar Patel Road, Adyar, Chennai 600 020, India
| | - S Franceschi
- International Agency for Research on Cancer, 150 cours Albert Thomas, F-69372 Lyon, cedex 08, France
| | - S Vaccarella
- International Agency for Research on Cancer, 150 cours Albert Thomas, F-69372 Lyon, cedex 08, France
| | - V Gajalakshmi
- Epidemiological Research Center, Chennai 600 010, India
| | - A Sharmila
- Cancer Institute (WIA), 18 Sardar Patel Road, Adyar, Chennai 600 020, India
| | - P J F Snijders
- Free University Medical Center, Postbus 7057, NL–1007 MB Amsterdam, the Netherlands
| | - N Muñoz
- International Agency for Research on Cancer, 150 cours Albert Thomas, F-69372 Lyon, cedex 08, France
| | - C J LM Meijer
- Free University Medical Center, Postbus 7057, NL–1007 MB Amsterdam, the Netherlands
| | - R Herrero
- Proyecto Epidemioloágico Guanacaste, Costa Rican Foundation for Health Sciences, San Joseá, Costa Rica
| |
Collapse
|
16
|
Rajkumar T, Sridhar H, Balaram P, Vaccarella S, Gajalakshmi V, Nandakumar A, Ramdas K, Jayshree R, Muñoz N, Herrero R, Franceschi S, Weiderpass E. Oral cancer in Southern India: the influence of body size, diet, infections and sexual practices. Eur J Cancer Prev 2003; 12:135-43. [PMID: 12671537 DOI: 10.1097/00008469-200304000-00007] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Between 1996 and 1999, we carried out a study in Southern India on risk factors for oral cancer. The study included 591 incident cases of cancer of the oral cavity (282 women) and 582 hospital controls (290 women). Height was unrelated to oral cancer risk. Body mass index (weight in kilograms/height in metres squared) was inversely associated with risk (P for trend<0.001). Paan chewers with low BMI were at particularly high risk. Risk was increased among subjects consuming meat (odds ratio (OR) 1.54, 95% confidence interval (CI) 1.00-2.37), ham and salami (OR 4.40, 95% CI 2.88-6.71) two or more times per week. Frequent consumption of fish, eggs, raw green vegetables, cruciferous vegetables, carrots, pulses, apples or pears, citrus fruit, and overall consumption of vegetables and fruit decreased oral cancer risk (P for trend for each of these items less than or equal to 0.001). The risk associated with low consumption of vegetables was higher among smokers than among non-smokers. Men, but not women, who practised oral sex had an increased oral cancer risk (OR 3.14, 95% CI 1.15-8.63). Women with more than one sexual partner during life were at increased oral cancer risk (OR 9.93, 95% CI 1.57-62.9).
Collapse
Affiliation(s)
- T Rajkumar
- Cancer Institute (WIA), Adyar, Chennai 600 020, India
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Talamini R, Bosetti C, La Vecchia C, Dal Maso L, Levi F, Bidoli E, Negri E, Pasche C, Vaccarella S, Barzan L, Franceschi S. Combined effect of tobacco and alcohol on laryngeal cancer risk: a case-control study. Cancer Causes Control 2002; 13:957-64. [PMID: 12588092 DOI: 10.1023/a:1021944123914] [Citation(s) in RCA: 177] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To provide information on the effects of alcohol and tobacco on laryngeal cancer and its subsites. METHODS This was a case-control study conducted between 1992 and 2000 in northern Italy and Switzerland. A total of 527 cases of incident squamous-cell carcinoma of the larynx and 1297 hospital controls frequency-matched with cases on age, sex, and area of residence were included. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated using multiple logistic regression. RESULTS In comparison with never smokers, ORs were 19.8 for current smokers and 7.0 for ex-smokers. The risk increased in relation to the number of cigarettes (OR = 42.9 for > or = 25 cigarettes/day) and for duration of smoking (OR = 37.2 for > or = 40 years). For alcohol, the risk increased in relation to number of drinks (OR = 5.9 for > or = 56 drinks per week). Combined alcohol and tobacco consumption showed a multiplicative (OR = 177) rather than an additive risk. For current smokers and current drinkers the risk was higher for supraglottis (ORs 54.9 and 2.6, respectively) than for glottis (ORs 7.4 and 1.8) and others subsites (ORs 10.9 and 1.9). CONCLUSIONS Our study shows that both cigarette smoking and alcohol drinking are independent risk factors for laryngeal cancer. Heavy consumption of alcohol and cigarettes determined a multiplicative risk increase, possibly suggesting biological synergy.
Collapse
Affiliation(s)
- R Talamini
- Servizio di Epidemiologia, Centro di Riferimento Oncologico, Istituto Nazionale Tumori, Aviano, Italy.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Fernandez L, Serraino D, Rezza G, Lence J, Ortiz RM, Cruz T, Vaccarella S, Sarmati L, Andreoni M, Franceschi S. Infection with human herpesvirus type 8 and human T-cell leukaemia virus type 1 among individuals participating in a case-control study in Havana City, Cuba. Br J Cancer 2002; 87:1253-6. [PMID: 12439714 PMCID: PMC2408905 DOI: 10.1038/sj.bjc.6600613] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2002] [Revised: 08/14/2002] [Accepted: 09/04/2002] [Indexed: 12/02/2022] Open
Abstract
Infection with human herpesvirus type 8 and with human T-cell leukaemia virus type-1 shows strong geographic variations. We conducted this study to assess prevalence and risk factors for human herpesvirus type 8 infection in Havana City, Cuba. Information and residual serum samples already collected for a hospital based case-control study were used. A total of 379 individuals (267 males and 112 females; median age=63 years) were evaluated. Antibodies to the lytic antigen of human herpesvirus type 8 were detected by using an immunofluorescence assay, while human T-cell leukaemia virus type-1 serology was performed by means of an ELISA test (alpha Biotech). Overall, 64 subjects (16.9%, 95% confidence interval: 13.1-20.0) were positive for human herpesvirus type 8 antibodies. Human herpesvirus type 8 seroprevalence significantly increased with age (odds ratio=1.9 for >/=65 vs <55 years), and was twice as frequent in blacks than in whites. No association emerged with gender, socio-economic indicators, family size, history of sexually transmitted disease, sexual behaviour. Overall, 16 persons had anti-human T-cell leukaemia virus type-1 antibodies (4.2%, 95% confidence interval: 2.2-6.4). No relationship emerged between human T-cell leukaemia virus type-1 and human herpesvirus type 8 serostatus. The study findings indicate that human herpesvirus type 8 infection is relatively common in Havana City, Cuba, suggesting that Cuba may represent an intermediate endemical area. Sexual transmission does not seem to play a major role in the spread human herpesvirus type 8 infection.
Collapse
Affiliation(s)
- L Fernandez
- Instituto Nacional de Oncología y Radiobiología, Havana, Cuba
| | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Dal Maso L, Franceschi S, Negri E, Conti E, Montella M, Vaccarella S, Canzonieri V, Parazzini F, La Vecchia C. Body size indices at different ages and epithelial ovarian cancer risk. Eur J Cancer 2002; 38:1769-74. [PMID: 12175694 DOI: 10.1016/s0959-8049(02)00155-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The relationship between body mass measures at diagnosis and/or at different ages and ovarian cancer risk was investigated using an Italian multicentre case-control study. The study, conducted between 1992 and 1999, included 1031 cases of incident, histologically-confirmed epithelial ovarian cancer and 2411 controls admitted to the same network of hospitals for acute non-neoplastic conditions. Odds ratios (OR) and 95% confidence intervals (CI) were obtained using unconditional multiple logistic regression analyses. Weight and body mass index (BMI, kg/m(2)) 1 year prior to diagnosis/interview were not associated with ovarian cancer risk. A direct association emerged with waist-to-hip ratio (W/H) (OR=1.45 in the highest category), particularly among women with stage I-II cancers. Cases also had a higher BMI at age 30 years (OR=1.22). Conversely, cases had lower weight gain between age 30 years and the year prior to diagnosis/interview, both for cases with stage I-II and those with stage III-IV cancers.
Collapse
Affiliation(s)
- L Dal Maso
- Servizio di Epidemiologia, Centro di Riferimento Oncologico, Aviano, Italy.
| | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Augustin LS, Dal Maso L, La Vecchia C, Parpinel M, Negri E, Vaccarella S, Kendall CW, Jenkins DJ, Francesch S. Dietary glycemic index and glycemic load, and breast cancer risk: a case-control study. Ann Oncol 2001; 12:1533-8. [PMID: 11822751 DOI: 10.1023/a:1013176129380] [Citation(s) in RCA: 149] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Certain types of carbohydrates increase glucose and insulin levels to a greater extent than others. In turn, insulin may raise levels of insulin-like growth factors, which may influence breast cancer risk. We analyzed the effect of type and amount of carbohydrates on breast cancer risk, using the glycemic index and the glycemic load measures in a large case-control study conducted in Italy. PATIENTS AND METHODS Cases were 2,569 women with incident, histologically-confirmed breast cancer interviewed between 1991 and 1994. Controls were 2588 women admitted to the same hospital network for a variety of acute, non-neoplastic conditions. Average daily glycemic index and glycemic load were calculated from a validated 78-item food frequency questionnaire. RESULTS Direct associations with breast cancer risk emerged for glycemic index (odds ratio, OR for highest vs. lowest quintile = 1.4; P for trend <0.01) and glycemic load (OR = 1.3; P < 0.01). High glycemic index foods, such as white bread, increased the risk of breast cancer (OR = 1.3) while the intake of pasta, a medium glycemic index food, seemed to have no influence (OR = 1.0). Findings were consistent across different strata of menopausal status, alcohol intake, and physical activity level. CONCLUSIONS This study supports the hypothesis of moderate, direct associations between glycemic index or glycemic load and breast cancer risk and, consequently, a possible role of hyperinsulinemia/insulin resistance in breast cancer development.
Collapse
Affiliation(s)
- L S Augustin
- Servizio di Epidemiologia, Centro di Riferimento Oncologico, Istituto Nazionale Tumori, Aviano, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Abstract
In terms of worldwide levels, Cuba has an intermediate incidence of cancer of the oral cavity and oro-pharynx. We studied 200 cases of cancer of the oral cavity and pharynx, of whom 57 women (median age = 64) and 200 hospital controls, frequency matched with cases by age and sex, in relation to smoking and drinking history, intake of 25 foods or food groups, indicators of oral hygiene and sexual activity, and history of sexually transmitted diseases. Odds ratios (OR) and 95% confidence intervals (CI) were obtained from unconditional multiple logistic regressions and adjusted for age, sex, area of residence, education, and smoking and drinking habits. In the multivariate model, high educational level and white-collar occupation, but not white race, were associated with halving of oral cancer risk. Smoking > or =30 cigarettes per day showed an OR of 20.8 (95% CI: 8.9-48.3), similar to smoking > or =4 cigars daily (OR = 20.5). Drinking > or = 70 alcoholic drinks per week showed an OR of 5.7 (95% CI: 1.8-18.5). Hard liquors were by far the largest source of alcohol. Increased risk was associated with the highest tertile of intake for maize (OR = 1.9), meat (OR = 2.2) and ham and salami (OR = 2.0), whereas high fruit intake was associated with significantly decreased risk (OR = 0.4). Among indicators of dental care, number of missing teeth and poor general oral condition at oral inspection showed ORs of 2.7 and 2.6, respectively. Number of sexual partners, marriages or contacts with prostitutes, practice of oral sex and history of various sexually transmitted diseases, including genital warts, were not associated with oral cancer risk. 82% of oral cancer cases in Cuba were attributable to tobacco smoking, 19% to smoking cigars or pipe only. The fractions attributable to alcohol drinking (7%) and low fruit intake (11%) were more modest. Thus, decreases in cigarette and cigar smoking are at present the key to oral cancer prevention in Cuba.
Collapse
Affiliation(s)
- L F Garrote
- Instituto de Oncologia y Radiobiologia, Calle 29 y E Vedado, La Habana, 10400, Cuba
| | | | | | | | | | | | | | | |
Collapse
|
22
|
Abstract
In an Italian case-control study of oral cancer, number of missing teeth and other aspects of dental care were similar, but the general condition of the mouth, as indicated by gum bleeding, tartar deposits and mucosal irritation, was worse among oral cancer cases than controls. No differences were detected in sexual practices (including oral sex) and (previous) sexually transmitted infections.
Collapse
Affiliation(s)
- R Talamini
- Servizio di Epidemiologia, Centro di Riferimento Oncologico, via Pedemontana Occ., Aviano, 33081, Italy
| | | | | | | | | | | | | | | |
Collapse
|