Benign breast disease and breast cancer: a case-control study in a cohort in Italy

Sixty-two cases of invasive breast cancer were identified in a large cohort of women previously treated for biopsy-proven benign breast disease (BBD) at the Breast Unit of CSPO, in Florence, along with a group of 315 controls, strictly matched by age and year of diagnosis. A pathologist reviewed and reclassified all the original BBD slides according to recently proposed criteria (no evidence of epithelial proliferation, epithelial proliferation without or with atypia). Information about potential confounding factors was collected during personal interviews. In comparison to the women with "non-proliferative" BBD, women classified as having "proliferative disease without atypia" showed a weak and non-significant increase in risk (OR 1.3; 95% CI: 0.5-3.5). In contrast, women with "atypical hyperplasia" were at very high risk of developing breast cancer (OR 13.0; 95% CI: 4.1-41.7). When planning mammography screening or other large-scale early-diagnosis programmes for breast cancer in the general female population, follow-up of high-risk subgroups of BBD patients should be considered.     

A case-control study of dietary and nondietary factors in ovarian cancer

A case-control study is presented that estimates ovarian cancer risk for various factors, including diet. Data collected by interview between 1957 and 1965 for 274 white women aged 30-79 years with epithelial carcinoma of the ovary are compared to data similarly collected for 1,034 hospital controls. Relative risk estimates are presented for the total group as well as for premonopausal (ages 30-49) and postmenopausal (ages 50-79) are groups. In the total group, cancer risk increased with increasing age at first marriage (P less than .01) and previous history of benign breast disease (P less than 0.1), and risk decreased with increasing number of previous pregnancies (P less than .01). In the 50- to 79-year age group, a marginally significant trend for decreasing risk with increasing obesity was observed (P less than .10). There was no significant risk (i.e., P less than .10) associated with the consumption of alcohol, cigarettes, coffee, tea, total dietary protein, vitamin C, or fat at any age. In the 30- to 49-year age group only, increased risk (P less than .01) was seen in women reporting diets low in fiber and vitamin A from fruit and vegetable sources. Multiple regression analysis demonstrated that the apparent protective effect of vitamin A in the 30- to 49-year age group (but not dietary fiber) was independent of the nondietary factors analyzed in this study (P less than .05).     

A case-control study of dietary factors and stomach cancer risk in Poland

We report results from a case-control study on stomach cancer conducted in 1980-81 in Cracow, Poland, where the risk of this disease is among the highest reported world-wide. One hundred and ten cases from a surgical clinic were matched by age and sex to the same number of controls from the same hospital. A matched series from a population-based health survey was also considered. After adjusting for residency, smoking and various food items, cases and hospital controls showed significant differences in consumption of fruits (RR rarely vs. daily: 3.24; 95% CI: 1.56-6.77), joint consumption of vegetables, salads and fruits (RR low vs. high: 4.23; 95% CI: 1.41-12.63), and consumption of protein-containing foods (RR low vs. high: 0.23; 95% CI: 0.08-0.61). Consumption of strong alcoholic beverages on an empty stomach (before breakfast) was associated with an RR of 2.09 (1.04-4.22). The findings are discussed in relation to the apparent urban/rural difference in stomach cancer incidence in Poland and the possible underlying etiological factors involved.     

Benign thyroid disease is associated with breast cancer: a meta-analysis

The controversial relationship between benign thyroid diseases and breast cancer (BC) has been investigated for over 50 years. Despite extensive population studies, the results as a whole have been inconsistent. The purpose of this study was to collate and analyse available data, calculating a pooled odds ratio (OR) of the risk of BC in patients diagnosed with benign thyroid diseases. Studies were obtained from a database search of MEDLINE, EMBASE, PubMed, Current Contents Connect and Google Scholar with additional cross checking of reference lists. Inclusion criteria required a confirmed diagnosis of a benign thyroid disease, reporting of an OR or data to calculate an OR (and 95% confidence interval, CI) and the use of an internal control group as the comparator. Collated data was assessed for heterogeneity and a pooled OR calculated. 28 studies were included in the meta-analysis. There was significant evidence of an increased risk of BC in patients with autoimmune thyroiditis, evident in a pooled OR 2.92 (95% CI 2.13-4.01). In addition, the results supported an increased risk associated with the presence of anti-thyroid antibodies (OR 2.02, 95% CI 1.63-2.50) and goitre (OR 2.26, 95% CI 1.39-3.69). Subgroup analysis of antibody presence revealed increased risk associated with both anti-TPO (OR 2.64, 95% CI 1.82-3.83) and anti-TG (2.71, 95% CI 1.58-4.69). Quantitative analysis of hypothyroidism and hyperthyroidism was not significant. While these results indicate an association between thyroid auto-immunity and BC, further prospective studies are required to definitively prove causality.     

Benign breast disease, recent alcohol consumption, and risk of breast cancer: a nested case-control study

Introduction  

Alcohol consumption is a well-established risk factor for breast cancer. Some studies have suggested that the risk of breast cancer associated with alcohol consumption is greater for women with a history of benign breast disease (BBD). We hypothesized that among women with biopsy-confirmed BBD, recent alcohol consumption would increase the risk of breast cancer in women with proliferative breast disease to a greater extent than in women with nonproliferative breast disease.     

Risk factors for ovarian cancer: a case-control study

A hospital-based case-control study of ovarian cancer was conducted in London and Oxford between October 1978 and February 1983. Menstrual characteristics, reproductive and contraceptive history and history of exposure to various environmental factors were compared between 235 women with histologically diagnosed epithelial ovarian cancer and 451 controls. High gravidity, hysterectomy, female sterilisation and oral contraceptive use were associated with a reduced risk of ovarian cancer. Infertility and late age at menopause were associated with an increase in risk. While these factors were related, they were each found to be independently associated with ovarian cancer risk after adjusting for the effect of the other factors.     

胰腺癌危险因素的病例对照研究

目的:探讨与胰腺癌发病可能有关的各种危险因素。方法:回顾性分析2000年6月-2010年6月收治的290例胰腺癌患者和同期312例非肿瘤来源、非代谢性疾病患者的性别、年龄、高血压、吸烟史、肿瘤家族疾病史、消化系统手术史、胆系疾病史、慢性胰腺疾病史、总胆固醇、三酰甘油、乙型肝炎病毒表面抗原(hepatitis B surface antigen,HBsAg)、丙型肝炎病毒抗体(hepatitis C virus antibody,anti-HCV)和糖尿病等资料,进行单因素和多因素logistic分析。结果:单因素分析表明,糖尿病、高血压、吸烟史、肿瘤家族疾病史、消化系统手术史、胆系疾病史、慢性胰腺疾病史、总胆固醇水平和三酰甘油水平在2组间的差异有统计学意义(P<0.05);多因素logistic分析表明,吸烟[比数比(odds ratio,OR)=1.66,95%可信区间(confidence interval,CI)=1.08～2.56)]、糖尿病(OR=11.14,95%CI=5.07～24.49)、高血压(OR=1.64,95%CI=1.07～2.51)、胆系疾病史(OR=4.19,95%CI=2.74～6.40)和三酰甘油水平(OR=1.83,95%CI=1.44～2.32)是胰腺癌独立的高危因素(P<0.05)。结论:吸烟、糖尿病、高血压、胆系疾病史和三酰甘油水平可能是胰腺癌独立的高危因素。     

A case-control study of dietary and nondietary risk factors for breast cancer in Shanghai

A case-control study of breast cancer (186 cases, 186 population, and 186 hospital controls) was conducted in Shanghai, China, between 1982 and 1984. This population has a high daily caloric intake (population control mean, 2394 kcal) and low percentage of calories from fat (22.7%) compared to Western populations. Cases have a significantly greater daily caloric intake than controls, primarily because of increased consumption of monounsaturated fat for which the relative risk is 1.89 for the highest compared to the lowest quintile (P = 0.02). This finding requires cautious interpretation but seems worthy of further study in populations with similar dietary practices.     

Benign breast disease and risk of thyroid cancer

Background

It has been suggested that breast and thyroid diseases may be linked. The aim of this study was to investigate the association between benign breast disease and subsequent risk of thyroid cancer.

Methods

Postmenopausal women (n = 133,875) aged 50–79 years were followed up for a mean of 14 years. Benign breast disease was defined by history of biopsy. Incident thyroid cancer cases were confirmed by medical record review. Multivariable Cox proportional hazard modeling was used to estimate hazard ratios.

Results

There were 370 incident thyroid cancer cases during the follow-up period. Compared to women without BBD, women with BBD had a significant increased risk of thyroid cancer after adjusting for potential confounders (HR 1.38 95% CI 1.10–1.73), especially for women with more than two biopsies (HR 1.59 95% CI 1.10–2.26). There were no significant differences in thyroid tumor size, stage or histologic types between women with and without BBD.

Conclusion

Our large prospective study observed that postmenopausal women with BBD had an increased risk for thyroid cancer compared with women without BBD. A more detailed investigation of thyroid cancer risk according to different subtypes of benign breast disease is needed to better understand the association observed between thyroid and benign breast diseases.

     

Dietary factors and gastric cancer in Korea: a case-control study.

To assess gastric cancer (GC) risk in relation to dietary intake in Korea, a case-control study was performed. Trained dietitians interviewed 136 patients diagnosed with GC, and the same number of controls were selected by matching sex, age and hospital. A significant decrease in GC risk was observed with increased intake of Baiechu kimchi (prepared with salted Chinese cabbage and red pepper, etc.), Baiechu kimchi-stew, garlic, mushroom and soybean milk. On the contrary, a significant increase in the risk of GC was observed with increased intake of cooked rice with bean, charcoal grilled beef, pollack soup, Kkakduki (a kind of kimchi prepared with salted radish and red pepper, etc.), Dongchimi (a kind of kimchi prepared with radish and a large quantity of salt water) and cooked spinach. In food groups, increased intake of soybean products was associated with decreased risk of GC. Intake of citrus fruits rather than total fruits was shown to have a protective effect on the risk of GC, but was not significant. In this study, intake of total vegetables was shown to have a protective effect, whereas high nitrate-containing vegetables increased the risk of GC. In conclusion, our study suggests that the risk of GC decreased with high consumption of fresh vegetables and fruits, whereas high consumption of foods rich in nitrate and carcinogenic substances produced during the cooking process increased the risk of GC.     

Risk factors for prostate cancer: a case-control study in Greece

A case-control study of prostate cancer (PC) was undertaken in Athens, Greece. Cases were 320 patients with histologically confirmed incident disease, whereas controls were 246 patients without history or symptomatology of benign prostatic hyperplasia, treated in the same hospitals as the cases for minor diseases or conditions. Cases and controls had similar distributions with respect to height, body mass index, sibship size and birth order in the parental family, marital status and number of offspring in the subject's own family and a long series of previous surgical operations and medical diagnoses, including diabetes mellitus, hepatitis and sexually transmitted diseases. There was also no evidence for a positive association between vertex baldness, tobacco smoking and drinking of coffee or alcoholic beverages, on the one hand, and PC, on the other. There was evidence, however, that some aspect of urban life may increase the risk for PC and a suggestion that sexual activity in early adulthood may be inversely associated with this risk.     

Dietary factors and stomach cancer in Spain: a multi-centre case-control study

A multi-centre case-control study of diet and gastric cancer was carried out in 4 regions of Spain (Aragon, Castile, Catalonia and Galicia). We selected 354 cases of pathologically confirmed gastric adenocarcinoma from 15 hospitals, representative of nearly all those in the study areas. A control for each case, matched by age, sex and area of residence, was selected from the same hospital as the case. Habitual diet was investigated by the dietary history method, and past diet by means of a frequency questionnaire. The results regarding consumption of food items are presented here. With respect to habitual diet, an increase in risk was associated with consumption of preserved fish, cold cuts and oleaginous fruits. A high intake of cooked green vegetables, fresh noncitrus fruit and dried fruit showed an inverse association with the risk of gastric cancer. Simultaneous intake of 2 groups of food which increase or decrease the risk of cancer strengthens the respective individual effect. The intake of protective food items seems to neutralize the effects of food items which increase risk. With reference to past diet, a possible protective effect was observed for daily consumption of fresh fruit and green vegetables.     

Risk factors for breast cancer in Iran: a case-control study

Background  

Iranian breast cancer patients are relatively younger than their Western counterparts. The objective of the present study was to investigate risk factors for breast cancer in Iranian women.     

Non-occupational risk factors for bladder cancer: a case-control study

AIMS: The aim of this study was to determine non-occupational risk factors for bladder cancer in Serbia. METHODS AND DESIGN: A hospital-based, case-control study included 130 newly diagnosed bladder cancer patients and the same number of individually matched controls with respect to sex, age (+/- 2 years) and type of residence (rural or urban), from the Clinical Center of Serbia in Belgrade and from the Clinical Center in Kragujevac in central Serbia. The study took place from June 1997 to March 1999. RESULTS: According to multivariate logistic regression analysis, there was an association between: frequency of daily urination (OR = 0.18; 95% CI = 0.08-0.39); consumption of liver (OR = 13.81; 95% CI = 2.49-76.69), canned meat (OR = 8.38; 95% CI = 1.74-40.36), fruit juices (OR = 0.08; 95% CI = 0.01-0.56); the highest tertile of pork (OR = 4.55; 95% CI = 1.30-15.93), cabbage (OR = 0.25; 95% CI = 0.06-1.01) and vinegar (OR = 4.41; 95% CI = 1.18-16.50) intake and risk for bladder cancer. CONCLUSIONS: Consumption of liver, canned meat, pork (h vs l tertile) and vinegar (m vs l tertile) was indicated as a risk factor for bladder cancer, whereas frequent daily urination, consumption of fruit juices and cabbage (h vs l tertile) were indicated as protective factors.     

Epidemiology of reproductive and hormonal factors in thyroid cancer: evidence from a case-control study in the Middle East.

Thyroid cancer is the second most common neoplasm among women in Kuwait and several other countries in the Middle East. Most of these countries also have relatively high birth and total fertility rates. To examine potential relationships between reproductive and hormonal factors and thyroid cancer, we conducted a population-based case-control interview study among 238 women diagnosed with thyroid cancer and a similar number of individually matched controls in Kuwait. Among the demographic variables, women with 12+ years of education had a significantly reduced risk of thyroid cancer (OR = 0.4; 95% CI: 0.2-0.8; p-trend <0.05). The average age at diagnosis (+/-SD) of thyroid cancer was 34.7 +/- 11 years. Events such as age at menarche, pregnancy, menopausal status and age at menopause were not associated with thyroid cancer. There was an association with age at last pregnancy and parity. Women who had their last pregnancy at ages > or = 30 years were at a significantly increased risk (OR = 2.1; 95% CI: 1.2-3.8); there was also a significant trend in risk with increasing age at last pregnancy. There was a modest increase in risk among women who had borne > or = 5 children (OR = 1.5; 95% CI: 0.9-2.5). A joint analysis of these factors showed that childbearing during the latter half of reproductive life had a substantial effect on the incidence of thyroid cancer; for any given level of parity, there was about a 2-fold increased risk if the age at last pregnancy was > or = 30 years. A substantial recent-birth effect, in relation to subsequent diagnosis of thyroid cancer, was observed during the second and third year after a birth (OR = 2.0; 95% CI: 1.0-4.1). In contrast, spontaneous abortion seemed to have a protective effect. There was a significant decrease in risk among women who had a miscarriage as outcome of first pregnancy (OR = 0.1; 95% CI: 0.03-0.4) and those who had experienced > or = 3 miscarriages (OR = 0.3; 95% CI: 0.1-0.8; p-trend <0.05). Overall, any female hormone use was not associated with thyroid cancer risk. New association is suggested for a history of post-partum thyroiditis (OR = 10.2; 95% CI: 2.3-44.8). These data support the hypothesis that reproductive factors and patterns may influence, or contribute to, the risk of thyroid cancer among women.     

A population-based case-control study of thyroid cancer

A population-based case-control interview study of thyroid cancer (159 cases and 285 controls) was conducted in Connecticut. Prior radiotherapy to the head or neck was reported by 12% of the cases and 4% of the controls [odds ratio (OR) = 2.8; 95% confidence interval = 1.2-6.9]. Risk was inversely related to age at irradiation and was highest among children exposed under age 10. Few persons born after 1945 received prior radiotherapy, consistent with the declining use of radiation to treat benign conditions in the 1950's. Among females the radiogenic risk appeared to be potentiated by the number of subsequent live-births. Other significant risk factors included a history of benign thyroid nodules (OR = 33) or goiter (OR = 5.6). Miscarriage and multiparity increased risk but only among women who developed thyroid cancer before age 35 years. Consumption of shellfish (a rich source of iodine) seemed to increase the risk of follicular thyroid cancer, whereas consumption of goitrogen-containing vegetables appeared to reduce risk of total thyroid cancer, possibly because of their cruciferous nature. A significantly low risk was observed among persons of English descent, whereas Italian ancestry appeared to increase risk. No significant associations were found with a number of suspected risk factors: diagnostic x-rays, radioactive isotope scans, occupational radiation exposure, tonsillectomy, Jewish ethnicity, alcohol intake, cigarette smoking, oral contraceptives, lactation suppressants, menopausal estrogens, most other common medications, and water source. New associations were suggested for obesity among females (OR = 1.5), surgically treated benign breast disease (OR = 1.6), use of spironolactone (OR = 4.3) or vitamin D supplements (OR = 1.8), and a family history of thyroid cancer (OR = 5.2). About 9% of the incident thyroid cancers could be attributed to prior head and neck irradiation, 4% to goiter, and 17% to thyroid nodular disease, leaving the etiology of most thyroid cancers yet to be explained.     

Benign ovarian teratomas: a population-based case-control study.

We attempted to identify all cases of benign ovarian teratoma which occurred in two health districts in the UK during a 56 month period. The crude incidence was 8.9 cases/100,000 women. One hundred and twenty cases and 119 age-matched controls were interviewed to identify risk factors for this disease. In addition, 137 mothers completed postal questionnaires. Cases were older at leaving school, had higher social class occupations, were more often unmarried or married late, and had fewer children than controls. Oral contraceptive use was similar for both. Cases reported more exercise at all ages, and more alcohol consumption 1 year before diagnosis. Cases'' mothers reported slightly less nausea during pregnancy than controls'' mothers, and none of the mothers reported exogenous hormone exposure during the index pregnancy. In this study benign ovarian teratomas strongly resemble testicular cancer in their age distribution in the population. They also resemble testicular cancer in their association with educational status and marital status. There was, however, no similarity regarding prenatal hormone exposure. The increased risks associated with exercise and alcohol use were unexpected; we need further information about how these exposures affect the ovary, and whether they affect the testis.     

A case-control study of occupational and dietary factors in colorectal cancer in young men by subsite

With the hope that exposures responsible for colorectal cancer might be especially obvious among those in whom it develops early, 147 men with colorectal carcinomas first diagnosed between the ages of 25 and 44 years were compared to neighborhood controls. Physical activity on the job was protective for tumors located in the transverse and descending portions of the colon. Rectal cancer and to a lesser extent sigmoid cancers were associated with jobs in which dusts or fumes were inhaled, especially if those jobs were held for long periods in young adulthood. While risk for rectal cancer did not seem to be limited to any particular type of dust or fume, the excess risk was strongest for wood and metal dusts. Consumption of fruits and vegetables and a preference for whole grain breads were protective for colon but not rectal cancers, while consumption of deep fried foods and barbecued/smoked meats increased risk at specific subsites. Beef intake, alcohol consumption, and cigarette smoking appeared to play little or no role at any subsite.