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Notes: Abstract The relationship between first degree family history of colorectal cancer and some pathological and clinical features was investigated in 302 patients affected by large bowel carcinoma. Patients with inherited forms of polyposis of the large bowel were excluded. Thirty-six (11.9%) had at least one close relative affected by intestinal cancer. No relationship between family history and pathological features (anatomic distribution, stage and grading) was found. Moreover no difference in prognosis between patients with a family history and those without was shown. These results suggest no relationship between a first degree family history and the natural history of the disease.

Notes: Abstract Purpose: The goal of the present analyses is to assess the associationbetween different therapeutic approaches and both the probability ofachieving a complete response and the risk of death in patients with stageIII–IV, inoperable, squamous cell carcinoma of the head and neck(SCC-HN). Patients and methods: Between August 1983 and December 1990, 273 patientswith stage III–IV, previously untreated, unresectable SCC of the oralcavity, pharynx and larynx. were included into two consecutive randomizedmulti-institutional trials (HN-7 and HN-8 protocols) coordinated by theNational Institute for Cancer Research (NICR) of Genoa. The HN-7 protocolcompared neo-adjuvant chemotherapy (four cycles of vinblastine, 6mg/m2 i.v. followed by bleomycin, 30 IU i.m. six hours later,day 1; methotrexate, 200 mg i.v., day 2; leucovorin, 45 mg orally, day 3)(VBM) followed by standard radiotherapy (70–75 Gy in 7–8 weeks)(55 patients) to alternating chemo-radiotherapy based on four cycles of thesame chemotherapy alternated with three splits of radiation, 20 Gy each (61patients). In the HN-8 protocol standard radiotherapy (77 patients) wascompared to the same alternating program as the one used in the previousprotocol but employing cisplatin, 20 mg/m2/day andfluorouracil, 200 mg/m2/day, bolus, both given for fiveconsecutive days (CF) instead of VBM (80 patients). A single database wascreated with the patients on the two protocols. Age at diagnosis, gender,site of the primary tumor, size of the primary, nodal involvement,performance status and treatment approach were analyzed by the multiplelogistic regression model and the Cox regression method. The analyses wererepeated including the treating institutions as a covariate (coordinatingcenter versus others). Results: The multiple logistic regression analysis indicates thattreatment (alternating more so than others, regardless of the chemotherapyregimen used) (P = 0.0001) is more likely to be associated with completeresponse. In addition, size of the primary tumor (P = 0.004), nodalinvolvement (P = 0.02) and performance status (P = 0.009) are prognosticvariables affecting the probability of achieving a complete response. TheCox regression analysis indicates that treatment, performance status, sizeof the primary tumor, nodal involvement and, marginally, site of the primarytumor, are independent prognostic variables affecting the risk of death.When the radiation-alone therapy is adopted as the reference treatment, therelative risk of death is 0.58 (95% confidence interval (CI)0.40–0.84) for alternating CF and radiation, 0.79 (95% CI0.53–1.16) for alternating VBM and radiation and 1.30 (95% CI0.89–1.92) for sequential VBM and radiation. When the treatinginstitution is included in the model, a 34% increased risk of death(P = 0.04) is observed for patients treated outside the coordinating center. Conclusion: In our series of patients with advanced, unresectable SCC-HN,treatment with cisplatin and fluorouracil alternating with radiation wasassociated with a more favourable prognosis. The role of the treatinginstitution in the modulation of the treatment outcomes was also relevant.

Notes: Abstract In 1990 an investigation aimed at evaluating the possibility of organizing a regional screening programme for the early detection of cervical cancer was carried out in Liguria. Information on resources available for early detection of cervical cancer was obtained from 12 of 20 Public Health Units; a screening programme was feasible in 8 of them. The number of Pap tests examined was evaluted for 6 of 20 cytology laboratories. Only one laboratory examined more than 20,000 Pap tests in 1989 and, according to the international guidelines, can be a referring centre for screening. However, no information was available concerning inter- and intralaboratory quality control programmes. In the same period a population-based survey was carried out using a self-administered questionnaire in order to evaluate the attitudes of women towards cervical cancer prevention. A total of 1,454 of 4,197 women (35%) participated in the study. Younger, well educated women employed in non non-manual work were more likely to participate in the study. About 65% of the respondents had satisfactory practices with regards to the Pap test, suggesting a strong self-selection that probably resulted in a sample of women more health-conscious than the general population. In conclusion, our results suggest that major interventions should be carried out in the Public Health Units to direct resources to the needs of the population. In addition, new educational methods should be adopted to reach selected population groups to encourage them to have a Pap test performed on a regular basis.