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  • 1
    Electronic Resource
    Electronic Resource
    Invasive cervical cancer in young women (1984)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 91 (1984), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. Between 1970 and 1979, 103 women below 35 years of age with invasive cervical cancer were treated at the First Obstetrics and Gynaecology Clinic of the University of Milan. Nine patients were pregnant or less than 3 months postpartum. Estimated 10–year disease–free survival, determined by the life–table method, was 100% in stage IA (37 patients), 79% in stage IB (45 patients), 67% in stage 11 (15 patients), 0% in stages III (5 patients) and IV (1 patient). Prognosis was also strongly associated with lymph–node involvement, 10–year actuarial survival decreasing from 93% in lymph–node–negative to 44% in lymph–node– positive patients (P〈O.001). The prognostic relevance of the clinical stage decreased after adjustment for lymph–node involvement, but the statistical significance of lymph–node involvement was unaffected when stage was allowed for. In the present series, the estimated 10–year disease–free survival was 80% in patients treated by radical hysterectomy compared with 62% in the group treated by total hysterectomy (stage IB to IV patients only); this difference, however, was not statistically significant when the data were adjusted for clinical stage (P=O.10). None of the 20 patients with recurrent disease could be managed successfully.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1984.tb15093.x
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  • 2
    Electronic Resource
    Electronic Resource
    Trends in multiple births in Italy: 1955–1983 (1991)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 98 (1991), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. On the basis of the numbers of single and multiple births routinely collected by the Central Institute of Statistics, trends in multiple births in Italy over the period 1955–1983 were analyzed. Between 1955 and 1983 the frequency of multiple births declined by about 25% (from 12–6/1000 deliveries to 9-6/1000 deliveries). The downward trend was constant until the early 1970s when rates tended to level off and increase slightly. This finding was largely attributable to trends in dizygotic rates, monozygotic births being approximately constant over the period considered. Multiple birth rates rose till age 35–39, being more than two times higher in this age group than in teenagers, but flattened off in the subsequent strata of age: this finding was constant over the period considered. Despite the general decreasing trend, the regional differences persisted largely unchanged, multiple birth rates being about 30% higher in Southern (and less developed areas) of the country than in the North of Italy. Geographic differences were limited to dizygotic pregnancies, monozygotic rates being constant (about 4/1000 pregnancies) in various areas.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1991.tb10366.x
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  • 3
    Electronic Resource
    Electronic Resource
    Determinants of caesarean section rates in Italy (1992)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 99 (1992), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To analyse the determinants of caesarean section rates in Italy.Design Analysis of information using a standard form on all the deliveries after the 28th week of gestation routinely collected by the Italian Central Institute of Statistics.Setting National data of all Italian deliveries in the periods 1980–1983.Subjects A total of more than 2 400 000 deliveries occurred in Italy in the period and are considered in this analysis.Results The frequency of caesarean section rose from 11.2/100 deliveries in 1980 to 14.5/100 in 1983. Caesarean section rates were lower in the Southern (less rich) areas, and rose steadily with maternal age, being about three times higher in women aged ≥40 years than in teenagers. Maternal education was directly associated with caesarean section rates: compared with women with only primary school education, those with a college education reported an about 40% higher rate of caesarean section, but this difference dropped markedly after allowance for maternal age and birth-weight. The section rate was 13.3/100 deliveries in public hospitals and 11.8/100 in private ones, but this reflected the different utilization of public and private services in various geographical areas. Birthweight and gestational age at delivery were important determinants of caesarean section rates; lowest values were observed for very-low-birthweight and very preterm deliveries and babies weighing 3000–3999 g and term deliveries. Caesarean section rates were about 20% higher in nulliparous than in parous women and the rates increased with number of stillbirths or miscarriages; further, the rate ratio was about double in multiple than in single births.Conclusion Caesarean section rates in Italy in the early 1980s were still lower than in North America, but their determinants share several similarities with those reported in other areas.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1992.tb14499.x
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  • 4
    Electronic Resource
    Electronic Resource
    Maternal and paternal moderate daily alcohol consumption and unexplained miscarriages (1990)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 97 (1990), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. The relation between parental moderate alcohol consumption and the risk of miscarriage was analysed using data from a casecontrol study in Milan between January 1987 and June 1988. Cases were 94 women who had two or more ‘unexplained’ miscarriages (after exclusion of genetic, endocrine and Miillerian factors) and without full-term pregnancies, admitted or referred to the First Obstetric and Gynecologic Clinic of the University of Milan. A total of 176 women admitted for normal delivery on selected days to the same university clinic and without previous miscarriages were chosen as controls. Compared with non-drinkers the risk of recurrent miscarriage was 0·9 for regular drinkers. The point estimates were 0·9 for women reporting one drink per day and 0·8 for those reporting two or more. Compared with non-drinkers, the relative risk estimates for drinking by fathers were slightly above unity, being 1·7 for less than three drinks and 1·4 for three or more drinks per day, but the trend in risk was not statistically significant.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1990.tb02550.x
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  • 5
    Electronic Resource
    Electronic Resource
    Ten-year survival in 290 patients with endometrial cancer: prognostic factors and therapeutic approach (1983)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 90 (1983), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. Between 1970 and 1976, 290 patients with endometrial cancer were treated at the 1st Obstetrics and Gynecology Clinic of the University of Milan. The median age was 62 years. Surgery was completed in 262 (90.3%) patients. Abdominal hysterectomy was used in 158 (70.9%) stage I and 40 (71.4%) stage II/III patients; vaginal hysterectomy in 55 (24.7%) stage I and nine (16.1%) stage II/III patients. Resection of the upper vagina was performed in 168 patients. Postoperative external beam radiotherapy was used in stage II/III patients and in 44 (19.7%) stage I high-risk patients. Ten-year survival, determined by the life-table method, was 84.8% in stage I (223 patients), 53.4% in stage II (37 patients), 64.4% in stage III (19 patients), and 9.1% in stage IV (11 patients). Factors associated with poorer prognosis were: late age at diagnosis (P〈0.001); deep myometrial invasion (P〈0.001); poorly differentiated histological grade (P=0.11); lack of resection of the upper vagina (P= 0.13). The role and importance of surgery is discussed, with special emphasis on the selective use of the vaginal route in aged, obese and medically high-risk patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1983.tb09285.x
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  • 6
    Electronic Resource
    Electronic Resource
    Use of oral contraceptives and uterine fibroids: results from a case-control study (1999)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 106 (1999), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To analyse the association between oral contraceptive use and the risk of uterine fibroids.Design Participants We considered data collected in a case-control study on risk factors for uterine fibroids.Participants We studied 843 women with uterine fibroids, whose clinical diagnosis dated back no more than two years. Controls were 1557 non-hysterectomised patients younger than 55 years admitted for acute, non-gynecological, non-hormonal, non-neoplastic conditions.Results A total of 254 cases (30.1 %) and 360 controls (23.1 %) reported ever using oral contraceptives: the odds ratio (OR) for ever vs never users was 1–1 (95% CI 0-8–1.3). The risk in current users was below unity when compared with never users (OR 0.3,95% CI 0.2–0.6), while ex-users had a risk of fibroids comparable with never users (OR 1. I, 95% CI 0.9–1.4). The risk of uterine fibroids decreased with duration of oral contraceptive use: compared with never users, the estimated OR was 0.8 (95% CI 0.5–1.2) in ever users for four to six years and 0.5 (95% CI 0.349) for seven years or more (trend = 4.6, P= 0.03).Conclusions Although the role of selection bias should be carefully evaluated, the present data suggest that uterine fibroids should not be considered a contra-indication for oral contraceptive use.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1999.tb08409.x
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  • 7
    Electronic Resource
    Electronic Resource
    Cancer mortality in young adults in Switzerland, 1951–1989 (1991)
    Springer
    Journal of cancer research and clinical oncology 117 (1991), S. 497-501 
    Details
    ISSN: 1432-1335
    Keywords: Mortality rates ; Young adults ; Neoplasms ; Time trends ; Descriptive epidemiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Trends in mortality from all neoplasms and major cancer sites in Switzerland among populations aged between 20 and 44 years are presented. In men total cancer mortality was approximately constant around 270/106 between 1951 and 1965, but declined appreciably thereafter to 217 per million in 1980–1989. The overall fall was 20%. The pattern of trends was similar for women, although a modest decline was already apparent in the earlier calendar period, and the overall fall was 29% (from 303 to 215/106). These favourable trends reflect therapeutic advancements for Hodgkin's disease, leukaemias, testis and (chiefly non-epithelial) ovarian cancer, better control of cervical cancer, the long-term decline in gastric cancer, but also the downward trends in cancer of the intestines and a few less common sites, such as gallbladder and thyroid neoplasms for reasons that are not yet clear. Appreciable rises were observed for lung and other tobacco-related sites in women, for the oral cavity in men and (in earlier calendar periods) cutaneous melanoma in both sexes. Although restricted to a selected number of sites, these rises are discouraging, since the causes of these neoplasms have long been recognized. Somewhat discouraging also is the absence of decline in male lung cancer. These problems notwithstanding, the overall pattern of trends in cancer mortality in young Swiss adults over the last few decades is still reassuring, particularly in comparison with those observed in other European countries, and in the more general frame-work of the debate on the perspectives of progress in cancer control. Although restricted to a small proportion of all cancer deaths, in fact, trends in young adults offer useful indications on the likely future trends in the same generations in the near future, since they reflect more recent changes in the pattern of exposure. The size of the changes, however, will probably differ, since the prevalent cancers in middle age are different from those in the young.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01612774
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  • 8
    Electronic Resource
    Electronic Resource
    Cancer mortality in young adults: Italy 1955–1985 (1990)
    Springer
    Journal of cancer research and clinical oncology 116 (1990), S. 215-219 
    Details
    ISSN: 1432-1335
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Although cancer mortality in young adults accounts for only a small proportion of all cancer deaths, it is important since it provides useful indications of the most likely future trends, and relevant information on the role of exposure to specific, or newer, carcinogens. We, therefore, analysed trends in cancer mortality between 1955 and 1985 among Italian men and women aged 20–44 years. In those three decades, overall cancer mortality declined steadily, by 27% in young women (from 33.8 to 24.7/100000, world standard) but only by 3% (from 27.3 to 26.4/100000) among men. The decline for men, however, was 16% from the peak rate of 31.5 reached in 1970–1974. The major underlying component causing the different trends in the two sexes was lung and other tobacco-related neoplasms, which had been considerably on the increase in young men up to the early 1970s, and levelled-off thereafter, while showing no appreciable change in women. The falls were about 50% for stomach cancer in both sexes, and over 80% for cervical cancer. A clear impact of improved treatment was reflected in the substantial declines in Hodgkin's disease, of testicular cancer in the last decade and, possibly, in the favourable trends in cancers of the breast, bone, brain and leukemias over the most recent calendar periods. Only two sites showed appreciable and persisting upward trends: oral cavity in men and skin melanoma in both sexes. They therefore constitute priorities for intervention in the near future.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01612680
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  • 9
    Electronic Resource
    Electronic Resource
    The application of age, period and cohort models to predict Swiss cancer mortality (1990)
    Springer
    Journal of cancer research and clinical oncology 116 (1990), S. 207-214 
    Details
    ISSN: 1432-1335
    Keywords: Cancer mortality ; Age/period/cohort models ; Projections
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In order to project trends in mortality from 11 major cancer sites in Switzerland to the end of the current century, a log-linear Poisson age/period/cohort model with arbitrary constraints on the parameters was used, fitted to the observed rates for the period 1950–84. One projection was based on the assumption of a total absence of change in the effect of period, the second was based on a linear extrapolation of the logarithms of the seven known periods, and the third was related to a series of a priori external epidemiological hypotheses, whenever available. For instance, coefficients below unity were used for lung and other tobacco-related neoplasms in men, since some decline in exposure to tobacco carcinogens was observed among Swiss men, and above unity for women since the prevalence of smoking has risen among successive generations of women. Although the method has limitations and uncertainties, several qualitative indications could be derived from this exercise. For instance, the various models suggest that the age-standardized mortality from oral cancer in men will probably increase up to the end of the century, even under the optimistic assumption of an appreciable decline in smoking, while cancer of the oesophagus is likely to level-off around current values, as other tobacco-related neoplasms, prostate cancer in men, and breast cancer in women will probably do. Some steady decline is predicted by various models fitted to the incidence of stomach and intestinal cancer in both sexes, and to ovarian cancer. Lung cancer will continue to rise in women but will stop rising in men, and it will possibly fall if the hypothesis of a decline in exposure to tobacco carcinogens proves correct. Although any prediction has, by definition, substantial difficulties and uncertainties, projections of cancer mortality in the near future are based on a substantial amount of information already available, and may offer valuable information for epidemiological inferences and health planning purposes.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01612679
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  • 10
    Electronic Resource
    Electronic Resource
    Descriptive epidemiology of gall-bladder cancer in Europe (1993)
    Springer
    Journal of cancer research and clinical oncology 119 (1993), S. 165-171 
    Details
    ISSN: 1432-1335
    Keywords: Gall-bladder cancer ; Epidemiology ; Europe
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Trends in mortality from cancer of the gall-bladder and bile ducts over the period 1965–1989 were analysed for 25 European countries on the basis of official death certifications from the World Health Organization databank. A high-mortality area — i.e. with overall death certification rates, world standard, around or over 2/100 000 men and 4/100000 women in 1985–1989 — was identified in Germany and the surrounding central European countries (Austria, Czechoslovakia, Hungary and Poland). The highest rates were in Hungary (3.9/100 000 men and 7.4/100 000 women). During the two decades considered, rates increased in Czechoslovakia and Hungary, remained stable in Poland and declined in Austria and Germany. Intermediate-mortality areas included Scandinavian countries (except Norway) and Switzerland: their rates in the late 1980s were between 1.5 and 2.5/100 000 men and between 2.2 and 4.2/100 000 women. Mortality increased in Finland and Sweden, declined in the Netherlands and Switzerland, and did not change consistently in Denmark. Low-mortality countries (i.e. with rates in 1985–1989 below 2.0/100 000 men and 2.5/100 000 women) included Belgium, France, Britain, Ireland, Norway, Bulgaria and Mediterranean countries. Over the last two decades, certification rates declined in Bulgaria and Great Britain, but increased in all other countries. The ratio between the countries with the highest and lowest gall-bladder cancer mortality rates declined from 21 to 12 in women, although they remained stable around 10 for men. The pattern was similar when analysis was restricted to truncated rates from patients aged between 35 and 64 years. These trends, and particularly lthe exceedingly high rates in central Europe, the low rates in Mediterranean countries and the low and declining rates in Britain and Ireland are discussed in terms of known (cholelithiasis) or potential (dietary) factors in gall-bladder cancer aetiology, and of trends in cholecystectomy rates.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01229532
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