1,721,008 research outputs found
Cancers Attributable to Modifiable Risk Factors: A Road Map for Prevention
The implementation of primary and secondary preventive strategies is based on the evidence generated by cancer epidemiology, where the identification of risk factors and the description of their prevalence are fundamental to derive estimates on the burden of cancer from different etiologies, typically expressed as the population attributable fraction, which corresponds to the proportion of a cancer that may be prevented by controlling a given risk factor. However, even when cancer finds its etiology in modifiable factors, its prevention through the control of those factors is not always feasible, or it remains suboptimal despite the possibility of reducing the burden. We reviewed selected associations between modifiable risk factors and cancer, including tobacco smoking, occupational exposures, infections, air pollution, alcohol, and diet and obesity, and illustrated examples of both successes and failures in cancer control, underlying how current understanding of the avoidable causes of cancer is incomplete
Cancer epidemiology
Cancer encompasses a family of several hundreds of diseases which are distinguished by site, morphology, clinical behavior, and response to therapy. Whether considered from a biological, a clinical, or a public health point of view, it is the malignant and invasive nature of many of these diseases and their ability to spread to distant organs (metastasis) that are of dominant importance
Occupational exposure to diesel exhaust and head and neck cancer: a systematic review and meta-analysis of cohort studies
Exposure to diesel exhaust (DE) and other fossil fuels in the workplace can cause several health effects including cancer. We conducted a systematic review and meta-analysis of cohort studies examining the association between occupational DE exposure and the risk of head and neck cancer (HNC), including cancer of the oral cavity, pharynx and larynx. We included cohort studies mentioned in the Monograph of the International Agency for Research on Cancer, 2014, on DE. Forest plots of relative risk (RR) were constructed for HNC overall and its anatomical subtypes. A random-effects model was used to address heterogeneity between studies. Fifteen articles were included after removing duplicates and irrelevant reports. The summary RR for DE exposure was 1.08 [95% confidence interval (CI) = 1.01-1.17, P heterogeneity = <0.001] for HNC overall, 0.98 (95% CI = 0.87-1.11) for oral cavity, 1.05 (95% CI = 0.77-1.43) for pharyngeal, 1.15 (95% CI = 0.96-1.38) for oral cavity and pharyngeal combined, and 1.13 (95% CI = 1.03-1.24) for laryngeal cancer. There were elevated RRs for incidence studies of HNC (RR = 1.13; 95% CI = 1.05-1.22, P = 0.001), European studies (RR = 1.13; 95% CI = 1.05-1.23, P = 0.001), and female studies (RR = 1.77; 95% CI = 1.31-2.39, P = 0.003). Our study suggested an association between occupational DE exposure and the risk of HNC, particularly laryngeal cancer. Although residual confounding cannot be ruled out, our results support the importance of controlling occupational DE exposure
Going Beyond Counting First Authors in Author Co-citation Analysis
The present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
The role of the occupational physician in controlling gastric cancer attributable to Helicobacter pylori infection: A review
This review aimed to describe the potential role of occupational physician in the implementation of a screening program for Helicobacter pylori (Hp) infection for gastric cancer prevention. We reviewed the epidemiological background of gastric cancer and its association with Hp, exploring the hypothesis of a “test-and-treat” protocol among working population. Clinical trials and model-based studies were collected to provided empirical evidence of the feasibility of eradication on large scale. In particular, previous studies conducted in occupational settings were discussed. Hp prevalence ranges between about 20 and 90%, with higher rates in Asia and Latin America and lower rates in Europe and North America. Large-scale trials on screening and treatment of infection have been conducted especially in East Asia, lacking elsewhere. Only few studies investigated Hp prevalence among workers. The benefit of eradication at occupational level has not yet been adequately studied. The design of a workplace-based Hp screening program appears to be innovative and could contribute to controlling gastric cancer. The benefit would involve not only high-risk subjects, but also their families, since the route of transmission is principally within the household. An occupational setting for a Hp screening would have positive consequences in terms of individual and public health
Understanding the epidemiology of gastric cancer: A review and case-only analysis from Italy
Background Gastric cancer epidemiology evolved rapidly in the last century, shifting from being one of the main causes of cancer-related death to the sixth in high-income countries. Methods We conducted a narrative review on gastric cancer epidemiology. Our review focused on trends of gastric cancer and its relationship with Helicobacter pylori infection; cardia and noncardia gastric cancer risk factors; early onset gastric cancer; second primary cancers in patients with gastric cancer; and implementation of gastric cancer prevention strategies. In addition, we provided results of a case-only analysis of recently diagnosed gastric cancer from a middle-risk population. Results Literature consistently describes the ongoing declining trend of gastric cancer rates and the overall increase in in absolute number of incident cases because of a change in population. The evolving distribution of risk factor prevalence impacts the epidemiology of gastric cancer, with an increase in early onset and in cardia gastric cancer. A negative correlation was observed between H. pylori prevalence and the proportion of cardia gastric cancer. The analysis of 117 gastric cancer cases observed between 2016 and 2020 in Bologna, Italy, showed that smoking and epigastric pain were significantly associated with increased risk of early-onset gastric cancer after accounting for confounders. Conclusion Multifaceted strategies are needed to address challenges in gastric cancer control, early diagnosis, and clinical management in a changing epidemiological landscape. Prevention remains the cornerstone to reduce the gastric cancer burden
Comparing the attitude toward the COVID-19 and the 2020/21 and 2019/20 flu vaccination campaigns among Italian healthcare workers
Background: While the uptake of the COVID-19 vaccine among healthcare workers (HCWs) is suboptimal, vaccine hesitancy has not been characterized in detail in this population. Objective: The aim of this study was to compare the prevalence of health-related conditions reported by HCWs during the COVID-19, 2020/21 flu, and 2019/20 flu vaccination campaigns, so to test the hypothesis that HCWs were more prone to report health conditions during the COVID-19 campaign. Methods: We analyzed vaccination questionnaires of 176 hospital-based HCWs who underwent the COVID-19 and the 2020/21 flu vaccinations; 2019/20 flu vaccination questionnaires were available for 130 of them. Outcomes included self-reported allergies, chronic diseases, and use of medications. We tested for prevalence equality, analyzed differences using the kappa statistics and concordance correlation, and explored factors associated with differences in reporting. Results: There was no difference in the proportion of HCWs reporting allergies in the three questionnaires, while chronic diseases were more frequently reported in the COVID-19 than in both 2020/21 (p = 0.04) and 2019/20 flu questionnaires (p = 0.02). Furthermore, a higher proportion of HCWs reported medications use in the COVID-19 vaccination questionnaire, compared to both the 2020/21 and the 2019/20 flu vaccination questionnaires (p < 0.001 for both). In each vaccine campaign, women reported more conditions than men, and the difference between chronic disease reports was greater for women than for men. Conclusions: Our results show more frequent reporting of health conditions during the COVID-19 than the flu vaccination campaigns, providing quantitative evidence of hesitancy of HCWs towards the COVID-19 vaccine
Variations on the Author
“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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