We analysed the relation between coffee consumption and hepatocellular carcinoma in two case-control studies conducted between 1984 and 1998 in Italy and Greece, including 834 cases and 1912 controls. Compared to non coffee drinkers, the multivariate odds ratio was 0.7 for drinkers of three or more cups per day. The possible relation between coffee drinking and the risk of several cancers, particularly of cancers of the urinary bladder, pancreas and colorectum, has been widely investigated. These have shown a direct relation with bladder, an inverse one with colorectum, but no consistent association with other major sites, including liver cancer (IARC, 1991;Tavani and La Vecchia, 2000).Coffee drinking has been inversely related to the risk of liver cirrhosis in several studies (Klatsky and Armstrong, 1992;Klatsky et al, 1993;Corrao et al, 1994Corrao et al, , 2001Gallus et al, 2002). Although cirrhosis is a major correlate of hepatocellular carcinoma (Adami et al, 1992;La Vecchia et al, 1998, Kuper et al, 2000, the relation between coffee drinking and risk of hepatocellular carcinoma has been examined in only two studies which provided, however, no definite results. An Italian case-control study (La Vecchia et al, 1989), based on 151 cases with hepatocellular carcinoma, reported a multivariate odds ratio (OR) of 0.78 for drinkers of 53 cups of coffee per day, compared to non coffee drinkers. In a Greek casecontrol study (Kuper et al, 2000), based on 333 cases, the age-and sex-adjusted OR was 0.7 for drinkers of 520 cups per week compared to non drinkers.To clarify the role of coffee drinking in hepatocellular cancer, we updated and re-analysed the Italian and Greek studies. MATERIALS AND METHODS Selection of cases and controlsThe present data derived from two case-control studies of hepatocellular carcinoma. The first was conducted between 1984 and 1997, in a network of teaching and general hospitals in the Greater Milan area (La Vecchia et al, 1989. Cases were 501 subjects with incident, histologically confirmed hepatocellular carcinoma. Of these, 378 were males and 123 were females; the age range was 20 -75 years, median age 60. Controls were 1552 patients with acute non neoplastic conditions, unrelated to long-term changes in diet or coffee drinking habit (i.e., gastritis or other chronic digestive tract disorders), from the same catchment areas as the cases, and admitted to the same hospitals. Of these, 1141 were males and 411 were females; the age range was 18 -75 years, median age 56.The second study was conducted between 1995 and 1998 in three teaching hospitals from Athens (Kuper et al, 2000). Cases were 333 subjects with incident hepatocellular carcinoma. Of these, 283 were males and 50 were females; the age range was 31 -79 years, median age 65. Controls were 360 patients admitted to the same hospitals as the cases, for injuries, or eye, ear, nose or throat conditions. Of these, 298 were males and 62 were females; the age range was 24 -79 years, median age 65.Thus, a total of 834 cases of hepatocellular...

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Background-The relation between n-3 polyunsaturated fatty acids (PUFAs), fish intake, and risk of coronary heart disease is controversial. Methods and Results-An Italian case-control study including 507 patients with nonfatal acute myocardial infarction (AMI) and 478 hospital controls found a multivariate odds ratio (OR) of 0.67 (95% CI, 0.47 to 0.95) for the highest n-3 PUFA intake and 0.68 (95% CI, 0.47 to 0.98) for an intake of Ͼ1 portion of fish per week compared with Ն2 portions per week. Conclusions-Small amounts of n-3 PUFAs may be inversely related to AMI risk in this low-risk population. (Circulation.2001;104:2269-2272.)

The separate effect of alcohol and tobacco on laryngeal cancer was analysed in two case -control studies from Italy and Switzerland, comprising 40 non-smoking and 68 non-drinking cases, and 160 non-smoking and 161 non-drinking controls. The multivariate odds ratio was 2.46 for heavy drinkers non-smokers, and 9.38 for current smokers non-drinkers. Alcohol drinking and tobacco smoking increase the risk of laryngeal cancer, and show a multiplicative effect on risk (IARC, 1986(IARC, , 1988Tuyns et al, 1988;Franceschi et al, 1990;Sankaranarayanan et al, 1990;Dosemeci et al, 1997). In developed countries, laryngeal cancer is extremely rare in individuals who do not smoke and do not drink alcohol and information on risk in such people is therefore limited.A hospital-based US study found an association with tobacco in non/moderate alcohol drinkers, but had no information on alcohol in non-smokers (Wynder et al, 1976). A case -control study from Canada, reported an increasing risk of laryngeal cancer in relation to alcohol drinking in non-smokers, based, however, on three case -control pairs only (Burch et al, 1981). A case -control study conducted in Italy, Spain, Switzerland and France reported odds ratios (OR) of 1.7 for 580 g day 71 of alcohol among nine nonsmoking cancer cases of the hypopharynx and epilarynx, and of 6.7 for 540 g day 71 of alcohol among 22 non-smoking cancer cases of the endolarynx (Tuyns et al, 1988). A Polish study found a strong association with number of cigarettes among non-vodka drinkers, but the reference category was based on a single case (Zatonski et al, 1990). PATIENTS AND METHODSThe separate effect of alcohol and tobacco on laryngeal cancer risk was analysed in the combined data of two case -control studies, including a uniquely large number of non-smoking and non-drinking subjects. The first study, conducted between 1986 and 1992 in the province of Pordenone and the greater Milan area, northern Italy, included 162 subjects with incident, histologically confirmed cancer of the larynx La Vecchia et al, 1990). The second one was conducted between 1992 and 2000 in the province of Pordenone and the greater Milan area, Italy, and in the Swiss Canton of Vaud, on 527 incident, histologically confirmed laryngeal cancer cases. Forty non-smoking cases (median age 60 years, range 30 -72) and 68 non-drinking ones (median age 61 years, range 42 -74) were identified in the two studies, and included in the present analysis. Non-smoking cases included 20 glottis, two supraglottis and 18 other or unspecified laryngeal cancers; non-drinking ones included 21 glottis, 12 supraglottis and 35 other or unspecified laryngeal cancers. They were matched on study, sex, age and study center to 160 non-smoking controls (median age 60 years, range 31 -79) and 161 non-drinking controls (median age 59 years, range 40 -77), selected from a database of 4781 patients, admitted to the same network of hospitals as cases, for a wide spectrum of acute, non-neoplastic conditions, unrelated to alcohol consumption and tobacc...