The incidence of pancreatic cancer in BRCA1 and BRCA2 mutation carriers.

BACKGROUND: Germline mutations in BRCA1 and BRCA2 predispose to pancreatic cancer. We estimated the incidence of pancreatic cancer in a cohort of female carriers of BRCA1 and BRCA2 mutation. We also estimated survival rates in pancreatic cancer cases from families with a BRCA mutation. METHODS: We followed 5149 women with a mutation for new cases of pancreatic cancer. The standardised incidence ratios (SIR) for pancreatic cancer were calculated based on age group and country of residence. We also reviewed the pedigrees of 8140 pedigrees with a BRCA1 or a BRCA2 mutation for those with a case of pancreatic cancer. We recorded the year of diagnosis and the year of death for 351 identified cases. RESULTS: Eight incident pancreatic cancer cases were identified among all mutation carriers. The SIR for BRCA1 carriers was 2.55 (95% CI=1.03-5.31, P=0.04) and for BRCA2 carriers was 2.13 (95% CI=0.36-7.03, P=0.3). The 5-year survival rate was 5% for cases from a BRCA1 family and 4% for cases from a BRCA2 family. CONCLUSION: The risk of pancreatic cancer is approximately doubled in female BRCA carriers. The poor survival in familial pancreatic cancer underscores the need for novel anti-tumoural strategies.

[Quality control of spirometry in workers' medical surveillance]. / Il controllo di qualità della spirometria nella sorveglianza sanitaria dei lavoratori.

Spirometry plays an important role in occupational respiratory health surveillance programs. However, when not performed correctly, the values obtained can be misleading, resulting in misclassification of the workers' health status. Studies carried out in Italy have shown that spirometries recorded by occupational physicians often do not comply with quality criteria for recording FEV1 and FVC, according to joint statements on lung function testing for the American Thoracic Society and the European Respiratory Society, issued in 2005. For this reason, they are useless for the purposes of their execution. Compliance with ATS/ERS statements is essential to assure that spirometry results are beneficial for the monitoring of workers' health.