Population attributable risks of oral cavity cancer to behavioral and medical risk factors in France: results of a large population-based case–control study, the ICARE study

ICARE Study GroupInternational audienceBackgroundPopulation attributable risks (PARs) are useful tool to estimate the burden of risk factors in cancer incidence. Few studies estimated the PARs of oral cavity cancer to tobacco smoking alone, alcohol drinking alone and their joint consumption but none performed analysis stratified by subsite, gender or age. Among the suspected risk factors of oral cavity cancer, only PAR to a family history of head and neck cancer was reported in two studies. The purpose of this study was to estimate in France the PARs of oral cavity cancer to several recognized and suspected risk factors, overall and by subsite, gender and age.MethodsWe analysed data from 689 oral cavity cancer cases and 3481 controls included in a population-based case–control study, the ICARE study. Unconditional logistic regression models were used to estimate odds ratios (ORs), PARs and 95 % confidence intervals (95 % CI).ResultsThe PARs were 0.3 % (95 % CI −3.9 %; +3.9 %) for alcohol alone, 12.7 % (6.9 %–18.0 %) for tobacco alone and 69.9 % (64.4 %–74.7 %) for their joint consumption. PAR to combined alcohol and tobacco consumption was 74 % (66.5 %–79.9 %) in men and 45.4 % (32.7 %–55.6 %) in women. Among suspected risk factors, body mass index 2 years before the interview <25 kg.m−2, never tea drinking and family history of head and neck cancer explained 35.3 % (25.7 %–43.6 %), 30.3 % (14.4 %–43.3 %) and 5.8 % (0.6 %–10.8 %) of cancer burden, respectively. About 93 % (88.3 %–95.6 %) of oral cavity cancers were explained by all risk factors, 94.3 % (88.4 %–97.2 %) in men and only 74.1 % (47.0 %–87.3 %) in women.ConclusionOur study emphasizes the role of combined tobacco and alcohol consumption in the oral cavity cancer burden in France and gives an indication of the proportion of cases attributable to other risk factors. Most of oral cavity cancers are attributable to concurrent smoking and drinking and would be potentially preventable through smoking or drinking cessation. If the majority of cases are explained by recognized or suspected risk factors in men, a substantial number of cancers in women are probably due to still unexplored factors that remain to be clarified by future studies

Incidence and survival rates for adult malignant neuro-epithelial brain tumors in the Somme county (France): A retrospective, population-based study from 2003 to 2013

International audienceAims: To describe the incidence and survival rates for neuro-epithelial primary brain tumors (NPBTs) in adults in the Somme county between 2003 and 2013. Methods: By analyzing the Somme Cancer Registry, we calculated the age-standardized incidence rates (ASRs) for NPBTs. Independent effects of age, gender and period of diagnosis on the incidence were evaluated in a Poisson regression analysis. A Cox proportional hazards model was used to adjust the overall survival rates for age, gender, histologic group and period. Results: Of the 257 registered NPBTs, 193 (75.1%) were astrocytic tumors. The subpopulations most affected by NPBTs were men (incidence rate ratio (IRR) [95% confidence interval (CI)] females/males = 0.7 [0.55-0.90], p < 0.001) and the elderly (IRR [95% CI] = 1.02 [1.01-1.03] per year increment, p < 0.001). The ASR [95% CI] was 4.5 [3.9-5.1] cases per 100,000 person-years. The increase in incidence [95%CI] between 2003 and 2013 was estimated to be 7.6% [3.4-11.2%] per year (p < 0.001). Survival improved significantly between the 2003-2008 period and the 2009-2013 period (hazard ratio [95%CI] = 0.70 [0.50-0.96], p = 0.03). Conclusion: We observed an increase in the incidence of NPBTs and in survival rates between 2009 and 2013. These increases might have been due to broader, earlier access to diagnostic tools and/or improvements in treatment procedures

Health professionals and the early detection of head and neck cancers: a population-based study in a high incidence area

International audienceAbstractBackgroundIn the context of early detection of head and neck cancers (HNC), the aim of this study was to describe how people sought medical consultation during the year prior to diagnosis and the impact on the stage of the cancer.MethodsPatients over 20 years old with a diagnosis of HNC in 2010 were included from four French cancer registries. The medical data were matched with data regarding uptake of healthcare issued from French National Health Insurance General Regime.ResultsIn 86.0 % of cases, patients had consulted a general practitioner (GP) and 21.1 % a dentist. Consulting a GP at least once during the year preceding diagnosis was unrelated to Charlson index, age, sex, département, quintile of deprivation of place of residence. Patients from the ‘quite privileged’, ‘quite underprivileged’ and ‘underprivileged’ quintiles consulted a dentist more frequently than those from the ‘very underprivileged’ quintile (p = 0.007).The stage was less advanced for patients who had consulted a GP (OR = 0.42 [0.18–0.99]) - with a dose–response effect.ConclusionsIn view of the frequency of consultations, the existence of a significant association between consultations and a localised stage at diagnosis and the absence of a socio-economic association, early detection of HNC by GPs would seem to be the most appropriate way

Unbiased estimates of long-term net survival of hematological malignancy patients detailed by major subtypes in France.

Long-term population-based survival data detailed by cancer subtype are important to measure the overall outcomes of malignancy managements. We provide net survival estimates at 1, 3, 5 and 10-year postdiagnosis on 37,549 hematological malignancy (HM) patients whose ages were >15 years, diagnosed between 1989 and 2004 and actively followed until 2008 by French population-based cancer registries. These are, to our knowledge, the first unbiased estimates of 10-year net survival in HMs detailed by subtypes. HMs were classified according to the International Classification of Diseases-Oncology 3. Net survival was estimated with the unbiased Pohar-Perme method. The results are reported by sex and age classes. The changes of these indicators by periods of diagnosis were tabulated and the trends of the net mortality rates over time since diagnosis graphed. In all, 5- and 10-year age-standardized net survivals after HMs varied widely from 81 and 76% for classical Hodgkin lymphoma (CHL) to 18 and 14% for acute myeloid leukemia (AML). Even in HMs with the most favorable prognoses, the net survival decreased between 5- and 10-year postdiagnosis. Women had better prognoses than men and age at diagnosis was an unfavorable prognostic factor for most HMs. In patients <55 years old, the net mortality rate decreased to null values 5-year postdiagnosis in AML and 10-year postdiagnosis in CHL, precursor non-HL, chronic myelogenous leukemia, diffuse large B-cell lymphoma and follicular lymphoma. The prognoses improved for various HMs over the study period. The obtained unbiased indicators are important to evaluate national cancer plans

Validation of an algorithm for identifying incident cancer cases based on long‐term illness and diagnosis related group program data from the French National Health Insurance Information System ( SNDS )

International audiencePurpose Three generic claims‐based algorithms based on the Illness Classification of Diseases (10th revision‐ ICD‐10) codes, French Long‐Term Illness (LTI) data, and the Diagnosis Related Group program (DRG) were developed to identify retirees with cancer using data from the French national health insurance information system (Système national des données de santé or SNDS) which covers the entire French population. The present study aimed to calculate the algorithms' performances and to describe false positives and negatives in detail. Methods Between 2011 and 2016, data from 7544 participants of the French retired self‐employed craftsperson cohort (ESPrI) were first matched to the SNDS data, and then toFrench population‐based cancer registries data, used as the gold standard. Performance indicators, such as sensitivity and positive predictive values, were estimated for the three algorithms in a subcohort of ESPrI. Results The third algorithm, which combined the LTI and DRG program data, presented the best sensitivities (90.9%–100%) and positive predictive values (58.1%–95.2%) according to cancer sites. The majority of false positives were in fact nearby organ sites (e.g., stomach for esophagus) and carcinoma in situ. Most false negatives were probably due to under declaration of LTI. Conclusion Validated algorithms using data from the SNDS can be used for passive epidemiological follow‐up for some cancer sites in the ESPrI cohort

Incidence des principaux cancers en France métropolitaine en 2023 et tendances depuis 1990

International audienceLes cancers constituent un ensemble de pathologies dont la fréquence, le pronostic et l’évolution sont trèsvariables. Dans le cadre d’une collaboration partenariale pour la surveillance des cancers, des indicateursd’incidence et de mortalité sont produits régulièrement. La dernière étude publiée portait sur la période 1990-2018.L’objectif de celle-ci est d’estimer l’incidence des 19 cancers les plus fréquents, celle de l’ensemble descancers en France métropolitaine pour l’année 2023 et d’actualiser l’analyse des évolutions depuis 1990,en particulier pour les années récentes. Des projections ont été réalisées à partir des données des registresde cancers observées de 1985 jusqu’en 2018.En 2023, le nombre de nouveaux cancers, toutes localisations confondues, est estimé à 433 136 cas. Les tauxd’incidence standardisés monde sont de 355 et 274 cas pour 100 000 personnes-années chez l’homme et lafemme respectivement. Depuis 1990, chez la femme, le taux d’incidence « tous cancers » augmente de façoncontinue de +0,9% par an. Chez l’homme, ce taux a augmenté en moyenne de +0,3% par an de 1990 à 2023 :après une augmentation jusqu’en 2005, le taux d’incidence a diminué et semble se stabiliser depuis 2012.Deux cancers ont vu leurs tendances récentes modifiées : le cancer de la prostate, avec depuis 2015 une nouvelleaugmentation de l’incidence, et le cancer de la thyroïde, avec depuis 2014 une diminution de l’incidence. Pources deux cancers, les projections de l’incidence de 2019 à 2023 étaient incertaines et n’ont pas été réalisées.Tous cancers confondus, ces évolutions du taux d’incidence combinées aux évolutions démographiques ontconduit à un doublement du nombre de nouveaux cas de cancers depuis 1990 chez l’homme et la femme

Incidence des principaux cancers en France métropolitaine en 2023 et tendances depuis 1990

International audienceLes cancers constituent un ensemble de pathologies dont la fréquence, le pronostic et l’évolution sont trèsvariables. Dans le cadre d’une collaboration partenariale pour la surveillance des cancers, des indicateursd’incidence et de mortalité sont produits régulièrement. La dernière étude publiée portait sur la période 1990-2018.L’objectif de celle-ci est d’estimer l’incidence des 19 cancers les plus fréquents, celle de l’ensemble descancers en France métropolitaine pour l’année 2023 et d’actualiser l’analyse des évolutions depuis 1990,en particulier pour les années récentes. Des projections ont été réalisées à partir des données des registresde cancers observées de 1985 jusqu’en 2018.En 2023, le nombre de nouveaux cancers, toutes localisations confondues, est estimé à 433 136 cas. Les tauxd’incidence standardisés monde sont de 355 et 274 cas pour 100 000 personnes-années chez l’homme et lafemme respectivement. Depuis 1990, chez la femme, le taux d’incidence « tous cancers » augmente de façoncontinue de +0,9% par an. Chez l’homme, ce taux a augmenté en moyenne de +0,3% par an de 1990 à 2023 :après une augmentation jusqu’en 2005, le taux d’incidence a diminué et semble se stabiliser depuis 2012.Deux cancers ont vu leurs tendances récentes modifiées : le cancer de la prostate, avec depuis 2015 une nouvelleaugmentation de l’incidence, et le cancer de la thyroïde, avec depuis 2014 une diminution de l’incidence. Pources deux cancers, les projections de l’incidence de 2019 à 2023 étaient incertaines et n’ont pas été réalisées.Tous cancers confondus, ces évolutions du taux d’incidence combinées aux évolutions démographiques ontconduit à un doublement du nombre de nouveaux cas de cancers depuis 1990 chez l’homme et la femme

Incidence des principaux cancers en France métropolitaine en 2023 et tendances depuis 1990

International audienceLes cancers constituent un ensemble de pathologies dont la fréquence, le pronostic et l’évolution sont trèsvariables. Dans le cadre d’une collaboration partenariale pour la surveillance des cancers, des indicateursd’incidence et de mortalité sont produits régulièrement. La dernière étude publiée portait sur la période 1990-2018.L’objectif de celle-ci est d’estimer l’incidence des 19 cancers les plus fréquents, celle de l’ensemble descancers en France métropolitaine pour l’année 2023 et d’actualiser l’analyse des évolutions depuis 1990,en particulier pour les années récentes. Des projections ont été réalisées à partir des données des registresde cancers observées de 1985 jusqu’en 2018.En 2023, le nombre de nouveaux cancers, toutes localisations confondues, est estimé à 433 136 cas. Les tauxd’incidence standardisés monde sont de 355 et 274 cas pour 100 000 personnes-années chez l’homme et lafemme respectivement. Depuis 1990, chez la femme, le taux d’incidence « tous cancers » augmente de façoncontinue de +0,9% par an. Chez l’homme, ce taux a augmenté en moyenne de +0,3% par an de 1990 à 2023 :après une augmentation jusqu’en 2005, le taux d’incidence a diminué et semble se stabiliser depuis 2012.Deux cancers ont vu leurs tendances récentes modifiées : le cancer de la prostate, avec depuis 2015 une nouvelleaugmentation de l’incidence, et le cancer de la thyroïde, avec depuis 2014 une diminution de l’incidence. Pources deux cancers, les projections de l’incidence de 2019 à 2023 étaient incertaines et n’ont pas été réalisées.Tous cancers confondus, ces évolutions du taux d’incidence combinées aux évolutions démographiques ontconduit à un doublement du nombre de nouveaux cas de cancers depuis 1990 chez l’homme et la femme

Methodological issues of assessing the risk of a second cancer occurring in the same site as a first cancer using registry data

International audienceObjectiveTo present methodological issues that can arise with the assessment of the risk of a second primary cancer (SPC) occurring in the same site as a first cancer using registry data.Material and methodsData from ten French cancer registries were used, including data for patients with a first prostate cancer (in males), breast cancer (in females), and colon, lung and kidney cancer (in both sexes) diagnosed between 1989 and 2004. Standardized incidence ratios (SIRs) of SPC were computed by excluding, or not, the risk of an SPC at the same site.ResultsFor prostate cancer, the SIR dropped from 1.11 to 0.72 when the risk of SPC of the prostate was included. SIRs increased from 1.36 to 1.45, from 1.14 to 1.21, from 1.57 to 2.01, and from 1.37 to 1.51 for breast, colon, lung, and kidney respectively.ConclusionThe inclusion, or not, of an SPC at the same site can impact on SPC risk estimates