Cancer incidence in Morocco: report from Casablanca registry 2005-2007

Introduction: Few population-based cancer registries are in place in developing countries. In order to know the burden of cancer in Moroccanpopulation, cancer registry initiative was put in place in the Casablanca district, the biggest city of Morocco. Methods: The data collected covers3.6 millions inhabitant and included Casablanca city and the administrative region.Results: The data collected in the years 2005-07 show that the top 5 forms of cancers in women were breast (ASR: 36.4 per 100,000), cervical (15.0), thyroid (6.7), colon-rectum (5.8), and ovarian (5.3); the top 5 cancers in men were lung (25.9), prostate (13.5), bladder (8.7), colon-rectum (8.1) and non-Hodgkin lymphoma (7.2). Tumours of haematopoietic and lymphoid tissues represented 11% of all cancers (skin excluded); some presented unusual sex ratios. For breast, cervical, colorectal and thyroid cancer, respectively 57%, 42%, 28% and 60% of the cases were under 50 years of age. This was attributable to particularly low numbers of cases recorded among old people, and the young age of the general population; the observed age-specific incidences under age 50 were not higher than in western countries. Cancers at young ages were particularly common in women: 67% of the cases were under 50. Stageat diagnosis could be obtained for 82% of the breast cancer cases and was as follows: 28% local, 63% regional and 9% distant, in the absence ofscreening.Conclusion: These first population-based data have provided an invaluable resource for the national cancer control plan of Morocco, and will be useful tool to its future evaluation

Conceptual Framework to Guide Early Diagnosis Programs for Symptomatic Cancer as Part of Global Cancer Control

ACKNOWLEDGMENT This research arises from the CanTest Collaborative, which is funded by Cancer Research UK (C8640/A23385), of which MMK and NC are Postdoctoral Researchers, GL is Associate Director, GPR is Chair and FMW is Director. GL is supported by Cancer Research UK Clinician Advanced Scientist Fellowship (grant number: C18081/A18180). The funder has had no role in the study, writing of the report, or decision to submit the paper for publication.Peer reviewedPublisher PD

Conceptual Framework to Guide Early Diagnosis Programs for Symptomatic Cancer as Part of Global Cancer Control.

Diagnosing cancer earlier can enable timely treatment and optimize outcomes. Worldwide, national cancer control plans increasingly encompass early diagnosis programs for symptomatic patients, commonly comprising awareness campaigns to encourage prompt help-seeking for possible cancer symptoms and health system policies to support prompt diagnostic assessment and access to treatment. By their nature, early diagnosis programs involve complex public health interventions aiming to address unmet health needs by acting on patient, clinical, and system factors. However, there is uncertainty regarding how to optimize the design and evaluation of such interventions. We propose that decisions about early diagnosis programs should consider four interrelated components: first, the conduct of a needs assessment (based on cancer-site-specific statistics) to identify the cancers that may benefit most from early diagnosis in the target population; second, the consideration of symptom epidemiology to inform prioritization within an intervention; third, the identification of factors influencing prompt help-seeking at individual and system level to support the design and evaluation of interventions; and finally, the evaluation of factors influencing the health systems' capacity to promptly assess patients. This conceptual framework can be used by public health researchers and policy makers to identify the greatest evidence gaps and guide the design and evaluation of local early diagnosis programs as part of broader cancer control strategies

Breast and cervical cancer screening practices in nine countries of Eastern Europe and Central Asia : A population-based survey

Background: Eastern Europe and Central Asia (EECA) countries have higher cervical and breast cancer mortality rates and later stage at diagnosis compared with the rest of WHO European Region. The aim was to explore current early detection practices including “dispensarization” for breast and cervix cancer in the region. Methods: A questionnaire survey on early detection practices for breast and cervix cancer was sent to collaborators in 11 countries, differentiating services in the primary health setting, and population-based programs. Responses were received from Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, the Russian Federation (Arkhangelsk, Samara and Tomsk regions), Tajikistan, Ukraine, and Uzbekistan. Results: All countries but Georgia, Kyrgyzstan, and the Russian Federation had opportunistic screening by clinical breast exam within “dispensarization” program. Mammography screening programs, commonly starting from age 40, were introduced or piloted in eight of nine countries, organized at national oncology or screening centres in Armenia, Belarus and Georgia, and within primary care in others. Six countries had “dispensarization” program for cervix cancer, mostly starting from the age 18, with smears stained either by Romanowsky-Giemsa alone (Belarus, Tajikistan and Ukraine), or alternating with Papanicolaou (Kazakhstan and the Russian Federation). In parallel, screening programs using Papanicolaou or HPV test were introduced in seven countries and organized within primary care. Conclusion: Our study documents that parallel screening systems for both breast and cervix cancers, as well as departures from evidence-based practices are widespread across the EECA. Within the framework of the WHO Initiatives, existing opportunistic screening should be replaced by population-based programs that include quality assurance and control.Peer reviewe

Trend-TDT – a transmission/disequilibrium based association test on functional mini/microsatellites

<p>Abstract</p> <p>Background</p> <p>Minisatellites and microsatellites are associated with human disease, not only as markers of risk but also involved directly in disease pathogenesis. They may play significant roles in replication, repair and mutation of DNA, regulation of gene transcription and protein structure alteration. Phenotypes can thus be affected by mini/microsatellites in a manner proportional to the length of the allele. Here we propose a new method to assess the linear trend toward transmission of shorter or longer alleles from heterozygote parents to affected child.</p> <p>Results</p> <p>This test (trend-TDT) performs better than other TDT (Transmission/Disequilibrium Test) type tests, such as TDT_maxand TDT_L/S, under most marker-disease association models.</p> <p>Conclusion</p> <p>The trend-TDT test is a more powerful association test when there is a biological basis to suspect a relationship between allele length and disease risk.</p

Carcinomes nasopharyngés associés au virus d’Epstein-Barr : De l’épidémiologie à la thérapeutique et au dépistage

Les carcinomes nasopharyngés interpellent cliniciens et biologistes dans de nombreuses disciplines dont l’épidémiologie, la génétique, la virologie et l’immunologie. Ces tumeurs ont une répartition géographique tout à fait surprenante, faible dans la plus grande partie du monde, leur incidence est élevée en Extrême-Orient et en Afrique du Nord. Elles sont associées de façon constante au virus d’Epstein-Barr et leur étude revêt donc une importance particulière à l’heure où le virus d’Epstein-Barr est incriminé dans d’autres affections malignes humaines (carcinomes gastriques, mammaires et thyroïdiens, par exemple). Favoriser les échanges entre la recherche clinique sur les carcinomes nasopharyngés au Sud et la recherche fondamentale au Nord, tel était l’objectif de l’Atelier Nord-Sud sur les carcinomes nasopharyngés qui s’est tenu à l’Institut Gustave Roussy début décembre 2003.Nasopharyngeal carcinomas (NPC) challenge clinicians and biologists in various fields including epidemiology, genetics, virology and immunology. These tumours have a striking geographical distribution. They are constantly associated with the Epstein-Barr virus (EBV) and contain a massive lymphocytic infiltrate. Their study has major implications especially at this moment while a pathological role of EBV is suspected in several other human epithelial malignancies (for example gastric, mammary and thyroid carcinomas). The North-South Workshop on Nasopharyngeal Carcinoma was held at the Institut Gustave-Roussy in early December 2003. Its main goal was to support the exchanges between clinical research on NPC in the South and basic research in the North. With regard to epidemiology and genetics, the main information was the possible existence of several susceptibility genes (including two of them on the 4p and 5p chromosomes). In virology, participants have emphasized the selection of peculiar EBV variants within the malignant cells and the expression of novel oncogenic viral proteins : LMP2 and BARF1. Cellular gene alterations also contribute to NPC development, especially inactivation of tumor suppressor genes located on the 3p chromosome. Therapeutic research was not forgotten. Hope of higher rate of cure relies on improved ballistic processes in radiotherapy (IMRT) and on the development of targeted therapeutics : induction of the lytic/productive viral cycle, gene therapy with conditional replicative adenoviruses, antitumor vaccination directed against the viral protein LMP2

Carcinomes nasopharyngés associés au virus d’Epstein-Barr

Les carcinomes nasopharyngés interpellent cliniciens et biologistes dans de nombreuses disciplines dont l’épidémiologie, la génétique, la virologie et l’immunologie. Ces tumeurs ont une répartition géographique tout à fait surprenante, faible dans la plus grande partie du monde, leur incidence est élevée en Extrême-Orient et en Afrique du Nord. Elles sont associées de façon constante au virus d’Epstein-Barr et leur étude revêt donc une importance particulière à l’heure où le virus d’Epstein-Barr est incriminé dans d’autres affections malignes humaines (carcinomes gastriques, mammaires et thyroïdiens, par exemple). Favoriser les échanges entre la recherche clinique sur les carcinomes nasopharyngés au Sud et la recherche fondamentale au Nord, tel était l’objectif de l’Atelier Nord-Sud sur les carcinomes nasopharyngés qui s’est tenu à l’Institut Gustave Roussy début décembre 2003