LE CANCER DE LA PROSTATE DE 1982 A 1996 (EVOLUTION DE L'INCIDENCE ET DE LA MORTALITE DANS 5 DEPARTEMENTS FRANCAIS COUVERTS PAR UN REGISTRE DE POPULATION)

GRENOBLE1-BU Médecine pharm. (385162101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Le cancer du sein chez la femme de moins de 50 ans à la Réunion entre 2005 et 2010

La Réunion est un département français d'outre-mer de plus de 800000 habitants composé d'une population très cosmopolite et relativement jeune. Des spécificités épidémiologiques de l'île résultent des différences significatives par rapport à la situation en France métropolitaine pour ce qui concerne l'incidence des cancers. Un peu moins de 25000 cas de cancers ont été enregistrés dans la population réunionnaise entre 1988 et 2006 ; les taux d'incidence standardisés (TIS) sur la population mondiale sont de 285 cas pour 100000 hommes et de 175 cas pour 100000 femmes pour 2004-2006, significativement moins élevés que ceux décrits en métropole (respectivement 376 et 252/100000 chez les hommes et les femmes en 2005). Environ 2400 cancers du sein ont été enregistrés sur l'île entre 1990 et 2006 chez la femme ; le TIS en 2005 est de 54.7/100000 (données nationales 2005:101.5/100000). L'âge moyen lors du diagnostic est de 54.7 ans alors qu'il est de 61 ans en France métropolitaine en 2005. La proportion des femmes âgées de moins de 50 ans au diagnostic d'un cancer du sein est de 41% environ à la Réunion contre 20 % environ au niveau national. Au total, nous observons une sous-incidence des cancers du sein à la Réunion par rapport à la métropole mais avec une proportion de cas chez la femme jeune significativement supérieure. L'objectif de cette étude est de décrire la population de ces femmes de moins de 50 ans diagnostiquées d'un cancer du sein invasif entre 2005 et 2010.BORDEAUX1-Bib.electronique (335229901) / SudocSudocFranceF

PROM SSCOL—Impact of a Papillomavirus Vaccination Promotion Program in Middle Schools to Raise the Vaccinal Coverage on Reunion Island

Introduction: On Reunion Island, cervical cancer is the third most common cause of cancer in women. Primary prevention is based on the HPV vaccination, yet coverage rate is low (8.1%). The objective of the study was to evaluate the impact of a health promotion program on the proportion of middle school girls who have completed the HPV vaccination schedule. Material and methods: In this prospective, controlled intervention study of superiority, 12 classes were randomly selected in an intervention school where the promotion program took place, and in a control school where no specific intervention was planned. The program combined: information to students during school classes, information to parents by letter and phone calls, information to general practitioners by letter and video conference call, and the free school-based vaccination (in a “health bus” parked in the schoolyard) with the nonavalent HPV vaccine. Results: In the intervention group, the completion was achieved for 26 girls, which was significantly higher than in the control group (three girls, p −3). The initiated vaccination was also higher in the intervention group (31 girls vs. 6 girls in the control group, p −3). The same results were obtained for the boys as for the full or partial scheme (seven boys vs. 0, p = 0.01; 16 boys vs. 1, p −3, respectively). Conclusions: Implementing a health promotion program and offering the free, school-based vaccination raised the vaccination coverage. These results are promising and may be a stepping stone to expanding this program to the whole Reunion Island and hopefully someday decrease the burden of cervical cancer

Impact of a Papillomavirus Vaccination Promotion Program in Middle School: Study Protocol for a Cluster Controlled Trial

BackgroundOn Reunion Island, incidence and mortality for uterine cervical cancer is high, yet coverage rate for human papillomavirus (HPV) vaccination is low. ObjectiveThe main objective of the study is to evaluate the impact of a health promotion program promoting HPV vaccination on the proportion of middle school girls who complete the full HPV vaccination schedule (2 or 3 doses) by the end of school year. MethodsThis study is a cluster controlled intervention study using a superiority design. A combined health promotion program will be offered containing information to students and parents, training of general practitioners, and free school-based vaccination (in a “health bus”). Children who attend this program will constitute the intervention group and will be compared to children from another middle school who will not attend the program constituting the control group. ResultsRecruitment began in October 2020. In the intervention school, of 780 students, 245 were randomly selected in the 12 classes. In the control school, 259 students out of 834 were randomly selected. ConclusionsIn this study, we explore the impact of a health promotion program combining information toward students, parents, and general practitioners with free school-based vaccination. We expect a significantly higher HPV vaccination coverage in the intervention school as compared to the control school, whether it be among girls or boys. The final implication would be an extension of this program in all middle schools on the Island and thus an increase in HPV vaccination coverage. Trial RegistrationClinicalTrials.gov NCT04459221; https://clinicaltrials.gov/ct2/show/NCT04459221 International Registered Report Identifier (IRRID)DERR1-10.2196/3569

Factors associated with mammography screening among Reunionese women : a cross-sectional study

International audienceObjective: To explore the factors associated with the uptake of mammography screening in Reunionese women aged 50-65 years.Methods: This study included all women aged 50 to 65 years participating in a population-based cross-sectional study "FOSFORE". Participants were recruited between March and June 2017 using two sampling frames. The first frame consisted of households with a landline telephone, with or without a mobile line, by first randomly generating a telephone number and then randomly selecting an individual from among all eligible women in the household. The second sampling frame was constituted of women with an exclusive mobile line, who were selected directly if they met the eligibility criteria. Data were weighted for age and socio-professional status to ensure representativeness at the Reunion Island level. Weighted logistic regression was used to calculate odds ratios while adjusting for confounders.Results: 417 women were included in the study; 63.8% were up to date with guidelines on mammography screening and 36.2% were not up to date. Four factors were significantly associated with mammography screening, with an adjusted odds ratio of 2.92 (95% CI 1.51-5.61) for not having an Active Solidarity Income, 1.98 (95% CI 1.22-3.23) for having a regular gynecological follow-up by a physician, 6.53 (95% CI 3.23-13.21) for performing a Pap smear test in the past two years, and 2.07 (95% CI 1.21-3.52) for having an adequate literacy level (HLQ3).Conclusion: The findings of this study suggest that higher socio-economic status is an indicator of participation in mammography screening in La Réunion, and future educational and intervention programs should target women in deprived areas

326 (PB-121) - Mammography screening among women living in Reunion Island (South Indian Ocean)

Abstract dans revueInternational audienceContext: Reunion Island is an overseas French department with a large proportion of young people, higher than in the metropolitan territory. It is also noteworthy that there is a high proportion of single parents and of early childbearing. The unemployment rate was estimated at 29% in 2013 versus a national rate of 10%. By contrast with other French overseas territories, the population of the Reunion island is very cosmopolite with eight major ethnic groups (from India, China, Africa, Comoros, Mayotte, Madagascar) and four religions (Muslims, Christians, Buddhists, and Hindus). In this context, it is important to describe health behaviors of this French population, especially cancer screening practices to face the current lack of data.The objective of this study is to describe the coverage of breast cancer screening with mammography among women aged 25–65 years living in Reunion Island.Materiel and methods: A cross sectional survey has been conducted byphone questionnaire to 1000 women aged 25–65. Question on use ofscreening mammography was asked to all respondents. Univariate andmultivariate statistical analyses have been performed to identify theassociated factors with mammography use during the two previous years.Results: Among women included in the survey, 33.9% have done a mammography during the past two years, 20.9% have done a mammography more than two years ago and 45.2% have never done a mammography. Among the 417 women aged from 50 to 65 years (i.e. those concerned by the organized breast cancer screening every two years), when comparing those who have done a mammography during the two past years (63,9%) to the others (36,1%), associated factors found were: reporting a low income, and/or a low literacy level, reporting a regular gynecologic follow-up, and having done a vaginal smear in the past two years (as recommended by medical authorities).Conclusions: Social inequalities are major in Reunion Island and directly affect health behavior such as breast cancer screening by mammography. Public Policy have to be implemented in Reunion Island to promote specific action toward low income women, especially health education to increase health literacy

Human Papillomavirus (HPV) Infections Among Participants Undergoing Chlamydia trachomatis Testing in Reunion Island (RUN-SurV-HPV Study): Protocol for a Prevalence Study

BackgroundInfection by human papillomavirus (HPV) induces various cancers, mainly cervical cancer but also anal and pharyngeal cancers. Reunion Island is a French department in the Indian Ocean. Due to the history of its settlement, the island’s population has a wide variety of origins, and the population’s sociodemographic characteristics differ from those of the French mainland. These characteristics make the island’s population an original French population in its own right, particularly in terms of health. Cervical cancer incidence and mortality in Reunion Island are 10.4 per 100,000 and 4.4 per 100,000, respectively, both of which are much higher than those in mainland France. There is also a disparity in the prevalence of different HPV types, with types 33 and 52 being overrepresented and type 18 being underrepresented. However, vaccination and screening coverage in Reunion Island is low. It is important to understand the burden of infection and its risk factors in members of the young Reunionese population at risk of HPV infection to promote and evaluate the implementation of future vaccination and screening programs on a larger scale. ObjectiveThe RUN-SurV-HPV study will have the following four objectives: (1) to describe the prevalence of HPV genotypes in a population at risk of sexually transmitted infections in Reunion Island; (2) to describe the prevalence of HPV genotypes by anatomical site, gender, and sexuality; (3) to describe the correlates and risk factors for HPV detection; and (4) to examine HPV genotypes between different anatomical sites. MethodsCross-sectional analyses of 1200 routine vaginal, anal, pharyngeal, and urinary samples collected between October 2020 to December 2022 from female and male patients aged 16 to 30 years undergoing Chlamydia trachomatis testing at a sexually transmitted infection (STI) testing center at Reunion Island will be performed. The population included 333 women who all had vaginal and pharyngeal swabs, with 80 of them also having had an anal swab. There are 167 men who have sex with men who have had anal and pharyngeal swabs, and 120 men who have sex with women who have had a urine swab only. Results will be correlated with sociodemographic and clinical data collected routinely during the consultations. HPV detection and genotyping will be performed using the Anyplex II HPV28 detection assay (Seegene). ResultsThe first polymerase chain reactions should begin in November 2023. The first results should be submitted for publication in 2024. ConclusionsThe study will determine HPV prevalence by age, sex, male sexual preference, human immunodeficiency virus status, and STI co-infection. Collecting data from young patients not usually routinely screened for HPV infection will be a simple and reproducible way of better understanding local specificities, encouraging vaccination campaigns in the short-term, and evaluating their effectiveness in the future. International Registered Report Identifier (IRRID)DERR1-10.2196/4737

Health Impacts of the COVID-19 Lockdown Measure in a Low Socio-Economic Setting: A Cross-Sectional Study on Reunion Island

International audienceIn March 2020, the French government implemented nationwide measures to reduce social contact and slow the progression of the emerging coronavirus responsible for COVID-19, the most significant being a complete home lockdown that lasted 8 weeks. Reunion Island is a French overseas department marked by large social inequalities. We draw the hypothesis that distancing and lockdown measures may have contributed to an increase in the social inequalities in health (SIH) on Reunion Island. The aim of our study was to describe the SIH during lockdown in the Reunionese population. We implemented a cross-sectional telephone survey conducted between 13 May and 22 July 2020, using a retrospective data collection on the lockdown period. A total of 892 adult participants (≥18 years) were recruited in the 114 large Reunionese neighborhoods using the quota method within the national "White Pages" telephone directory. Degraded psychological states, an increase in addictive behaviors, difficulties in accessing food, a decrease in physical activity, delayed medical appointments, violence against women, and health problems in children were driven by the socioeconomic characteristics of the population, most often to the disadvantage of social groups exposed to poor living conditions. These results suggest that the COVID-19 lockdown contributed to an increase in SIH

Net survival in colon and rectal cancer by stage according to neoadjuvant treatment. A French population-based study

International audienceAimReal-life estimations of survival by stage in colorectal cancer are scanty. We estimated population-based net survival by pathological stage and location, and for rectal cancer by patterns of evolution according to clinical and pathological stage with regard to neoadjuvant therapy.MethodAge-standardized net survival was estimated on 19,630 colorectal cancers diagnosed between 2009 and 2015.ResultsFive-year net survival was 64 % for colon and 62 % for rectal cancer. The highest absolute difference between colon and rectum was 12 % for stage II women aged 75 (91% vs. 79 %). Among patients with clinical stage III rectal cancer, 67 % no longer had pathological node involvement after neoadjuvant treatment. Survival was similar in clinical stage I, II or III and pathological stage III after neoadjuvant treatment and in pathological stage III without neoadjuvant treatment (between 67 % and 72 %). It ranged between 80 and 82 % in pathological stage II, without neoadjuvant treatment or with clinical stage I, II or III before neoadjuvant treatment. Survival ranged between 93 % and 95 % in pathological stage I, treated with surgery only or with clinical stage II or III before neoadjuvant treatment.ConclusionPrognosis is associated with stage determined on surgical specimens rather than stage at the initial workup