Socioeconomic status and site-specific cancer incidence, a Bayesian approach in a French Cancer Registries Network study

International audienceThe aim of this study was to identify and compare cancer sites whose incidence is influenced by social deprivation. The study population comprised 189 144 cases of cancer diagnosed between 2006 and 2009, recorded in member registries of the French Network of Cancer Registries. Social environment was assessed at an aggregate level using the European Deprivation Index. The association between incidence and socioeconomic status was assessed by a geographical Bayesian Poisson model enabling a reduction of the overall variability and smoothing of the relative risks by sharing information provided by multiple geographic units. For cancers of the stomach, liver, lips-mouth-pharynx, and lung, a higher incidence in deprived populations was found for both sexes as well as for cancers of the larynx, esophagus, pancreas, and bladder in men and cervical cancer in women. For melanoma, prostate, testis, ovarian, and breast cancer, a higher incidence was observed in affluent populations. The highest relative risks of the lowest social class compared with the highest social class were found for larynx [relative risk (RR) = 1.67 (1.43-1.95)], lips-mouth-pharynx [RR = 1.89 (1.72-2.07)], and lung cancer [RR = 1.59 (1.50-1.68)] in men and for cervix [RR = 1.62 (1.40-1.88)] and lips-mouth-pharynx [RR = 1.56 (1.30-1.86)] cancer in women. By estimating the burden of social deprivation on cancer incidence throughout France, this study enables us to measure the gains that could be achieved by implementing targeted prevention efforts

The impact of patients’ and physicians’ characteristics on surgery decision for head and neck cancer: Results of a national survey

Background: Population’s aging leads to an increased diagnosis of head and neckcancer (HNC) in older patients (pts). Treatment can involve surgery, radiation, sys-temic therapy or multimodal therapy. Due to heterogeneity of older pts, thecomprehensive geriatric assessment (CGA) is considered the gold standard tool toclassify pts according to frailty profile. Multidisciplinary approach including a geria-trician is essential. CGA may be helpful to personalize treatment plan and to detectgeriatric conditions that can be reversible through geriatric interventions. We aim toevaluate the impact of CGA on therapeutic decision

Breast cancer survival in the US and Europe: a CONCORD high-resolution study.

Breast cancer survival is reportedly higher in the US than in Europe. The first worldwide study (CONCORD) found wide international differences in age-standardized survival. The aim of this study is to explain these survival differences. Population-based data on stage at diagnosis, diagnostic procedures, treatment and follow-up were collected for about 20,000 women diagnosed with breast cancer aged 15-99 years during 1996-98 in 7 US states and 12 European countries. Age-standardized net survival and the excess hazard of death up to 5 years after diagnosis were estimated by jurisdiction (registry, country, European region), age and stage with flexible parametric models. Breast cancers were generally less advanced in the US than in Europe. Stage also varied less between US states than between European jurisdictions. Early, node-negative tumors were more frequent in the US (39%) than in Europe (32%), while locally advanced tumors were twice as frequent in Europe (8%), and metastatic tumors of similar frequency (5-6%). Net survival in Northern, Western and Southern Europe (81-84%) was similar to that in the US (84%), but lower in Eastern Europe (69%). For the first 3 years after diagnosis the mean excess hazard was higher in Eastern Europe than elsewhere: the difference was most marked for women aged 70-99 years, and mainly confined to women with locally advanced or metastatic tumors. Differences in breast cancer survival between Europe and the US in the late 1990s were mainly explained by lower survival in Eastern Europe, where low healthcare expenditure may have constrained the quality of treatment

Apports de l’épidémiologie descriptive, registres et cohortes

Cet article décrit la situation du cancer chez les personnes âgées en France à partir d’une synthèse de différentes études réalisées par le réseau français des registres de cancer, seule source d’information qui ne soit pas entachée de biais de sélection. Le cancer est surtout une pathologie du sujet âgé, 47 % des cas de cancers surviennent chez des hommes de plus 70 ans, 30 % au-delà de 75 ans et 14 % chez les hommes de plus de 80 ans. Cette proportion est de 42 % chez les femmes de plus 70 ans, 30 % au-delà de 75 ans et 17 % chez les femmes de plus de 80 ans. Le pronostic de ces patients se dégrade avec l’âge. Le mauvais pronostic des sujets âgés est souvent associé, et parfois totalement dû, à une forte mortalité initiale qui peut être liée soit à la gravité initiale de la maladie, soit à la prise en charge qui est à la fois moins agressive pour les sujets âgés et plus sélective

Fin de vie de patients cancéreux (histoires de patients et opinions de médecins généralistes)

TOULOUSE3-BU Sciences (315552104) / SudocTOULOUSE3-BU Santé-Allées (315552109) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Incidence et survie des patients atteints d'un cancer de la vessie dans les départements du Tarn et de l'Isère entre 1990 et 1994

TOULOUSE3-BU Santé-Centrale (315552105) / SudocTOULOUSE3-BU Santé-Allées (315552109) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Total and partial cancer prevalence in the adult French population in 2008.

BACKGROUND: To provide estimations of partial and total prevalence of 24 cancer sites in France in 2008. The estimations of partial prevalence were compared with the previous estimations for 2002. METHODS: Nationwide estimations of incidence and survival data from cancer registries were used for partial prevalence. Nationwide incidence and mortality data were used to estimate total prevalence. RESULTS: At the end of 2008, in France, nearly 3 million people still alive had received a diagnosis of cancer. Of all prevalent cases, 36% were diagnosed 0 to 5 years earlier and 43% diagnosed 6 to 10 years earlier. The cancer sites with the highest prevalence were the prostate, the breast, and the colon-rectum. The changes in partial prevalence over 5 years (2002 to 2008) were considerable (+244,000 cases) and deemed to be highly related to changes in incidence. CONCLUSION: The present estimations update the French prevalence data and highlight the burden of cancer in the population, especially in the elderly. The methods of this study had the advantage of using recent incidence and survival data, which is necessary to show sudden changes in incidence trends and changes in survival that impact prevalence

MESURE DE LA SURVIE DES PATIENTS CANCEREUX EN POPULATION A PARTIR DES REGISTRES DE CANCERS (INTERETS ET LIMITES (DOCTORAT : SANTE PUBLIQUE))

LE KREMLIN-B.- PARIS 11-BU Méd (940432101) / SudocPARIS-BIUM (751062103) / SudocPARIS-BIUP (751062107) / SudocSudocFranceF