ABSTRACT: To identify which morphologic or densitometric parameters are modified in cell nuclei from bronchopulmonary cancer based on 18 parameters involving shape, intensity, chromatin, texture, and DNA content and develop a bronchopulmonary cancer screening method relying on analysis of sputum sample cell nuclei.
A total of 25 sputum samples from controls and 22 bronchial aspiration samples from patients presenting with bronchopulmonary cancer who were professionally exposed to cancer were used. After Feulgen staining, 18 morphologic and DNA content parameters were measured on cell nuclei, via image cytom- etry. A method was developed for analyzing distribution quantiles, compared with simply interpreting mean values, to characterize morphologic modifications in cell nuclei.
Distribution analysis of parameters enabled us to distinguish 13 of 18 parameters that demonstrated significant differences between controls and cancer cases. These parameters, used alone, enabled us to distinguish two population types, with both sensitivity and specificity > 70%. Three parameters offered 100% sensitivity and specificity. When mean values offered high sensitivity and specificity, comparable or higher sensitivity and specificity values were observed for at least one of the corresponding quantiles.
Analysis of modification in morphologic parameters via distribution analysis proved promising for screening bronchopulmonary cancer from sputum.
Analytical and quantitative cytology and histology / the International Academy of Cytology [and] American Society of Cytology 08/2011; 33(4):183-95. · 0.41 Impact Factor
ABSTRACT: The aim of our study was to analyse the dose-response relationship between occupational asbestos exposure and risk of cancer.
Our study was a retrospective morbidity study based on 2024 subjects occupationally exposed to asbestos, conducted over the period 1 January 1978 to 31 December 2004. Analysis of the dose-response relationship between occupational asbestos exposure, as a time-dependant variable, and risk of cancer was performed using a Cox model. In order to account for the effect of latency, we conducted the analysis with a lag of 10 years.
285 cases of cancers were observed in our cohort. The relative risk of pleuro-peritoneal mesothelioma, lung cancer and colorectal cancer associated with asbestos exposure, adjusted for age as a time-dependant variable and for sex, was correlated with exposure intensity (or average exposure level, AEL). The risk of cancer, whatever the anatomical site, did not increase with the duration of exposure to asbestos.
While confirming the established relationship between asbestos exposure and pleuropulmonary and peritoneal cancers, this study also suggests a causal relationship between asbestos exposure and colorectal cancer.
Occupational and environmental medicine 03/2011; 68(11):832-6. · 3.64 Impact Factor
ABSTRACT: Although the literature on factors associated with mammography screening is abundant, reasons for underparticipation remain unclear, most studies having focused exclusively on individual factors. This study aimed at investigating the ecological influence of socioeconomic status and healthcare supply on compliance to organized breast cancer screening programs, on an unbiased sample based on data from the entire target population within a French geographical area, Calvados (n=98,822 women).
Individual data on participation and aggregate data on healthcare supply and socioeconomic status, respectively obtained from the structure responsible for organizing screening and the French census, were analyzed simultaneously using a multilevel model.
Uptake was lower among the youngest (50-54 years) and the oldest (70-74 years) women, compared to the intermediate 55-69 year age-group, with respectively OR=0.73 (95%CI: 0.64-0.83) and OR=0.78 (95%CI: 0.67-0.91). Uptake fell with increasing level of deprivation, a difference in uptake probability being observed between the least deprived and the most deprived areas (OR=0.71; 95%CI: 0.59-0.86). Neither radiologist- nor primary care physicians-to-100,000 inhabitants ratios were associated with participation.
Multilevel analysis allows to detect areas of weak participation statistically linked to areas of strong deprivation. So, even with organized breast cancer screening giving screening free of charge for target women, ecological socioeconomic factors have a more significant impact on participation than healthcare supply. These results suggest that targeting populations, in accurate geographical areas where women are less likely to participate, as identified socially and geographically in this study, could be adopted to reduce disparities in screening.
Cancer epidemiology. 06/2010; 34(3):309-15.
ABSTRACT: Compliance in cancer screening among socially disadvantaged persons is known to be lower than among more socially advantaged persons. However, most of the studies regarding compliance proceed via a questionnaire and are thus limited by self-reported measures of participation and by participation bias. This study aimed at investigating the influence of socioeconomic characteristics on compliance to an organised colorectal cancer screening programme on an unbiased sample based on data from the entire target population within a French geographical department, Calvados (n=180 045).
Individual data of participation and aggregate socioeconomic data, from the structure responsible for organising screening and the French census, respectively, were analysed simultaneously by a multilevel model.
Uptake was significantly higher in women than in men (OR=1.33; 95% CI 1.21 to 1.45), and significantly lower in the youngest (50-59 years) and in the oldest (70-74 years) persons, compared with intermediate ages (60-69 years), with OR=0.70 (95% CI 0.63 to 0.77) and OR=0.82 (95% CI 0.72 to 0.93), respectively. Uptake fell with increasing level of deprivation. There was a significant difference of uptake probability between the least deprived and the most deprived areas (OR=0.68; 95% CI 0.59 to 0.79). No significant influence of the general practitioners density was found.
Multilevel analysis allowed to detect areas of weak uptake linked to areas of strong deprivation. These results suggest that targeting populations with a risk of low compliance, as identified both socially and geographically in our study, could be adopted to minimise inequalities in screening.
Journal of epidemiology and community health 10/2009; 64(4):318-24. · 3.04 Impact Factor