Patricia Delafosse

Centre Hospitalier Universitaire de Grenoble, Grenoble, Rhône-Alpes, France

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Publications (56)121.78 Total impact

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    ABSTRACT: Objective: The objective of the study was to investigate the joint effect of occupational exposure to asbestos, and tobacco and alcohol consumption, on the risk of laryngeal cancer among men. Methods: We used data from a large population-based case-control study conducted in France. We estimated two-way and three-way interactions between asbestos exposure (never vs ever exposed), tobacco consumption (<20 vs ≥20 pack-years) and alcohol consumption (<5 vs ≥5 drinks per day). The interaction on an additive scale was assessed by estimating the relative excess risk due to interaction (RERI) and the attributable proportion due to interaction, and the interaction on a multiplicative scale was assessed by estimating the multiplicative interaction parameter (ψ). Multiplicative interactions were also assessed using fractional polynomials for alcohol drinking, tobacco smoking and asbestos exposure. Results: When compared with light-to-moderate smokers and drinkers never exposed to asbestos, the increase in laryngeal cancer risk was smallest among light-to-moderate drinkers and smokers exposed to asbestos (OR=2.23 (1.08 to 4.60)), and highest among heavy smokers and drinkers ever exposed to asbestos (OR=69.39 (35.54 to 135.5)). We found an additive joint effect between asbestos exposure and alcohol consumption (RERI=4.75 (-4.29 to 11.12)), whereas we observed a more than additive joint effect between asbestos exposure and tobacco consumption (RERI=8.50 (0.71 to 23.81)), as well as between asbestos exposure, and tobacco and alcohol consumption (RERI=26.57 (11.52 to 67.88)). However, our results did not suggest any interaction on a multiplicative scale. Conclusions: Our results suggest that asbestos exposure, in combination with tobacco and alcohol exposure, accounted for a substantial number of laryngeal cancer cases. Our findings therefore highlight the need for prevention in activities, such as construction work, where exposure to asbestos-containing materials remains.
    No preview · Article · Sep 2015 · Occupational and environmental medicine
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    ABSTRACT: Objective: The aim of this epidemiological study was to describe the incidence, mortality and survival of ovarian cancer (OC) in France, according to age, period of diagnosis, and histological type. Methods: Incidence and mortality were estimated from 1980 to 2012 based on data in French cancer registries and from the Centre for Epidemiology of Causes of Death (CépiDc-Inserm) up to 2009. Net survival was estimated from registry data using the Pohar-Perme method, on cases diagnosed between 1989 and 2010, with date of last follow-up set at 30 June 2013. Results: In 2012, 4615 cases of OC were diagnosed in France, and 3140 women died from OC. World population age-standardized incidence and mortality rates declined by respectively 0.6% and 1.2% per year between 1980 and 2012. Net survival at 5years increased slightly, from 40% for the period 1989-1993 to 45% for the period 2005-2010. Net survival varied considerably according to histological type. Germ cell tumors had better net survival at 10years (81%) compared to epithelial tumors (32%), sex cord-stromal tumors (40%) and tumors without biopsy (8%). Conclusions: Our study shows a decline in incidence and mortality rates from ovarian cancer in France between 1980 and 2012, but net survival remains poor overall, and improved only slightly over the whole study period.
    No preview · Article · Sep 2015 · Gynecologic Oncology
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    ABSTRACT: Tobacco is currently the largest risk factor for cancers of the lung, lip/oral cavity/pharynx (LOCP) and esophagus. Variations in tobacco consumption over time have led to changes in cancer incidence in the general population. Data on the incidence of cancers at these sites in adults aged 20-44 years old are scarce. Our objective was to provide estimates of incidence trends for these cancers in France among this age group over the last 30 years. Observed incidence data over the period 1982-2010 for the 20-44 age group were provided from six cancer registries (eight for esophagus) covering approximately 6% of the French population. Age-period-cohort models were used on the observed period, and estimates of cancer incidence for France in 2012 were provided on the basis of short-term predictions. In men, a sharp decline was observed over time for LOCP and esophageal cancers, while lung cancer saw only a slight decline. In women, a large increase was seen in lung cancer incidence, while LOCP cancer incidence did not vary significantly. Smoking behaviors among adults aged 20-44 impact incidence trends in cancers of the lung, LOCP and esophagus, although other factors are involved, particularly in LOCP and esophageal cancers. Our results highlight the importance of preventative efforts which particularly target women aged 20-44. Efforts to curb tobacco smoking in men should also be pursued. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Full-text · Article · Jul 2015
  • M Colonna · Z Uhry · Av Guizard · P Delafosse · C Schvartz · A Belot · P Grosclaude
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    ABSTRACT: Over the past few decades, the incidence of thyroid cancer has dramatically increased in many countries. This increase was mainly seen in papillary cancer. The role of diagnostic practices and the effects of other risk factors were suggested to explain this increase. We provide a descriptive analysis in terms of changes in incidence, geographical distribution, and survival to check the relevance of assumptions about the increase. A detailed analysis of changes in incidence recorded in French cancer registries between 1982 and 2010 was performed taking into account age, period, and birth cohort. The geographical distribution of the incidence in the 2006-2010 period was estimated from the standardized incidence ratios. The net survival was estimated to evaluate the effects of sex, age, and period of diagnosis in patients diagnosed between 1989 and 2004 and followed-up until 2013. The incidence of papillary cancer has increased sharply over the 1982-2010 period; the average annual rate of increase was 7.8% in men and 7.2% in women. The increase has slowed in the recent period in people aged less than 50 at the time of diagnosis. It has also slowed in the cohorts born 1945 and after. There was a strong geographic disparity in incidence between areas covered by cancer registries. Finally, the net survival was very high; the 10-year net survival was 96% and improved progressively from 82% in patients diagnosed between 1989 and 1993 to 95% in those diagnosed between 1999 and 2004. The increased incidence results most probably from the effect of medical practice, although other risk factors seem also involved, but to a lesser extent. The increase seems to have slowed down in the recent years, especially in the youngest age groups. This observation suggests a recent trend towards saturation of the effects of medical practices in post-1945 cohorts associated with an effect of the gradual dissemination of the recommendations relative to the management of thyroid nodules. Copyright © 2015 Elsevier Ltd. All rights reserved.
    No preview · Article · May 2015

  • No preview · Article · Apr 2015 · Annals of Oncology
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    ABSTRACT: The objective of this work was to detail the incidence and mortality trends of invasive and in situ breast cancer (BC) in France, especially regarding the development of screening, over the 1990-2008 period. Data issued from nine population-based cancer registries were studied. The incidence of invasive BC increased annually by 0.8 % from 1990 to 1996 and more markedly by 3.2 % from 1996 to 2003, and then sharply decreased until 2006 (-2.3 % per year), especially among women aged 50-69 years (-4.9 % per year). This trend was similar whatever the introduction date of the organized screening (OS) program in the different areas. The incidence of ductal carcinoma in situ steadily increased between 1990 and 2005, particularly among women aged 50-69 years and 70 and older. At the same time, the mortality from BC decreased annually by 1.1 % over the entire study period. This decrease was more pronounced in women aged 40-49 and 50-69 and, during the 1990-1999 period, in the areas where OS began in 1989-1991. The similarity in the incidence trends for all periods of implementation of OS in the different areas was striking. This suggests that OS alone does not explain the changes observed in incidence rate. Our study highlights the importance of closely monitoring the changes in incidence and mortality indicators, and of better understanding the factors causing variation.
    Full-text · Article · Aug 2014 · Breast Cancer Research and Treatment
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    ABSTRACT: The aim of this study was to draw a picture of diagnostic assessment and patterns of care for rectal cancer in France using population-based registries data. The study included a random sample of 669 cases of rectal cancers diagnosed in 2005. Diagnostic assessment was performed by colonoscopy in 91.4% of the cases. An abdominal computed tomography was performed in 59.4% of the cases and chest computed tomography in 47.8%. An R0 resection was performed in 65.8% of cases and an R1/R2 resection in 16.1%. A rectal endosocography was performed in 40.4% and MRI in 10.4%. The sphincter was preserved in 73.6% of patients aged younger than 75 years of age and in 62.5% of those older than 75 years of age (P=0.002). In cases of R0 resection, neoadjuvant radiotherapy was performed in 47.8% of patients younger than 75 years of age and in 34.1% of older patients (P=0.007). Postoperative chemotherapy was administered in 23.9% of stage II and 67.8% of stage III resected patients. The management of rectal cancers can be improved. Preoperative staging has not reached its full development; very few patients received neoadjuvant treatment, whereas adjuvant chemotherapy was often performed, although its benefit is still unclear. The management of elderly patients was less optimal than that of younger patients.
    No preview · Article · May 2014 · European journal of gastroenterology & hepatology
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    ABSTRACT: Few studies have investigated rectal cancer management at the population level. We compared how rectal cancers diagnosed in Italy (2003-2005) and France (2005) were managed, and evaluated the extent to which management adhered to European guidelines. Samples of 3938 Italian and 2287 French colorectal cancer patients were randomly extracted from 8 and 12 cancer registries respectively. Rectal cancer patients (860 Italian, 559 French) were analysed. Logistic regression models estimated odds ratios (ORs) of being treated with curative intent, receiving sphincter-saving surgery, and receiving preoperative radiotherapy. Similar proportions of Italian and French patients were treated with curative intent (70% vs. 67%; OR=0.92 [0.73-1.16]); the respective proportions receiving sphincter-saving surgery were 21% and 33% (OR=1.15 [0.86-1.53]). In about 50% of those treated with curative intent, ≥12 lymph nodes were harvested in both countries. The proportion receiving postoperative radiotherapy was higher in Italy than in France (25% vs. 11%, p<0.01), but French patients were more likely to receive preoperative radiotherapy (52% vs. 21%; OR=4.06 [2.79-5.91]). The proportions of patients receiving preoperative radiotherapy and the numbers of lymph nodes sampled were low in both countries. Centralising treatment and potentiating screening would be practical ways of improving outcomes and adhering to guidelines.
    No preview · Article · Apr 2014 · Digestive and Liver Disease
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    ABSTRACT: Position du problème Cette étude présente les estimations d’incidence et de mortalité par cancer en France entre 1980 et 2012. Méthodes Parmi les tumeurs solides, 19 localisations cancéreuses ont été analysées. Les données d’incidence proviennent de 21 registres départementaux et correspondent aux cancers invasifs diagnostiqués entre 1975 et 2009. Les données de mortalité par cancer sur cette période ont été fournies par l’Institut national de la santé et de la recherche médicale. L’estimation nationale de l’incidence est basée sur l’utilisation de la mortalité comme corrélat de l’incidence. Les données d’incidence et de mortalité ont été modélisées à l’aide d’un modèle âge-période-cohorte. Les nombres de nouveaux cas de cancer et de décès entre 2010 et 2012 sont issus de projections à court terme. Résultats En 2012, le nombre de nouveaux cas de cancer a été estimé à 355 000 et le nombre de décès par cancer à 148 000. L’évolution des taux d’incidence n’était pas linéaire sur l’ensemble de la période. Après une augmentation continue depuis 1980, l’incidence du cancer chez l’homme a diminué entre 2005 et 2012. Cette diminution récente est en grande partie liée à la baisse de l’incidence du cancer de la prostate. Chez la femme, on observe une stabilisation essentiellement due à la modification de l’évolution de l’incidence du cancer du sein. La mortalité est en diminution sur l’ensemble de la période pour la majorité des localisations. L’analyse conjointe de l’incidence et de la mortalité par localisation permet de distinguer les cancers dont l’incidence et la mortalité ont diminué (ex. : estomac) des cancers dont l’incidence et la mortalité ont augmenté (ex. : poumon chez la femme). D’autres cancers combinent une augmentation de l’incidence et une diminution de la mortalité (ex. : thyroïde). Conclusion Ce travail met en évidence des modifications récentes et marquées de l’évolution de l’incidence, plus particulièrement pour les cancers du sein et de la prostate.
    Full-text · Article · Apr 2014 · Revue d Épidémiologie et de Santé Publique
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    ABSTRACT: Objective: The association between body mass index (BMI) and the risk of oral cavity cancer, suggested by the few available studies, is controversial because of weight loss preceding cancer diagnosis and possible confounding by tobacco and alcohol consumption. The aim of this study was to evaluate in France, a high-incidence country, the association between the risk of oral cavity cancer and body mass index at interview, 2 years before the interview and at age 30, as well as BMI change. Methods: We used data from a population-based case-control study, the Investigation of occupational and environmental CAuses of REspiratory cancers study, with personal interviews and standardized questionnaires including 689 cases of oral cavity squamous cell carcinoma and 3,481 controls. Odds ratios (ORs) and 95% confidence intervals (95% CI) were estimated by unconditional logistic regression and were adjusted for gender, age, area of residence, education, tobacco smoking, and alcohol drinking. Results: ORs were increased in underweight subjects at interview (OR 6.25, 95% CI 3.74-10.45). No association with underweight 2 years before the interview and at age 30 was found. Overweight and obesity at interview, 2 years before the interview and at age 30 were associated with decreased ORs (ranging from 0.13 to 0.60). BMI gain greater than 5% between age 30 and 2 years before the interview was inversely associated with oral cavity cancer (OR 0.42, 95% CI 0.33-0.54). These associations were stronger in men, and in smokers and drinkers. Conclusion: These results add further support to the existence of a reduced risk of oral cavity cancer among overweight and obese people or among people who increased their BMI in adulthood. The underlying mechanisms remain to be clarified.
    No preview · Article · May 2013 · Cancer Causes and Control
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    ABSTRACT: Purpose: Biological markers are crucial factors in order to differentiate female breast cancers and to determine the right therapy. This study aims at evaluating whether testing for biomarkers for female breast cancer has similar frequency and characteristics across and within countries. Methods: Population-based cancer registries of the Association for cancer registration and epidemiology in Romance language countries (GRELL) were asked to complete a questionnaire on biomarkers testing. The data collected referred to invasive female breast cancer cases diagnosed between 2004 and 2009. The investigation focused on 1) the overexpression and amplification of the human epidermal growth factor receptor 2 oncogene (HER2); 2) the expression of oestrogen (ER) and progesterone (PgR) receptors; and 3) the proliferation index (PI). Weighted percentages, the heterogeneity among and within countries, and the correlation between responses and calendar years were evaluated. The study was based on 19,644 breast cancers. Results: Overall, 85.9% of the cases were tested for HER2, 91.8% for both ER and PgR, and 74.1% for proliferative markers. For HER2 and ER-PgR, the frequency of testing increased from 2004 to 2009. Testing varied among countries (HER2 from 82.0% to 95.9%, ER-PgR from 89.3% to 98.9%, PI from 10% to 92%) and also within the same country (e.g. HER2 in Italy from 51% to 99%) as well as within single cancer registries. The most relevant differences were in the scores for positive/negative/not clearly defined HER2 (e.g. HER2 was defined positive if IHC 3+ in 21/33 registries), and in the cut-off of positive cells for ER/PgR (from >0% to >30%) and PI positivity (from >0% to >20%). Conclusions: Biological markers are widely tested in the Romance language countries; however, the parameters defining their positivity may vary, raising concerns about homogeneity in breast cancer classification and treatment.
    Full-text · Article · May 2013 · Breast (Edinburgh, Scotland)
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    ABSTRACT: Waiting times are key indicators of a health's system performance, but are not routinely available in France. We studied waiting times for diagnosis and treatment according to patients' characteristics, tumours' characteristics and medical management options in a sample of 1494 breast cancers recorded in population-based registries. The median waiting time from the first imaging detection to the treatment initiation was 34 days. Older age, co-morbidity, smaller size of tumour, detection by organised screening, biopsy, increasing number of specimens removed, multidisciplinary consulting meetings and surgery as initial treatment were related to increased waiting times in multivariate models. Many of these factors were related to good practices guidelines. However, the strong influence of organised screening programme and the disparity of waiting times according to geographical areas were of concern. Better scheduling of diagnostic tests and treatment propositions should improve waiting times in the management of breast cancer in France.
    Full-text · Article · Mar 2013 · Breast (Edinburgh, Scotland)
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    ABSTRACT: This study aimed to describe cancer incidence (2000-2008) and survival (2000-2004) in France in adolescents and young adults (AYA). All cases of cancer diagnosed in 15-24 years, recorded by all French population-based registries (14% of the French population), over the 2000-2008 period, were included. Incidence change over time was described with the conventional annual percentage change (cAPC). The survival of cases diagnosed (2000-2004) was estimated using Kaplan-Meier method. A total of 1022 in adolescents and 1396 in young adults were diagnosed. Overall incidence rates were 219.4/10(6) in 15-19 year olds and 293.1/10(6) in 20-24 year olds. The most frequently diagnosed cancers in male AYA were malignant gonadal germ-cell tumors and Hodgkin's disease, and were melanoma, thyroid carcinoma, and Hodgkin's disease in females. The age-standardized rates appeared stable over time in AYA, with a cAPC of +2.0% (P = 0.68). The 5-year overall survival for all cancers was different between genders and age groups, with 78.8% (95%CI: 75.6-82.0) for males and 85.2% (95%CI: 82.2-88.1) for females (P = 0.01), and 78.5% (95%CI: 75.0-82.1) in 15-19 year olds and 84.3% (95% CI: 81.6-87.0) in 20-24 year olds (P = 0.02). Noteworthy, the frequency and the distribution of tumor types in AYA are unique and different from the observed at any other age group. Survival in French AYA has improved over time. Epidemiological data might reflect major trends in the risk factors and preventive interventions. Thus, further research into etiology of cancers affecting AYA should become key priorities for cancer control among AYA.
    No preview · Article · Jan 2013 · Pediatric Hematology and Oncology
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    ABSTRACT: The objective was to examine the role of tobacco smoking and alcohol drinking in the incidence of oral cavity cancer by subsite in France, a high-incidence area. We analysed detailed data on lifelong tobacco smoking and alcohol drinking from 772 oral cavity cancer cases and 3555 controls included in a population-based case-control study, the ICARE study. Tobacco smoking increased the risk of oral cavity cancer even for the smaller quantities and durations, whereas alcohol drinking increased this risk only in heavy drinkers who were also ever smokers. The combined effect of smoking and drinking was greater than multiplicative. The floor of the mouth was the subsite that was the most affected by the harmful effects of tobacco and alcohol, whereas the gums were less susceptible. The risk associated with tobacco and alcohol consumption did not differ between intraoral cavity and subsites usually included in the oropharynx (soft palate and base of the tongue). Population-attributable risks for oral cavity cancer were 78.6% for tobacco smoking, 7.3% for alcohol drinking and 80.7% for tobacco and/or alcohol consumption. These results indicate that regular oral check-ups should be targeted at smokers and heavy drinkers, and that prevention efforts should be focused on smoking cessation.
    No preview · Article · Sep 2012 · European journal of cancer prevention: the official journal of the European Cancer Prevention Organisation (ECP)
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    ABSTRACT: A major French chlorine chemical plant (chlor-alkali process with diaphragm cell and manufacturing of organochlorine chemicals) has used or produced known or suspected carcinogenic compounds. A cohort study, based on the plant occupational health service and the regional cancer registry, analyzed the standardized incidence ratios of malignant tumors for the period 1979-2002. Individual exposures were estimated from workers' occupational histories in a dual division of jobs into 9 sectors and 115 workshops with known exposures. Men (2,742) were followed, corresponding to 52,794 person-years. Primary tumors (304) were observed for 290 expected cases, a non-significant 5% excess. A significant excess was found of pleural mesothelioma and bladder cancer in employees hired before 1964. Excesses of mesothelioma and bladder cancer were found, whereas there was no excess of hematopoietic cancers despite high benzene and dioxin exposures. Surprisingly, mesothelioma cases did not include workers who were the most exposed to asbestos.
    Full-text · Article · Sep 2012 · American Journal of Industrial Medicine
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    ABSTRACT: Background and aims: In France, participation in organized colorectal cancer screening remains low. The objective of this study was to identify the determinants of participation in colorectal cancer screening in Isère, a French administrative entity. Methods: This study examined the target population invited for screening between 2007 and 2008 in Isère. The statistical analysis method was based on a two-level logistic regression model: the first was the individual level relative to the individuals invited for screening and the second was an aggregate level corresponding to the socioeconomic level of an invited person's residence area (IRIS: "Ilot regroupé pour l'Information Statistique"; Regrouped statistical information block). The evaluation of the socioeconomic level was based on the Townsend deprivation. Results: Participation varied depending on sex, age, and health insurance plan. The people residing in the least deprived IRISes participated more than individuals residing in the most deprived IRISes. The multilevel analysis showed a 24% difference in participation between the least and the most deprived IRISes. Conclusions: The use of socioeconomic data on the IRIS geographical unit has identified, socially and geographically, the populations that participate the least, although this reflects "mean" behaviors. These results could be used to set up targeted actions to encourage participation in these populations.
    No preview · Article · Jun 2012 · Gastroentérologie Clinique et Biologique
  • K Ligier · A Belot · G Launoy · M Velten · P Delafosse · A.V. Guizard
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    ABSTRACT: We had for objective to describe the updated epidemiology of oral cancers in France. Estimates made from data collected from various French cancer institutions. The distribution by topography, histology, regions, mean age, and specific incidence rates were calculated from the collected data. The survival data was taken from the Francim network studies. Approximately 7000 oral cavity cancers were diagnosed in France in 2005. In 2007, 1746 people died of that cancer. Standardized (world population) incidence rates are respectively, in men and women, 12.3 and 3.0 cases per 100,000 person-years. These cancers have significantly decreased in men: the standardized incidence rate decreased by 43.2% between 1980 and 2005. Among women, the trend is reversed with an increased incidence of 51.7% over the same period. In France, the incidence of oral cavity cancers has been strongly decreasing in men and strongly increasing in women. This trend should be compared to the frequency of the main risk factors: alcohol and tobacco.
    No preview · Article · Jun 2011 · Revue de stomatologie et de chirurgie maxillo-faciale
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    ABSTRACT: The incidence of female lung cancer in developed countries has been increasing since 1950. In order to have recent and reliable data on the association between cigarette smoking and the risk of lung cancer in women, we analysed cases from a French population-based case-control study. The ICARE study is a multicenter case-control study on respiratory cancers (lung and UADT cancers), set up in 10 départements that include a general cancer registry. We included 648 women lung cancer cases up to 76 years of age, with a histologically confirmed primary lung cancer. The 775 controls were randomly selected from the general population and frequency-matched with cases by age and département. Overall, smoking cigarettes at some time was associated with a 8-fold increase in lung cancer risk (OR=8.2, 95% CI 6.0-11.4). A dose-response relationship was observed as a function of duration, intensity and pack-years. Using restricted splines cubic models, we have shown that intensity dose-response departed significantly from linearity while the risk increased linearly with duration and decreased linearly with time since cessation. The following characteristics were associated with a higher relative risk: smoke inhalation, smoking non-filter cigarettes, smoking dark tobacco cigarettes and starting at a young age. In addition, duration, intensity and time since cessation was significantly related with histological type. This was not the case for characteristics such as the use of a filter or not, the inhalation pattern, or the type of tobacco smoked. The proportion of lung cancer cases attributable to cigarette smoking was 55% (95% CI: [47-63%]). Our results confirm that cigarette smoking is by far the most important cause of the current epidemic of lung cancer among French women and that the most important smoking-related variables for varying the risk of lung cancer are the duration, the intensity and the time since cessation.
    No preview · Article · May 2011 · Lung cancer (Amsterdam, Netherlands)
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    ABSTRACT: The objective of this study is to determine whether the likelihood of returning for routine breast cancer screening differed for false-positive cases depending on the diagnostic work-up. Using the original data from a French population-based breast cancer screening program, we compared the attendance rates at the subsequent round of screening for 16,946 and 1,127 participants who received negative (i.e., American College of Radiology, ACR, categories 1-2) and false-positive mammograms, respectively. False-positive mammograms were categorized ACR 0 (i.e., warranting additional imaging evaluation), 3 (i.e., warranting clinical and imaging follow-up), and 4-5 (i.e., warranting biopsy). We estimated the odds ratios of attendance at subsequent screening round using logistic regression, adjusting for age and history of previous mammography. The attendance rates at the subsequent screening round were 80.6% for women who received negative mammograms versus 69.6, 74.3, and 70.1% for women who received false-positive mammograms warranting additional imaging evaluation, clinical and imaging follow-up, or biopsy, respectively. In comparison to women who received negative mammograms, the corresponding adjusted odds ratios of returning for routine screening were 0.6 [95% confidence interval (CI) 0.4-0.8], 0.8 (95% CI 0.6-0.9), and 0.6 (95% CI 0.4-0.8). No significant differences were found in odds ratios of attendance across ACR categories among women who received false-positive mammograms. Similar figures were observed for attending at least one of the two subsequent screening rounds. In conclusion, in comparison to women with normal or benign findings on index mammograms, false-positive cases warranting additional imaging evaluation, clinical and imaging follow-up, or biopsy had uniformly decreased odds of attending subsequent routine screening rounds.
    Full-text · Article · May 2011 · Breast Cancer Research and Treatment
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    ABSTRACT: Over the 1998-2002 period, some French Départements have been shown to have the world's highest incidence of upper aerodigestive tract (UADT) cancers in men. The objectives were to describe the changes in UADT cancer incidence in France over the 1980-2005 period, present projections for 2010, and describe the anatomical and histological characteristics of these tumours. The trend of cancer-incidence over 1980-2005 and projection up to 2010 were obtained using age-period-cohort models (data from eleven cancer registries) and incidence/mortality ratios in the area covered by these registries. The description of UADT cancers by anatomical and histological characteristics concerned data collected between 1980 and 2004 in eleven cancer registries. In men, cancer incidence decreased in all cancer sites and the world-standardized incidence rates decreased by 42.9% for lip-oral cavity-pharynx (LOCP) cancers and 50.4% for larynx cancer. In women, the world-standardized incidence rates increased by 48.6% for LOCP cancers and 66.7% for larynx cancer. Incidence increased the most for oropharynx, palate, and hypopharynx cancers. Incidence analysis by one-year cohorts revealed a progressive shift of the incidence peak towards younger and younger generations, with no change as yet in the mean age at diagnosis. In France, the incidence of these cancers is still higher than in other European and North American countries. This urges actions towards reducing the major risk factors for those cancers, namely alcohol and tobacco consumption, especially among young people, and reducing exposure to risk factors due to social inequalities.
    No preview · Article · Mar 2011 · Oral Oncology