1
|
Dantony E, Uhry Z, Fauvernier M, Coureau G, Mounier M, Trétarre B, Molinié F, Roche L, Remontet L. Multidimensional penalized splines for survival models: illustration for net survival trend analyses. Int J Epidemiol 2024; 53:dyae033. [PMID: 38499394 DOI: 10.1093/ije/dyae033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 02/13/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND In descriptive epidemiology, there are strong similarities between incidence and survival analyses. Because of the success of multidimensional penalized splines (MPSs) in incidence analysis, we propose in this pedagogical paper to show that MPSs are also very suitable for survival or net survival studies. METHODS The use of MPSs is illustrated in cancer epidemiology in the context of survival trends studies that require specific statistical modelling. We focus on two examples (cervical and colon cancers) using survival data from the French cancer registries (cases 1990-2015). The dynamic of the excess mortality hazard according to time since diagnosis was modelled using an MPS of time since diagnosis, age at diagnosis and year of diagnosis. Multidimensional splines bring the flexibility necessary to capture any trend patterns while penalization ensures selecting only the complexities necessary to describe the data. RESULTS For cervical cancer, the dynamic of the excess mortality hazard changed with the year of diagnosis in opposite ways according to age: this led to a net survival that improved in young women and worsened in older women. For colon cancer, regardless of age, excess mortality decreases with the year of diagnosis but this only concerns mortality at the start of follow-up. CONCLUSIONS MPSs make it possible to describe the dynamic of the mortality hazard and how this dynamic changes with the year of diagnosis, or more generally with any covariates of interest: this gives essential epidemiological insights for interpreting results. We use the R package survPen to do this type of analysis.
Collapse
Affiliation(s)
- Emmanuelle Dantony
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
- Equipe Biostatistique-Santé, Laboratoire de Biométrie et Biologie Évolutive, CNRS UMR 5558, Villeurbanne, France
- Université de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Zoé Uhry
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
- Direction des Maladies Non Transmissibles et des Traumatismes, Santé Publique France, Saint-Maurice, France
| | - Mathieu Fauvernier
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
- Equipe Biostatistique-Santé, Laboratoire de Biométrie et Biologie Évolutive, CNRS UMR 5558, Villeurbanne, France
- Université de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Gaëlle Coureau
- French Network of Cancer Registries (Francim), Toulouse, France
- Gironde General Cancer Registry, Univ Bordeaux, Bordeaux, France
- Service d'information Médicale, CHU de Bordeaux, Bordeaux, France
| | - Morgane Mounier
- French Network of Cancer Registries (Francim), Toulouse, France
- Registre des Hémopathies Malignes de la Côte-d'Or, CHU de Dijon Bourgogne, Dijon, France
- UMR INSERM 1231, Université Bourgogne Franche-Comté, Dijon, France
| | - Brigitte Trétarre
- French Network of Cancer Registries (Francim), Toulouse, France
- Hérault Cancer Registry, Montpellier, France
- CERPOP, UMR 1295, Université de Toulouse III, Toulouse, France
| | - Florence Molinié
- French Network of Cancer Registries (Francim), Toulouse, France
- CERPOP, UMR 1295, Université de Toulouse III, Toulouse, France
- Loire-Atlantique/Vendée Cancer Registry, SIRIC-ILIAD, Nantes, France
| | - Laurent Roche
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
- Equipe Biostatistique-Santé, Laboratoire de Biométrie et Biologie Évolutive, CNRS UMR 5558, Villeurbanne, France
- Université de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Laurent Remontet
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
- Equipe Biostatistique-Santé, Laboratoire de Biométrie et Biologie Évolutive, CNRS UMR 5558, Villeurbanne, France
- Université de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Villeurbanne, France
| |
Collapse
|
2
|
Comoz B, Ollivier-Hourmand I, Bouvier AM, Nousbaum JB, Nguyen TTN, Launoy G, Bouvier V, Bryere J. Impact of socio-economic environment on incidence of primary liver cancer in France between 2006 and 2016. Liver Int 2024; 44:446-453. [PMID: 38010978 DOI: 10.1111/liv.15784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/23/2023] [Accepted: 10/30/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND AND AIMS To measure the impact of socio-economic environment on the incidence of hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (iCCA). METHOD The study used data from the French Network of Cancer Registries (FRANCIM) between 2006 and 2016. Classification of patients into HCC and iCCA was performed according to the topographical and morphological codes of the 3rd edition of the International Classification of Diseases for Oncology. Patient addresses were geolocalized and assigned to an IRIS, the smallest French geographic unit. Socio-economic environment was assessed by the European Deprivation Index (EDI). Sex- and age-standardized incidence rates with 95% confidence intervals (CI) were estimated per 100 000 inhabitants, by national quintiles, for each IRIS, sex and age group. Quintile 1 (Q1) characterized the most affluent areas. A Poisson regression was performed to model the impact of deprivation. RESULTS We included 22 249 cases (79.64% HCC, 16.97% iCCA). Incidence rates were 11.46 and 2.39 per 100 000 person-years for HCC and iCCA, respectively. There was an over-incidence of HCC in quintiles 2, 3, 4 and 5 compared to quintile 1: Q1 10.28 [9.9-10.66] per 100 000 person-years, Q2 11.43 [10.48-12.47] (p < .0001), Q3 11.81 [10.82-12.89] (p < .0001), Q4 12.26 [11.25-13.37] (p < .001) and Q5 11.53 [10.57-12.57] (p < .0001). By contrast, there was no difference for iCCa. Deprivation was significantly associated with HCC in men (p = .0018) and women (p = .0009), but not with iCCA (p = .7407). CONCLUSION The incidence of HCC is related to socio-economic environment, unlike iCCA. HCC and iCCA should be studied separately in epidemiological studies.
Collapse
Affiliation(s)
- Bertille Comoz
- Service d'hépato-gastroentérologie, CHU de Caen, Caen, France
- ANTICIPE U1086 INSERM-UCN, Université de Caen Normandie UNICAEN, Centre François Baclesse, Caen, France
| | - Isabelle Ollivier-Hourmand
- Service d'hépato-gastroentérologie, CHU de Caen, Caen, France
- ANTICIPE U1086 INSERM-UCN, Université de Caen Normandie UNICAEN, Centre François Baclesse, Caen, France
| | - Anne-Marie Bouvier
- Registre Bourguignon des Cancers digestifs, INSERM UMR 1231, UFR Santé de Bourgogne, Dijon, France
| | - Jean-Baptiste Nousbaum
- Service d'hépato-gastroentérologie, CHU de Brest, Brest, France
- Registre des Cancers digestifs du Finistère, EA 7479 SPURBO, Université de Bretagne Occidentale, Brest, France
| | - Thi Thu Nga Nguyen
- Service d'hépato-gastroentérologie, CHU de Caen, Caen, France
- ANTICIPE U1086 INSERM-UCN, Université de Caen Normandie UNICAEN, Centre François Baclesse, Caen, France
| | - Guy Launoy
- ANTICIPE U1086 INSERM-UCN, Université de Caen Normandie UNICAEN, Centre François Baclesse, Caen, France
- Registre des Cancers digestifs du Calvados, CHU de Caen, Caen, France
| | - Véronique Bouvier
- ANTICIPE U1086 INSERM-UCN, Université de Caen Normandie UNICAEN, Centre François Baclesse, Caen, France
- Registre des Cancers digestifs du Calvados, CHU de Caen, Caen, France
| | - Joséphine Bryere
- ANTICIPE U1086 INSERM-UCN, Université de Caen Normandie UNICAEN, Centre François Baclesse, Caen, France
| |
Collapse
|
3
|
Trétarre B, Dantony E, Coureau G, Defossez G, Guizard AV, Delafosse P, Daubisse L, Velten M, Karima Hammas, Barra S, Lapotre B, Plouvier S, d'Almeida T, Molinié F, Woronoff AS. Trends in incidence of invasive vaginal cancer in France from 1990 to 2018 and survival of recently diagnosed women - A population-based study. Eur J Obstet Gynecol Reprod Biol 2023; 283:125-129. [PMID: 36842246 DOI: 10.1016/j.ejogrb.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 01/26/2023] [Accepted: 02/10/2023] [Indexed: 02/15/2023]
Abstract
OBJECTIVE The aim of this study was to analyze trends in the incidence of vaginal cancer in France over a 28-year period and to present survival for recently-diagnosed women. METHODS French cancer registries provided data on invasive vaginal cancers diagnosed from 1990 to 2015 and followed up through June 2018. Trends in incidence were analyzed using a Poisson model with a bidimensional penalized spline of age and year at diagnosis. Net survival analysis was restricted to recently-diagnosed cases (2010-2015) and used a novel approach based on a bidimensional penalized spline of age and time-since-diagnosis to model excess mortality hazard. RESULTS With 162 new cases estimated in France in 2018, vaginal cancer represented 0.9 % of genital cancers in French women. In 2018, the world population age-standardized incidence rate was 0.2 per 100,000 person-years, median age at diagnosis was 75 years. The standardized incidence rate decreased significantly by 3 % per year (95 % CI, -3.8; -2.2) between 1990 and 2018 (0.4 cases per 100,000 person-year in 1990, vs 0.2 in 2018). Age-standardized net survival at 1 and 5 years after diagnosis was respectively 74 % and 45 %. CONCLUSIONS This study confirms that vaginal cancer is still a rare malignancy in France with 5-year net survival that remains low. We observed a consistent decrease in the incidence rate between 1990 and 2018. It may be too early to attribute these trends to a positive impact of vaccination campaigns against hrHPV infection, since vaginal cancer mainly affects older women and HPV vaccination has only been available since the early 2000s, and only targets young girls.
Collapse
Affiliation(s)
- Brigitte Trétarre
- Registre des Tumeurs de l'Hérault, 208 rue des Apothicaires, Montpellier, France; CERPOP INSERM U1295, Toulouse III University, F-31000, France; FRANCIM Network, Toulouse F-31073, France.
| | - Emmanuelle Dantony
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France; Laboratoire de Biométrie et Biologie Evolutive, UMR 5558, CNRS, Université Lyon 1, Université de Lyon, Villeurbanne, France
| | - Gaëlle Coureau
- FRANCIM Network, Toulouse F-31073, France; Epicene, Centre Inserm U1219/CHU de Bordeaux, Service d'information Médicale, Université Bordeaux, Bordeaux, France
| | - Gautier Defossez
- FRANCIM Network, Toulouse F-31073, France; Registre général des cancers de Poitou-Charentes, Pôle Biologie, Pharmacie et Santé Publique, CHU de Poitiers, Poitiers, France; Université de Poitiers, Poitiers, France; INSERM Centre d'Investigation Clinique CIC1402, Poitiers, France
| | - Anne-Valérie Guizard
- FRANCIM Network, Toulouse F-31073, France; Registre Général des Tumeurs du Calvados, Caen, France
| | - Patricia Delafosse
- FRANCIM Network, Toulouse F-31073, France; Registre Général des Cancers de l'Isère, Meylan, France
| | - Laetitia Daubisse
- CERPOP INSERM U1295, Toulouse III University, F-31000, France; FRANCIM Network, Toulouse F-31073, France; Claudius Regaud Institute, Regional Cancer Center, IUCT-O, Tarn Cancer Registry, Toulouse, F-31059, France
| | - Michel Velten
- FRANCIM Network, Toulouse F-31073, France; Registre des Cancers du Haut-Rhin, Mulhouse, France
| | - Karima Hammas
- FRANCIM Network, Toulouse F-31073, France; Registre des Cancers du Haut-Rhin, ARER68, Groupe Hospitalier de la Région de Mulhouse et Sud-Alsace (GHRMSA), Mulhouse, France
| | - Simona Barra
- FRANCIM Network, Toulouse F-31073, France; Registre des Cancers de la Manche, Cherbourg-Octeville, France
| | - Bénédicte Lapotre
- FRANCIM Network, Toulouse F-31073, France; Registre du cancer de la Somme, hôpital nord CHU Amiens-Picardie, Amiens, France
| | - Sandrine Plouvier
- FRANCIM Network, Toulouse F-31073, France; Registre général des cancers de Lille et de sa région, Lille, France
| | - Tania d'Almeida
- FRANCIM Network, Toulouse F-31073, France; Registre général des cancers de la Haute-Vienne - CHU de Limoges, Limoges, France
| | - Florence Molinié
- CERPOP INSERM U1295, Toulouse III University, F-31000, France; FRANCIM Network, Toulouse F-31073, France; Registre des Cancers de Loire-Atlantique et Vendee, CHU de Nantes, France
| | - Anne-Sophie Woronoff
- FRANCIM Network, Toulouse F-31073, France; Doubs Cancer Registry, Besançon University Hospital, Besançon, France; Research Unit EA3181, Franche-Comté University, Besançon, France
| |
Collapse
|
4
|
Renou A, Guizard AV, Chabrillac E, Defossez G, Grosclaude P, Deneuve S, Vergez S, Lapotre-Ledoux B, Plouvier SD, Dupret-Bories A. Evolution of the Incidence of Oral Cavity Cancers in the Elderly from 1990 to 2018. J Clin Med 2023; 12:jcm12031071. [PMID: 36769722 PMCID: PMC9917397 DOI: 10.3390/jcm12031071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/12/2023] [Accepted: 01/17/2023] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES To describe the evolution of the incidence of oral cavity cancers (OCC) among elderly patients in France between 1990 and 2018 and to compare it to the incidence of other cancers sharing the same main risk factors. MATERIAL AND METHODS The incidence of cancers in mainland France from 1990 to 2018 was estimated from incidence data observed in every cancer registry of the Francim network. Incidence was modeled by a 2-dimensional penalized spline of age and year of diagnosis, associated with a random effect corresponding to the registry. The elderly population was divided into two groups: 70-79 years old and ≥80 years old. RESULTS There was a 72% increase in the number of OCC cases in women over 70 years of age between the periods 1990-1999 and 2010-2018. As for men, there was a stabilization in the number of cases (+2%). Over the same period, for laryngeal and hypopharyngeal cancers, there was a decrease in incidence in elderly men and an increase in elderly women, although less marked than for OCC. CONCLUSIONS Since the 1990s, the incidence of OCC has been increasing in elderly subjects in France, particularly in women. Population aging and growth or alcohol and tobacco consumption alone do not seem to explain this increase, which is not observed in the same proportions for other upper aerodigestive tract cancer subsites sharing the same main risk factors.
Collapse
Affiliation(s)
- Alice Renou
- Department of Surgery, University Cancer Institute Toulouse—Oncopole, Hôpitaux Universitaires de Toulouse, 31009 Toulouse, France
| | - Anne-Valérie Guizard
- French Network of Cancer Registries, 31073 Toulouse, France
- General Tumor Registry of Calvados, Centre François Baclesse, 14000 Caen, France
- ANTICIPE U 1086 Inserm-UCN, 14000 Caen, France
| | - Emilien Chabrillac
- Department of Surgery, Institut Claudius Regaud, University Cancer Institute Toulouse—Oncopole, 31009 Toulouse, France
| | - Gautier Defossez
- French Network of Cancer Registries, 31073 Toulouse, France
- General Cancer Registry of Poitou-Charentes, Pôle Biologie, Pharmacie et Santé Publique, CHU/Université de Poitiers, 86000 Poitiers, France
| | - Pascale Grosclaude
- French Network of Cancer Registries, 31073 Toulouse, France
- Tarn Cancer Registry, Claudius Regaud Institute, University Cancer Institute Toulouse—Oncopole, 31009 Toulouse, France
- CERPOP, UMR 1295 Inserm Toulouse III University, 31000 Toulouse, France
| | - Sophie Deneuve
- Department of ENT, Rouen University Hospital, 76000 Rouen, France
- Quantification en Imagerie Fonctionnelle-Laboratoire d’Informatique, du Traitement de l’Information et des Systèmes Equipe d’Accueil 4108 (QuantIF-LITIS EA4108), University of Rouen, 76000 Rouen, France
| | - Sébastien Vergez
- Department of Surgery, University Cancer Institute Toulouse—Oncopole, Hôpitaux Universitaires de Toulouse, 31009 Toulouse, France
| | - Bénédicte Lapotre-Ledoux
- French Network of Cancer Registries, 31073 Toulouse, France
- Somme Cancer Registry, CHU Amiens, CEDEX 1, 80054 Amiens, France
- CHIMERE, Surgery, Imaging and Tissue REgeneration of the Cephalic Extremity-Morphological and Functional Characterization, 7516 UR UPJV, CHU-Amiens Picardie, 1 Rond Point du Professeur Cabrol, 80000 Amiens, France
| | - Sandrine D Plouvier
- French Network of Cancer Registries, 31073 Toulouse, France
- General Cancer Registry of Lille Area, GCS-C2RC, 59000 Lille, France
| | - Agnès Dupret-Bories
- Department of Surgery, University Cancer Institute Toulouse—Oncopole, Hôpitaux Universitaires de Toulouse, 31009 Toulouse, France
- Correspondence: ; Tel.: +33-53-1155-373
| | | |
Collapse
|
5
|
Le Bihan-Benjamin C, Rocchi M, Putton M, Méric JB, Bousquet PJ. Estimation of Oncologic Surgery Case Volume Before and After the COVID-19 Pandemic in France. JAMA Netw Open 2023; 6:e2253204. [PMID: 36701152 PMCID: PMC9880797 DOI: 10.1001/jamanetworkopen.2022.53204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
IMPORTANCE COVID-19 has had a major effect on health care activities, especially surgery. At first, comparisons were proposed using 2019 activities as the highest standard. However, while such an approach might have been suitable during the first months of the pandemic, this might no longer be the case for a longer period. OBJECTIVE To examine approaches that may better assess the use of cancer surgeries. DESIGN, SETTING, AND PARTICIPANTS In a cross-sectional design, the nationwide French hospital facility data (Medicalised Information System Program) were used to assess cancer surgery for 6 cancer site categories in adults from January 1, 2010, to December 31, 2021. EXPOSURE Estimated cancer surgery activity during the COVID-19 pandemic. MAIN OUTCOMES AND MEASURES Three models were proposed to assess the expected number of surgical procedures between 2020 and 2021 and make a comparison with those observed in earlier years. RESULTS In France, cancer removal surgeries account for approximately 7000 hospitalizations per year for liver cancer; 4000 for pancreatic cancer; 7700 for ovarian cancer; 1300 for esophagus cancer; 23 000 for ear, nose, and throat (ENT) cancer; 78 000 for breast cancer; and 16 600 for thoracic cancers. For most cancer sites, the number of surgical procedures increased from 2010 to 2019: liver, 14%; pancreas, 38%; ovary, 14%; esophagus, 18%; breast, 8%; and thoracic, 29%. Assuming stability, these values underestimate the gap in activity observed in 2020-2021. For other procedures, a decrease was observed: stomach, -10%, and ENT, -6%. Assuming stability, these values overestimate the gap in activity observed in 2020-2021. At the end of 2021, according to the model, the gap in activity observed in 2020-2021 was estimated at between -1.4% and 1.7% for breast, -6.6% and -7.3% for thoracic, -3.1% and -2.5% for ovarian, -4.2% and -1.7% for pancreas, -6.7% and 5.9% for stomach, and -13.0% and -13.9% for esophageal cancers. For ENT, liver, and urologic cancers, because the trend was different before and after 2015, it was necessary to opt for modeling using only the most recent period. The cumulative gap in activity observed in 2020-2021 was estimated at -1.0% for ENT cancers, -5.3% for liver cancers, and -2.9% for urologic cancers. CONCLUSIONS AND RELEVANCE The findings of this study suggest that short- and medium-term trends must be considered to estimate COVID-19 cancer surgery activities. Breast cancer is the site for which the activity showed the smallest decrease during the pandemic, with almost full recovery in 2021.
Collapse
Affiliation(s)
- Christine Le Bihan-Benjamin
- Health Data and Assessment Department, Survey Data Science and Assessment Division, National Cancer Institute, Boulogne-Billancourt, France
| | - Mathieu Rocchi
- Health Data and Assessment Department, Survey Data Science and Assessment Division, National Cancer Institute, Boulogne-Billancourt, France
| | - Maxime Putton
- Care Paths Organization Department, Public Health Division, National Cancer Institute, Boulogne-Billancourt, France
| | - Jean-Baptiste Méric
- Public Health Division, National Cancer Institute, Boulogne-Billancourt, France
| | - Philippe Jean Bousquet
- Survey Data Science and Assessment Division, National Cancer Institute, Boulogne-Billancourt, France
- Aix Marseille University, INSERM, IRD, Economics and Social Sciences Applied to Health & Analysis of Medical Information, Marseille, France
| |
Collapse
|
6
|
How Can the EU Beating Cancer Plan Help in Tackling Lung Cancer, Colorectal Cancer, Breast Cancer and Melanoma? Healthcare (Basel) 2022; 10:healthcare10091618. [PMID: 36141230 PMCID: PMC9498919 DOI: 10.3390/healthcare10091618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/16/2022] [Accepted: 08/19/2022] [Indexed: 12/09/2022] Open
Abstract
Cancer is the second leading cause of mortality in EU countries, and the needs to tackle cancer are obvious. New scientific understanding, techniques and methodologies are opening up horizons for significant improvements in diagnosis and care. However, take-up is uneven, research needs and potential outstrip currently available resources, manifestly beneficial practices—such as population-level screening for lung cancer—are still not generalised, and the quality of life of patients and survivors is only beginning to be given attention it merits. This paper, mainly based on a series of multistakeholder expert workshops organised by the European Alliance for Personalised Medicine (EAPM), looks at some of those specifics in the interest of planning a way forward. Part of this exercise also involves taking account of the specific nature of Europe and its constituent countries, where the complexities of planning a way forward are redoubled by the wide variations in national and regional approaches to cancer, local epidemiology and the wide disparities in health systems. Despite all the differences between cancers and national and regional resources and approaches to cancer care, there is a common objective in pursuing broader and more equal access to the best available care for all European citizens.
Collapse
|
7
|
Deneuve S, Pérol O, Dantony E, Guizard AV, Bossard N, Virard F, Fervers B. Diverging incidence trends of oral tongue cancer compared to other head and neck cancers in young adults in France. Int J Cancer 2021; 150:1301-1309. [PMID: 34889463 DOI: 10.1002/ijc.33896] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 10/18/2021] [Accepted: 11/02/2021] [Indexed: 01/02/2023]
Abstract
While head and neck cancer incidence decreased worldwide due to reduced tobacco and alcohol consumption, oral tongue cancer (OTC) incidence has been reported to be increasing in several countries. Our study examines the incidence trends of OTC in France from 1990 to 2018, globally and by age; and compares the incidence trends with the evolution of the incidence of other human papilloma virus-unrelated head and neck squamous cell carcinoma, that is, cancers of the remaining subsites of the oral cavity (RSOCC) and laryngeal cancers for the period 1990 to 2018. World age-standardized incidence rates of oral tongue cancers (C02), cancers of the remaining subsites of the oral cavity (RSOCC, C03-06) and laryngeal cancers (C32) were estimated using the French National Network of Cancer Registries for the period 1990 to 2018. Trends in national incidence rates were estimated from a mixed-effect Poisson model including age and year effects using penalized splines and a district-random effect. In women aged 30 and 40, a significant increase in OTC incidence was observed, while ROSCC showed a nonsignificant incidence decrease. In young men aged 25, a marginally significant increase of OTC incidence years was observed, while incidence rates of RSOCC significantly declined. The results suggest a tendency towards diverging incidence trends for OTC compared to RSOCC and laryngeal cancer in young adults. The observed trends may reflect changes in underlying exposures or emerging exposures not yet identified, and stress the need to further investigate the etiology of oral tongue cancers.
Collapse
Affiliation(s)
- Sophie Deneuve
- Department of Surgical Oncology, Centre Léon Bérard, Lyon, France.,INSERM 1296 Unit, Radiations: Defense, Health and Environment, Centre Léon Bérard, Lyon, France
| | - Olivia Pérol
- INSERM 1296 Unit, Radiations: Defense, Health and Environment, Centre Léon Bérard, Lyon, France.,Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France
| | - Emmanuelle Dantony
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France.,Laboratoire de Biométrie et Biologie Évolutive, UMR 5558, CNRS, Université Lyon 1, Université de Lyon, Villeurbanne, France
| | - Anne-Valérie Guizard
- Calvados General Tumor Registry, Centre Francois Baclesse, Caen, France.,U1086 INSERM-UCN "ANTICIPE", Centre Francois Baclesse, Caen, France
| | - Nadine Bossard
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France.,Laboratoire de Biométrie et Biologie Évolutive, UMR 5558, CNRS, Université Lyon 1, Université de Lyon, Villeurbanne, France
| | - François Virard
- Cancer Research Center of Lyon, INSERM 1052, Claude Bernard University, Lyon, France.,Faculté d'Odontologie, Hospices Civils de Lyon, Université de Lyon, Lyon, France
| | - Béatrice Fervers
- INSERM 1296 Unit, Radiations: Defense, Health and Environment, Centre Léon Bérard, Lyon, France.,Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France
| | | |
Collapse
|
8
|
Li M, Delafosse P, Meheus F, Borson-Chazot F, Lifante JC, Simon R, Groclaude P, Combes JD, Dal Maso L, Polazzi S, Duclos A, Colonna M, Vaccarella S. Temporal and geographical variations of thyroid cancer incidence and mortality in France during 1986-2015: The impact of overdiagnosis. Cancer Epidemiol 2021; 75:102051. [PMID: 34743057 DOI: 10.1016/j.canep.2021.102051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 10/07/2021] [Accepted: 10/14/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND France is among the countries showing fastest growth of thyroid cancer (TC) incidence and highest incidence rates in Europe. This study aimed to clarify the temporal and geographical variations of TC in France and to quantify the impact of overdiagnosis. METHODS We obtained TC incidence data in 1986-2015, and mortality data in 1976-2015, for eight French departments covering 8% of the national population, and calculated the age-standardised rates (ASR). We estimated the average annual percent changes (AAPC) of TC incidence, overall and by department and histological subtype. Numbers and proportions of TC cases attributable to overdiagnosis were estimated by department and period, based on the comparison between the shape of the age-specific curves with that observed prior to changes in diagnostic practice. RESULTS During 1986-2015, there were 13,557 TC cases aged 15-84 years. Large variations of TC incidence were observed across departments, with the highest ASR and the fastest increase in Isère. Papillary subtype accounted for 82.8% of the cases, and presented an AAPC of 7.0% and 7.6% in women and men, respectively. Anaplastic TC incidence decreased annually 3.0% in women and 0.8% in men. Mortality rates declined consistently for all departments. The absolute number (and proportion) of TC cases attributable to overdiagnosis grew from 1074 (66%) in 1986-1995 to 3830 (72%) in 2006-2015 in women, and varied substantially across departments. CONCLUSIONS Overdiagnosis plays an important role in the temporal and regional variations of TC incidence in France. Monitoring the time trends and regulating the regional healthcare practice are needed to reduce its impact.
Collapse
Affiliation(s)
- Mengmeng Li
- Department of Cancer Prevention, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; International Agency for Research on Cancer, Lyon, France
| | | | - Filip Meheus
- International Agency for Research on Cancer, Lyon, France
| | - Françoise Borson-Chazot
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France; Fédération d'Endocrinologie, Groupement Hospitalier Est and Registre des Cancers Thyroïdiens du Rhône, Hospices Civils de Lyon, Lyon, France
| | - Jean-Christophe Lifante
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France; Service de Chirurgie Endocrinienne, Groupement Hospitalier Sud and Registre des Cancers Thyroïdiens du Rhône, Hospices Civils de Lyon, Lyon, France
| | - Raphael Simon
- International Agency for Research on Cancer, Lyon, France
| | - Pascale Groclaude
- Claudius Regaud Institute, IUCT-Oncopole, Tarn Cancer Registry, Toulouse, France
| | | | - Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO), Istituto di Ricovero e Cura a Carattere Scientifico, Aviano, Italy
| | - Stéphanie Polazzi
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France; Health data department, Lyon University Hospital, Lyon, France
| | - Antoine Duclos
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France; Health data department, Lyon University Hospital, Lyon, France
| | - Marc Colonna
- Registre du cancer de l'Isère, Grenoble, France.
| | | |
Collapse
|
9
|
Cancer incidence and mortality trends in France over 1990-2018 for solid tumors: the sex gap is narrowing. BMC Cancer 2021; 21:726. [PMID: 34167516 PMCID: PMC8223369 DOI: 10.1186/s12885-021-08261-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 04/22/2021] [Indexed: 01/05/2023] Open
Abstract
Objective To analyze trends in cancer incidence and mortality (France, 1990–2018), with a focus on men-women disparities. Methods Incidence data stemmed from cancer registries (FRANCIM) and mortality data from national statistics (CépiDc). Incidence and mortality rates were modelled using bidimensional penalized splines of age and year (at diagnosis and at death, respectively). Trends in age-standardized rates were summarized by the average annual percent changes (AAPC) for all-cancers combined, 19 solid tumors, and 8 subsites. Sex gaps were indicated using male-to-female rate ratios (relative difference) and male-to-female rate differences (absolute difference) in 1990 and 2018, for incidence and mortality, respectively. Results For all-cancers, the sex gap narrowed over 1990–2018 in incidence (1.6 to 1.2) and mortality (2.3 to 1.7). The largest decreases of the male-to-female incidence rate ratio were for cancers of the lung (9.5 to 2.2), lip - oral cavity - pharynx (10.9 to 3.1), esophagus (12.6 to 4.5) and larynx (17.1 to 7.1). Mixed trends emerged in lung and oesophageal cancers, probably explained by differing risk factors for the two main histological subtypes. Sex incidence gaps narrowed due to increasing trends in men and women for skin melanoma (0.7 to 1, due to initially higher rates in women), cancers of the liver (7.4 to 4.4) and pancreas (2.0 to 1.4). Sex incidence gaps narrowed for colon-rectum (1.7 to 1.4), urinary bladder (6.9 to 6.1) and stomach (2.7 to 2.4) driven by decreasing trends among men. Other cancers showed similar increasing incidence trends in both sexes leading to stable sex gaps: thyroid gland (0.3 to 0.3), kidney (2.2 to 2.4) and central nervous system (1.4 to 1.5). Conclusion In France in 2018, while men still had higher risks of developing or dying from most cancers, the sex gap was narrowing. Efforts should focus on avoiding risk factors (e.g., smoking) and developing etiological studies to understand currently unexplained increasing trends. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-08261-1.
Collapse
|
10
|
Chatignoux E, Uhry Z, Grosclaude P, Colonna M, Remontet L. How to produce sound predictions of incidence at a district level using either health care or mortality data in the absence of a national registry: the example of cancer in France. Int J Epidemiol 2021; 50:279-292. [PMID: 33232469 DOI: 10.1093/ije/dyaa217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In many countries, epidemiological surveillance of chronic diseases is monitored by local registries (LR) which do not necessarily cover the whole national territory. This gap has fostered interest in using non-registry databases (e.g., health care or mortality databases) available for the whole territory as proxies for incidence at the local level. However, direct counts from these databases do not provide reliable incidence measures. Accordingly, specific methods are needed to correct proxies and assess their epidemiological usefulness. METHODS This study's objective was to implement a three-stage turnkey methodology using national non-registry data to predict incidence in geographical areas without an LR as follows: constructing a calibration model to make predictions including accurate prediction intervals; accuracy assessment of predictions and rationale for the criteria to assess which predictions were epidemiologically useful; mapping after spatial smoothing of the latter predictions. The methodology was applied to a real-world setting, whereby we aimed to predict cancer incidence, by gender, at the district level in France over the 2007-15 period for 24 different cancer sites, using several health care indicators and mortality. In the present paper, the spatial smoothing performed on predicted incidence of epidemiological interest is illustrated for two examples. RESULTS Predicted incidence of epidemiological interest was possible for 27/34 solid site-gender combinations and for only 2/8 haematological malignancies-gender combinations. Mapping of smoothed predicted incidence provided a clear picture of the main contrasts in incidence between districts. CONCLUSIONS The methodology implemented provides a comprehensive framework to produce valuable predictions of incidence at a district level, using proxy measures and existing LR.
Collapse
Affiliation(s)
- Edouard Chatignoux
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - Zoé Uhry
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France.,Hospices Civils de Lyon, Service de Biostatistique-Bioinformatique, Pierre-Bénite, Université Lyon 1, France
| | - Pascale Grosclaude
- FRANCIM Network, Toulouse, France.,Tarn Cancer Registry, Claudius Regaud Institute, IUCT-O, Toulouse, France
| | - Marc Colonna
- FRANCIM Network, Toulouse, France.,Isere Cancer Registry, CHU Grenoble-Alpes, Grenoble, France
| | - Laurent Remontet
- Hospices Civils de Lyon, Service de Biostatistique-Bioinformatique, Pierre-Bénite, Université Lyon 1, France.,CNRS; UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Villeurbanne, France
| |
Collapse
|
11
|
Pujol JL, Thomas PA, Giraud P, Denis MG, Tretarre B, Roch B, Bommart S. Lung Cancer in France. J Thorac Oncol 2021; 16:21-29. [PMID: 33384058 DOI: 10.1016/j.jtho.2020.09.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 09/15/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Jean-Louis Pujol
- Thoracic Oncology Unit, University Hospital of Montpellier, Arnaud de Villeneuve Hospital, Montpellier, France; Cancerology Research Institute of Montpellier (IRCM), Institut national de la santé et de la recherche médicale (INSERM) unit U1194, Montpellier, France.
| | | | - Philippe Giraud
- Service d'oncologie radiothérapie, Hôpital Européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - Marc G Denis
- Department of Biochemistry and INSERM U1232, Nantes University Hospital, Nantes, France
| | - Brigitte Tretarre
- Herault Department Register, French National Network of Cancer Registers, Montpellier, France
| | - Benoît Roch
- Thoracic Oncology Unit, University Hospital of Montpellier, Arnaud de Villeneuve Hospital, Montpellier, France; Cancerology Research Institute of Montpellier (IRCM), Institut national de la santé et de la recherche médicale (INSERM) unit U1194, Montpellier, France
| | - Sebastien Bommart
- Department of Medical Imaging, University Hospital of Montpellier, Arnaud de Villeneuve Hospital, Montpellier, France; PhyMedExp, INSERM U1046, Centre national de la recherche scientifique Unité mixte de recherche 9214, University of Montpellier, Montpellier, France
| |
Collapse
|