Strasbourg, France
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Lepage C.,University of Burgundy | Ciccolallo L.,Fondazione IRCCS Instituto Nazionale dei Tumori | Ciccolallo L.,Instituto Nazionale dei Tumori | De Angelis R.,Instituto Superiore Of Sanita | And 64 more authors.
International Journal of Cancer | Year: 2010

The aim of this study was to report on malignant digestive endocrine tumours (MDET) prognosis in several European countries. We analysed survival data from 19 cancer registries in 12 European countries on 3,715 MDET diagnosed between 1985 and 1994. The overall 5-year survival rate was 47.5%. It was 58.1% for differentiated MDET and 8.1% for small-cell MDET (p < 0.001), 55.9% for patients under 65 and 37.0% for older patients. Survival rates for small intestinal and colorectal were higher than for the other sites. The 5-year relative survival rates were 60.3% in Northern Europe, 53.6% in Western Continental Europe, 42.5% in the UK, 37.6% in Eastern Europe (p < 0.001). Among well-differentiated pancreatic tumours, 5-year relative survival was 55.6% for insulinoma, 48.4% for gastrinoma, 33.4% for glucagonoma, 28.8% for carcinoïd tumours and 49.9% for non-functioning tumours. The relative excess risk of death was significantly lower in Western Continental Europe and Northern Europe and significantly higher in Easter European compared to the UK. MDET differentiation, site, geographic area, age and sex, were independent prognostic factors. Overall, in Europe approximately half of the patients with MDET survive 5 years after the initial diagnosis. Prognosis varies with tumour differentiation, anatomic site and histological type. There are significant differences in survival from MDET among European countries, independently of other prognostic factors.


Crocetti E.,Clinical and Descriptive Epidemiology Unit | Caldarella A.,Clinical and Descriptive Epidemiology Unit | Ferretti S.,Ferrara Cancer Registry | Ardanaz E.,Navarra Public Health Institute | And 37 more authors.
Breast | Year: 2013

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. © 2013 Elsevier Ltd.


Lepage C.,Digestive Cancer Registry Institute National Of La Sante Et Of La Recherche Medicale U866 | Sant M.,Fondazione Instituto Of Ricovero E Cura A Carattere Scientifico | Verdecchia A.,Instituto Superiore Of Sanita | Forman D.,Northern and Yorkshire Cancer Registry | And 13 more authors.
British Journal of Surgery | Year: 2010

Background: Little is known at a population level about operative mortality after surgery for gastric cancer and whether differences between countries can explain differences in long-term survival. This study compared operative mortality recorded by ten cancer registries in seven European countries. Methods: Non-conditional logistic regression analysis was performed to estimate the independent effect of the studied factors onmortality within 30 days of surgery. A multivariable survival model was employed with and without operative mortality. Results: The overall operative mortality rate in 1611 patients studied was 8.9 (range 5.2-16) per cent. Country of residence was a significant prognostic factor in the multivariable analysis. The likelihood of operative mortality was lower in Italy, France and the UK than in the Netherlands, Spain, Slovenia and Poland. Age, type of gastrectomy and stage at diagnosis were also significant factors. Cancer site was not found to be significant in the multivariable analysis. The overall 5-year relative survival rate varied between 42.0 per cent (Italy) and 24 per cent (Poland); after excluding operative mortality, the 5-year survival rate was 44.3 and 28 per cent respectively. Conclusion: Within Europe, the substantial differences in operative mortality after gastrectomy only partly explain marked differences in survival after gastric cancer resection. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons Ltd.


Bouvier A.-M.,French Institute of Health and Medical Research | Sant M.,Fondazione IRCCS | Verdecchia A.,Instituto Superiore Of Sanita | Forman D.,Northern and Yorkshire Cancer Registry | And 15 more authors.
European Journal of Cancer | Year: 2010

Background: Wide geographic variations in survival for gastric cancer in Europe have been reported. The aim of this study was to analyse the effect of stage at diagnosis, treatment and cancer characteristics on long-term survival for gastric cancer in populations covered by cancer registries. Methods: We analysed survival in 4620 cases of gastric cancer from 17 European population-based cancer registries from 8 countries. Univariate and multivariate regression of relative survival were performed. Results: Five-year relative survival varied between 10.6% and 24.0%, while 10-year survival ranged from 7.7% to 23.0%. After adjustment for age and sex, the regional excess hazard ratio (EHR) of death was significantly higher in Ragusa, Granada, Yorkshire, Slovakia, Slovenia and Poland than in France, Northern Italy, The Netherlands and the Basque Country. After further adjustment for surgical resection versus no resection (a proxy of stage), the EHR of death remained significantly higher only in Granada and Yorkshire than in the reference country (France). After adjustment for stage, the EHR was significantly higher only in Yorkshire (EHR: 1.51; 95% confidence interval (CI): 1.29-1.77). The EHR in this area was limited to the first year following diagnosis. Conclusion: Differences across Europe in gastric cancer survival depend to a large extent on differences in stage at diagnosis. However they do not explain all variations. Quality of management and treatment can explain some differences. © 2010 Elsevier Ltd. All rights reserved.


Minicozzi P.,Fondazione IRCCS Instituto Nazionale dei Tumori | Bouvier A.-M.,University of Burgundy | Faivre J.,University of Burgundy | Sant M.,Fondazione IRCCS Instituto Nazionale dei Tumori | And 31 more authors.
Digestive and Liver Disease | Year: 2014

Background: 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. Methods: 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. Results: 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]). Conclusion: 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. © 2014 Editrice Gastroenterologica Italiana S.r.l.


Stiller C.A.,University of Oxford | Trama A.,Instituto Nazionale dei Tumori | Brewster D.H.,Scottish Cancer Registry | Verne J.,Public Health England | And 100 more authors.
Cancer Epidemiology | Year: 2014

Kaposi sarcoma (KS) is a virus-related malignancy which most frequently arises in skin, though visceral sites can also be involved. Infection with Kaposi sarcoma herpes virus (KSHV or HHV-8) is required for development of KS. Nowadays, most cases worldwide occur in persons who are immunosuppressed, usually because of HIV infection or as a result of therapy to combat rejection of a transplanted organ, but classic Kaposi sarcoma is predominantly a disease of the elderly without apparent immunosuppression. We analyzed 2667 KS incident cases diagnosed during 1995-2002 and registered by 75 population-based European cancer registries contributing to the RARECARE project. Total crude and age-standardized incidence rate was 0.3 per 100,000 per year with an estimated 1642 new cases per year in the EU27 countries. Age-standardized incidence rate was 0.8 per 100,000 in Southern Europe but below 0.3 per 100,000 in all other regions. The elevated rate in southern Europe was attributable to a combination of classic Kaposi sarcoma in some Mediterranean countries and the relatively high incidence of AIDS in several countries. Five-year relative survival for 2000-2002 by the period method was 75%. More than 10,000 persons were estimated to be alive in Europe at the beginning of 2008 with a past diagnosis of KS. The aetiological link with suppressed immunity means that many people alive following diagnosis of KS suffer comorbidity from a pre-existing condition. While KS is a rare cancer, it has a relatively good prognosis and so the number of people affected by it is quite large. Thus it provides a notable example of the importance of networking in diagnosis, therapy and research for rare cancers. © 2014 Elsevier Ltd.


Radoi L.,French Institute of Health and Medical Research | Radoi L.,University of Versailles | Paget-Bailly S.,French Institute of Health and Medical Research | Paget-Bailly S.,University of Versailles | And 20 more authors.
Cancer Epidemiology | Year: 2013

Background: Results on the relationship between coffee and tea drinking and the risk of oral cavity cancer are contrasted.The aim of this study was to evaluate the relation between coffee and tea drinking and the risk of oral cavity cancer in France, a high incidence area. Material and methods: We conducted a population based case-control study with face-to-face interviews and standardized questionnaires (the ICARE study, Investigation of occupational and environmental causes of respiratory cancers). We used data from 689 cases of oral cavity squamous cell carcinoma and 3481 controls. Odds-ratios (ORs) and 95% confidence intervals (95% CI) associated with tea and coffee consumption (quantity, duration, cumulative consumption) were estimated by unconditional logistic regression with adjustment for age, gender, area of residence, education, body mass index, tobacco smoking and alcohol drinking. Results: We observed inverse associations between oral cavity cancer and tea or coffee consumption (odds ratio, 0.39; 95% CI 0.21-0.70, for the highest quartile of tea consumption, and 0.60, 95% CI 0.34-1.05, for the highest quartile of coffee consumption). Exclusive tea or coffee consumption was associated with a reduced risk of oral cavity cancer and their joint effect was multiplicative. No differences in risk between men and women or between consumers of tobacco and alcohol and non-consumers were observed. The odds ratios related to the subsites usually included in the oropharynx (soft palate and base of the tongue) did not differ significantly from that observed for the other subsites of the oral cavity. Conclusions: Tea and coffee drinking may decrease the risk of oral cavity cancer through antioxidant components which play a role in the repair of cellular damages. These findings need further investigation in prospective studies and the underlying mechanisms in humans remain to be clarified. © 2013 Elsevier Ltd.


Paget-Bailly S.,French Institute of Health and Medical Research | Paget-Bailly S.,University of Versailles | Guida F.,Environmental Epidemiology of Cancer Team | Guida F.,University Paris - Sud | And 18 more authors.
Journal of Occupational and Environmental Medicine | Year: 2013

OBJECTIVE:: To investigate the associations between occupations and head and neck (HN) cancer risk in men. METHODS:: ICARE is a French population-based case-control study on HN cancer. Analyses included 1833 cases and 2747 controls. Complete occupational history was collected. Odds ratios (ORs) were estimated for occupations and industries ever held and according to duration of employment. RESULTS:: Elevated ORs, increasing with duration of employment, were observed for several occupations, including cleaners (OR = 1.7; 95% confidence interval [CI], 1.0 to 2.8), launderers (OR = 6.8; CI, 1.3 to 34.4), firefighters (OR = 3.9; CI, 1.4 to 11.2), several agricultural occupations, welders (OR = 1.9; CI, 1.3 to 2.8), structural metal preparers and erectors (OR = 2.1; CI, 1.2 to 3.7), rubber workers (OR = 2.0; CI, 1.0 to 3.9), several construction occupations, and material-handling equipment operators (OR = 1.8; CI, 1.1 to 2.9). Analyses by industry corroborated these findings. CONCLUSIONS:: These results confirmed the role of occupational exposures in HN cancer. Copyright © 2013 by American College of Occupational and Environmental Medicine.

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