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Toulouse, France

Colonna M.,Grenoble University Hospital Center | Uhry Z.,Institute of Veille Sanitaire | Uhry Z.,French National Center for Scientific Research | Guizard A.V.,Francim | And 10 more authors.
Cancer Epidemiology

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. Methods: 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. Results: 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. Conclusion: 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. © 2015 Elsevier Ltd. Source

Gilhodes J.,Institute of Veille Sanitaire | Gilhodes J.,University of Lyon | Gilhodes J.,University Claude Bernard Lyon 1 | Belot A.,Institute of Veille Sanitaire | And 15 more authors.
Cancer Epidemiology

Background: 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. Methods: 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. Results: 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. Conclusion: 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. © 2015 Elsevier Ltd. Source

Haddy N.,French Institute of Health and Medical Research | Haddy N.,Institute Gustave Roussy | Haddy N.,University Paris - Sud | Dondon M.-G.,French Institute of Health and Medical Research | And 32 more authors.
Cancer Causes and Control

Purpose: A cohort study was performed to investigate the carcinogenic effect of treatment of skin hemangioma with ionizing radiation in early childhood. This paper presents the incidence of breast cancer (BC) in this cohort and its association with radiotherapy. Methods and materials: In an incidence study, 3,316 women treated for a skin hemangioma between 1941 and 1977 at the Institut Gustave-Roussy were included, among whom 2,697 had received radiotherapy. The mean age at first exposure was 0.7 years, and the mean absorbed dose to the breast was 70 mGy. Treatment reconstruction and the estimation of radiation doses delivered to the breast were obtained for 92% of the women who had received radiotherapy. External and internal analyses were performed. Results: During an average follow-up of 35 years, a total of 17 women developed an invasive BC, compared to 7.5 expected in the French general population (SIR = 2.3, 95% CI, 1.4-3.5), and the absolute excess risk strongly increased with attained age. Compared to individuals with no radiotherapy, the risk of BC increased with increasing radiation dose with RRs of 3.2, 6.3, and 8.0 for dose categories of >0-10, 10-100, and >100 mGy, respectively; however, dose-response relationship was not significant. Conclusion: This study confirms that radiation treatment performed in the past for hemangioma during childhood increases the risk of BC. © 2010 Springer Science+Business Media B.V. Source

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