Effets sanitaires liés aux rayonnements électromagnétiques basses fréquences en milieu de travail
Introduction L’Anses presente un etat des connaissances sur les dangers lies aux champs electromagnetiques basses frequences (CEM-BF) et les resultats de son expertise collective concernant les risques pour la sante lies aux expositions en milieu professionnel. Materiel et methodes Ce travail est fonde sur l’analyse des donnees de la litterature scientifique. Pour chaque effet sanitaire etudie, le niveau de preuve apporte par les donnees scientifiques a ete evalue en s’appuyant sur une methode adaptee au contexte des champs electromagnetiques. Resultats Toutes les professions peuvent etre exposees a des CEM-BF, mais a des intensites tres diverses. Ainsi, un photocopieur genere un champ magn…
Factors related to the relative survival of patients with diffuse large B-cell lymphoma in a population-based study in France: does socio-economic status have a role?
IF 7.702; International audience; The survival of patients with diffuse large B-cell lymphoma has increased during the last decade as a result of addition of anti-CD20 to anthracycline-based chemotherapy. Although the trend is encouraging, there are persistent differences in survival within and between the USA and European countries suggesting that non-biological factors play a role. Our aim was to investigate the influence of such factors on relative survival of patients with diffuse large B-cell lymphoma. We conducted a retrospective, multicenter, registry-based study in France on 1165 incident cases of diffuse large B-cell lymphoma between 2002 and 2008. Relative survival analyses were p…
Influence of non-clinical factors on restorative rectal cancer surgery: An analysis of four specialized population-based digestive cancer registries in France.
Abstract Background This study aims to measure the association between deprivation, health care accessibility and health care system with the likelihood of receiving non-restorative rectal cancer surgery (NRRCS). Methods All adult patients who had rectal resection for invasive adenocarcinoma diagnosed between 2007 and 2016 in four French specialised cancer registries were included. A multilevel logistic regression with random effect was used to assess the link between patient and health care structure characteristics on the probability of NRRCS. Results 2997 patients underwent rectal cancer resection in 68 health care structures: 708 (23.63%) had NRRCS. The likelihood of receiving NRCCS was…
The influence of geographical access to health care and material deprivation on colorectal cancer survival: Evidence from France and England
International audience; This article investigates the influence of distance to health care and material deprivation on cancer survival for patients diagnosed with a colorectal cancer between 1997 and 2004 in France and England. This population-based study included all cases of colorectal cancer diagnosed between 1997 and 2004 in 3 cancer registries in France and 1 cancer registry in England (N=40,613). After adjustment for material deprivation, travel times in England were no longer significantly associated with survival. In France patients living between 20 and 90min from the nearest cancer unit tended to have a poorer survival, although this was not statistically significant. In England, …
How do age and social environment affect the dynamics of death hazard and survival in patients with breast or gynecological cancer in France?
Several studies have investigated the association between net survival and social inequalities in people with cancer, highlighting a varying influence of deprivation depending on the type of cancer studied. However, few of these studies have accounted for the effect of social inequalities over the follow-up period, and/or according to the age of the patients. Thus, using recent and more relevant statistical models, we investigated the effect of social environment on net survival in women with breast or gynecological cancer in France. The data were derived from population-based cancer registries, and women diagnosed with breast or gynecological cancer between 2006 and 2009 were included. We …
Socioeconomic Environment and Survival in Patients with Digestive Cancers: A French Population-Based Study
Simple Summary Studies investigating the social gradient in digestive cancer survival are scarce, and the statistical methods used do not always consider important assumptions in survival analysis for adequate assessment. Using an ecological index (European Deprivation Index), we found a negative impact of social environment in digestive cancers net survival (especially for esophagus, stomach, bile ducts among females; colon and rectum for both sexes) and provided insight into how this social gradient in cancer survival builds up, and at what time of follow-up it appears. These results can guide clinical practice/public health actions to address social inequalities in survival by targeting …
Pancreatic cancer: Wait times from presentation to treatment and survival in a population-based study
Pancreatic survival is one of the worst in oncology. To what extent wait times affect outcomes in unknown No population-based study has previously explored patient and treatment delays among individuals with pancreatic cancer. The aim of this study was to estimate patient and treatment delays in patients with pancreatic cancer and to measure their association with survival in a nonselected population. All patients diagnosed with pancreatic cancer for the first time between 2009 and 2011 and registered in two French digestive cancer registries were included. Patient delay (time from onset of symptoms until the first consultation categorized into <1 or ≥1 month), and treatment delay (time bet…
Multi-state relative survival modelling of colorectal cancer progression and mortality.
Abstract Accurate identification of factors associated with progression of colorectal cancer remains a challenge. In particular, it is unclear which statistical methods are most suitable to separate the effects of putative prognostic factors on cancer progression vs cancer-specific and other cause mortality. To address these challenges, we analyzed 10 year follow-up data for patients who underwent curative surgery for colorectal cancer in 1985–2000. Separate analyses were performed in two French cancer registries. Results of three multivariable models were compared: Cox model with recurrence as a time-dependent variable, and two multi-state models, which separated prognostic factor effects …
Socio-geographical determinants of colonoscopy uptake after faecal occult blood test
Survival from colorectal cancer is poorer in patients of lower socioeconomic level, or living far from the cancer reference centre.To evaluate the impact of material deprivation and geographical remoteness on the uptake of colonoscopy after a positive screening faecal occult blood test.Data from two large French average-risk population-based trials comparing two faecal occult blood tests were used. Compliance with colonoscopy after a positive faecal occult blood test was analysed using a logistic model and a Cox model considering time between faecal occult blood test and colonoscopy. Covariates studied were sex, age, distance to nearest gastroenterologist, distance to regional capital, and …
For patients with breast cancer, geographic and social disparities are independent determinants of access to specialized surgeons. A eleven-year population-based multilevel analysis.
Abstract Background It has been shown in several studies that survival in cancer patients who were operated on by a high-volume surgeon was better. Why then do all patients not benefit from treatment by these experienced surgeons? The aim of our work was to study the hypothesis that in breast cancer, geographical isolation and the socio-economic level have an impact on the likelihood of being treated by a specialized breast-cancer surgeon. Methods All cases of primary invasive breast cancer diagnosed in the Côte d’Or from 1998 to 2008 were included. Individual clinical data and distance to the nearest reference care centre were collected. The Townsend Index of each residence area was calcul…
Trends in net survival from rectal cancer in six European Latin countries: results from the SUDCAN population-based study.
Rectal cancer is a common and serious disease. The aim of the SUDCAN collaborative study was to compare the net survival from rectal cancer between six European Latin countries (Belgium, France, Italy, Portugal, Spain, and Switzerland) and provide trends in net survival and dynamics of excess mortality rates up to 5 years after diagnosis. The data were extracted from the EUROCARE-5 database. First, net survival was studied over the period 2000-2004 using the Pohar-Perme estimator. For trend analyses, the study-period was specific to each country. The results are reported from 1992 to 2004 in France, Italy, Spain, and Switzerland and from 2000 to 2004 in Belgium and Portugal. These analyses …