Population-based cancer registries (PBCR) participate in epidemiological surveillance and in the evaluation of cancer types by enabling analysis of incidence and survival data over time. The aim of this study was to examine overall survival (OS) in patients with colorectal cancer (CRC) by analyzing data from the Martinique population-based cancer registry between 1993 and 2012. All colorectal cancer cases diagnosed in Martinique between 1993 and 2012 were included. Characteristics of CRC patients were analyzed according to age subgroups, namely: <50 years, 50 to 74 years and over 75 years.We recorded the following socio-demographic and clinical variables: year of diagnosis, age at diagnosis, sex, histology, zone of residence, and subsite of the cancer. Incidence of malignant neoplasms of the colon and rectum (ICD-10 C18–21) was extracted from the Martinique Cancer Registry database. Stage at diagnosis (localized: stage I–II, regional: stage III and metastatic stage: stage IV) were also analyzed for the 2008 to 2012 period.A total of 2230 cases of incident invasive CRC were included during the study period (1993–2012): 1171 were women (52.5%); 1588 patients (71.2%) had colon cancer. Stage at diagnosis was evaluated in 779 patients (89.6%): 486/779 (62.4%) had stage III–IV at diagnosis, including 285 (36.6%) patients with metastases at diagnosis (stage IV). One-year, 5-year and 10-year OS for the study period 1993 to 2012 was 74.6%, 43.8% and 33.0% respectively. There was a statistical difference in overall survival according to gender (P = .0153), age at diagnosis (P < .001) and stage (P < .001).Median OS was 2.0 years (95% CI [1.4–2.1]) in the stage III–IV group during the period 2008 to 2012, whereas it was unreached in the stage I–II group. Multivariable analysis confirmed that stage III–IV at diagnosis (hazard ratio (HR) = 3.70 [2.89–4.99]; P < .0001) and colon cancer (HR = 1.30 [1.01–1.69]; P = .04) were main prognostic factors for OS. Women had a HR of 0.78 [0.62–0.96], P = .02. CRC patients in the 50 to 74 years age group had a HR of 0.63 [0.50–0.80], P = .0001.This study underlines the importance of structuring management of CRC cancer patients.
Background: The Caribbean ranks seventh among world regions most affected by cervical cancer. Social health inequalities, such as differences in access to screening services, engender disparities in incidence and mortality between low- and middle-income countries and industrialized countries. The French National Cancer Plan 2014–2019 focuses on reducing inequalities in cervical cancer.Objective: The aim of this study was to describe the geographical distribution and overall survival of cervical cancer, based on data from a population-based cancer registry in Martinique (French West-Indies).Methods: We included all cases of cervical cancer diagnosed between 2002 and 2011. The geographical distribution was described by zone of residence and by aggregated units for statistical information (IRIS). Based on the results of the model, standardized incidence rates (SIRs) were calculated using a Gamma Poisson model. Survival rates were calculated using the Kaplan–Meier method. Cox proportional hazards models were used to investigate the risk factors for cervical cancer mortality.Results: A total of 1253 cases were analyzed (947 in situ tumors and 306 invasive cancers). 1230 cases with geolocalization were used to map the distribution of the incidence of in situ and invasive cervical cancers. Five IRIS were significantly over-incident. The 5-year overall survival rate was 55%, with a median survival of 6.5 years [95% CI: 4.9–10.1]. Multivariate analysis confirmed age at diagnosis (HR = 2.15 [1.50–3.09]; p < 0.0001), FIGO stage (HR = 3.53 [2.50–4.99]; p < 0.0001) and zone of residence (HR = 1.51 [1.06–2.13]; p = 0.02) as risk factors.Conclusions: Prognostic factors suggest that cervical cancer needs to be diagnosed at an early stage. Our results could allow cervical cancer screening programs to clearly identify geographical areas that would benefit from targeted interventions with a view to reducing incidence and mortality of cervical cancer in the Caribbean.
BackgroundFertility preservation (FP) is a major determinant of quality of life after cancer remission for women who may not have achieved their ideal family size. This article describes the FP services and strategy currently available, highlighting issues of oncofertility worldwide.Main body of the abstractFor these patients in complex situations, health networks are essential to improve coordination of care, and the strengthening of this coordination is a major challenge to improve the performance of the health system. Two international networks have been created in order to foster scientific exchange between countries and to standardize the oncofertility healthcare circuit. However, the paucity of referral nationwide networks lead to a structural gap in health care policies.Short conclusionManagement strategies of oncofertility in the world are still fragile and uneven. To structure the oncofertility sector, a multidisciplinary project allowing teams to collaborate is of utmost importance particularly in low and middle-income countries.
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