2023-06-10 17:21:00
The Regional Health Observatory, in charge of drawing up the general register of cancers in Corsica since its creation, by deliberation of the Assembly of Corsica, recently published a first complete inventory of the activity for the period 2017-2019 by tumor type
The year 2018, “year 0” of the general register of cancers of Corsicahad marked a major step in the history of this scientific document, the result of a long political battle waged at the regional level. “The creation of the register, decided by deliberation of the Assembly of Corsica, was born of a unanimous political will of all the territorial councilors of the time, recalls the epidemiologist and biomathematician, Jean Arrighi, adviser to the director ofRegional Health Observatory (ORS), notably in charge from 2000 to 2012 of studies on the health consequences of Chernobyl on the island. In this particular context of research on thyroid cancers in connection with the accident at the nuclear power plant, the president of the executive council of Corsica at the time, Paul Giacobbi, had requested from 2008, from the State, the establishment of a regional cancer registry, but without success”.
After eight years of waiting, the Community of Corsica therefore took on the file on its own, for which it provides full funding, entrusting its implementation to the ORS of Corsica, an association which has been documenting the state of health of the population since 1986 and has skills in epidemiology and biostatistics.
“There are more than twenty cancer registers in France, but unlike the Corsican register, they are generally departmental and backed by a hospital center, CHU or CHR. Significant work has been carried out from the start, supported by the French network of cancer registries (Francim), for the implementation of the computerized version of the registry, on the model of what exists in Poitou-Charentes, an agreement having allowed a transfer of the innovative methodology of its system of Our regional document thus carries out a continuous and exhaustive recording of tumor pathologies diagnosed since 1is January 2107 among Corsican residents, whether they are cared for in Corsica or on the Continent”adds Jean Arrighi.
“Completeness and quality of data”
On the basis of this very large amount of data, alongside the interim director of the ORS, Estelle Casta-Cervetti, a sociologist by training, the former surgeon and director of research, Dr.r Jean-Pierre Amoros, in charge of the scientific management of the document, of the Dr Joseph Battaglini for medical coordination, and the biostatistician and study technician, Yannick Vidal, the latter has thus drawn up a first report on the incidence of cancers in Corsica for the period from 2017 to 2019. “You should know that it is customary to group together a minima three years in the publication of such results in order to erase, especially in the presence of small numbers, the sensitivity to local events, specify the Dr Amorous. By the end of 2023, we will validate two additional years of incidence, 2020 and 2021. For the data to be significant, we must wait to have at least six years of follow-up. However, it seemed important to us to carry out a first progress report with these results smoothed over three years, in order to propose an initial inventory and also to value the work carried out in this context..
Concerning the main types of cancer, the multiple data collected are naturally subject to a particularly rigorous scientific methodology. “The completeness and quality of the data condition the qualification of the register, officials say. Epidemiological monitoring of tumor pathologies includes medical records, laboratory analysis results, reports of multidisciplinary oncology consultation meetings, information provided by health insurance and hospitalization data. The collection of the latter is carried out through partnership agreements with healthcare establishments in Corsica, as well as in Ile de France and Paca. Only one agreement remains to be made effective with the Antoine Lacassagne center in Nice”.
Insofar as “the real impact can only be observed from results over at least five consecutive years”, the detailed report presents in this sense an average incidence over the period according to the location of the tumours, eighteen in number. Namely lip-mouth-pharynx, esophagus, stomach, colon-rectum, liver, pancreas, larynx, lung, skin melanoma, breast, cervix, body of uterus, ovary, prostate, testis, bladder , kidney and central nervous system.
Average of 1,873 cases over the period
In terms of average incidence for all cancers combined (invasive tumours, excluding skin carcinomas), over the period 2017-2019, with a validity rate of 99%, this amounts to 1,873 cases, including 1,019 men ( 54%) and 854 women (46%). The age group of 70-74 years has the highest crude incidence (299 cases), followed by 65-69 years (282 cases), 75-79 years (244 cases), 60-64 years (211 cases ) and 80-84 year olds (199 cases). This last category has the highest crude incidence rate per 100,000 inhabitants (1,777).
Unsurprisingly, the gross incidences are highest in the populated life basins of Ajaccio (565 cases) and Bastia (415 cases). However, the risk of cancer is higher in the Grossetto-Prugna and Corte basins, in contrast to the Bastia and Ghisonaccia basins.
Among the different types of cancer, the highest incidence over this same period concerns the breast (300 cases including 299 women), the lung (293 cases including 188 men and 105 women), the prostate (245 men), or even the colon-rectum (202 cases including 104 men and 97 women). For each tumour, the incidences are thus detailed according to sex, age and place of residence. It also specifies the clinical and therapeutic course, the bases of the diagnosis, the number of sources per tumor and investigations on medical files.
So many key statistical elements, also opening up broad development prospects (read below), including concrete applications for improving patient care, or the development of knowledge in oncology. The disease represents, in France, the leading cause of death in men and the second in women.
Find the whole of this file in Corse-Matin of Sunday June 11
www.ors.corsica
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