G Defossez1,2,3,4, Z Uhry5,6,7,8,9, P Delafosse10,11, E Dantony6,7,8,9, T d'Almeida10,12, S Plouvier10,13, N Bossard6,7,8,9, A M Bouvier10,14, F Molinié10,15, A S Woronoff10,16,17, M Colonna10,11, P Grosclaude10,18,19, L Remontet6,7,8,9, A Monnereau10,20,21. 1. Registre général des cancers de Poitou-Charentes, Pôle Biologie, Pharmacie et Santé Publique, CHU de Poitiers, Poitiers, France. gautier.defossez@univ-poitiers.fr. 2. Université de Poitiers, Bâtiment D1, 6 rue de la Milétrie, 86073, Poitiers, France. gautier.defossez@univ-poitiers.fr. 3. INSERM Centre d'Investigation Clinique CIC1402, Poitiers, France. gautier.defossez@univ-poitiers.fr. 4. Réseau français des registres des cancers, Francim, Toulouse, France. gautier.defossez@univ-poitiers.fr. 5. Direction des Maladies Non Transmissibles et des Traumatismes, Santé publique France, Saint-Maurice, France. 6. Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France. 7. Université de Lyon, Lyon, France. 8. Université Lyon 1, Villeurbanne, France. 9. Équipe Biostatistique-Santé, Laboratoire de Biométrie et Biologie Évolutive, CNRS, UMR 5558, Villeurbanne, France. 10. Réseau français des registres des cancers, Francim, Toulouse, France. 11. Registre des cancers de l'Isère, CHU de Grenoble Alpes, Grenoble, France. 12. Registre des cancers de la Haute-Vienne, CHU de Limoges, Limoges, France. 13. Registre général des cancers de Lille et de sa région, Centre de Référence Régional en Cancérologie (C2RC), Lille, France. 14. Registre Bourguignon des cancers digestifs, Université de Dijon, Dijon, France. 15. Registre des tumeurs de Loire-Atlantique et Vendée, CHU de Nantes, Nantes, France. 16. Registre des tumeurs du Doubs, CHU de Besançon, Besançon, France. 17. EA 3181, Université de Bourgogne Franche-Comté, Besançon, France. 18. Registre des cancers du Tarn, Institut Claudius Regaud, Toulouse, France. 19. Institut Universitaire du Cancer de Toulouse Oncopole (IUCTO), Toulouse, France. 20. Registre des hémopathies malignes de Gironde, Institut Bergonié, Bordeaux, France. 21. INSERM U219 (équipe EPICENE), Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), Université de Bordeaux, Bordeaux, France.
Abstract
OBJECTIVE: To analyze trends in cancer incidence and mortality (France, 1990-2018), with a focus on men-women disparities. METHODS: Incidence data stemmed from cancer registries (FRANCIM) and mortality data from national statistics (CépiDc). Incidence and mortality rates were modelled using bidimensional penalized splines of age and year (at diagnosis and at death, respectively). Trends in age-standardized rates were summarized by the average annual percent changes (AAPC) for all-cancers combined, 19 solid tumors, and 8 subsites. Sex gaps were indicated using male-to-female rate ratios (relative difference) and male-to-female rate differences (absolute difference) in 1990 and 2018, for incidence and mortality, respectively. RESULTS: For all-cancers, the sex gap narrowed over 1990-2018 in incidence (1.6 to 1.2) and mortality (2.3 to 1.7). The largest decreases of the male-to-female incidence rate ratio were for cancers of the lung (9.5 to 2.2), lip - oral cavity - pharynx (10.9 to 3.1), esophagus (12.6 to 4.5) and larynx (17.1 to 7.1). Mixed trends emerged in lung and oesophageal cancers, probably explained by differing risk factors for the two main histological subtypes. Sex incidence gaps narrowed due to increasing trends in men and women for skin melanoma (0.7 to 1, due to initially higher rates in women), cancers of the liver (7.4 to 4.4) and pancreas (2.0 to 1.4). Sex incidence gaps narrowed for colon-rectum (1.7 to 1.4), urinary bladder (6.9 to 6.1) and stomach (2.7 to 2.4) driven by decreasing trends among men. Other cancers showed similar increasing incidence trends in both sexes leading to stable sex gaps: thyroid gland (0.3 to 0.3), kidney (2.2 to 2.4) and central nervous system (1.4 to 1.5). CONCLUSION: In France in 2018, while men still had higher risks of developing or dying from most cancers, the sex gap was narrowing. Efforts should focus on avoiding risk factors (e.g., smoking) and developing etiological studies to understand currently unexplained increasing trends.
OBJECTIVE: To analyze trends in cancer incidence and mortality (France, 1990-2018), with a focus on men-women disparities. METHODS: Incidence data stemmed from cancer registries (FRANCIM) and mortality data from national statistics (CépiDc). Incidence and mortality rates were modelled using bidimensional penalized splines of age and year (at diagnosis and at death, respectively). Trends in age-standardized rates were summarized by the average annual percent changes (AAPC) for all-cancers combined, 19 solid tumors, and 8 subsites. Sex gaps were indicated using male-to-female rate ratios (relative difference) and male-to-female rate differences (absolute difference) in 1990 and 2018, for incidence and mortality, respectively. RESULTS: For all-cancers, the sex gap narrowed over 1990-2018 in incidence (1.6 to 1.2) and mortality (2.3 to 1.7). The largest decreases of the male-to-female incidence rate ratio were for cancers of the lung (9.5 to 2.2), lip - oral cavity - pharynx (10.9 to 3.1), esophagus (12.6 to 4.5) and larynx (17.1 to 7.1). Mixed trends emerged in lung and oesophageal cancers, probably explained by differing risk factors for the two main histological subtypes. Sex incidence gaps narrowed due to increasing trends in men and women for skin melanoma (0.7 to 1, due to initially higher rates in women), cancers of the liver (7.4 to 4.4) and pancreas (2.0 to 1.4). Sex incidence gaps narrowed for colon-rectum (1.7 to 1.4), urinary bladder (6.9 to 6.1) and stomach (2.7 to 2.4) driven by decreasing trends among men. Other cancers showed similar increasing incidence trends in both sexes leading to stable sex gaps: thyroid gland (0.3 to 0.3), kidney (2.2 to 2.4) and central nervous system (1.4 to 1.5). CONCLUSION: In France in 2018, while men still had higher risks of developing or dying from most cancers, the sex gap was narrowing. Efforts should focus on avoiding risk factors (e.g., smoking) and developing etiological studies to understand currently unexplained increasing trends.
Authors: L Remontet; J Estève; A-M Bouvier; P Grosclaude; G Launoy; F Menegoz; C Exbrayat; B Tretare; P-M Carli; A-V Guizard; X Troussard; P Bercelli; M Colonna; J-M Halna; G Hedelin; J Macé-Lesec'h; J Peng; A Buemi; M Velten; E Jougla; P Arveux; L Le Bodic; E Michel; M Sauvage; C Schvartz; J Faivre Journal: Rev Epidemiol Sante Publique Date: 2003-02 Impact factor: 1.019
Authors: F Binder-Foucard; N Bossard; P Delafosse; A Belot; A-S Woronoff; L Remontet Journal: Rev Epidemiol Sante Publique Date: 2014-03-07 Impact factor: 1.019
Authors: A Belot; P Grosclaude; N Bossard; E Jougla; E Benhamou; P Delafosse; A-V Guizard; F Molinié; A Danzon; S Bara; A-M Bouvier; B Trétarre; F Binder-Foucard; M Colonna; L Daubisse; G Hédelin; G Launoy; N Le Stang; M Maynadié; A Monnereau; X Troussard; J Faivre; A Collignon; I Janoray; P Arveux; A Buemi; N Raverdy; C Schvartz; M Bovet; L Chérié-Challine; J Estève; L Remontet; M Velten Journal: Rev Epidemiol Sante Publique Date: 2008-06-10 Impact factor: 1.019
Authors: Delphine Praud; Matteo Rota; Jürgen Rehm; Kevin Shield; Witold Zatoński; Mia Hashibe; Carlo La Vecchia; Paolo Boffetta Journal: Int J Cancer Date: 2015-10-28 Impact factor: 7.396
Authors: Jacques Ferlay; Isabelle Soerjomataram; Rajesh Dikshit; Sultan Eser; Colin Mathers; Marise Rebelo; Donald Maxwell Parkin; David Forman; Freddie Bray Journal: Int J Cancer Date: 2014-10-09 Impact factor: 7.396