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Imounga Desroziers L, Belliardo S, Deloumeaux J, Plenet J, Bhakkan-Mambir B, Péruvien J, Chatignoux E, Macni J, Boullard M, Beaubrun-Renard M, Véronique-Baudin J, Joachim C. Burden of gastric and digestive cancers in the French Caribbean: perspectives from population-based cancer registries of Martinique, Guadeloupe and French Guiana (2007-2014). BMJ Open 2022; 12:e047167. [PMID: 35110303 PMCID: PMC8811555 DOI: 10.1136/bmjopen-2020-047167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
Abstract
OBJECTIVES Data from population-based cancer registries contribute to improving our knowledge of digestive cancer trends worldwide. In this study, we present cancer incidence and mortality in Guadeloupe, French Guiana and Martinique for the periods 2008-2014, 2010-2014 and 2007-2014, respectively. DESIGN Data were extracted from population-based cancer registries. World-standardised incidence (WSI) and mortality (WSM) rates were calculated. Main digestive cancers were analysed, including oesophagus, stomach, colorectum, liver and pancreas cancers. SETTING This study was performed based on data from French Territories in the Caribbean. RESULTS We observed a lower-incidence compared with mainland France, except for stomach cancer for which the incidence is high, with significant standardised incidence ratios in men and women at 1.90 vs 2.29 for Guadeloupe and French Guiana and 1.58 vs 2.31 for Martinique. We found a lower-mortality, except for stomach cancer for which the mortality remains high, with significant mortality ratios in men and women at 2.10 vs 2.74 for Guadeloupe, 1.64 vs 1.79 for French Guiana and 2.05 vs 2.53 for Martinique. Overall, these three regions have similar WSI and WSM rates which remain lower than those in mainland France. We noticed an overall high incidence and high mortality in men compared with women as in France. CONCLUSIONS There is a high incidence of stomach cancer in French overseas territories. Publication of these data contributed to expanding knowledge on the epidemiology of world cancers with data from the Caribbean zone.
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Affiliation(s)
| | - Sophie Belliardo
- Registre Général des cancers de la Guyane, URPS Guyane, Cayenne, French Guiana
| | - Jacqueline Deloumeaux
- Registre Général des cancers de la Guadeloupe, Centre Hospitalier Universitaire de la Guadeloupe, Pointe-a-Pitre, Guadeloupe
| | - Juliette Plenet
- Registre Général des cancers de la Guyane, URPS Guyane, Cayenne, French Guiana
| | - Bernard Bhakkan-Mambir
- Registre Général des cancers de la Guadeloupe, Centre Hospitalier Universitaire de la Guadeloupe, Pointe-a-Pitre, Guadeloupe
| | - Jessica Péruvien
- Registre Général des cancers de la Guadeloupe, Centre Hospitalier Universitaire de la Guadeloupe, Pointe-a-Pitre, Guadeloupe
| | | | - Jonathan Macni
- Registre Général des cancers de la Martinique UF1441, Centre Hospitalier Universitaire de Martinique, Fort-de-France, Martinique
| | - Manon Boullard
- Registre Général des cancers de la Martinique UF1441, Centre Hospitalier Universitaire de Martinique, Fort-de-France, Martinique
| | - Murielle Beaubrun-Renard
- Registre Général des cancers de la Martinique UF1441, Centre Hospitalier Universitaire de Martinique, Fort-de-France, Martinique
| | - Jacqueline Véronique-Baudin
- Unité Fonctionnelle Recherche en Cancérologie UF3596, Centre Hospitalier Universitaire de Martinique, Fort-de-France, Martinique
| | - Clarisse Joachim
- Registre Général des cancers de la Martinique UF1441, Centre Hospitalier Universitaire de Martinique, Fort-de-France, Martinique
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Deloumeaux J, Bhakkan-Mambir B, Desroziers L, Plenet J, Peruvien J, Chatignoux É, Belliardo S, Macni J, Ulric-Gervaise S, Véronique-Baudin J, Joachim C. Urological Cancers in French Overseas Territories: A Population-Based Cancer Registry Pooled Analysis in Martinique, Guadeloupe and French Guiana (2007-2014). J Epidemiol Glob Health 2022; 12:232-238. [PMID: 35041179 PMCID: PMC9470795 DOI: 10.1007/s44197-022-00033-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 01/06/2022] [Indexed: 12/24/2022] Open
Abstract
Purpose Prostate cancer is the most common cancer in the Caribbean. We present world-standardized incidence (WSI) and mortality (WSM) rates for urological cancers for French overseas territories. Materials and Methods Standardized incidence ratio (SIR) and standardized mortality ratio (SMR) were calculated for 2008–2014, 2007–2014 and 2010–2014 in Guadeloupe, Martinique and French Guiana. Results For prostate cancer, in Guadeloupe and Martinique, the WSI rates are among the highest in the world (173.0 and 164.5 per 100,000 person-years) and 94.4 in French Guiana. Mortality remains more than twice that observed in mainland France, at 23.0 in Guadeloupe and Martinique, and 16.9 in French Guiana. For bladder cancer, WSI rates were 5.9, 4.9 and 4.1 in men, and 1.9, 1.4 and 1.3 in women, in French Guiana, Guadeloupe and Martinique. WSM rates from bladder varied from 1.5 in French Guiana to 1.8 in Guadeloupe and 2.0 in Martinique in men. In women, it ranges from 0.2 in French Guiana to 0.5 in Guadeloupe and 1.1 in Martinique. Regarding kidney, WSI rates in men are 4.3 in Martinique, 5.2 in Guadeloupe and 6.1 in French Guiana, and 2.3, 2.5 and 3.4, respectively, in women. Mortality rates in men were 1.7 in Guadeloupe, 1.4 in Martinique, and 1.5 in French Guiana, while in women, rates were 0.8 in Guadeloupe and Martinique and 0.6 in French Guiana. All these rates are lower than in mainland France. Conclusions Identifying the profile of patients with urological cancers is key to understanding the needs of patients in these regions.
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Affiliation(s)
- Jacqueline Deloumeaux
- Registre Général des Cancers de Guadeloupe, Centre Hospitalier Universitaire de Guadeloupe, Guadeloupe F.W. I., Route de Chauvel, 97159 Pointe-à-Pitre Cedex, France
| | - Bernard Bhakkan-Mambir
- Registre Général des Cancers de Guadeloupe, Centre Hospitalier Universitaire de Guadeloupe, Guadeloupe F.W. I., Route de Chauvel, 97159 Pointe-à-Pitre Cedex, France
| | | | | | - Jessica Peruvien
- Registre Général des Cancers de Guadeloupe, Centre Hospitalier Universitaire de Guadeloupe, Guadeloupe F.W. I., Route de Chauvel, 97159 Pointe-à-Pitre Cedex, France
| | - Édouard Chatignoux
- French National Public Health Agency, 12 rue du Val d’Osne, 94410 Saint Maurice, France
| | | | - Jonathan Macni
- CHU de Martinique, Pôle de Cancérologie Hématologie Urologie, UF 1441 Registre Général des Cancers de la Martinique, Fort de France, 97200 Martinique
| | - Stephen Ulric-Gervaise
- CHU de Martinique, Pôle de Cancérologie Hématologie Urologie, UF 1441 Registre Général des Cancers de la Martinique, Fort de France, 97200 Martinique
| | - Jacqueline Véronique-Baudin
- CHU de Martinique, Pôle de Cancérologie Hématologie Urologie, UF 1441 Registre Général des Cancers de la Martinique, Fort de France, 97200 Martinique
| | - Clarisse Joachim
- CHU de Martinique, Pôle de Cancérologie Hématologie Urologie, UF 1441 Registre Général des Cancers de la Martinique, Fort de France, 97200 Martinique
- Hôpital Albert Clarac, Avenue Pasteur, CS 90632, 97200 Fort de France, Martinique
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Cottin V, Larrieu S, Boussel L, Si-Mohamed S, Bazin F, Marque S, Massol J, Thivolet-Bejui F, Chalabreysse L, Maucort-Boulch D, Jouneau S, Hachulla E, Chollet J, Nasser M. Epidemiology, Mortality and Healthcare Resource Utilization Associated With Systemic Sclerosis-Associated Interstitial Lung Disease in France. Front Med (Lausanne) 2021; 8:699532. [PMID: 34552943 PMCID: PMC8451591 DOI: 10.3389/fmed.2021.699532] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 08/04/2021] [Indexed: 11/17/2022] Open
Abstract
Objectives: To investigate the clinical characteristics, epidemiology, survival estimates and healthcare resource utilization and associated costs in patients with systemic sclerosis-associated interstitial lung disease (SSc-ILD) in France. Methods: The French national administrative healthcare database, the Système National des Données de Santé (SNDS), includes data on 98.8% of the French population, including data relating to ambulatory care, hospitalizations and death. In our study, claims data from the SNDS were used to identify adult patients with SSc-ILD between 2010 and 2017. We collected data on clinical features, incidence, prevalence, survival estimates, healthcare resource use and costs. Results: In total, 3,333 patients with SSc-ILD were identified, 76% of whom were female. Patients had a mean age [standard deviation (SD)] of 60.6 (14.4) years and a mean (SD) individual study duration of 3.9 (2.7) years. In 2016, the estimated overall incidence and prevalence were 0.69/100,000 individuals and 5.70/100,000 individuals, respectively. The overall survival estimates of patients using Kaplan-Meier estimation were 93, 82, and 55% at 1, 3, and 8 years, respectively. During the study, 98.7% of patients had ≥1 hospitalization and 22.3% of patients were hospitalized in an intensive care unit. The total annual mean healthcare cost per patient with SSc-ILD was €25,753, of which €21,539 was related to hospitalizations. Conclusions: This large, real-world longitudinal study provides important insights into the epidemiology of SSc-ILD in France and shows that the disease is associated with high mortality, healthcare resource utilization and costs. SSc-ILD represents a high burden on both patients and healthcare services. Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT03858842.
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Affiliation(s)
- Vincent Cottin
- Hôpital Louis Pradel, Centre Coordonnateur National de Référence des Maladies Pulmonaires Rares, Hospices Civils de Lyon, UMR754 INRAE and Université Claude Bernard Lyon 1, Member of ERN-LUNG, RespiFil, OrphaLung, Lyon, France
| | | | - Loic Boussel
- Département de Radiologie, Hospices Civils de Lyon, Lyon, France
- Université Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS Inserm, CREATIS UMR 5220, Lyon, France
| | - Salim Si-Mohamed
- Département de Radiologie, Hospices Civils de Lyon, Lyon, France
- Université Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS Inserm, CREATIS UMR 5220, Lyon, France
| | | | | | | | | | - Lara Chalabreysse
- Département d'anatomo-pathologie, Hospices Civils de Lyon, Lyon, France
| | - Delphine Maucort-Boulch
- Hospices Civils de Lyon, Pôle Santé Publique, Service de Biostatistique et Bioinformatique, Lyon, France
- Université de Lyon, Lyon, France
- Université Lyon 1, Villeurbanne, France
- CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, Villeurbanne, France
| | - Stéphane Jouneau
- Centre Hospitalier Universitaire de Rennes, Centre de Compétences pour les Maladies Pulmonaires Rares, Univ Rennes, Inserm, EHESP, IRSET (Institut de recherche en santé, environnement et travail), RespiFil, OrphaLung, Rennes, France
| | - Eric Hachulla
- Hôpital Claude Huriez, Centre National de Référence des maladies auto-immunes systémiques rares (CeRAINO), CHU de Lille, Lille, France
| | | | - Mouhamad Nasser
- Hôpital Louis Pradel, Centre Coordonnateur National de Référence des Maladies Pulmonaires Rares, Hospices Civils de Lyon, UMR754 INRAE and Université Claude Bernard Lyon 1, Member of ERN-LUNG, RespiFil, OrphaLung, Lyon, France
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Chatignoux E, Uhry Z, Grosclaude P, Colonna M, Remontet L. How to produce sound predictions of incidence at a district level using either health care or mortality data in the absence of a national registry: the example of cancer in France. Int J Epidemiol 2021; 50:279-292. [PMID: 33232469 DOI: 10.1093/ije/dyaa217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In many countries, epidemiological surveillance of chronic diseases is monitored by local registries (LR) which do not necessarily cover the whole national territory. This gap has fostered interest in using non-registry databases (e.g., health care or mortality databases) available for the whole territory as proxies for incidence at the local level. However, direct counts from these databases do not provide reliable incidence measures. Accordingly, specific methods are needed to correct proxies and assess their epidemiological usefulness. METHODS This study's objective was to implement a three-stage turnkey methodology using national non-registry data to predict incidence in geographical areas without an LR as follows: constructing a calibration model to make predictions including accurate prediction intervals; accuracy assessment of predictions and rationale for the criteria to assess which predictions were epidemiologically useful; mapping after spatial smoothing of the latter predictions. The methodology was applied to a real-world setting, whereby we aimed to predict cancer incidence, by gender, at the district level in France over the 2007-15 period for 24 different cancer sites, using several health care indicators and mortality. In the present paper, the spatial smoothing performed on predicted incidence of epidemiological interest is illustrated for two examples. RESULTS Predicted incidence of epidemiological interest was possible for 27/34 solid site-gender combinations and for only 2/8 haematological malignancies-gender combinations. Mapping of smoothed predicted incidence provided a clear picture of the main contrasts in incidence between districts. CONCLUSIONS The methodology implemented provides a comprehensive framework to produce valuable predictions of incidence at a district level, using proxy measures and existing LR.
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Affiliation(s)
- Edouard Chatignoux
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - Zoé Uhry
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France.,Hospices Civils de Lyon, Service de Biostatistique-Bioinformatique, Pierre-Bénite, Université Lyon 1, France
| | - Pascale Grosclaude
- FRANCIM Network, Toulouse, France.,Tarn Cancer Registry, Claudius Regaud Institute, IUCT-O, Toulouse, France
| | - Marc Colonna
- FRANCIM Network, Toulouse, France.,Isere Cancer Registry, CHU Grenoble-Alpes, Grenoble, France
| | - Laurent Remontet
- Hospices Civils de Lyon, Service de Biostatistique-Bioinformatique, Pierre-Bénite, Université Lyon 1, France.,CNRS; UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Villeurbanne, France
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Uhry Z, Chatignoux E, Dantony E, Colonna M, Roche L, Fauvernier M, Defossez G, Leguyader-Peyrou S, Monnereau A, Grosclaude P, Bossard N, Remontet L. Multidimensional penalized splines for incidence and mortality-trend analyses and validation of national cancer-incidence estimates. Int J Epidemiol 2021; 49:1294-1306. [PMID: 32830255 DOI: 10.1093/ije/dyaa078] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Cancer-incidence and mortality-trend analyses require appropriate statistical modelling. In countries without a nationwide cancer registry, an additional issue is estimating national incidence from local-registry data. The objectives of this study were to (i) promote the use of multidimensional penalized splines (MPS) for trend analyses; (ii) estimate the national cancer-incidence trends, using MPS, from only local-registry data; and (iii) propose a validation process of these estimates. METHODS We used an MPS model of age and year for trend analyses in France over 1990-2015 with a projection up to 2018. Validation was performed for 22 cancer sites and relied essentially on comparison with reference estimates that used the incidence/health-care ratio over the period 2011-2015. Alternative estimates that used the incidence/mortality ratio were also used to validate the trends. RESULTS In the validation assessment, the relative differences of the incidence estimates (2011-2015) with the reference estimates were <5% except for testis cancer in men and < 7% except for larynx cancer in women. Trends could be correctly derived since 1990 despite incomplete histories in some registries. The proposed method was applied to estimate the incidence and mortality trends of female lung cancer and prostate cancer in France. CONCLUSIONS The validation process confirmed the validity of the national French estimates; it may be applied in other countries to help in choosing the most appropriate national estimation method according to country-specific contexts. MPS form a powerful statistical tool for trend analyses; they allow trends to vary smoothly with age and are suitable for modelling simple as well as complex trends thanks to penalization. Detailed trend analyses of lung and prostate cancers illustrated the suitability of MPS and the epidemiological interest of such analyses.
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Affiliation(s)
- Zoé Uhry
- Direction des Maladies Non Transmissibles et des Traumatismes, Santé Publique France, Saint-Maurice, France.,Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
| | - Edouard Chatignoux
- Direction des Maladies Non Transmissibles et des Traumatismes, Santé Publique France, Saint-Maurice, France
| | - Emmanuelle Dantony
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France.,Laboratoire de Biométrie et Biologie Évolutive, UMR 5558, CNRS, Université Lyon 1, Université de Lyon, Villeurbanne, France
| | - Marc Colonna
- Registre des cancers de l'Isère, Grenoble, France
| | - Laurent Roche
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France.,Laboratoire de Biométrie et Biologie Évolutive, UMR 5558, CNRS, Université Lyon 1, Université de Lyon, Villeurbanne, France
| | - Mathieu Fauvernier
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France.,Laboratoire de Biométrie et Biologie Évolutive, UMR 5558, CNRS, Université Lyon 1, Université de Lyon, Villeurbanne, France
| | | | | | - Alain Monnereau
- Registre des hémopathies malignes de la Gironde, Institut Bergonié, Bordeaux, France
| | - Pascale Grosclaude
- Registre des cancers du Tarn Cancer, Institut Claudius Regaud, Institut universitaire du cancer de Toulouse Oncopole (IUCT-O), Toulouse, France.,Laboratoire d'Epidémiologie et Analyses en Santé Publique (LEASP), UMR 1027, Inserm; Université Toulouse III, Toulouse, France
| | - Nadine Bossard
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France.,Laboratoire de Biométrie et Biologie Évolutive, UMR 5558, CNRS, Université Lyon 1, Université de Lyon, Villeurbanne, France
| | - Laurent Remontet
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France.,Laboratoire de Biométrie et Biologie Évolutive, UMR 5558, CNRS, Université Lyon 1, Université de Lyon, Villeurbanne, France
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Joachim C, Véronique-Baudin J, Desroziers L, Chatignoux É, Belliardo S, Plenet J, Macni J, Ulric-Gervaise S, Peruvien J, Bhakkan-Mambir B, Deloumeaux J. Gynaecological cancer in Caribbean women: data from the French population-based cancer registries of Martinique, Guadeloupe and French Guiana (2007-2014). BMC Cancer 2020; 20:643. [PMID: 32650744 PMCID: PMC7350571 DOI: 10.1186/s12885-020-07128-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 07/02/2020] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND For the first time, we present regional-level cancer incidence and world-standardized mortality rates for cancers for Martinique, Guadeloupe and French Guiana. METHODS For Martinique, Guadeloupe and French Guiana, incidence data come from population-based cancer registries, and cover the periods 2007-2014, 2008-2014 and 2010-2014 respectively. Standardized incidence and mortality rates were calculated using the world population. RESULTS In the 3 regions, all cancers combined represent 3567 new cases per year, of which 39.8% occur in women, and 1517 deaths per year (43.4% in women). Guadeloupe and Martinique present similar world-standardized incidence rates. Among gynaecological cancers, breast cancer, the second most common cancer type in the 3 regions, has an incidence rate 35 to 46% lower than in mainland France. On the other hand, cervical cancer has a higher incidence rate, particularly in French Guiana. For both endometrial cancer and ovarian cancer, no significant differences in incidence rates are found compared to mainland France. Regarding mortality, world-standardized mortality rates are similar between Guadeloupe and Martinique, and higher than in French Guiana. This situation compares favourably with mainland France (all cancers). Among gynaecological cancers, the mortality rate is lower for breast cancer in all regions compared to mainland France, and also lower for ovarian cancer in Martinique and Guadeloupe, but higher (albeit non-significantly) in French Guiana. CONCLUSION The ethno-geographic and socio-demographic characteristics in this population of mainly Afro-Caribbean origin could partially explain these disparities. Major disparities exist for certain cancer sites: excess incidence and excess mortality for cervical cancer; lower, but increasing incidence of breast cancer.
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Affiliation(s)
- Clarisse Joachim
- CHU de Martinique, Pôle de Cancérologie Hématologie Urologie Pathologie, UF 1441 Registre Général des cancers de la Martinique, F-97200 Martinique, France
- French Network of Cancer Registries, F-31000 Toulouse, France
| | - Jacqueline Véronique-Baudin
- CHU de Martinique, Pôle de Cancérologie Hématologie Urologie Pathologie, UF 1441 Registre Général des cancers de la Martinique, F-97200 Martinique, France
| | - Laure Desroziers
- French Network of Cancer Registries, F-31000 Toulouse, France
- Registre général des cancers de la Guyane, Guyane, France
| | - Édouard Chatignoux
- French National Public Health Agency, 12 rue du Val d’Osne, 94410 Saint Maurice, France
| | - Sophie Belliardo
- French Network of Cancer Registries, F-31000 Toulouse, France
- Registre général des cancers de la Guyane, Guyane, France
| | - Juliette Plenet
- French Network of Cancer Registries, F-31000 Toulouse, France
- Registre général des cancers de la Guyane, Guyane, France
| | - Jonathan Macni
- CHU de Martinique, Pôle de Cancérologie Hématologie Urologie Pathologie, UF 1441 Registre Général des cancers de la Martinique, F-97200 Martinique, France
- French Network of Cancer Registries, F-31000 Toulouse, France
| | - Stephen Ulric-Gervaise
- CHU de Martinique, Pôle de Cancérologie Hématologie Urologie Pathologie, UF 1441 Registre Général des cancers de la Martinique, F-97200 Martinique, France
- French Network of Cancer Registries, F-31000 Toulouse, France
| | - Jessica Peruvien
- French Network of Cancer Registries, F-31000 Toulouse, France
- Registre Général des Cancers de Guadeloupe, Centre Hospitalier Universitaire de Guadeloupe, Guadeloupe F.W. I. Route de Chauvel, 97159 Pointe-à-Pitre Cedex, France
| | - Bernard Bhakkan-Mambir
- French Network of Cancer Registries, F-31000 Toulouse, France
- Registre Général des Cancers de Guadeloupe, Centre Hospitalier Universitaire de Guadeloupe, Guadeloupe F.W. I. Route de Chauvel, 97159 Pointe-à-Pitre Cedex, France
| | - Jacqueline Deloumeaux
- French Network of Cancer Registries, F-31000 Toulouse, France
- Registre Général des Cancers de Guadeloupe, Centre Hospitalier Universitaire de Guadeloupe, Guadeloupe F.W. I. Route de Chauvel, 97159 Pointe-à-Pitre Cedex, France
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