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1. Cancer Among Adolescents and Young Adults Between 2000 and 2016 in France: Incidence and Improved Survival

Author

Laetitia Daubisse-Marliac, Brigitte Lacour, Tania d'Almeida, Karima Hammas, Olivier Ganry, Alain Monnereau, Emmanuel Desandes, Nicolas Boissel, Brigitte Trétarre, Isabelle Baldi, Anne-Valérie Guizard, Anne Cowppli-Bony, Patricia Delafosse, Thomas Raze, Jacqueline Clavel, G. Coureau, Michel Velten, Sandrine Plouvier, Gautier Defossez, Xavier Troussard, Simona Bara, Véronique Bouvier, Anne-Sophie Woronoff, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Registre National des Tumeurs Solides de l'Enfant (RNTSE), Equipe 7 : EPICEA - Epidémiologie des cancers de l'enfant et de l'adolescent (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Registre National des Cancers de l'Enfant - National Registry of Childhood Cancers [Villejuif & CHU Nancy] (RNCE), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), French network of cancer registries [Toulouse] (Francim), Registre des cancers de Loire‐Atlantique et Vendée, Imaging and Longitudinal Investigations to Ameliorate Decision-making [Nantes] (ILIAD), Site de Recherche Intégrée sur le Cancer [Nantes] (SIRIC), Centre hospitalier universitaire de Nantes (CHU Nantes)-Centre hospitalier universitaire de Nantes (CHU Nantes), FRANCIM, Réseau des registres français du cancer, Registre des cancers de l’Isère [CHU de Grenoble], Centre Hospitalier Universitaire [Grenoble] (CHU)-Université Grenoble Alpes (UGA), CRLCC Paul Strauss, Registre des Tumeurs de l'Hérault, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), CIC - Poitiers, Université de Poitiers-Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM), MethodS in Patients-centered outcomes and HEalth ResEarch (SPHERE), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, Université de Nantes (UN)-Université de Nantes (UN), Registre des tumeurs du Doubs et du Territoire de Belfort [CHRU Besançon], Pôle cancérologie (CHRU Besançon), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), CHU Amiens-Picardie, CHirurgie, IMagerie et REgénération tissulaire de l’extrémité céphalique - Caractérisation morphologique et fonctionnelle - UR UPJV 7516 (CHIMERE), Université de Picardie Jules Verne (UPJV), Registre général des cancers de Lille et de sa région (GCS-C2RC), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Hôpital Albert Calmette [Lille], Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Registre Général des Tumeurs du Calvados, CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-UNICANCER, Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers (ANTICIPE), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM), Registre des cancers de la Manche [CHPC - Site Louis Pasteur], Site Louis Pasteur [CHPC], CH Centre Hospitalier Public du Cotentin (CHPC)-CH Centre Hospitalier Public du Cotentin (CHPC), A&O (Apprentissage et Optimisation) (A&O), Laboratoire Interdisciplinaire des Sciences du Numérique (LISN), Institut National de Recherche en Informatique et en Automatique (Inria)-CentraleSupélec-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS)-Institut National de Recherche en Informatique et en Automatique (Inria)-CentraleSupélec-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS)-Science des Données (SDD), Institut National de Recherche en Informatique et en Automatique (Inria)-CentraleSupélec-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS)-Institut National de Recherche en Informatique et en Automatique (Inria)-CentraleSupélec-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS)-Algorithmes, Apprentissage et Calcul (AAC), Institut National de Recherche en Informatique et en Automatique (Inria)-CentraleSupélec-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS)-Institut National de Recherche en Informatique et en Automatique (Inria)-CentraleSupélec-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS), Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Université Sorbonne Paris Nord, Cancer environnement (EPICENE ), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Registre National des Hémopathies malignes de l'Enfant (RNHE), and Institut de Veille Sanitaire (INVS)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Male, Pediatrics, medicine.medical_specialty, Survival, Adolescent, Lymphoma, [SDV]Life Sciences [q-bio], Population, Improved survival, Adolescents, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Neoplasms, Medicine, Humans, 030212 general & internal medicine, Registries, Young adult, education, Melanoma, Cancer, education.field_of_study, business.industry, Incidence (epidemiology), Incidence, Cancer survival, Neoplasms, Germ Cell and Embryonal, medicine.disease, humanities, Young Adults, Survival Rate, Oncology, 030220 oncology & carcinogenesis, Pediatrics, Perinatology and Child Health, Female, France, Trends, business
Abstract

International audience; Purpose: This study was undertaken to determine cancer survival and describe the spectrum of cancers diagnosed among French adolescent and young adult (AYA) population.Methods: All cases of cancer diagnosed in 15-24 years, recorded by all French population-based registries (18% of the French population), over the 2000-2016 period, were included. Age-standardized incidences rates (ASR), conventional annual percentage change (cAPC) of incidence over time, and 5-year overall survival (5yOS) were calculated.Results: We analyzed 2,734 cancer diagnoses in adolescents and 4,199 in young adults. Overall incidence rates were 231.9/106 in 15-19 year olds and 354.0/106 in 20-24 year olds. The most frequently diagnosed cancers in male AYA were malignant gonadal germ-cell tumors (GCT), Hodgkin lymphoma (HL), and malignant melanoma, and were HL, thyroid carcinoma, and malignant melanoma in females. Cancer incidence was stable over time with a cAPC of 0.8% (p=0.72). For all cancers combined, 5yOS was 86.6% (95%CI: 85.8-87.4), greater than 85% for HL, non-Hodgkin lymphomas (NHL), GCT, thyroid carcinomas, and malignant melanomas, and around 60% and lower for osteosarcomas, Ewing tumors, hepatic carcinomas, and rhabdomyosarcomas. The 5yOS has significantly improved from 2000-2007 to 2008-2015 for all cancers pooled, with a substantial gain of 4% for 15-19 year-olds, and 3% for 20-24 year-olds.Conclusion: Notwithstanding the encouraging results for some cancers, and overall, persistent poorer survivals in AYA were shown compared to children for acute lymphoblastic leukemia, osteosarcoma, Ewing tumor, rhabdomyosarcoma and malignant hepatic tumors. These disparities require further investigation to identify and address the causes of these inferior outcomes.

Published
2020

2. What is the most appropriate period to define synchronous cancers?

Author

Jérémie Jégu, Delphine Klein, Xavier Troussard, Véronique Bouvier, Emilie Marrer, Sandrine Plouvier, Florence Molinié, Anne-Sophie Woronoff, Michel Velten, Simona Bara, Brigitte Trétarre, Bénédicte Lapôtre-Ledoux, Anne-Valérie Guizard, Marc Colonna, Laetitia Daubisse-Marliac, Florent Baicry, and Pascale Grosclaude

Subjects
Cancer Research, Pediatrics, medicine.medical_specialty, Time Factors, Joinpoint regression, Epidemiology, Population, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Humans, Medicine, Registries, 030212 general & internal medicine, education, education.field_of_study, Bladder cancer, business.industry, Incidence, Incidence (epidemiology), Cancer, Neoplasms, Second Primary, medicine.disease, First cancer diagnosis, Oncology, 030220 oncology & carcinogenesis, Cohort, France, business
Abstract

Background Studies about second primary cancers (SPC) incidence exclude a period following the first cancer diagnosis given the high probability of diagnosing another primary cancer during this phase (synchronous cancers). However, definition of synchronicity period varies widely, from one to six months, without clear epidemiological justification. The objective of this study was to determine the most appropriate synchronicity period. Methods Data from 13 French population-based cancer registries were used to establish a cohort of all patients diagnosed with a first cancer between 1989 and 2010. The incidence rate of subsequent cancer was computed by day within 1 year of follow-up after the first diagnosis. Incidence was modelized by joinpoint regression models with an initial quadratic trend and a second constant part (plateau). The joinpoint was the point from which the plateau began and defining the synchronicity period. Results Our cohort included 696,775 patients with a first cancer, of which 12,623 presented a SPC. The median joinpoint for all sites combined was estimated at 120.5 days [112.0−129.0]. Analysis by gender reported a higher difference in 32 days for males (127.8 vs 96.1 days). Noteworthy differences were found depending on patient age and the site of first cancer, with joinpoint ranging from 84.7 (oesophagus cancer) to 250.1 days (bladder cancer). Conclusion Although some heterogeneity was observed based on the characteristic of the patients, the appropriate synchronicity period appears to be 4 months after the diagnosis of first cancer.

Published
2021

3. Douleurs à différents sites anatomiques et situation socio-économique : résultats d’une enquête nationale

Author

Sandrine Plouvier, Diane Cyr, R. Taiba, A. Leclerc, P. Pascal, J.-F. Chastang, Alexis Descatha, Cohortes épidémiologiques en population (CONSTANCES), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université de Paris (UP), UMR 1168, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), Hôpital Raymond Poincaré [AP-HP], Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université Paris Cité (UPCité), and Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Adult, Male, Musculoskeletal pain, medicine.medical_specialty, Socioeconomic position, Epidemiology, [SDV]Life Sciences [q-bio], Young Adult, 03 medical and health sciences, 0302 clinical medicine, Musculoskeletal Pain, Risk Factors, Surveys and Questionnaires, Prevalence, medicine, Back pain, Humans, Social position, 030212 general & internal medicine, Occupations, Socioeconomic status, Aged, Neck pain, business.industry, Public Health, Environmental and Occupational Health, Odds ratio, Middle Aged, 030210 environmental & occupational health, Occupational Diseases, medicine.anatomical_structure, Social Class, Physical therapy, Upper limb, Female, France, medicine.symptom, business
Abstract

International audience; BACKGROUND: Prevalence of musculoskeletal pain according to sites of pain and associated factors in the community has not been thoroughly documented. The association between pain and socioeconomic position has been studied by several authors, but without details in most studies regarding sites of pain, whereas the relations with social position could differ according to the site of pain. The objective of this study was to explore these differences in the community in France.METHODS: The national Health and Occupational History survey was conducted in France in 2006 in subjects aged 20-74 years. Self-assessment of pain at various sites in the previous year was recorded. Five sites were considered here: back, neck, shoulder, upper limb, and lower limb. After a description of prevalence according to gender and age, the associations with socioeconomic position at the beginning of the subjects' working life, in seven categories, were studied with logistic models adjusted for age. The analyses were limited to those aged 30-74 years and were conducted separately for men and women.RESULTS: Of the 5520 males and 6643 females studied, prevalence was the highest for back pain (35% for males, 37% for females). Pain was globally more frequent for women. For all sites of pain an increase with age was significant for women. This was not observed in men for back pain (highest prevalence in the 40- to 49-year-old age group) or neck pain. Overall, prevalence of pain was the lowest for professionals (reference category in the analyses). For males, the first occupation as a farmer or blue-collar worker was associated with an increased prevalence for most sites of pain, with odds ratios close to 2. For females, prevalence was increased for more socioeconomic categories, as compared to professionals. Among the five sites, neck pain was an exception: for both men and women, no association was observed between neck pain and socioeconomic position.CONCLUSION: Although exploratory, these results are consistent with the available knowledge on occupational and personal risk factors for pain, which differ according to the site of pain. Other studies are needed to better understand the causal mechanisms underlying the associations observed.

Published
2016

4. Facteurs personnels et professionnels associés aux lombalgies en population générale au travail en France

Author

Julie Gourmelen, Sandrine Plouvier, Jean-Louis Lanoë, Annette Leclerc, Isabelle Niedhammer, and Jean-François Chastang

Subjects
medicine.medical_specialty, education.field_of_study, Multivariate analysis, Epidemiology, business.industry, Public health, Population, Public Health, Environmental and Occupational Health, 030210 environmental & occupational health, Low back pain, Occupational safety and health, 3. Good health, Occupational medicine, 03 medical and health sciences, 0302 clinical medicine, Physical therapy, Medicine, Population study, 030212 general & internal medicine, medicine.symptom, business, education, Socioeconomic status, Demography
Abstract

Background Low-back pain is a major public health concern because of its socioeconomic burden, especially for chronic forms. The purpose of this study was to analyse the associations between low-back pain and occupational and personal factors, with a special focus on interactions between age and occupational exposures. Methods The study population comprised a sample of 3958 and 4526 working women and men aged 30 to 59 derived from a national health survey (2002–2003 EDS). Low-back pain was assessed using the French version of the Nordic questionnaire. Weight, height and smoking status were obtained through interview at home. Occupational exposures were self-assessed. The associations between low-back pain for more than 30 days in the previous year and occupational and personal factors were assessed using logistic models. An interaction between age and each occupational exposure was studied. Results In the multivariate models, age was the only personal factor significantly associated with low-back pain for both genders. The other personal factors studied were significantly associated with low-back pain for women only. Handling heavy loads and awkward postures at work were strongly associated with low-back pain for both genders (respectively OR = 1.80 [1.46–2.23] and OR = 1.65 [1.34–2.03] for men, and OR = 1.65 [1.32–2.06] and OR = 1.28 [1.04–1.59] for women). A high level of psychological demands at work and a low level of decision latitude were also associated with low-back pain for both genders (respectively OR = 1.22 [1.03–1.46] and OR = 1.32 [1.11–1.57] for men, and OR = 1.31 [1.10–1.56] and OR = 1.27 [1.06–1.51] for women). Only the interaction between age and awkward postures for men was borderline significant. Conclusion This study showed strong associations between occupational exposures and persistent/recurrent low-back pain in a general working population in France. Targeting these exposures in prevention programs could be useful.

Published
2010

5. Description of musculoskeletal disorders and occupational exposure from a field pilot study of large population-based cohort (CONSTANCES)

Author

Annette Leclerc, Alexis Descatha, Matthieu Carton, Eléonore Herquelot, Marie Zins, Marcel Goldberg, Yves Roquelaure, Sandrine Plouvier, Laboratoire d'Ergonomie et d'Épidémiologie en Santé au Travail (LEEST), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM)-Université d'Angers (UA)-Institut de Veille Sanitaire (INVS), and PRES Université Nantes Angers Le Mans (UNAM)

Subjects
Public Health Informatics, medicine.medical_specialty, business.industry, Field (Bourdieu), [SDV]Life Sciences [q-bio], Public Health, Environmental and Occupational Health, Large population, 030210 environmental & occupational health, Cohort Studies, Study Protocol, 03 medical and health sciences, 0302 clinical medicine, Cohort, Physical therapy, medicine, Humans, Female, 030212 general & internal medicine, Occupational exposure, business, Epidemiologic Methods
Abstract

Background Prospective cohorts represent an essential design for epidemiological studies and allow for the study of the combined effects of lifestyle, environment, genetic predisposition, and other risk factors on a large variety of disease endpoints. The CONSTANCES cohort is intended to provide public health information and to serve as an "open epidemiologic laboratory" accessible to the epidemiologic research community. Although designed as a "general-purpose" cohort with very broad coverage, it will particularly focus on occupational and social determinants of health, and on aging. Methods/Design The CONSTANCES cohort is designed as a randomly selected representative sample of French adults aged 18-69 years at inception; 200,000 subjects will be included over a five-year period. At inclusion, the selected subjects will be invited to fill a questionnaire and to attend a Health Screening Center (HSC) for a comprehensive health examination: weight, height, blood pressure, electrocardiogram, vision, auditory, spirometry, and biological parameters; for those aged 45 years and older, a specific work-up of functional, physical, and cognitive capacities will be performed. A biobank will be set up. The follow-up includes a yearly self-administered questionnaire, and a periodic visit to an HSC. Social and work-related events and health data will be collected from the French national retirement, health and death databases. The data that will be collected include social and demographic characteristics, socioeconomic status, life events, behaviors, and occupational factors. The health data will cover a wide spectrum: self-reported health scales, reported prevalent and incident diseases, long-term chronic diseases and hospitalizations, sick-leaves, handicaps, limitations, disabilities and injuries, healthcare utilization and services provided, and causes of death. To take into account non-participation at inclusion and attrition throughout the longitudinal follow-up, a cohort of non-participants will be set up and followed through the same national databases as participants. A field-pilot was performed in 2010 in seven HSCs, which included about 3,500 subjects; it showed a satisfactory structure of the sample and a good validity of the collected data. Discussion The constitution of the full eligible sample is planned during the last trimester of 2010, and the cohort will be launched at the beginning of 2011.

Published
2013

6. Low back pain around retirement age and physical occupational exposure during working life

Author

Sandrine Plouvier, Julie Gourmelen, Jean-Louis Lanoë, Annette Leclerc, Jean-François Chastang, Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), and BMC, Ed.

Subjects
Male, medicine.medical_specialty, Population, 03 medical and health sciences, 0302 clinical medicine, Occupational Exposure, Surveys and Questionnaires, Environmental health, Epidemiology, medicine, Humans, 030212 general & internal medicine, Risk factor, education, Aged, Retirement, education.field_of_study, business.industry, Public health, lcsh:Public aspects of medicine, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, Middle Aged, 030210 environmental & occupational health, Low back pain, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Population study, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, Biostatistics, medicine.symptom, business, Low Back Pain, Retirement age, Research Article
Abstract

Background Physical occupational exposure is a risk factor for low back pain in workers but the long term effects of exposure remain unclear. As several countries consider increasing the retirement age, further information on this topic is relevant. This study aimed to describe the prevalence of low back pain among middle aged and aging individuals in the general French population according to physical occupational exposure and retirement status. Methods The study population originated from the French national survey 'Enquête décennale santé 2002'. Low back pain for more than 30 days within the previous twelve months (LBP) was assessed using a French version of the Nordic questionnaire. Occupational exposure was self assessed. Subjects were classified as "exposed" if they were currently or had previously been exposed to handling of heavy loads and/or to tiring postures. The weighted prevalence of LBP was computed separately for men and women, for active (aged 45-59) and retiree (aged 55-74), according to 5-year age group and past/present occupational exposure. Results For active men, the prevalence of LBP was significantly higher in those currently or previously exposed (n = 1051) compared with those never exposed (n = 1183), respectively over 20% versus less than 11%. Among retired men, the prevalence of LBP tended towards equivalence with increasing age among those previously exposed (n = 748) and those unexposed (n = 599). Patterns were quite similar for women with a higher prevalence in exposed active women (n = 741) compared to unexposed (n = 1260): around 25% versus 15%. Similarly, differences between previously exposed (n = 430) and unexposed (n = 489) retired women tended to reduce with age. Conclusion The prevalence of LBP in active workers was associated with occupational exposure. The link with past exposure among retirees decreased with age. These results should be considered for policies dealing with prevention at the workplace and retirement.

Published
2011

7. Socioeconomic position and low-back pain--the role of biomechanical strains and psychosocial work factors in the GAZEL cohort

Author

Sébastien Bonenfant, Annette Leclerc, Marcel Goldberg, Jean-François Chastang, Sandrine Plouvier, Santé publique et épidémiologie des déterminants professionnels et sociaux de la santé, Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Equipe RPPC, CETAF, Département santé travail (DST-InVS), Institut de Veille Sanitaire (INVS), Kaniewski, Nadine, and Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Male, Gerontology, MESH: Low Back Pain, Cohort Studies, 0302 clinical medicine, Musculoskeletal disorder, Recurrence, 030212 general & internal medicine, MESH: Cohort Studies, MESH: Biomechanics, education.field_of_study, MESH: Middle Aged, Middle Aged, 030210 environmental & occupational health, Low back pain, Biomechanical Phenomena, Occupational Diseases, Cohort, population characteristics, Female, France, medicine.symptom, Psychosocial, Cohort study, Adult, MESH: Occupational Diseases, medicine.medical_specialty, Population, Article, Occupational medicine, MESH: Social Class, 03 medical and health sciences, medicine, Humans, education, Socioeconomic status, MESH: Humans, business.industry, Public Health, Environmental and Occupational Health, MESH: Adult, medicine.disease, MESH: Male, MESH: Recurrence, MESH: France, Social Class, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Low Back Pain, MESH: Female
Abstract

International audience; OBJECTIVE: To analyze the role that biomechanical strains and psychosocial work factors play in occupational class disparities in low-back pain in the GAZEL cohort. METHODS: Recruited in 1989, the GAZEL cohort members were employees of the French national company in charge of energy who volunteered to enroll in an annual follow-up survey. The study population comprised 1487 men who completed questionnaires in 1996 (past occupational exposure to manual material handling, bending/twisting, and driving), 1997 (psychosocial work factors), and 2001 (low-back pain using a French version of the Nordic questionnaire for the assessment of low-back pain). Associations between low-back pain for >30 days in the preceding 12 months and social position at baseline (four categories) were described with a Cox model to determine prevalence ratios for each category. We compared adjusted and unadjusted ratios to quantify the contribution of occupational exposures. RESULTS: The prevalence of low-back pain for >30 days was 13.6%. The prevalence of low-back pain adjusted for age was significantly higher for blue-collar workers and clerks than for managers. The number of socioeconomic disparities observed was significantly reduced when biomechanical strains were taken into account; adjusting for psychosocial factors had little impact. CONCLUSION: In this population, occupational exposures--especially biomechanical strains--played an important role in occupational class disparities for persistent or recurrent low-back pain.

Published
2009

8. Level of education and back pain in France: the role of demographic, lifestyle and physical work factors

Author

Jean-François Chastang, Jean-Louis Lanoë, Julie Gourmelen, Sandrine Plouvier, Isabelle Niedhammer, Annette Leclerc, Santé publique et épidémiologie des déterminants professionnels et sociaux de la santé, Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Kaniewski, Nadine, and Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
musculoskeletal diseases, Gerontology, Adult, Employment, Male, medicine.medical_specialty, medicine.medical_treatment, Overweight, Occupational safety and health, Article, Occupational medicine, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, health services administration, Occupational Exposure, Epidemiology, medicine, Back pain, Prevalence, Humans, 030212 general & internal medicine, Life Style, Aged, Demography, 2. Zero hunger, Rehabilitation, business.industry, Public health, Public Health, Environmental and Occupational Health, Age Factors, social sciences, Middle Aged, Low back pain, Occupational Diseases, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Physical therapy, population characteristics, Educational Status, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, medicine.symptom, business, human activities, Low Back Pain, 030217 neurology & neurosurgery
Abstract

International audience; PURPOSE: To investigate the pathways from level of education to low back pain (LBP) in the adult population, especially concerning the role of physical working constraints, and personal factors (overweight, tobacco consumption, and tallness). METHODS: The study population consisted of 15,534 subjects from the National Health Survey, with data on LBP, level of education, personal factors, and physical working constraints. Logistic models for LBP (pain more than 30 days during the previous 12 months) were compared in order to check the consistency of the data with specific causal pathways. RESULTS: Low back pain was strongly associated with level of education. This association was almost completely explained if present or past exposure to tiring work postures and handling of heavy loads were taken into account. For men, the OR for "no diploma", adjusted only for age, was 1.75; it was 1.02 after additional adjustment on physical work factors. Personal factors played also a role, especially overweight for women. Among them, the OR associated with a body mass index = 27 or more was 1.58 after adjustment on all the other factors. CONCLUSIONS: In this national population the main pathways from education to LBP were through occupational exposure and lifestyle factors.

Published
2008

9. Socioeconomic disparities in gait speed and associated characteristics in early old age

Author

A. Leclerc, Séverine Sabia, Alexis Descatha, Matthieu Carton, Sandrine Plouvier, Diane Cyr, Marie Zins, Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), UMS011, Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Department of Epidemiology & Public Health, University College of London [London] (UCL), This study was supported by IReSP (Institute for research in public health, inFrench- http://www.iresp.net/).The CONSTANCES Cohort is supported by the Caisse Nationale d’AssuranceMaladie des travailleurs salariés-CNAMTS, and is funded by the Institut deRecherche en Santé Publique/Institut Thématique Santé Publique, and thefollowing sponsors: Ministère de la santé et des sports, Ministère délégué àla recherche, Institut national de la santé et de la recherche médicale, Institutnational du cancer et Caisse nationale de solidarité pour l'autonomie., and BMC, BMC

Subjects
Male, medicine.medical_specialty, Cross-sectional study, [SDV]Life Sciences [q-bio], Population, Poison control, Pilot Projects, Occupational safety and health, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Risk Factors, Medicine, Humans, Orthopedics and Sports Medicine, 030212 general & internal medicine, Occupations, 10. No inequality, education, Socioeconomic status, Life Style, Usual gait speed, Aged, education.field_of_study, 030505 public health, business.industry, Human factors and ergonomics, Health Status Disparities, Occupational exposure, Middle Aged, Walking Speed, Preferred walking speed, [SDV] Life Sciences [q-bio], Socioeconomic position, Cross-Sectional Studies, Socioeconomic Factors, Physical therapy, Female, France, 0305 other medical science, business, Cohort study, Demography, Research Article, Follow-Up Studies
Abstract

International audience; AbstractBackgroundA few studies have documented associations between socioeconomic position and gait speed, but the knowledge about factors from various domains (personal factors, lifestyle, occupation…) which contribute to these disparities is limited. Our objective was to assess socioeconomic disparities in usual gait speed in a general population in early old age in France, and to identify potential contributors to the observed disparities, including occupational factors.MethodsThe study population comprised 397 men and 339 women, aged 55 to 69, recruited throughout France for the field pilot of the CONSTANCES cohort. Gait speed was measured in meters/second. Socioeconomic position was based on self-reported occupational class. Information on personal characteristics, lifestyle, comorbidities and past or current occupational physical exposure came either from the health examination, from interview or from self-administered questionnaire. Four groups were considered according to sex-specific distributions of speed (the two slowest thirds versus the fastest third, for each gender). Logistic regression models adjusted for health screening center and age allowed to the study of cross-sectional associations between: 1- slower speed and occupational class; 2- slower speed and each potential contributor; 3- occupational class and selected potential contributors. The association between speed and occupational class was then further adjusted for the factors significantly associated both with speed and occupational class, in order to assess the potential contribution of these factors to disparities.ResultsWith reference to managers/executives, gait speed was reduced in less skilled categories among men (OR 1.21 [0.72–2.05] for Intermediate/Tradesmen, 1.95 [0.80–4.76] for Clerks, Sale/service workers, 2.09 [1.14–3.82] for Blue collar/Craftsmen) and among women (OR 1.12 [0.55–2.28] for Intermediate/Tradesmen, 2.33 [1.09–4.97] for Clerks, 2.48 [1.18–5.24] for Sale/service workers/Blue collar/Craftsmen). Among men, occupational exposure to carrying heavy loads explained a large part of socioeconomic disparities. Among women, obesity and occupational exposure to repetitive work contributed independently to the disparities.ConclusionsThis study suggests that some potentially modifiable occupational and personal factors explain at least part of the differences in gait speed between occupational classes, and that these factors differ between men and women. Longitudinal studies are needed to confirm and complement these findings.

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10. Cancer incidence and mortality trends in France over 1990-2018 for solid tumors: the sex gap is narrowing

Author

G, Defossez, Z, Uhry, P, Delafosse, E, Dantony, T, d'Almeida, S, Plouvier, N, Bossard, A M, Bouvier, F, Molinié, A S, Woronoff, M, Colonna, P, Grosclaude, L, Remontet, A, Monnereau, Anne-Sophie, Woronoff, Centre hospitalier universitaire de Poitiers (CHU Poitiers), Université de Poitiers, CIC - Poitiers, Université de Poitiers-Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM), FRANCIM, Réseau des registres français du cancer, Santé publique France, Direction des maladies non transmissibles et traumatismes, Saint-Maurice, France, parent, Hospices Civils de Lyon (HCL), Université de Lyon, Université Claude Bernard Lyon 1 (UCBL), Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Registre des cancers de l’Isère [CHU de Grenoble], Centre Hospitalier Universitaire [Grenoble] (CHU)-Université Grenoble Alpes (UGA), Registre général des cancers de Lille et de sa région (GCS-C2RC), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Hôpital Albert Calmette [Lille], Registre Bourguignon des Cancers Digestifs, Lipides - Nutrition - Cancer (U866) (LNC), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon (ENSBANA)-Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon (ENSBANA)-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre hospitalier universitaire de Nantes (CHU Nantes), Registre des tumeurs du Doubs et du Territoire de Belfort [CHRU Besançon], Pôle cancérologie (CHRU Besançon), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Registre général des cancers du Tarn, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM), Registre des hémopathies malignes de la Gironde, Institut Bergonié [Bordeaux], UNICANCER-UNICANCER, Cancer environnement (EPICENE ), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), Université Bordeaux Segalen - Bordeaux 2, French Network of Cancer Registries (FRANCIM): Brice Amadeo, Isabelle Baldi, Simona Bara, Anne-Marie Bouvier, Véronique Bouvier, Marc Colonna, Gaëlle Coureau, Anne Cowppli-Bony, Sandrine Dabakuyo-Yonli, Tania d'Almeida, Laetitia Daubisse-Marliac, Gautier Defossez, Patricia Delafosse, Emmanuel Desandes, Pascale Grosclaude, Anne-Valérie Guizard, Brigitte Lacour, Bénédicte Lapôtre-Ledoux, Karima Hammas, Florence Molinié, Jean-Baptiste Nousbaum, Sandrine Plouvier, Camille Pouchieu, Michel Robaszkiewicz, Claire Schvartz, Brigitte Trétarre, Michel Velten, Anne-Sophie Woronoff, Malbec, Odile, Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Albert Calmette [Lille]-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Registre des Cancers du Tarn, Registre des cancers du Tarn, and Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Male, Cancer Research, [SDV]Life Sciences [q-bio], Rate ratio, History, 21st Century, 03 medical and health sciences, 0302 clinical medicine, Surgical oncology, Neoplasms, Genetics, medicine, Humans, Registries, 030212 general & internal medicine, Mortality, Esophagus, RC254-282, Cancer, business.industry, Research, Incidence (epidemiology), Mortality rate, Incidence, Pharynx, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Gender Identity, History, 20th Century, medicine.disease, 3. Good health, [SDV] Life Sciences [q-bio], medicine.anatomical_structure, Oncology, 030220 oncology & carcinogenesis, Etiology, Sex, Female, Trends, business, Demography
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.

Published
2020

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