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ObjectiveTo study the role of occupational exposures in lung cancer risk in the French West Indies, with special attention to some specific activities, such as sugarcane work, that can only be studied in a limited number of populations.MethodsWe used data from a population-based case-control study that included 147 incident lung cancer cases and 405 controls. Smoking history and a detailed occupational history with a description of tasks and substances were collected by questionnaire during face-to-face interviews. Odds ratios (OR) adjusted for sex, age, region, smoking status and cigarette pack-years and 95% confidence intervals (95% CI) were estimated by unconditional logistic regression.ResultsSignificantly increased risks of lung cancer were found in sugarcane farm workers (OR=2.7; 95% CI 1.1-6.6) and more generally in the sugarcane growing sector (OR=2.5; 95% CI 1.0-6.3) and to a lesser extent in rum production. Elevated risks of lung cancer were also observed among other agricultural workers, painters, warehouse porters, labourers, maintenance and motor vehicle repair workers. Exposure to herbicides in sugarcane cultivation was associated with an increased risk of lung cancer (OR=2.6; 95% CI 0.9-7.6).ConclusionThese results showed that occupational exposures contributed to lung cancer risk in the French West Indies, and highlighted the role of exposures related to sugarcane work.

National audience

International audience; Understanding the views of cancer survivors on their experience is important for informing community-based interventions. We studied, for the first time, the views of cancer survivors residing in Saint Lucia on their overall care experience. We used interview data from a cohort of adult cancer survivors from Saint Lucia between 2019 and 2020. We performed a thematic analysis to derive themes from codes. Forty-four survivors provided responses to at least one of the three questions. The majority of survivors were black, female and diagnosed with breast cancer. Survivors were interviewed on average five years after diagnosis. Four common themes emerged; "Availability of support groups", "Importance of support from family and friends", "Access to finances" and "Health education and patient navigation". Travel overseas for health services was common among survivors. Survivors expressed emotional distress during travel due to isolation from family and local providers. This is typical among island populations and is distinct from existing patient frameworks. Survivors also suggested that networking amongst providers and interventions assisted families of cancer survivors. Although tertiary care services are limited, we showed that survivors deeply value and depend on their inter-personal relationships during care. Interventions aimed at strengthening the inter-personal environment of survivors are warranted.

International audience; Background: Africa and the Caribbean are projected to have greater increases in Head and neck cancer (HNC) burden in comparison to North America and Europe. The knowledge needed to reinforce prevention in these populations is limited. We compared for the first time, incidence rates of HNC in black populations from African, the Caribbean and USA. Methods: Annual age-standardized incidence rates (IR) and 95% confidence intervals (95%CI) per 100,000 were calculated for 2013-2015 using population-based cancer registry data for 14,911 HNC cases from the Caribbean (Barbados, Guadeloupe, Trinidad and Tobago, N = 443), Africa (Kenya, Nigeria, N = 772) and the United States (SEER, Florida, N = 13,696). We compared rates by sub-sites and sex among countries using data from registries with high quality and completeness. Results: In 2013-2015, compared to other countries, HNC incidence was highest among SEER states (IR: 18.2, 95%CI = 17.6-18.8) among men, and highest in Kenya (IR: 7.5, 95%CI = 6.3-8.7) among women. Nasopharyngeal cancer IR was higher in Kenya for men (IR: 3.1, 95%CI = 2.5-3.7) and women (IR: 1.5, 95% CI = 1.0-1.9). Female oral cavity cancer was also notably higher in Kenya (IR = 3.9, 95%CI = 3.0-4.9). Blacks from SEER states had higher incidence of laryngeal cancer (IR: 5.5, 95%CI = 5.2-5.8) compared to other countries and even Florida blacks (IR: 4.4, 95%CI = 3.9-5.0). Conclusion: We found heterogeneity in IRs for HNC among these diverse black populations; notably, Kenya which had distinctively higher incidence of nasopharyngeal and female oral cavity cancer. Targeted etiological investigations are warranted considering the low consumption of tobacco and alcohol among Kenyan women. Overall, our findings suggest that behavioral and environmental factors are more important determinants of HNC than race.

Developing robust systems for cancer care delivery is essential to reduce the high cancer mortality in small island developing states (SIDS). Indigenous data are scarce, but community-based cancer research can inform care in SIDS where formal research capacity is lacking, and we describe the experiences of cancer survivors in Saint Lucia in accessing health services. Purposive and snowball sampling was used to constitute a sample of survivors for interviews. Subjects were interviewed with a questionnaire regarding socio-demographics, clinical characteristics, health services accessed (physicians, tests, treatment), and personal appraisal of experience. We recruited 50 survivors (13 men, 37 women). Only 52% of first presentations were with general practitioners. The mean turnaround for biopsy results in Saint Lucia was three times longer than overseas (p = 0.0013). Approximately half of survivors commenced treatment more than one month following diagnosis (median of 32 days, IQR 19–86 days), and 56% of survivors traveled out-of-country for treatment. Most survivors (60%) paid for care with family/friends support, followed by savings and medical insurance (38% each). In conclusion, cancer survivors in Saint Lucia are faced with complex circumstances, including access-to-care and health consequences. This study can guide future research, and possibly guide practice improvements in the near term.

Background Cervical cancer is the fourth cancer worldwide. The Human Papilloma Virus is responsible for 99% of the cases but the distribution of its genotypes varies among populations. We aimed to identify HPV genotypes distribution in women with grade 2/3 cervical intraepithelial dysplasia or invasive cervical cancer in Guadeloupe, a French Caribbean territory with a population mainly of African descent. Methods We used paraffin-embedded tumors for viral DNA extraction from women diagnosed between 2014 and 2016 and identified by the population-based cancer registry. The HPV Genotyping was performed with the InnoLIPA HPV Genotyping Extra kit®. Results Overall, 213 samples out of the 321 eligible records were analyzed. The HPV status was positive for 94% of the cases. The five most common oncogenic HPV genotypes were HPV31 (47%), HPV33 (38%), HPV16 (32%), HPV44 (31%) and HPV26 (28%). HPV18 was found in only in 5% of the cases. Among the studied cases, 94% had multiple infections. More than 60% of single infections were HPV16-related, accounting for 35% of HPV16 infections. Conclusions These results show a different distribution of oncogenic HPVs in Guadeloupe with “31 > 33 > 16” and a high frequency of multiple infections. Despite a lower coverage, the nine-valent vaccine is nevertheless adequate.

e22508 Background: Abuja, Nigeria’s annual World Cancer Day Walk (WCDW) is a tool for promoting public awareness of cancer risk factors, preventative lifestyle strategies, and the importance of early screening as critical elements of prevention and control. The day includes physical activities (walk, race, ride, skate, cycle, marathon), as well as health education and free breast cancer, cervical, and prostate screenings. The effectiveness of the event to attract the most vulnerable Nigerian populations has not been studied. Aim: To determine the social-demographic characteristics of participants and evaluate the impact of outreach campaigns. Methods: Approximately 2,000 Nigerians attended Abuja WCDW on February 1, 2020. A similar number attended Abuja WCDW on February 5, 2022. Trained research assistants recruited participants to complete a one-sheet questionnaire that assessed basic demographic, social, and lifestyle information. Participants were given informed consent. In 2020, 237 (11%) participants, aged 18-68 years voluntarily completed survey (ClinicalTrials #NCT04248881). In 2022, 111 (6%), aged 17-74 years voluntarily completed survey (ClinicalTrials #NCT05239325). Note: In 2021, Abuja WCDW was canceled due to COVID. Results: In 2020, the mean age for participants was 28; SD 7.71. Sixty-eight percent were women. Eighty-seven percent had at least an undergraduate education. Of the 237 participants, 65% reported that they attended to obtain free cancer screening. More than 50% reported they had no health insurance. Of those insured, more had National Health Insurance Scheme (NHIS) than private insurance. The average body mass index (BMI) was between 24-28; BMI was highest among the mid-20 age group. Lifestyle data revealed more men than women were concerned with their health; those with health worries were more likely to have had cancer screening at the event. The 2022 WCDW data were being analyzed at the time of abstract submission; findings will be presented at the meeting. Analysis: Data from 2020 revealed participants are predominately associated with a lower risk of developing cancer. They have higher levels of knowledge about cancer and lifestyle/health-related behaviors beneficial for early detection and prevention. WCDW is a great avenue for cancer awareness/lifestyle prevention interventions yet there is an urgent need to evaluate efficacy of current outreach to target underserved members of Nigerian population: those with lower levels of education, unemployed, lower income, and without insurance. Conclusions: Attendees in 2020 are younger people of higher socioeconomic status with lifestyle practices that could reduce cancer risk. If our 2022 data are similar, we must elaborate better strategies to reach populations at greater risk and encourage them to attend future events to have more impactful lifestyle/prevention outcomes. Clinical trial information: NCT05239325.

International audience; Purpose Human papillomavirus (HPV) is known to play a role in the development of head and neck squamous cell carcinomas (HNSCC) and to date, no study has reported on the association between oral HPV infection and HNSCC in the Caribbean. The objective was to determine the prevalence of oral HPV infection in the French West Indies (FWI), overall and by HPV genotype, among HNSCC cases and healthy population controls. Method We used data from a population-based case-control study conducted in the FWI. The prevalence of oral HPV was estimated separately among 100 HNSCC cases (mean age 59 years) and 308 population controls (mean age 57 years). Odds ratios (OR) and 95% confidence intervals (CI) were estimated using a logistic regression adjusting for age, sex, tobacco, and alcohol consumption, to assess the association between oral HPV infection and HNSCC. Results Prevalence of oral HPV infections was 26% in controls (30% in men and 14% in women) and 36% in HNSCC cases (36% in men, 33% in women). HPV52 was the most commonly detected genotype, in cases and in controls. The prevalence of HPV16, HPV33, and HPV51 was significantly higher in cases than in controls (p = 0.0340, p = 0.0472, and 0.0144, respectively). Oral infection with high-risk HPV was associated with an increase in risk of HNSCC (OR 1.99, 95% CI 0.95-4.15). HPV16 was only associated with oropharyngeal cancer (OR 16.01, 95% CI 1.67-153.64). Conclusion This study revealed a high prevalence of oral HPV infection in this middle-aged Afro-Caribbean population, and a specific distribution of HPV genotypes. These findings may provide insight into HNSCC etiology specific to the FWI.

ObjectiveTo investigate the association between occupational exposure to welding and the risk of head and neck cancer in a large French population-based case-control study, the Investigation of occupational and environmental CAuses of REspiratory cancers study.MethodsAnalyses were restricted to men (2703 controls and 1588 cases of squamous-cell carcinoma of the oral cavity, oropharynx, hypopharynx and larynx). Welding activity and potential confounders were assessed by detailed questionnaires. ORs and CIs (95% CI) were estimated by unconditional logistic regression, adjusted for age, area of residence, tobacco smoking, alcohol consumption and occupational exposure to asbestos.ResultsWelding was associated with an increased risk of head and neck cancer overall (OR=1.31, 95% CI 1.03 to 1.67). The association was strongest for laryngeal cancer (OR=1.66, 95% CI 1.15 to 2.38) and the risk increased with the cumulative duration (p-trend ConclusionOur findings suggest that welding and several welding-related tasks increase the risk of laryngeal cancer and to a lesser extent oral cancer.

Context The molecular subtype of breast tumours plays a major role in cancer prognosis and treatment options. Triple negative tumours (TN) carry the worst prognosis and affects most frequently women of low socioeconomic status (SES). Studies have shown that non-biologic factors, such as the socioeconomic status could have an influence on tumour biology. To this date no study has been done investigating this association in French women. The objective is to study the association between the SES and the molecular tumour subtype of breast cancer patients in the French county of Cote d’Or. This study benefits from the population data from the Cote d’Or breast cancer registry known for its strict quality control policy. Methods Invasive breast cancer cases between 2003 and 2013 were extracted from the Breast cancer registry database in Cote d’Or. A multivariate analysis was conducted using a hierarchical polytomous regression for the multinomial outcomes for the cancer subtype with HR+/HER2 as reference category. Results A total of 4553 cases were included in our study. There was no significant association found between SES and tumour subtype in French women at diagnosis. Women older than 75 years were less likely to have a TN and HR+/HER2+ breast cancer (OR = 0.66; CI95% = [0.46–0.94] and OR = 0.51; CI95% = [0.37–0.70] respectively). Women with TN tumour subtype had significantly less lymph node invasion when compared to HR+/HER2- subtype (OR = 0.71; CI95% = [0.54–0.92]). Conclusion No significant association was found between socioeconomic status and molecular subtype. Further studies are needed to clarify the mechanisms associated with developing each tumour subtype.