Cancer incidence registration and trends in the department of Doubs, France

Abstract

THE CANCER Registry of Doubs is located in the eastern part of France. It covers a population of 478272 (1982 census) and started functioning in 1976. Two thirds of the population lives in urban areas. Reliable data were first published in 1977 in Cancer Inc&nce in Five Continents, vol IV [ 11. Information collected includes site and morphology. Histologic confirmation was obtained in 95.7% of cases. Type of treatment and recent socioeconomic data were also collected. Overall survival is calculated for major sites every 5 years. About 1630 incident cases are recorded each year with a world age standardised incidence of 35 1 for males and 2 15 for females (1983-1986) per 100000. Figure 1 summarises the age standardised incidence rates from major cancer sites between 1983 and 1986: the world standard population has been used in all age-adjustment. The most interesting facets are the high frequency of head and neck cancers (oral cavity, pharynx, larynx) which ranks third after lung and prostate among the male population. The inclusion of non invasive tumours in bladder cancer explain its high incidence. For women, breast cancer accounts for 30% of all tumours (skin cancers excluded) and cancer of the uterus cervix is still slightly more frequent than cancer of the corpus uterus. The trend over time is shown in Table 1 for some sites. There is an increase of all cancers excepted for cervix and brain tumours contrary to what other authors have reported [2]. In males, the incidence rates of lung and larynx cancer remain stable while the incidence of pharynx cancer is still increasing in young and old. Most interesting are the tumours in the female population. Breast cancer and acute leukaemia incidences increased, as has the incidence of lung cancer although remaining at a low level. A downward trend is observed for cancer of the cervix. If younger birth cohorts are considered, the only upward trends are those for cancer of the pharynx in males and breast cancer in females. Changes in the incidence rate of cancer of the prostate cancer must be interpreted with caution, since it seems that an increased accuracy of diagnosis is also likely to explain the incidence increase. Curiously skin melanoma has increased in males while remaining at the same level in females. Blot et al. [3] have described an increase of adenocarcinoma of the oesophagus in the U.S.A., this has not been seen in the Registry of Doubs probably because of the small number of cases. The percentage of multiple tumours is 5.5% in males and 2.5% in females with a relative risk of 5.36 for bronchus cancer and 8.37 for head and neck cancer. Most of the second cancers are located