Bulletin électronique de veille Cancer Environnement N° 8 du 11/ 04/ 2014 Ce bulletin de veille signale mensuellement une sélection de documents identifiés dans le cadre de la veille cancer environnement. La méthodologie mise en œuvre est présentée dans la fiche du site cancer environnement : http://www.cancer-environnement.fr/334-Veille-scientifique.ce.aspx Publications récentes Cancer incidence and mortality in France over the 1980–2012 period: Solid tumors Incidence et mortalité des cancers en France durant la période 1980–2012 : tumeurs solides Binder-Foucard F et al., Revue d'Épidémiologie et de Santé Publique, Mars 2014 Position du problème : Cette étude présente les estimations d’incidence et de mortalité par cancer en France entre 1980 et 2012. Méthodes : Parmi les tumeurs solides, 19 localisations cancéreuses ont été analysées. Les données d’incidence proviennent de 21 registres départementaux et correspondent aux cancers invasifs diagnostiqués entre 1975 et 2009. Les données de mortalité par cancer sur cette période ont été fournies par l’Institut national de la santé et de la recherche médicale. L’estimation nationale de l’incidence est basée sur l’utilisation de la mortalité comme corrélat de l’incidence. Les données d’incidence et de mortalité ont été modélisées à l’aide d’un modèle âgepériode-cohorte. Les nombres de nouveaux cas de cancer et de décès entre 2010 et 2012 sont issus de projections à court terme. Résultats : En 2012, le nombre de nouveaux cas de cancer a été estimé à 355 000 et le nombre de décès par cancer à 148 000. L’évolution des taux d’incidence n’était pas linéaire sur l’ensemble de la période. Après une augmentation continue depuis 1980, l’incidence du cancer chez l’homme a diminué entre 2005 et 2012. Cette diminution récente est en grande partie liée à la baisse de l’incidence du cancer de la prostate. Chez la femme, on observe une stabilisation essentiellement due à la modification de l’évolution de l’incidence du cancer du sein. La mortalité est en diminution sur l’ensemble de la période pour la majorité des localisations. L’analyse conjointe de l’incidence et de la mortalité par localisation permet de distinguer les cancers dont l’incidence et la mortalité ont diminué (ex. : estomac) des cancers dont l’incidence et la mortalité ont augmenté (ex. : poumon chez la femme). D’autres cancers combinent une augmentation de l’incidence et une diminution de la mortalité (ex. : thyroïde). Conclusion : Ce travail met en évidence des modifications récentes et marquées de l’évolution de l’incidence, plus particulièrement pour les cancers du sein et de la prostate. 1 The AGRIculture and CANcer (AGRICAN) cohort study: enrollment and causes of death for the 2005–2009 period L'étude de cohorte AGRIculture et CANcer (Agrican): Effectif et causes de décès pour la période 20052009 Levêque-Morlais N et al., Int Arch Occup Environ Health., March, 2014 Objective: To elaborate and describe a large prospective agricultural cohort including males and females in France with various agricultural activities and to study causes of death. Methods: To date, few large prospective cohorts have been conducted among agricultural population. AGRIculture and CANcer cohort is a large prospective cohort of subjects in agriculture studying cancer among active and retired males and females, farm owners and workers, living in eleven areas of France with a population-based cancer registry. Results: Enrollment was conducted from 2005 to 2007 with a postal questionnaire. In January 2008, 180,060 individuals (54 % males, 54 % farm owners, 50 % retired) were enrolled. Mortality was studied until December 2009 (605,956 person-years with standardized mortality ratio (SMR) by comparison with the general population of the areas. Over this period, 11,450 deaths 6,741 in men and 4,709 in women were observed, including 3,405 cancer-related deaths. SMRs were significantly reduced for global mortality (SMR = 0.68, 95 % CI 0.67–0.70 in males and SMR = 0.71, 95 % CI 0.69–0.73 in females) and for death by cancer (SMR = 0.67, 95 % CI 0.65, 0.70 in males and SMR = 0.76, 95 % C: 0.71, 0.80 in females). These results were mainly explained by less frequent smoking-related causes of death (lung cancer, cardiovascular diseases). Nonsignificant excesses of death were observed only for rheumatoid arthritis and arthrosis, suicides (in females), death for event of undetermined intent (in males) and breast cancer in male agricultural workers. Conclusions: These first results are the first ones obtained in France based on a large prospective agricultural cohort showing that farmers would be in healthier condition than the general population Occupation and thyroid cancer Activité professionnelle et cancer de la thyroïde Aschebrook-Kilfoy B et al. Occup Environ Med., Mar 2014 Numerous occupational and environmental exposures have been shown to disrupt thyroid hormones, but much less is known about their relationships with thyroid cancer. Here we review the epidemiology studies of occupations and occupational exposures and thyroid cancer incidence to provide insight into preventable risk factors for thyroid cancer. The published literature was searched using the Web of Knowledge database for all articles through August 2013 that had in their text 'occupation' 'job' 'employment' or 'work' and 'thyroid cancer'. After excluding 10 mortality studies and 4 studies with less than 5 exposed incident cases, we summarised the findings of 30 articles that examined thyroid cancer incidence in relation to occupations or occupational exposure. The studies were grouped by exposure/occupation category, study design and exposure assessment approach. Where available, gender-stratified results are reported. The most studied (19 of 30 studies) and the most consistent associations were observed for radiation-exposed workers and healthcare occupations. Suggestive, but inconsistent, associations were observed in studies of pesticide-exposed workers and agricultural occupations. Findings for other exposures and occupation groups were largely null. The majority of studies had few exposed cases and assessed exposure based on occupation or industry category, self-report, or generic (population-based) job exposure matrices. The suggestive, but inconsistent findings for many of the occupational exposures reviewed here indicate that more studies with larger numbers of cases and better exposure assessment are necessary, particularly for exposures known to disrupt thyroid homeostasis. 2 Alcohol and liver cancer: a systematic review and meta-analysis of prospective studies. Alcool et cancer du foie : une revue systématique et une méta-analyse d'études prospectives. Turati F et al. Ann Oncol. Mar 2014 Despite several studies support a positive association between heavy alcohol consumption and liver cancer risk, a consistent dose-risk relationship has not yet been established. We carried out a systematic review and a metaanalysis of the association between alcohol intake and liver cancer occurrence, following the Meta-analysis Of Observational Studies in Epidemiology guidelines. We searched for cohort and nested case-control studies on the general population published before April 2013, using PubMed and EMBASE. Summary meta-analytic relative risks (RRs) were estimated using random-effect models. We included 16 articles (19 cohorts) for a total of 4445 incident cases and 5550 deaths from liver cancer. Compared with non-drinking, the pooled RRs were 0.91 (95% confidence interval, CI, 0.81-1.02) for moderate drinking (<3 drinks per day) and 1.16 (95% CI, 1.01-1.34) for heavy drinking (≥3 drinks per day), with significant heterogeneity among studies. The dose-risk curve suggested a linear relationship with increasing alcohol intake in drinkers, with estimated excess risk of 46% for 50 g of ethanol per day and 66% for 100 g per day. This systematic review suggests a moderate detrimental role of consumption of 3 or more alcoholic drinks per day on liver cancer, and a lack of association with moderate drinking. Our results have to be taken with due caution on account of the possible limitations of the original studies included in the meta-analysis. Adherence to Mediterranean diet and risk of cancer: A systematic review and meta-analysis of observational studies. Pratique du régime méditerranéen et risque de cancer: Une revue systématique et méta-analyse d'études observationnelles. Schwingshackl L et al, Int J Cancer. Mar 2014 The aim of this research study was to meta-analyze the effects of adherence to Mediterranean diet (MD) on overall cancer risk, and different cancer types. Literature search was performed using the electronic databases MEDLINE, SCOPUS and EMBASE until January 10, 2014. Inclusion criteria were cohort or case-control studies. Study specific risk ratios (RRs) were pooled using a random effect model by the Cochrane software package Review Manager 5.2. Twenty-one cohort studies including 1,368,736 subjects and 12 case-control studies with 62,725 subjects met the objectives and were enclosed for meta-analyses. The highest adherence to MD category resulted in a significantly risk reduction for overall cancermortality/incidence (cohort; RR: 0.90, 95% CI 0.86-0.95, p < 0.0001; I2 = 55%), colorectal (cohort/casecontrol; RR: 0.86, 95% CI 0.80-0.93, p < 0.0001; I2 = 62%], prostate (cohort/case-control; RR: 0.96, 95% CI 0.92-0.99, p = 0.03; I2 = 0%) and aerodigestive cancer (cohort/case-control; RR: 0.44, 95% CI 0.26-0.77, p = 0.003; I2 = 83%). Nonsignificant changes could be observed for breast cancer, gastric cancer and pancreatic cancer. The Egger regression tests provided limited evidence of substantial publication bias. High adherence to a MD is associated with a significant reduction in the risk of overall cancer mortality (10%), colorectal cancer (14%), prostate cancer (4%) and aerodigestive cancer (56%). 3 Effects of exercise on treatment-related adverse effects for patients with prostate cancer receiving androgen-deprivation therapy: a systematic review. Conséquence de l’activité physique sur les effets indésirables liés au traitement anti-androgénique chez des patients atteints de cancer de la prostate : une revue systématique. GardnerJR et al., J Clin Oncol. Feb. 2014 PURPOSE: Androgen-deprivation therapy is a commonly used treatment for men with prostate cancer; however, the adverse effects can be detrimental to patient health and quality of life. Exercise has been proposed as a strategy for ameliorating a range of these treatment-related adverse effects. We conducted a systematic review of the literature regarding the effects of exercise on treatment-related adverse effects in men receiving androgendeprivation therapy for prostate cancer. METHODS: An online electronic search of the Cochrane Library, EMBASE, MEDLINE, CINAHL, SPORTDiscus, and Health Source databases was performed to identify relevant peer-reviewed articles published between January 1980 and June 2013. Eligible study designs included randomized controlled trials as well as uncontrolled trials with pre- and postintervention data. Information was extracted regarding participant and exercise intervention characteristics as well as the effects of exercise on bone health, body composition, physical performance, cardiometabolic risk, fatigue, and quality of life. RESULTS: Ten studies were included, with exercise interventions involving aerobic and/or resistance training. Exercise training demonstrated benefits in muscular strength, cardiorespiratory fitness, functional task performance, lean body mass, and fatigue, with inconsistent effects observed for adiposity. The impact of exercise on bone health, cardiometabolic risk markers, and quality of life are currently unclear. CONCLUSION: Among patients with prostate cancer treated with androgen-deprivation therapy, appropriately prescribed exercise is safe and may ameliorate a range of treatment-induced adverse effects. Ongoing research of high methodologic quality is required to consolidate and expand on current knowledge and to allow the development of specific evidence-based exercise prescription recommendations. Association between physical activity and mortality among breast cancer and colorectal cancer survivors: a systematic review and meta-analysis. Association entre pratique d’activité physique et taux de décès chez des patients atteints de cancer du sein et de cancer colorectal : une revue systématique et méta-analyse. Schmid D et al., Ann Oncol. 2014 Mar 18 BACKGROUND: Physical activity improves physical function during and after cancer treatment, but whether physical activity imparts survival benefit remains uncertain. DESIGN: Using prospective studies published through June 2013, we conducted a systematic review and random-effects meta-analysis of pre- and post-diagnosis physical activity in relation to total and cancer mortality among breast or colorectal cancer survivors. RESULTS: Sixteen studies of breast cancer survivors and seven studies of colorectal cancer survivors yielded 49095 total cancer survivors, including 8129 total mortality cases and 4826 cancer mortality cases. Comparing the highest versus lowest levels of pre-diagnosis physical activity among breast cancer survivors, the summary relative risks (RRs) of total and breast cancer mortality were 0.77 [95% confidence interval (CI) = 0.69-0.88] and 0.77 (95% CI = 0.66-0.90, respectively. For post-diagnosis physical activity, the summary RRs of total and breast cancer mortality were 0.52 (95% CI = 0.42-0.64) and 0.72 (95% CI = 0.60-0.85), respectively. For prediagnosis physical activity among colorectal cancer survivors, the summary RRs of total and colorectal cancer mortality were 0.74 (95% CI = 0.63-0.86) and 0.75 (95% CI = 0.62-0.91), respectively. For post-diagnosis physical activity, the summary RRs of total and colorectal cancer mortality were 0.58 (95% CI = 0.48-0.70) and 0.61 (95% CI = 0.40-0.92), respectively. Each 10 metabolic equivalent task-hour/week increase in post-diagnosis 4 physical activity (equivalent to current recommendations of 150 min/week of at least moderate intensity activity) was associated with 24% (95% CI = 11-36%) decreased total mortality risk among breast cancer survivors and 28% (95% CI = 20-35%) decreased total mortality risk among colorectal cancer survivors. Breast or colorectal cancer survivors who increased their physical activity by any level from pre- to post-diagnosis showed decreased total mortality risk (RR = 0.61; 95% CI = 0.46-0.80) compared with those who did not change their physical activity level or were inactive/insufficiently active before diagnosis. CONCLUSION: Physical activity performed before or after cancer diagnosis is related to reduced mortality risk among breast and colorectal cancer survivors. 5 Actualités et lettres d’information des acteurs Santé Environnement Région Rhône-Alpes Agence Régionale de Santé Rhône-Alpes National Agence nationale de sécurité sanitaire, de l’alimentation, de l’environnement et du travail Air Rhône-Alpes Bulletin de veille bibliographique Nota Bene Cancer de l’Institut National du Cancer (INCa) Lettre d’information de l’INCa Espace Régional de Santé Publique Rhône-Alpes Institut national de recherche en sciences et technologies pour l’environnement et l’agriculture Fédération Rhône-Alpes de Protection de la Nature Lettre d’information de l’Institut National de Recherche et de Sécurité pour la prévention des accidents du travail et des maladies professionnelles Institut de Recherche en Santé Publique Lettre d’information “Ademe et vous” Lettre Santé-Environnement Rhône-Alpes de l’ORS Rhône-Alpes La lettre de la Société Française de Santé Environnement Société Française de Santé Publique Bulletin Flash e-mail SFSP Société Française de Médecine du Travail Nos partenaires Avec le soutien de Pour tout abonnement/désabonnement au e-bulletin ou pour nous faire part d'informations à diffuser dans les prochains numéros, écrivez à [email protected]. 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