Luce Danièle, Michel Stéphane, Dugas Julien, Bhakkan Bernard, Menvielle Gwenn, Joachim Clarisse, Deloumeaux Jacqueline
INSERM UMRS 1085-Institut de Recherche en Santé, Environnement et Travail (IRSET), Faculté de Médecine, Campus de Fouillole, BP 145, 97154, Pointe-à-Pitre, Guadeloupe, France.
University of Rennes 1, Rennes, France.
Cancer Causes Control. 2017 Nov;28(11):1305-1312. doi: 10.1007/s10552-017-0946-3. Epub 2017 Aug 28.
Social inequalities in cancer incidence and mortality have been reported in France, but no data are available for the French overseas territories. Our objective was to explore the association between cancer incidence and the socioeconomic level of the residence area in the French West Indies.
Cancer incidence data were obtained from the cancer registries of Guadeloupe and Martinique (2009-2010). To assess socioeconomic status, we developed a specific index of social deprivation from census data at a small area level. We used Bayesian methods to evaluate the association between cancer incidence and the deprivation index, for all cancers combined and for the major cancer sites.
There was no clear association between area-based deprivation and the incidence of all cancers combined. In men, higher area deprivation was associated with a higher incidence of prostate cancer (relative risk (RR) 1.25, 95% credible interval (CI) 1.04-1.49; RR 1.08, CI 0.91-1.29 in the categories of intermediate and high deprivation, respectively, compared to low deprivation), but was not associated with respiratory cancer. Women living in the most deprived areas had a higher incidence of stomach (RR 1.77, CI 1.12-2.89), breast (RR 1.15, CI 0.90-1.45), and cervical (RR 1.13, CI 0.63-2.01) cancers and a lower incidence of respiratory cancer (RR 0.65, CI 0.38-1.11).
These first results in the French West Indies suggest specific patterns for some cancer sites that need to be further investigated.
法国已报告了癌症发病率和死亡率方面的社会不平等现象，但法国海外领地尚无相关数据。我们的目标是探讨法属西印度群岛癌症发病率与居住地区社会经济水平之间的关联。
癌症发病率数据取自瓜德罗普岛和马提尼克岛的癌症登记处（2009 - 2010年）。为评估社会经济地位，我们根据小区域层面的人口普查数据制定了一个特定的社会剥夺指数。我们使用贝叶斯方法评估所有癌症综合以及主要癌症部位的癌症发病率与剥夺指数之间的关联。
基于区域的剥夺与所有癌症综合发病率之间没有明确关联。在男性中，较高的区域剥夺与前列腺癌发病率较高相关（相对风险（RR）1.25，95%可信区间（CI）1.04 - 1.49；与低剥夺相比，中等和高剥夺类别中的RR分别为1.08，CI 0.91 - 1.29），但与呼吸道癌症无关。生活在最贫困地区的女性胃癌（RR 1.77，CI 1.12 - 2.89）、乳腺癌（RR 1.15，CI 0.90 - 1.45）和宫颈癌（RR 1.13，CI 0.63 - 2.01）发病率较高，而呼吸道癌症发病率较低（RR 0.65，CI 0.38 - 1.11）。
法属西印度群岛的这些初步结果表明某些癌症部位存在特定模式，需要进一步研究。
