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J Faivre

Publications and source records attributed to J Faivre.

At least 127 records · Page 7Linked to original sources
PubMed1999

[Prognostic factors of recurrence and/or death in colorectal cancer: multistate modeling].

Analysis of survival of patients with cancer sets particular epidemiological and statistical problems, especially when one wants to take into account metastasis or local recurrences. Cox's model does not allow modeling multiple events. Wei et al. have proposed an extension of Cox's model, by formulating the marginal distributions of multivariate failure times, which allows testing covariates effects on different events. We applied these methods to data from the Registry of Digestive Tumors of Burgundy, France. Prognostic factors of recurrence are rectal location of tumor and advanced stage at diagnosis. Prognostic factors of death are male gender, age greater than 75, rectal location and advanced stages. However, relative risk of recurrence for advanced stages is significantly greater than relative risk of death (p=4.10(-3)), while tumor location has the same influence on the two events.

Aged↗
PubMed1999

Family history, metabolic gene polymorphism, diet and risk of colorectal cancer.

Colorectal cancer is thought to be largely due to dietary factors. There is evidence of familial aggregation of colorectal cancer suggesting that genetic susceptibility may be important in the aetiology of the disease. Only limited data are available comparing risk factors for colorectal cancer with and without a family history. There are arguments suggesting that individuals with a first-degree relative with colorectal cancer are at a greater risk from a diet high in energy than individuals without such a family history. Failure to take into account both genetic and environmental factors can lead to bias in the estimation of disease risk. Genetic polymorphisms interact with dietary intake. A number of associations have been observed between specific genetic polymorphisms and colorectal cancer. But there are inconsistencies between studies, because of methodological limitations in initial studies. Different effects of dietary factors on colorectal cancer risk among individuals with different genotypes or of different effects of a genotype on colorectal cancer risk among individuals with different exposures need to be addressed in future works.

Acetylation↗
PubMed1998

Lymph node harvest reporting in patients with carcinoma of the large bowel: a French population-based study.

BACKGROUND: In patients with resected colorectal carcinoma, lymph node involvement has particular importance for patient prognosis and adjuvant therapy. The network of French cancer registries (FRANCIM) established a study aimed at analyzing the validity of lymph node harvest reporting in a population-based sample. METHODS: The study population was comprised of 1081 resected tumors without distant visceral metastasis and classified using the TNM system. Correlation between the number of examined lymph nodes and the staging of the tumor was examined by logistic regression analysis to establish an estimate of the minimum number of lymph nodes required to determine whether a tumor is lymph node negative. RESULTS: An average of 7.7 +/- 0.2 lymph nodes were examined per specimen in the 851 patients for whom the number of lymph nodes examined was known. The proportion of cases classified as N+ increased significantly with the number of examined lymph nodes (chi-square trend = 24.6; P < 0.0001). If the probability of correct lymph node status assessment is 1 in the reference group (comprised of pathology reports of specimens with > or = 16 examined lymph nodes), the probability of correct N+/N- dichotomization was significantly < 1 for the 1 to 3 lymph nodes group and the 4 to 7 lymph nodes group (i.e., 53.7% of cases). CONCLUSIONS: To comply with current rules for adjuvant chemotherapy, surgeons must provide pathologists with at least eight lymph nodes for optimal N+/N- dichotomization to reduce the risk of misclassification and understaging.

Aged↗
PubMed1998

Diet and squamous-cell cancer of the oesophagus: a French multicentre case-control study.

An increasing number of reports suggest that diet has an impact on oesophageal cancer risk in Western countries, where alcohol and tobacco are held to be the major determinants of the risk. The aim of our study was to identify dietary factors influencing the risk of oesophageal cancer in France and to determine whether certain of these could explain some of the geographical variations. We conducted a multicentre case-control study in 3 regions expected to have different diet and drinking habits (Normandy, Burgundy and Midi Pyrénées). Two hundred eight cases and 399 controls, all males, were interviewed about their eating, drinking and smoking habits. After proper adjustment for drinking and smoking, high consumption of butter and low consumption of fresh fish, vegetables and fruits were associated strongly and independently with an increase in oesophageal-cancer risk. Consistently, cholesterol appeared as a risk factor and vitamin E, vitamin D and phosphorus as independent protective factors. The protective effect of citrus and other fresh fruits (vitamin C) was confined strictly to heavy drinkers. Our findings suggest that more than one-third of the high incidence of oesophageal cancer in northwest France could be explained by the local excess in butter consumption, whereas geographical variations in consumption of dietary protective factors could explain no more than 10% of it. Overall, a large proportion (57%) of the excess incidence of oesophageal cancer in northwest France could be explained by local dietary habits, e.g., drinking hot Calvados liquor and excessive consumption of butter.

Alcohol Drinking↗
PubMed1998

Colonoscopic screening in first-degree relatives of patients with 'sporadic' colorectal cancer: a case-control study. The Association Nationale des Gastroentérologues des Hôpitaux and Registre Bourguignon des Cancers Digestifs (INSERM CRI 9505)

BACKGROUND & AIMS: A screening policy has not been well defined in first-degree relatives of patients with sporadic colorectal cancer. This study estimated the risk of colorectal adenoma in a cohort of individuals with only 1 affected first-degree relative. METHODS: A total of 476 first-degree relatives (age, 40-74 years) of 195 patients with sporadic colorectal cancer were offered a colonoscopy. Each examined relative was matched with 2 controls for age, sex, symptoms, and center. The prevalence of colorectal adenomas was compared using a multiple logistic regression analysis. RESULTS: In 185 relatives, odds ratios were 1.5 (95% confidence interval [CI], 1.0-2.4) for adenomas, 2.5 for large adenomas (95% CI, 1.1-5.4), 1.2 for small adenomas (95% CI, 0.7-1.9), and 2.6 (95% CI, 1.3-5.1) for high-risk adenomas (> or = 1 cm in size and/or with a villous component). The prevalence of high-risk adenomas in relatives was higher when the index patient was younger than 65 years, was male, and had distal rather than proximal cancer. CONCLUSIONS: Subjects with only 1 affected first-degree relative are at increased risk for developing large adenomas.

Adenoma↗
PubMed1998

Time trends and age-period-cohort effects on the incidence of primary liver cancer in a well-defined French population: 1976-1995.

BACKGROUND/AIMS: There is growing interest worldwide in primary liver cancer. The aim of this study was to describe the incidence of this cancer over a 20-year period in a well-defined French population. METHODS: Time trends by 4-year period were studied by sex, age group, place of residence, histological type and associated cirrhosis. Trends were also analysed using the age-period-cohort model. RESULTS: Primary liver cancer incidence in men increased from 7.5/100000 for the period 1976-79 to 10.2/100000 for the period 1992-95. The mean annual variation was +2.2%, (p<0.05). The increase in incidence was seen mainly in the 55-64 and 65-74 age groups and concerned hepatocellular carcinomas. In men, the increase in incidence rates with time was observed mainly in rural areas, whereas incidence rates in urban areas remained stable. The rise in incidence was due mostly to an increase in primary liver cancer with cirrhosis, in relation to a progressive increase in post-hepatitic cirrhosis and a recent increase in alcoholic cirrhosis. The estimated cumulative risk for the life span 30-74 years increased from 0.8% for the 1904-1908 cohort to 2.1% for the 1934-1938 cohort. There was no significant trend in female rates. CONCLUSIONS: In France, incidence rates for primary liver cancer are increasing in men, whilst they are remaining stable in women. Our data confirm the primary importance of alcohol in the aetiology of this cancer. Further studies are necessary to unravel the respective roles of alcohol and hepatitis C virus in the increasing incidence of primary liver cancer.

Adult↗
PubMed1998

Survival of colorectal cancer patients in Europe during the period 1978-1989. EUROCARE Working Group.

This study concerns the survival of European patients diagnosed between 1978 and 1989 with colorectal cancer. Variations in survival in relation to age, country and period of diagnosis were examined. Data from the EUROCARE study were supplied by population-based cancer registries in 17 countries to a common protocol. Five years after diagnosis, relative survival rates were 47 and 43% for cancers of the colon and rectum, respectively. Survival decreased with increasing age: the relative risk of dying for the oldest patients (75+) was 1.39 for rectum and 1.54 for colon compared with the youngest patients (15-44 years). In 1985-1989 survival from colorectal cancer differed significantly between different European countries: the Nordic countries (Denmark excluded), The Netherlands, Switzerland, France and Austria were characterised by high survival, whilst Eastern European countries, the U.K. and Denmark were characterised by low survival. There was a general improvement in survival over the period 1978-1989: from 40 to 48% for colon cancer and 38 to 46% for rectal cancer. For neither cancer site did between-country survival differences narrow over the study period. Intercountry and time differences in survival differences are probably related to stage at diagnosis and postoperative mortality.

Adolescent↗
PubMed1998

Survival of patients with oesophageal and gastric cancers in Europe. EUROCARE Working Group.

The EUROCARE study is a European Union project to collect survival data from population-based cancer registries and analyse them according to standardised procedures. We investigated and compared oesophageal and gastric cancer survival in 17 countries between 1985 and 1989. Time trends in survival over the 1978-1989 period were also investigated in 13 countries. The overall European 1-year relative survival rates were 33% for oesophageal cancer and 40% for gastric cancer. The corresponding 5-year relative survival rates were 10 and 21%, respectively. Important intercountry survival differences exist within Europe for oesophageal and gastric cancer. Taking the European average as the reference, the relative risk (RR) of death at 5 years was at least 30% higher in Denmark, Poland, Estonia and Slovenia for oesophageal cancer and in Denmark, England, Scotland and Poland for gastric cancer. In the other countries survival figures were close to the European average. Gender had little influence on survival, whilst age at diagnosis was inversely related to prognosis. There was a slight improvement between 1978 and 1989 in 5-year overall relative survival rates for both oesophageal cancer (RR = 0.80, 95% confidence interval (CI) 0.72-0.90) and gastric cancer (RR = 0.88, 95% CI 0.82-0.94). Differences in quality of care and stage at diagnosis can explain in part the differences in survival found in the EUROCARE countries. Significant improvement in prognosis has still to be achieved.

Adolescent↗
PubMed1998

Survival of patients with primary liver cancer, pancreatic cancer and biliary tract cancer in Europe. EUROCARE Working Group.

The EUROCARE Study is a European Union project to assemble survival data from population-based cancer registries and analyse them according to standard procedures. We investigated and compared liver, pancreatic and biliary tract cancer survival in 17 countries from 1985 to 1989. Time trends in survival over the 1978-1989 period were also investigated in 12 countries. The overall European mean 1 year relative survival was 16% for primary liver cancer, 26% for biliary tract cancer and 15% for pancreatic cancer. The corresponding 5-year relative survival was 5, 12 and 4%, respectively. Taking the European average as the reference, the relative risk (RR) of death was at least 20% higher for the three cancers in Denmark and Estonia. Survival tended to be higher in Spain for primary liver cancer and biliary tract cancer. Gender had little influence on survival whilst age at diagnosis was inversely related to prognosis. There was an improvement in 1-year relative survival rate for primary liver cancer: relative risk (RR) of 0.68 (95% confidence interval (CI) of 0.60-0.77) for 1987-1989 versus 1978-1980 and biliary tract cancer (RR 0.77, 95% CI 0.68-0.87). There was less variation in 5-year relative survival rate over time. Some intercountry survival differences for primary liver, biliary tract and pancreatic cancers exist over Europe. Differences in quality of care, in particular treatment aggressiveness, may explain some of these differences in survival. New approaches to the management of these cancers need to be found.

Adolescent↗
PubMed1998

How to ensure data security of an epidemiological follow-up: quality assessment of an anonymous record linkage procedure.

A computerised record hash coding and linkage procedure is proposed to allow the chaining of medical information within the framework of epidemiological follow-up. Before their extraction, files are rendered anonymous using a one-way hash coding based on the standard hash algorithm (SHA) function, in order to respect the legislation on data privacy and security. To avoid dictionary attacks. two keys have been added to SHA coding. Once rendered anonymous, the linkage of patient information can be accomplished by means of a statistical model, taking into account several identification variables. Quality assessment of this anonymous record linkage procedure shows a specificity of 100% and a sensitivity of 95%.

Algorithms↗
PubMed1998

A 15-year series of gastrointestinal non-Hodgkin's lymphomas: a population-based study.

Data from the Registry of Digestive tumours of the Département of Côte d'Or (France) were used to study the characteristics of gastrointestinal non-Hodgkin's lymphomas in the 1976-90 period. The mean annual age-standardized incidence rate was 0.94 per 100,000 for men, and 0.54 per 100,000 for women. Incidence varied little during the study period. Overall 5-year survival rate was 34.3 +/- 5.6%.

Adolescent↗
PubMed1998

Prognostic comparison of the pathological classifications of gastric cancer: a population-based study.

AIMS: There is controversy over the value of the pathological classifications of gastric carcinomas in the prediction of patient survival. This study was designed to assess the prognostic value of four widely used pathological classifications, in addition to classical prognostic factors. METHODS AND RESULTS: Records from the population-based registry of digestive tract tumours in the department of Côte d'Or (France) have been analysed. All available histopathological slides of gastric cancer resected between 1976 and 1985 were reviewed and classified according to World Health Organization (WHO), Laurén, Ming and Goseki pathological coding systems. A relative survival analysis was performed using a relative survival model with proportional hazard applied to net mortality by interval. WHO, Laurén or Goseki classifications were not found to be independent prognostic factors. In addition to advanced age group, depth of parietal involvement, nodal involvement, presence of metastases, tumour site and gross appearance of the tumour, the Ming's infiltrative type was associated with a lower survival. CONCLUSION: This study suggests an independent prognostic value of the Ming subtypes with respect to survival in patients resected for gastric carcinoma.

Adult↗
PubMed1998

Primary prevention of colorectal cancer through fibre supplementation.

Epidemiological studies have emphasized the importance of diet in the etiology of large bowel cancer. A high intake of dietary fibre has been hypothesized to decrease the risk of colorectal cancer. This hypothesis is now being tested within the framework of intervention studies. Supplemental fibre is being used in four chemopreventive trials as wheat bran (22.5 g/day together with vitamins C and E, New York study; 25 g/day, Australian study; 50 g/day, Toronto study; 13.5 g/day, Arizona study) and in one trial as ispaghula husk (a mucilaginous substance) at 3.8 g/day (European Cancer Prevention Organization study). One study is evaluating the effect of fibre on adenoma size in patients with familial polyposis and an intact rectum, and the other four studies are focusing on the recurrence of adenoma in patients with previous adenomas. The results available so far provide some evidence for the inhibition of adenoma growth through a high-fibre and/or low-fat diet. Further results are expected within a year. If there is sufficient evidence for a protective effect of dietary fibre on colorectal carcinogenesis, a simple, safe and inexpensive prophylaxis for a very common cancer will be indicated.

Chemoprevention↗
PubMed1998

[Incidence and prevalence of colostomies. The future of stoma societies. Results of a Côte-d'Or survey. Federation of Stoma Patients in France].

Few data are available in France about the impact of Ostomy Associations in the population of patients with permanent colostomy. The aim of this study was to assess the percentage of patients with permanent colostomy involved in local Ostomy Associations in a well-defined population (Côte-d'Or department, 493,931 inhabitants) in 1992. A minimum number of incident colostomy cases was computed using data from the Digestive Tract Tumor Registry in case of cancer and using the surgical reports from the University Hospital in case of benign disease. The maximum number of incident cases was computed using results from a survey conducted by the Public Administration (Social Security) during the same period. An interval of prevalent cases was assessed the number of collecting pouches based on sold during 1992 in the same area. A colostomy was set up in 37 to 84 patients. The number of prevalent cases was in a range of 274 to 410 patients. The corresponding percentages of Ostomy Associations members were included in a 8.3% to 19% range for incident cases and 9.5% to 19% for prevalent cases. These percentages are less than 30%, which is the presumed value previously evaluated in a survey conducted among physicians. As the incidence of colostomy cases continues to decline regularly, more effective methods must be developed to maintain a constant number of members.

Colostomy↗
PubMed1998

[Superficial cancer of the stomach: evolution of their characteristics over a 20 year period in one population].

OBJECTIVES: The aim of this study was to analyse the incidence, treatment and prognosis of early gastric cancer in a population-based series and to draw a picture of time trends. METHODS: Over a 20-year period (1976-1995), 80 early gastric cancers were diagnosed in the Côte-d'Or area (493,000 residents). Incidence rates were calculated by sex, age groups and 5-year periods. Prognostic factors were determined using the Kaplan-Meier method and the Cox model. RESULTS: Age-standardized incidence rates were 0.8/100,000 in men and 0.3/100,000 in women. Incidence increased slightly over time (NS) and their proportion among gastric cancers increased from 3.4% (1976-1980) to 7.9% (1991-1995) (P < 0.01). Among these cancers, 25 were intramucosal (31.3%), 55 were submucosal (68.8%) and 8 had lymph node metastases (10.0%). Overall 21 patients (24.1%) had already been treated for a peptic ulcer. The 5-year crude survival rate was 63.1% and the corresponding net survival rate was 86.3%. Lymph node metastases, location, sex and cancer extension and age were independent prognostic factors. CONCLUSIONS: Though it is on the increase, the proportion of early gastric cancers remains low among gastric cancers. This study confirms the importance of performing a gastroscopy with biopsy upon each bout of ulcer and that the prognosis is lower than suggested by hospital based series.

Aged↗