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J Faivre

Publications and source records attributed to J Faivre.

At least 163 records · Page 9Linked to original sources
PubMed1997

Participation in faecal occult blood screening for colorectal cancer in a well defined French population: results of five screening rounds from 1988 to 1996.

OBJECTIVE: To evaluate the influence on compliance of demographic variables and of the way of proposing a faecal occult blood test in a colorectal cancer mass screening programme. SETTING: Well defined population in Burgundy (France). METHODS: From 1988 to 1996 five screening rounds were conducted in people aged 45 to 74 on entering the study. The screening test was provided free of charge by primary care physicians over a four month period, then mailed to non-consultants, followed by a potential reminder letter. The whole population was invited to participate in each screening campaign. RESULTS: During the five successive rounds, compliance was 52.8%, 54.0%, 57.3%, 58.3%, and 56.2%. It was higher in women than in men, in those initially aged 50 to 69 than in the extreme age groups, and in urban than in rural areas. Overall, 68.7% of the invited population completed at least one screening test and 37.2% completed the five rounds. Among those who participated once in a screening campaign, between 79.6% and 87.6% participated in the succeeding ones. Compliance was higher when the test was proposed by GPs (varying between 85.2% and 94.0% according to the screening campaign) than when it was sent by post (varying between 26.0% and 33.7%). CONCLUSION: In France, a participation rate of over 50% can be achieved in colorectal cancer screening by means of a faecal occult blood test. To achieve this, primary care physicians have to play an active part in the programme and the test must be mailed to non-consultants.

Aged↗
PubMed1997

[Digestive cancers in France. Geographic distribution and estimation of national incidence].

OBJECTIVES: The purpose of this study was to compare the incidence of digestive cancers in 9 French departments and to give an estimate of this incidence for the whole of France, based on this data. METHODS: This study focused on the 1983-1987 period. The record quality for the 9 included registries (Calvados, Côted'Or, Doubs, Haute-Garonne, Hérault, Isère, Bas-Rhin, Somme, Tarn) has been assessed by the National Committee of Registries. The crude incidence rates and those standardized according to the world population have been worked out per localization and per sex. Incidence and mortality rates per department as well as mortality rates for the whole of France have enabled the assessment of the incidence and number of new digestive cancer cases per year. RESULTS: Esophagus and liver cancers are distinguished by large incidence disparities, fluctuating in a ratio of 1 to 5, and by a high sex ratio. In other localizations, incidence rates vary in a ratio of 1 to 2. The incidence rates of digestive cancers were especialy high in the Bas-Rhin department. They tended to be higher in Côte-d'Or, Doubs, Calvados and Somme, than in Haute-Garonne. Hérault and Tarn. The estimated number of digestive cancers was 30,071 in males and 19,951 in females: colorectal cancer was particularly frequent, 14,179 cases and 12,228 cases, respectively. CONCLUSION: There are some geographical variations, from one region to another, in digestive cancer incidence in France more pronounced for esophagus and liver cancers than for other localizations. Because of its frequency, colorectal cancer represents a serious problem for public health.

Adolescent↗
PubMed1997

Environmental and familial risk factors in relation to the colorectal adenoma--carcinoma sequence: results of a case-control study in Burgundy (France).

A case-control study in the Cote-d'Or area (Burgundy, France) investigated the relationship between environmental and familial risk factors and the different steps of the adenoma-carcinoma sequence. Two adenoma groups (< 10 mm and > or = 10 mm), a polyp-free control group, a colorectal cancer group and a general population control group were recruited. Tobacco was associated with the risk of adenomas, and alcohol with the risk of large adenomas. They proved to be independently related to large adenoma formation when compared with controls. There was no association with cancer risk. Refined cereals, delicatessen, offal and fats appear to be risk factors along the adenoma-carcinoma sequence. This data does not support an increased risk with high consumption of fresh meat, or a protective effect of dairy products and calcium. A high consumption of vegetables was a protective factor for cancer, mainly in men. Excess weight and body mass index influenced the earlier step of the adenoma carcinoma sequence and excess calorie intake was risk factor for cancer. The decision to study precancerous lesions as well as cancer appears fruitful. Results suggest that the three stages of large bowel carcinogenesis are partly related to diet in different ways. They are concordant with risk factors recorded for colorectal cancer, but suggest some local specificities.

Adenoma↗
PubMed1997

Chemoprevention of metachronous adenomas of the large bowel: design and interim results of a randomized trial of calcium and fibre. ECP Colon Group.

A European multicentric intervention study, led by the colon group of the European Cancer Prevention Organization, is under way. The main aim of the study is to test the efficacy of oral calcium supplementation with 2 g calcium per day and oral dietary supplementation with mucilaginous substances (as 3.8 g of ispaghula husk) on adenoma recurrence. Secondary aims are the study of treatment efficacy on colonic cell proliferation and on stool bile acid and sterol concentration. Serum and plasma samples are also collected. To better interpret the effect of the intervention, a diet history questionnaire and an aspirin and anti-inflammatory drug questionnaire are administered. The aim will be achieved through a randomized placebo-controlled clinical trial using a parallel design in patients aged 35 to 75 at entry with a complete colonoscopy and a clean colon. Overall, 655 subjects have been included. All randomized patients are followed up every six months for 3 years. If one of the evaluated interventions proves efficient, the benefits of a simple, safe and inexpensive prophylaxy for a very common cancer will be clear.

Adenoma↗
PubMed1997

Population-based study of diagnosis, treatment and prognosis of gastric cancer.

BACKGROUND: Gastric cancer remains a common cancer with a poor prognosis. Improving trends seen in Japan have not yet been observed in Western countries. METHODS: A population-based series of 1329 patients with gastric cancer diagnosed over an 18-year period in Côte d'Or, France, was used to establish time trends in diagnostic strategy, treatment and prognosis. RESULTS: The use of endoscopy alone increased from 2.7 per cent in 1976-1978 to 76.6 per cent in 1991-1993 (P < 0.0001). This trend was associated at first with a significant decrease in the use of radiography alone, then by a significant decrease in the use of both radiography and endoscopy. The proportion of resections for cure increased from 37.9 per cent in 1976-1978 to 50.0 per cent in 1991-1993 (mean 3-year variation + 5.8 per cent, P < 0.01). The proportion of cases confined to the gastric wall increased from 6.1 to 11.7 per cent (mean 3-year variation + 13.1 per cent, P < 0.01), while the proportion of other stages remained stable. The operative mortality rate decreased dramatically from 25.6 per cent in 1976-1978 to 13.6 per cent in 1991-1993 (P < 0.001) and the 5-year relative survival rate rose from 12.8 per cent in 1976-1978 to 26.4 per cent in 1988-1990 (P < 0.001). CONCLUSION: This study has demonstrated that improvements in the care of patients with gastric cancer have been achieved, but that further progress may be made.

Adult↗
PubMed1997

Population-based study of the treatment and prognosis of carcinoma of the rectum.

BACKGROUND: Few population-based studies address the issue of treatment of carcinoma of the rectum (15 cm or less from the anal verge) both from surgical and epidemiological aspects. METHODS: Some 827 patients were analysed in the cancer registry of the Côte-d'Or (Burgundy, France) from 1976 to 1990 (493,931 inhabitants). RESULTS: Resection for cure increased from 57.2 per cent before 1981 to 77.0 per cent after 1985 (P < 0.001), and the proportion of Dukes A and B cases from 35.8 to 52.5 per cent (P < 0.001). Among patients resected for cure, continence-preserving resections were performed more frequently during the 1986-1990 period (48.0 per cent) than during the two previous 5-year periods (20.0 per cent; P < 0.001), more often in women, in the upper half of the ampulla and for tumours of less than 45 mm. The operative mortality rate after curative surgery decreased from 13.9 to 3.7 per cent (P < 0.001) between the first and the last period whereas the 5-year crude survival rate rose from 25.8 to 42.6 per cent (P < 0.001). Age, stage of disease and period of diagnosis were independent prognostic factors of death in a relative survival model. CONCLUSION: This study indicates that significant advances have been achieved at a population level in the treatment of rectal cancer in terms of diagnosis, continence-preserving procedures and survival.

Aged↗
PubMed1997

[Endoscopic monitoring after excision of colorectal cancer].

The aim of coloscopy after radical colorectal surgery for cancer is: to find another tumor or a local recurrence. The policy must be adapted. When the preoperative approach is inadequate, coloscopy must performed between 3 to 6 months. After complete polypectomy, a coloscopic survey significantly reduces mortality and the incidence of colorectal cancer and has to be done at 3 years and then every 5 years. Data are not sufficient to establish a strategy for the local recurrence survey. The patients aged 75 and over, do not necessarily require repeated coloscopy.

Adenoma↗
PubMed1996

Transanal electroresection of small rectal cancer: a sole treatment?

PURPOSE: Because abdominoperineal resection is associated with high morbidity and mortality, there is interest in local treatment of distal rectal carcinoma. Our technique of transanal electroresection ensures full-thickness tumor excision and complete histopathologic examination. METHODS: From July 1983 to July 1990, 227 patients underwent surgery. Criteria for cure were no extramural invasion (61 exclusions) and negative margins (34 exclusions). Six patients underwent postoperative radiotherapy and, therefore, were excluded. RESULTS: Among those included were 126 patients (66 men), who had a mean age of 68 +/- 11 (median, 68) years. Median tumor size was 35 mm. Distance from anal verge was less than 6 cm for 68 percent and 6-10 cm for 30 percent of patients. Deepest layer invaded was as follows: submucosa (T1), 35 percent; inner muscular layer (T2a), 42 percent; outer muscular layer (T2b), 23 percent. There was one postoperative death. Immediate postoperative course was uneventful for 94 percent of patients; at long-term, five cases of incontinence and two stenoses were noted (6 patients). Median follow-up was 88 (1-137) months. Global survival was 71 and 46 percent, and cancer-specific survival was 85 and 81 percent at 5 and 10 years, respectively. Of 35 patients (28 percent) with recurrence, 24 were treated. Global survival after recurrence was 72 and 50 percent at one and two years, respectively. The only pejorative prognostic factors isolated for survival or recurrence were mucinous contingent and intratumoral vascular invasion. CONCLUSION: Results of local treatment for rectal carcinoma in selected patients are favorable (5-year specific survival, 85 percent). Decisive prognostic factors are seldom isolated, but some patients would benefit from adjuvant therapy.

Adult↗
PubMed1996

Multiple primary cancers and estimation of the incidence rates and trends.

The use of different registration rules from one registry to another, both generally and also for paired organs, leads to variations in the proportion of multiple primary cancers: in men, from 0.4 to 4.9% for the colon, 0.1 to 2.7% for the lung, and 4.1 to 8.6% for the mouth and pharynx. Subjective factors, often impossible to verify, contribute to these variations. The impact on the estimation of incidence rates and trends is not negligible for cancers of the mouth and the pharynx and for all the cancers taken together. The trend towards an increase of cancers of the mouth and pharynx in the Bas-Rhin disappeared when the incidence was expressed taking only the first cancer (incidence by individual) into consideration, and the differences in incidence between the Calvados and the Bas-Rhin registries for the same site also disappeared. In the absence of harmonisation of the rules and methods followed for registration, incidence by individual is the only approach which makes it possible to compare incidence rates and trends between registries.

Breast Neoplasms↗
PubMed1996

Calcium, phosphorus, vitamin D, dairy products and colorectal carcinogenesis: a French case--control study.

A protective effect of calcium against colorectal cancer has been described in Anglo-Saxon but not in Latin communities, and no such effect has been observed regarding adenomas. We investigated the relationship between calcium, dairy products and the adenoma-carcinoma sequence in a French region by comparing small adenoma ( < 10 mm, n = 154), large adenoma (n = 208) and polyp-free (n = 426) subjects, and cancer cases (n = 171) with population controls (n = 309). There was no protective effect of calcium against colorectal tumours except for low fat calcium and large adenomas in men (OR for highest quintile = 0.3, P for trend = 0.06). There was even a trend towards an increased risk of cancer with dairy calcium in men and non-dairy calcium in women. Vitamin D was inversely related to the risk of small adenomas in women (OR for highest quintile = 0.4, P for trend = 0.04). Regarding dairy products, only consumption of yoghurt displayed an inverse relationship with risk of large adenomas, in both men and women. These data failed to demonstrate a protective effect of calcium against colorectal carcinogenesis. They suggest that the type of dairy product might be the important factor with regard to prevention of colorectal tumours.

Adenoma↗
PubMed1996

Folate and alcohol intakes: related or independent roles in the adenoma-carcinoma sequence?

Epidemiologic studies have suggested that high alcohol and low folate intakes might be jointly associated with colorectal tumors via DNA metabolism. We investigated this hypothesis in a case-control study comparing small adenoma (< 10 mm, n = 154), large adenoma (n = 208), and polyp-free (n = 426) subjects, recruited after colonoscopy, and cancer cases (n = 171) with population controls (n = 309). Odds ratios for the fifth vs. the first quintile of intake (OR5) were as follows: Folate intake was related to the risk of small and large adenomas compared with polyp-free subjects [OR5 = 0.5, 95% confidence interval (CI) 0.3-1.0; OR5 = 0.5, 95% CI 0.3-1.0, respectively], whereas alcohol was related to risk of large adenomas (OR5 = 4.1, 95% CI 2.1-8.1), but not of small adenomas (OR5 = 1.2, 95% CI 0.7-2.2). In large adenomas, there was some interaction between alcohol and folate, with a stronger protective effect of folate with high alcohol intake and a stronger risk with alcohol with low folate intake. For cancer patients compared with general population controls, neither alcohol (OR5 = 1.6, 95% CI 0.8-3.0) nor folates (OR5 = 1.0, 95% CI 0.5-2.0) were related to risk. Our data support the hypothesis that folate intake might be mostly beneficial to prevent adenoma formation but might have an additional protective effect against adenoma growth associated with alcohol.

Adenoma↗
PubMed1996

Inflammatory cells infiltrating human colorectal carcinomas express HLA class II but not B7-1 and B7-2 costimulatory molecules of the T-cell activation.

Colon cancer cells express potentially immunogenic proteins but are not rejected by the immune system. To induce an effective immune response, antigenic peptides have to be presented to T lymphocytes by professional antigen-presenting cells in association with HLA class II molecules. Antigen-presenting cells also have to express B7 family molecules, B7-1 and B7-2, which deliver the costimulatory signals that are required to prevent T cell anergy. We studied B7-1 and B7-2 expression by the antigen-presenting cells that infiltrate colorectal cancer stroma. In 25 samples of colorectal carcinomas, a panel of monoclonal antibodies was used to label macrophages, dendritic cells, and T lymphocytes that infiltrate the tumor stroma and the morphologically normal distant mucosa. The expression of HLA class II and B7 molecules involved in T-cell activation was studied using specific monoclonal antibodies. Biopsy pieces from two patients with active Crohn's disease were used as controls. All of the samples were heavily infiltrated by macrophages and/or dendritic cells that strongly expressed HLA class II molecules. In contrast, antibodies to B7-1 and/or B7-2 stained no cells in 16 of the 25 samples of colorectal tumors and less than 1% of the inflammatory cells that infiltrated tumor stroma of the other nine tumor samples. B7 molecules were also poorly expressed by rare cells in the lamina propria of the morphologically normal colorectal mucosa. In contrast, many inflammatory cells that infiltrated the two Crohn's disease samples strongly expressed B7-1 and B7-2, especially in the granulomas. We conclude that most HLA class II+ inflammatory cells that infiltrate colorectal cancers do not express the B7-1 and B7-2 costimulatory molecules. This defect may contribute to the failure of the immune system to recognize tumor cells as antigenic.

Adenocarcinoma↗