Author:
Defossez G.,Uhry Z.,Delafosse P.,Dantony E.,d’Almeida T.,Plouvier S.,Bossard N.,Bouvier A. M.,Molinié F.,Woronoff A. S.,Colonna M.,Grosclaude P.,Remontet L.,Monnereau A.,Amadeo Brice,Baldi Isabelle,Bara Simona,Bouvier Anne-Marie,Bouvier Véronique,Colonna Marc,Coureau Gaëlle,Cowppli-Bony Anne,Dabakuyo-Yonli Sandrine,d’Almeida Tania,Daubisse-Marliac Laetitia,Defossez Gautier,Delafosse Patricia,Desandes Emmanuel,Grosclaude Pascale,Guizard Anne-Valérie,Lacour Brigitte,Lapôtre-Ledoux Bénédicte,Hammas Karima,Molinié Florence,Nousbaum Jean-Baptiste,Plouvier Sandrine,Pouchieu Camille,Robaszkiewicz Michel,Schvartz Claire,Trétarre Brigitte,Velten Michel,Woronoff Anne-Sophie,
Abstract
Abstract
Objective
To analyze trends in cancer incidence and mortality (France, 1990–2018), with a focus on men-women disparities.
Methods
Incidence data stemmed from cancer registries (FRANCIM) and mortality data from national statistics (CépiDc). Incidence and mortality rates were modelled using bidimensional penalized splines of age and year (at diagnosis and at death, respectively). Trends in age-standardized rates were summarized by the average annual percent changes (AAPC) for all-cancers combined, 19 solid tumors, and 8 subsites. Sex gaps were indicated using male-to-female rate ratios (relative difference) and male-to-female rate differences (absolute difference) in 1990 and 2018, for incidence and mortality, respectively.
Results
For all-cancers, the sex gap narrowed over 1990–2018 in incidence (1.6 to 1.2) and mortality (2.3 to 1.7). The largest decreases of the male-to-female incidence rate ratio were for cancers of the lung (9.5 to 2.2), lip - oral cavity - pharynx (10.9 to 3.1), esophagus (12.6 to 4.5) and larynx (17.1 to 7.1). Mixed trends emerged in lung and oesophageal cancers, probably explained by differing risk factors for the two main histological subtypes. Sex incidence gaps narrowed due to increasing trends in men and women for skin melanoma (0.7 to 1, due to initially higher rates in women), cancers of the liver (7.4 to 4.4) and pancreas (2.0 to 1.4). Sex incidence gaps narrowed for colon-rectum (1.7 to 1.4), urinary bladder (6.9 to 6.1) and stomach (2.7 to 2.4) driven by decreasing trends among men. Other cancers showed similar increasing incidence trends in both sexes leading to stable sex gaps: thyroid gland (0.3 to 0.3), kidney (2.2 to 2.4) and central nervous system (1.4 to 1.5).
Conclusion
In France in 2018, while men still had higher risks of developing or dying from most cancers, the sex gap was narrowing. Efforts should focus on avoiding risk factors (e.g., smoking) and developing etiological studies to understand currently unexplained increasing trends.
Publisher
Springer Science and Business Media LLC
Subject
Cancer Research,Genetics,Oncology