[Bladder tumors in the Hérault department: Results of the Hérault tumor registry registration from1987 to 2019]. / Les tumeurs de la vessie dans le département de l'Hérault : résultats de l'enregistrement du registre des tumeurs de l'Hérault de1987 à 2019.

OBJECTIVES: The Hérault Tumor Registry (RTH) is a general registry qualified by the national committee of registries since 1987. The objective of this study is to present the evolution of the epidemiology of bladder cancer (stage≥T1) in the Hérault department based on data collected by the RTH over a period from 1987 to 2019. MATERIAL AND METHODS: We analyzed trends in bladder cancer incidence in Hérault between 1987 and 2019 by sex, age, and stage, as well as mortality trends between 1987 and 2017. For the years 2018-2019, which are the last two years validated by the registry, we described relative frequencies, sex ratio, mean and median age at diagnosis, cumulative risk, stages at diagnosis, pathology data, and primary treatments. Observed and net survival data are analyzed for those diagnosed between 01/01/2000 and 12/31/2015 with a point date of 06/30/2018. RESULTS: In 2018-2019, bladder cancer was the 7th most common cancer in Hérault (5th in men and 12th in women) with an incidence sex ratio of 3.9 men to one woman. The mean age at diagnosis was 75.3 years for men and 77.8 years for women. The probability of having bladder cancer before the age of 75 years was 1.68% for a man (1/59) and 0.34% for a woman (1/295). Urothelial carcinomas accounted for 90.7% of cancers. Between 1987 and 2019, bladder cancer incidence TSMs (worldwide standardized rates) decreased by 0.8% per year in men and remained stable in women. Mortality TSMs between 1987 and 2017 followed the same trends with a decrease of 2.2% per year in men and stability in women. For the 3304 bladder cancers diagnosed between 01/01/2000 and 12/31/2015, the observed 5-year survival was 38% (34% in women and 38% in men). CONCLUSIONS: Bladder cancer incidence and mortality rates have decreased slightly in men but remain stable in women in the Hérault. Registries collect only a limited number of variables for each patient. In 2018 the Hérault Registry Specialized in Onco-Urology (RHESOU) was created, to have comprehensive data.

Determinants of doctors' antibiotic prescriptions for patients over 75 years old in the terminal stage of palliative care.

INTRODUCTION: Notwithstanding high prevalence of presumably bacterial infections in elderly persons (EP) in palliative care (PC), there exists no recommendation on the role of antibiotic therapy (ABP) in this type of situation. OBJECTIVE: To describe the determinants of antibiotic prescription by general practitioners (GP) and by doctors practicing in institutions (DPI) for patients>75 years, in end-of-life situations in PC. METHOD: Descriptive investigation by anonymous self-administered questionnaire disseminated in France by e-mail. RESULTS: A total of 301 questionnaires analyzed: 113 GP, 188 DPIs. The latter were mainly geriatricians (69, 36.6%) and infectologists/internists (41, 21.8%). Sixty-three (55,75%) GPs and 144 (78.7%) DPIs stated that they had prescribed antibiotics. Practice in "EHPAD" retirement homes or intensive care was often associated with non-prescription of antibiotics. Age, PC training and number of patients monitored bore no influence. Family involvement in decision-making was more frequent for GPs than for DPIs. The main purpose of antibiotic therapy was to relieve different symptoms (fever, respiratory congestion, functional urinary signs). Most of the doctors (81%) had previously encountered complications (allergy, adverse effect), which represented the main causes of treatment discontinuation. CONCLUSION: Antibiotic use in end-of-life EPs in PC seems frequent. In accordance with the principle of beneficence, its goal of often symptom-related; that said, in the absence of scientific data, antibiotic prescription in end-of-life situations should be individualized in view of observing the other ethical caregiving principles (beneficence, non-maleficence, justice, patient autonomy) and re-evaluated daily.

[Female lung cancer trends, staging and histology in Hérault, France]. / Tendance, stade, histologie du cancer bronchopulmonaire chez les femmes dans l'Hérault, France.

BACKGROUND: In France, lung cancer is the third most common cancer and the third leading cause of cancer death in women. The main objective of this study is to analyse specificities of lung cancer in the female population in an administrative district in France, focusing on histology, staging and trends over time. METHODS: Incidence data from 1987 to 2004 were extracted from the Hérault cancer registry. The variables of interest considered at diagnosis were stage, histology and age. Mortality data were extracted from the CépiDc-Inserm database for the same period. RESULTS: Among the 6,650 patients studied, 16.8% were women. 18.3% of whom were aged less than 50 at diagnosis, (9.9% of men, p<0.001). Lung cancer incidence is increasing in the female population (+6.4% per year) as well as lung cancer mortality (+3.5% per year). This occurred faster for adenocarcinoma, young women and stages III-IV. CONCLUSION: This population-based study confirmed the specific features of lung cancer in women: younger age at diagnosis, adenocarcinoma and stage at diagnosis with poor prognosis. These results raise the question of possible differences to lung cancer susceptibility between males and females.

[Impact of the French consensus guidelines on the management of colonic and rectal cancer: a population-based study]. / Impact des conférences de consensus sur la prise en charge du cancer du côlon et du rectum.

AIM: To compare the management of colorectal cancer (CRC) before and after the French consensus conferences of rectal cancer (RC) in 1994 and colonic cancer (CC) in 1998. METHODS: From 344 CCR incident cases in 1992 and 545 in 2000, patient characteristics, tumor data, and diagnostic and treatment modalities were collected to compare the management of CRC. RESULTS: Post-operative mortality did not change significantly (4% in 1992 and 2.8% in 2000). No trends were observed in disease stage at diagnosis or rate of resection. For patients with CC (n=244 in 1992 and n=396 in 2000), the number of resection specimens with at least 12 lymph nodes increased from 11% in 1992 to 27% in 2000 (p<0.001). For CC with Dukes stage C and D, the use of chemotherapy increased significantly: for Dukes Stage C from 45% in 1992 to 55% in 2000; for Dukes Stage D from 37% in 1992 to 67% in 2000. For patients with RC (n=100 in 1992 and n=149 in 2000), no change in use of adjuvant radiotherapy was observed: 59% in 1992 versus 53.4% in 2000. Preoperative radiotherapy for RC was performed in 63% in 1992 and 75% in 2000 (p=0.7). CONCLUSION: The consensus guidelines appear to have moderately influenced management practices. A better diffusion of guidelines to practitioners and a systematic evaluation of actual practices would be helpful to improve their impact.

[Not Available]. / Impact des conférences de consensus sur la prise en charge du cancer du côlon et du rectum: Étude de population.

UNLABELLED: Impact of the French consensus guidlines on the management of colonic and rectal cancer: A population-based study F. Borie, M. El Nasser, A. Herrero, C. Gras-Aygon, CRISAP-LR, J.-P. Daures, B. Tretarre Aim: To compare the management of colorectal cancer (CRC) before and after the French consensus conferences of rectal cancer (RC) in 1994 and colonic cancer (CC) in 1998. METHODS: From 344 CCR incident cases in 1992 and 545 in 2000, patient characteristics, tumor data, and diagnostic and treatment modalities were collected to compare the management of CRC. Résults: Post-operative mortality did not change significantly (4% in 1992 and 2.8% in 2000). No trends were observed in disease stage at diagnosis or rate of resection. For patients with CC (n=244 in 1992 and n=396 in 2000), the number of resection specimens with at least 12 lymph nodes increased from 11% in 1992 to 27% in 2000 (p<0.001). For CC with Dukes stage C and D, the use of chemotherapy increased significantly: for Dukes Stage C from 45% in 1992 to 55% in 2000; for Dukes Stage D from 37% in 1992 to 67% in 2000. For patients with RC (n=100 in 1992 and n=149 in 2000), no change in use of adjuvant radiotherapy was observed: 59% in 1992 versus 53.4% in 2000. Preoperative radiotherapy for RC was performed in 63% in 1992 and 75% in 2000 (p=0.7). CONCLUSION: The consensus guidelines appear to have moderately influenced management practices. A better diffusion of guidelines to practitioners and a systematic evaluation of actual practices would be helpful to improve their impact.