Incidence of haematological malignancies in French Polynesia between 1990 and 1995.

To determine the incidence of haematological malignancies in French Polynesia from 1990 to 1995, we collected cases from the local cancer registry, sanitary evacuation files and all the histopathology and clinical biology laboratories. All leukaemias, non Hodgkin's lymphomas, and multiple myelomas incidence was slightly lower among French Polynesians than among Maoris from New-Zealand and Hawaiians of Hawaii. Standardised Incidence Ratio (SIR) for Hodgkin's disease among females was 0.08 when comparing to Hawaiians and 0.33 when comparing to Maoris. Other salient features were a high proportion of high grade and Burkitt's lymphoma, the absence of Hodgkin's disease after 40 years of age, a low incidence of chronic lymphoid leukaemia, and a high non lymphoblastic/lymphoblastic acute leukaemia ratio in childhood. This study stresses the peculiar incidence of some haematological malignancies in this south pacific area.

Dengue 1 epidemic in French Polynesia, 1988-1989: surveillance and clinical, epidemiological, virological and serological findings in 1752 documented clinical cases.

An epidemic of dengue 1 occurred in French Polynesia in December 1988 and June 1989. This paper records (i) the trend of the outbreak and its surveillance and (ii) the clinical, epidemiological and virological data obtained from 1752 documented cases. The epidemic reached its peak in February in Tahiti Island, 7 weeks after its recognition. Among 6034 suspect cases reported by sentinel physicians, 60.3% were < 20 years old. The illness was classical dengue. No fatality or case of dengue haemorrhagic fever/dengue with shock syndrome was reported. Of 4792 patients subjected to laboratory testing, 41% were confirmed as positive. The serological attack rate was c. 40%. The estimated number of dengue infections in the Windward Islands was about 20,000. Transmission was associated with Aedes aegypti. Study of documented cases showed a higher confirmation rate in both the civilian population < 15 years old (46.5%) and the susceptible French military population (47.6%) than in older civilians (31.1%, P < 0.05). Furthermore, primary dengue infections were predominant in both of the first 2 groups. The diagnosis was mostly confirmed (i) by virus isolation on day < 5 of illness and (ii) by detection of immunoglobulin (Ig) M on day > or = 5 of illness. The study showed that adequate surveillance of an epidemic requires both clinically and laboratory-based systems.

[Goiter in Tahiti]. / Le goître à Tahiti.

The authors report on a prospective study about goitre in French Polynesia carried out in 1989, dealing with epidemiology and disease characterization in 39 patients. 1. Epidemiology of goitre in Tahiti; In schools: 517 children (236 boys and 281 girls) aged from 10 to 15. Prevalence rate is 1.55 p.c. (8/517); Adults: 226 adults (112 males and 114 females) aged from 50 to 65. Prevalence rate is 4.42 p.c. (10/226). 2. Case study on 39 Polynesian patients (38 females and 1 male) living in Tahiti (mean age: 35.6 years old) showing euthyroidic goitre, detected from 1989 April 1st and October 31; Goitre did not present in Tahiti any particularity. It is a pathology mainly feminine, at low evolution and late local consequences; In 3/4 of the cases, goitre is visible and more it is voluminous more modules are present; There is no iodine deficiency, and the mean value of iodine excretion (536 mcg/24 h) is very high in comparison with what is described in the literature; Presence of a high thiocyanatemia (greater than 100 mmol/l) is found in 1/4 of the patients; There is no correlation between consumption of foods well-known as cyanogenical ones and the level of thiocyanatemia; There is a correlation between the rate of thiocyanatemia and tabagism.

[Epidemiological surveillance of infection by the human immunodeficiency virus (HIV) and of the acquired immunodeficiency syndrome (AIDS) in French Polynesia in 1991]. / Surveillance épidémiologique de l'infection par le virus de l'immunodéficience humaine (VIH) et du syndrome d'immunodéficience acquise (SIDA) en Polynésie Française en 1991.

The authors make out a statement about HIV infection in French Polynesia at the date of 1991 December 31. 96 cases all together of seropositive and AIDS infected people were recorded. These patients are young generally (78 p.c. between 21 and 40 years old) sexually contaminated (72 out of 96) and live in Tahiti island (94 p.c.). Sex-ratio is 2.8 male/1 female. Among them, we noted 55 p.c. of Europeans, 38 p.c. of Polynesians and 7 p.c. of Asiatic people. Epidemiological monitoring of the infection was made easy because of a set of laws and possibilities of detection highly favourable. Progress of the infection is constant, with 20 new cases detected each year with a prevalence of 150 cases of AIDS per 1 million of inhabitants, French Polynesia could be classified as the 5th or 6th region of France as far as the importance of the disease. Clinical, biological and epidemiological taking of charge of patients is detailed as well as the prevention campaign.

PIP: Serological surveillance of HIV infection in accordance with World Health Organization guidelines has taken place in French Polynesia since 1985. 20,000 tests are conducted annually in a population not exceeding 200,000. 30% of tests are among blood donors. An average of 20 new cases of HIV infection are diagnosed each year. A total of 96 cases of HIV infection or AIDS were reported to the public health authorities between 1985 and December 31, 1990. 78% of the 96 persons were aged 21-40 years. The sex ratio was 2.8 men per woman. 55% were in Europeans (53 cases among 24,000 European residents), and 7% were in Asians (7 cases among 10,000 Asians). 94% of the patients were inhabitants of Tahiti. 44 of the 96 patients were male homosexuals or bisexuals, 18 were heterosexuals with multiple partners, 13 received transfusions before 1985, 10 were sex partners of seropositive persons, 9 were former addicts, 1 was the infant of an infected mother, and 1 had no known risk factor. ELISA tests were conducted in 6 different laboratories in the island of Tahiti, with confirmation by Western blot at the laboratory of the Louis Mallarde Territorial Medical Research Institute. Contacts are traced and tested, and seropositive individuals are followed regularly, with consultations at 6 month intervals for seropositive persons. Of the 46 patients present in the territory as of December 1990, 36 were at stage 1, 2 at stage 2, 5 at stage 3, and 3 at stage 4 according to the World Health Organization guidelines. 20 of the other 50 had died and 30 left the territory.

Cancer registry of French Polynesia: results for the 1990-1995 period among native and immigrant population.

We present the data of the Cancer Registry of French Polynesia (FP) for the 1990-1995 period, highlighting the difference between the incidences among inhabitants born in FP and in immigrants. A total of 1606 incident cases of cancer were registered during the 6-year period from 1990 to 1995, about 90% of which were histologically confirmed. Among these incident cases, 1361 occurred in native French Polynesians (FPs) and 245 in immigrants. Overall cancer incidence was found to be very slightly higher among women in the native population (209/10(5)) than among immigrants (191/10(5)), and lower among men in the native population (186/10(5)) than in the immigrants (241/10(5)). Cervix, corpus uteri, and thyroid cancer incidence rates were higher among women born in FP than among immigrant women. In contrast, colorectal cancer and melanoma incidences rates were lower, and colorectal cancer was similar. Laryngeal cancer incidence was higher among men born in FP than among immigrant men. In contrast, cancers of the oral cavity, colon and rectum, prostate gland, bladder and melanoma were less frequent. This first report, based on the data from the Cancer Registry of French Polynesia, shows high cancer incidence rates in females and low incidence in males born in FP, as compared to those recorded in France; and low cancer incidence rates, as compared to New Zealand Maoris and Hawaiians. For certain cancers, for example colorectal cancer, the incidence in the immigrant population seems to be between that of the native FP population and that of the population living in France, and lower than in New Zealand Maoris and Hawaiians.

Cancer incidence in French Polynesia 1985-95.

OBJECTIVE: To describe the variations in cancer incidence in the population born in French Polynesia (FP) according to the archipelago of birth and to compare this incidence with that of Hawaiians and Maoris. METHODS: Study of data from the Cancer Registry of FP, evacuation files, insurance records, hospital and pathology laboratory files. RESULTS: The overall world standardized cancer incidence in FP during the 1985-95 period in the populations born and living in FP was 246 per 105 person-years (PY) among women and 244 per 105 PY among men. The overall cancer incidence was similar to that in Hawaiians, but 25% lower than in Maoris. Digestive tract cancer incidence was a third that of these two reference populations, whereas that of pharynx, larynx and thyroid cancers was approximately twice as high. The overall cancer incidence rate increased between the period 1985-89 and the period 1990-95 in women, but was stable in men. Colorectal cancer incidence was highest in inhabitants born on the Windward Islands. Women born on the Austral Islands had a higher thyroid and liver cancer incidence and a lower breast cancer incidence. CONCLUSIONS: Further studies are needed to elucidate the variations observed between FP archipelagos, Maoris and Hawaiians.

An ecological study of diet and lung cancer in the South Pacific.

Incidence rates of lung cancer have been markedly lower for Fiji than for other South Pacific countries, despite similar rates of smoking. We conducted population-based surveys in several island nations of the South Pacific (Cook Islands, Fiji, Tahiti and New Caledonia) and used data from Caucasian, Japanese, Hawaiian, Filipino and Chinese controls in a case-control study of lung cancer in Hawaii to investigate the role of diet in explaining differences in lung cancer incidence among 20 ethnic-sex groups. In a stepwise linear regression of lung cancer rates on smoking, diet and other variables, smoking, as expected, explained the majority (61%) of the variability in incidence. However, several dietary components also explained significant portions of the variance. Lutein intake explained 14% and vitamin E intake, cholesterol intake and height explained 5-7% each of the remaining variance in incidence. Associations with lutein and vitamin E were inverse, whereas those with cholesterol and height were direct. Dietary beta-carotene intake was not associated with lung cancer incidence. These ecological data provide evidence for a protective effect of lutein against lung cancer. A protective effect of dietary vitamin E and a risk-enhancing effect of dietary cholesterol are also suggested.