Colorectal cancer in Central Tunisia: increasing incidence trends over a 15-year period.

INTRODUCTION: Significant variation in colorectal cancer incidence rates and trends has been observed across countries. Data from Tunisia are sparse. In this paper, we analyzed trends in incidence rates of the colorectal cancer over a 15-year period, 1993-2007, in Central Tunisia. DESIGN: Five-year age-specific rates, crude incidence rates, world age-standardized rates, and annual percent change were calculated using annual data on population size and its estimated age structure. RESULTS: A total of 1,443 incident cases of colorectal cancer were registered, with a male to-female sex ratio of 1.1:1. The world age-standardized rate was 10.0 per 100,000 among females and 11.7 among males. Over time, there were significant increasing trends by +2.6% (95% CI: 0.1%, 5.1%) and +5.3% (95% CI: 2.7%, 7.9%) for females and males, respectively. CONCLUSION: The absence of a screening program for colorectal cancer could explain the increasing trends observed among males and females in Central Tunisia. Our findings point the need to plan and develop effective programs aimed at the control and prevention of the spread of colorectal cancer in Tunisia.

Cervical adenocarcinoma and squamous cell carcinoma incidence trends among Tunisian women.

INTRODUCTION: Uterine cervix cancer is an important public health problem in Tunisia. In this study, we report trends in the incidence of adenocarcinoma and squamous cell carcinoma of the cervix uteri in the central region of Tunisia during 1993-2006. DESIGN: Data were obtained from the Cancer Registry of the Center of Tunisia which registers invasive cancer cases by active methods. Five-year age-specific rates, crude incidence rates (CR), world age-standardized rates (ASR), percent change (PC) and annual percent change (APC) were calculated using annual population data. RESULTS: Among all women cancers, cervix uteri cancer accounted for 5.9% and ranked the fourth during the study period with an ASR of 6.9 per 100,000. The ASRs decreased notably with an APC of -6.7% over the whole period. However, incidence rates of adenocarcinomas have increased during the last years (APC: +14.4%). CONCLUSION: The introduction of cytological screening programs has led to a marked decrease of the incidence rates of cervix uteri cancer among Tunisian women. The data underline the fact that the population-based cancer registry is an indispensable tool for providing data for planning and evaluation of programs for cancer control.

Clinicopathological patterns of colorectal cancer in Tunisia.

INTRODUCTION: Colorectal cancer is the third most commonly diagnosed cancer worldwide. DESIGN: In order to review the clinical and pathological features of colorectal cancer in Tunisia, a retrospective study was carried out on 1,443 cancer cases diagnosed in the Pathology Department, Farhet Hached University Hospital of Sousse, for a 15-year period (1993-2007). RESULTS: The median age was 61 years. Adenocarcinoma was the most frequent (90.9%) with moderately differentiated tumors accounting for 76.7% of cases. Only eighty patients were identified as being in early stages (0 and A) and 85.8% in advanced stages (B-D). Over time, we observed a significant decrease of stage B (p=0.02) and a significant increase of stage D (p=0.002). The tumor size was larger than 5 cm in 67.5% of cases. CONCLUSION: The large proportion of patients presented at advanced stages, compared to only 5.5% of patients at early stages, emphasizes the need to plan and develop a screening program for the early detection of this cancer and its precursor lesions in Tunisia.