Genotype distribution of cervical HPV among Caribbean women in a population-based study in Martinique: The DEPIPAPUFR study.

The Caribbean ranks seventh among the world regions most affected by cervical cancer. HPV-prevalence and genotype distributions also differ from regions. Knowledge of HPV genotype profiles is important for patients care and HPV vaccination implementation. The objective of this study was to describe HPV genotype distribution and risk factors in a population-based cohort of women in Martinique. In this study, 1312 women were included and underwent cervical cancer screening with successful sample collection between 2009 and 2014. Sociodemographic and clinical variables were recorded. Cytological examination of cervical vaginal smear was performed and classified(Bethesda). Detection of HPV DNA was performed with the PapilloCheck© Kit from Greiner Bio-one. Genotypes were analyzed for18 high-risk HPV (hrHPV) and 6low-risk HPV(lrHPV) types. A total of 1075 women were included with a mean age of 49.1±10.5 years. HPV prevalence was 27.6% (297/1075) with 19.4% (209/1075) women with only hrHPV, 5.3% (57/1075) with only lrHPV. Multiple infections (hrHPV/lrHPV) were detected in 31/240 cases of hrHPV (12.9%). A total of 353 hrHPV genotypes were analyzed; the most common HPV types were HPV51 (11.0%), HPV68 (10.8%), HPV53 (9.1%) and HPV 52 (7.1%). HPV16 and HPV18 represented respectively 4.8% and 4.0% of hrHPV genotypes. Abnormal cytology was observed in 34 cases (3.2%), with 14 ASCUS (1.3%), 10 LSIL (0.9%), 5 HSIL (0.5%), 3 ASC-H (0.3%) and 2 AGC (0.2%). Fifteen (44.1%) were hrHPV and 4 (14.7%) lrHPV; 7 cases of hrPHV were in the age-group 25-34 years. Among 1041cases of normal cytology, 225 had positive hrHPV detection (21.6%). This is the first population-based study of HPV profiles in our country, and we found a high prevalence of hrHPV. The most common genotypes were HPV51, 68, 53. These results could serve for cancer vaccination strategies and HPV surveillance in Martinique.

Geographic variations and temporal trends in prostate cancer in Martinique over a 25-year period.

BACKGROUND: In Martinique, prostate cancer incidence rates have been increasing since the 1980s and are actually among the highest worldwide. Exposure to lifestyle (changes in dietary habits), environmental factors (exposure to organochlorine pesticides) and modifications in diagnostic and screening procedures, are favored etiological hypotheses. The aim of the present study is to describe and interpret prostate cancer incidence trends over the past 25 years (1981-2005) in Martinique. METHODS: Data on incident prostate cancer cases from 1981 to 2005 were obtained from the population-based Martinique Cancer Registry. World age-standardised incidence rates were calculated and an age-period-cohort model was used to determine average annual variations for prostate cancer during the study period. Age and period effects were assessed, employing the method proposed by Clayton and Schifflers. Relative changes in prostate cancer incidence, at five-year intervals between 1981 and 2005, were also studied with an organochlorine pesticide exposure index, built as a proxy of the relative intensity of chlordecone use on the island between 1973 and 1993. RESULTS: Prostate cancer incidence was found to increase by 5.07% annually between 1981 and 2005. Compared to 1981-1985, prostate cancer relative risk, in men aged 50-74 years and 75 years and above was respectively 5.98% and 3.07% from 2001 to 2005. An inverse association between population pesticide exposure levels and prostate cancer risk was also highlighted, with highest prostate cancer incidences observed in urban zones showing the lowest soil contamination levels by the chlordecone pesticide (zone 1). CONCLUSION: No conclusive association was found between the intensity of pesticide use and the subsequent rise in prostate cancer incidence. However, it remains necessary to develop and reinforce continuous monitoring of prostate cancer incidence and mortality trends on the island. Further studies are also needed in order to consider other risk factors such as modifications in diagnostic and screening procedures over the last 25 years.

Cancer incidence in Martinique: a model of epidemiological transition.

In this paper, we present data from the Martinique Cancer Registry for the period 1981-2000 and interpret cancer incidence trends in the light of risk factor patterns. In Martinique, cancer data are available from 1981. The sources of information are represented by insurance records, medical evacuations, hospitals and laboratory files. We performed a Mantel-Haenszel chi test stratified on age in order to assess time trends and to compare incidence rates between men and women over the whole period. A total of 8992 incidents of cancer cases were recorded during the last 20 years among men and 6832 in women. (The overall age-standardized incidence rate is 222 per 10 person-years for men and 145 per 10 person-years for women.) The most common cancers are prostate cancer in men (104 per 10 person-years) and breast cancer in women (42 per 10 person-years). Except for thyroid and salivary gland cancer, men experienced higher incidence rates for all other cancers. Incidence of prostate cancer in men, breast cancer in women and colorectal cancer in both sexes strongly increased between 1981-1990 and 1991-2000, whereas no significant variation was observed for that of all digestive cancers together. Among women, cervical cancer incidence strongly decreased. These results demonstrate that Martinique tends to have the same cancer risk profile as France Mainland with, however, higher incidence rates for cervical, stomach and prostate cancer. Changes in lifestyle and greater accessibility to diagnostic and therapeutic procedures, in particular screening, have strongly contributed to the 'epidemiological transition' observed.

[Case-control study of the genes of receptors of the androgens of vitamin-D and of 5-alphareductase in a population of Afro-Caribbean population with prostate cancer]. / Etude cas-témoins des gènes des récepteurs des androgènes, de la vitamine-D et de la 5-alpharéductase dans une population afro-antillaise de cancer de prostate.

OBJECTIVE: The proliferation of prostate cells appears to be influenced by two steroidal hormones: testosterone and vitamin D, whose action appears to mediated by their respective receptors. The genes coding for these two receptors and the gene coding for 5-alpha-reductase (enzyme involved in testosterone metabolism) have been identified as candidate genes for prostate cancer predisposition. Previous epidemiological and genetic susceptibility studies have reported controversial results concerning the role of these genes on prostate cancer incidence in various populations. The objective of this study was to determine the possible association in this population between polymorphisms of these genes, and the clinical and pathological stage and grade of prostate cancer. METHODOLOGY: This case-control epidemiogenetic study was based on 253 subjects living in Martinique. Prostate cancer is the most frequent cancer in men and the leading cause of cancer death in Martinique. Its incidence is 80 per 100,000 inhabitants (world population standardized rates), which makes Martinique one of the most severely affected regions in the world with an incidence close to that of Afro-Americans. Cases and controls were recruitedfrom the hospital and general populations. The following gene polymorphisms were evaluated: the androgen receptor (AR) was studied by microsatellites of the CAG codon repeat domain; the vitamin D receptor (VDR) gene was studied on poly(A) sequences of the 3'-UTR region; 5a-reductase II (SRD5A2) was studied by poly(TA) microsatellites. The odds-ratio (OR) was estimated by logistic regression with integration of clinical and biological parameters. RESULTS: Our results for the androgen receptor showed an association between the presence of more than 20 CAG repeats and localized or low-grade forms. A risk related to the heavy allele of VDR was observed in advanced and low-grade forms (PSA-T > 20 ng/ml). Lastly, no 5a-reductase polymorphism distinguishing cases from controls was observed. CONCLUSION: This study demonstrated results that differ from those observed for other populations with a similar ethnic origin. For AR and VDR genes, the presence of a heavy allele is associated with an increased risk of developing prostate cancer with a poor prognosis. No high-risk group was identified according to 5a-reductase gene polymorphism.