[Conduct of epidemiologic studies in French cancer survivors: Methods, difficulties encountered and solutions provided. Lessons learned from the SIMONAL study on long-term toxicities after non-Hodgkin lymphoma treatment]. / Conduire des études épidémiologiques après cancer en France : modalités, difficultés et propositions de solutions. Les enseignements de l'étude SIMONAL sur les toxicités tardives des traitements du lymphome non Hodgkinien.

INTRODUCTION: Since the introduction of targeted therapies, specific lymphoma mortality has decreased. Possible long-term toxicities, however, are not known yet. This article describes the implementation of the SIMONAL study that investigates the hypothesis of an overconsumption of care after lymphoma treatment with a 10-year follow-up. METHODS: After the mandatory regulatory steps (CCTIRS and CNIL) the vital status and address of 5247 patients treated in 131 French centers were retrieved using a secure web portal, in order to send a quality of life after lymphoma questionnaire. After an additional vital status validation request at the center for epidemiologic research and population health (CESP), the questionnaires were sent. Double data entry was performed on the collected data and a request to access data from France's public health insurance scheme information system (SNIIRAM) was formulated. RESULTS: Retrieval of the addresses via the portal has been slow and multiple reminders were needed. The CESP identified 9.4 % additional deaths not known by the treatment centers. Of the 3391 questionnaires sent, the response rate was 50%. A comparison between the responders and non-responders revealed no demographic differences but showed that the responders were more often treated with targeted drugs as they were included in more recent trials. DISCUSSION: Logistic and information technology (IT) aspects rendered the implementation of the SIMONAL study more complex, time consuming and costly. However, using the collected data, many future research questions will be addressed.

Detection and estimation trends linked to air quality and mortality on French Riviera over the 1990-2005 period.

There is a profound relation between human health and well being from the one side and air pollution levels from the other. Air quality in South of France and more specifically in Nice, is known to be bad, especially in summer. The non-parametric Mann-Kendall test has been developed for detecting and estimating monotonic trends in the time series and applied in our study at annual values of pollutants air concentrations and mortality. An important objective of many environmental monitoring programs is to detect changes or trends in pollution levels over time. Over the period 1990-2005, concerning the emissions of main pollutants, we obtained significant decreasing trends. By considering the ozone mean values in urban areas over the 1997-2005 period, an increase of 3.0% year(-1) was obtained with annual averages and 3.9% year(-1) with median values. A clear increasing trend for PM(10) ambient concentrations is obtained. In addition, we observed an increase of the Olea (and Grass) pollination season. Over the same period, an annual change rate of +0.31% year(-1) for "airway diseases" and of +2.50% year(-1) for "unknown causes" were identified in the "Alpes Maritimes" county. To see the results, there seems to be a short-term link between the levels of these pollutants and mortality for respiratory causes. The other pollutants concentration showed a downward trend reflecting the reduction policy of the emissions. In addition, we obtained significant decreasing trends concerning the "ischemic heart diseases" (-1.20% year(-1)) and "asthma" (-4.03% year(-1)) categories. No significant gender-related difference was identified for these groups.