Trends in the incidence of cancer in the Sousse region, Tunisia, 1993-2006.

In this article, we analyzed trends in incidence rates of the major cancer sites for a 14-year period, 1993-2006, in the Sousse region localized in the centre of Tunisia. 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 data on population size and its estimated age structure. A total of 6,975 incident cases of cancer were registered, with a male to-female sex ratio of 1.4:1. ASRs showed stable trends (-0.1% in males, and +1.0% in females). The leading cancer sites in rank were lung, breast, lymphoma, colon-rectum, bladder, prostate, leukemia, stomach and cervix uteri. For males, the incidence rates of lung, bladder and prostate cancers remained stable over time. While, cancers of colon-rectum showed a marked increase in incidence (APC: +4.8%; 95% CI: 1.2%, 8.4%) and non-Hodgkin's lymphoma (NHL) showed a notable decline (APC: -4.4%; 95% CI: -8.2, -0.6). For females, cancers of the breast (APC: +2.2%; 95% CI: 0.4%, 4.0%) and corpus uteri (APC: +7.4%; 95% CI: 2.8%, 12.0%) showed a marked increase in incidence during the study period, while the cervix uteri cancer decreased significantly (APC: -6.1%; 95% CI: -9.2%, -3.0%). The results underline the increasing importance of cancer as a cause of mortality and morbidity in Tunisia. Our findings justify the need to develop effective program aiming at the control and prevention of the spread of cancer amongst Tunisian population.

Breast cancer in Tunisia: clinical and pathological findings.

INTRODUCTION: The aim of this study was to survey the clinical and pathological features of breast cancer in the Center of Tunisia. DESIGN: Characteristics of all breast cancer cases diagnosed in the Pathology Department, Farhet Hached Hospital, Sousse, Tunisia during a 15-year period (1993-2007) were analyzed. RESULTS: A total of 2,404 new cases of breast cancer were recorded, only 48 being diagnosed in men. The age-standardized incidence rate was 0.7 and 29.2 per 100,000 in men and women, respectively, with median ages of 48.0 and 64.5 years. Invasive ductal carcinoma was the most common (2,012 cases). Stage II was the most frequent (47.7%) followed by advanced stages (Stage III and IV, 41%). CONCLUSION: Cancer of the breast remains the most common cancer in the absence of specific screening measures among Tunisian women. Our study justifies the need to plan and develop effective programs aiming at the control and prevention of the spread of breast cancer in Tunisia.

Cancer of corpus uteri in Tunisia: epidemiological and clinicopathological features.

INTRODUCTION: The aim of this study was to survey for the first time the burden and characteristics of corpus uteri cancers in Central Tunisia. DESIGN: Characteristics of all cancer cases diagnosed during a 15-year period were analyzed based on the data of the Cancer Registry of the Center of Tunisia. Five-year age-specific rates, crude incidence rates, world age-standardized rates (ASR), and annual percent change (APC) were calculated using annual data on population size and its estimated age structure. RESULTS: A total of 218 new cases of corpus uteri cancer were recorded. The ASR was 3.1 per 100,000 with a significant increase over time (APC: +7.1%; 95% CI: 3.1%, 11.1%). The median age at diagnosis was 60 years and only 20.6% of patients were less than 50 years old. The tumor size was higher than 2 cm in 83.5% of cases. Stage I was the most frequent (59.9%) followed by advanced stages (23.2%). Endometrial adenocarcinoma was the most frequent histological type (62.8%) with grade II accounting for 48.5% of cases. CONCLUSION: Corpus uteri cancer is an important female cancer with increasing trend over time. These findings justify the need to plan and develop effective programs aiming at the control of the spread of cancer in Tunisia.

Childhood cancer frequency in the center of Tunisia.

OBJECTIVE: In this paper, we analyzed the frequency of childhood cancer in the Center of Tunisia during 1993-2006. DESIGN: The different types of cancer were grouped according to the International Classification for Cancer in Children. The general and specific frequencies by age and by sex were analyzed. RESULTS: A total of 727 new cases of childhood cancer were registered, with a male to-female sex ratio of 1.7/1. Leukemias had the highest frequency (27%) and, of these, lymphoid leukemias were the most prevalent (73.5%). Thereafter, in descending order of frequency, were lymphomas (25.7%), tumors of the central nervous system (CNS, 9.2%), neuroblastomas (7.7%), sarcomas (6.9%), carcinomas (6.3%), bone tumors (5.8%), nephroblastomas (5.5%), and germinal cell tumors (2.6%). The highest frequency of cancer was found at age 10-14 years (34.9%). Leukemias were the most frequent in age groups 1-4 and 5-9 years, whereas, neuroblastomas and lymphomas were the most frequent at age under one year and 10-14 years, respectively. Of those cases of solid tumors, 55.8% were diagnosed as having advanced stages of the disease. CONCLUSION: Leukemias, lymphomas, and CNS tumors were the principal cancers in the Center of Tunisia. A childhood cancer registry with high-resolution data collection is advocated for in-depth analysis of pediatric malignancies.

Pediatric rhabdomyosarcomas in Tunisia.

INTRODUCTION: Rhabdomyosarcoma is the most common soft tissue sarcoma in the first two decades of life. Since there is a paucity of reports on the pattern of its occurrence in Tunisia, we here analysed the epidemiological pattern, clinical features, and pathology. DESIGN: We retrospectively studied 30 consecutive cases of histologically proven rhabdomyosarcoma in children aged 0-15 years extracted from the database of the Cancer Registry of the Center of Tunisia for the period 1993-2007. RESULTS: Rhabdomyosarcomas represented 53.6% of soft tissue sarcomas and 3.8% of all children cancer cases registered during this period. The male/female ratio was 2.7 with a mean age at diagnosis of 5.9 years. The embryonal subtype was the most frequent (60%) and the two most common sites of disease were the head and neck (50%) and genito-urinary tract(23.3%). Chemotherapy was used in 90% of patients; 43.3% of patients had radical surgery and 26.7% of patients received radiation therapy. CONCLUSION: The epidemiology, pathology and clinical features of rhabdomyosarcoma in Tunisian children are close to those reported from other countries.