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Trends in the incidence of cancer in the Sousse region,Tunisia, 1993–2006
Authors:Nabiha Missaoui  Amel Trabelsi  Donald M Parkin  Lilia Jaidene  Daniel Chatti  Moncef Mokni  Sadok Korbi  Sihem Hmissa
Institution:1. Research Unit 03/UR/08‐13, Cancer Epidemiology and Cytopathology in Tunisian Centre, Medicine Faculty, Sousse, Tunisia;2. Cancer Registry of the Centre of Tunisia, Farhet Hached University Hospital, Sousse, TunisiaTel.: 216 21 506 343 Fax: 216 73 369 308;3. Department of Pathology, Farhet Hached University Hospital, Sousse, Tunisia;4. Cancer Research UK Centre for Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom;5. Cancer Registry of the Centre of Tunisia, Farhet Hached University Hospital, Sousse, Tunisia
Abstract: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.
Keywords:cancer  incidence  time trends  Tunisia  population‐based registry
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