title: [Diagnostic modalities and treatment of cancer of the pancreas. Evolution in the population in the department of Côte d'Or from 1976 to 1988].
abstract: There is no study establishing time trends for the diagnostic and therapeutic approaches to pancreatic cancer based on population data. The data of the Registry of Digestive Tumors of Côte-d'Or (France) were used to this end in 544 cancers diagnosed between 1976 and 1988. The proportion of the histologically confirmed cases increased annually by 13.4% (P < 0.001). This was mainly due to progress in percutaneous biopsy (+25.7% per year between 1983 and 1988, P < 0.001). As regards the diagnosis, ultrasonography was used more frequently (+21.9% per year, P < 0.001) as well as CT scan since its introduction in 1983 (+19.6% per year, P < 0.001). Pancreatic cancer was diagnosed by sonography in 16.7% of the cases in 1976 and 70.6% in 1988 (mean annual variation: +5.7%, P < 0.001). The proportions for CT scan were 12.8% in 1983 and 23.5% in 1988 (mean annual variation: +3.5%, NS). There was no significant change in the use of retrograde cholangiopancreatography over time. Other diagnosis criteria were less frequently used: laparoscopy was no longer used after 1983 and intraoperative diagnosis was made less frequently (-2.5% per year, P < 0.001). Endoscopy or radiographic data were rarely used as a diagnosis criterion. These changes in approaches to the diagnosis of pancreatic cancer were not accompanied by any progress in diagnosis stage, therapeutic approach or survival suggesting that when clinical symptoms become evident, pancreatic cancer is already advanced. Therapeutic advances, early diagnosis in patient at risk or identification or reasons for pancreatic cancer are the only means of progress in this problem.
authors.affiliation: Registre Bourguignon des Tumeurs Digestive (Equipe associée INSERM-DGS), Faculté de Médecine, Dijon.
authors.forename: J
authors.initials: J
authors.lastname: Fauconnier
authors.forename: J
authors.initials: J
authors.lastname: Faivre
authors.forename: V
authors.initials: V
authors.lastname: Quipourt
authors.forename: A
authors.initials: A
authors.lastname: Liabeuf
authors.forename: J P
authors.initials: JP
authors.lastname: Moutet
authors.forename: C
authors.initials: C
authors.lastname: Michiels
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D005602:France; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D009362:Neoplasm Metastasis; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
vernacular_title: Les modalités diagnostiques et le traitement du cancer du pancréas. Evolution dans la population du département de la Côte-d'Or de 1976 à 1988.