Cancer incidence and mortality in France over the period 1980-2005.
BACKGROUND
The objective of this study was to provide updated estimates of national trends in cancer incidence and mortality for France for 1980-2005.


METHODS
Twenty-five cancer sites were analysed. Incidence data over the 1975-2003 period were collected from 17 registries working at the department level, covering 16% of the French population. Mortality data for 1975-2004 were provided by the Inserm. National incidence estimates were based on the use of mortality as a correlate of incidence, mortality being available at both department and national levels. Observed incidence and mortality data were modelled using an age-cohort approach, including an interaction term. Short-term predictions from that model gave estimates of new cancer cases and cancer deaths in 2005 for France.


RESULTS
The number of new cancer cases in 2005 was approximately 320,000. This corresponds to an 89% increase since 1980. Demographic changes were responsible for almost half of that increase. The remainder was largely explained by increases in prostate cancer incidence in men and breast cancer incidence in women. The relative increase in the world age-standardised incidence rate was 39%. The number of deaths from cancer increased from 130,000 to 146,000. This 13% increase was much lower than anticipated on the basis of demographic changes (37%). The relative decrease in the age-standardised mortality rate was 22%. This decrease was steeper over the 2000-2005 period in both men and women. Alcohol-related cancer incidence and mortality continued to decrease in men. The increasing trend of lung cancer incidence and mortality among women continued; this cancer was the second cause of cancer death among women. Breast cancer incidence increased regularly, whereas mortality has decreased slowly since the end of the 1990s.


CONCLUSIONS
This study confirmed the divergence of cancer incidence and mortality trends in France over the 1980-2005 period. This divergence can be explained by the combined effects of a decrease in the incidence of the most aggressive cancers and an increase in the incidence of less aggressive cancers, partly due to changes in medical practices leading to earlier diagnoses.
Service de biostatistique, hospices civils de Lyon, centre hospitalier Lyon-Sud, 69424 Lyon, France; Université Lyon-I, 69622 Villeurbanne, France; UMR 5558, laboratoire biostatistique santé, CNRS, bâtiment 4D, 106, chemin du Grand Revoyet, 69495 Pierre-Bénite cedex, France; Département des maladies chroniques et des traumatismes, institut de veille sanitaire, 12, rue du Val-d'Osne, 94415 Saint-Maurice, France.
A
A
Belot
Registre des cancers du Tarn, France.
P
P
Grosclaude
Service de biostatistique, hospices civils de Lyon, centre hospitalier Lyon-Sud, 69424 Lyon, France; Université Lyon-I, 69622 Villeurbanne, France; UMR 5558, laboratoire biostatistique santé, CNRS, bâtiment 4D, 106, chemin du Grand Revoyet, 69495 Pierre-Bénite cedex, France.
N
N
Bossard
Inserm, CépiDc, France.
E
E
Jougla
Institut de cancérologie Gustave-Roussy, France.
E
E
Benhamou
Registre des cancers de l'Isère, France.
P
P
Delafosse
Registre des cancers du Calvados, France.
A-V
AV
Guizard
Registre des cancers de Vendée et de Loire-Atlantique, France.
F
F
Molinié
Registre des cancers du Doubs, France.
A
A
Danzon
Registre des cancers de la Manche, France.
S
S
Bara
Registre Bourguignon des tumeurs digestives, France.
A-M
AM
Bouvier
Registre des cancers de l'Hérault, France.
B
B
Trétarre
Registre des cancers du Bas-Rhin, France.
F
F
Binder-Foucard
Registre des cancers de l'Isère, France.
M
M
Colonna
Registre des cancers du Tarn, France.
L
L
Daubisse
Registre des cancers du Bas-Rhin, France.
G
G
Hédelin
Registre des cancers digestifs du Calvados, France; Réseau FRANCIM des registres des cancers, France.
G
G
Launoy
Registre multicentrique à vocation nationale des mésothéliomes pleuraux, France.
N
N
Le Stang
Registre des hémopathies malignes de Côte d'Or, France.
M
M
Maynadié
Registre des hémopathies malignes de la Gironde, France.
A
A
Monnereau
Registre régional des hémopathies malignes de Basse Normandie, France.
X
X
Troussard
Registre Bourguignon des tumeurs digestives, France.
J
J
Faivre
Registre régional des hémopathies malignes de Basse Normandie, France.
A
A
Collignon
Registre des hémopathies malignes de Côte d'Or, France.
I
I
Janoray
Registre des cancers du sein et cancers gynécologiques de Côte d'Or, France.
P
P
Arveux
Registre des cancers du Haut-Rhin, France.
A
A
Buemi
Registre des cancers de la Somme, France.
N
N
Raverdy
Registre des cancers thyroïdiens de Champagne-Ardennes, France.
C
C
Schvartz
Inserm, CépiDc, France.
M
M
Bovet
Département des maladies chroniques et des traumatismes, institut de veille sanitaire, 12, rue du Val-d'Osne, 94415 Saint-Maurice, France.
L
L
Chérié-Challine
Service de biostatistique, hospices civils de Lyon, centre hospitalier Lyon-Sud, 69424 Lyon, France; Université Lyon-I, 69622 Villeurbanne, France; UMR 5558, laboratoire biostatistique santé, CNRS, bâtiment 4D, 106, chemin du Grand Revoyet, 69495 Pierre-Bénite cedex, France.
J
J
Estève
Service de biostatistique, hospices civils de Lyon, centre hospitalier Lyon-Sud, 69424 Lyon, France; Université Lyon-I, 69622 Villeurbanne, France; UMR 5558, laboratoire biostatistique santé, CNRS, bâtiment 4D, 106, chemin du Grand Revoyet, 69495 Pierre-Bénite cedex, France.
L
L
Remontet
Registre des cancers du Bas-Rhin, France.
M
M
Velten
D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D009369:Neoplasms / Q000453:epidemiology*; D012042:Registries