Revue D Epidemiologie Et De Sante Publique 

About: Revue D Epidemiologie Et De Sante Publique is an academic journal published by Elsevier BV. The journal publishes majorly in the area(s): Medicine & Population. It has an ISSN identifier of 0398-7620. Over the lifetime, 4272 publications have been published receiving 27417 citations. The journal is also known as: RESP & Epidemiology and public health (En ligne).

Jackknife and bootstrap

Abstract: The jackknife and the bootstrap are two non parametric methods which provide estimates- of the bias and the variance of an estimator, without any assumption about its statistical distribution. The jackknife is based on the observation of the estimator for subsamples, generally of size n-1, obtained from the original sample. The bootstrap is based on the observation of the estimator on size n samples drawn from the original sample. The two methods are presented, their principle is illustrated through their application to simple examples and to more complex epidemiological problems.

Cancer incidence and mortality in France over the period 1978-2000

Abstract: Position du probleme : La surveillance de la tendance de l'incidence et de la mortalite par cancers est essentielle a la recherche en cancerologie et a la planification en sante publique. Les registres de cancer francais ne couvrent pas l'ensemble du territoire et ne procurent pas un echantillon representatif de l'ensemble de la population. Notre etude a pour objectif d'estimer la tendance de l'incidence et de la mortalite, au niveau national et sur la plus longue periode possible. Materiel et methode : Les donnees d'incidence et de mortalite ont ete collectees sur la periode 1978-1997. Vingt-sept sites de cancer ont ete retenus ; pour chaque site, les taux d'incidence et de mortalite par sexe et par âge ont ete estimes pour chaque annee de 1978 a 2000. Les donnees d'incidence et de mortalite observees dans les populations couvertes par un registre ont ete modelisees par un modele âge-cohorte. Une estimation du rapport incidence/mortalite a ete obtenue a partir de cette modelisation et appliquee a des taux de mortalite predits par un modele âge-cohorte issu des donnees de mortalite de l'ensemble de la France. Les personnes-annees d'observation ont ete calculees par cohorte de naissance a partir des donnees du recensement de la population. Resultats : L'incidence du cancer a augmente de 63 % au cours de la periode d'etude, passant de 170 000 nouveaux cas en 1980 a 278 000 nouveaux cas en 2000. Cette croissance est due au changement demographique mais aussi a l'augmentation du risque de cancer qui est estimee a 35 % durant la meme periode. Pour les hommes, ce changement est largement explique par l'augmentation de l'incidence du cancer de la prostate. Pour les femmes, cette evolution est dominee par l'accroissement continu de l'incidence du cancer du sein. Des augmentations importantes ont aussi ete observees pour le lymphome malin non hodgkinien, le melanome de la peau et le cancer de la thyroide pour les deux sexes, pour le cancer du poumon dans la population feminine. La mortalite par cancer a augmente de 20 %, passant de 125 000 deces en 1980 a 150 000 deces en 2000. Cette augmentation est moindre que celle predite par les changements demographiques et correspond en fait a une diminution du risque de deces estimee a environ 8 %, diminution legerement plus importante chez les femmes que chez les hommes. La baisse de la mortalite est associee a une baisse de l'incidence pour les cancers de l'estomac pour les deux sexes, pour les cancers lies a l'alcool chez l'homme et pour les cancers du col de l'uterus chez la femme. Conclusion : Entre 1980 et 2000, cette etude montre un large changement, a la fois qualitatif et quantitatif du poids que represente le cancer en France. La diminution des expositions, un diagnostic plus precoce et les progres therapeutiques expliquent en partie cette situation, mais d'une facon generale la distribution des cancers tend vers une distribution avec moins de cancers agressifs. Une divergence frappante est observee entre les tendances de l'incidence et les tendances de la mortalite pour un grand nombre de cancers. Le cancer de la prostate partage avec le cancer du sein le meme type d'evolution, avec un accroissement severe de son incidence et une stabilite de sa mortalite. Ceci indique d'importants changements dans les pratiques medicales qui necessitent des analyses supplementaires.

Cancer incidence and mortality in France over the period 1980–2005

Abstract: 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. CONCLUSION: 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.

Value of a national administrative database to guide public decisions: From the système national d'information interrégimes de l'Assurance Maladie (SNIIRAM) to the système national des données de santé (SNDS) in France.

Abstract: In 1999, French legislators asked health insurance funds to develop a systeme national d'information interregimes de l'Assurance Maladie (SNIIRAM) [national health insurance information system] in order to more precisely determine and evaluate health care utilization and health care expenditure of beneficiaries. These data, based on almost 66 million inhabitants in 2015, have already been the subject of numerous international publications on various topics: prevalence and incidence of diseases, patient care pathways, health status and health care utilization of specific populations, real-life use of drugs, assessment of adverse effects of drugs or other health care procedures, monitoring of national health insurance expenditure, etc. SNIIRAM comprises individual information on the sociodemographic and medical characteristics of beneficiaries and all hospital care and office medicine reimbursements, coded according to various systems. Access to data is controlled by permissions dependent on the type of data requested or used, their temporality and the researcher's status. In general, data can be analyzed by accredited agencies over a period covering the last three years plus the current year, and specific requests can be submitted to extract data over longer periods. A 1/97th random sample of SNIIRAM, the echantillon generaliste des beneficiaires (EGB), representative of the national population of health insurance beneficiaries, was composed in 2005 to allow 20-year follow-up with facilitated access for medical research. The EGB is an open cohort, which includes new beneficiaries and newborn infants. SNIIRAM has continued to grow and extend to become, in 2016, the cornerstone of the future systeme national des donnees de sante (SNDS) [national health data system], which will gradually integrate new information (causes of death, social and medical data and complementary health insurance). In parallel, the modalities of data access and protection systems have also evolved. This article describes the SNIIRAM data warehouse and its transformation into SNDS, the data collected, the tools developed in order to facilitate data analysis, the limitations encountered, and changing access permissions.