Fiche publication
Date publication
février 2012
Auteurs
Membres identifiés du Cancéropôle Est :
Pr BINQUET Christine
,
Dr BOUVIER Anne-Marie
,
Dr FOURNEL Isabelle
,
Dr JOOSTE Valérie
,
Dr COTTET Vanessa
Tous les auteurs :
Fournel I, Cottet V, Binquet C, Jooste V, Faivre J, Bouvier AM, Bonithon-Kopp C
Lien Pubmed
Résumé
BACKGROUND: Because few data are available on this topic, we investigated the influence of geographical determinants on colorectal adenoma detection and cancer incidence rates. METHODS: Between 1990 and 1999, 6220 Cote d'Or inhabitants (France) were first-diagnosed with a colorectal adenoma, and 2389 with an invasive adenocarcinoma. The impact of the rural-urban place of residence and of a physician location in municipalities on adenoma and cancer detection rates was studied using Poisson regression. RESULTS: World-standardized adenoma detection rate was significantly higher in urban areas (102 [95% CI: 97-107]) than in rural areas (78 [95% CI: 72-84]). The impact of the absence of physicians in municipalities was only found in rural areas. The detection rate ratio associated with the absence of a primary care physician was 0.70 [95% CI: 0.61-0.81], and the detection rate ratio associated with the absence of a gastroenterologist was 0.75 [95% CI: 0.64-0.89]. Colorectal cancer incidence rates were similar in urban and rural areas with only marginal variations related to physician location. CONCLUSIONS: These results suggested a differential impact of geographical variables on the detection rates of colorectal adenomas and cancers in the population. Further studies are needed to examine socio-economic factors likely to be involved in these disparities.
Référence
Dig Liver Dis. 2012 Feb;44(2):172-7
