Nasopharyngeal carcinoma (NPC) is the second most common neoplasm of head and neck in Tunisia. The distribution is bimodal with a first period occurrence between 15 and 20 years old and a second peak at around 50 years of age. Undifferentiated carcinoma of nasopharynx type III (UCNT) is the predominant histological type (93.4%). Data of cancer registry of North Tunisia confirmed that it is an intermediate risk area for NPC with overall ASRs of 3.6 and 1.6/100,000 respectively in males and females. This study aimed to present the evolution of incidence rate of nasopharyngeal carcinoma over a period of 12 years (1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006). Data of cancer registry of North Tunisia (NTCR), covering half of the Tunisian population, were used to determine evolution of NPC incidence, calculated by 5 year periods. The estimated annual percentage change (EAPC) was used as an estimate of the trend. To best summarize the behavior or the data trend across years, we used a join-point regression program. Between 1994 and 2006, we observed negative annual average change of standardized incidence in men and women (-3.3%and -2.7%) also for the standardized incidences which showed a rather important decline (26.4% in males and 22.3% in females). The truncated age standardized incidence rate of NPC in adults aged of 30 years old and more (N= 1209) decreased by -0.4% per year from 1994 to 2006 over time in north Tunisia dropping from 6.09 to 4.14 person-years. However, the rate was relatively stable during this period among youths aged 0-29 years (N= 233) in both sexes. NPC demonstrated a favorable evolution from 1994-2006 probably due to a improvement in socioeconomic conditions.
Cystic echinococcosis is a public health problem. Surgery represents the basic treatment and the surgeon is regularly faced with the choice of the appropriate surgical procedure (radical versus conservative surgical approach). The conservative procedure is safe and easy but can lead to a recurrence in the site of residual cavity. The aim of this study was to evaluate the predictive factors of the recurrence of hepatic hydatid cysts, to optimize surgical management and to implement preventive measures. The current retrospective study included 391 patients with hepatic hydatid cysts operated at our institution from 1996 to 2006. The diagnosis of recurrence was suspected by radiological survey and confirmed at laparotomy. The univariate study of predictive factors of recurrence was based on the Fisher test and the multivariate one on the logistic regression model. The recurrence rate reached 12% in our study with an average period of 50 months. Univariate analysis showed that the predictive factors of recurrence were: the rural origin of patients, the voluminous cysts larger than 7 cm, and unilocular hydatid cyst. Multivariate analysis showed that only voluminous cysts and unilocular ones were the predictive factors of recurrence. The unilocular and voluminous hydatid cysts represent the cysts that relapse frequently because of their immunogenic character and the presence of exocysts in the pericysts. This is very important for the therapeutic strategy the main aim of which is to prevent the recurrence.
Introduction Tunisia as a developing country is passing through an epidemiologic changing with less infectious diseases and the occurrence of several other chronic diseases.Cancer is becoming a major problem of public health. The registry of cancer in Tunisia started in 1997 by the creation of the cancer registry of Northern Tunisia (CRNT), a population registry involving about half the population. This study aimed to present data of the CRNT including the epidemiologic profile and the evolution of the incidence rate of most cancers sites during a 10 year period (1994e2003) in the north of the country. Methods Referring to the CRNT data,we were able to determine the repartition of cancer according to sex,to calculate the brut and standardised incidence rate with a direct method on the basis of a world reference population. We could also find the incidence evolution and the cancer number of cases between 1994 and 2003. The results were compared to other registries data.Results From 1999 to 2003, the CRNT registered the average of 5049 cases per annum of invasive cancers. This average was about 3744 in 1994. The increase was about 36% in a 10 year period. The brut incidence rate was 120.2 in men and 94.8 in women. If standardised on age according to a referent world population, the result stayed the same (133.2 v/s101.4). Lung cancer occurred first in men and then bladder cancer. In women, the increased brut incidences concerned breast cancer and colon cancer, cervical cancer occupied the fourth position after the skin cancer. Over the period (1994e2003), the increase of 36% in cancer occurrence is due in men to the 60% increase of lung, colon and prostate cancer cases and in women the increase of 50% of breast cancer new cases and then 10% of colon cancer cases. Conclusion It seems that there is a continuous increasing of some cancers in Tunisia: breast cancer in women and lung cancer in men, colon cancer for both.
Breast cancer is the most frequent cancer localisation in Tunisian women. With ageing of population, combined to a generation effect, it is very likely that we will see in near future an important rise in breast cancer incidence. Also all the Tunisian data have always shown a high rate of young patients (ages below 35 years) around 11%. This study is designed to establish a forecast of the level of the incidence and of a numbers of cases of breast cancer until 2024 in Northern Tunisia. We also try to foresee the evolution of the percentage of young women.MethodsData given by the Cancer Registry of Northern Tunisia (CRNT) from 1994 to 2003 are used as a baseline for further prediction. This cancer register is covering half of the Tunisian population. Data of the incidence have estimated for the periods 2004–2008; 2009–2013; 2014–2018; 2019–2024. Predictions were based on a Bayesian Age-Cohort model. The implementation of this trial has been carried out by sampling after Gibbs method using WinBugs software.ResultsThe number of cases is growing continuously over the four periods. Thus, in 2019–2024, nearly 2000 cases/year are expected in the Northern part of the country. The standardised incidence will grow from 21.6 cases/100 000 women in 1994–1998 to 46.4 cases/100 000 women in 2019–2024, an increase of 80%. Until the age of 59 the specific rates par age rise moderately, beyond we can observe acceleration. Finally the projection allows a follow-up of the percentage of young women < 35 years in step with the periods. The ageing of the population and the cohort effect let us prevue a clear tendency to fall.ConclusionThe evolution of the percentage of young women show that the modification of the ages pyramid of the general population paired to a cohort effect (the future generations will have a higher risk), will lead to a lowering of this percentage over years. Thus it is very likely that we can't keep the genetic hypothesis (Tunisian women would have a higher risk due to genetic state).
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