In this article, we analyzed trends in incidence rates of the major cancer sites for a 14-year period, 1993-2006, in the Sousse region localized in the centre of Tunisia. Five-year age-specific rates, crude incidence rates (CR), world age-standardized rates (ASR), percent change (PC) and annual percent change (APC) were calculated using annual data on population size and its estimated age structure. A total of 6,975 incident cases of cancer were registered, with a male to-female sex ratio of 1.4:1. ASRs showed stable trends (20.1% in males, and 11.0% in females). The leading cancer sites in rank were lung, breast, lymphoma, colon-rectum, bladder, prostate, leukemia, stomach and cervix uteri. For males, the incidence rates of lung, bladder and prostate cancers remained stable over time. While, cancers of colon-rectum showed a marked increase in incidence (APC: 14.8%; 95% CI: 1.2%, 8.4%) and non-Hodgkin's lymphoma (NHL) showed a notable decline (APC: 24.4%; 95% CI: 28.2, 20.6). For females, cancers of the breast (APC: 12.2%; 95% CI: 0.4%, 4.0%) and corpus uteri (APC: 17.4%; 95% CI: 2.8%, 12.0%) showed a marked increase in incidence during the study period, while the cervix uteri cancer decreased significantly (APC: 26.1%; 95% CI: 29.2%, 23.0%). The results underline the increasing importance of cancer as a cause of mortality and morbidity in Tunisia. Our findings justify the need to develop effective program aiming at the control and prevention of the spread of cancer amongst Tunisian population.Cancer is an eminent health problem in the developing countries. The high-ranking cancer instances that have been reported are, primarily, the outcome of growing population rates, increasing tobacco consumption, industrialization and westernization of diet and lifestyle.1,2 The establishment of population-based cancer registries provides more accurate statistics and help to improve both the monitoring of cancer trends over time and the understanding of this growing epidemic. [3][4][5] In Tunisia, there are almost three population-based cancer registries at the present time providing data on cancer incidence and survival. 5 The population-based cancer registry of the centre of Tunisia was established in 1987 under the auspices of the International agency of research on cancer (IARC), Lyon, France and located in the Pathology Department of the Farhet Hached University Hospital, Sousse, Tunisia. The cancer registry has provided important information on cancer patterns over the previous years. The quality of the data provided by the cancer registry of the centre region of Tunisia was judged quite appropriate to appear in ''Cancer Incidence in Five Continents (CI5) Vol. IX'' 6 and ''Cancer in Africa, Epidemiology and Prevention. '' 5 In this article, we report trends in the cancer incidence during the span of time between 1993 and 2006 from the population-based cancer registry of the centre of Tunisia.
Material and Methods
Data collection and follow-upCancer registry of the centre region of Tunisia includes six provinces: ...