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H Lefevre

Publications and source records attributed to H Lefevre.

9 recordsLinked to original sources
PubMed2002

[Diagnosis, treatment, and prognosis of lung cancer in the Manche (France) (1997-1999) according to patients socioeconomic characteristics].

BACKGROUND: In France, data on social environment influence on cancer management and prognosis are rare and no study has been conducted on lung cancer. This study was designed to investigate the associations between place of residence and occupation class, and diagnosis, treatment and prognosis of lung cancer. METHODS: The study population consisted of the 585 cases of lung cancer collected by the cancer registry of the Manche department (France) over a three-year period (1997-1999). Distribution of qualitative variables was tested using chi(2) test. Multivariate analysis were conducted using logistic regressions. Differences in actuarial survival were tested using log-rank test. RESULTS: Difference in diagnostic conditions did not demonstrate any prominence by social characteristics. People living in rural areas did however have a higher probability of therapeutic abstention than people living in urban areas (adjusted odds ratio=2.20 [1.18-4.10]). Similarly, people without any occupational activity had a probability of therapeutic abstention higher than people with an occupational activity (adjusted odds ratio=3.40 [1.99-5.80]). Moreover, occupational class and place of residence had a significant influence on the place of diagnosis and treatment, lower class and rural people being less often managed in university hospitals. Regarding prognosis, our results do not give prominence to difference in survival according to social characteristics. CONCLUSION: This study suggests that the type of center providing patient care and the nature of treatment given could be associated with the socioeconomic status of the patient. Nevertheless, due to the small sample size, further studies in a larger series would be required to make any formal conclusion.

Adult↗
PubMed2001

Stage of extension and treatment for colorectal cancer after a negative test and among non-responders in mass screening with guaiac faecal occult blood test: a French experience.

Despite its proven efficacy in three randomized trials, the relevance of mass screening for colorectal cancer using the guaiac faecal occult blood test is still debated. The low sensitivity of the test and the poor participation rate, especially in France, are major obstacles to its effectiveness. The aim of our study was to characterize cancers occurring after a negative test and among non-participants in the screening programme organized in the French department of Calvados. Cancers in the negative test group had a later stage of extension than subjects testing positively but an earlier stage of extension than cancers in the reference group, which were not different from those of non-responders. The proportion of resection for non-responders was significantly lower than that for participants, whatever the test result (P < 0.001), and lower than that for reference subjects (P < 0.05). There was no difference in treatment between negative and positive responders. Negative responders did not have a delayed cancer diagnosis or a worse condition of treatment than people who were not screened. Low sensitivity reduced the efficacy of colorectal cancer screening but did not seem to increase the potential to do harm.

Aged↗
PubMed1999

Colorectal cancer after a negative Haemoccult II test and programme sensitivity after a first round of screening: the experience of the Department of Calvados (France).

Colorectal cancers emerging after a negative Haemoccult II are described in the context of a first round of mass screening in the Department of Calvados (France), from April 1991 to the end of December 1994. People with a cancer occurring after a negative test until 31 December 1995 were identified by a local cancer registry. Incidence was calculated and the programme sensitivity was estimated. The incidence of cancer emerging after a negative test was 57.7 per 100000, i.e. half of the calculated incidence in the reference group (141.6 per 100000). These cancers did not differ from those of either the non-responder or reference groups, in particular for the stage of extension. The programme sensitivity was globally higher than that estimated in European trials: 77.2, 66.3 and 55.9%, 1, 2 and 3 years after the test respectively. Programme sensitivity was higher for distal colon cancer 1 year after the test, which is probably due to the relatively slow growth of this subsite.

Aged↗
PubMed1999

Recent time trends in cancer of the oesophagus and gastric cardia in the region of Calvados in France, 1978-1995: a population based study.

The incidence of oesophageal cancer differs from country to country, and even between areas of the same country. Many studies in recent years have shown an upward trend of a particular histologic type: adenocarcinoma of the oesophagus. It is difficult to precisely locate adenocarcinomas situated at the junction between the oesophagus and the gastric cardia. Clear criteria to define and classify such tumours are essential in order to analyse their evolution. The present study describes the changing incidence of cancers of the oesophagus and gastric cardia according to histologic type from 1978 to 1995 in Calvados, the highest-risk French region with two different topographic classifications of adenocarcinomas: one based on Misumi's criteria and the other based on local extension of cancer. In total, 1835 cancers of the oesophagus and gastric cardia were diagnosed in this period. Incidence rates for oesophageal and gastric cardia cancers standardized on the world population were 24.4/10(5) and 2.4/10(5) in men and 1.4/10(5) and 0.4/10(5) in women, respectively. The time trend in the incidence of squamous cell cancers was downward in men -0.74 (P < 10(-6)) and stable in women +0.04 (P = 0.65). Regarding adenocarcinomas, with the classification based on Misumi's categories, there was a slight but significant upward trend for oesophageal adenocarcinoma in men [mean annual variation of +0.09 (P < 10(-5))] while the tendency was downward and significant for gastric cardia adenocarcinoma [mean annual variation of -0.09 (P < 10(-4))]. When adenocarcinomas of the oesophagus and those of the gastric cardia with oesophageal involvement are taken together (second classification), there was an upward trend which was not significant in men and was significant in women. There was no such upward trend in adenocarcinomas limited to the gastric cardia and/or involving the stomach. Because of the difficulties in determining accurate localization routinely in population-based studies, it seems sensible to preclude classification biases in recommending the grouping together of gastric cardia adenocarcinomas with oesophageal adenocarcinomas, at least with those among the latter occurring in the lower third of the oesophagus.

Adenocarcinoma↗