Prostate Cancer Incidence in Guadeloupe, a French Caribbean Archipelago
Introduction
Prostate cancer is now the most common non-skin cancer diagnosed and the second cause of deaths due to cancer in men in most western countries [1]. Despite the many studies carried out, not all the etiological factors have yet been clearly identified. Aging, geographic origin and a family history of prostate cancer are the only well-established risk factors for the disease [2].
Worldwide, there is considerable geographic variation in the incidence of prostate cancer. Asian countries have much lower rates of occurrence of the disease than North American, and North and Western European countries, with Southern European and South American countries displaying an intermediate incidence rate [3]. Such differences seem to be linked to ethnic characteristics. It has been shown that black men living in the USA have a high incidence of prostate cancer [4]. However, environmental factors seems to be determinant, as demonstrated by the rapid increase in the incidence of prostate cancer observed in populations migrating from geographic areas of low risk to areas of high risk [5].
Consequently, identifying and studying the environmental and genetic characteristics of high-risk populations could help to improve significantly our understanding of the disease and its prevention. We report here the data for prostate cancer incidence from 1995 to 2003 in Guadeloupe, an overseas department of France in the Caribbean with unique geographic, ethnic and environmental characteristics, which may help to improve our understanding of the etiology of the disease.
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Materials and methods
Guadeloupe is an archipelago of seven islands covering 1706 square km, with around 420,000 inhabitants. It is located between the eastern Caribbean Sea and the North Atlantic Ocean. All prostate cancers diagnosed from 1995 to 2003 in Guadeloupe were included in this study. In the absence of a cancer registry for Guadeloupe, data were collected from all the pathology laboratories comprising the Department of Pathological Anatomy at the University Hospital of Guadeloupe and the two private
Results
There were 2531 new cases of pathologically confirmed prostate cancer from 1995 to 2003 (Table 1). The mean, median and range of ages at prostate cancer diagnosis for the period as a whole were 72, 72, and 42 to 98 years, respectively. The number of cases remained stable at about 228 cases per year from 1995 to 1999, but then increased by almost 87% over the next four years. Consequently, the crude and world age-standardized rates, which did not vary significantly between 1995 and 1999 period,
Discussion
In the absence of a cancer registry in Guadeloupe, information collected from the records of pathology laboratories may present certain limitations. The absence of systemic double checking at the medical or clinical office and at the pathology laboratory may result in under or overestimation. The lack of a standardised case assessment chart means it is not possible to collect complete data on pathological stage for all new cases. Nevertheless, despite this limitation, our data clearly show that
Acknowledgments
This study was supported by funds from INSERM and from the French Ministry of Health (PHRC). We would like to thank to M. Roudier, B. Geoffroy-Perez, M. Le Houcq, A. Marel, J.B. Poirat, B. Théron-Aboud, M. Trival, and A. Youcef-Khodja for helping us to collecting data.
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