Publications by authors named "Zoe Uhry"

Background: In descriptive epidemiology, there are strong similarities between incidence and survival analyses. Because of the success of multidimensional penalized splines (MPSs) in incidence analysis, we propose in this pedagogical paper to show that MPSs are also very suitable for survival or net survival studies.

Methods: The use of MPSs is illustrated in cancer epidemiology in the context of survival trends studies that require specific statistical modelling.

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Article Synopsis
  • This study compares two methods for estimating death probabilities in multiple sclerosis (MS) patients: the Cause-Specific Framework (CSF) which requires known causes of death, and the Excess Mortality Framework (EMF) which does not.
  • Using data from a large MS registry and a subset with detailed death records, the researchers found that EMF generally estimated higher death probabilities than CSF across different age groups.
  • Overall, the analysis revealed varying mortality probabilities for MS patients based on the initial disease type, sex, and age; with significant differences particularly noted between relapsing-onset MS and primary progressive patients over a 30-year follow-up.
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Objective: To determine the effects of current age and disease duration on excess mortality in multiple sclerosis (MS), we describe the dynamics of excess death rates over these 2 time scales and study the effect of age at MS clinical onset on these dynamics, separately in each initial phenotype.

Methods: We used data from 18 French MS expert centers participating in the Observatoire Français de la Sclérose en Plaques. Patients with MS living in metropolitan France and having a clinical onset between 1960 and 2014 were included.

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Background: In many countries, epidemiological surveillance of chronic diseases is monitored by local registries (LR) which do not necessarily cover the whole national territory. This gap has fostered interest in using non-registry databases (e.g.

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Background: Cancer-incidence and mortality-trend analyses require appropriate statistical modelling. In countries without a nationwide cancer registry, an additional issue is estimating national incidence from local-registry data. The objectives of this study were to (i) promote the use of multidimensional penalized splines (MPS) for trend analyses; (ii) estimate the national cancer-incidence trends, using MPS, from only local-registry data; and (iii) propose a validation process of these estimates.

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Background: It is of interest to both the clinicians and patients to estimate the probability of death owing to cancer in the presence of other causes as time elapses since diagnosis. The objective of this study was to depict for patients diagnosed with colon cancer between 1990 and 2010 in France, the probability of surviving up to 10 years after diagnosis and to disentangle the probability of death owing to cancer from that of death owing to other causes.

Patients And Methods: Individuals with cancer were described, up to 10 years after diagnosis, as belonging to one of three categories: those who died owing to a cause related to cancer, those who died owing to another cause and those who survived.

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Cancer survival trend analyses are essential to describe accurately the way medical practices impact patients' survival according to the year of diagnosis. To this end, survival models should be able to account simultaneously for non-linear and non-proportional effects and for complex interactions between continuous variables. However, in the statistical literature, there is no consensus yet on how to build such models that should be flexible but still provide smooth estimates of survival.

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There is a growing interest in using health care (HC) data to produce epidemiological surveillance indicators such as incidence. Typically, in the field of cancer, incidence is provided by local cancer registries which, in many countries, do not cover the whole territory; using proxy measures from available nationwide HC databases would appear to be a suitable approach to fill this gap. However, in most cases, direct counts from these databases do not provide reliable measures of incidence.

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Background: Pancreatic cancer is one of the most lethal. Most countries have exhibited a stable or decreasing incidence over time. The aim of this study was to provide updated French temporal trends in pancreatic cancer incidence and mortality over the past three decades.

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This study provides updates of net survival (NS) estimates at 5, 10, and 15 years as well as survival trends for 35 solid cancers in France using data from 19 population-based cancer registries. The study considered all cases of solid cancer diagnosed between 1989 and 2010 in patients older than 15 years of age who were actively followed up until 30 June 2013. NS was estimated using the Pohar-Perme method.

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Net survival, the one that would be observed if the disease under study was the only cause of death, is an important, useful, and increasingly used indicator in public health, especially in population-based studies. Estimates of net survival and effects of prognostic factor can be obtained by excess hazard regression modeling. Whereas various diagnostic tools were developed for overall survival analysis, few methods are available to check the assumptions of excess hazard models.

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Human papillomavirus (HPV) has been recently recognised as a carcinogenic factor for a subset of head and neck cancers (HNC). In Europe, France has one of the highest incidence rates of HNC. The aim of this study is to explore changes in HNC incidence in France, potentially in relation with infection by HPV.

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European Latin countries have some similarities in their health systems. It is thus interesting to look at their differences in cancer survival (here, ovarian cancer) through monitoring of specific indicators of quality care. The aim of this SUDCAN collaborative study was to compare the trends in 1 and 5-year net survival from ovarian cancer and the trends in the excess mortality rates between six European Latin countries (Belgium, France, Italy, Portugal, Spain and Switzerland).

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In Europe as a whole, survival from skin malignant melanoma (SMM) has increased constantly since the 1980s. The aim of the SUDCAN collaborative study was to compare the trends in the 5-year net survival from SMM and in related excess mortality rate between six European Latin countries (Belgium, France, Italy, Portugal, Spain, and Switzerland). The data were extracted from the EUROCARE-5 database (end of follow-up: 01 January 2009).

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Survival is a key measure of the effectiveness of a healthcare system. European Latin countries have some similarities in their health systems; it is thus interesting to examine their differences in survival from cancer, here, lung cancer. The aim of the SUDCAN collaborative study was to compare the trends in the 1- and 5-year net survival from lung cancer and the trends in the excess mortality rates between six European Latin countries (Belgium, France, Italy, Portugal, Spain and Switzerland).

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The aim of the SUDCAN collaborative study was to compare the trends in 1- and 5-year net survival and the trends in the dynamics of the excess mortality rates in head and neck cancers between six European Latin countries (Belgium, France, Italy, Portugal, Spain and Switzerland). The data were extracted from the EUROCARE-5 database. First, the net survival was studied over the 2000-2004 period using the Pohar-Perme estimator.

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The main objective of the SUDCAN study was to compare, for 15 cancer sites, the trends in net survival and excess mortality rates from cancer 5 years after diagnosis between six European Latin countries (Belgium, France, Italy, Portugal, Spain and Switzerland). The data were extracted from the EUROCARE-5 database. The study period ranged from 6 (Portugal, 2000-2005) to 18 years (Switzerland, 1989-2007).

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The aim of the SUDCAN collaborative study was to compare the net survival from 15 cancers diagnosed in 2000-2004 in six European Latin countries and provide trends in net survival and dynamics of excess mortality rates up to 5 years after diagnosis from 1992 to 2004 in France, Italy, Spain, and Switzerland, and from 2000 to 2004 in Belgium and Portugal. This paper presents a detailed description of the data analyzed and quality indicators. Incident cases from Belgium, France, Italy, Portugal, Spain, and Switzerland were retrieved from 56 general or specialized population-based cancer registries that participated in the EUROCARE-5 database.

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Objective: To assess disease activity within 12 months after natalizumab (NZ) discontinuation in a large French postmarketing cohort.

Methods: In France, patients exposed at least once to NZ were included in the TYSEDMUS observational and multicenter cohort, part of the French NZ Risk Management Plan. Clinical disease activity during the year following NZ discontinuation was assessed in this cohort.

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Objective: The aim of this epidemiological study was to describe the incidence, mortality and survival of ovarian cancer (OC) in France, according to age, period of diagnosis, and histological type.

Methods: Incidence and mortality were estimated from 1980 to 2012 based on data in French cancer registries and from the Centre for Epidemiology of Causes of Death (CépiDc-Inserm) up to 2009. Net survival was estimated from registry data using the Pohar-Perme method, on cases diagnosed between 1989 and 2010, with date of last follow-up set at 30 June 2013.

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Data on anal cancer epidemiology are rare. The aim of this study was to report on trends of incidence and survival for anal cancer in France before the implementation of the human papilloma virus vaccine. This analysis was carried out on 1150 squamous-cell carcinomas of the anal canal diagnosed from 1989 to 2004 in a population of 5.

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Background: District-level cancer incidence estimation is an important issue in countries without a national cancer registry. This study aims to both evaluate the validity of district-level estimations in France for 24 cancer sites, using health insurance data (ALD demands--Affection de Longue Durée) and to provide estimations when considered valid. Incidence is estimated at a district-level by applying the ratio between the number of first ALD demands and incident cases (ALD/I ratio), observed in those districts with cancer registries, to the number of first ALD demands available in all districts.

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Objective. Use of cancer cases from registries and PMSI claims database to estimate Département-specific incidence of four major cancers. Methods.

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Mortality from asthma has decreased in many countries since the 1990s. Mortality statistics are usually based only on the underlying cause of death. The objectives of this study were to describe the characteristics of deaths and the trends in asthma-related mortality using multiple-cause analysis.

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The aim of this study was to analyse the role of women's sociodemographic and healthcare access characteristics according to breast cancer screening practices (organized, individual or no screening). A cross-sectional study was set up in seven French districts using a self-administered postal questionnaire. Randomization was stratified proportionally on age and urban/rural status in each district separately among attendees and nonattendees to the organized breast cancer screening programme (OS).

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