IntroductionOccupation can contribute to differences in risk and stage at diagnosis of breast cancer. This study aimed at determining whether occupation, along with skill level and the socio-professional category, affect the breast cancer survival (BCS) up to 10 years after diagnosis.Materials and methodsWe used cancer registry records to identify women diagnosed with primary invasive breast cancer in western Switzerland over the period 1990–2014 and matched them with the Swiss National Cohort. The effect of work-related variables on BCS was assessed using non-parametric and parametric net survival methods.ResultsStudy sample included 8,678 women. In the non-parametric analysis, we observed a statistically significant effect of all work-related variables on BCS. Women in elementary occupations, with low skill level, and in paid employment not classified elsewhere, had the lowest BCS, while professionals, those with the highest skill level and belonging to top management and independent profession category had the highest BCS. The parametric analysis confirmed this pattern. Considering elementary occupations as reference, all occupations but Craft and related trades had a hazard ratio (HR) below 1. Among professionals, technicians and associate professionals, and clerks, the protective effect of occupation was statistically significant and remained unchanged after adjustment for age, calendar period, registry, nationality, and histological type. After adjusting for tumor stage, the HRs increased only slightly, though turned non-significant. The same effect was observed in top management and independent professions and supervisors, low level management and skilled laborers, compared to unskilled employees.ConclusionThese results suggest that work-related factors may affect BCS. Yet, this study was conducted using a limited set of covariates and a relatively small study sample. Therefore, further larger studies are needed for more detailed analyses of at risk occupations and working conditions and assessing the potential interaction between work-related variables and tumor stage.

Introduction Lung and breast cancer are important in the working-age population both in terms of incidence and costs. The study aims were to estimate the 10-year risk of lung and breast cancer by occupation and smoking status and to create easy to use age-, and sex-specific 10-year risk charts. Methods New lung and breast cancer cases between 2010 and 2014 from all 5 cancer registries of Western Switzerland, matched with the Swiss National Cohort were used. The 10-year risks of lung and breast cancer by occupational category were estimated. For lung cancer, estimates were additionally stratified by smoking status using data on smoking prevalence from the 2007 Swiss Health Survey. Results The risks of lung and breast cancer increased with age and were the highest for current smokers. Men in elementary professions had a higher 10-year risk of developing lung cancer compared to men in intermediate and managerial professions. Women in intermediate professions had a higher 10-year risk of developing lung cancer compared to elementary and managerial professions. However, women in managerial professions had the highest risk of developing breast cancer. Discussion The 10-year risk of lung and breast cancer differs substantially between occupational categories. Smoking creates greater changes in 10-year risk than occupation for both sexes. The 10-year risk is interesting for both patients and professionals to inform choices related to cancer risk, such as screening and health behaviors. The risk charts can also be used as public health indicators and to inform policies to protect workers.

IntroductionOccupation and socio-economic status may both contribute to differences in risk and stage at diagnosis of breast cancer. We aimed at determining whether occupation, skill level required for the occupation and the socio-professional category affect the breast cancer survival (BCS) up to 10 years after diagnosis.Material and MethodsWe used cancer registry records to identify women diagnosed with primary invasive breast cancer between 1990 and 2014 in western Switzerland and matched them with the Swiss National Cohort. The effect of work-related variables on BCS was assessed using non-parametric and parametric net survival methods.ResultsStudy sample included 8,678 women. In the non-parametric analysis, we observed a statistically significant effect of all work-related variables on BCS. Women in elementary occupations, with low skill level, and in paid employment not classified elsewhere, had the lowest BCS, while professionals, those with the highest skill level and belonging to top management and independent profession category had the highest BCS. The parametric analysis confirmed this pattern. Considering elementary occupations as reference, all occupations but Craft and related trades had a hazard ratio (HR) below 1. Among professionals, technicians and associate professionals, and clerks, the protective effect of occupation was statistically significant and remained unchanged after adjustment for age, calendar period, registry, nationality and histological type. After adjustment for tumor stage, the HRs increased only slightly, though turned non-significant. The same effect was observed in top management and independent professions and supervisors/low level management and skilled laborers, compared to unskilled employees.ConclusionThese results suggest that work-related factors may affect BCS. As this study was conducted using a relatively small sample and limited set of covariates, further larger studies are required for a more detailed analyses of at risk occupations and working conditions and assessing the potential interaction between work-related variables and tumor stage.

While previous Swiss studies have demonstrated differences in lung cancer mortality between occupational groups, no estimates are available on the association of occupation-related factors with lung cancer survival. This study aimed at determining whether occupation or work-related factors after diagnosis affect lung cancer survival. We used cancer registry records to identify lung cancer patients diagnosed between 1990 and 2014 in western Switzerland (n = 5773) matched with the Swiss National Cohort. The effect of occupation, the skill level required for the occupation, and the socio-professional category on 5-year lung cancer survival was assessed using non-parametric and parametric methods, controlling for histological type and tumour stage. We found that the net survival varied across skill levels and that the lowest skill level was associated with worse survival in both men and women. In the parametric models with minimal adjustment, we identified several occupational groups at higher risk of mortality compared to the reference category, particularly among men. After adjustment for histological type of lung cancer and tumour stage at diagnosis, most hazard ratios remained higher than 1, though non-statistically significant. Compared to top managers and self-employed workers, workers in paid employment without specific information on occupation were identified as the most at-risk socio-professional category in nearly all models. As this study was conducted using a relatively small sample and limited set of covariates, further studies are required, taking into account smoking habits and administrated cancer treatments. Information on return to work and working conditions before and after lung cancer diagnosis will also be highly valuable for analysing their effect on net lung cancer survival in large nationwide or international studies. Such studies are essential for informing health and social protection systems, which should guarantee appropriate work conditions for cancer survivors, beneficial for their quality of life and survival.

Socioeconomic differences in breast cancer (BC) incidence are driven by differences in lifestyle, healthcare use and occupational exposure. Women of high socioeconomic status (SES) have a higher risk of BC, which is diagnosed at an earlier stage, than in low SES women. As the respective effects of occupation and SES remain unclear, we examined the relationships between occupation-related variables and BC incidence and stage when considering SES. Female residents of western Switzerland aged 18–65 years in the 1990 or 2000 census, with known occupation, were linked with records of five cancer registries to identify all primary invasive BC diagnosed between 1990 and 2014 in this region. Standardized incidence ratios (SIRs) were computed by occupation using general female population incidence rates, with correction for multiple comparisons. Associations between occupation factors and BC incidence and stage at diagnosis were analysed by negative binomial and multinomial logistic regression models, respectively. The cohort included 381,873 women-years and 8818 malignant BC, with a mean follow-up of 14.7 years. Compared with reference, three occupational groups predominantly associated with a high socioprofessional status had SIRs > 1: legal professionals (SIR = 1.68, 95%CI: 1.27–2.23), social science workers (SIR = 1.29; 95%CI: 1.12–1.49) and some office workers (SIR = 1.14; 95%CI: 1.09–1.20). Conversely, building caretakers and cleaners had a reduced incidence of BC (SIR = 0.69, 95%CI: 0.59–0.81). Gradients in BC risk with skill and socioprofessional levels persisted when accounting for SES. A higher incidence was generally associated with a higher probability of an early-stage BC. Occupation and SES may both contribute to differences in risk and stage at diagnosis of BC.

Le cancer du sein est le cancer le plus frequent et le plus mortel chez la femme. Le depistage par mammographie est actuellement le seul moyen avec une efficacite demontree pour diminuer la mortalite dans la population feminine de 50 a 74 ans. La mammographie permet de detecter une tumeur avant qu’elle ne devienne palpable et le plus souvent avant qu’elle n’envahisse les ganglions lymphatiques. Les femmes beneficiant d’un diagnostic precoce ont plus de 90% de chance de guerison. Le programme BEJUNE de depistage a demarre en 2005 dans le canton du Jura avant de s’etendre au canton de Neuchâtel en 2007 et a l’arrondissement du Jura bernois des 2009. Il offre une mammographie prise en charge a 90% hors franchise par l’assurance de base, tous les deux ans, a toutes les femmes âgees entre 50 et 74 ans. Les Jurassiennes beneficient de la gratuite de cet examen, la quote-part de 10% etant prise en charge par les collectivites publiques. Contrairement au depistage effectue hors des programmes, les programmes doivent satisfaire a des normes strictes de qualite et se soumettre a des evaluations periodiques externes de leurs performances afin d’assurer leur efficacite. Ce document resume les principaux resultats du rapport complet de l’evaluation realisee par unisante, avec un focus sur la plus recente periode (2014-2017).

Malgre une baisse de l’incidence et de la mortalite, le cancer du sein demeure le plus frequent et le plus mortel chez la femme avec environ 370 femmes touchees chaque annee a Geneve et 80 qui en decedent. Le depistage par mammographie reste le seul moyen dont l’efficacite est scientifiquement prouvee pour diminuer son impact. Le cancer du sein est le plus frequent et le plus mortel. Des evaluations independantes et regulieres permettent de s’assurer que la qualite et l’efficacite d’un programme de depistage repondent a des normes internationales. Le mandat d’evaluation du programme genevois de depistage du cancer du sein a ete confie au Departement epidemiologie et systemes de sante du Centre universitaire de medecine generale et sante publique a Lausanne (Unisante)a, en charge de l’evaluation de nombreux programmes de depistage en Suisse et de la precedente evaluation du programme genevois. Evaluation externe du programme par un centre expert. Deuxieme evaluation du programme genevois par Unisante. Ce rapport porte sur la periode 2012 a 2017. Il inclut une evaluation de l’activite du programme, de son utilisation, de sa qualite et de son efficacite. En outre, des analyses de l’impact de l’introduction de la lecture de consensus et de l’effet de l’intervalle entre deux depistages sur la precocite diagnostique sont presentees. Evaluation de l’activite, de la participation, de la qualite et de l’efficacite entre 2012 et 2017. L’activite du programme continue de croitre, atteignant en 2018 plus de 13'000 mammographies realisees. Grâce a l’augmentation du nombre de mammographies et aux mesures prises par le programme (reduction du nombre de radiologues ; complement de lectures avec un logiciel d’entrainement), le volume de lectures par radiologue respecte les normes suisses de qualite depuis 2016. La participation au programme reste en-dessous de la moyenne nationale et des normes preconisees, malgre une tendance a la hausse. Sur 10 femmes invitees, 3 participent et, parmi les participantes, 8 sur 10 repondent positivement a l’invitation suivante (fidelisation). La participation est plus basse chez les femmes dont le resultat du precedent depistage etait un faux-positif. La qualite du programme a vu des ameliorations importantes et rapides avec l’introduction de la lecture de consensus en septembre 2014. Depuis ce changement, les taux de reconvocation et de faux-positifs ont fortement baisse et satisfont les normes europeennes en tour incident, mais pas en tour prevalent. La qualite radiologique du programme genevois est desormais au moins similaire a la moyenne des programmes suisses, mais demeure inferieure a celle des programmes romands. La frequence des cancers d’intervalle du programme genevois satisfait la norme europeenne de qualite en premiere mais pas en deuxieme annee apres le depistage. L’efficacite du programme atteint en grande partie les normes europeennes et demeure stable depuis la derniere evaluation. La proportion de cancers de stade avance reste trop elevee. Un long delai (>26 mois) entre deux depistages influence marginalement le profil pronostique des cancers depistes. Ce profil est nettement plus favorable que celui des cancers d’intervalle et des cancers diagnostiques suite a des symptomes. La precocite diagnostique des cancers depistes par le programme est largement comparable a celle des cancers depistes en dehors du programme. Les performances du programme se traduisent, pour 1000 participations, par 946 resultats de mammographie normaux (vrais negatifs), 54 resultats faussement positifs (dont 6 donnent lieu a une investigation invasive), 5 cancers depistes (1 in situ, 2 de stade precoce et 2 de stade avance) et 2 cancers d’intervalle, ce qui equivaut a une sensibilite du programme de 79,4% et une specificite de 93,7%. Chez les femmes de 70 a 74 ans, invitees depuis 2014, la qualite du depistage est accrue et la participation est comparable a celle des femmes de 50 a 69 ans. Ces resultats donnent lieu a trois recommandations : 1.Poursuivre les efforts de diminution du taux de reconvocation en tour prevalent 2.Organiser des relectures periodiques des cliches 3.Documenter rigoureusement les mesures et strategies mises en place pour ameliorer la qualite du programme.

Le cancer du sein est le cancer le plus frequent et le plus mortel chez la femme. Dans les cantons du Jura et de Neuchâtel, 200 femmes en sont atteintes et 45 en decedent chaque annee. Le depistage par mammographie reste le seul moyen avec une efficacite demontree pour diminuer son impact. Le programme BEJUNE, en fonction depuis mai 2005 dans le canton du Jura, 2007 dans le canton de Neuchâtel et 2009 pour l’arrondissement du Jura bernois, promeut et organise l’action de depistage aupres de la population feminine de 50 a 69 ans des regions concernees. Depuis 2014, le programme a ete etendu aux femmes jusqu’a 74 ans. Des evaluations independantes et regulieres permettent de s’assurer que la qualite et l’efficacite d’un programme de depistage repondent a des normes internationales. L’evaluation du programme BEJUNE a ete confiee au Departement Epidemiologie et systemes de sante du Centre universitaire de medecine generale et sante publique a Lausanne (Unisante), en charge de l’evaluation de nombreux programmes de depistage en Suisse. Ce rapport decrit l’evolution de l’activite du programme depuis son debut jusqu’en 2017 (section 2) et analyse son utilisation (section 3), sa qualite (section 4) et son efficacite (section 5). Pour la premiere fois, il traite les participantes de 70 a 74 ans et evalue les cancers d’intervalle du programme. Les resultats presentes dans ce rapport se basent sur 143’000 mammographies et pres de 44’000 femmes. Le nombre annuel de mammographies effectuees dans le programme BEJUNE augmente depuis 2005, avec un plateau entre 2011 et 2015. Les R2 interpretent depuis 2015 pres de 5000 lectures par an, surpassant largement les normes recommandees en Suisse. Grâce a la collaboration avec le programme bernois, le volume de lectures des radiologues 1e lecteurs (R1) satisfait egalement les normes. La participation au programme de six femmes sur dix (cantons du Jura et de Neuchâtel, periode 2014-17 : 63,6% et 61,9%), dont neuf reviennent regulierement, est comparativement elevee dans le contexte suisse. La participation est plus basse chez les femmes dont le resultat du depistage precedent etait un faux-positif, celles de 70 a 74 ans, dans les regions les moins peuplees et l’arrondissement du Jura bernois (44,1%). La hausse de la participation en premiere invitation devrait augurer de tendances participatives favorables. En tenant compte du depistage hors programme, la couverture par mammographie de la population feminine de la region BEJUNE approche les normes europeennes. Les indicateurs de qualite des lectures, en termes de taux de reconvocation, de faux-positifs et de detection respectent les normes europeennes avec des valeurs plus favorables que la moyenne suisse. Ces performances se sont ameliorees en tour incident jusqu’en 2014. Une legere tendance inverse apparait depuis avec une augmentation des taux de reconvocation et de faux-positifs. La frequence des cancers d’intervalle du programme BEJUNE satisfait la norme europeenne de qualite en premiere mais pas pour la deuxieme annee apres le depistage. Leur frequence est plus elevee que dans les autres programmes suisses evalues a ce jour. Les performances en termes d’efficacite et de precocite diagnostique atteignent globalement les normes europeennes, sont stables dans le temps et comparables aux autres programmes suisses. La comparaison des profils cliniques des cancers depistes avec les cancers d’intervalle et les cancers diagnostiques sur une base symptomatologique confirme une detection de cancers a un stade et avec un profil pronostic plus favorables dans le cadre du programme de depistage. Le premier bilan des resultats pour les femmes de 70 a 74 ans est encourageant. La qualite des lectures radiologiques s’ameliore avec l’âge de sorte que les performances qualitatives sont superieures a celles observees chez les femmes plus jeunes La precocite diagnostique des cancers depistes est similaire a celle mesuree chez les femmes de 50 a 69 ans. Ces resultats sont ponderes par un niveau de participation et de fidelisation plus bas et une frequence relative des cancers d’intervalle plus elevee (basee sur un faible effectif). Plus de recul est necessaire pour evaluer fiablement les benefices et risques du depistage apres 69 ans. Les performances recentes du programme se traduisent, pour 1000 participations, par 968 resultats de mammographie normaux (vrais negatifs), 25 resultats faussement positifs (dont 5 donnent lieu a un examen invasif), 5 cancers depistes (1 in situ, 3 de stade precoce et 1 de stade avance) et 2 cancers d’intervalle (sensibilite du programme: 70,1% ; specificite du programme: 97,7%). Trois recommandations accompagnent ce rapport: • Une surveillance plus rapprochee de la frequence des cancers d’intervalle. • Une documentation plus rigoureuse et systematique des informations cliniques sur les cancers, avec un controle retrospectif de qualite • Une documentation systematique des mesures et des strategies mises en place pour ameliorer la qualite du programme.

The new federal Act on registration of oncological diseases requires since January 1st 2020 institutions and treating physicians to transmit regulated data on all Swiss cancer cases and some precancerous pathologies to the competent tumour registry, and to inform their patients about it. This legal basis is intended to enlarge cancer data collection and registration in a traceable, better standardized, more complete and rapid manner. These legal provisions are expected to improve the reliability and efficiency of the analysis of the data, which is crucial for the epidemiological surveillance of cancer in Switzerland, for the benefit of public health policy, clinical management and for the population.

Abstract Abstract Introduction The incidence of neuroendocrine neoplasms (NENs) seems to increase worldwide. However, long-term, population-based data that consider differentiation levels are sparse. Objective To evaluate the incidence trend of lung and gastroenteropancreatic (GEP) NENs according to the latest International Agency for Research on Cancer/World Health Organization classification over a 41-year time period in two Swiss regions. Methods All cases of lung and GEP NENs recorded in the Vaud and Neuchâtel Cancer Registries from 1976–2016 were included. NENs were stratified into well-differentiated neuroendocrine tumors (NETs) and poorly differentiated neuroendocrine carcinomas (NECs). Changes in annual age-standardized incidence rates were calculated for lung and GEP NETs and NECs by sex. Results There were 4141 patients diagnosed with NENs, of which 65% were men. The incidence of lung NETs did not reveal any statistically significant trend in men, but increased in women by 4.9%/year between 1976–2016. The incidence of lung NECs in men decreased significantly by 2.6%/year from 1985–2016 whereas the incidence of lung NECs in women increased significantly between 1976–1998 by 6%/year. For GEP NETs, a steady annual increase in incidence occurred between 1976–2016 with a magnitude of 1.7% in men and 1.3% in women. No trend in incidence of GEP NECs was found for both sexes. Conclusions The incidence trends of lung NECs in men and women parallel changes in smoking prevalence in the population whereas causes of the increase in incidence of GEP NETs are not fully understood. Our study supports the importance of evaluating the epidemiology of NENs by their differentiation level.

The incidence of neuroendocrine neoplasms (NENs) seems to increase worldwide. Long‐term, population‐based series that consider tumor differentiation are, however, sparse. We assessed the incidence trend of lung and gastroenteropancreatic (GEP) NENs according to the latest International Agency for Research on Cancer/World Health Organization classification over a 41‐year time period in two Swiss regions. All cases of lung and GEP NENs recorded in the Vaud and Neuchâtel Cancer Registries from 1976 to 2016 were included. NENs were stratified into well‐differentiated neuroendocrine tumors (NETs) and poorly differentiated neuroendocrine carcinomas (NECs). Changes in annual age‐standardized incidence rates were calculated for lung and GEP NETs and NECs by sex. Of 4,141 patients diagnosed with NENs, 65% were men. The incidence of lung NETs among men and women increased by 3.9%/year (95% CI: −5.3, 14.1%) and 4.9%/year (0.1, 9.9%), respectively, between 1976 and 2016. The incidence of lung NECs decreased by 2.6%/year (−3.1,‐1.8%) in men from 1985 to 2016 whereas it increased in women between 1976 and 1998 by 6%/year (4.2, 7.9%). For GEP NETs, a steady annual increase in incidence occurred between 1976 and 2016 with a magnitude of 1.7% (0.7, 2.7%) in men and 1.3% (0.5, 2.1%) in women. No significant trend in incidence of GEP NECs was found for both sexes. The incidence trends of lung NECs in men and women parallel changes in smoking prevalence in the population. Causes of the increase in incidence of GEP NETs are likely multifactorial. Our study supports the importance of evaluating the epidemiology of NENs by tumor differentiation.

BACKGROUND:Screening for prostate cancer is frequent in high-income countries, including Switzerland. Notably due to overdiagnosis and overtreatment, various organisations have recently recommended against routine screening, potentially having an impact on incidence, mortality, and surgery rates. Our aim was therefore to examine whether secular trends in the incidence and mortality of prostate cancer, and in prostatectomy rates, have recently changed in Switzerland.METHODS:We conducted a population-based trend study in Switzerland from 1998 to 2012. Cases of invasive prostate cancer, deaths from prostate cancer, and prostatectomies were analysed. We calculated changes in age-standardised prostate cancer incidence rates, stratified by tumor stage (early, advanced), prostate cancer-specific mortality, and prostatectomy rates.RESULTS:The age-standardised incidence rate of prostate cancer increased greatly in men aged 50-69 years (absolute mean annual change +4.6/100,000, 95% CI: +2.9 to +6.2) between 1998 and 2002, and stabilised afterwards. In men aged ≥ 70 years, the incidence decreased slightly between 1998 and 2002, and more substantially since 2003. The incidence of early tumor stages increased between 1998 and 2002 only in men aged 50-69 years, and then stabilised, while the incidence of advanced stages remained stable across both age strata. The rate of prostatectomy increased markedly until 2002, more so in the 50 to 69 age range than among men aged ≥ 70 years; it leveled off after 2002 in both age strata. Trends in surgery were driven by radical prostatectomy. Since 1998, the annual age-standardised mortality rate of prostate cancer slightly declined in men aged 50-69 years (absolute mean annual change -0.1/100,000, 95% CI: -0.2 to -0.1) and ≥ 70 years (absolute mean annual change -0.5/100,000, 95% CI: -0.7 to -0.3).CONCLUSIONS:The increases in the incidence of early stage prostate cancer and prostatectomy observed in Switzerland among men younger than 70 years have concomitantly leveled off around 2002/2003. Given the decreasing mortality, these trends may reflect recent changes in screening and clinical workup practices, with a possible attenuation of overdiagnosis and overtreatment.

Lung cancer is the commonest cancer worldwide. Mortality and incidence rates are traditionally used to assess cancer burden and as public health indicators. However, these metrics are difficult to interpret at an individual level. Providing the lifetime and 10-year risks of cancer could improve risk communication. Our aim was to estimate current lifetime and 10-year risks of lung cancer by smoking status and changes in these risks between 1995 and 2013 in a Swiss population. We used all lung cancer cases recorded between 1995 and 2013 by two population-based cancer registries in the contiguous cantons of Vaud and Valais, in Western Switzerland. We estimated sex-specific lifetime risk and 10-year risk of lung cancer using the current probability method, accounting for competing risk of death. Estimates were also provided by smoking status. Between 1995 and 2013, 9623 cases of lung cancer were recorded. During this period, the lifetime risk decreased in men from 7.1% to 6.7% and increased in women from 2.5% to 4.1%. In both sexes, the 10-year risk of lung cancer increased with age until the age of 60–70 and decreased thereafter. Difference in the cumulative risk between current, former, and never smokers were very large and reported in user-friendly charts to ease risk communication. These lifetime and 10-year risk estimates could be used systematically as public health indicators. Regularly updating risk estimations are necessary for conditions like lung cancer whose incidence has changed substantially.

Background The increase in incidence of thyroid cancer during the last decades without concomitant rise in mortality may reflect the growing detection of indolent forms of thyroid cancer, and may have fueled unnecessary thyroidectomies. Our aim was therefore, to compare recent secular trends in surgical intervention rate for thyroid cancer with the incidence and mortality of thyroid cancer to assess overdiagnosis and resulting overtreatment. Methods We conducted a population-based temporal trend study in Switzerland from 1998 to 2012. All cases of invasive thyroid cancer, deaths from thyroid cancer, and cancer-related thyroidectomies were analyzed. We calculated changes in age-standardized thyroid cancer incidence rates, stratified by histologic subtype and tumor stage, thyroid cancer-specific mortality, and thyroidectomy rates. Results Between 1998 and 2012, the age-standardized annual incidence of thyroid cancer increased from 5.9 to 11.7 cases/100,000 among women (annual mean absolute increase: +0.43/100,000/year) and from 2.7 to 3.9 cases/100,000 among men (+0.11/100,000/year). The increase was limited to the papillary subtype, the most indolent form of thyroid cancer. The incidence of early stages increased sharply, the incidence of advanced stages increased marginally, and the mortality from thyroid cancer decreased slightly. There was a three- to four-fold increase in the age-standardized annual thyroidectomy rate in both sexes. Conclusions We observed a large increase in the incidence of thyroid cancer, limited to papillary and early stage tumors, with a three- to four-fold parallel increase in thyroidectomy. The mortality slightly decreased. These findings suggest that a substantial and growing part of the detected thyroid cancers are overdiagnosed and overtreated. Impact Targeted screening and diagnostic strategies are warranted to avoid overdetection and unnecessary treatment of thyroid cancers.

Une enquete par questionnaire (annexe 1) a ete conduite dans les cantons du Jura, de Neuchâtel et de l’arrondissement du Jura bernois aupres des medecins dont l’activite majoritaire est la medecine de famille (generalistes et internistes, ci-apres referes comme medecins de premiers recours (MPR)). Cette enquete, menee par l’IUMSP, documente les pratiques usuelles de depistage du cancer colorectal (CCR), ainsi que la position, les attentes et les difficultes attendues face a un modele de programme organise de depistage du CCR. Le modele propose prevoit l’offre conjointe d’un test immunologique de recherche de sang dans les selles et d’une coloscopie. L’enquete s’interesse aussi a la faisabilite de modeles alternatifs de depistage. Validee par un groupe de travail intercantonal l’enquete a ete prealablement testee aupres de 25 medecins et professionnels de sante en suisse romande. L’envoi du questionnaire a ete gere par le Centre de depistage du cancer du sein BEJUNE avec le soutien des societes medicales neuchâteloises et jurassiennes, et du Cercle medical de Pierre-Pertuis. Le traitement des donnees et les analyses ont ete effectuees par l’IUMSP. A titre comparatif, les resultats agreges de ces enquetes pour l’ensemble des cantons romands (sauf Vaud) sont fournis en annexe 2.