EPICENE

Theme 1: Cancer survival
Theme 2: Methods in environmental and occupational exposures
Theme 3: Environmental Etiology of Cancer

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Theme 1: Cancer survival: improving knowledge, detecting frail individuals, identifying surrogate endpoints

Although survival rates have improved for the main cancers over the past decades, they remain highly variable depending on the cancer site and on many more individual parameters. We strive to further understand the factors associated with better survival for cancer patients.

Thanks to our involvement in population based cancer registries, we generate new data on cancer survival and its determinants (treatments, comorbidities, care practices, palliative care) for several cancer types (hematological cancers, breast cancer…).We pay particular attention to frail people, for whom efforts of detection and prevention are strongly needed, including elderly people whose number will rapidly increase in the coming decades. We develop new tools for detection programs and we investigate cancer literacy in elderly cancer patients.

Our efforts also focus on improving cancer screening strategies (including organized mass screening). We also develop new biostatistical approaches to assess treatment efficacy and patient survival in randomized controlled trials and in real-life settings

Theme 2: Methods in environmental and occupational exposures: the exposome knowledege

Our research aims to improve the knowledge of levels and determinants of exposure to major contaminants with field measurements in order to identify the main determinants of exposure (usable in retrospective questionnaires and in large population cohorts).

Our research on pesticide exposures started 25 years ago and continues to provide many original data through the PESTEXPO program. We now aim to document baseline levels for “everyday” contamination on a farm and explore pesticide exposures in non-farming jobs (i.e., gardening, wood industry…).

We also explore the exposures of the general population living near treated fields.
We combine field measurements and ergonomic observations. Levels and determinants of exposures to other pollutants are also studied, such as nanoparticles in the occupational and environmental settings, antineoplastic drugs in healthcare workers, electromagnetic fields…

We also develop indirect exposure assessment tools, such as Job Exposure Matrices (PESTIMAT, MATPUF) and spatial modeling. Usable retrospectively in large populations with minimal collection of data (job or residential calendars), they are very useful to our epidemiological studies.

Theme 3: Environmental Etiology of Cancer

For more than 20 years, we have studied the etiology of CNS tumors, hematological malignancies and mesothelioma thanks to registries that we set up in this domain and our collaborations at both national and international levels.

Recently, we also developed studies on sarcomas. As etiological research, including the role of the environment, remains scarce for most rare cancers, we intend to analyze the role of environmental determinants in the occurrence of these cancers, for which the role of environmental factors is suspected.

Our efforts rely on cohorts (AGRICAN, LUCSO, REALYSA), case-control studies (CERENAT, ETIOSARC), and data from international consortia (AGRICOH, INTERLYMPH).

We attempt to better understand cancer risks in specific populations, suspected to be more vulnerable because of individual conditions or comorbidities (e.g., allergies, immunological disorders), genetic characteristics (polymorphisms of detoxification genes,…) or specific exposures (women, smokers…)