Cancer incidence trend in northern tunisia: 1994-2009

Abstract Background Cancer is a major public health problem in Tunisia. The objectives of this study were to describe the epidemiological pattern of cancer for all and main cancer sites in Northern Tunisia during the period 2007-2009 and to analyze it’s incidence trend between 1994 and 2009. Methods Cancer registry of Northern Tunisia was the source of data for the identification of patients for this study. This registry notify, since 1994, all cases of malignant tumor in people living in the District of Tunis, Nabeul, Zaghouan, Bizerte (North East) Beja, Jendouba, Kef and Siliana (North West). Cases were codified using the third version of International Classification of Diseases for Oncology. Demographic data were provided by the National Statistical Institute. Incidence trend analysis was achieved by using JoinPoint Software. Results During the period 2007-2009, the age-standardised incidence rate of all sites combined was 149.2/100 000 person-years and 112.3/100 000 person-years respectively among males and females. The sex ratio was 1.26. The mean age at diagnosis was 58.28±16.77 years. The most common sites for males were: lung, bladder, prostate and colorectal; while for females, they were breast, colorectal, thyroid and cervix uteri. Local stage at diagnosis was observed in 37.7% of cases. The highest incidence rates were observed in the District of Tunis and in the governorates of North East. The trend incidence cancer of all sites combined during the period from 1994 to 2009 was significantly risen except for stomach cancer among males and cervix uteri among females with annual percent changes of -2.5% and of -4.1% respectively. Conclusions Despite the existence of a national cancer strategy in Tunisia, many barriers affect the implementation of interventions; while the trend cancer incidence continues to rise particularly in males. Strengthening prevention strategy of this scourge is strongly recommended. Key messages Cancer is a major public health in world and in Tunisia. Prevention must be applied to reduce the incidence of cancer.