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      Collaborative digital platform France – Cuba: oncorehabilitation in reproductive and sexual health

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          Abstract

          Background

          In the French West-Indies, few studies have been performed on fertility and sexual problems in cancer survivors, which are frequent and recurring issues reported by surveys on unmet needs. Additionally, mutualizing human and material resources and promoting cooperation through a collaborative platform are the most appropriate response to complex health pathways in the Caribbean territories. Implementation of such a collaborative platform will help to launch a strategic Caribbean partnership to transfer theoretical and technical skills and care standards in oncofertility and oncosexuality.

          Methods

          We propose to set up a collaborative digital platform to strengthen, from the French expertise, Cuban health professionals’ knowledge, know-how, and skills in oncofertility and oncosexuality. The project will be coordinated by a coordinating, scientific, and supervisory committee, and the main activities will include:

          1. Theoretical training in e-learning adapted to low-speed Internet.

          2. Practical training in fertility preservation and sexual rehabilitation.

          3. Digital multidisciplinary consultation meetings for medical decisions to be taken for complex clinical cases.

          The platform will benefit from a recurrent evaluation, by the two cancer registries of Martinique and Cuba, with the following performance indicators: number of Cuban professionals trained, number of professionals sensitized , hourly volumes (or number of training courses provided) , satisfaction of trained professionals , number of e-RCPs carried out online and number of missionaries supported. These indicators will be set up and analyzed by the registers.

          This project meets the Cuban and French health policies (cancer plans and national sexual health strategies) and will be implemented in liaison with the Health Agencies of both countries and the Embassy of France in Cuba.

          Discussion

          This project aims to provide support through bilateral exchanges to improve reproductive and sexual health in Cuba’s cancer patients. This collaboration will be based on a long-lasting French expertise and a solid Cuban health system. Consequently, this collaborative digital platform will contribute to data collection for cancer surveillance, and the two participating countries will ultimately be identified in the Caribbean as having centers of competence and excellence in oncofertility and oncosexuality with care standards.

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          Most cited references31

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          Global surveillance of trends in cancer survival 2000–14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries

          In 2015, the second cycle of the CONCORD programme established global surveillance of cancer survival as a metric of the effectiveness of health systems and to inform global policy on cancer control. CONCORD-3 updates the worldwide surveillance of cancer survival to 2014.
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            Average risks of breast and ovarian cancer associated with BRCA1 or BRCA2 mutations detected in case Series unselected for family history: a combined analysis of 22 studies.

            Germline mutations in BRCA1 and BRCA2 confer high risks of breast and ovarian cancer, but the average magnitude of these risks is uncertain and may depend on the context. Estimates based on multiple-case families may be enriched for mutations of higher risk and/or other familial risk factors, whereas risk estimates from studies based on cases unselected for family history have been imprecise. We pooled pedigree data from 22 studies involving 8,139 index case patients unselected for family history with female (86%) or male (2%) breast cancer or epithelial ovarian cancer (12%), 500 of whom had been found to carry a germline mutation in BRCA1 or BRCA2. Breast and ovarian cancer incidence rates for mutation carriers were estimated using a modified segregation analysis, based on the occurrence of these cancers in the relatives of mutation-carrying index case patients. The average cumulative risks in BRCA1-mutation carriers by age 70 years were 65% (95% confidence interval 44%-78%) for breast cancer and 39% (18%-54%) for ovarian cancer. The corresponding estimates for BRCA2 were 45% (31%-56%) and 11% (2.4%-19%). Relative risks of breast cancer declined significantly with age for BRCA1-mutation carriers (P trend.0012) but not for BRCA2-mutation carriers. Risks in carriers were higher when based on index breast cancer cases diagnosed at <35 years of age. We found some evidence for a reduction in risk in women from earlier birth cohorts and for variation in risk by mutation position for both genes. The pattern of cancer risks was similar to those found in multiple-case families, but their absolute magnitudes were lower, particularly for BRCA2. The variation in risk by age at diagnosis of index case is consistent with the effects of other genes modifying cancer risk in carriers.
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              Chlordecone exposure and risk of prostate cancer.

              Determining whether environmental estrogens are associated with the risk of prostate cancer may have important implications for our general understanding of this disease. The estrogenic insecticide chlordecone was used extensively in the French West Indies, contaminating the population for more than 30 years. We analyzed the relationship between exposure to chlordecone and the risk of prostate cancer. We investigated 623 men with prostate cancer and 671 controls. Exposure was analyzed according to case-control status, using either current plasma concentration or a cumulative exposure index based on years of exposure. We genotyped two single-nucleotide polymorphisms (rs3829125 and rs17134592) in the gene encoding chlordecone reductase. We found a significant increase in the risk of prostate cancer with increasing plasma chlordecone concentration (odds ratio [OR], 1.77; 95% CI, 1.21 to 2.58 for the highest tertile of values above the limit of detection [LD]; P trend = .002) and for cumulative exposure index (OR, 1.73; 95% CI, 1.04 to 2.88 for the highest quartile; P trend = .004). Stronger associations were observed among those with a positive family history of prostate cancer and among those who had lived in a Western country. The rs3829125 and rs17134592 allele variants were in complete linkage disequilibrium and were found at low frequency (0.04). Among subjects with plasma chlordecone concentrations above the LD, carriers of the allele variants had a higher risk of prostate cancer (OR, 5.23; 95% CI, 0.82 to 33.32). These findings support the hypothesis that exposure to environmental estrogens increases the risk of prostate cancer.
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                Author and article information

                Contributors
                thierry.almont@chu-martinique.fr
                Journal
                BMC Med Educ
                BMC Med Educ
                BMC Medical Education
                BioMed Central (London )
                1472-6920
                9 June 2021
                9 June 2021
                2021
                : 21
                : 337
                Affiliations
                [1 ]GRID grid.412874.c, Research on Cancer UF3596, Cancerology Department, , Martinique University Hospital (CHU Martinique), ; Fort-de-France, Martinique
                [2 ]GRID grid.412874.c, General Cancer Registry of Martinique UF1441, Cancerology Department, , Martinique University Hospital (CHU Martinique), ; Fort-de-France, Martinique
                [3 ]GRID grid.411175.7, ISNI 0000 0001 1457 2980, French Education and Research Group in Andrology, Urology and Sexology (GEFRAUS), Reproductive Medicine Department, , Paule de Viguier University Hospital, ; 330 avenue de Grande-Bretagne, TSA 70034, 31059, Toulouse cedex 9, France
                [4 ]GRID grid.411175.7, ISNI 0000 0001 1457 2980, EA 3694 Human Fertility Research Group, Reproductive Medicine Department, , Toulouse University Hospital, Paule de Viguier, ; 330 avenue de Grande-Bretagne, TSA 70034, 31059, Toulouse cedex 9, France
                [5 ]GRID grid.414381.b, Caribbean Center for Reproductive Medicine, CECOS CARAIBES, Pôle Parents-Enfants CHU de Pointe-à-Pitre 97159, ; Pointe-à-Pitre, Guadeloupe
                [6 ]Hospital Ginecobstétrico Ramón González Coro, Calle 21 No. 854 e/. 4 y 6 Vedado, Plaza de la Revolución, 10400 La Habana, Cuba
                [7 ]Registro Nacional de Cáncer de Cuba, Hospital Ginecobstétrico Ramón González Coro, Calle 21 No. 854 e/. 4 y 6 Vedado, Plaza de la Revolución, 10400 La Habana, Cuba
                [8 ]World Francophone Digital University, UNFM / HNSM 14 rue du Val d’Osne, 94450 Saint-Maurice, France
                [9 ]GRID grid.489492.a, Francophone Association for Supportive Care (AFSOS), ; 76, rue Marcel Sembat, 33130 Bègles, France
                Author information
                http://orcid.org/0000-0002-2536-2636
                Article
                2774
                10.1186/s12909-021-02774-w
                8190995
                34107919
                6675a8bc-8924-4bc6-91a2-ddce4accc18a
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 20 May 2021
                : 27 May 2021
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100011061, Agence Française de Développement;
                Award ID: 2147369
                Categories
                Study Protocol
                Custom metadata
                © The Author(s) 2021

                Education
                oncosexuality,oncofertility,collaborative platform,caribbean
                Education
                oncosexuality, oncofertility, collaborative platform, caribbean

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