Introduction Today, a growing need exists for greater research into cancer survivorship, focusing on different spheres of the day-to-day life of diagnosed patients. This article describes the design and implementation of VICAN (VIe après le CANcer), a national survey on French cancer survivors. Method and analysis The target population included patients aged 18–82, diagnosed with cancer between January and June 2010, and registered in one of the three main French Health Insurance Schemes. It was restricted to 12 tumour sites. Sampling was stratified using a non-proportional allocation, based on age at diagnosis (18–52 and 53–82) and tumour site. Data were collected from telephone interviews with patients 2 and 5 years after diagnosis, a medical survey completed by the physician who initiated cancer treatment, and information from the national medicoadministrative database on reimbursement data and hospital discharge records. First data collection, 2 years after diagnosis, occurred between March and December 2012. Second data collection, 5 years after diagnosis, will be conducted in 2015. Analyses will be conducted on various outcomes: quality of life, health status and psychosocial conditions, with a particular focus on the impact of cancer diagnosis on the labour market. The variety of measurements included in the survey will enable us to control a wide range of factors. Ethics and dissemination The methodology of the VICAN survey was approved by three national ethics commissions. Results of the study will be disseminated through national and international research conferences, and in articles published in international peer-reviewed journals.

The objective of this study was to analyse the respective roles of personal factors and HIV infection markers on the systemic immune activation/inflammatory profile of long-term antiretroviral treatment-controlled patients. A panel of soluble immune activation/inflammatory biomarkers was measured in 352 HIV-infected treatment-controlled patients from the APROCO-COPILOTE cohort, all of whom were started on a PI in 1997–99 and had a final evaluation 11 years later, and in 59 healthy controls. A total of 81.5% of the patients were male, with the following characteristics: median age 49 years; 620 CD4 cells/mm³; 756 CD8 cells/mm³; CD4/CD8 ratio 0.81; BMI 23.0 kg/m²; waist-to-hip ratio 0.95. Markers of inflammation—high-sensitivity (hs) IL-6 (median and IQR) (1.3 pg/L, 0.7–2.6), hs C-reactive protein (CRP) (2.1 mg/L, 0.9–4.5) and D-dimer (252 ng/mL, 177–374)—were elevated compared with healthy controls (P < 0.001) and strongly related to each other, as were markers of immune activation [soluble (s) CD14 (1356 ng/mL, 1027–1818), β₂-microglobulin (2.4 mg/L, 2.0–3.1) and cystatin-C (0.93 mg/L, 0.82–1.1)]. Inflammatory and immune activation markers were also associated with each other. In HIV-infected patients: age was related to D-dimer, β₂-microglobulin and cystatin-C levels; being a smoker was related to increased IL-6 and cystatin-C; and BMI and waist-to-hip ratio were related to CRP. Conversely, markers of HIV infection, current CD4 or CD8 values, CD4 nadir, CD4/CD8 ratio, AIDS stage at initiation of PIs, current viral load and duration of ART were not associated with immune activation/inflammation markers. In these long-term treatment-controlled HIV-infected patients, all systemic markers of inflammation and immune activation were increased compared with healthy controls. This was related to demographic and behavioural factors, but not to markers of severity of the HIV infection. Intervention to decrease low-grade inflammation must thus prioritize modifiable personal factors.

Background: Colorectal cancer (CRC) is accompanied by specific treatment-related physical (ostomy, incontinence) and psychosexual (body image, depression) consequences on sexual health. Aim: To assess sexual health of patients with CRC 2 years after diagnosis. Methods: We selected all patients with CRC from a French nationwide longitudinal study. Data sources included patient questionnaires, medical questionnaires, and medico-administrative databases. Main Outcome Measure: We evaluated sexual health using the Relationship and Sexuality Scale and assessed self-reported rates of discussion about sexuality with health care providers. Results: Across the 487 patients, 258 were men and 229 were women; 77% were diagnosed with colon cancer and 23% with rectal cancer. Overall, 54% of patients reported a decrease in sexual desire, 61% a decrease in frequency of intercourse, and 48% a decrease in the possibility to reach an orgasm. Patients still experiencing fecal incontinence 2 years after diagnosis had decreases in all sexual desire, intercourse, orgasm, and satisfaction Relationship and Sexuality Scale items. Patients with rectal cancer had significantly more frequent troubles with desire and orgasm than did patients with colon cancer (P = .003 and P = .014, respectively). Regarding the discussion about sexuality, only 20% of men, 11% of women, 11% of patients with colon cancer, and 33% of patients with rectal cancer recalled having discussed sexuality with the medical team. Factors independently increasing the chance to have discussed sexuality with the medical team were younger age (odds ratio [OR] = 2.77 [1.31; 5.84]; P = .007), having an ostomy (OR = 2.93 [1.27; 6.73]; P = .011), and radiotherapy (OR = 2.78 [1.23; 6.27]; P = .014). Clinical Implications: These results highlight the need for developing interventions to improve information delivery at cancer announcement and for managing sexual troubles during survivorship in patients with CRC, particularly those experiencing fecal incontinence. Strength & Limitations: Strengths are the sample size and the national representation using the data of a large-scale nation-wide survey, with the possibility of comparing colon and rectal cancers. Limitations are the assessment of sexuality 2 years after diagnosis and using only self-reported measures. Conclusion: This study highlights the lack of discussion about sexuality with the oncology team and the need for specific sexual rehabilitation interventions, especially for patients with rectal cancer and fecal incontinence. Developing these aspects may help patients with CRC improve their sexual prognosis.