Latest database descriptions

1. Carry out epidemiological surveillance of congenital abnormalities in the population of Reunion Island (determination of prevalence and distribution) and identification of malformation risk factors (genetic, environmental, related to drugs or toxins); with the purpose of sounding the alert when any environmental teratogenic agents become evident (e.g. drug, pesticide exposure, industrial accident) at local, national and international level. Should clusters of malformations be detected (surveillance-alert of an increase in prevalence over time of a given malformation), checks must be made regarding recording bias before conducting further investigations. Then specific risk factors will be sought.

2. Evaluate the impact of public health initiatives in the population:
- Evaluation of prenatal screening of malformations is a fundamental objective for the registry, with participation in the field of perinatal medicine and local obstetric practices

- Implementation and evaluation of prevention initiatives are also important, such as the primary prevention of neural tube closing defects via folic acid supplements before conception.

2. Identification of possible new syndromes and supply of new information for genetic counseling of families. e-transmission method, genetic heterogeneity, genetic susceptibility factor.

The registry's primary objective is to conduct epidemiological surveillance of congenital malformations
in Auvergne, with a role of sounding the alert when any environmental teratogenic agents become evident. With the
development of prevention measures - particularly in the field of prenatal diagnosis - this surveillance-alert mission has gradually been extended to include an essential role in evaluating the impact of public health policies with regards to perinatal care on the population.
The registry also helps to improve knowledge in the field of malformations
by collaborating on studies with specialist clinical departments (particularly genetic and
foetal medicine departments) and by being involved in the Multidisciplinary Center for Prenatal Diagnosis in Clermont-
Ferrand (the registry's data provides food for thought from obstetricians on the meaning and action to take when certain malformations are observed during prenatal diagnosis).
Lastly, the registry's data informs healthcare stakeholders and the public authorities
about congenital malformations and chromosomal abnormalities.

To establish a sustainable information system by unifying data, its interpretation and potential use for public health decision-making or clinical practice for all partners involved (network organisation) and to organise epidemiological knowledge, biostatistics and data necessary to: - Estimate the number of dialysis or transplant patients for chronic renal disease in France and overseas territories, - Assess the impact (Objective 80 of Public Health Law), prevalence, mortality rates and trends in chronic renal disease at regional level, patient sociodemographic characteristics, baseline renal disease, comorbidities and associated disabilities - Specifically describe dialysis treatment modalities (method, modality, dose) and changing tendencies towards population requirements and medical practices - Evaluate relative aspects of different dialysis and transplantation modalities and to describe patient trajectories through these treatment modalities - Assess quality and efficacy of care in terms of early detection, dialysis dose, control of anaemia and nutritional balance, particularly with regard to good clinical practice - Evaluate patients' quality of life (Objective 81 of Public Health Law); - Evaluate the medical and economic outcomes of health care practices.

Objectives of the registry in terms of public health (surveillance, evaluation):
Thanks to the multi-source collection of digestive cancer cases, the registry's aim is to produce
quality data for calculating health indicators: it allows for the exact measurement of
incidence trends for digestive cancers depending on the tumour site or
anatomopathological type as well as patient survival.
By recording incident cancer cases, in the years to come, we will be able to evaluate the efficacy of Hémoccult screening for colorectal cancer, conducted in the département since June 2004 (Cancer Screening Association ADEC 29).

- Objectives of the registry in terms of research:
The digestive tumour registry has already been used for medical theses and
publications. Locally, incidence and survival studies are undertaken on a regular basis by the
registry's team. We also have projects with local partners: the Brest University Hospital Centre team,
University of West Brittany (prognostic factor of statin prescription on the occurrence of cancers).

The registry's data covers the entire validated period (1984-2006) and is sent annually to the national cancer incidence base managed by the FRANCIM network, the French Institute for Public Health Surveillance and Lyon Civil Hospices. As such, we are participating in the national cancer surveillance programme and contributing to national research.