Why an observatory?

The observatory’s pilot study was conducted in the Bouches-du-Rhône department due to the presence of numerous industrial sites and requests from the local population regarding their health in this specific area. The Revela 13 observatory is a program focused on environmental health: it collects data used to study the geographic distribution of cancers. Three types of cancer—kidney, bladder, and acute leukemia in adults—were selected based on the department’s industrial characteristics and health data from previous national and local studies.

What are the results?

This study described the distribution of the three targeted cancers (kidney, bladder, and acute leukemias in adults) across the Bouches-du-Rhône department and its municipalities.
Over the study period (2013–2016), Santé publique France identified more than 2,000 new cases of bladder cancer, 1,500 new cases of kidney cancer, and 400 cases of acute myeloid leukemia.

• The incidence rates for kidney cancer and acute myeloid leukemia are similar to those expected.

• Incidence rates for bladder cancer in men and women are higher than those observed in metropolitan France.

• Cases of bladder cancer are not distributed evenly across the department: the incidence rate is higher in Marseille and in the southeastern part of the department.

• This study alone does not allow for the identification of exposure factors that could explain this finding and will need to be supplemented by further studies.

The published results will be supplemented by an analysis at the sub-municipal level to determine whether there are smaller clusters of cases that are not visible at the municipal level. The influence of smoking, the primary risk factor for bladder cancer, on the geographic distribution of cases will be studied using an indicator reflecting smoking rates in each municipality.

Continuation of the surveillance system

The ARS Paca has requested methodological support from Santé publique France to continue and expand the surveillance of environment-related cancers in the Bouches-du-Rhône department. The details of the future surveillance system have not yet been finalized; they will be reviewed shortly by experts in the fields of cancer and the environment in consultation with a local committee comprising various stakeholders (associations, elected officials, citizens, scientists, etc.).