[Exposome and prostate cancer: Experience in a remote hospital in French Guiana]

West Guiana is characterized by a precarious, poor, dispersed population, exposed to infectious and chemical factors. Prostate cancer is the leading cancer in terms of incidence in men. We examined its characteristics, management and main exposomes in this context.

This is a retrospective, descriptive, observational, monocentric study. We considered general external expositions (medico-social status, precariousness, geographical remoteness, culture), specific external (viral serologies, occupation, hypothesizing chemical exposures), and risk factors (comorbidities, overweight), cross-referenced with two cancer characteristics (histopronostic grade and stage).

Over a 6-year period, 70 patients were managed: the majority at a metastatic stage (53%), with a high histopronostic grade. Possible exposures were precariousness 45%, scattered housing 39%, maroon culture 48%, exposure to chemical agents 53%, but no exposure to viruses or notable medical risk factors. None of the comparisons showed any significant difference, with the exception of a higher proportion of metastatic cancers in the case of precariousness (71% versus 39%; P=0.015) and a trend for patients living in rural areas (67% versus 45%; P=0.09).

These results lead us to propose two strategies: 1 - organization of care as close as possible to patients; 2 - prospective translational research which, after an exhaustive review of the literature, concerns the study of candidate carcinogenic microorganisms, in particular HPV, and chemical pollution, which is very prevalent in French Guiana.