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Purpose Sexuality, a substantial factor in quality of life, may be altered after breast cancer (BC) treatments as they intimately afflict femininity. This study aimed to assess the prevalence of sexual dysfunction in women with a history of BC and to compare it with women without a BC history. Methods The French general epidemiological cohort CONSTANCES includes more than 200,000 adults. All inclusion questionnaires from CONSTANCES non-virgin adult female participants were analyzed. Women reporting a history of BC were compared to controls in univariate analysis. Multivariate analysis was performed to highlight any demographic risk factor for sexual dysfunction. Results Among the 2,680 participants who had a history of BC, 34% did not engage in sexual intercourse (SI) in the month preceding the completion of the questionnaire (n=911), 34% had pain during SI (n=901) and 30% were not satisfied with their sex life (n=803). After adjustment on age, sexual dysfunction was significantly more frequent in women who had a history of BC: they had less frequent SI (OR 0.59 [0.54,0.64], ppConclusions Overall, in this real-life study in a large national cohort, history of BC appeared to be a risk factor for sexual disorders. Implications for Cancer Survivors Efforts to detect sexual disorders in BC survivors and offer quality support must be pursued.

ImportancePersistent symptoms after SARS-CoV-2 infection are an emerging public health problem. The duration of these symptoms remains poorly documented.ObjectiveTo describe the temporal dynamics of persistent symptoms after SARS-CoV-2 infection and the factors associated with their resolution.Design, Setting, and ParticipantsThis cross-sectional study involved 53 047 participants from 3 French adult population-based cohorts (CONSTANCES [Consultants des Centres d’Examens de Santé], E3N/E4N, and Nutrinet-Santé) who were included in a nationwide survey about SARS-CoV-2 infection. All participants were asked to complete self-administered questionnaires between April 1 and June 30, 2020. Variables included sociodemographic characteristics, comorbid conditions, COVID-19 diagnosis, and acute symptoms. Blood samples were obtained for serologic analysis between May 1 and November 30, 2020, from patients with SARS-CoV-2 infection defined as enzyme-linked immunosorbent assay immunoglobulin G antispike detection confirmed with a neutralization assay. A follow-up internet questionnaire was completed between June 1 and September 30, 2021, with details on persistent symptoms, their duration, and SARS-CoV-2 infection diagnosis by polymerase chain reaction.Main Outcomes and MeasuresPersistent symptoms were defined as symptoms occurring during the acute infection and lasting 2 or more months. Survival models for interval-censored data were used to estimate symptom duration from the acute episode. Multivariable adjusted hazard ratios (HRs) were estimated for age, sex, and comorbid conditions. Factors associated with the resolution of symptoms were assessed.ResultsA total of 3972 participants (2531 women [63.7%; 95% CI, 62.2%-65.2%]; mean [SD] age, 50.9 [12.7] years) had been infected with SARS-CoV-2. Of these 3972 participants, 2647 (66.6% [95% CI, 65.1%-68.1%]) reported at least 1 symptom during the acute phase. Of these 2647 participants, 861 (32.5% [95% CI, 30.8%-34.3%]) reported at least 1 persistent symptom lasting 2 or more months after the acute phase. After 1 year of follow-up, the estimated proportion of individuals with complete symptom resolution was 89.9% (95% CI, 88.7%-90.9%) with acute symptoms. Older age (>60 years; HR, 0.78; 95% CI, 0.68-0.90), female sex (HR, 0.64; 95% CI, 0.58-0.70), history of cancer (HR, 0.61; 95% CI, 0.47-0.79), history of tobacco consumption (HR, 0.80; 95% CI, 0.73-0.88), high body mass index (≥30: HR, 0.75; 95% CI, 0.63-0.89), and high number of symptoms during the acute phase (>4; HR, 0.43; 95% CI, 0.39-0.48) were associated with a slower resolution of symptoms.Conclusions and RelevanceIn this cross-sectional study, persistent symptoms were still present in 10.1% of infected individuals at 1 year after SARS-CoV-2 infection. Given the high level of cumulative incidence of COVID-19, the absolute prevalent number of people with persistent symptoms is a public health concern.

Background Self-reported data are prone to item non-response and misreporting. We investigated to what extent the use of self-reported data for participation in breast (BCS) and cervical cancer screening (CCS) impacted socioeconomic inequalities in cancer screening participation. Methods We used data from a large population-based survey including information on cancer screening from self-reported questionnaire and administrative records (n = 14 122 for BCS, n = 27 120 CCS). For educational level, occupation class and household income per capita, we assessed the accuracy of self-reporting using sensitivity, specificity and both positive and negative predictive value. In addition, we estimated to what extent the use of self-reported data modified the magnitude of socioeconomic differences in BCS and CCS participation with age-adjusted non-screening rate difference, odds ratios and relative indices of inequality. Results Although women with a high socioeconomic position were more prone to report a date for BCS and CCS in questionnaires, they were also more prone to over-declare their participation in CCS if they had not undergone a screening test within the recommended time frame. The use of self-reported cancer screening data, when compared with administrative records, did not impact the magnitude of social differences in BCS participation but led to an overestimation of the social differences in CCS participation. This was due to misreporting rather than to item non-response. Conclusions Women’s socioeconomic position is associated with missingness and the accuracy of self-reported BCS and CCS participation. Social inequalities in cancer screening participation based on self-reports are likely to be overestimated for CCS.

Objectives To investigate the relationship between patterns of gynaecological check-up and body mass index while accounting for various determinants of health care use. Methods Sequence analysis and clustering were used to highlight patterns of gynaecological check-up, which included the regularity of breast and cervical cancer screening and visits to the gynaecologist over four years, among 6182 women aged 54–65 included in the CONSTANCES cohort between 2013 and 2015 in France. Multinomial logistic regressions were used to study the association between these patterns and women’s body mass index. Results We identified four patterns of gynaecological check-up, from (A) no or inappropriate check-up (20%) to (D) almost one visit to the gynaecologist every year, overscreening for cervical cancer and frequent use of opportunistic breast cancer screening (12%). From patterns A to D, the proportion of obese women decreased and that of women with normal body mass index increased. Obese and overweight women underwent more breast than cervical cancer screening and were less often overscreened than normal weight women. These differences were only partly explained by the lower socioeconomic situation of overweight and obese women. Beyond the financial barrier, the screening modality and the type of exam may play a role. Among women who were screened for cervical cancer, obese and overweight women were less often screened by a gynaecologist. Conclusion Further efforts should be made to enhance the take-up of screening among obese women who are deterred by the healthcare system.

Resume Position du probleme Le developpement et l’utilisation des bases de donnees en sante accentuent le besoin d’outils, notamment d’algorithmes reconnus et valides de selection de sejours ou de patients atteints de cancer. Dans le cadre du developpement du reseau REDSIAM (Reseau de donnees Sniiram, Systeme national d’information inter-regimes de l’assurance maladie), le groupe « Tumeurs » avait pour objectif de dresser un etat des lieux des algorithmes publies dans les etudes en cancerologie, francaises ou etrangeres, afin de permettre au lecteur en recherche d’algorithme de cibler ceux susceptibles de l’interesser. Methode Une recherche non systematique de la litterature a ete effectuee pour diverses localisations. Les resultats sont presentes pour le poumon, sein, colon et rectum. Les publications jusqu’en aout 2016 ont ete recherchees dans les bases de donnees Medline, Scopus, Base de donnee en sante publique, Google Scholar et dans les sommaires des principales revues francaises en cancerologie et sante publique. Une grille d’extraction adaptee a la cancerologie a ete construite et utilisee lors du processus d’extraction. Resultats Au total, 18 publications ont ete retenues pour le cancer du poumon, 18 pour le cancer du sein et 12 pour le cancer colorectal. Les performances et le choix des algorithmes utilises s’averent dependant du contexte, de l’objectif et de la localisation etudiee. La grille de description construite par le groupe « Tumeurs » est plus detaillee compare au socle bibliographique commun aux autres groupes de REDSIAM, mais son remplissage reste simple. Conclusions Cette etude montre la complexite de la detection des cas de cancers a partir des bases de donnees en sante et l’insuffisance d’algorithmes valides. Il est necessaire de promouvoir et de developper les travaux visant a normaliser et faciliter la validation de ces algorithmes.

International audience; PURPOSE:Despite their higher risk for and mortality from cervical cancer, evidence indicates low rates of cervical cancer screening (CCS) among women with obesity. The literature on the specific factors related to CCS nonadherence in this population is limited.METHODS:We examined the data on 2,934 women with obesity included in the CONSTANCES survey from 2012 to 2015. Using the Andersen's behavioral model, we studied the relationships between the socioeconomic, sociodemographic, health, health personal behaviors, and healthcare use-related factors with CCS nonadherence. The analysis was performed using structural equation models.RESULTS:Regular follow-up by a gynecologist, good quality of primary care follow-up, and comorbidities were negatively associated with CCS nonadherence. Limited literacy, older age, being single, living without children, and financial strain were positively associated with CCS nonadherence. Our results do not point to competitive care, since women with comorbidities had better CCS behaviors, which were explained by a good quality of primary care follow-up.CONCLUSION:Our study identified the factors that explain CCS nonadherence among women with obesity and clarified the effects of health status and healthcare use on screening. Further efforts should be undertaken to reduce the obstacles to CCS by improving care among women with obesity.

International audience; Background: The combined association between primary care utilization and health status with breast cancer screening (BCS) and cervical cancer screening (CCS) remains unclear. Our aim was to identify women's profiles based on their health status and primary care utilization and study their associated adherence to BCS and CCS recommendations.Methods: Using data from the cohort of people visiting health screening centers (CONSTANCES) in France (2012–2015), we first identified women's profiles based on their health status (self-perceived health, physical, and mental health) and primary care utilization (visit to the General Practitioner [GP], uptake of blood tests) using a multiple correspondence analysis and a hierarchical cluster analysis. We then investigated the association of these profiles to BCS and CCS using logistic regression models adjusted for age, smoking status, sociodemographic and socioeconomic characteristics, and the regularity of gynecologist consultation.Results: We identified five distinct profiles of women with contrasted participation in BCS (n = 14,122) and CCS (n = 27,120). In multivariate analyses, cancer screening participation increased from women with very good health and poor primary care utilization, to those with poor health and frequent visits to the GP, and those with very good health and average primary care utilization. The most favorable profiles regarding cancer screening rates were women with average-to-poor health and regular visits to the GP and uptake of blood tests.Conclusions: Our results suggest that policies aiming at increasing cancer screening participation should simultaneously account for women's use of primary care and health and consider more specific subgroups than what is usually done. Further research should investigate factors motivating cancer screening practice, such as women's beliefs regarding cancer screening and women's psychological characteristics

International audience; BACKGROUND:Immigrant women often have lower cervical cancer screening (CCS) rates, tend to have a higher body mass index (BMI) and may be more vulnerable to BMI-related stigmatization. Our aim was to assess the role of BMI in differences in CCS rates by migration history.METHODS:Analyses were based on the 2012-2015 inclusion data (n = 27,226) for the population-based CONSTANCES cohort, including detailed, self-reported information on demographics and socioeconomic characteristics, migration history, health behaviours, health, and health care use. Measured BMI (underweight (30)) was collected. Poisson regression models with robust variance were conducted to assess the contribution of BMI to differences in CCS rates by migration history, and analyses stratified by BMI were done. Multiple imputations were performed.RESULTS:The CCS rates ranged from 87% among French-born women with two French parents to 86% among French-born women with at least one parent of foreign origin, 82% among naturalized immigrants and 74% among non-naturalized immigrants. After adjusting for covariates, non-naturalized immigrants showed an 11% (95% CI: 8%-14%) lower CCS rate than French-born women with two French parents. Adjusting for BMI did not change the estimates. When stratifying by BMI category, non-naturalized immigrants showed an 11% (7%-14%) lower CCS rate then French-born with two French parents when normal weight, a 9% (2%-16%) lower CCS rate when overweight, and an 18% (5%-30%) lower CCS rate when obese.CONCLUSION:Migration history and BMI jointly impact CCS rates. They were lower among all non-naturalized immigrants, particularly those who were obese.

Background Socioeconomic inequalities are observed in breast cancer screening (BCS) and cervical cancer screening (CCS) in France. A large range of determinants is associated with BCS and CCS. Most of these determinants are socially stratified and are likely to contribute to socioeconomic inequalities in BCS and CCS. Various factors associated with BCS and CCS non-adherence have been identified in many studies. However, limited evidence exists on their contributions to socioeconomic inequalities. This study quantified the contributions of these determinants to BCS and CCS income inequalities in France. Methods The study utilised the 2012–2014 baseline data in the CONSTANCES survey conducted in France (10,260 women for BCS and 18,761 for CCS). Screening non-adherence was defined by having last BCS for more than 2 years and last CCS for more than 3 years. The standard concentration index (Ch) was computed to measure the income inequalities in BCS and CCS non-adherence. Decomposition analyses quantified the contributions of the determinants to the income inequalities. We used the method proposed by Wagstaff. A large range of determinants were accounted for: sociodemographic (age, partner, children, migration status, area of residence), socioeconomic (education, employment status, unmet healthcare need for financial reasons), healthcare access (health insurance for low-income individuals, potential spatial accessibility to gynecologists and general practitioners), health status (measured BMI, taking anti-diabetic treatment, taking antihypertensive treatment, self-reported physical limitations, self-reported cognitive limitation, personal history of cancer, family history of cancer, perceived health status, self-reported smoking status) and healthcare use (last visit to a gynaecologist from inclusion, number of GP visits during the inclusion year; and last glucose test from inclusion). Results BCS non-adherence was concentrated towards the lower income groups [Ch = −0.0756 (95% CI: −0.1000 to −0.0512)], these inequalities were explained mainly by less frequent visit to gynaecologist (50.0%), more unmet healthcare needs (13.9%) and higher BMI status (8.4%) in lower income groups. CCS non-adherence was concentrated towards the poorer groups [Ch = −0.1264 (CI: −0.1422 to −0.1106)], these inequalities were mostly explained by less frequent visit to gynaecologist (54.6%), having a partner (8.2%), and more unmet healthcare needs (7.0%) in lower income groups. Regular visits to general practitioner contributed negatively to both inequalities in BCS and CCS non-adherence (−10.2% and −4.8%, respectively): they were associated with lower BCS and CCS non-adherence and they were more common in poorer women. Conclusion Awareness of healthcare professionals should be raised regarding different factors contributing to the socioeconomic inequalities in BCS and CCS non-adherence as they are in the front-line of giving health advice adapted to women's characteristics.

Contexte Des inegalites sociales sont observees pour la pratique du depistage du cancer du sein (CS) et du col de l’uterus (CCU). De nombreux facteurs sont associes au recours au depistage. La plupart sont socialement stratifies et sont donc susceptibles de contribuer aux inegalites sociales de depistage observees. Toutefois, peu d’etudes ont porte sur ce sujet. L’objectif est de quantifier la contribution de nombreux determinants du recours au depistage aux inegalites sociales de non-recours au depistage. Methode Nous avons utilise les donnees d’inclusion dans la cohorte Constances (10 260 femmes pour le depistage du CS et 18 761 pour le depistage du CCU). Le fait de ne pas etre a jour pour ces depistages a ete defini comme ne pas avoir eu de frottis au cours des trois dernieres annees et ne pas avoir eu de mammographie au cours des deux dernieres annees. Les inegalites sociales ont ete quantifiees a l’aide de l’indice de concentration calcule en fonction du revenu. Nous avons utilise la methode proposee par Wagstaff pour estimer la contribution de differents facteurs (sociodemographiques, socioeconomiques, acces aux soins, etat de sante, suivi medical) aux inegalites sociales de non-recours au depistage. Resultats Ne pas etre a jour pour le depistage du CS etait plus frequent parmi les femmes ayant un faible revenu (Indice de concentration C = −0,0756 (IC 95 % : −0,1000 a −0,0512)). Ces inegalites etaient expliquees principalement par un moindre suivi par un gynecologue (50,0 %), des renoncements aux soins plus frequents (13,9 %) et un IMC plus eleve (8,4 %) chez les femmes ayant un faible revenu. Ne pas etre a jour pour le depistage du CCU etait plus frequent parmi les femmes ayant un faible revenu (C = −0,1264 (IC 95 % : −0,1422 a −0,1106)). Ces inegalites etaient expliquees principalement par un moindre suivi par un gynecologue (54,6 %), l’absence de partenaire (8,2 %) et des renoncements aux soins plus frequents (7,0 %) chez les femmes ayant un faible revenu. Un suivi regulier par un medecin generaliste contribuait de facon negative aux inegalites pour le depistage du CS (−10,2 %) et du CCU (−4,8 %) : ce facteur est associe avec un meilleur recours au depistage et est plus frequent parmi les femmes ayant un faible revenu. Conclusion Il est important de former et de sensibiliser les professionnels de sante aux facteurs contribuant aux inegalites sociales de recours au depistage pour le CS et le CCU car ils sont en premiere ligne pour suivre les pratiques de depistage des femmes.

Population-based epidemiological cohorts may include nowadays hundreds of thousands of subjects, followed-up during decades. France has a major potential strength: nationwide medical and social databases set up for administrative purposes. The main databases useful for epidemiology are the social security database which contains individual medical data from different sources, and the retirement fund database on employment and social benefits. These databases have several advantages: they cover the whole French population, with no lost to follow-up, data are often of good quality and it is possible to link them with individual surveys. However medical data are not always ascertained and an important methodological and practical work has to be done, and some legal and practical problems have to be solved for an optimal use.

Background and Objective To assess the influence of medical conditions on road traffic accidents among a cohort of middle-aged workers and pensioners. Study Design and Setting A longitudinal study of 13,548 participants from a cohort study of French workers. Follow-up data covered the 1989–2000 period. Adjusted hazards ratios (HR adj ) for serious accidents were computed by Cox's proportional hazards regression with time-dependent covariates adjusted for age, occupation, annual mileage in 2001, alcohol consumption, and number of reported health problems. Results Men who reported treated dental or gingival problems (HR adj =8.57, 95% confidence interval CI=2.70–27.2) and women who reported treated renal colic or kidney stones (HR adj =9.71, 95% CI=2.40–39.3) were much more likely to have a serious traffic accident. Treated glaucoma, hiatal hernia or gastric ulcers, and diabetes among women and treated cataract among men were also found to be associated with the risk of serious traffic accidents. Conclusions This study raises the hypothesis that pain and pain treatment (singly or in combination) could increase the risk of road traffic accident and confirms that medical conditions traditionally found to be associated with traffic accident involvement of older drivers are also risk factors for middle-aged drivers.

International audience; OBJECTIVE: To investigate whether height is associated with low back pain (LBP) and surgery, taking into account personal and socioeconomic risk factors in a general population. METHODS: In 2001, 13,680 participants of the Gazel cohort completed a self-reported questionnaire on LBP and surgery interventions. Three groups were compared according to their body height: no LBP (reference group, participants who declared they never had LBP), LBP without surgery (participants who ever had LBP but without surgery), and back surgery (participants who ever had surgery for LBP). Adjusted variables were sex, age, educational level, marital status, height, and body mass index. RESULTS: Mean height was significantly higher in men in the back surgery group than in the reference group and the LBP group. The proportion of surgically-treated LBP was higher for people whose height was > or =4th quartile (P < 0.0001). Being in the highest quartile for height was a stronger risk factor for surgery (adjusted odds ratio [OR(adj)] = 2.01, 95% confidence interval [95% CI] 1.61-2.51) than for LBP without surgery (OR(adj) = 1.29, 95% CI 1.18-1.40). CONCLUSION: The results suggest that being tall is a predictor for back surgery.

Depression has long been hypothesized to be associated with cancer incidence. However, there is evidence for a positive publication bias in this field. In the present study, we examined the association between various measures of depression and cancer incidence at several sites. A total of 14,203 members of the French GAZEL (Gaz et Electricite) cohort (10,506 men, 3,697 women) were followed up for diagnoses of primary cancers from January 1, 1994, to December 31, 2009. All medically certified sickness absences for depression recorded between January 1, 1990, and December 31, 1993, were compiled. Depressive symptoms were self-reported in 1993, 1996, and 1999 with the Center for Epidemiologic Studies Depression Scale. During a mean follow-up period of 15.2 years, 1,119 participants received a cancer diagnosis, excluding nonmelanoma skin cancer and in situ neoplasms. Considering 6 cancer sites (prostate, breast, colorectal, smoking-related, lymphoid and hematopoietic tissues, other sites) and 4 measures of depression, we found 1 positive association and 1 negative association. Overall, there was no compelling evidence for an association between depression and cancer incidence. Such null results should be considered when addressing concerns of cancer patients and their relatives about the role of depression in cancer onset.

International audience; Objective Large-scale prospective studies do not support an association between neuroticism and extroversion with cancer incidence. However, research on other personality constructs is inconclusive. This longitudinal study examined the associations between four personality measures, Type 1, "suppressed emotional expression"; Type 5, "rational/antiemotional"; hostility; and Type A with cancer incidence. Methods Personality measures were available for 13,768 members in the GAZEL cohort study (baseline assessment in 1993). Follow-up for diagnoses of primary cancers was obtained from January 1, 1994 to December 31, 2009. Associations between personality and cancer incidence were evaluated using Cox proportional hazards analyses and adjusted for potential confounders. Results During a median follow-up of 16.0 years (range, 9 days-16 years), 1139 participants were diagnosed as having a primary cancer. The mean duration between baseline and cancer diagnosis was 9.3 years. Type 1 personality was associated with a decreased risk of breast cancer (hazard ratio per standard deviation = 0.81, 95% confidence interval = 0.68-0.97, p = .02). Type 5 personality was not associated with prostate, breast, colorectal, or smoking-related cancers, but was associated with other cancers (hazard ratio per standard deviation = 1.17, 95% confidence interval = 1.04-1.31, p = .01). Hostility was associated with an increased risk of smoking-related cancers, which was explained by smoking habits, and Type A was not associated with any of the cancer endpoints. Conclusions Several personality measures were prospectively associated with the incidence of selected cancers. These links may warrant further epidemiological studies and investigations about potential biobehavioral mechanisms.

BACKGROUND:: Personal responses to stressful life events are suspected of increasing the risk of serious traffic accidents. METHODS:: We analyzed data from a French cohort study (the GAZEL cohort), including a retrospective driving behavior questionnaire, from 13,915 participants (10,542 men age 52-62 years and 3373 women age 47-62 years in 2001). Follow-up data covered 1993-2000. Hazard ratios for serious accidents (n = 713) were computed by Cox's proportional hazard regression with time-dependent covariates. Separate analyses were also performed to consider only at-fault accidents. RESULTS:: Marital separation or divorce was associated with an increased risk of a serious accident (all serious accidents: hazard ratio 2.9, 95% confidence interval = 1.7-5.0; at-fault accidents: 4.4, 2.3-8.3). The impact of separation and divorce did not differ according to alcohol consumption levels. Other life events associated with increased risk of serious accident were a child leaving home (all accidents: 1.2, 0.97-1.6; at-fault accidents: 1.5, 1.1-2.1), an important purchase (all accidents: 1.4, 1.1-1.7; at-fault accidents: 1.6, 1.2-2.1), and hospitalization of the partner (all accidents: 1.4, 1.1-2.0). CONCLUSION:: This study suggests that recent separation and divorce are associated with an increase in serious traffic accidents.

Background Prospective cohorts represent an essential design for epidemiological studies and allow for the study of the combined effects of lifestyle, environment, genetic predisposition, and other risk factors on a large variety of disease endpoints. The CONSTANCES cohort is intended to provide public health information and to serve as an "open epidemiologic laboratory" accessible to the epidemiologic research community. Although designed as a "general-purpose" cohort with very broad coverage, it will particularly focus on occupational and social determinants of health, and on aging. Methods/Design The CONSTANCES cohort is designed as a randomly selected representative sample of French adults aged 18-69 years at inception; 200,000 subjects will be included over a five-year period. At inclusion, the selected subjects will be invited to fill a questionnaire and to attend a Health Screening Center (HSC) for a comprehensive health examination: weight, height, blood pressure, electrocardiogram, vision, auditory, spirometry, and biological parameters; for those aged 45 years and older, a specific work-up of functional, physical, and cognitive capacities will be performed. A biobank will be set up. The follow-up includes a yearly self-administered questionnaire, and a periodic visit to an HSC. Social and work-related events and health data will be collected from the French national retirement, health and death databases. The data that will be collected include social and demographic characteristics, socioeconomic status, life events, behaviors, and occupational factors. The health data will cover a wide spectrum: self-reported health scales, reported prevalent and incident diseases, long-term chronic diseases and hospitalizations, sick-leaves, handicaps, limitations, disabilities and injuries, healthcare utilization and services provided, and causes of death. To take into account non-participation at inclusion and attrition throughout the longitudinal follow-up, a cohort of non-participants will be set up and followed through the same national databases as participants. A field-pilot was performed in 2010 in seven HSCs, which included about 3,500 subjects; it showed a satisfactory structure of the sample and a good validity of the collected data. Discussion The constitution of the full eligible sample is planned during the last trimester of 2010, and the cohort will be launched at the beginning of 2011.