{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T13:39:17Z","timestamp":1790689157125,"version":"4.1.0"},"reference-count":36,"publisher":"BMJ","issue":"6","funder":[{"DOI":"10.13039\/501100006364","name":"Institut National Du Cancer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006364","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001677","name":"Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001677","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,5,22]]},"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Sarcomas are rare tumours of connective tissue. The exact overall incidence of sarcomas is unknown due to diagnostic difficulties and the various histological subtypes (over 80 subtypes). However, the apparent increasing incidence of sarcomas suggests environmental causes such as pesticides. Except for some specific factors (ie, ionising radiation, vinyl chloride, dioxin and genetic predispositions) the scientific knowledge on the aetiology of sarcomas is sparse and inconsistent. France is a particularly appropriate country to set up a study investigating the causes of sarcoma occurrence due to the French organisation in treatment and care of sarcoma patients, which is highly structured and revolved around national expert networks. The main objective of the ETIOlogy of SARcomas (ETIOSARC) project is to study the role of lifestyle, environmental and occupational factors in the occurrence of sarcomas among adults from a multicentric population-based case\u2013control study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and analysis<\/jats:title><jats:p>Cases will be all incident patients (older than 18 years) prospectively identified in 15 districts of France covered by a general population-based cancer registry and\/or a reference centre in sarcoma\u2019s patient care over a 3-year period with an inclusion start date ranging from February 2019 to January 2020 and histologically confirmed by a second review of the diagnosis. Two controls will be individually matched by sex, age (5\u2009years group) and districts of residence and randomly selected from electoral rolls. A standardised questionnaire will be administered by a trained interviewer in order to gather information about occupational and residential history, demographic and socioeconomic characteristics and lifestyle factors. At the end of the interview, a saliva sample will be systematically proposed. This study will permit to validate or identify already suspected risk factors for sarcomas such as phenoxyherbicides, chlorophenol and to generate new hypothesis to increase our understanding about the genetic and environmental contributions in the carcinogenicity process.<\/jats:p><\/jats:sec><jats:sec><jats:title>Ethics and dissemination<\/jats:title><jats:p>The present study is promoted by the French National Institute of Health and Medical Research (identification number C17-03). This study received National French Ethic committee (CPP Sud M\u00e9diterrann\u00e9e I) approval (identification number 18-31) and French Data Protection Authority (CNIL) approval (identification number 918171). Results of this study will be published in international peer-reviewed journals. Technical appendix, statistical code and dataset will be available in the Dryad repository when collection data are completed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration number<\/jats:title><jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"NCT03670927\" ext-link-type=\"clintrialgov\">NCT03670927<\/jats:ext-link>.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2019-030013","type":"journal-article","created":{"date-parts":[[2020,5,7]],"date-time":"2020-05-07T23:11:32Z","timestamp":1588893092000},"page":"e030013","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["ETIOSARC study : environmental aetiology of sarcomas from a French prospective multicentric population-based case\u2013control study\u2014study protocol"],"prefix":"10.1136","volume":"9","clinical-trial-number":[{"clinical-trial-number":"nct03670927","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Aude","family":"Lacourt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brice","family":"Amad\u00e9o","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9line","family":"Gramond","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilie","family":"Marrer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandrine","family":"Plouvier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Baldi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Yves","family":"Blay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Michel","family":"Coindre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gonzague","family":"de Pinieux","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Gouin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Italiano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Le Cesne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Le Loarer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain","family":"Monnereau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Pellegrin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Penel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Ray-Coquard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maud","family":"Toulmonde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7oise","family":"Ducimeti\u00e8re","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Mathoulin-P\u00e9lissier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,6,18]]},"reference":[{"key":"2024052014021051000_9.6.e030013.1","doi-asserted-by":"publisher","DOI":"10.1186\/2045-3329-2-14"},{"key":"2024052014021051000_9.6.e030013.2","unstructured":"Howlader N , Noone AM , Krapcho M . et al. SEER Cancer Statistics Review, 1975-2012, National Cancer Institute. Bethesda, MD, 2015."},{"key":"2024052014021051000_9.6.e030013.3","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-009-0853-4"},{"key":"2024052014021051000_9.6.e030013.4","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2407-10-150","article-title":"Epidemiological evaluation of concordance between initial diagnosis and central pathology review in a comprehensive and prospective series of sarcoma patients in the Rhone-Alpes region","volume":"10","author":"Lurkin","year":"2010","journal-title":"BMC Cancer"},{"key":"2024052014021051000_9.6.e030013.5","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0020294","article-title":"Incidence of sarcoma histotypes and molecular subtypes in a prospective epidemiological study with central pathology review and molecular testing","volume":"6","author":"Ducimeti\u00e8re","year":"2011","journal-title":"PLoS One"},{"key":"2024052014021051000_9.6.e030013.6","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdt407"},{"key":"2024052014021051000_9.6.e030013.7","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdp415"},{"key":"2024052014021051000_9.6.e030013.8","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/93.11.824"},{"key":"2024052014021051000_9.6.e030013.9","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.22239"},{"key":"2024052014021051000_9.6.e030013.10","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdr610"},{"key":"2024052014021051000_9.6.e030013.11","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.annpat.2014.11.003","article-title":"[Fourth edition of WHO classification tumours of soft tissue]","volume":"35","author":"Karanian","year":"2015","journal-title":"Ann Pathol"},{"key":"2024052014021051000_9.6.e030013.12","unstructured":"IARC. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, Vol. 100. A review of human carcinogens, part D: radiation. Lyon: IARC, 2012."},{"key":"2024052014021051000_9.6.e030013.13","unstructured":"IARC. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, Vol. 100. A review of human carcinogens, part F: chemical agents and related occupations. Lyon: IARC, 2012."},{"key":"2024052014021051000_9.6.e030013.14","doi-asserted-by":"publisher","DOI":"10.2307\/3432311"},{"key":"2024052014021051000_9.6.e030013.15","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/82.6.486"},{"key":"2024052014021051000_9.6.e030013.16","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19880801)62:3<652::AID-CNCR2820620334>3.0.CO;2-4"},{"key":"2024052014021051000_9.6.e030013.17","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-199905000-00016"},{"key":"2024052014021051000_9.6.e030013.18","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-199507000-00012"},{"key":"2024052014021051000_9.6.e030013.19","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.1992.90"},{"key":"2024052014021051000_9.6.e030013.20","first-page":"899","article-title":"Soft tissue sarcoma and non-Hodgkin\u2019s lymphoma in relation to phenoxyherbicide and chlorinated phenol exposure in western Washington","volume":"78","author":"Woods","year":"1987","journal-title":"J Natl Cancer Inst"},{"key":"2024052014021051000_9.6.e030013.21","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1002\/ajim.4700210305","article-title":"A follow-up study of agricultural chemical production workers","volume":"21","author":"Sathiakumar","year":"1992","journal-title":"Am J Ind Med"},{"key":"2024052014021051000_9.6.e030013.22","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1002\/ijc.2910560209","article-title":"Risk excess of soft-tissue sarcoma and thyroid cancer in a community exposed to airborne organochlorinated compound mixtures with a high hexachlorobenzene content","volume":"56","author":"Grimalt","year":"1994","journal-title":"Int J Cancer"},{"key":"2024052014021051000_9.6.e030013.23","doi-asserted-by":"publisher","DOI":"10.1097\/01.jom.0000083033.56116.c1"},{"key":"2024052014021051000_9.6.e030013.24","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1986.03380090081023"},{"key":"2024052014021051000_9.6.e030013.25","doi-asserted-by":"crossref","first-page":"224","DOI":"10.5271\/sjweh.1928","article-title":"A case-referent study of soft-tissue sarcoma and Hodgkin\u2019s disease. Farming and insecticide use","volume":"14","author":"Hoar Zahm","year":"1988","journal-title":"Scand J Work Environ Health"},{"key":"2024052014021051000_9.6.e030013.26","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1002\/ijc.21388","article-title":"Occupational factors and risk of adult bone sarcomas: a multicentric case-control study in Europe","volume":"118","author":"Merletti","year":"2006","journal-title":"Int J Cancer"},{"key":"2024052014021051000_9.6.e030013.27","doi-asserted-by":"crossref","first-page":"1386","DOI":"10.1097\/JOM.0b013e318157d2f2","article-title":"Case-control study on occupational risk factors for soft-tissue sarcoma","volume":"49","author":"Hossain","year":"2007","journal-title":"J Occup Environ Med"},{"key":"2024052014021051000_9.6.e030013.28","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.93.10.1748"},{"key":"2024052014021051000_9.6.e030013.29","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19900815)66:4<806::AID-CNCR2820660435>3.0.CO;2-U"},{"key":"2024052014021051000_9.6.e030013.30","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1289\/ehp.9086143","article-title":"Critical assessment of epidemiologic studies on the human carcinogenicity of 1,3-butadiene","volume":"86","author":"Landrigan","year":"1990","journal-title":"Environ Health Perspect"},{"key":"2024052014021051000_9.6.e030013.31","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1016\/S1470-2045(16)30147-4","article-title":"Monogenic and polygenic determinants of sarcoma risk: an international genetic study","volume":"17","author":"Ballinger","year":"2016","journal-title":"Lancet Oncol"},{"key":"2024052014021051000_9.6.e030013.32","doi-asserted-by":"publisher","DOI":"10.1038\/nrg2764"},{"key":"2024052014021051000_9.6.e030013.33","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1500523"},{"key":"2024052014021051000_9.6.e030013.34","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0193330","article-title":"The cost-saving effect of centralized histological reviews with soft tissue and visceral sarcomas, GIST, and desmoid tumors: The experiences of the pathologists of the French Sarcoma Group","volume":"13","author":"Perrier","year":"2018","journal-title":"PLoS One"},{"key":"2024052014021051000_9.6.e030013.35","doi-asserted-by":"crossref","first-page":"2852","DOI":"10.1093\/annonc\/mdx484","article-title":"Improved survival using specialized multidisciplinary board in sarcoma patients","volume":"28","author":"Blay","year":"2017","journal-title":"Ann Oncol"},{"key":"2024052014021051000_9.6.e030013.36","unstructured":"Fletcher CD , Hogendoorn P , Mertens F , et al . WHO Classification of Tumours of Soft Tissue and Bone. 4th edn. Lyon, France: IARC Press, 2013."}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2019-030013","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T21:02:44Z","timestamp":1716238964000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2019-030013"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6]]},"references-count":36,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2019,6,18]]},"published-print":{"date-parts":[[2019,6]]}},"alternative-id":["10.1136\/bmjopen-2019-030013"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2019-030013","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,6]]}}}