Explore the vast range of titles available.

When we talk about cancer patients, we often think that they have a lower survival and a reduced life expectancy compared to the general population. They also often find it more difficult to take out a loan or a life insurance because banks and insurance companies charge higher prices or even refuse to lend them money. However, thanks to progress in medicine, prognosis of many types of cancer has greatly improved over the last decades. This PhD thesis consists of three main topics, all in the context of cancer research. First, using tools from biostatistics and actuarial sciences, we estimate the time after which cancer patients can be considered as cured. Second, we aim at adapting the actuarial pricing of life insurance products depending on the type of cancer and the duration of survival at the time of application. Last, we compute the risk of developing cancer for a healthy individual, and the number of years of life lost due to cancer given that the patient already survived some years after diagnosis. Some European countries have implemented the “right to be forgotten” in insurance, that is, the right for a client seeking a loan not to declare a previous cancer after at most 10 years after a successful treatment. In Belgium, the waiting period opening the RTBF is currently 8 years, and it will be reduced to 5 years in 2025. In this PhD thesis, we show that for some cancer types, survival is similar to that of the general population only after a few years after diagnosis, supporting the fact that the waiting period can be further reduced. More importantly, we also promote a waiting period starting at the time of diagnosis and not at the end of the treatment to avoid any dispute in case of death. We use data from the Belgian Cancer Registry on melanoma, thyroid and female breast cancers as examples, but we hope that this research will pave the way for other cancer types, and even for other chronic diseases such as HIV, hepatitis or leukemia.

Advancements in medicine and biostatistics have already resulted in a better access to insurance for people diagnosed with cancer. This materializes into the “right to be forgotten” adopted in several EU member states, granting access to insurance after a waiting period of at most 10 years starting at the end of the successful therapeutic protocol. This paper concentrates on insurance covers on a market where such a right has been implemented. Stand-alone products are considered, as well as guarantees included as a rider in an existing package. The cost of offering standard premium rates to all applicants in mortgage insurance related to property loans is also evaluated. The 3-state (healthy–ill–dead) Semi-Markov hierarchical model developed in Denuit et al. [ 4 ] for long-term care insurance is adopted here for actuarial calculations. Semi-Markov transition intensities are estimated from cancer cases recorded by the Belgian Cancer Registry. The obtained results suggest that a new offer could develop, targeting the particular needs of cancer patients.

Between 2021 and 2023, the Scientific Council of Dietplus®, a group specialized in overweight and obesity management, conducted a clinical study on 170 volunteer subjects with a BMI > 29 Kg/m2 consecutively recruited. The Dietplus® program comprises nutritional education, intensive, personalized coaching, and consuming food supplements rich in plant derivatives. The aim of this study was to assess the effect of the Dietplus® program on biometric, behavioral, and biological parameters. A control group of 30 obese patients was followed for a similar 12-week period. Mean weight loss reached 9 ± 2.1 kg in the Dietplus® test group versus a 1 ± 0.1 kg weight gain in the control group. Excess weight loss reached 33 ± 13%, and fat mass loss was 7.6% (p < 0.001); waist circumference was reduced by 30%. Quality of Life, Nutriscore, and Prochaska di Clemente scale significantly improved (p < 0.001). Biological parameters showed substantial improvements in the carbohydrate profile and insulin resistance (HOMA index) and in the lipid profile with lower plasma triglyceride (p < 0.01) and VLDL (p < 0.01) concentrations. Inflammatory parameters (orosomucoid, ultrasensitive C-reactive protein, and PINI indices) were also substantially reduced. These results indicate a substantial benefit in subjects who followed the Dietplus® program. (Dietplus® 116 Rue Robert Bunsen, 57460 Behren-lès-Forbach, France is active in France Belgium and Spain. Plant Derived Food Supplements are produced in France). Indeed, improvements were observed in all biometric, behavioral, and metabolic parameters.

The Massart (J Cancer Policy 15:70–71, 2018) testimonial illustrates the difficulties faced by patients having survived cancer to access mortgage insurance securing home loan. Data collected by national registries nevertheless suggest that excess mortality due to some types of cancer becomes moderate or even negligible after some waiting period. In relation to the insurance laws passed in France and more recently in Belgium creating a right to be forgotten for cancer survivors, the present study aims to determine the waiting period after which standard premium rates become applicable. Compared to the French and Belgian laws, a waiting period starting at diagnosis (as recorded in national databases) is favored over a waiting period starting at the end of the therapeutic treatment protocol. This aims to avoid disputes when a claim is filed. Since diagnosis is often recorded in the official registry database, as is the case for the Belgian Cancer Registry, its date is reliable and unquestionable in case of claim. Based on 28,994 melanoma and thyroid cancer cases recorded by the Belgian Cancer Registry, the length of the waiting period is assessed with the help of widely-accepted tools from biostatistics, including relative survival models and time-to-cure indicators. It turns out for instance that a waiting period of 4 years after diagnosis is enough for 30-year-old thyroid cancer patients. This appears to be similar to the 3-year period starting at the end of treatment protocol according to the Belgian law in such a case.

Abstract Background This retrospective hospital-based surveillance aimed to assess the epidemiology, causative pathogens trend, and serotypes distribution of pneumococcal meningitis among children aged under 5 years with bacterial meningitis in Southern Vietnam after the introduction of pentavalent vaccine in the Expanded Program on Immunization (EPI). Methods From 2012 to 2021, cerebrospinal fluid samples were collected from children aged under 5 years with suspected bacterial meningitis at Children's Hospitals 1 and 2 in Ho Chi Minh City. Probable bacterial meningitis (PBM) cases were identified using biochemistry and cytology. Real-time polymerase chain reaction was used to confirm cases of confirmed bacterial meningitis (CBM) caused by Streptococcus pneumoniae, Haemophilus influenzae, or Neisseria meningitidis. Streptococcus pneumoniae serotyping was performed. Results Of the 2560 PBM cases, 158 (6.2%) were laboratory-confirmed. The CBM proportion decreased during the 10-year study and was associated with age, seasonality, and permanent residence. Streptococcus pneumoniae was the most common pathogen causing bacterial meningitis (86.1%), followed by H influenzae (7.6%) and N meningitidis (6.3%). The case-fatality rate was 8.2% (95% confidence interval, 4.2%–12.2%). Pneumococcal serotypes 6A/B, 19F, 14, and 23F were the most prevalent, and the proportion of pneumococcal meningitis cases caused by the 10-valent pneumococcal conjugate vaccine (PCV) serotypes decreased from 96.2% to 57.1% during the PCV eras. Conclusions Streptococcus pneumoniae is the most frequent causative agent of bacterial meningitis in children aged under 5 years in Southern Vietnam over the last decade. Policymakers may need to consider introducing PCVs into the EPI to effectively prevent and control bacterial meningitis. After the introduction of the Hib vaccine in the EPI, bacterial meningitis patterns among children under 5 in Southern Vietnam have shifted, with Streptococcus pneumoniae being the most common causative pathogen. Policymakers should prioritize introducing PCVs into the EPI. Graphical Abstract Graphical Abstract

Advancements in medicine and biostatistics have already resulted in a better access to insurance for people diagnosed with cancer. This materializes into the “right to be forgotten” adopted in several EU member states, granting access to insurance after a waiting period of at most 10 years starting at the end of the successful therapeutic protocol. This paper concentrates on insurance covers on a market where such a right has been implemented. Stand-alone products are considered, as well as guarantees included as a rider in an existing package. The cost of offering standard premium rates to all applicants in mortgage insurance related to property loans is also evaluated. The 3-state (healthy–ill–dead) Semi-Markov hierarchical model developed in Denuit et al. [4] for long-term care insurance is adopted here for actuarial calculations. Semi-Markov transition intensities are estimated from cancer cases recorded by the Belgian Cancer Registry. The obtained results suggest that a new offer could develop, targeting the particular needs of cancer patients.