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The latest report from the General Inspectorate of Social Affairs (Igas) is clear: organized screening programs for breast, cervical and colorectal cancer are not achieving their objectives in terms of participation and reaching the audiences concerned.
Do the three organized screening programs need to be rethought? For IGAS, the answer is categorical: their management and organization must be reviewed, by reaching out more to the audiences concerned and by strengthening digital tools.
Nine million screenings carried out each year
The report is dated May 30. The Igas, seized by the Ministry of Health, had to study the capacity of the current cancer screening system to deal with the challenges of screening wanted by Emmanuel Macron. In particular to carry out the ten-year strategy for the fight against cancer, as desired by the President of the Republic.
The objective of this is to fight against inequalities in access to screening and to carry out one million additional screenings by 2025 – currently, 9 million are carried out each year.
Figures that are stagnating or even falling
For Igas, the account is not there. “The results of the programs remain well below the assigned objectives”, in view of the 600 million euros in overall expenditure they generate and the public health issues. “The participation of the target population in organized screenings for breast cancer, set up in 2004, and colorectal cancer, which has existed since 2008, has stagnated or even fallen since 2018-2019“, underlines the report.
With regard to breast cancer screening, the participation rate in France is 42.8%, very far from the European objective, set at 70%. Same observation for colorectal cancer with a rate of 28.9% for a desired objective of 45%.
And if for certain cancers, such as that of the cervix, for which screening has been generalized since 2018, France does better with a rate of 58.2%, it remains far behind the first in the class such as Ireland or the United Kingdom, which are around 75%.
Low efficiency of CRCDCs
The regional cancer screening coordination centers (CRCDC) are singled out in the report. According to Igas, these structures, 17 in number throughout the territory, are not efficient enough and are undermined by staffing and internal reorganization problems.
Furthermore, the report denounces the non-implementation of certain reorganizations which should have been made, such as the transfer of invitations and reminders to the Cnam, the dematerialization of the second reading of mammograms and the constitution of a system national information center to process the data collected.
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Review prevention and follow-up actions
In addition to taking over these three major reorganizations, Igas also invites the regional centers dedicated to cancer screening to work more on promoting screening among professionals and to reach out more to the various audiences concerned.
This would make it possible to entrust them with the follow-up of people not included in screenings and to better define the overall approach to cancer prevention.