Oncologist, Professor Daniel Nizri worked for a long time as a clinician at Pitié-Salpêtrière, in Paris. He also supported the implementation and monitoring of the Cancer plan. In July 2021, aged 70, he replaced Axel Kahn, deceased, as president of the League against cancer. Since August 2020, he has also chaired the follow-up committee for the National Health Nutrition Plan. Interview with an ambassador for the fight against cancer, determined to advance prevention and reduce inequalities.
The Covid-19 epidemic has widened inequalities and led to loss of opportunity for cancer patients. Is this also the observation of the League?
The health crisis has had strong consequences on care pathways, and not everything can be quantified. We were alerted, at the level of the headquarters and the 103 departmental committees, from the first confinement. The deprogrammings mainly affected surgical procedures, and in particular the excision of tumors, the anesthetists-resuscitators being very mobilized on the front line of the epidemic. And there was a concern to protect fragile people by avoiding places where they could be infected. Catch-up is in progress.
What are the consequences for patients?
Certainly, those people who have had their surgery postponed have been treated. For early prostate cancer, for example, it’s boring, but it’s not the end of the world in terms of prognosis either. But the consequences can be psychologically deleterious. When you are told you have cancer, you receive an anvil on the head, and if in addition, your care is delayed, this can do damage in terms of confidence in the healthcare teams, in the authorities… Especially since postponements, even changes in treatment strategy, were sometimes announced by a simple SMS. In addition, many breast reconstruction or oocyte preservation operations have not been carried out. These people are alive, of course, but their life plan is completely changed.
In 2020, the number of new cases of cancer fell by 93,000 in France compared to previous years, according to League estimates, a drop of 25%…
Invitations to organized screenings were completely stopped during the two months of confinement. Then it slowly went away. But there too, the delay has not been caught up. With regard to breast cancer, the participation fell from 52% in 2018-2019 to 42% in 2020. The drop is even greater in departments such as Seine-Saint-Denis, rural areas and overseas , where turnout was already low. For some women, a rescheduled appointment will never be rescheduled. For colorectal cancer screening, the already very insufficient participation rate of 30% has fallen further. It would also be necessary to analyze the underlying reasons for such low adherence to these public health policies.
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