Breast cancer and colorectal cancer screenings still suffer from low participation in France, and the Covid-19 pandemic has, in the first case, not helped, according to two studies published on Tuesday July 11 by Public Health France (SPF).
Faced with the most frequent and deadliest cancer for them, French women aged 50 to 74 are offered, every two years, a clinical breast examination and a mammogram, followed by a second reading by an expert if the first is normal or a diagnostic check-up in the event of a suspicious image.
But “France is struggling to reach [l’]objective “ European of at least 70% participation in screening, notes a study published in the weekly epidemiological bulletin of SPF. Participation is around 50% and has been declining for ten years, with, in addition, repercussions from the crisis due to Covid-19.
After rising until 2012 and peaking around 52%, it fell to 48.5% in 2019. Against the backdrop of the pandemic, it fell to 42.6% in 2020, before rising to 50.6% in 2021. “While the participation for the year 2021 partly offset the deficit for the year 2020, that for the period 2020-2021 remains lower than that for the period 2018-2019”, note the authors of this study. In addition to the impacts of the health crisis on access to care, it is “Also possible that the underlying downward trend in screening will continue”according to them.
Colorectal cancer, second leading cause of cancer death
Several hypotheses could explain this trend: “Doubt about the usefulness of screening”, “consequence of less attractiveness”, “medical desertification”… It is however complicated to have a complete panorama because mammograms are also done outside organized screening.
For colorectal cancer, the second leading cause of cancer death in France, screening is based on a test to detect occult blood in the stool, offered every two years to French people aged 50-74. Since the generalization of the program, “the participation rate is low, around 32%”notes a specific study.
In 2020-2021, with the health crisis, the number of screening tests dropped during the first confinement, colonoscopies after a positive test were delayed, etc. But participation rates in colorectal cancer screening do not seem to be “not to have dropped significantly during the pandemic”say the researchers, who however regret the figures “too low compared to European recommendations”.
While consulting a general practitioner to collect the screening kit seems to constitute ” a brake “new delivery methods were introduced in 2022 (possibility of ordering your kit online or picking it up at a pharmacy).