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1. Impact of general practitioners' sex and age on systematic recommendation for cancer screening

Author

Jean-François Morère, Yvan Coscas, François Eisinger, Jean-Yves Blay, Xavier Pivot, Jérôme Viguier, Anne Calazel-Benque, Claire Roussel, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD), Institut de Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Service d'Oncologie Médicale [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Clinique de la Porte de St Cloud, Institut national cancer (INCA), INCA, Capio Clinique du Parc, E11, Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), ROCHE SAS, Roche SAS, Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Male, MESH: Carcinoma, Oncology, Cancer Research, Epidemiology, Colorectal cancer, Breast cancer screening, Prostate cancer, 0302 clinical medicine, Cancer screening, Medicine, 030212 general & internal medicine, Referral and Consultation, Early Detection of Cancer, MESH: Aged, Sex Characteristics, MESH: Middle Aged, MESH: Directive Counseling, medicine.diagnostic_test, Age Factors, Middle Aged, MESH: Interviews as Topic, MESH: General Practitioners, 3. Good health, Prostate cancer screening, 030220 oncology & carcinogenesis, Female, France, MESH: Sex Characteristics, Adult, medicine.medical_specialty, Directive Counseling, [SDV.CAN]Life Sciences [q-bio]/Cancer, Interviews as Topic, MESH: Referral and Consultation, 03 medical and health sciences, General Practitioners, Internal medicine, Humans, MESH: Early Detection of Cancer, Patient participation, Aged, MESH: Age Factors, MESH: Humans, business.industry, Carcinoma, Public Health, Environmental and Occupational Health, Prostatic Neoplasms, Cancer, MESH: Adult, Odds ratio, medicine.disease, MESH: Male, MESH: France, MESH: Prostatic Neoplasms, business, MESH: Female
Abstract

International audience; Characteristics of primary-care providers have been associated with their patients' participation in breast cancer screening. A nationwide observational survey, 'EDIFICE', was conducted by telephone from December 2007 to January 2008 on a representative sample of 600 general practitioners (GPs) working in France, to investigate how a GP's characteristics may influence patient participation in screening for breast, colorectal and prostate cancer. For breast cancer screening, systematic recommendation was associated with female physicians [odds ratio (OR) =1.9; 95% confidence interval (CI) 1.2-3.1]. This systematic recommendation was also correlated with systematic referral for colorectal cancer (OR=1.5; 95% CI=1.0-2.5) and prostate cancer screening (OR=2.7; 95% CI=1.8-4.1). For colorectal cancer screening, the sex of the GP had no significant impact. However, systematic recommendation for both breast and prostate cancer screening was shown to be associated with systematic recommendation for colorectal cancer screening (OR=2.7; 95% CI=1.6-4.7 and OR=1.8; 95% CI=1.1-3.0, respectively). For prostate cancer screening, there was no significant sex specificity. However, systematic recommendation for both breast and colorectal cancer screening was associated with an advice on prostate cancer screening (OR=2.9; 95% CI=2.0-4.4 and OR=2.0; 95% CI=1.3-3.2, respectively). The age of the GP was not associated with a higher rate of systematic recommendation for screening for the three types of cancer. Male GPs were more likely than female GPs to perform digital rectal examinations on male patients (69 vs. 54%; OR=1.86; 95% CI=1.31-2.63). There is a global pattern of physicians being screening-prone (as suggested by the cross impact of recommendations from one cancer type to another). Although the frequency of systematic recommendation for breast cancer screening is higher with female GPs, systematic recommendation for prostate cancer is not higher among male GPs. The factors associated with systematic recommendation for screening are both a matter of concern and a target for action, to improve adherence of individuals through GP commitment.

Published
2011
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2. Organized colorectal cancer screening programmes: how to optimize efficiency in the general population

Author

Jean-François Morère, Anne Calazel-Benque, Jean-Yves Blay, Xavier Pivot, Yvan Coscas, Jérôme Viguier, François Eisinger, Claire Roussel, Capio Clinique du Parc, ROCHE SAS, Roche SAS, Service d'Oncologie Médicale [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Equipe 11, Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Clinique de la Porte de St Cloud, Hôpital Avicenne [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)

Subjects
MESH: Carcinoma, Oncology, Male, Cancer Research, Health Knowledge, Attitudes, Practice, Epidemiologic Factors, Epidemiology, Colorectal cancer, MESH: Health Knowledge, Attitudes, Practice, Efficiency, 0302 clinical medicine, Medicine, MESH: Data Collection, 030212 general & internal medicine, Early Detection of Cancer, MESH: Aged, MESH: Program Evaluation, education.field_of_study, MESH: Middle Aged, Crc screening, Data Collection, Middle Aged, MESH: Government Programs, 3. Good health, Government Programs, Colorectal cancer screening, 030220 oncology & carcinogenesis, Calibration, Female, France, Colorectal Neoplasms, medicine.medical_specialty, Referral, Population, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH: Calibration, MESH: Epidemiologic Factors, 03 medical and health sciences, Internal medicine, MESH: Early Detection of Cancer, Humans, education, Aged, MESH: Humans, business.industry, Carcinoma, Public Health, Environmental and Occupational Health, Faecal occult blood, MESH: Efficiency, medicine.disease, MESH: Male, MESH: Population, MESH: France, Family medicine, Observational study, business, MESH: Female, MESH: Colorectal Neoplasms, Program Evaluation
Abstract

International audience; In France, free faecal occult blood testing is offered to individuals aged between 50 and 74 years every 2 years as a method of screening for colorectal cancer (CRC). To assess how a proposed organized programme of CRC screening would be perceived among a representative sample of individuals living in France, aged between 40 and 75 years, and by a representative sample of general practitioners, two nationwide observational telephone surveys were carried out in 2005 (EDIFICE 1; 1601 individuals) and 2008 (EDIFICE 2; 1801 individuals). In 2008, 38% of individuals aged between 50 and 74 years reported undergoing screening for CRC; this corresponded to a statistically significant 13% increase in CRC screening rate compared with 2005 (P=0.01). When asked whether it was possible to screen for CRC, 94% of individuals who had undergone screening (N=350) responded positively compared with 87% of individuals who had not been screened. The main reason for individuals not to undergo screening was a lack of awareness (35% of men and 37% of women, P=not significant); the second reason was lack of advice and referral from their general practitioner (21% of women versus 15% of men, P=0.03). The French population is aware of the potential benefit of CRC screening; however, many do not undergo regular screening. It is therefore important to identify the hurdles associated with CRC screening.

Published
2011
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3. Breast cancer screening in women aged 50-74 years: is there room for improvement?

Author

Yvan Coscas, Jean-Yves Blay, Xavier Pivot, François Eisinger, Claire Roussel, Jérôme Viguier, Anne Calazel-Benque, Jean-François Morère, Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'Oncologie Médicale [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Equipe 11, Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Service d'Oncologie Médicale, Centre Léon Bérard [Lyon], Capio Clinique du Parc, Clinique de la Porte de St Cloud, ROCHE SAS, Roche SAS, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD), Institut de Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), and Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
MESH: Carcinoma, Cancer Research, Epidemiology, Screening programme, Breast cancer screening, 0302 clinical medicine, Cancer screening, MESH: Data Collection, Referral and Consultation, Early Detection of Cancer, MESH: Aged, MESH: Program Evaluation, 030219 obstetrics & reproductive medicine, MESH: Middle Aged, medicine.diagnostic_test, Screening mammography, Data Collection, Middle Aged, MESH: Patient Compliance, Quality Improvement, 3. Good health, MESH: General Practitioners, Oncology, 030220 oncology & carcinogenesis, Female, France, Mammography screening, Mammography, medicine.medical_specialty, MESH: Mammography, Breast Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH: Quality Improvement, 03 medical and health sciences, MESH: Referral and Consultation, Age Distribution, Breast cancer, General Practitioners, Female patient, medicine, Humans, MESH: Early Detection of Cancer, MESH: Age Distribution, Aged, Gynecology, MESH: Humans, business.industry, Carcinoma, Public Health, Environmental and Occupational Health, medicine.disease, MESH: France, Family medicine, Patient Compliance, business, MESH: Female, MESH: Breast Neoplasms, Program Evaluation
Abstract

International audience; Regular mammography screening has been available in France, free of charge, for all women aged 50-74 years since 2005. Two nationwide surveys [EDIFICE 1 (507 women interviewed; age 50-74 years) and EDIFICE 2 (488 women)] recently collected data on individuals' access to cancer screening procedures. Two further surveys interviewed 600 general practitioners (GPs) each to determine their attitudes towards screening in general and screening for breast cancer in particular. The method of quotas ensured the populations surveyed were representative. In 2005, 93%, and in 2008, 94% of women reported having undergone a screening mammography. Anage-related effect was apparent in the 70-74 year subgroup in 2005, whereas in 2008, over 90% of women aged 50-74 years had had a mammography in their lifetime. In 2008, 66% of women had undergone a mammography as a part of an organized screening programme, versus 45% in 2005. In 2005, 15% of women reported having received no recommendation from their GP, whereas this figure fell to 4% in 2008. In both EDIFICE surveys, two thirds of GPs systematically recommended breast cancer screening to female patients aged 50-74 years; however, female GPs were more likely to systematically recommend this screening. In 2008, 77% of the GPs questioned were aware of the recommended frequency for breast cancer screening, compared with 71% in 2005. Results of studies such as EDIFICE may help increase the proportion of women who undergo breast cancer screening. Successful implementation of organized screening relies heavily on treating physicians. The impact of mammography in breast cancer screening may be further improved by systematic organized screening, by encouraging regular examination and by targeting women who give up screening.

Published
2011
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4. Impact of awareness of cancer among acquaintances on cancer screening attendance

Author

Xavier Pivot, Claire Roussel, Jean-François Morère, Jean-Yves Blay, Anne Calazel-Benque, Yvan Coscas, François Eisinger, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD), Institut de Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), E11, Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Clinique de la Porte de St Cloud, Capio Clinique du Parc, ROCHE SAS, Roche SAS, Service d'Oncologie Médicale [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), and Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Cancer Research, Health Knowledge, Attitudes, Practice, Social stigma, MESH: Awareness, Epidemiology, Colorectal cancer, Health Behavior, MESH: Health Knowledge, Attitudes, Practice, Friends, Social Environment, Prostate cancer, 0302 clinical medicine, Neoplasms, Cancer screening, Prevalence, MESH: Neoplasms, 030212 general & internal medicine, Age of Onset, Early Detection of Cancer, MESH: Social Environment, MESH: Aged, education.field_of_study, MESH: Middle Aged, Attendance, Awareness, Middle Aged, MESH: Patient Compliance, 3. Good health, Oncology, 030220 oncology & carcinogenesis, France, Adult, medicine.medical_specialty, MESH: Age of Onset, MESH: Health Behavior, Population, education, [SDV.CAN]Life Sciences [q-bio]/Cancer, 03 medical and health sciences, Breast cancer, medicine, Humans, MESH: Early Detection of Cancer, Psychiatry, MESH: Prevalence, Aged, MESH: Humans, business.industry, Public Health, Environmental and Occupational Health, Cancer, MESH: Friends, MESH: Adult, medicine.disease, MESH: France, Patient Compliance, business, Demography
Abstract

International audience; Two nationwide observational surveys were carried out in France in 2005 and 2008 with the aim of assessing the impact on attitudes towards cancer screening of a positive history of cancer among a person's close circle of acquaintances (relatives, friends or colleagues). In 2005, 67% (993/1482) of people interviewed reported having someone in their close circle of acquaintances affected by cancer and in 2008, the rate was 80% (1158/1454). In 2008, having someone within a person's close circle of acquaintances affected by cancer did not increase the rate of screening for breast cancer (already high at >80%). However, it did increase the rate of screening for colorectal cancer [odds ratio (OR)=2.3; 95% confidence interval (CI)=1.6-3.3] and prostate cancer (OR=2.2; 95% CI=1.4-3.5). Knowing someone affected by cancer within the close circle of acquaintances clearly increases awareness, and thus could be an incentive for undergoing cancer screening. With regard to cancer types, such as prostate cancer, for which there is no national programme or media communication, this awareness might be the main source of information and motivation. The impact of awareness on screening behaviour seems to be greatest for the same cancer location as that in the affected acquaintance, as opposed to cancers at other sites. Increased awareness as observed in our survey, which may be attributable to less social stigma associated with a diagnosis of cancer, might increase the rate of screening attendance in the general population.

Published
2011
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5. [Edifice program: analysis of screening exam practices for cancer in France]

Author

Blay, Jean-Yves, Eisinger, François, Rixe, Olivier, Calazel-Benque, Anne, Morère, Jean-François, Cals, Laurent, Coscas, Yvan, Dolbeault, Sylvie, Namer, Moïse, Serin, Daniel, Roussel, Claire, Pivot, Xavier, Oncogénèse et progression tumorale, Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Cancérologie (Inserm U599/IPC), Université de la Méditerranée - Aix-Marseille 2-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Capio Clinique du Parc, Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hopital Font-Pre, Clinique de la Porte de St Cloud, Unité de Psycho-Oncologie (UPO), Institut Curie [Paris], Centre Azuréen de cancérologie, Centre Azureen de cancérologie, Institut Sainte Catherine [Avignon], ROCHE SAS, Roche SAS, Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (RIGHT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS BFC)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service d'Oncologie Médicale [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Saas, Philippe, Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Université de Franche-Comté (UFC), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Franche-Comté (UFC), and Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])

Subjects
Adult, Male, Lung Neoplasms, [SDV.IMM] Life Sciences [q-bio]/Immunology, MESH: Mammography, Breast Neoplasms, Sex Factors, MESH: Sex Factors, Humans, MESH: Family Practice, Aged, MESH: Age Factors, MESH: Aged, MESH: Colonic Neoplasms, MESH: Middle Aged, MESH: Humans, Rectal Neoplasms, Age Factors, MESH: Rectal Neoplasms, Prostatic Neoplasms, MESH: Adult, Middle Aged, MESH: Male, MESH: Lung Neoplasms, MESH: France, MESH: Prostatic Neoplasms, Colonic Neoplasms, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, France, Family Practice, MESH: Female, MESH: Breast Neoplasms, Mammography
Abstract

International audience; INTRODUCTION: The practices of screening and the parameters influencing these practices are not well known in France. The objectives of the Edifice study were to analyze a large cohort of patients and doctors in order to further characterize these parameters. PATIENTS AND METHODS: The study was performed by the Institute TNS Healthcare-SOFRES, and included 2 parallel studies: 1) on 1 609 healthy persons representative of the global French population and aged 40 to 75 years (N = 1 509), with an over representation of patients aged 50 to 74 years living in the 22 pilot French departments pilots; 2) on 600 generalist practitioners. Data were collected and analyzed by the expert panel... RESULTS: Ninety-three, 25, 36 and 6% of the patients in the general population declared to have performed at least one a screening exam for breast, colon, prostate, and lung carcinoma respectively. Seventy, 20, 60 and 4% of GP declare to propose systematically to a 40-75-year-old patient a screening test for breast, colon, prostate, or lung cancer. For breast cancer screening the adhesion of the GP is independent of the date of implementation of a general screening in their own regions, while for colorectal screening, 34 and 20% of the patients living in the pilot versus other departments were screened. Overall, prostate cancer screening is recommended by the GP panel for 77.1% of patients aged 50 to 75 years. CONCLUSIONS: This study shows a good adhesion of screening procedures for GP and patients, shows that screening is improved by general screening policy in colorectal cancer, but that prostate cancer screening practices exceed what is recommended according to evidence based medicine.

Published
2008
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6. Cancer screening in France: subjects' and physicians' attitudes

Author

Yvan Coscas, Xavier Pivot, Jean-François Morère, Daniel Serin, Claire Roussel, Anne Calazel-Benque, Sylvie Dolbeault, Jean-Yves Blay, Moïse Namer, Laurent Cals, Olivier Rixe, François Eisinger, Cancérologie (Inserm U599/IPC), Université de la Méditerranée - Aix-Marseille 2-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Capio Clinique du Parc, Hopital Font-Pre, Clinique de la Porte de St Cloud, Conception synthèse et étude d'antitumoraux, Institut Curie [Paris]-Centre National de la Recherche Scientifique (CNRS), Institut Sainte Catherine [Avignon], ROCHE SAS, Roche SAS, Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (RIGHT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté]), Service d'Oncologie Médicale [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Université de Franche-Comté (UFC), Saas, Philippe, and Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS BFC)-Université de Franche-Comté (UFC)

Subjects
Male, Cancer Research, Health Behavior, Mass-screening, 0302 clinical medicine, Neoplasms, Surveys and Questionnaires, Epidemiology, Cancer screening, Mass Screening, MESH: Neoplasms, 030212 general & internal medicine, Practice Patterns, Physicians', MESH: Aged, education.field_of_study, MESH: Middle Aged, medicine.diagnostic_test, Brief Report, Physicians, Family, MESH: Physician's Role, Middle Aged, MESH: Patient Compliance, 3. Good health, Prostate cancer screening, Oncology, 030220 oncology & carcinogenesis, Health care opinion poll, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, France, Compliance, Adult, medicine.medical_specialty, [SDV.IMM] Life Sciences [q-bio]/Immunology, Attitude of Health Personnel, MESH: Physicians, Family, MESH: Attitude of Health Personnel, MESH: Health Behavior, education, Population, Sampling Studies, 03 medical and health sciences, MESH: Sampling Studies, medicine, Health services research, Humans, Mammography, MESH: Mass Screening, Physician's Role, MESH: Physician's Practice Patterns, Mass screening, Aged, MESH: Humans, business.industry, MESH: Questionnaires, Cancer, MESH: Adult, medicine.disease, MESH: Male, MESH: France, Health services misuse, Family medicine, Patient Compliance, business, MESH: Female, Lung cancer screening
Abstract

International audience; OBJECTIVE: Since screening for cancer has been advocated, funded, and promoted in France, it is important to evaluate the attitudes of subjects in the general population and general practitioners (GPs) toward cancer screening strategies. METHODS: EDIFICE is a nationwide opinion poll that was carried out by telephone among a representative sample of 1,504 subjects living in France and aged between 40 and 75 years and among a representative sample of 600 GPs. The questionnaire administered to subjects queried about previous screening for cancer. RESULTS: Ninety-three percent of women stated that they had undergone at least one mammography. Although rated "A" recommendation-strongly recommended-by the US Preventive Services Task Force, screening for colorectal cancer received less attention than prostate cancer screening which is rated "I"-insufficient evidence-(reported screening rates of 25% and 36%, respectively). Six percent of subjects stated that they had undergone lung cancer screening. GPs' attitudes toward cancer screening showed similar inconsistencies. CONCLUSIONS: It thus appears that understanding of cancer screening practices in the French general population does not match scientific evidence. To a lesser extent, this also holds for GPs.

Published
2008
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7. Impact of organised programs on colorectal cancer screening

Author

Sylvie Dolbeault, Claire Roussel, Anne Calazel-Benque, Jean-François Morère, Xavier Pivot, Daniel Serin, Olivier Rixe, Jean-Yves Blay, Laurent Cals, Yvan Coscas, François Eisinger, Moïse Namer, Cancérologie (Inserm U599/IPC), Université de la Méditerranée - Aix-Marseille 2-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hopital Font-Pre, Capio Clinique du Parc, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Clinique de la Porte de St Cloud, Conception synthèse et étude d'antitumoraux, Institut Curie [Paris]-Centre National de la Recherche Scientifique (CNRS), Centre Azureen de cancérologie, Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (RIGHT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté]), Service d'Oncologie Médicale [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Sainte Catherine [Avignon], ROCHE SAS, Roche SAS, Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), The EDIFICE committee, Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS BFC)-Université de Franche-Comté (UFC), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Saas, Philippe, and Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Université de Franche-Comté (UFC)

Subjects
Male, Cancer Research, Colorectal cancer, MESH: Logistic Models, MESH: Health Care Surveys, Logistic regression, 0302 clinical medicine, Mass Screening, Practice Patterns, Physicians', MESH: Aged, education.field_of_study, MESH: Middle Aged, Physicians, Family, Middle Aged, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, 3. Good health, Oncology, Colorectal cancer screening, 030220 oncology & carcinogenesis, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, 030211 gastroenterology & hepatology, France, Colorectal Neoplasms, Attitude to Health, Research Article, medicine.medical_specialty, [SDV.IMM] Life Sciences [q-bio]/Immunology, Attitude of Health Personnel, MESH: Physicians, Family, MESH: Attitude of Health Personnel, Population, MESH: Attitude to Health, MEDLINE, lcsh:RC254-282, 03 medical and health sciences, Genetics, medicine, Humans, MESH: Mass Screening, MESH: Physician's Practice Patterns, education, Mass screening, Aged, Gynecology, MESH: Humans, business.industry, Odds ratio, medicine.disease, MESH: Male, MESH: France, Logistic Models, Health Care Surveys, Family medicine, Observational study, business, MESH: Female, MESH: Colorectal Neoplasms
Abstract

Purpose Colorectal cancer (CRC) screening has been shown to decrease CRC mortality. Organised mass screening programs are being implemented in France. Its perception in the general population and by general practitioners is not well known. Methods Two nationwide observational telephone surveys were conducted in early 2005. First among a representative sample of subjects living in France and aged between 50 and 74 years that covered both geographical departments with and without implemented screening services. Second among General Practionners (Gps). Descriptive and multiple logistic regression was carried out. Results Twenty-five percent of the persons(N = 1509) reported having undergone at least one CRC screening, 18% of the 600 interviewed GPs reported recommending a screening test for CRC systematically to their patients aged 50–74 years. The odds ratio (OR) of having undergone a screening test using FOBT was 3.91 (95% CI: 2.49–6.16) for those living in organised departments (referent group living in departments without organised screening), almost twice as high as impact educational level (OR = 2.03; 95% CI: 1.19–3.47). Conclusion CRC screening is improved in geographical departments where it is organised by health authorities. In France, an organised screening programs decrease inequalities for CRC screening.

Published
2008
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