Headlines - Organized colorectal cancer screening – low participation rates

With nearly 45,000 new cases in France—including nearly 21,000 cases in women and more than 24,000 cases in men—colorectal cancer remains the second deadliest cancer, causing 18,000 deaths per year. In 90% of cases, this cancer can be cured when detected at an early stage. Organized colorectal cancer screening is intended for women and men aged 50 to 74 who have no symptoms or risk factors other than age—that is, 16.5 million people who are invited every two years to undergo a screening test. Since April 2015, the immunological test (OC-sensor®) has been incorporated into the national organized screening program. Easier to use than the former Hemoccult® guaiac test, it is also more effective, detecting 2.4 times more cancers and 3.7 times more advanced adenomas (precancerous lesions).According to the latest figures published by Santé publique France, participation in the national screening program, despite a slight increase since the 2014–2015 period (23.1%), remains below the European recommendation of a minimum threshold of 45%. It stood at 33.5% for the 2016–2017 period versus 29.0% for the 2015–2016 period. This rate is higher among women than among men (34.7% vs. 32.1%, respectively), regardless of age group.It increases with age among men, from 28.1% among those aged 55–59 to 39.5% among those aged 70–74, and among women, from 33.3% among those aged 55–59 to 38.1% among those aged 70–74. Regional disparities in participation rates are observed (map). Rates are particularly low (<25%) in eight departments (Corse, Guyane, Ardèche, Paris, Lozère, Ariège, Alpes-Maritimes, and Hérault). The highest rates are found in Saône-et-Loire (47.3%) and Ille-et-Vilaine (50.6%), two departments where the antibody test is sent on an experimental basis directly to individuals invited during the second round of invitations. In Bourgogne-Franche-Comté, the regional participation rate is 39.7%, and apart from Saône-et-Loire, all departmental rates are below 45%, notably including Nièvre at 30%.In this context, the National Cancer Institute is taking action to raise public awareness of the dangers of this cancer and the importance of screening to facilitate early diagnosis and increase the chances of recovery. It also reminds the public that a visit to their primary care physician is an opportunity to discuss the topic. Finally, the Institute has made colorectal cancer screening a priority initiative for 2018.