Cancer screening: reaching the limits or terra incognita? Lessons from the EDIFICE surveys.
The main lessons from the EDIFICE surveys can be summed up in five points. (i) Evidence talks but very quietly: cancer-screening practices in the French general population do not match scientific evidence; (ii) Give time to time: the rate of appropriation of screening behaviour is slow; (iii) Where there is a will there is a way: the organization of screening decreases inequalities for cancer screening; (iv) Do not aim only at the target: although monitoring of adhesion and compliance for the targeted population is mandatory, monitoring the utilization of screening resources, particularly in countries such as France that have no financial constraints (screening outside the official range is still almost fully reimbursed) is also useful; and (v) Trees do not reach the sky: we have observed a ceiling effect for breast cancer with 90-95% of women who have had a mammogram in their lifetime and 80-85% of women from the targeted population who had a mammogram within the previous 2 years. For colorectal cancer, even with the longstanding programme, the ceiling level observed in France is close to 60%.
Paoli-Calmettes Institute, Department of Anticipation and Follow-up of Cancer, Marseille, France. eisingerf@marseille.fnclcc.fr
François
F
Eisinger
Claire
C
Roussel
Jean-François
JF
Morère
Jérôme
J
Viguier
D003625:Data Collection; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D005602:France; D006078:Government Programs / Q000458:organization & administration / Q000592:standards; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D011153:Population; D058996:Quality Improvement