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#Time4Change: France

Published on 08 March 2018 back to previous

The Situation in France

Every year around 45,000 new cases of CRC are being diagnosed and almost 18,000 persons are dying of it, which makes CRC the 3rd most frequent cancer in France and the 2nd in terms of mortality.

Despite the implementation of a national CRC screening program using the FIT test, only around 32% of those between 50 and 74 years of age (the defined target) are complying with this test. What could be a preventable disease (through precancerous lesion removal during colonoscopy) is still a major cause of death. Although colorectal cancer care in France is optimal thanks to our health system, too many patients are still dying, mainly because their cancer was diagnosed at the metastatic state.

A National Screening Program Which Disappoints Everyone Involved

Although it was thought that introducing FIT in 2015 would increase screening compliance by 10 points, this has not been the case as only one third of the target complies. The reasons for this failure are many, for example the necessity to visit one’s GP to get the test kit. Pilot programs are being run to involve pharmacists as kit providers. In addition, kits will be sent through mail (as it used to be the case for the previous test) to a selection of patients.

However, as a patient organisation we cannot help but notice that colorectal cancer screening has been put somewhat on the back burner, with little national exposure planned for March 2018. Emphasis is on the reform of cancer screening organisations which drains the time and energy of most professionals involved.

A Disease Harsher on Women Than on Men

In 2016, we ran a national survey among persons with colorectal cancer. The results show clearly that female patients experience CRC in a much more difficult way than men. Not only do they complain about the way the diagnosis was announced to them, in a much too brutal manner, but they are also more likely to experience financial and relational difficulties in their personal relationships and at the workplace. These findings are especially significant in younger women, before they retire and when they still have kids at home. Overall patients younger than 60 report more social/financial difficulties than pensioners.

Still a Long Way to Go Despite our Excellent Health System

Beside pushing for a better, wider and more pragmatic national CRC screening program, we as a patient organization are currently fighting to raise healthcare professionals awareness of the situation for female and younger patients. There is a need to better understand the specifities of their experience in a more detailed way than we were able to do through our survey. We advocate for specific quality of life studies as well as increased attention about financial and social issues in these populations.

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