Breast cancer screening remains “low” in France, where less than one in two women aged 50 to 74 participate, according to a study published by Public Health France (SPF) on Tuesday April 30. Faced with the most common and deadliest cancer for them (12,000 deaths per year), 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 assessment in the event of a suspicious image.
Some 2.6 million women had an organized screening mammogram in 2023, or 48.2% participation (compared to 44.8% in 2022). “An increase in participation is therefore observed in 2023 but participation over the period of the two sliding years 2022-2023 (46.5%) remains lower than that of 2021-2022 (47.7%)”, notes the study .
France is struggling to reach the European target of at least 70%. The level of participation has tended to decline in the country over the past ten years. “After increasing until 2011-2012 to reach a peak at 52.3%, participation in the program has since been decreasing, for all age groups and all regions,” underlines the study.
“Invitation cycle disrupted”
An impact of the Covid crisis “continues”, points out the health agency, according to which “the cycle of invitations” to cancer screening has been “disrupted”, the deadlines for making appointments have been lengthened, and “ therefore the performance of mammograms”. “It is likely that the consequences of disruptions due to Covid will once again have an impact on the calculation of participation in 2024”, the year in which the new organization of screening will also apply, for which Health Insurance has taken over on the invitations.
In addition to the Covid crisis, a previous SPF study published in July put forward several hypotheses to explain the downward trend in participation in breast cancer screening, including “doubt about the usefulness” or “medical desertification”.
Another lesson: the rate of cancers detected among women undergoing screening is increasing regularly in France, “consistent with the observed increase in the incidence of breast cancer in the population”, particularly among the youngest categories. Mammograms are also done outside of organized screening.