Publications et travaux de recherche
2023
Duchange, Nathalie; Poiseuil, Marie; Rollet, Quentin; Piette, Christine; Cosson, Mathilde; Quertier, Marie-Christine; Moutel, Grégoire; Darquy, Sylviane
How do women comply with cancer screenings? A study in four regions of France Article de journal
Dans: BMC Women's Health, iss. 23, no. 190, 2023.
Résumé | Liens | BibTeX | Étiquettes: Dépistage des cancers
@article{Duchange2023,
title = {How do women comply with cancer screenings? A study in four regions of France},
author = {Nathalie Duchange and Marie Poiseuil and Quentin Rollet and Christine Piette and Mathilde Cosson and Marie-Christine Quertier and Grégoire Moutel and Sylviane Darquy},
url = {https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-023-02311-5},
doi = {10.1186/s12905-023-02311-5},
year = {2023},
date = {2023-04-21},
urldate = {2023-04-21},
journal = {BMC Women's Health},
number = {190},
issue = {23},
abstract = {Background
This article looks at the behaviour of women facing different cancer screening options available to them from the age of 50 onward. The study was conducted in 2019 in four departments of the French territory with the objective of identifying the factors that influence acceptance of a population-based screening proposal.
Methods
A questionnaire was sent to women who had received three invitations to organised screenings (OS) for both breast and colorectal cancer. The categories of participants in both OS were designed from data from the regional cancer screening coordination centres in each department. Participation in opportunistic cervical cancer screening was evaluated as self-reported data.
Results
4,634 questionnaires were returned out of the 17,194 sent, giving a global return rate of 27%. The highest rate of return (73.5%) was obtained from women who had participated at least once in both breast and colorectal cancer OS. An intermediate rate was obtained from women participating in breast cancer OS only (18.7%). Poor levels of return came from women who had participated in colorectal cancer OS only (3.6%) and from non-participants (4.1%). Our results suggest that women with lower educational levels tend to be the most regular attendants at OS (50.3%), compared to highly educated women (39.7%). 11.8% of women were overdue in their opportunistic cervical cancer screening. This percentage rose to 35.4% in the category of non-participants. In addition, women’s comments provide a better understanding of the reasons for irregular attendance and non-participation.
Conclusion
Overall, similar behaviours towards screening were observed in the four departments. Our analysis suggests that participation in one cancer OS increases the likelihood of participating in others. This adhesion could be an interesting lever for raising women’s awareness of other cancer screenings.},
keywords = {Dépistage des cancers},
pubstate = {published},
tppubtype = {article}
}
Background
This article looks at the behaviour of women facing different cancer screening options available to them from the age of 50 onward. The study was conducted in 2019 in four departments of the French territory with the objective of identifying the factors that influence acceptance of a population-based screening proposal.
Methods
A questionnaire was sent to women who had received three invitations to organised screenings (OS) for both breast and colorectal cancer. The categories of participants in both OS were designed from data from the regional cancer screening coordination centres in each department. Participation in opportunistic cervical cancer screening was evaluated as self-reported data.
Results
4,634 questionnaires were returned out of the 17,194 sent, giving a global return rate of 27%. The highest rate of return (73.5%) was obtained from women who had participated at least once in both breast and colorectal cancer OS. An intermediate rate was obtained from women participating in breast cancer OS only (18.7%). Poor levels of return came from women who had participated in colorectal cancer OS only (3.6%) and from non-participants (4.1%). Our results suggest that women with lower educational levels tend to be the most regular attendants at OS (50.3%), compared to highly educated women (39.7%). 11.8% of women were overdue in their opportunistic cervical cancer screening. This percentage rose to 35.4% in the category of non-participants. In addition, women’s comments provide a better understanding of the reasons for irregular attendance and non-participation.
Conclusion
Overall, similar behaviours towards screening were observed in the four departments. Our analysis suggests that participation in one cancer OS increases the likelihood of participating in others. This adhesion could be an interesting lever for raising women’s awareness of other cancer screenings.
This article looks at the behaviour of women facing different cancer screening options available to them from the age of 50 onward. The study was conducted in 2019 in four departments of the French territory with the objective of identifying the factors that influence acceptance of a population-based screening proposal.
Methods
A questionnaire was sent to women who had received three invitations to organised screenings (OS) for both breast and colorectal cancer. The categories of participants in both OS were designed from data from the regional cancer screening coordination centres in each department. Participation in opportunistic cervical cancer screening was evaluated as self-reported data.
Results
4,634 questionnaires were returned out of the 17,194 sent, giving a global return rate of 27%. The highest rate of return (73.5%) was obtained from women who had participated at least once in both breast and colorectal cancer OS. An intermediate rate was obtained from women participating in breast cancer OS only (18.7%). Poor levels of return came from women who had participated in colorectal cancer OS only (3.6%) and from non-participants (4.1%). Our results suggest that women with lower educational levels tend to be the most regular attendants at OS (50.3%), compared to highly educated women (39.7%). 11.8% of women were overdue in their opportunistic cervical cancer screening. This percentage rose to 35.4% in the category of non-participants. In addition, women’s comments provide a better understanding of the reasons for irregular attendance and non-participation.
Conclusion
Overall, similar behaviours towards screening were observed in the four departments. Our analysis suggests that participation in one cancer OS increases the likelihood of participating in others. This adhesion could be an interesting lever for raising women’s awareness of other cancer screenings.
Poiseuil, Marie; Moutel, Grégoire; Cosson, Mathilde; Quertier, Marie-Christine; Duchange, Nathalie; Darquy, Sylviane
Participation in breast cancer screening and its influence on other cancer screening invitations: study in women aged 56 years old in four French departments Article de journal
Dans: European Journal of Cancer Prevention, iss. Online ahead of print, 2023.
Résumé | Liens | BibTeX | Étiquettes: Dépistage des cancers
@article{Poiseuil2023,
title = {Participation in breast cancer screening and its influence on other cancer screening invitations: study in women aged 56 years old in four French departments},
author = {Marie Poiseuil and Grégoire Moutel and Mathilde Cosson and Marie-Christine Quertier and Nathalie Duchange and Sylviane Darquy},
doi = {10.1097/CEJ.0000000000000777},
year = {2023},
date = {2023-02-13},
urldate = {2023-02-13},
journal = {European Journal of Cancer Prevention},
issue = {Online ahead of print},
abstract = {Background: Today, women 50 years of age are offered three types of cancer screening in France. However, participation is not optimal. The aim was to describe (1) participation in organised breast cancer screening (OS) of women aged 56 years old, and the influence of this participation on colorectal and cervical cancer screening, (2) the reasons for non-participation in breast cancer OS, and (3) the reasons for screening before age 50.
Methods: A questionnaire was sent to 56-year-old women in four French departments to identify their participation behaviour in three breast cancer OS invitations and their reasons for non-participation. Three groups were determined according to the number of participations in breast cancer OS (3, 1-2 and 0). We described the quantitative responses and grouped the qualitative responses thematically.
Results: A total of 4634 women responded to the questionnaire. Seventy-six percent had undergone all three breast cancer OS, 16% irregular and 7% non-participant. Among women who irregularly perform breast cancer OS, 50.5% also irregularly perform colorectal cancer OS. Women who participated in all three invitations for the breast cancer OS performed more smear tests than women in the other groups. Many of the irregular participants or non-participants underwent opportunistic screening, often initiated before the age of 50. The reasons for non-participation in breast cancer OS were mainly medical or participation in opportunistic screening.
Conclusion: There is no fundamental opposition to participation in breast cancer screening. However, it remains of the utmost importance that women should be better informed about OS and its benefits.},
keywords = {Dépistage des cancers},
pubstate = {published},
tppubtype = {article}
}
Background: Today, women 50 years of age are offered three types of cancer screening in France. However, participation is not optimal. The aim was to describe (1) participation in organised breast cancer screening (OS) of women aged 56 years old, and the influence of this participation on colorectal and cervical cancer screening, (2) the reasons for non-participation in breast cancer OS, and (3) the reasons for screening before age 50.
Methods: A questionnaire was sent to 56-year-old women in four French departments to identify their participation behaviour in three breast cancer OS invitations and their reasons for non-participation. Three groups were determined according to the number of participations in breast cancer OS (3, 1-2 and 0). We described the quantitative responses and grouped the qualitative responses thematically.
Results: A total of 4634 women responded to the questionnaire. Seventy-six percent had undergone all three breast cancer OS, 16% irregular and 7% non-participant. Among women who irregularly perform breast cancer OS, 50.5% also irregularly perform colorectal cancer OS. Women who participated in all three invitations for the breast cancer OS performed more smear tests than women in the other groups. Many of the irregular participants or non-participants underwent opportunistic screening, often initiated before the age of 50. The reasons for non-participation in breast cancer OS were mainly medical or participation in opportunistic screening.
Conclusion: There is no fundamental opposition to participation in breast cancer screening. However, it remains of the utmost importance that women should be better informed about OS and its benefits.
Methods: A questionnaire was sent to 56-year-old women in four French departments to identify their participation behaviour in three breast cancer OS invitations and their reasons for non-participation. Three groups were determined according to the number of participations in breast cancer OS (3, 1-2 and 0). We described the quantitative responses and grouped the qualitative responses thematically.
Results: A total of 4634 women responded to the questionnaire. Seventy-six percent had undergone all three breast cancer OS, 16% irregular and 7% non-participant. Among women who irregularly perform breast cancer OS, 50.5% also irregularly perform colorectal cancer OS. Women who participated in all three invitations for the breast cancer OS performed more smear tests than women in the other groups. Many of the irregular participants or non-participants underwent opportunistic screening, often initiated before the age of 50. The reasons for non-participation in breast cancer OS were mainly medical or participation in opportunistic screening.
Conclusion: There is no fundamental opposition to participation in breast cancer screening. However, it remains of the utmost importance that women should be better informed about OS and its benefits.
2022
Charvin, Maud; Moutel, Grégoire; Launoy, Guy; Berchi, Célia
Perceptions et connaissances concernant la décision de réaliser le dépistage du cancer de la prostate Article de journal
Dans: Santé Publique, vol. 34, no. 1, p. 107-118, 2022.
Résumé | Liens | BibTeX | Étiquettes: Dépistage des cancers
@article{Charvin2022,
title = {Perceptions et connaissances concernant la décision de réaliser le dépistage du cancer de la prostate},
author = {Maud Charvin and Grégoire Moutel and Guy Launoy and Célia Berchi},
doi = {10.3917/spub.221.0107},
year = {2022},
date = {2022-05-01},
urldate = {2022-05-01},
journal = {Santé Publique},
volume = {34},
number = {1},
pages = {107-118},
abstract = {Background: Because of the benefit-risk ratio, the French health authorities recommend that patients make an informed choice concerning prostate cancer screening. The aim of this study was to investigate men's decision process. The process was explored by assessing information-seeking behavior, knowledge on prostate cancer, and men's involvement in screening decisions.
Methods: Nineteen men aged 50 to 75 years old were included in the study in 2018. Semi structured face-to-face interviews were performed. Interviews were audio-recorded and then transcribed verbatim. A thematic analysis was performed.
Results: In some cases, men's knowledge about prostate anatomy, prostate physiology, and prostate cancer screening modalities (procedure and risks) was poor. Moreover, despite international recommendations about shared decision-making, several GPs (General Practitioner) prescribed prostate cancer screening without discussing the matter with their patients.
Conclusion: French men should receive better information so that they can make an informed choice about prostate cancer screening and share the decision with their GP.},
keywords = {Dépistage des cancers},
pubstate = {published},
tppubtype = {article}
}
Background: Because of the benefit-risk ratio, the French health authorities recommend that patients make an informed choice concerning prostate cancer screening. The aim of this study was to investigate men's decision process. The process was explored by assessing information-seeking behavior, knowledge on prostate cancer, and men's involvement in screening decisions.
Methods: Nineteen men aged 50 to 75 years old were included in the study in 2018. Semi structured face-to-face interviews were performed. Interviews were audio-recorded and then transcribed verbatim. A thematic analysis was performed.
Results: In some cases, men's knowledge about prostate anatomy, prostate physiology, and prostate cancer screening modalities (procedure and risks) was poor. Moreover, despite international recommendations about shared decision-making, several GPs (General Practitioner) prescribed prostate cancer screening without discussing the matter with their patients.
Conclusion: French men should receive better information so that they can make an informed choice about prostate cancer screening and share the decision with their GP.
Methods: Nineteen men aged 50 to 75 years old were included in the study in 2018. Semi structured face-to-face interviews were performed. Interviews were audio-recorded and then transcribed verbatim. A thematic analysis was performed.
Results: In some cases, men's knowledge about prostate anatomy, prostate physiology, and prostate cancer screening modalities (procedure and risks) was poor. Moreover, despite international recommendations about shared decision-making, several GPs (General Practitioner) prescribed prostate cancer screening without discussing the matter with their patients.
Conclusion: French men should receive better information so that they can make an informed choice about prostate cancer screening and share the decision with their GP.
2020
Raginel, Thibaut; Grandazzi, Guillaume; Launoy, Guy; Trocmé, Mélanie; Christophe, Véronique; Berchi, Célia; Guittet, Lydia
Social inequalities in cervical cancer screening: a discrete choice experiment among French general practitioners and gynaecologists Article de journal
Dans: BMC Health Services Research, 2020.
Résumé | Liens | BibTeX | Étiquettes: Dépistage des cancers
@article{Raginel2020,
title = {Social inequalities in cervical cancer screening: a discrete choice experiment among French general practitioners and gynaecologists},
author = {Thibaut Raginel and Guillaume Grandazzi and Guy Launoy and Mélanie Trocmé and Véronique Christophe and Célia Berchi and Lydia Guittet},
doi = {10.1186/s12913-020-05479-w},
year = {2020},
date = {2020-08-27},
urldate = {2020-08-27},
journal = {BMC Health Services Research},
abstract = {Background
Cervical cancer screening is effective in reducing mortality due to uterine cervical cancer (UCC). However, inequalities in participation in UCC screening exist, especially according to age and social status. Considering the current situation in France regarding the ongoing organized UCC screening campaign, we aimed to assess general practitioners’ (GPs) and gynaecologists’ preferences for actions designed to reduce screening inequalities.
Methods
French physicians’ preferences to UCC screening modalities was assessed using a discrete choice experiment. A national cross-sectional questionnaire was sent between September and October 2014 to 500 randomly selected physicians, and numerically to all targeted physicians working in the French region Midi-Pyrénées. Practitioners were offered 11 binary choices of organized screening scenarios in order to reduce inequalities in UCC screening participation. Each scenario was based on five attributes corresponding to five ways to enhance participation in UCC screening while reducing screening inequalities.
Results
Among the 123 respondents included, practitioners voted for additional interventions targeting non-screened women overall (p < 0.05), including centralized invitations sent from a central authority and involving the mentioned attending physician, or providing attending physicians with the lists of unscreened women among their patients. However, they rejected the specific targeting of women over 50 years old (p < 0.01) or living in deprived areas (p < 0.05). Only GPs were in favour of allowing nurses to perform Pap smears, but both GPs and gynaecologists rejected self-collected oncogenic papillomavirus testing.
Conclusions
French practitioners tended to value the traditional principle of universalism. As well as rejecting self-collected oncogenic papillomavirus testing, their reluctance to support the principle of proportionate universalism relying on additional interventions addressing differences in socioeconomic status needs further evaluation. As these two concepts have already been recommended as secondary development leads for the French national organized screening campaign currently being implemented, the adherence of practitioners and the adaptation of these concepts are necessary conditions for reducing inequalities in health care.},
keywords = {Dépistage des cancers},
pubstate = {published},
tppubtype = {article}
}
Background
Cervical cancer screening is effective in reducing mortality due to uterine cervical cancer (UCC). However, inequalities in participation in UCC screening exist, especially according to age and social status. Considering the current situation in France regarding the ongoing organized UCC screening campaign, we aimed to assess general practitioners’ (GPs) and gynaecologists’ preferences for actions designed to reduce screening inequalities.
Methods
French physicians’ preferences to UCC screening modalities was assessed using a discrete choice experiment. A national cross-sectional questionnaire was sent between September and October 2014 to 500 randomly selected physicians, and numerically to all targeted physicians working in the French region Midi-Pyrénées. Practitioners were offered 11 binary choices of organized screening scenarios in order to reduce inequalities in UCC screening participation. Each scenario was based on five attributes corresponding to five ways to enhance participation in UCC screening while reducing screening inequalities.
Results
Among the 123 respondents included, practitioners voted for additional interventions targeting non-screened women overall (p < 0.05), including centralized invitations sent from a central authority and involving the mentioned attending physician, or providing attending physicians with the lists of unscreened women among their patients. However, they rejected the specific targeting of women over 50 years old (p < 0.01) or living in deprived areas (p < 0.05). Only GPs were in favour of allowing nurses to perform Pap smears, but both GPs and gynaecologists rejected self-collected oncogenic papillomavirus testing.
Conclusions
French practitioners tended to value the traditional principle of universalism. As well as rejecting self-collected oncogenic papillomavirus testing, their reluctance to support the principle of proportionate universalism relying on additional interventions addressing differences in socioeconomic status needs further evaluation. As these two concepts have already been recommended as secondary development leads for the French national organized screening campaign currently being implemented, the adherence of practitioners and the adaptation of these concepts are necessary conditions for reducing inequalities in health care.
Cervical cancer screening is effective in reducing mortality due to uterine cervical cancer (UCC). However, inequalities in participation in UCC screening exist, especially according to age and social status. Considering the current situation in France regarding the ongoing organized UCC screening campaign, we aimed to assess general practitioners’ (GPs) and gynaecologists’ preferences for actions designed to reduce screening inequalities.
Methods
French physicians’ preferences to UCC screening modalities was assessed using a discrete choice experiment. A national cross-sectional questionnaire was sent between September and October 2014 to 500 randomly selected physicians, and numerically to all targeted physicians working in the French region Midi-Pyrénées. Practitioners were offered 11 binary choices of organized screening scenarios in order to reduce inequalities in UCC screening participation. Each scenario was based on five attributes corresponding to five ways to enhance participation in UCC screening while reducing screening inequalities.
Results
Among the 123 respondents included, practitioners voted for additional interventions targeting non-screened women overall (p < 0.05), including centralized invitations sent from a central authority and involving the mentioned attending physician, or providing attending physicians with the lists of unscreened women among their patients. However, they rejected the specific targeting of women over 50 years old (p < 0.01) or living in deprived areas (p < 0.05). Only GPs were in favour of allowing nurses to perform Pap smears, but both GPs and gynaecologists rejected self-collected oncogenic papillomavirus testing.
Conclusions
French practitioners tended to value the traditional principle of universalism. As well as rejecting self-collected oncogenic papillomavirus testing, their reluctance to support the principle of proportionate universalism relying on additional interventions addressing differences in socioeconomic status needs further evaluation. As these two concepts have already been recommended as secondary development leads for the French national organized screening campaign currently being implemented, the adherence of practitioners and the adaptation of these concepts are necessary conditions for reducing inequalities in health care.
Charvin, Maud; Launoy, Guy; Berchi, Célia
The effect of information on prostate cancer screening decision process: a discrete choice experiment Article de journal
Dans: BMC Health Services Research, 2020.
Résumé | Liens | BibTeX | Étiquettes: Dépistage des cancers, Information
@article{Charvin2020,
title = {The effect of information on prostate cancer screening decision process: a discrete choice experiment},
author = {Maud Charvin and Guy Launoy and Célia Berchi },
doi = {https://doi.org/10.1186/s12913-020-05327-x},
year = {2020},
date = {2020-05-26},
urldate = {2020-05-26},
journal = {BMC Health Services Research},
abstract = {Background
Prostate cancer screening is controversial because of uncertainty about its benefits and risks. The aim of this survey was to reveal preferences of men concerning prostate cancer screening and to test the effect of an informative video on these preferences.
Methods
A stated preferences questionnaire was sent by e-mail to men aged 50–75 with no history of prostate cancer. Half of them were randomly assigned to view an informative video. A discrete choice model was established to reveal men’s preferences for six prostate cancer screening characteristics: mortality by prostate cancer, number of false positive and false negative results, number of overdiagnosis, out-of-pocket costs and recommended frequency.
Results
A population-based sample composed by 1024 men filled in the entire questionnaire. Each attribute gave the expected sign except for overdiagnosis. The video seemed to increase the intention to abstain from prostate cancer screening.
Conclusions
The participants attached greater importance to a decrease in the number of false negatives and a reduction in prostate cancer mortality than to other risks such as the number of false positives and overdiagnosis. Further research is needed to help men make an informed choice regarding screening.},
keywords = {Dépistage des cancers, Information},
pubstate = {published},
tppubtype = {article}
}
Background
Prostate cancer screening is controversial because of uncertainty about its benefits and risks. The aim of this survey was to reveal preferences of men concerning prostate cancer screening and to test the effect of an informative video on these preferences.
Methods
A stated preferences questionnaire was sent by e-mail to men aged 50–75 with no history of prostate cancer. Half of them were randomly assigned to view an informative video. A discrete choice model was established to reveal men’s preferences for six prostate cancer screening characteristics: mortality by prostate cancer, number of false positive and false negative results, number of overdiagnosis, out-of-pocket costs and recommended frequency.
Results
A population-based sample composed by 1024 men filled in the entire questionnaire. Each attribute gave the expected sign except for overdiagnosis. The video seemed to increase the intention to abstain from prostate cancer screening.
Conclusions
The participants attached greater importance to a decrease in the number of false negatives and a reduction in prostate cancer mortality than to other risks such as the number of false positives and overdiagnosis. Further research is needed to help men make an informed choice regarding screening.
Prostate cancer screening is controversial because of uncertainty about its benefits and risks. The aim of this survey was to reveal preferences of men concerning prostate cancer screening and to test the effect of an informative video on these preferences.
Methods
A stated preferences questionnaire was sent by e-mail to men aged 50–75 with no history of prostate cancer. Half of them were randomly assigned to view an informative video. A discrete choice model was established to reveal men’s preferences for six prostate cancer screening characteristics: mortality by prostate cancer, number of false positive and false negative results, number of overdiagnosis, out-of-pocket costs and recommended frequency.
Results
A population-based sample composed by 1024 men filled in the entire questionnaire. Each attribute gave the expected sign except for overdiagnosis. The video seemed to increase the intention to abstain from prostate cancer screening.
Conclusions
The participants attached greater importance to a decrease in the number of false negatives and a reduction in prostate cancer mortality than to other risks such as the number of false positives and overdiagnosis. Further research is needed to help men make an informed choice regarding screening.
2019
Jullian, Odile; Darquy, Sylviane; Moutel, Grégoire; Duchange, Nathalie
Apport de la réflexion éthique dans l’évolution des programmes de dépistage organisé des cancers Article de journal
Dans: La Revue du Praticien, vol. 69, no. 1, p. 107-109, 2019.
Résumé | Liens | BibTeX | Étiquettes: Dépistage des cancers
@article{Jullian2019,
title = {Apport de la réflexion éthique dans l’évolution des programmes de dépistage organisé des cancers},
author = {Odile Jullian and Sylviane Darquy and Grégoire Moutel and Nathalie Duchange},
url = {https://www.hal.inserm.fr/inserm-02124282/},
year = {2019},
date = {2019-01-01},
urldate = {2019-01-01},
journal = {La Revue du Praticien},
volume = {69},
number = {1},
pages = {107-109},
abstract = {Depuis 2009, l’Institut national du cancer a mis en place un groupe de réflexion sur l’éthique des programmes de dépistage des cancers du sein, du côlon et du col de l’utérus. L’intérêt collectif et individuel, l’équité et le respect de l’autonomie sont les valeurs abordées dans les rapports respectifs. L’analyse éthique a fait émerger des enjeux spécifiques à chaque programme : l’importance de l’information délivrée par les professionnels de santé dans un contexte d’incertitude, pour le dépistage du cancer du sein ; les professionnels de santé comme relais d’information, d’accès au test et d’accompagnement dans le parcours de dépistage du cancer colorectal et pour le dépistage du cancer du col de l’utérus, la mise en place d’une organisation adaptée aux populations de femmes concernées. Une politique de santé publique dont l’efficience dépend de l’adhésion de la population aux propositions de dépistage doit respecter un principe éthique fondamental qui est l’évaluation de la balance bénéfices-risques.},
keywords = {Dépistage des cancers},
pubstate = {published},
tppubtype = {article}
}
Depuis 2009, l’Institut national du cancer a mis en place un groupe de réflexion sur l’éthique des programmes de dépistage des cancers du sein, du côlon et du col de l’utérus. L’intérêt collectif et individuel, l’équité et le respect de l’autonomie sont les valeurs abordées dans les rapports respectifs. L’analyse éthique a fait émerger des enjeux spécifiques à chaque programme : l’importance de l’information délivrée par les professionnels de santé dans un contexte d’incertitude, pour le dépistage du cancer du sein ; les professionnels de santé comme relais d’information, d’accès au test et d’accompagnement dans le parcours de dépistage du cancer colorectal et pour le dépistage du cancer du col de l’utérus, la mise en place d’une organisation adaptée aux populations de femmes concernées. Une politique de santé publique dont l’efficience dépend de l’adhésion de la population aux propositions de dépistage doit respecter un principe éthique fondamental qui est l’évaluation de la balance bénéfices-risques.
Moutel, Grégoire; Darquy, Sylviane; Jullian, Odile; Duchange, Nathalie
Éthique et dépistages organisés des cancers en France Article de journal
Dans: Santé Publique, vol. HS2, no. S2, p. 67-74, 2019.
Résumé | Liens | BibTeX | Étiquettes: Dépistage des cancers
@article{Moutel2019,
title = {Éthique et dépistages organisés des cancers en France},
author = {Grégoire Moutel and Sylviane Darquy and Odile Jullian and Nathalie Duchange},
doi = {10.3917/spub.197.0067},
year = {2019},
date = {2019-01-01},
urldate = {2019-01-01},
journal = {Santé Publique},
volume = {HS2},
number = {S2},
pages = {67-74},
abstract = {Le dépistage des cancers est une des priorités des Plans cancer en France depuis 2003. Cependant, la participation aux programmes de dépistage reste en deçà des objectifs attendus. La prédominance de la valeur de l’autonomie dans la société actuelle peut mettre en péril le bien-fondé d’une action de santé publique si celle-ci ne remporte pas l’adhésion des personnes. Le Groupe de réflexion sur l’éthique du dépistage (Gred) mis en place par l’Institut national du cancer (INCa) a réuni des experts de différentes disciplines autour de cette problématique. L’objectif de cet article est de présenter une synthèse des travaux du groupe qui s’est intéressé successivement aux programmes de dépistage du cancer du sein et du cancer colorectal, puis à la mise en place du dépistage organisé du cancer du col de l’utérus. L’information et l’éducation pour la santé apparaissent être des leviers pour permettre aux individus de comprendre l’intérêt collectif des politiques de santé publique et ainsi d’adhérer de manière informée aux actions proposées. Ceci peut être rendu possible par la délivrance d’une information complète et de qualité, abordant les limites de chaque dépistage en en présentant les bénéfices ainsi que les risques. La valorisation de la dimension collective de la santé publique qui fait appel à la solidarité doit permettre de sensibiliser à la bonne utilisation du bien public.
},
keywords = {Dépistage des cancers},
pubstate = {published},
tppubtype = {article}
}
Le dépistage des cancers est une des priorités des Plans cancer en France depuis 2003. Cependant, la participation aux programmes de dépistage reste en deçà des objectifs attendus. La prédominance de la valeur de l’autonomie dans la société actuelle peut mettre en péril le bien-fondé d’une action de santé publique si celle-ci ne remporte pas l’adhésion des personnes. Le Groupe de réflexion sur l’éthique du dépistage (Gred) mis en place par l’Institut national du cancer (INCa) a réuni des experts de différentes disciplines autour de cette problématique. L’objectif de cet article est de présenter une synthèse des travaux du groupe qui s’est intéressé successivement aux programmes de dépistage du cancer du sein et du cancer colorectal, puis à la mise en place du dépistage organisé du cancer du col de l’utérus. L’information et l’éducation pour la santé apparaissent être des leviers pour permettre aux individus de comprendre l’intérêt collectif des politiques de santé publique et ainsi d’adhérer de manière informée aux actions proposées. Ceci peut être rendu possible par la délivrance d’une information complète et de qualité, abordant les limites de chaque dépistage en en présentant les bénéfices ainsi que les risques. La valorisation de la dimension collective de la santé publique qui fait appel à la solidarité doit permettre de sensibiliser à la bonne utilisation du bien public.
Moutel, Grégoire; Duchange, Nathalie; Lièvre, Astrid; Orgerie, Marie Brigitte; Jullian, Odile; Sancho-Garnier, Hélène; Darquy, Sylviane
Low participation in organized colorectal cancer screening in France: underlying ethical issues Article de journal
Dans: European Journal of Cancer Prevention, vol. 28, no. 1, p. 27-32, 2019.
Résumé | Liens | BibTeX | Étiquettes: Dépistage des cancers
@article{Moutel2019b,
title = {Low participation in organized colorectal cancer screening in France: underlying ethical issues},
author = {Grégoire Moutel and Nathalie Duchange and Astrid Lièvre and Marie Brigitte Orgerie and Odile Jullian and Hélène Sancho-Garnier and Sylviane Darquy},
url = {https://hal.archives-ouvertes.fr/inserm-01657936},
doi = {10.1097/CEJ.0000000000000417},
year = {2019},
date = {2019-01-01},
urldate = {2019-01-01},
journal = {European Journal of Cancer Prevention},
volume = {28},
number = {1},
pages = {27-32},
abstract = {International studies have shown a significant reduction in colorectal cancer (CRC) mortality following the implementation of organized screening programs, given a sufficient participation rate and adequate follow-up. The French national CRC screening program has been generalized since 2008 and targets 18 million men and women aged 50-74 years. Despite broad recommendations, the participation rate remains low (29.8%), questioning the efficiency of the program. A panel of experts was appointed by the French National Cancer Institute to critically examine the place of autonomy and efficiency in CRC screening and propose recommendations. In this paper, we explore the ethical significance of a public health intervention that falls short of its objectives owing to low take-up by the population targeted. First, we analyze the reasons for the low CRC screening participation. Second, we examine the models that can be proposed for public health actions, reconciling respect for the individual and the collective good. Our expert panel explored possible ways to enhance take-up of CRC screening within the bounds of individual autonomy, adapting awareness campaigns, and new educational approaches that take into account knowledge and analysis of sociocultural hurdles. Although public health actions must be universal, target actions should nonetheless be developed for nonparticipating population subgroups.},
keywords = {Dépistage des cancers},
pubstate = {published},
tppubtype = {article}
}
International studies have shown a significant reduction in colorectal cancer (CRC) mortality following the implementation of organized screening programs, given a sufficient participation rate and adequate follow-up. The French national CRC screening program has been generalized since 2008 and targets 18 million men and women aged 50-74 years. Despite broad recommendations, the participation rate remains low (29.8%), questioning the efficiency of the program. A panel of experts was appointed by the French National Cancer Institute to critically examine the place of autonomy and efficiency in CRC screening and propose recommendations. In this paper, we explore the ethical significance of a public health intervention that falls short of its objectives owing to low take-up by the population targeted. First, we analyze the reasons for the low CRC screening participation. Second, we examine the models that can be proposed for public health actions, reconciling respect for the individual and the collective good. Our expert panel explored possible ways to enhance take-up of CRC screening within the bounds of individual autonomy, adapting awareness campaigns, and new educational approaches that take into account knowledge and analysis of sociocultural hurdles. Although public health actions must be universal, target actions should nonetheless be developed for nonparticipating population subgroups.
2018
Darquy, Sylviane; Moutel, Grégoire; Jullian, Odile; Barré, Stéphanie; Duchange, Nathalie
Towards equity in organised cancer screening: the case of cervical cancer screening in France Article de journal
Dans: BMC Womens health, vol. 18, no. 1, 2018.
Résumé | Liens | BibTeX | Étiquettes: Dépistage des cancers
@article{Darquy2018,
title = {Towards equity in organised cancer screening: the case of cervical cancer screening in France},
author = {Sylviane Darquy and Grégoire Moutel and Odile Jullian and Stéphanie Barré and Nathalie Duchange},
doi = {10.1186/s12905-018-0683-0},
year = {2018},
date = {2018-11-26},
urldate = {2018-11-26},
journal = {BMC Womens health},
volume = {18},
number = {1},
abstract = {Background
The French national cancer institute (INCa) conducted a series of studies to assist decision-making in view of the implementation of organised cervical cancer screening that will be launched in 2018. The programme will concern all women aged 25–65 and targeted interventions will be developed for underscreened populations. This is an evolution from an equality-based approach to a step-by-step strategy of equity aiming to tackle health cancer inequalities that are avoidable and represents unfair differences. Here we present the work of the expert-group in ethics drafted by INCa to review the ethical issues prior to the programme implementation.
Discussion
We discuss the value of such a strategy and presents reflections with regard to issues of stigmatization, respect for individual freedom and autonomy. Indeed, the balance has to be found between the search for beneficence and the potential occurrence of perverse effects, which should be considered with particular attention.
Conclusion
Moving toward an equity-oriented policy under a strategy of proportionate universalism faces a number of challenges, thus an overview of ethics and social sciences must be an integral part of the process.},
keywords = {Dépistage des cancers},
pubstate = {published},
tppubtype = {article}
}
Background
The French national cancer institute (INCa) conducted a series of studies to assist decision-making in view of the implementation of organised cervical cancer screening that will be launched in 2018. The programme will concern all women aged 25–65 and targeted interventions will be developed for underscreened populations. This is an evolution from an equality-based approach to a step-by-step strategy of equity aiming to tackle health cancer inequalities that are avoidable and represents unfair differences. Here we present the work of the expert-group in ethics drafted by INCa to review the ethical issues prior to the programme implementation.
Discussion
We discuss the value of such a strategy and presents reflections with regard to issues of stigmatization, respect for individual freedom and autonomy. Indeed, the balance has to be found between the search for beneficence and the potential occurrence of perverse effects, which should be considered with particular attention.
Conclusion
Moving toward an equity-oriented policy under a strategy of proportionate universalism faces a number of challenges, thus an overview of ethics and social sciences must be an integral part of the process.
The French national cancer institute (INCa) conducted a series of studies to assist decision-making in view of the implementation of organised cervical cancer screening that will be launched in 2018. The programme will concern all women aged 25–65 and targeted interventions will be developed for underscreened populations. This is an evolution from an equality-based approach to a step-by-step strategy of equity aiming to tackle health cancer inequalities that are avoidable and represents unfair differences. Here we present the work of the expert-group in ethics drafted by INCa to review the ethical issues prior to the programme implementation.
Discussion
We discuss the value of such a strategy and presents reflections with regard to issues of stigmatization, respect for individual freedom and autonomy. Indeed, the balance has to be found between the search for beneficence and the potential occurrence of perverse effects, which should be considered with particular attention.
Conclusion
Moving toward an equity-oriented policy under a strategy of proportionate universalism faces a number of challenges, thus an overview of ethics and social sciences must be an integral part of the process.
Launoy, Guy; Duchange, Nathalie; Darquy, Sylviane; Moutel, Grégoire
Participation aux programmes organisés de dépistage des cancers : enjeu individuel, enjeu collectif Article de journal
Dans: Bulletin du Cancer, vol. 106, no. 7-8, p. 678-683, 2018.
Résumé | Liens | BibTeX | Étiquettes: Dépistage des cancers
@article{Launoy2018,
title = {Participation aux programmes organisés de dépistage des cancers : enjeu individuel, enjeu collectif},
author = {Guy Launoy and Nathalie Duchange and Sylviane Darquy and Grégoire Moutel },
doi = {10.1016/j.bulcan.2018.04.008},
year = {2018},
date = {2018-05-28},
urldate = {2018-05-28},
journal = {Bulletin du Cancer},
volume = {106},
number = {7-8},
pages = {678-683},
abstract = {L’évaluation de la balance bénéfices/risques en santé publique est une question éthique incontournable qui repose sur l’impératif premier de ne pas nuire aux personnes. Un des aspects fondamentaux du dépistage est d’être une démarche probabiliste, qui, pour rendre service à quelques-uns, engage le plus grand nombre dans une démarche dans laquelle chacun partage les effets délétères potentiels. L’accumulation des connaissances scientifiques et l’ouverture du débat à l’ensemble de la société ont fait varier au cours du temps les relations entre les enjeux collectifs et les enjeux individuels. Cet article retrace l’évolution du discours autour des dépistages des cancers, en particulier suite à l’avènement de la controverse autour du dépistage du cancer du sein. Il décrit comment, dans le contexte français, le débat a permis de revisiter complètement les modalités d’information et de consentement amenant à passer d’une communication de type promotion du dépistage à une information plus équilibrée sur les bénéfices et les risques afin que les personnes décident de participer ou non sur un mode plus éclairé.},
keywords = {Dépistage des cancers},
pubstate = {published},
tppubtype = {article}
}
L’évaluation de la balance bénéfices/risques en santé publique est une question éthique incontournable qui repose sur l’impératif premier de ne pas nuire aux personnes. Un des aspects fondamentaux du dépistage est d’être une démarche probabiliste, qui, pour rendre service à quelques-uns, engage le plus grand nombre dans une démarche dans laquelle chacun partage les effets délétères potentiels. L’accumulation des connaissances scientifiques et l’ouverture du débat à l’ensemble de la société ont fait varier au cours du temps les relations entre les enjeux collectifs et les enjeux individuels. Cet article retrace l’évolution du discours autour des dépistages des cancers, en particulier suite à l’avènement de la controverse autour du dépistage du cancer du sein. Il décrit comment, dans le contexte français, le débat a permis de revisiter complètement les modalités d’information et de consentement amenant à passer d’une communication de type promotion du dépistage à une information plus équilibrée sur les bénéfices et les risques afin que les personnes décident de participer ou non sur un mode plus éclairé.
2017
Pimpec, Fanny Le; Moutel, Grégoire; Piette, Christine; Lièvre, Astrid; Bretagne, Jean-François
Fecal immunological blood test is more appealing than the guaiac-based test for colorectal cancer screening Article de journal
Dans: Digestive and Liver Disease, vol. 49, no. 11, p. 1267-1272, 2017.
Résumé | Liens | BibTeX | Étiquettes: Dépistage des cancers
@article{Pimpec2017,
title = {Fecal immunological blood test is more appealing than the guaiac-based test for colorectal cancer screening},
author = {Fanny Le Pimpec and Grégoire Moutel and Christine Piette and Astrid Lièvre and Jean-François Bretagne},
doi = {https://doi.org/10.1016/j.dld.2017.08.018},
year = {2017},
date = {2017-11-01},
urldate = {2017-11-01},
journal = {Digestive and Liver Disease},
volume = {49},
number = {11},
pages = {1267-1272},
abstract = {Background
The reasons for participation in fecal immunological testing (FIT) of subjects who were previously non-respondents to guaiac fecal occult blood testing (g-FOBT) have not been assessed.
Population and methods
We aimed to determine the reasons for current compliance with FIT among non-responders to g-FOBT, termed “converts‿, in a French district. A questionnaire was returned by 170 converts aged from 55 to 75 years (response rate 75.2% after exclusions).
Results
The major barriers to participation in screening with g-FOBT were test-related: the test was perceived as complicated (24%) and it required three consecutive stools (28%). Among the test-related major determinants of FIT compliance was the perception that the test was less complicated than previous test (30%) and that a unique stool sample was required (29%). Among the non-test related major determinants of FIT compliance were the perception that the general practitioner was more convincing (31%) and the feeling to be more concerned because of age (21%). The reasons for compliance among converts did not differ according to age, sex, and rural or urban residence.
Conclusions
Our study demonstrated that the simplicity of FIT and the endorsement of practitioners were both major motivations for FIT compliance among non-respondents in at least two previous consecutive campaigns.},
keywords = {Dépistage des cancers},
pubstate = {published},
tppubtype = {article}
}
Background
The reasons for participation in fecal immunological testing (FIT) of subjects who were previously non-respondents to guaiac fecal occult blood testing (g-FOBT) have not been assessed.
Population and methods
We aimed to determine the reasons for current compliance with FIT among non-responders to g-FOBT, termed “converts‿, in a French district. A questionnaire was returned by 170 converts aged from 55 to 75 years (response rate 75.2% after exclusions).
Results
The major barriers to participation in screening with g-FOBT were test-related: the test was perceived as complicated (24%) and it required three consecutive stools (28%). Among the test-related major determinants of FIT compliance was the perception that the test was less complicated than previous test (30%) and that a unique stool sample was required (29%). Among the non-test related major determinants of FIT compliance were the perception that the general practitioner was more convincing (31%) and the feeling to be more concerned because of age (21%). The reasons for compliance among converts did not differ according to age, sex, and rural or urban residence.
Conclusions
Our study demonstrated that the simplicity of FIT and the endorsement of practitioners were both major motivations for FIT compliance among non-respondents in at least two previous consecutive campaigns.
The reasons for participation in fecal immunological testing (FIT) of subjects who were previously non-respondents to guaiac fecal occult blood testing (g-FOBT) have not been assessed.
Population and methods
We aimed to determine the reasons for current compliance with FIT among non-responders to g-FOBT, termed “converts‿, in a French district. A questionnaire was returned by 170 converts aged from 55 to 75 years (response rate 75.2% after exclusions).
Results
The major barriers to participation in screening with g-FOBT were test-related: the test was perceived as complicated (24%) and it required three consecutive stools (28%). Among the test-related major determinants of FIT compliance was the perception that the test was less complicated than previous test (30%) and that a unique stool sample was required (29%). Among the non-test related major determinants of FIT compliance were the perception that the general practitioner was more convincing (31%) and the feeling to be more concerned because of age (21%). The reasons for compliance among converts did not differ according to age, sex, and rural or urban residence.
Conclusions
Our study demonstrated that the simplicity of FIT and the endorsement of practitioners were both major motivations for FIT compliance among non-respondents in at least two previous consecutive campaigns.
Papin-Lefebvre, Frédérique; Guillaume, Elodie; Moutel, Grégoire; Launoy, Guy; Berchi, Célia
General practitioners' preferences with regard to colorectal cancer screening organisation Colon cancer screening medico-legal aspects Article de journal
Dans: Health Policy, vol. 121, no. 10, p. 1079-1084, 2017.
Résumé | Liens | BibTeX | Étiquettes: Dépistage des cancers
@article{Papin-Lefebvre2017,
title = {General practitioners' preferences with regard to colorectal cancer screening organisation Colon cancer screening medico-legal aspects},
author = {Frédérique Papin-Lefebvre and Elodie Guillaume and Grégoire Moutel and Guy Launoy and Célia Berchi},
doi = {https://doi.org/10.1016/j.healthpol.2017.08.013},
year = {2017},
date = {2017-09-06},
urldate = {2017-09-06},
journal = {Health Policy},
volume = {121},
number = {10},
pages = {1079-1084},
abstract = {Objective
French health authorities put general practitioners at the heart of the colorectal cancer screening. This position raises organisational issues and poses medico-legal problems for the professionals and institutions involved in these campaigns, related to the key concepts of medical decisions and suitability of standards. The objective of our study is to reveal the preferences of general practitioners related to colorectal cancer screening organisation with regard to the medico-legal risk
Methods
A discrete choice questionnaire presenting hypothetical screening scenarios was mailed to 2114 physicians from 20 French different areas. The preferences of 358 general practitioners were analysed using logistic regression models.
Results
The factors that have significant impact on the preferences of general practitioners are the capacity of the primary care professional in the procedure, the manner in which pre-screening information is given to patients, the manner in which screening results are given to patients, the number of reminders sent to patients who test positive and who do not undergo a colonoscopy and the remuneration of the attending physician.
Conclusions
Our results reveals that current colorectal cancer screening organisation is not adapted to general practitioners preferences. This work offers the public authorities avenues for reflection on possible developments in order to optimize the involvement of general practitioners in the promotion of cancer screening programme.},
keywords = {Dépistage des cancers},
pubstate = {published},
tppubtype = {article}
}
Objective
French health authorities put general practitioners at the heart of the colorectal cancer screening. This position raises organisational issues and poses medico-legal problems for the professionals and institutions involved in these campaigns, related to the key concepts of medical decisions and suitability of standards. The objective of our study is to reveal the preferences of general practitioners related to colorectal cancer screening organisation with regard to the medico-legal risk
Methods
A discrete choice questionnaire presenting hypothetical screening scenarios was mailed to 2114 physicians from 20 French different areas. The preferences of 358 general practitioners were analysed using logistic regression models.
Results
The factors that have significant impact on the preferences of general practitioners are the capacity of the primary care professional in the procedure, the manner in which pre-screening information is given to patients, the manner in which screening results are given to patients, the number of reminders sent to patients who test positive and who do not undergo a colonoscopy and the remuneration of the attending physician.
Conclusions
Our results reveals that current colorectal cancer screening organisation is not adapted to general practitioners preferences. This work offers the public authorities avenues for reflection on possible developments in order to optimize the involvement of general practitioners in the promotion of cancer screening programme.
French health authorities put general practitioners at the heart of the colorectal cancer screening. This position raises organisational issues and poses medico-legal problems for the professionals and institutions involved in these campaigns, related to the key concepts of medical decisions and suitability of standards. The objective of our study is to reveal the preferences of general practitioners related to colorectal cancer screening organisation with regard to the medico-legal risk
Methods
A discrete choice questionnaire presenting hypothetical screening scenarios was mailed to 2114 physicians from 20 French different areas. The preferences of 358 general practitioners were analysed using logistic regression models.
Results
The factors that have significant impact on the preferences of general practitioners are the capacity of the primary care professional in the procedure, the manner in which pre-screening information is given to patients, the manner in which screening results are given to patients, the number of reminders sent to patients who test positive and who do not undergo a colonoscopy and the remuneration of the attending physician.
Conclusions
Our results reveals that current colorectal cancer screening organisation is not adapted to general practitioners preferences. This work offers the public authorities avenues for reflection on possible developments in order to optimize the involvement of general practitioners in the promotion of cancer screening programme.
Moutel, Grégoire; Duchange, Nathalie; Lièvre, Astrid; Darquy, Sylviane
Addressing low participant in colorectal cancer screening: Respect for individual freedom versus the community good Article de journal
Dans: Digestive and Liver Disease, vol. 49, no. 9, p. 1064-1065, 2017.
Liens | BibTeX | Étiquettes: Dépistage des cancers
@article{Moutel2017b,
title = {Addressing low participant in colorectal cancer screening: Respect for individual freedom versus the community good},
author = {Grégoire Moutel and Nathalie Duchange and Astrid Lièvre and Sylviane Darquy},
doi = {10.1016/j.dld.2017.05.023},
year = {2017},
date = {2017-09-01},
journal = {Digestive and Liver Disease},
volume = {49},
number = {9},
pages = {1064-1065},
keywords = {Dépistage des cancers},
pubstate = {published},
tppubtype = {article}
}