Cancer survivors have an increased risk (36%) to develop cancer compared to the non-cancer population. Improvement in cancer detection and treatment has led to an important increase of the number of long-term cancer survivors, many of them being at risk of second cancer. Face to the lack of information on cancer screening practices in this population, we decided to study such practices among women cancer survivors using the VICAN5 data. We selected women because in France, organised breast cancer screening program has been implemented (mammography) since 2004 (every 2 years between 50 and 74 years) and national recommendations exist for cervical cancer screening (Pap smear) (every 3 years between 25 and 65 years).
VICAN5 is the first national French survey on life conditions, prevention practices and medical follow-up of cancer survivors five years after diagnosis. Data has been collected from patient questionnaire, personal medical file and medical insurance databases. Patient questionnaire includes questions on new cancer screening before interview. Univariates and multivariate analyses have been performed to compare cancer women to French non-cancer women regarding their screening practices.
VICAN5 surveyed 1149 women including 654 (60%) women with non-breast cancer and 1011 (88%) with non-cervical cancer. We found an underutilization of mammography screening in the non-breast cancer group compared with women in the general population (78% vs 87%).Concerning report of Pap smear in the 3 past years, no significantly differences were found between non-cervical cancer survivors and the general population (83% vs 81%). Use of a Pap smear test is strongly associated with having had a screening mammography. Several associated factors with tertiary prevention practices was found such as psychological state (anxiety level), physical characteristics (BMI) and life style (tobacco use).
Survivorship care plans are needed to improve information of survivors, and to increase physicians' awareness of the importance of tertiary prevention, especially among the cancer survivors who are at high risk to develop a second cancer.
Clinical trial identification
Legal entity responsible for the study
French National Institute of Health and Medical Research (Inserm)
French National Institute for Cancer (INCA)
All authors have declared no conflicts of interest.