The EDIFICE nationwide surveys assess attitudes to cancer screening in France. All 5 self-reported surveys (2005, 2008, 2011, 2014 and 2016) focused on breast (BC), colorectal (CRC), prostate cancer (PC) screening; the 4th and 5th editions also included cervical (CC) and lung cancer (LC) screening.
The 5th survey recruited a representative sample of 1299 subjects (men [M], women [F]; age, 50-74 y; no history of cancer) and focused on target populations of the national screening programs for BC and CRC (50-74 y), and on specific subpopulations for PC (M, 50-75 y), CC (F, 50-65 y) and LC (M and F, 55-74 y) screening. Participants were questioned about uptake of at least 1 lifetime screening test and compliance to recommended intervals. Data analysis encompassed nationwide screening programs, opportunistic screening, and vulnerability (assessed by the EPICES score).
Rates for at least 1 lifetime BC screening test (screening rate) were 93%/94%/95%/97%/97% in 2005/2008/2011/2014/2016, respectively. In line with recommendations, 75%/83%/83%/81%/75% women reported having had a mammogram in the past 2 years (compliance), with a significant drop in 2016 vs 2014 (P=0.02). Vulnerability had a negative impact on compliance in 2016, though not previously. For CRC, screening rates were 25%/38%/59%/60%/64%. Compliance (FOBT or FIT in the past 2 years) increased steadily from 7% (2005) to 33% (2014), and rose significantly to 38% in 2016 (P=0.02). The rise was mainly observed in the 50-54 y age group, among men, and in non-vulnerable subjects. In 2016, a significant drop in overall CC screening uptake was observed (99% in 2014 vs 94% in 2016, P
In 2016, compliance to national programs was seen to be high for BC screening (despite a decline), and on the rise for CRC, possibly due to the use since 2015 of the new FIT test. Although a national program is due to be implemented in France, uptake of CC screening is on the decline.
Clinical trial identification
Legal entity responsible for the study
S. Couraud, L. Greillier, J-Y. Blay, A. Cortot, J-F. Morere, F. Eisinger: Received honorarium fees from Roche/Edifice surveys were funded by Roche S.A. C. Lhomel: Employee of Roche. All other authors have declared no conflicts of interest.