John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive

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Results and lessons learned from the French organized colorectal cancer screening programme with guaiac FOBT Volume 24, issue 2, Février 2017

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Authors
Hôpitaux Civils de Colmar,
service de médecine A,
39 avenue de le Liberté,
68024, COLMAR Cedex ; ADECA Alsace (Association pour le Dépistage du Cancer colorectal en Alsace),
122 rue de Logelbach, 68020, Colmar Cedex,
France
* Tirés à part

France launched an organized colorectal cancer (CRC) screening programme in a few pilot areas in 2003 that was extended to the whole country in 2009. It is dedicated to average risk men and women aged 50 to 74 years. They were invited every two years for a CRC screening using a guaiac-based faecal occult blood test (gFOBT) (Hemoccult®) until January 2015, and a quantitative faecal immunochemical test (OC-Sensor) since spring 2015. The programme is a success, as France is one of the first countries providing a national organized CRC screening programme. It is also a success for all people who benefited from the programme. However, it is a failure too for several reasons: insufficient participation; inequalities in access; absence of measurable impact on CRC mortality; less favourable benefit/risk balance in the real life than in trials; absence of quality guidelines for screening colonoscopies... We suggest some points of improvement: diversifying the range of screening tests offered to the target population; enhancing involvement of general practitioners; promoting the reintroduction of the mailing of the FOBT kit; including people at increased CRC risk in the organized screening programme; establishing quality guidelines and organizing a quality improvement programme for screening colonoscopies... There is an urgent need that French medical and professional societies issue quality guidelines and organize a quality improvement programme for the colonoscopies performed within the organized CRC screening programme, so that gastroenterologists perform high quality colonoscopies to reduce CRC mortality and incidence in our country.