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Inventory screenings organized france:
Résumé
Organized breast cancer screening is intended for women aged 50 to 74, that of colorectal cancer to women and men aged 50 to 74 and that of cervical cancer to women from 25 to 65 years old.
The objective is to detect malignant tumors at their beginning. Furthermore, at the asymptomatic, even precancerous stage, in order to improve the prognosis by early management.
The indications for organized screening must be respected. Moreover, in particular in order to avoid falsely reassuring results in subjects which would have an individual risk higher than that of the target population.
In its latest version, the Vidal Reco on the organized screening of cancers specifies the indications and practical methods.
LE Management of organized screening programs (DO) is under the responsibility of the Directorate General of inventory screenings organized france Health (DGS), which exercises it in connection with health insurance organizations, the National Cancer Institute (INCA) and Public Health France. Therefore, Cancer’s DO programs are implemented by regional centers for coordinating cancer screening (CRCDC).
Since 2024, it is health insurance that has invited target populations to participate in screening.
Epidemiological data
Three cancers are affected By organized screening:
- breast cancer;
- le cancer colorectal ;
- cervical cancer.

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Breast cancer is the most common malignant tumor in women and is located at 1is Rank of cancer deaths with more than 61,000 new cases and more than 12,000 deaths per year. Nevertheless, The median age at diagnosis is 64 years.
Le cancer colorectal is 4e most frequent cancer (all sexes combined). Meanwhile, is located in 2e Rank of cancer deaths with more than 47,000 new cases and more than 17,000 deaths per year.
Cervical cancer is 12e Cancer inventory screenings organized france in women with more than 3,000 new cases, but it is responsible for around 1,100 deaths/year.
Breast cancer screening
Organized breast cancer screening, First program set up in France, is aimed at all women aged 50 to 74 ans (except exclusion criteria, cf. Moreover, infra). However, This age group was chosen from epidemiological criteria (significant increase in incidence after 50 years. In addition, followed by a tray from 70 years old), as well as on test performance criteria (less efficient on a dense breast) and benefit-risk balance (frequent comorbidities at an advanced age).
Exclusion criteria are the situations that expose women to a high risk. Therefore, even very high of breast cancer, and which justify a particular follow -up (instead of the DO). Therefore, These are in particular the personal history of breast cancer. Moreover, atypical breast lesions, or abnormal imaging on previous mammography, inventory screenings organized france the Family history at 1is or 2e degree (the hereditary risk of breast cancer is specified by the calculation of the Eisinger score [cf. Therefore, Encadré 1]). Furthermore,
Since 2024. it is health insurance that sends women entering into an invitation to make, without advance, every 2 yearsa mammography, coupled with a systematic clinical examination of the breasts by the radiologist (cf. Encadré 2).
Any normal mammography or showing benign images (classified ACR 1 or 2) is systematically reread by a 2e radiologist.
In 2022-2023, the participation rate of the population targeting this screening was about 46 %. The overall rate of breast cancer screening (organized and individual) is estimated at around 60 % in France.
Colorectal cancer screening
Given its frequency, slow development, deaths attributable to it, and the existence of a simple and reliable test, colorectal cancer is an ideal candidate for organized screening.
inventory screenings organized france
The latter is for women and men, aged 50 to 74except exclusion criteria (cf. infra).
Beyond the direct benefit for the detected person (most often. an excision of the lesion can be carried out during the colonoscopic examination), the early screening of adenomas and precancerous lesions in an index case allow also to warn related (siblings, children) of their risky situation; They can then benefit from individual screening.
Are excluded DO. people requiring special follow -up, due to:
- symptoms justifying colonoscopic exploration (rectorrhagia, melena, transit disorders or unexplained abdominal pain in recent appearance) or having already carried out colonoscopy in the last 5 years;
- high risk (personal or family history of cancer or colorectal adenoma, personal history of chronic inflammatory disease of the intestine) or very high colorectal cancer (family forms of colorectal cancer).

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The target population (without known exclusion criterion for health insurance) receives every two yearshealth inventory screenings organized france insurance, an invitation to carry out an immunological test, which aims to detect the presence of blood in the stool (cf. Encadré 2). The screening kit can be removed from the attending physician or in a pharmacy, or ordered online.
The test, done at home, is fast and painless and requires only one stool sample.
Health professionals (doctors. pharmacists) play a central role here: verification of inclusion/exclusion criteria, delivery of the patient test kit and, if it is a doctor, coordination of positive cases.
A positive test reflects the presence of blood in the stool which can have other causes than a cancer. in particular a polyp, but requires consultation with a gastroenterologist so that it achieves colonoscopy.
With a participation rate of approximately 34 % In 2022-2023. the do of colorectal cancer remains a collective challenge, hence the major interest in the involvement of health professionals to mobilize patients inventory screenings organized france and in particular lifting taboos on sampling methods.
Inventory screenings organized france
Cervical cancer screening
Most recent programstarted in 2018, the organized detection of cervical cancer concerns women aged 25 to 65 years, vaccinated or not against papillomavirus. In 2019-2020, the participation rate to this screening was 59.7 %.
The two main objectives of screening (which has existed for a long time in an individual framework). with a participation of 50 to 60 %, are to mobilize women who are not tested individually and to improve respect for recommendations in those who are tested too often, with a risk of unnecessary interventions.
As with the other DOs. it is health insurance that addresses the women concerned an invitation to carry out a screening test (cf. Encadré 2).
Are excludedwomen who have a known exclusion criterion of health insurance (total hysterectomy. treatment of a cancer or precancerous lesion inventory screenings organized france of the cervix).
The methods of organized screening vary depending on the age :
- 
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- In those under 30, it is based on the cytological examination of a cervico-united levy of endocol and exocol, in search of abnormal cells. A 1is withdrawal is taken at the age of 25. followed by a 2ea year later, then a 3e Department, 3 years after the second if the results are normal. The HPV-HR test (search for high-risk oncogenic papillomaviruses) is not recommended due to the high prevalence of transient infections. by HPV in this age group.
- From 30 years old, it is based on the realization of an HPV-HR test every 5 years. The first is made 3 years after the last cytological examination. the result of which was normal or from the age of 30 in the absence of previous screening. Additionally, The HPV-HR test allows the detection of 14 HPV inventory screenings organized france at high risk (HPV 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68) and the selective typing of types 16 and 18.

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As an alternative to conventional screening, the HPV-HR test can be carried out on a vaginal self -reproductive Made by women, with an almost equivalent performance to the samples practiced by a healthcare professional (but without however allowing cytological analysis made automatically after a positive HPV test). Recommended by the High Authority for Health. in particular to receive populations far from health systems, self -defects are not yet sent to the women’s homes during the recovery, but are offered by certain medical biology laboratories.
Inventory screenings organized france
The key role of health professionals
The investment of health professionals is essential for membership of organized screenings.
Indeed. they are on the front line to remind their patients that the prognosis of inventory screenings organized france breast, colorectal and cervix cancers is very linked to the stage to which the disease is diagnosed and taken care of. Early screening improves the chances of healing and limits the risk of having to use heavy and/or mutilating treatments.
They must also specify thatA positive test is not necessarily synonymous with the presence of cancer. In particular. with regard to colorectal cancer, the positivity of the test signs the presence of blood in the stool, which can also be linked to polyps, hemorrhoids or an anal crack. Thus. in the event of a positive result, additional examinations making it possible to confirm or invalidate this result are necessary.
Conversely. patients should be informed thatand negative test does not eliminate with certainty the presence of cancer And that the occurrence of any unusual sign between two screening examinations (modifications of the appearance of a nipple, pain or palpation of a inventory screenings organized france “ball” on a breast, lasting modification of transit, presence of blood in the stool, etc.) must lead to quickly consult a doctor.
According to an interview with Dr. Ken Haguenoer, Medical Director – Coordinator doctor, Regional Center for Coordinating Cancers – Center -Val de Loire, Chru Tours.
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The EISINGER score identifies patients who could benefit from an oncogenetic consultation, more in -depth assessment or specific screening.
It is based on a series of criteria, each associated with a certain number of points. These criteria take into account: 
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The Eisinger score thus makes it possible to assess inventory screenings organized france the level of risk:
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Box 2 – The invitation paths implemented by health insurance
Inventory screenings organized france
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