The European Commission recommended, on Tuesday 20 September, to widen the public concerned by the diagnosis of cancer, in the European Union (EU), in particular by lowering to 45 the age from which women are eligible for screening organized breast cancer. “We need to screen more and better,” insisted the European Commissioner for Health, Stella Kyriakides.
“Today, there are still real unacceptable inequalities in terms of screening, with for example coverage rates of the target population ranging from 6% to 90% for screening”, lamented the Cypriot. She wants 90% of European women meeting the required conditions to be offered such screening by 2025 (against a target of 70% currently). All this, while advocating a new age range: from 45 to 74 years against 50 to 69 years currently.
Strong social disparities
In France, according to the National Cancer Institute, the participation rate of the population targeted by “organized” breast cancer screening was 49.9% in 2017. To which is added a rate of 10% to 15% “individual” screening, which does not, however, benefit from the same guarantees in terms of quality and performance.
After a marked increase from 2004, when control was generalized (from 42.5% in 2004-2005 to 52.7% in 2011-2012), “a plateau has been observed since 2008 and the new data show a slight decrease”regrets the organization.
These figures are also marked by strong territorial disparities, with some regions peaking at less than 40%. “Social criteria, income and education levels, are decisive: disadvantaged groups are much less screened than the wealthiest”, explains oncologist François-Clément Bidard.
Modulate the age of screening
In 2017, still, 11,883 women died of breast cancer. The early diagnosis would have allowed a reduction in mortality of 1.5% between 2005 and 2012. Professor François-Clément Bidard recalls that the recommendations are national, without automatic transposition of those formulated for the EU, and relativizes the scope of the announcement : “Earlier screening may be effective, but the effect will remain limited: the incidence (you cancer) mostly around the age of 60. »
For the head of the breast cancer group at the Institut Curie, who has noted a drop in consultations following Covid-19, the « future » of the diagnosis is based instead on the results of a trial (MyPeps), launched in 2019 and coordinated by France, in progress throughout Europe. Its conclusions will confirm or not the interest of modulating the age of diagnosis according to the individual genetic risks, observed thanks to a blood test.