Why is the French colorectal cancer screening rates at 34.9 % ? According to GPs, a qualitative study

Paul Aujoulat, Delphine Le Goff, Jeanlin Viala, Lucas Beurton-Couraud, Bernard Le Floch, Jean Yves Le Reste

Keywords: CRC screening, early detection, public policies, qualitative study

Background:

CRC is the third most common cancer in men and the second most common cancer in women. There are more than 1.9 million patients diagnosed with CRC and more than 900000 deaths from the disease each year worldwide. In France, medium-risk subjects aged between 50 and 74 years are invited by mail, every 2 years, to consult their attending GP so they can receive a screening FOBT. The invitation letter is sent by the structure in charge of screening in each department. However, the French participation rate was at 34.6% in 2021.

Research questions:

According to GPs, what could explain the French (non)participation to CRC OS ?

Method:

Semi-structured interview were conducted with GPs around French department of Finistere. GPs were chosen in the control group of AmDepCCR, a study that aim to improve the CRC OS participating rate. Purposive sampling aimed for a maximum variation sample in participant age, gender, years in practice and rural/urban exercise. Interviews were audio-recorded, transcribed verbatim, and thematic analysis with principles of constant comparison was conducted.

Results:

13 interviews were conducted. GPs described a variety of elements that could influence the OS CRC, one way or the other. Several were already found in literature. The ignorance of the patients and the fact of not feeling concerned was a barrier, as well as the GP's lack of time to deliver information.The key to screening was the GP-patient relationship. The impact of the national campaign was a lever, as well as the facilitation of the test by the arrival of the immunotest. Performance of the GPs' software was also a facilitator.

Conclusions:

Improving the doctor-patient relationship appears to be a good way to increase OS CRC participation. This supports our idea of using motivational interviewing in this setting.

Points for discussion:

Is there an OS CRC in your country ?

Do you know the rate of participation in OS CRC in your country (if there is one)?

How do you explain the wide difference in participation in OS CRC between countries?

#140