Keywords: Prevention, screening, continuity of care

Background:

Non-communicable diseases, including cancers and cardiovascular diseases, are the leading causes of death in France. Prevention and screening are crucial but vary across regions, particularly in island areas.

Research questions:

The aim of this study was to assess the prevention measures and cancer screening practices of general practitioners (GPs) on the islands of Brittany.

Method:

Qualitative study conducted between February and May 2025, using semi-structured interviews with GPs practicing on the islands of Finistère. The interviews, which were recorded and transcribed, were analyzed using a method inspired by grounded theory. Data saturation was achieved after eight interviews.

Results:

Eight GPs (average age 43; 3 women, 5 men) participated. Three main areas emerged. The main areas of prevention involving GPs, nurses, and local associations, concerning cardiovascular risks factors, addictions, aging, and vaccination. Screening practices with colorectal cancer screening little affected by insularity; breast cancer screening was limited by the need to travel to the mainland; cervical cancer screening facilitated by the proximity of doctors to patients; and prostate cancer screening discussed on a case-by-case basis. Screening facilitators, including screening reminders, a variety of informational materials, mobile mammography units, and advanced specialist consultations. New perspectives are being considered, including consultations dedicated to prevention, training general practitioners in motivational interviewing, and more individualized screening.

Conclusions:

Prevention and screening practices on the islands of Brittany are broadly similar to those on the mainland, but insularity exacerbates certain barriers, particularly in term of access to breast cancer screening. The central role of GPs, combined with local initiatives and innovative solutions (mobile mammography units, self-testing), opens up avenues for improving equitable to preventive care.

Points for discussion:

Continuity of care in isolated island

Technology helping rural and remote health

GPs as the main role on isolated areas