INSERM U1193, Département d'Oncologie Médicale, Hôpital Paul Brousse, 12 avenue Paul Vaillant, 94800, Villejuif, France.
Département d'Anticipation et de Suivi du Cancer DASC, Institut Paoli Calmette, 232 boulevard Sainte Marguerite, BP 156, 13273, Marseille Cedex 9, France.
Curr Oncol Rep. 2018 Mar 5;20(Suppl 1):17. doi: 10.1007/s11912-017-0649-7.
We studied cancer screening over time and social vulnerability via surveys of representative populations.
Individuals aged 50-75 years with no personal history of cancer were questioned about lifetime participation in screening tests, compliance (adherence to recommended intervals [colorectal, breast and cervical cancer]) and opportunistic screening (prostate and lung cancer).
The proportion of vulnerable/non-vulnerable individuals remained stable between 2011 and 2016. In 2011, social vulnerability had no impact on screening participation, nor on compliance. In 2014, however, vulnerability was correlated with less frequent uptake of colorectal screening (despite an organised programme) and prostate cancer screening (opportunistic), and also with reduced compliance with recommended intervals (breast and cervical cancer screening). In 2016, the trends observed in 2014 were substantiated and even extended to breast, colorectal and cervical cancer screening uptakes. Social vulnerability has an increasingly negative impact on cancer screening attendance. The phenomenon was identified in 2014 and had expanded by 2016.
Although organised programmes have been shown to ensure equitable access to cancer screening, this remains a precarious achievement requiring regular monitoring. Further studies should focus on attitudes of vulnerable populations and on ways to improve cancer awareness campaigns.
我们通过对代表性人群的调查，研究了癌症筛查随时间推移和社会脆弱性的变化。
对 50-75 岁、无癌症个人病史的人群进行调查，询问他们一生中参加筛查测试的情况、依从性（遵守建议的间隔时间[结直肠癌、乳腺癌和宫颈癌]）和机会性筛查（前列腺癌和肺癌）。
脆弱/非脆弱个体的比例在 2011 年至 2016 年期间保持稳定。2011 年，社会脆弱性对筛查参与度和依从性没有影响。然而，在 2014 年，脆弱性与结直肠筛查（尽管有组织计划）和前列腺癌筛查（机会性）的参与度较低，以及乳腺癌和宫颈癌筛查建议间隔时间的依从性降低有关。2016 年，2014 年观察到的趋势得到了证实，甚至扩展到了乳腺癌、结直肠癌和宫颈癌的筛查参与度。社会脆弱性对癌症筛查的参与度有越来越大的负面影响。这一现象在 2014 年被发现，并在 2016 年有所扩大。
虽然有组织的计划已经被证明可以确保公平获得癌症筛查，但这仍然是一个不稳定的成就，需要定期监测。进一步的研究应关注脆弱人群的态度以及提高癌症宣传活动的方法。
