Final results of the evaluation of the cervical cancer screening program conducted in 13 departments in France, 2010–2014.

Between 2010 and 2012, 13 French departments implemented a pilot program for organized cervical cancer screening (CCS) based on a common protocol: inviting and reminding women aged 25 to 65 who had not been tested in the past three years, and having administrative offices collect data on all tests performed by women, whether the screening was done spontaneously or following an invitation. In the context of a future nationwide rollout of organized CCU screening, this article aims to estimate the impact of this screening program on coverage, sample quality, and the prevalence of abnormal Pap smears. The pilot program covered nearly 2.4 million women aged 25 to 65, representing 13.4% of the total target population in France (INSEE), including 1,319,660 women invited to undergo a Pap test. Overall screening coverage was 62%, with significant regional disparities and a decline after age 50. The invitations led to screening for nearly 231,000 women, and the follow-up letters for an additional 48,000 women; relative to the total target population, this represented a 12-percentage-point increase in screening participation. The quality of the samples was good, with the proportion of unsatisfactory Pap smears not exceeding the 2% threshold. However, the proportion of women who did not undergo a repeat Pap test was significant: 30% to 80% at six months, depending on the department. Among the interpretable Pap tests, 4.2% were positive, with the majority showing ASC-US (2.3%) or low-grade (1.2%) abnormalities. In total, 5,125 high-grade precancerous squamous cell lesions, 55 glandular carcinomas in situ (AIS), and 323 invasive cancers were detected, representing detection rates of 620.5, 6.7, and 39.1 per 100,000 women screened, respectively. This assessment shows that expanding organized screening would increase the number of women screened.

Author(s): Beltzer N, Hamers FF, Duport N

Publishing year: 2017

Pages: 26-31

Weekly Epidemiological Bulletin, 2017, n° 2-3, p. 26-31

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