1409P - Cervical cancer screening in France: recent change in behaviors

Abstract

Background: Cervical cancer (CC) is the fourth most common cancer in women in France. Human papillomavirus vaccination and screening are complementary secondary prevention measures against CC. Screening by conventional Pap smear is recommended every three years for women aged 25-65y. Methods: The EDIFICE nationwide observational surveys assess population attitudes to cancer screening in general. Representative samples of the French population aged 50-75 years are interviewed by phone using the quota method. Although the French CC screening program covers all women aged 26-65y, the present analysis pertains to a subpopulation aged 50-65y (N = 356 in 2014 and N = 460 in 2016). Interviewees, with no personal history of cancer, were asked if they had ever had a smear test during a gynecological exam. The date of the last test was noted. Data analysis focused on age group, socioprofessional categories (SPC) and social vulnerability (defined by the EPICE score). Results: In 2016, 94% of interviewees reported at least one lifetime smear test vs. 99% in 2014 (P<0.01). In line with current interval recommendations, 74% in 2016 and 75% in 2014 (P=0.81) had had the latest test done in the past three years. Younger age groups were significantly more likely to be compliant with the recommendations in 2014 (P<0.01) though not in 2016 (P=0.18). SPC also had a significant impact on compliance rates in 2016 (P=0.01) but not in 2014. Vulnerable women were less likely to be screened at least once in their lifetime; this trend was non-significant in 2014 (98% vs 100% in non-vulnerable, P=0.14) but significant in 2016 (89% vs. 97%, P<0.01). Vulnerable women were also significantly less likely to be compliant with the recommendations (64% vs 81%, P<0.01 in 2014; 63% vs.79%, P=0.01 in 2016). Conclusions: Between 2014 and 2016, participation in CC screening decreased and compliance rates stagnated. Compliance with screening recommendations was negatively affected by the following: unemployment, low SPC or classification among vulnerable populations. Additional analysis will further investigate these findings, which highlight the need for generalized population-based screening programs and targeted actions for non-participants, as advocated earlier this year by the French National Cancer Institute (INCa). Legal entity responsible for the study: Kantar Health Funding: Roche Disclosure: T. de la Motte Rouge: Consultancy work AstraZeneca, Roche, MSD, Eisai, Sanofi Travel Grants/meeting support Roche, Novartis, Pfizer. Corporate-sponsored research Novartis. J-F. Morere, J-Y. Blay, F. Eisinger: Honorarium fees from Roche Edifice surveys were funded by Roche S.A. C. Lhomel: Employee of Roche. All other authors have declared no conflicts of interest.