Impact de l’intégration du test immunologique dans le programme de dépistage du cancer colorectal en France

Abstract

While organized screening for colorectal cancer has been extended to the whole of France since 2008, there is no evidence to suggest that this screening based on use of the guaiac test had a significant impact on trends in its incidence and mortality in France in the last 10 years. Following the first prospective trials conducted in Normandy, FIT (Fecal Immunological Test) was proposed to the entire national territory from 2015. Three years after its generalization, it is of course impossible to measure the effects of this modification of strategy on the incidence or mortality from colorectal cancer. However, for both models and data from the ten departments of the Greater East region, this test should make it possible to detect 2.5 more cancers and 3.7 times more advanced adenomas than the guaiac test and sensitivity. A biennial program using an immunoassay should be about 75%. On the other hand, it is reasonable to hope that the technical characteristics of the test and the newfound confidence of the doctors eventually improve the participation of the target population. The result of an improvement in the technical performance of the test and an (expected) increase in participation should ultimately be measurable translation into the general population in terms of improving the survival of people with cancer, lowering the risk of cancer incidence of the most advanced forms and decline in mortality.