Oral question n° 0567S of
Ms Valrie Boyer
(Bouches-du-Rhne – The Republicans)
published in the JO Senate of 06/04/2023 – page 2235
Mrs. Valrie Boyer draws the attention of the Minister of Health and Prevention to the management of invitations to screening for breast cancer, colorectal cancer and cancer of the cervix.
For several months, the national health insurance fund (CNAM) has announced its desire to take over the management of invitations from the population, on the pretext that it would allow better results of participation and that it would save money.
In a press release, their national association of regional cancer screening coordination centers (ANCRCDC) is concerned about a form of nationalization of screening, with no guarantee of an improvement in participation rates.
However, since their creation in 2019, the centers have carried out this mission of sending invitations in conjunction with the regional health agencies (ARS) and the risk management coordination departments (DCGDR) and play a pivotal role in coordination, according to a recent report by the General Inspectorate of Social Affairs (Igas). They have been demanding for 3 years the means (human and technological resources, but also national governance) to go beyond the primary mission of inviting and monitoring the population.
However, currently, the health insurance has made it clear that there will be no more exchanges of population files with the CRCDCs (invited or screened populations). This makes it impossible for the medical mission of exhaustive monitoring by the CRCDCs.
This disconnection between the medical follow-up entrusted to the CRCDCs and the management of invitations could entail a major risk of degradation of the medical service provided (more evaluation).
The problem is that cancer is not a vaccination program (flu or covid) and that the transformation of a public health screening program into a promotion program, without medical follow-up of the results and without epidemiological evaluation leads to a loss of very heavy quality for the population, and is emerging without the awareness of decision makers.
These centers also fear a loss of local visibility that is detrimental to the promotion of organized screenings and denounce a contradiction with the initial desire for regionalization. They also say they are ready to orient part of their activities around prevention, fight against territorial and social inequalities in health or even optimize care for people at high risk of cancer.
But in order to do so, they are demanding better visibility, clarification of their local coordination mission and a budgetary support plan commensurate with the shared ambitions. The CRCDCs also ask to be included in the national monitoring committee for the ten-year cancer control strategy (2021-2030), the first meeting of which, on December 5, 2022, was held without them.
It also asks the Government whether it would be possible to reconsider this choice, which has a heavy impact on the quality of cancer screening in France and which places France outside the quality indicators for screening organized in Europe. The CRCDCs ask to strengthen their resources and maintain their missions.
Awaiting response from the Ministry of Health and Prevention.