Cancer screening and follow-up in general practice: A French nationwide cross-sectional study

Abstract

Background

The overall activity of general practitioners (GPs) related to cancer screening and follow-up is poorly documented.

Objectives

To describe cancer screening and follow-up activities carried out in general practice and analyse them according to the socio-economic characteristics of patients.

Methods

We used data from a French nationwide, multicentre, cross-sectional study that described the distribution of health problems managed in general practice and the associated processes of care. Analyses were adjusted on age and gender when appropriate, using a multivariate, hierarchical, linear mixed-effects model.

Results

Among 20,613 consultations recorded, 580 involved cancer screening (2.8%) and 475 cancer follow-ups (2.3%). The most frequent cancer screening procedures concerned colorectal cancer (38.6% of screening procedures), breast cancer (32.6%), cervical cancer (17.0%), and prostate cancer (9.3%). In consultations with female patients, the most frequent types of cancer followed up were breast (44.9%) and colorectal cancer (10.5%), and with male patients, the most frequent were prostate (37.3%) and skin cancer (10.3%). After adjustment on age and gender, consultations with cancer follow-up included a mean 1.9 health problems managed in addition to cancer. Consultations with cancer screening or follow-up issue less often involved a patient on low income than other consultations (2.4% vs. 4.2%, and 1.1% vs. 4.2%, respectively).

Conclusion

Around 5% of French general practice consultations include cancer screening or follow-up. Socio-economical inequalities demand further research.

Keywords:

• General practice
• cancer screening
• cancer survivor
• comorbidity
• procedure

Acknowledgements

We acknowledge the ECOGEN study group, including the Steering Committee, the 54 residents and the 128 GP trainers. The members of the Steering Committee were: Laurent Letrilliart, Alain Mercier, Irène Supper, Matthieu Schuers, David Darmon, Pascal Boulet, Dominique Ambros, Madeleine Favre, Gil Mury, Bernard Gay, Denis Pouchain, Eric Van Ganse, Philippe Ameline, Anne-Marie Schott, Angelique Denis. The residents (trainees) were: Céline Alexanian, Clement Barletta, Solene Baron de Preville, Muriel Baudoin-Bion, Naïma Belarbia, Clarisse Bertrand, Anne-Sophie Billet, Emilie Boulard, Emilie Breillat, Claire Brunet, Claire Camilleri, Hélène Carrier, Mathieu Carron, Nelly Cordeiro, Clément Coutarel, Sophie Dargent, Sarah Darriau, Hubert de Lary, Karen Denis, Yohana Dery, Isabelle Duquenne, Guillaume Farcis-Morgat, Charlotte Favier, Sarah Filoche, Mohamad Hamade, Marion Helly, Laura Hsiung, Thibault Lelong, Nathalie,Levernier, Julia Marquant, Prisca Martin, Caroline Martin-Bouyer, Ryma Metahri, Lesley-Ann Montigneaut, Noémie Morel, David Nakache, Claire Parker, Eric Pernollet, Solène Petitclerc, Alicia Pillot, Henri Plancke, Fanny Poirot, Thomas Proboeuf, Sophie Quien, Marie-Camille Rault-Tandonnet, Charlotte Regnier, Yohan Saynac, Saphanie Son, Damien Steciuk, Aurélie Urena-Dores, Yannick Vacher, Maxime Veques, Lucile Wies, Elodie Youssef. The GP trainers were: Ahmed Aadjour, Isabelle Aubin-Auger, Ghislaine Audran, Nadine Ayme, Catherine Bageot, Jérôme Bard, Bruno Beauchamps, Olivier Bisch, Paul Blanchet, Jean-Michel Blondel, Pierre Bobey, Jean-Yves Borgne, Jean-Yves Breton, Agnès Bryn, Martin Buisson, Marie Cabanas, Gérald Catsanedo, Maxime Cauchie, Nicole Caunes, Cerisier-Cornillot, Patrick Charbit, Pascal Clerc, Laurent Convert, Françoise Corlieu, Thierry Cornille, Alain Couatarmanac’h, Claude Danner, Jean-Claude Darrieux, Alain Dasse, François de Golmard, Gilles de Lorenzi, Anto de Pavljasevic, Pierre-François Delzanno, Nicole Derain, Pierre Deveche, Vincent Diquero, Bénédicte Chevreau, Christian Larcheron, Elise Dubreuil, Pierre Dupont, Charline Dupont, Richard Dymny, Catherine Elsass, Pierre Eterstein, Gilles Faivre, Eric Fanjeaux, Emmanuelle Farcy, Claudine Fity, Vasantha Flory, Anne Girard, Christophe Girault, Sabine Grutter, Murielle Guillier, Thérèse Guyenne-Chambru, Christophe Haguet, Jean-Yves Hascoet, Sophie Haudidier, Sylvain Hirsch, Gaëtan Houdard, Hélène Hubail, André Kastelik, Sylvain Kichelewski, Xavier Lainé, Valérie Lapouge, David Laurent, Laurent Laval, Serge Lavaure, Mireille Lavigne, Yves Leborgne, Odile Lion, Viviane Mannevy, Jean-Michel Mathieu, Laure-Emmanuelle Mavraganis, Denis Perrot, Yvon Petrault, Christophe Pigache, Maurice Ponchant, Véronique Poupet, Daniel Reynolds, Emmanuel Robin, Marie-Hélène Robineau, Jean-Loup Roblot, Larisa Savan, Pierre Sebbag, Patrick Serey, Michel Serraille, Corinne Simoneau, François Tahon, Jean Louis Teruel, Audrey Tordoir, Christian Verot, Valérie Zéline.

We thank Dr. Philip Robinson from the Hospices Civils de Lyon for help in manuscript preparation. We are grateful to the FASTRACS project for funding the article publishing charge.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The ECOGEN study was supported by the French National College of teachers in general practice via a grant from Pfizer laboratories.