AI Article Synopsis
- Organized screening programs significantly lower colorectal cancer (CRC) mortality, but France's national screening program, initiated in 2008, struggles with a low participation rate of just 29.8%.
- An expert panel from the French National Cancer Institute examined ethical concerns regarding the effectiveness of CRC screening given the low uptake and proposed recommendations to address this issue.
- The panel identified reasons for the low participation and suggested targeted awareness campaigns and educational strategies to encourage participation, particularly among subgroups with specific sociocultural challenges while respecting individual autonomy.
Article Abstract
International studies have shown a significant reduction in colorectal cancer (CRC) mortality following the implementation of organized screening programs, given a sufficient participation rate and adequate follow-up. The French national CRC screening program has been generalized since 2008 and targets 18 million men and women aged 50-74 years. Despite broad recommendations, the participation rate remains low (29.8%), questioning the efficiency of the program. A panel of experts was appointed by the French National Cancer Institute to critically examine the place of autonomy and efficiency in CRC screening and propose recommendations. In this paper, we explore the ethical significance of a public health intervention that falls short of its objectives owing to low take-up by the population targeted. First, we analyze the reasons for the low CRC screening participation. Second, we examine the models that can be proposed for public health actions, reconciling respect for the individual and the collective good. Our expert panel explored possible ways to enhance take-up of CRC screening within the bounds of individual autonomy, adapting awareness campaigns, and new educational approaches that take into account knowledge and analysis of sociocultural hurdles. Although public health actions must be universal, target actions should nonetheless be developed for nonparticipating population subgroups.
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| http://dx.doi.org/10.1097/CEJ.0000000000000417 | DOI Listing |
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