Access to cancer care “remains unequal across the country” for adults, underlines the National Academy of Medicine in a report made public on Monday, where it makes a series of proposals to try to remedy this. Cancers remain the leading cause of premature mortality in France among men, the second among women, and their frequency has doubled in around thirty years, with more than 433,000 new cases in mainland France in 2023.
However, “despite considerable advances in the field of treatments (robotic surgery, high-precision radiotherapy, targeted medical treatments and immunotherapy, supportive care, etc.) and diagnosis (molecular and genetic pathology), the current state of management diagnostic and therapeutic burden does not seem homogeneous across the territory, as does access to innovative practices,” underlines the Academy of Medicine. “These inequalities in access have perhaps increased in recent years (post-Covid), due to the economic and human resources difficulties encountered in community medicine and hospitals,” add the authors of the report.
Despite a very structured organization of oncology, there remain difficulties and territorial inequalities “all along the care pathway”, warns the Academy of Medicine. Prevention policies are thus judged to be “too general, insufficiently funded, poorly evaluated and of little concern to populations at risk for economic or socio-cultural reasons”.
The famous “Pink October”, for breast cancer screening, is criticized for having led to “no increase in the number of screening mammograms”. “It would undoubtedly have been preferable to carry out a precise assessment of this mobilization and to better identify unscreened women to raise their awareness,” according to the report.
The Academy of Medicine therefore recommends “precise targeting and evaluation of prevention policies” for cancer, but also “an active prevention policy” for patients who are cured but at high risk of complications and early death thereafter.
While the genomic characteristic of tumors is “indispensable”, the report also pleads for “maximum interaction” between two categories of analysts, anatomopathologists and molecular biologists, and the replacement of molecular tests on a single gene by tests on groups of genes, to avoid a “loss of opportunity” for patients.
The Academy also defends “price homogenization between public and private actors, and not weakening locoregional cancer treatments”, which act directly on the tumor or on the region of the tumor. She also urges, among other things, a policy to encourage careers in oncology because, otherwise, the shortage of caregivers could increase inequities of access, or even mortality.
