40% of women are still undiagnosed

Starting at the beginning of the year, women who haven’t had their cervical cancer screened in time will theoretically receive a letter in their Amelie account box (personal Social Security account) or by mail. In France, 40% of women are not tested.

This screening, which makes it possible to detect the presence of the virus responsible for this cancer, is recommended for women aged 25 to 65. 65, editor’s note).

Why not sooner? If they have not been vaccinated (HPV vaccine), young women almost always carry the virus after their first sexual intercourse. In most cases, the viral load decreases with age (due to the immune system response), but not always.

3,000 cases and 1,000 deaths per year

Cervical cancer usually takes decades to appear, but the death rate is high (3,000 new cases, 1,000 deaths per year). Hence the importance of vaccination and regular check-ups for teenagers.

This organized screening (the third after breast cancer and colorectal cancer screening) was only put in place in May 2018, at the instigation of Health Minister Agnes Buzin.

“It seemed to be going well, the gynecologists were very optimistic, but it didn’t live up to expectations”says Christine Bergeron, anatomical pathologist (specialist in the analysis of tumors) and former president of the SFCPCV (French Society of Colposcopy and Cervical Vaginal Pathology).

Avoid false positives

After a good start, screening of less than 60% of relevant women plateaus, and still suffers from failures: “European recommendations are for HPV testing as a primary screening in women over 30 years of age. And not for cytology. (Study of Cells, Editor’s Note) Only if this test is positive. Otherwise, we have a lot of false positives that lead to colposcopy (Examination of the cervix under the microscope, editor’s note) useless, and which is a source of stress ». And overload for professionals. Requests for colposcopies have (logically) doubled since the implementation of organized screening.

Self-debit

How to better engage women in screening. The SFCPCV suggests better promotion of self-sampling, which will be one of the keys to the high uptake of screening in Australia (80% of women screened): “Kits can be sent to your home and collected from a pharmacy or lab. »

Self Debit Limit: “It allows you to do HPV testing but not cytology. ». If the virus persists, a medical appointment will be needed to assess whether there is a risk of pre-cancerous lesions.

Countries like the Netherlands offer systematic self-debit. It must be integrated into the French screening campaign in the coming months.