Pink October: “find cancer before it finds us” but one in two women still does not get screened in Occitanie

Umbrellas have reappeared on Rue de la Loge in Montpellier. MIDI LIBRE – JEAN MICHEL MART

Every year, the month of October is marked by a national mobilization for the fight against breast cancer. In Occitanie, efforts may be renewed to raise awareness among all women aged 50 to 74 about organized screening, but the participation rate remains insufficient with only 56.6% of women concerned in 2023. When the threshold recommended at European level is 70%

Figures

More than 61,000 new cases of breast cancer in 2023. (+0.3% per year between 2010-2023).
80% of breast cancers develop after the age of 50.
1st cancer in women.
33% of cancers in women are breast cancers.
1st cause of death from cancer in women.
More than 12 000 deaths in 2018. (- 1.6 % per year (2010-2018).
40 120 cancers detected through the organized screening program. (7.6 per 1,000 women screened in 2017-2018).
88 % standardized net survival rate at 5 years of women diagnosed.

On the occasion of the launch of the awareness campaign for Pink October in Occitanie, the Primary Health Insurance Fund, the Regional Health Agency, the Regional Cancer Screening Coordination Center of Occitanie and the user representative France Assos Santé Occitanie met to take stock of breast cancer screening.

As a reminder, organized screening allows all women aged 50 to 74, without symptoms or particular risk factors, to benefit from a free mammogram every two years.

A million women in Occitanie invited to screening

“When it comes to breast cancer, as always, prevention is better than cure. You should not be afraid to get screened, the cure rates are extremely high. The progress is considerable”, begins Didier Jaffre of the ARS.

Breast cancer affects one in eight women during their lifetime. It is the most common type among women. Early detection is essential in order to offer the best chances of cure. The earlier breast cancer is detected, the easier it is to treat, and the higher the chances of recovery.

“Every year, one million women in Occitanie are invited to get screened by the CPAM. 56.6% respond with screening. We are not making progress, we have returned to the figure before the Covid crisis”, continues Philippe Trotabas, risk management coordinator in Occitanie for Health Insurance. “The rate is not increasing over the long term, it is a real difficulty. One in two women is not enough. Behind it are so many lives that we can no longer save.

Cured in 9 out of 10 cases

With more than 61,000 new cases in 2023 in France, breast cancer ranks first among the most common cancers, both sexes combined. Incidence has increased by an average of 0.3% per year since 2010. Mortality (12,100 deaths estimated in 2018) is slightly decreasing thanks to advances in treatments, of course, but especially to early diagnosis. This cancer can be cured in 9 out of 10 cases.

A fight that begins before the disease is declared

How? “First of all, by adopting a lifestyle that fights against the risk factors of cancer: stop smoking, limit alcoholic beverages, eat a balanced and varied diet, exercise at “at any age and avoid being overweight”, explains Dr. Marie Bichara.
These good lifestyle habits not only prevent the appearance of more than 40% of cancers, but also significantly reduce the risk of a possible recurrence.
The second way to fight breast cancer is to “find it before it finds us”. And therefore to get screened.

In terms of prevention, it is also about reducing inequalities, by reaching out to women who are furthest from the healthcare system, in rural areas and priority city neighborhoods, where participation falls to 44%. The offer is not always well ensured in sensitive neighborhoods. There is, however, a slight improvement, since they were only 39% in 2019.

Mammobile and “women's health” days

The Hérault mammobile has demonstrated its effectiveness. "Mammobiles are a real asset at a time when imaging centers are closing", raises Marie Bichara, doctor of the regional coordination center for screening.

Today, he travels to certain areas of Gard, Ariège or Aude, where the rate is the lowest, where the cancer rate is also the highest. “Occitanie is a very rural region. We therefore practice “going towards” via “women's health” days which allow screening as close as possible to isolated, elderly or precarious or disabled people, with partner radiologists. We have organized 73 in 2023. This year, the 13 CPAMs are planning 38 in October alone,” explains the director of CPAM Hérault, which is funding 43 associations on the ground to the tune of 169,000 euros.

“We currently have about twenty advisors who call the women concerned, mobilize radiologists to obtain slots in order to schedule an appointment. We made about 300 calls in three weeks. 10% accepted, which is already not so bad! It is essential to maintain this momentum throughout the year.”

For her part, Doctor Marie Bichara insists on the quality of the diagnosis, “Today, the second reading of the images allows us to recover 6% of cancers. Furthermore, we have obtained an exemption for the dematerialization of the photos to facilitate the circuit of the second analysis."

“Fear, it hurts, it's dangerous, no history…”: still very powerful obstacles

Women reluctant to undergo screening cite the danger of radiation. “There has been controversy about this”, explains Dr. Bichara. “In the 2000s, it was said that mammography caused cancer, this occupied many minds. Studies were conducted. The first thing is that today's mammograms are not the same as those of 20 years ago. They are much less irradiating. Regarding the dose of radiation delivered, between the ages of 50 and 74, that's 13 examinations in total. The total dose corresponds to what she would have received with a single chest scan. In medicine, zero risk does not exist, but we are not at increased risk. Not getting screened is much more dangerous."

"Fear of the result, fear of radiation, &it hurts, I don't have time, I don't have a history…". The obstacles are stubborn, as explained by Laurence Pochard, a volunteer member of the league against cancer and representative of users of France Assos Sant&eacute Occitanie, which brings together 110 approved associations. “Everyone knows the pink ribbon. Breast cancer is no longer taboo. We must take advantage of this month to raise awareness among our loved ones and friends, regardless of their age group. It is the responsibility of everyone and every woman to take charge of their health."

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