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

The overall activity of general practitioners (GPs) related to cancer screening and follow-up is poorly documented. To describe cancer screening and follow-up activities carried out in general practice and analyse them according to the socio-economic characteristics of patients. 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. 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). Around 5% of French general practice consultations include cancer screening or follow-up. Socio-economical inequalities demand further research.

全科医师（general practitioners, GPs）与癌症筛查及随访相关的整体诊疗活动，目前尚未得到充分记录。本研究旨在描述全科医疗中开展的癌症筛查与随访活动，并依据患者的社会经济特征对其进行分析。本研究使用了一项法国全国性多中心横断面研究的数据，该研究描述了全科医疗中处理的健康问题分布及相关诊疗流程。分析过程中，在适宜条件下采用多变量分层线性混合效应模型对年龄与性别进行校正。在记录的20613次就诊中，580次涉及癌症筛查（占比2.8%），475次涉及癌症随访（占比2.3%）。最常见的癌症筛查项目依次为结直肠癌筛查（占筛查总项目的38.6%）、乳腺癌筛查（32.6%）、宫颈癌筛查（17.0%）及前列腺癌筛查（9.3%）。在女性患者的就诊中，最常见的随访癌症类型为乳腺癌（44.9%）与结直肠癌（10.5%）；而在男性患者的就诊中，最常见的随访癌症类型为前列腺癌（37.3%）与皮肤癌（10.3%）。在校正年龄与性别后，涉及癌症随访的就诊中，除癌症相关问题外，平均还需处理1.9项其他健康问题。涉及癌症筛查或随访的就诊中，低收入患者的占比低于其他就诊（分别为2.4% vs 4.2%、1.1% vs 4.2%）。法国全科医疗的就诊中，约5%涉及癌症筛查或随访工作。社会经济层面的健康不平等现象仍需开展进一步研究。