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Access to cancer care “remains unequal on the territory” for adults, underlines the National Academy of Medicine in a report made public Monday November 18, 2024.
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.
Or, “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 diagnostic care and therapeutic does not seem homogeneous across the territory, as does access to innovative practices”underlines the Academy of Medicine.
Difficulties throughout the care pathway
“These inequalities of 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 “throughout the care pathway”warns the Academy of Medicine.
Prevention policies are thus judged “too general, insufficiently funded, poorly evaluated and hardly concerns populations at risk for economic or socio-cultural reasons”.
Better identify unscreened women
The famous “Pink October”, for breast cancer screening, is singled out for not having led to “no increase in the number of screening mammograms”.
“No doubt it would 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” cancer, but also “an active prevention policy” for patients who are cured but at high risk of complications and early death thereafter.
Collaborative work, harmonization of prices
While the genomic characteristic of tumors is « indispensable »the report also pleads for a « interaction maximale » 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 luck” 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.
Ized approaches to care. All these elements together create significant barriers to equitable access to cancer treatment across different regions.
Guest 1: Dr. John Smith, Oncologist at Memorial Sloan Kettering Cancer Center
Guest 2: Ms. Emily Johnson, Patient Advocate for Cancer Care Access
Interviewer: Welcome to our interview about the challenges and opportunities in cancer care today. Dr. Smith, as an oncologist, can you share your perspective on the National Academy of Medicine’s recent report that highlights inequalities in access to cancer care across different regions in France?
Dr. Smith: Yes, absolutely. The report highlights a concerning trend of inequitable access to cancer care, particularly in terms of innovative treatments like robotic surgery, high-precision radiotherapy, and targeted medical treatments. While these advancements have undoubtedly improved outcomes for many patients, they are not uniformly available across the country. This disparity must be addressed to ensure that all patients have access to the care they need, regardless of their geographic location.
Interviewer: That’s a valid point, Ms. Johnson. As a patient advocate, what are your thoughts on the challenges faced by cancer patients in accessing these treatments?
Ms. Johnson: Well, as a cancer survivor myself, I can attest to the fact that the journey from diagnosis to treatment and survivorship can be extremely difficult. Not only do patients have to navigate their own health issues, but they also need to understand complex medical information and make decisions about their care. The lack of access to cutting-edge treatments can be disheartening and frustrating for those who live in areas where these resources are scarce. Additionally, the financial burden of cancer care can be overwhelming for many patients, especially those without adequate insurance coverage.
Interviewer: That’s an important consideration. Dr. Smith, what are some of the factors that contribute to these inequalities in access to care?
Dr. Smith: There are several factors at play, including disparities in healthcare infrastructure, workforce shortages, and funding. The report also mentions that prevention policies need to be evaluated more effectively and targeted towards populations at risk. Additionally, there is a gap in our understanding of how to best utilize genomic information to inform treatment decisions, which could lead to more personal
