Corsica: alarming drop in cancer screenings

The significant decrease in the number of cancer screenings observed in Corsica in 2020, marked by the Covid-19 pandemic, is worrying many health professionals, but also several associations and structures, in particular those involved in the fight against smoking-related diseases.

In 2020, healthcare professionals working in Corsica noted an alarming drop in cancer screenings. At the beginning of October, as the “Pink October” campaign began[1], Franck Le Duff, medical director of the Regional Cancer Screening Coordination Centre in Corsica, had notably communicated the figures concerning the screening of two cancers, and was pessimistic for the coming months: “We are at -6 % for breast cancer this year, and at almost -10 % for colorectal cancer. And I don't see things improving by the end of the year”[2].

A decrease which can be explained by the health context and policy

For many health professionals, this significant decline in the number of screenings can be explained by the context of the Covid-19 pandemic, and in particular its political and health management. For Sauveur Merlenghi, president of the League against Cancer of South Corsica and general practitioner, “The health emergency has completely reorganized the French healthcare system by prioritizing the treatment of Covid over all other diseases, which is catastrophic”[3He notes that patients are no longer going to doctors' offices and testing centers "as they should." "They're waiting," he adds.

Franck Le Duff, for his part, deplores the postponement of a lung cancer screening action initially planned for September: “It was an experiment for the prevention of silent cancers in long-term smokers and we must wait until the end of the current health crisis”[4].

Several doctors criticize the authorities for over-mediatization and overly ubiquitous prevention of Covid-19, which, according to them, relegates other diseases to the background.5]. “All the doctors are busy with Covid,” laments Sauveur Merlenghi[6].

Furthermore, the health context has led to the cancellation of most events and operations that usually raise funds and carry out awareness and communication actions, whether on the dangers of smoking, smoking cessation or cancer screening. For example, no public events were able to take place on the occasion of No Tobacco Month[7] because of the new lockdown imposed from October 30.

Christian Sain, tobacco specialist and addiction specialist, is saddened by this situation: “Covid-19 killed 40,000 people in France in 2020, while smoking killed more than 75,000 in 2019, yet the lockdown prevents us from properly informing people and reaching out to them.”8He adds that the risks associated with smoking “are multiplied by this virus which also attacks the lungs”, and that “the anxiety created by confinement encourages people to smoke more”.

A worrying situation that suggests serious consequences

Christian Sain also considers that Corsica is particularly exposed to smoking-related illnesses, including cancer, because, according to him, it “is one of the regions of France where people smoke the most and which has the largest number of tobacco shops per thousand inhabitants”[9]. He also points out that the price of a packet of cigarettes is 25 % lower in Corsica than on the continent, thanks to a tax advantage decreed by Napoleon in 1811[10]. If the 2020 finance bill adopted by the deputies in October 2019 provides for the end of this exceptional regime, the price of the packet in Corsica will not begin to approach that of the continent until 2022, and will not be aligned with the latter until 2025.

The island's doctors are already beginning to see the consequences of the decline and delay in cancer screening, as Franck Le Duff testifies: "We are seeing a few more cancers appearing that are a little bigger, a little more advanced than last year. So we can feel that people are delaying getting screened."11].

Marc Germain, president of the Haute-Corse Cancer League, points out that it is essential to diagnose the disease as early as possible: “anything that is not detected today can cause cancers that are more difficult to treat later on.”12]. In 2019, 843 people died in Corsica from cancer, and Marc Germain is concerned about an increase in this figure due to the decline in screening. In October, the president of the National League Against Cancer, Axel Kahn, estimated that around 30,000 cancers had gone undetected since the start of the health crisis.13].

In Ajaccio, for example, the League Against Cancer was unable to implement a lung cancer screening operation for which it had obtained private funding. "These are people we could have saved, but we won't save them," laments Sauveur Merlenghi.14].

Attributable in 90% of cases to smoking, lung cancer is today the most deadly cancer in France, where it causes more than 30,000 deaths each year.15]. Despite this, there is no organized and massive screening for this cancer in France, while such a system is in place in the United States, Canada, and even Australia[16].

©Generation Without Tobacco

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[1] Organized every year in October since 1994, Pink October is “the campaign to fight breast cancer organized by the Ruban Rose association [which] aims to fight breast cancer by informing, engaging in dialogue and mobilizing.” The Pink October information campaign, breastcancer.org (accessed November 30, 2020). [2] Caroline Felix, Pink October: "a drop of 6% in breast cancer screenings" due to Covid-19 this year, France Bleu RCFM (the 1er October 2020, accessed November 30, 2020). [3] The South Corsica Cancer League warns of serious screening delays due to the Covid-19 crisis, France 3 Corsica ViaStella (November 11, 2020, accessed November 30, 2020). [4] Pierre-Manuel Pescetti, Smoking: the decline in cancer screening is alarming in Corsica, corsenetinfos.corsica (November 22, 2020, accessed November 30, 2020). [5] Ibid. [6] The South Corsica Cancer League warns of serious screening delays due to the Covid-19 crisis, France 3 Corsica ViaStella (November 11, 2020, accessed November 30, 2020).

[7] No Tobacco Month is a A major collective challenge that encourages smokers to not smoke during the month of November, every year since 2016. Studies have in fact shown that after a month without smoking, the chances of quitting permanently are multiplied by 5.

No Tobacco Month, tabac-info-service.fr (accessed November 30, 2020). [8] Pierre-Manuel Pescetti, Smoking: the decline in cancer screening is alarming in Corsica, corsenetinfos.corsica (November 22, 2020, accessed November 30, 2020). [9] Ibid. [10] PPierre Santini, Corsica: no more cheap tobacco, Le Parisien (November 12, 2019, consulted November 30, 2020). [11] Caroline Felix, Pink October: "a drop of 6% in breast cancer screenings" due to Covid-19 this year, France Bleu RCFM (the 1er October 2020, accessed November 30, 2020). [12] Pierre-Manuel Pescetti, Smoking: the decline in cancer screening is alarming in Corsica, corsenetinfos.corsica (November 22, 2020, accessed November 30, 2020). [13] The South Corsica Cancer League warns of serious screening delays due to the Covid-19 crisis, France 3 Corsica ViaStella (November 11, 2020, accessed November 30, 2020). [14] Ibid. [15] Lung cancer: conditions not met for screening among smokers, health problems.fr (May 19, 2016, accessed November 30, 2020). [16] Sandrine Cabut, Advocacy for lung cancer screening, Le Monde (November 21, 2018, consulted November 17, 2020). DNF - For a Zero Tobacco World |