Improving breast and colorectal screening uptake in France. One map to target intervention areas

Abstract Background Most intervention areas for improving cancer screening uptake are in deprived neighbourhoods. However, in recent years, determinants and attitudes to screening have evolved, and new perspectives are needed in understanding cancer screening practices. It is therefore necessary to develop simple, effective and reproducible strategies for identifying intervention areas. Using one map, the aim is to investigate spatially and temporally breast and colorectal cancer screening in France from 2015-2016 to 2021-2022. Methods Uptake in breast (BS) and colorectal (CS) cancer screening at the census block level was generated by the regional cancer screening centre for women aged 50 to 74, residing in the Rhône department (mostly rural but including the urban Lyon metropolitan area). We used spatial analysis to create a map highlighting groups of hotspots, identifying their direction of propagation between 2015-2019 and 2020-2022. Results The results reveal interesting areas for intervention with differences and similarities in uptake of the two screenings. For CS, there was a 5-pt increase in uptake between the two periods (2015-2019: 33% and 2020-2022: 38%), whereas for BS the uptake remained stagnant around 49% on average in the metropolitan area. The map highlights 49 urban census blocks with consistently lower uptake rates in both screenings (39.2% for BS, 23.7% for CS) than the overall average. Conversely, some census blocks have consistently lower uptake rates on one screening but not on the other (CS or BS). Conclusions This work may inform the breast and colorectal locally screening trend and inform policymakers to develop tailored prevention strategies. These analyses are easily reproducible at different times and spaces, and they have the potential for evaluation and comparison of screening uptake. Key messages • Maps may inform policymakers to develop tailored prevention strategies. • Investigate spatially and temporally breast and colorectal cancer screening reveal interesting areas for interventions.