Skip to Main content Skip to Navigation
Theses

Prévention du cancer du col de l'utérus : médecin généraliste et inégalités de santé aux prémices de la mise en place nationale du dépistage organisé

Abstract : Unequal participation in uterine cervical cancer screening (UCC) is multifactorial and primary prevention of UCC by vaccination against oncogenic human papillomavirus (HPV) may have similarities. As primary care physicians for the overall population, general practitioners (GPs) could be a major contributor in limiting these inequalities. We aimed to explore these contributions before the implementation of the French national organized screening (FNOS) of UCC.The comparison of reimbursement data from two French departments, one of which experimented a regional organized screening, revealed a greater participation in screening in the experimental department. The participation gradient decreasing with the increase of deprivation was stronger in the experimental department, and moreover in rural areas. Our data did not allow us to explore these aspects for HPV vaccination.Asked about their preferences to limit these inequalities when implementing the FNOS, gynecologists and GPs were in favour of targeting unscreened women, by centralized invitations involving the declared attending physician, or by providing them with a list of unscreened women among their patients. Targeting women over 50 years old or deprived women, as well as HPV self-sampling, were options rejected by practitioners.Our results confirmed the importance of a proportionate universalism when implementing the FNOS. The involvement of practitioners, including GPs, will require information on the rational of the proposed measures.
Document type :
Theses
Complete list of metadata

https://tel.archives-ouvertes.fr/tel-03420097
Contributor : ABES STAR :  Contact
Submitted on : Tuesday, November 9, 2021 - 1:01:11 AM
Last modification on : Friday, December 3, 2021 - 6:26:36 PM
Long-term archiving on: : Thursday, February 10, 2022 - 6:08:25 PM

File

sygal_fusion_27546-raginel-thi...
Version validated by the jury (STAR)

Identifiers

  • HAL Id : tel-03420097, version 1

Citation

Thibaut Raginel. Prévention du cancer du col de l'utérus : médecin généraliste et inégalités de santé aux prémices de la mise en place nationale du dépistage organisé. Médecine humaine et pathologie. Normandie Université, 2019. Français. ⟨NNT : 2019NORMC408⟩. ⟨tel-03420097⟩

Share

Metrics

Record views

157

Files downloads

37