In the United States, the use of an e-health application in a randomized trial has doubled the rate of colorectal cancer screening.
Detected in time, colorectal cancer is cured in 9 cases out of 10. Hence the importance of early detection, recalled by the Institute of Cancer (INCa) during the operation "Mars Blue". Between the ages of 50 and 74, all patients should consider, after talking to their doctor, to take a test. Simple on paper, this device is less practical: the screening rate is around 30%, far from the expected 45%.
Faced with the same problem in their country, a team of US researchers has developed a digital health intervention that could improve the situation. Their study, recently published in Annals of Internal Medicineshows that the use of a digital application has doubled the screening rate, from 15% to 30%, in a population of low social level - traditionally less sensitive to health issues.
An incentive for screening
Specifically, the 450 patients were invited to visit their health center to discuss with their doctor. In the intervention group, the subjects had to come back the next day to try an iPad application developed for the occasion. After a questionnaire and a 10-minute informational video, they could order a test directly. As for the control group, he just had to come watch a prevention film.
"A lot of factors contribute to lower screening rates, such as patients 'negative attitude toward testing, lack of awareness of the value of screening, or lack of doctors' time," says Pr David Miller, practitioner at Wake Forest Baptist University Hospital (North Carolina) and first author of the article.
"In an ideal world, the doctor should discuss screening with his patient, inform him of the options available, help him make a decision and then order the tests. But all this takes time, that doctors do not always have when the patient has other health problems to investigate ", continues the practitioner, himself a generalist.
Lack of time
Are these results transferable to us, where primary care is organized in a rather different way? A study conducted by INCa in 2010 shows that France is not an "ideal world" either. Only a third of GPs report systematically the possibility of screening with their eligible patients. In half of the cases, it is even the patient who spontaneously approaches the subject.
But this lack of care does not really seem to be due to a lack of time: doctors with the largest patient tend to be better scouts. It seems rather that some practitioners are still reluctant to integrate screening into their clinical practice - this is true for the colon, but also for the breast or prostate. Training problem, rather than time?