This is my second posting in a row with some observations on the French health care system. This time, my topic is a national program designed to screen for a type of cancer that can often be defeated if it’s caught early. To my mind, it’s a good example of government being proactive in detection, going well beyond public education.
In our département, the Dordogne, the program is known as Dépistage du cancer colorectal en Dordogne. (Dépistage is French for “screening,” and the rest is self-explanatory.)
Not long after I received my carte Vitale (the health insurance card I described in yesterday’s posting), I received a personal letter, as well as an educational brochure, from the group in charge of the screening program. It advised that after the age of 50, people should be screened regularly for the presence of blood in their bowels, because that can indicate the presence of bowel cancer (also known as colorectal cancer).
But the letter went beyond information alone. At the bottom of the letter were a number of adhesive labels, printed with my name, my department’s number (Dordogne is No. 24), my birth date — and a bar code to identify me precisely. Here’s how the program works:
1. See the doctor. A few days after receiving the letter, I took it to my doctor, who immediately gave me a kit that’s used for self-testing (in the privacy of your bathroom), to determine if blood is present in the large intestine.
2. Administer the test. Actually doing the self-testing isn’t the most pleasant task, but it’s pretty easy. It involves putting a very small smear from a stool sample onto a piece of cardboard that can be sealed, and doing this once per day for three days.
3. Mail it back. Once the three days are past, you just seal up the testing kit, and identify it with the bar code that was sent with the original letter. Then you mail it to the lab that does the work. All of this is free.
4. The results. Eventually I’ll receive a letter with the results. If all is well, nothing more needs to be done until it’s time for the next screening. If some blood is present, the recommended next procedure would be a coloscopie (colonoscopy).
When I lived in Toronto, my doctor was quite proactive about this kind of testing, so it could be argued that a national program isn’t really needed. But I suspect that many harried doctors (or their reluctant patients) would ignore this kind of screening and focus on more urgent examinations or treatments.
So, on balance, I’m happy that the French health system has invested in a program to catch problems before they get much, much worse.