Screening for gynecological cancers is a major public health issue. Combined with primary prevention measures, such as vaccination when available, it enables the early detection of precancerous lesions or cancers, improves patient prognosis, and reduces mortality. To illustrate the current challenges in prevention and screening, we will use France as an example, where public health programs reflect both the progress made and the challenges that remain.
The situation in France shows notable progress but also persistent challenges in the prevention and screening of gynecological cancers. For example, for cervical cancer (CC), there are nearly 3,100 new cases and approximately 1,100 deaths each year. CC is considered a largely preventable cancer thanks to vaccination against human papillomavirus (HPV) and appropriate regular screening.
The National Organized Cervical Cancer Screening Program (PNDOCCU), launched in 2018, aims to increase screening participation among women aged 25 to 65 through targeted invitations, follow-ups, and outreach efforts aimed at populations most disconnected from the healthcare system. Over the 2020-2022 period, the screening coverage rate reached 59.5%. Although this rate is increasing, it remains below the targets set by the World Health Organization (WHO), which recommends that 70% of women undergo screening using a high-performance test at age 35 and again at age 45 as part of its strategy to eliminate cervical cancer. It also remains below the rates observed in some European countries, where screening coverage is around 75%.
Regarding HPV vaccination,the primary preventive measure,France is making progress but still falls far short of its targets. In 2023, vaccination coverage (at least one dose) among 15-year-old girls was estimated at 54.6%, and 44.7% for two doses among 16-year-old girls. Significant regional disparities persist, particularly in the overseas territories and in certain metropolitan regions.
Furthermore, prevention of other gynecological cancers (such as ovarian cancer, endometrial cancer, vulvar cancer, and vaginal cancer) remains more limited in terms of organized or specific screening, which poses a challenge for early and effective management.
For healthcare professionals, it is essential to increase patient awareness and adherence to screening, to maintain rigorous follow-up in accordance with recommendations (for example, for cervical cancer: Pap smears or HPV testing depending on age), and to be mindful of inequalities in access to screening and vaccination (geographic areas, vulnerable populations). The role of awareness-raising, interprofessional coordination, and targeted strategies (health mediation, mobile units) remains central.
Thus, France is in a transitional phase: prevention and screening tools exist and are well-defined, but their dissemination and coverage still have room for improvement. It is imperative to improve patient engagement, optimize screening and vaccination pathways, and reduce regional disparities in order to achieve the goals of eliminating preventable gynecological cancers.
To learn more about gynecological imaging solutions that support early detection and prevention, or to contact our teams: