France’s 10-year cancer control plan: 2021-2030

The 2021-2030 Stratégie nationale de lutte contre le cancer (strategic anti-cancer plan) is France’s 10-year cancer control plan towards curbing case-rates and increasing survival rates nationwide. 

It is believed that at least 40% of cancers are preventable and the French government set an aim to bring the number of ‘preventable’ cancer cases down by 60,000 per year, from an estimated 153,000 yearly cases. There are nearly 3.8 million people currently living with or having recovered from cancer in France today.

The government’s broad action plan tackles prevention, treatment and aftercare. To achieve these goals, it wants to ramp up annual cancer screenings by an additional one million; to increase survival rates for cancers with poor diagnosis; and to bring down by an additional one-third the proportion of cancer survivors who still suffer from side-effects and after-effects five years after diagnosis. The strategy regards prevention as key.

As part of this, the government wants to see more people taking part in the various cancer screening programmes. Participation in these has been voluntary but rates are lower than hoped for. Participation for breast cancer screening was reported to have stalled at 49.3%; colorectal cancer screening was below 31%, and cervical cancer screening, although higher, at 59.5%, was still below the target. The strategy aims for a 70% participation rate for all three.

Colorectal cancer has a nine out of 10 survival rate if it is detected early enough but it has the lowest take-up for screening. As a result test kits were made available online, in one of the first concrete actions of the plan. They can now also be obtained in pharmacies.

More money is being targeted at research for the most difficult cancers to treat, including lung, liver, pancreas and oesophagus. There will be more investment in MRI scanning machines to improve detection. Healthier lifestyles are also prioritised. Among measures to be implemented will be additional restrictions on the sale of alcohol and tobacco.

Tobacco alone is believed to cause 45,000 cancer-related deaths (and 68,000 new cases) per year for both smokers and people affected by second-hand smoke. The authorities intend to make it harder to buy cigarettes and make them less appealing, with the ambitious aim of a first generation of non-smokers by 2030 (referring to young people who will be aged 20 in that year). Putting up prices further is one idea. The government is considering taking countries such as the UK or Australia, which have the highest prices – a pack costs over €20 in Australia – as a model.

Alcohol is another major source of disease, with nearly 41,000 deaths due to alcohol and 16,000 deaths due to alcohol-related cancers every year. The plan is to concentrate on those who drink excessively. In France, 10% of adults drink 68% of all alcohol sold. As part of its efforts to reduce the harmful effects of alcohol consumption, the government intends to bring in more stringent regulation of its sale and to create better safe consumption guidelines and labelling about risks.

Some virus-related cancers are also preventable. Human papillomavirus (HPV) infections alone may cause eight different cancers – cervical, anal, oropharyngeal, vulvar, vaginal, oral, laryngeal and penile. About 6,300 HPV-related cancers are detected every year in France, and although efficient HPV vaccines do exist, awareness remains low and HPV vaccine uptake has stalled at less than 25% among girls and young women. The government wants to boost HPV vaccination rates to 80% of the eligible population by 2030.

Environmental risk factors are another source of preventable disease the government hopes to mitigate, by introducing new guidelines and regulations intended to minimise long-term chronic exposure to specific substances and energies. Among environmental risk factors listed in the strategy are naturally-occurring radon gas, radiation, agricultural areas subject to use of pesticides, relay antennas, high-voltage power lines, air pollution and chemicals present in or near industrial areas.

France is also taking part in EU-wide initiatives to combat cancer. The European Commission launched its Beating Cancer Plan in 2021, with €4 billion in funds, aiming at the best prevention, early detection and innovative care. Long-term aims include setting up national comprehensive cancer centres linked to an EU network by 2030.