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International audience; OBJECTIVE: Since screening for cancer has been advocated, funded, and promoted in France, it is important to evaluate the attitudes of subjects in the general population and general practitioners (GPs) toward cancer screening strategies. METHODS: EDIFICE is a nationwide opinion poll that was carried out by telephone among a representative sample of 1,504 subjects living in France and aged between 40 and 75 years and among a representative sample of 600 GPs. The questionnaire administered to subjects queried about previous screening for cancer. RESULTS: Ninety-three percent of women stated that they had undergone at least one mammography. Although rated "A" recommendation-strongly recommended-by the US Preventive Services Task Force, screening for colorectal cancer received less attention than prostate cancer screening which is rated "I"-insufficient evidence-(reported screening rates of 25% and 36%, respectively). Six percent of subjects stated that they had undergone lung cancer screening. GPs' attitudes toward cancer screening showed similar inconsistencies. CONCLUSIONS: It thus appears that understanding of cancer screening practices in the French general population does not match scientific evidence. To a lesser extent, this also holds for GPs.

In a Cartesian perspective, knowing a threat is the first mandatory step for risk management. Cancer awareness is a strong momentum for risk mitigation. We have used the EDIFICE program, an iterative nationwide survey collecting data on people use of cancer screening procedures and its explicative factors, to analyze the trend for cancer awareness and its impact on cancer screening. Materials and Methods: Two nationwide observational studies were carried out in France: EDIFICE 1 was conducted from 18 January 2005 to 2 February 2005 among a representative sample of 1504 subjects aged between 40 and 75 years. EDIFICE 2 was conducted from 12 December 2007 to 7 January 2008 among a representative sample of 1802 subjects aged between 40 and 75 years. Two questions focused on awareness/experiential perspectives. Do you know someone affected with a cancer in your close circle of friends and family? Which location? Results: In 2005, 67% (993/1482) of people interviewed declared having someone in their close circle affected with a cancer. In 2008, the figure was 80% (1158/1454). Interestingly the increasing awareness is much more important for the close circle of friends and colleagues rising from 24% to 42% rather than for relatives (from 56% to 61%). The OR for close circle of friends is 2.3 (IC95% 2.0–2.7) and for relatives 1.2 (IC95% 1.1–1.4) With regard to location, three types of cancer exhibit a significant increase: breast from 25% in 2005 to 36% in 2008, prostate from 6% to 13% and colorectal from 7% to 12%, while for other locations (as a whole) no change occurred: 31% in 2005 and 30% in 2008. In our survey, having someone in its close circle affected with a cancer does not increase the rate of screening for breast cancer (already high at above 80%). Nevertheless, it does increase the rate of screening for colorectal cancer OR=2.3 (IC95% 1.6–3.3) and prostate cancer OR=2.2 (IC95% 1.4–3.5). The increase is more important for specific location (prostate cancer in its close circle increases prostate cancer screening), but it is also significant without taking into account the anatomical location of affected people in their close circle. For breast cancer, the mean age for the 1st mammogram carried out is 45.6 years (sd:9.6) for women with no one affected in their close circle of friends and family compared to 43.4 years (sd=9.2) for women with at least one known case p Comment and Conclusion: We observed a significant increase in awareness through experience of cancer in close circle, probably related to less social stigma on cancer. This increased awareness through experience impacts on cancer screening behaviors with a higher rate of declared attendance. Citation Information: Cancer Prev Res 2010;3(1 Suppl):A88.