Colorectal cancer screening is an effective way to reduce mortality and lower the cost of cancer care. Since 2024, the health insurance system has been providing general practitioners (GPs) with a list of their patients who are not up to date with their screening. Twenty-six medical students contacted the patients on their supervisors' lists by telephone to offer them screening.The aim of this study was to assess the medical student's feedback about the intervention.It was a qualitative study conducted using an approach inspired by focus groups. The focus groups were led by three investigators throughout the intervention, at fifteen-day intervals, via videoconference to allow as many people as possible to participate. The videoconferences were recorded and transcribed. A thematic analysis was conducted between each meeting by the investigators and a sociologist.Four focus groups lasting an average of 1.5 hours were held. The phone calls were well received by patients, who felt that their local healthcare professionals were committed to their care. Many had not felt concerned by the screenings and changed their perspective following the call. The main reason for refusing colorectal cancer screening were anxiety, being asymptomatic or having a serious illness at the time. The medical students were satisfied to be participating in improving prevention in the region. One of the difficulties they encountered was the time-consuming nature of the intervention. They also noted inconsistencies in the participation of pharmacies in the delivery of kits, with some reported deviations such as billing for this service.This study showed that both patients and healthcare professionals welcomed this telephone intervention. The reasons for not being up to date for colorectal cancer screening identified are consistent with the findings of other studies.There are several limitations in this study particularly with regard to information bias.This telephone intervention was well received and might increase the rate of colorectal cancer screening. This time-consuming work is difficult to replicate on the scale of a general practitioner within their own patient base. However, it can be replicated within the framework of coordinated care, for example with the help of medical assistants.

Lung cancer is the leading cause of cancer death in France. Tobacco is the risk factor. Scientific societies have advocated for lung cancer screening in smokers using low-dose chest CT scans. However, there are currently no official recommendations in France.To assess the practices of general practitioners who are also University Internship Supervisor in two french departments regarding lung cancer screening in smokers by low-dose chest CT scan.It is an observational study conducted among general practitioners practicing in two french departments. The questionnaire, administered in « face to face », was based on a smoker patient previously selected by each practitioners from their patient base, according to the screening criteria defined by the French Society of Pulmonology.60 general practitioners were recruited. 24 physicians prescribed a screening examination for the selected patient. 9 physicians still prescribed chest X-rays. 14 CT scans were nevertheless prescribed, 6 of which were low-dose scans, distributed equally between the physicians in the department n°1 (n = 3) and the department n°2 (n = 3). The lack of recommendations from the French National Authority for Health (HAS) remains the main obstacle for 62.9% of doctors. Access limitations to imaging facilities were cited by 40.7% of practitionners. Doctors who did not prescribe screening prioritized smoking cessation (83.3%).Our study highlights a heterogeneity of practices concerning the prescription of low-dose chest CT scans, without however revealing a statistically significant difference between two territories. Although the majority of the doctors surveyed are unfamiliar with low-dose chest CT scans, they nevertheless recognize their central role in lung cancer screening. Practitioners who do not prescribe this screening prefer to focus their action on smoking cessation. The lack of clear and official recommendations appears to be the main obstacle to prescribing a low-dose chest CT scan. It would therefore be necessary to develop harmonized recommendations adapted to primary care.The practices of general practitioners regarding lung cancer screening are heterogeneous. The majority do not perform low-dose chest CT scans. The lack of recommendations adapted to primary care is the main obstacle. It would therefore be necessary to develop harmonized recommendations.

Laryngeal cancer is a common head and neck malignancy, strongly associated with tobacco use. Early symptoms may be subtle and are frequently first encountered in primary care. Persistent hoarseness lasting longer than three weeks—particularly in high-risk individuals—should prompt urgent evaluation. Family physicians play a critical role in recognizing red-flag symptoms and initiating timely referral.A 62-year-old man presented to a family medicine clinic with progressive hoarseness lasting one month. He also reported sore throat and unintentional weight loss of 7 kg over the same period. He was an active heavy smoker (approximately three packs per day) with a family history of lung cancer. He denied fever, night sweats, or dyspnea. Physical examination revealed marked dysphonia and a firm, non-tender left cervical lymph node measuring approximately 2 cm. Vital signs and basic measurements were within normal limits. Given the persistence of hoarseness, heavy tobacco exposure, weight loss, and cervical lymphadenopathy, a laryngeal malignancy was strongly suspected, and the patient was urgently referred to otorhinolaryngology. Three weeks later, the patient returned with hospital records. Fiberoptic and direct laryngoscopy revealed a suspicious laryngeal lesion, and biopsy confirmed squamous cell carcinoma of the larynx.Persistent hoarseness beyond three weeks should always be evaluated carefully in primary care. Smoking history, weight loss, and cervical lymphadenopathy are critical red flags. Family physicians should maintain a low threshold for urgent referral, as early recognition can significantly affect prognosis and treatment options.Laryngeal cancer often presents with voice changes before advanced symptoms develop. In busy clinical settings, hoarseness may be misattributed to benign causes. This case demonstrates how systematic assessment and awareness of risk factors in primary care can prevent diagnostic delay.Primary care physicians are essential in the early identification of laryngeal cancer. Careful history-taking, focused examination, and timely referral enable earlier diagnosis and improved patient outcomes. MeSH keywords (plain text): Laryngeal Neoplasms; Hoarseness; Primary Health Care; Smoking; Early Diagnosis; Squamous Cell Carcinoma

Cervical cancer remains a major public health issue in XXX, with a significant development of organized screening programs in recent years. However, lesbian and bisexual women, transgender men, and non-binary individuals represent a population often overlooked by prevention policies. Several studies report numerous forms of discrimination leading to lower access to healthcare.This study aims to investigate the participation rate in cervical cancer screening among eligible LGBTIA+ individuals in the XXX region and to identify the factors influencing screening participation.An anonymous questionnaire was distributed online from March to July 2025 through LGBTIA+ associations. Lesbian and bisexual women, transgender men, and non-binary individuals aged 25 to 65 years and residing in the XXX region were included. The primary outcome was being up-to-date with cervical cancer screening. A univariate analysis was then conducted to identify the factors influencing screening participation.A total of 226 participants were included. The screening participation rate was 65.0%. Factors significantly associated with a higher screening rate were age, department of residence, having a general practitioner and discussing sexual orientation with the healthcare provider performing the cervical smear. Among the main barriers reported were negative experiences during gynecological consultations (29.1%) and the lack of screening proposal from healthcare provider (16.5%).This study is one of the few that includes transgender and non-binary individuals. However, the recruitment by LGBTIA+ associations introduces a selection bias, favoring younger, urban, and more informed participants, which may overestimate the screening rate. Nevertheless, the rate is similar to other XXX studies, such as XXX, which found a screening rate of 64,7% and also highlights the importance of the general practitioner and discussing sexual orientation in encouraging participation in screening.The disparities in cervical cancer screening among LGBTIA+ individuals highlighted in this study emphasize the need for more inclusive communication and improved training for healthcare providers to enhance the therapeutic alliance. The lack of data and epidemiological studies hinders the improvements of LGBTIA+ individuals healthcare. It is therefore essential to continue this work with large-scale quantitative studies, on STIs in general, to develop truly inclusive and equitable prevention policies.

The decision support tool XX (DST) was designed to assist French women in making shared decisions about whether or not to participate in organized breast cancer screening (OBCS) by mammography. The effects of this DST on women and their general practitioners (GPs) are to be evaluated.Main objective: To evaluate the effect of a trial incorporating the DST XX on the level of decision-making conflict regarding the choice of whether or not to participate among women invited to participate in OBCS. Secondary objectives: To evaluate women's intention to participate in OBCS, the implementation of shared decision-making, their knowledge of OBCS, and their care pathways after receiving the invitation  in OBCS.Design: Randomized controlled trial with two arms conducted in a region of France (February–September 2025). Cluster randomization of 2767 GPs. Participants: 20000 women aged 50–74 invited to the OBCS in January 2025 by the National Health Insurance Fund and having a GP. Intervention: In the experimental arm, women and their GPs received a letter encouraging them to implement shared decision-making and a flyer presenting the DST. In the control arm, women and GPs continued screening as usual. Primary endpoint and secondary endpoints: Overall score on the Decision Conflict Scale (DCS - 16 items). Data collected via questionnaire 2 months after presentation of the DST. Scores on the Measures of Decision scale (1 item), Shared Decision Making Questionnaire (9 items), number of correct answers on the knowledge questionnaire (10 items), description of healthcare professionals seen by women. Statistical analysis: Comparison of scores between arms using mixed covariance analysis.3104 questionnaires were received (out of 1522 needed to conclude that there was a difference). The results, which are currently being analyzed, will be presented at the conference. A decrease in decision conflict is expected in the experimental group, with no change in intention to participate.This study will evaluate the effect of DST on a large scale in a routine care setting.This DST, made available to women and all professionals in the OBCS, would promote interaction between women and GPs, could improve women's adherence to screening, and could limit health inequalities.

Pancreatic cancer is major global health burden and the seventh leading cause of cancer mortality. It is complex malignancy shaped by genetic and environmental factors, with about 10% inherited in an autosomal dominant pattern. Adenocarcinoma is most common type, typically diagnosed around age 70, and often carries a poor prognosis due to late detection and aggressive progression. Treatment varies by tumor type, stage, and patient condition, ranging from surgery and chemotherapy to targeted therapy, immunotherapy, and palliative care. Nutritional compromise is frequent in advanced disease, complicating outcomes further.This case describes 75‑year‑old immunocompromised female with pancreatic head adenocarcinoma, diffuse intraductal papillary mucinous neoplasm, and liver metastasis. Before medical and surgical interventions, comprehensive laboratory and imaging studies were performed. Nutritional screening guided tailored care plan that included total parenteral nutrition, enteral feeding, oral supplements, multivitamins, and trace elements, all adjusted to meet adequacy. Family members played central role in supporting adherence and strengthening psychosocial resilience.This case underscores nutrition as a cornerstone of readiness in complex malignancies and highlights family engagement in resilience building. Future directions include standardized nutrition protocols in cancer pathways, community‑based nutrition education, and embedding psychosocial support into perioperative and palliative care.The outcome illustrates that liberty in health is achieved when patients are empowered through adequate nutrition, equity is advanced when vulnerabilities are addressed through multidisciplinary care, and fraternity is embodied when families and healthcare providers collaborate. Success in cancer management is not solely technical but deeply dependent on holistic preparation.This case exemplifies how biomedical, nutritional, and psychosocial integration can transform outcomes in advanced pancreatic cancer. It advocates liberty through patient empowerment, equity through comprehensive care, and fraternity through family and community solidarity, principles resonant with 30th WONCA Europe Conference theme and global primary care values.

Schizophrenia and bipolar disorder are among the most severe psychiatric disorders (SPD) and affect 0.4% and 2% of the general population, respectively. The life expectancy of these patients is reduced by about 13 years compared to the rest of the general population. Cancer is the second leading cause of death. However, they are less likely to benefit from organized cancer screening programs.The aim of this study was to understand general practitioners' perceptions and experiences of patients with TPS, as well as their effects on the implementation of organized screening programs.Qualitative study inspired by grounded theory, conducted using semi-structured interviews with private general practitioners who treat patients with schizophrenia or bipolar disorder.  The interviews were recorded, transcribed, and analyzed using an inductive thematic approach.Twenty-five interviews were conducted between October 2023 and February 2024. The doctors interviewed discussed the difficulties they encountered in establishing a solid therapeutic alliance with these patients. They were able to express their perceptions of STPs, as well as the specific obstacles associated with organized screening. Finally, the study highlighted several factors—such as the anticipation of refusal or the fear of complex care in the event of a positive screening result—that could lead to organized screening not being systematically offered to all patients and, in fact, result in a kind of selection of patients to be screened. The results of this study help explain the difficulties these patients encounter in accessing organized screening. However, these inequalities in access do not appear sufficient to account for the difference in cancer-related mortality compared with the general population. The findings highlight the need for personalized support for these patients. Evaluating the impact of a systematic preventive medical examination at the initiation of psychiatric care could be particularly relevant.This study highlighted the perceptions that general practitioners had of patients with TPS, as well as the possible consequences of these perceptions on organized screening, which could lead to the selection of patients for screening.