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France’s Audit Court Flags Major Failings in Breast Cancer Care, Urges Overhaul

The report pushes targeted fixes across screening, surgery, digitization, plus enforceable after‑cancer support to reduce inequalities.

Overview

  • The Cour des comptes presented its evaluation to the National Assembly, citing widespread social and territorial inequalities and calling for vigorous public action.
  • Spending reached nearly €4.7 billion in 2023, up about 65% since 2015, with average out‑of‑pocket costs of €1,549 leading some women to forgo care.
  • Organized screening has fallen below 50% uptake and is being undercut by individual paid exams lacking double reading, with proposals to oblige radiologist participation and ban fee overruns for organized mammography.
  • The court urges digital image sharing and the use of AI to support second readings, addressing current paper‑based workflows that delay reviews.
  • To improve safety and quality, the court recommends raising surgical authorization to about 150 operations per year and making personalized after‑cancer programs mandatory from 2027, while decrees for a 2025 after‑care law remain unpublished.