Recommandations de dépistage en France : une revue systématique

Abstract

Introduction: To date, no systematic review of the recommended screening protocols in France has been carried out. The objective of this review was to identify the screening recommendations published by the Haute Autorité de Santé (HAS) (French National Authority for Health), to describe their characteristics, and to compare them with the screening recommendations published by the United States Preventive Services Task Force (USPSTF).

Methods: A systematic review of screening recommendations published by the HAS and the USPSTF.

Results: A total of fifty-three HAS recommendations and sixty-seven USPSTF recommendations were included. The HAS recommendations concerned seventy-four conditions, including sixty-seven recommended for screening, six not recommended for screening, and one with an uncertain benefit-risk balance. The USPSTF recommendations concerned sixty-five conditions; thirty recommended for screening, seven not recommended for screening, and twenty-eight with an uncertain benefit-risk balance. Among the sixty-seven conditions identified by the HAS as requiring screening, sixteen were cardiovascular or metabolic conditions (24%), eleven were neonatal conditions (16%), eleven were infections (16%), nine were developmental and sensory disorders (13%), five were psychosocial problems (8%), five were cancers (including one genetic predisposition) (8%), four were environmental exposures (6%), and six were other conditions (9%). A quarter of HAS recommendations were based on a graded level of evidence, including 71% on expert agreement.

Conclusions: The HAS recommends screening for sixty-seven conditions, including four cancers. It is hoped that, with the development of specific screening recommendations based on an appropriate methodology and including the presentation of their level of evidence, the quality and appropriateness of their use will improve.