Study of Health-risk Behaviours (Tobacco, Alcohol or Drug Consumption ; Nutrition ; Sedentary Lifestyle ; Sexual Practices) Among Cancer Survivors

• Cancer is now becoming a chronic condition though it was, until a short time ago, a fatal illness. Thus, according to the French national cancer institute, nearly 4 million French people have been diagnosed with cancer in their lifetime.
• Screening is used to detect the presence of a pathology at an early, infra-clinical stage, or the presence of a risk factor in people who are supposedly healthy.
• There are three organized screening programs in France (breast cancer, colorectal cancer, cervical cancer), as well as many others recommended by learned societies such as the National Authority for Health . However, they are underused, far from European recommendations and government targets.
• According to DREES (research, studies, evaluation and statistic department), public health and primary prevention interventions could have prevented 143 deaths per 100.000 inhabitants, and healthcare interventions could have spared 59 deaths per 100.000 inhabitants, for a total of 202 avoidable deaths per 100.000 inhabitants in France in 2020.
• As for cancers, French national cancer institute estimates the rate of avoidable cancers in France in 2023 at 40%. Breast cancer, for example, is the most common cancer that can be associated with alcohol consumption and estimations suggest that nearly 20.000 breast cancers could be prevented each year (a third of new cancer cases in 2018).
• In France, prevention accounts for 5.5% of healthcare expenses in 2021, with 46% for individual primary prevention, 41% for individual secondary prevention and 12% for collective prevention and prevention programs. These healthcare expenses must be set against the social cost of each risk factor, to see how important they are.
• Relative burden of cancer and noncancer mortality among long-term survivors of breast, prostate, and colorectal cancer in the US has been demonstrated. It shows that "patients with low oncologic risk at the time of diagnosis had at least 3-fold higher risk of noncancer death compared with death from the index cancer".
• In France, medical desertification is a reality. Now, according to the VICAN-5 study, nearly a third of cancer patients are not followed up by general practitioners. Though primary prevention is one of GP's prerogatives and a governmental priority.
• There is a high interest in screening and preventive action to limit the risk of other avoidable pathologies, whether cancerous or not.

The research hypothesis is that a customized screening will enable the implementation of comprehensive preventive action to limit the onset of avoidable diseases (second cancer or other pathology) for cancer survivors.