Psycho-Oncologie

, Volume 2, Issue 4, pp 250–265 | Cite as

Précarité sociale, cancer et vulnérabilité psychique, lien direct ou indirect ?

Article Original Dossier : Cancers et cultures

Résumé

La relation entre la vulnérabilité psychique et le cancer semble moins établie que celle entre la précarité sociale et certains facteurs liés au cancer. La fragilité psychique a été mise en cause dans certaines addictions facteurs de risque du cancer, comme le tabagisme. Les patients qui sont en précarité sociale risquent demoins bénéficier desméthodes de dépistage, d’avoir des traitements moins efficaces et finalement que le contrôle locorégional de leur pathologie et leur taux de survie soient plus faibles que ceux qui sont observés dans la population générale.

Les personnes en précarité ne sont cependant pas opposantes, il n’y a pas de rejet systématique du système de santé, et ces personnes sont souvent très au courant des méthodes de dépistage et de leur intérêt. Quelle que soit la classe de précarité dont l’analyse a été faite, la demande de soins de la part des patients est réelle.

Les problèmes principaux sont d’ordre organisationnel et de prise en charge. Le suivi des patients n’est pas toujours possible et la notion de « projet de vie » est souvent inexistante, ne permettant pas une organisation des soins. Dans le cadre des dépistages, celui-ci fait pour la population générale n’est pas adapté à une population en marge ou exclue.

Des solutions sont possibles, mais elles engagent les structures de politique sociale et de santé mais aussi la conduite de chaque personnel de santé.

Mots clés

Vulnérabilité psychique Précarité sociale Personnes âgées Sans domicile Prisonniers Cancer 

Social precariousness, cancer and psychological vulnerability: directly or indirectly linked?

Abstract

The link between psychological vulnerability and cancer is not clearly established. However, there does appear to be a link between cancer and social marginality. Psychological fragility has been shown to be associated with tobacco addiction. Socially vulnerable people are at risk of undergoing screening less frequently and being treated less efficiently. These data could explain the deficit in terms of both monitoring of their pathologies and observed survival rates, compared with those relating to the general population. Such people do not refuse treatment or screening and are often well aware of screening methods and their usefulness, and wish to be treated if they are ill.

The main problems relate to organisation and careprovision. Monitoring of such patients is not always possible and the notion of a “life-plan” is often nonexistent, thus preventing adequate management of the disease. Screening programs are not adapted for marginal and socially excluded populations. Solutions can be found but they depend on both social and health policies and the behaviour of every individual professional care-provider.

Keywords

Psychological vulnerability Social precariousness Elderly Homeless Prisoner Cancer 

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Copyright information

© Springer Verlag France 2008

Authors and Affiliations

  1. 1.CMCOSchiltigheimFrance
  2. 2.Centre de lutte contre le cancer Paul-StraussStrasbourg CedexFrance

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