Detect and wean better. This is the objective of the pilot program targeting certain smokers and former smokers, which will be deployed by the end of the year announced Thursday, January 23, the National Cancer Institute (INCa). Causal in about eight in ten cases by tobacco, this cancer marked by abnormal and uncontrolled growth of cells in the lungs remains the most fatal tumor in France, with 30,400 deaths each year. The pilot program will include 20,000 participants, aged 50 to 74, smokers or ex-smokers weaned for less than 15 years and with cumulative smoking consumption of at least 20 packages per year. They will be called upon to make two chest scanners at low dose – that is to say with moderate radiation, equivalent to a standard radiography – one year apart, then every two years, and will also be offered withdrawal smoking.
The objective here of this pilot project is to determine the most effective and safest methods of a chest scanner screening. In particular by evaluating the duration, the frequency, the role of artificial intelligence, the economic impact, or the impact on the supply of care, according to the president of the Inca, Norbert Ifrah. In France, three cancers (breast, colorectal, cervix) are the subject of organized screening, systematically proposed to a target population. But for lung cancer, the main obstacle of health authorities has long been a risk of «surdiagnostic» tumors that would not evolve in cancer.
Chest scanner in people at risk
Several studies have shown the benefits of organized lung cancer screening. A low dose scanner in people at risk can detect small beginners tumors early and reduce the risk of death by around 20 to 25 %. In 2022, the High Authority for Health had therefore recommended “The implementation of real -life experiments before considering the deployment of a wide -scale screening program”. Indeed, the results of the pilot study “Will condition the generalization of organized screening”said the President of the Inca, according to which “We can reasonably hope for generalization even before 2030”.
“We hope that the first scanners will be made at the start of the second half of 2025”said Professor Norbert Ifrah. Convinced that“A number of people wishing to be tested are in the starting blocks”the President of the Inca added that general practitioners, midwives, nurses in advanced practice, pharmacists, pulmonologists, tobaccoologists, addictologists or oncologists can orient patients to centers associated with the system. Region by region, the organization will be declined with regional health agencies.
-Cancer diagnosed today at a too late stage
“The interest of screening is major for public health”underlined Professor Norbert Ifrah. Indeed, the majority of diagnoses are made at a too late stage, complicating treatments and dropping the chances of survival, since the symptoms of lung cancer are long to appear. In addition, the number of new cases is stabilized in men, where it progresses strongly in women who later started smoking. For the latter, the number of lung cancer deaths could exceed this year that of breast cancer deaths, 12 600 Death in 2021 (the most recent figures by the National Cancer Institute). On the other hand, tobacco is not “The absolute enemy” warns the President of the Inca, at least it is not the only one. Other exhibitions are recognized carcinogenic for lungs (asbestos, exhaust gas of diesel engines, radon, certain hydrocarbons, certain ionizing radiation, etc.).
“Each year, we let a number of people die by not setting up this screening” national, had judged the director general of the Gustave Roussy Institute, Fabrice Barlesi on Wednesday during a press conference, while recognizing that“You have to organize it”. Appointed impetus, the pilot project selected is carried out by a consortium coordinated by teachers Marie -Pierre Revel at the Public Assistance – Hospitals of Paris and Sébastien Couraud (Civil Hospices in Lyon). The Inca will finance it up to 6 million euros, an amount «colossal» According to its president. For its part, health insurance will notably take care of the scanners 100 %.
Abroad, only the United States has already generalized lung cancer screening “In mind” But he is “Paying”which restricts participation, according to the President of the Inca. Other countries work there, such as Australia, which must start in July, or states of central and eastern Europe.
