“We have never been closer to launch”

“We have never been closer to launch”
“We have never been closer to launch”

France – According to the report from the European Cancer Organization published on May 13, France is lagging behind in lung cancer prevention and screening compared to its European neighbors.[1]. However, this could change soon: a call for tenders for the establishment of a clinical trial, prior to the deployment of an organized lung cancer screening program, should be launched during the month of June.

Budgetary decisions currently being finalized

Often diagnosed at a late stage, lung cancer is the deadliest malignant tumor in France, causing more than 33,000 deaths each year. In 2023, 52,777 new cases were estimated. Unlike colorectal, breast and cervical cancers, it is, until now, not the subject of an organized screening program in France.

But that could change in the coming years. In fact, the High Authority of Health (HAS) recommended in 2022 the commitment by the National Cancer Institute (INCa) of a pilot program and the establishment of additional studies prior to such a program.

“Currently, we have never been so close to start-up,” assures the Pr Sébastien Couraud, head of the pulmonology department at Lyon Sud hospital. “With INCa, we have completed the drafting of a scientific argument which will make it possible to launch a call for tenders in the coming days. Budgetary arbitrations are being finalized, because the project is expensive, but as soon as they are completed, the call for tenders can be published. Candidates will then have until September to submit their projects.

Start-up planned for early 2025

“It is a call for tenders which will be national. The idea will be to propose a clinical trial involving humans (RIPH). This was not our request because it complicates things, but it was arbitrated by the ANSM. The trial will aim to establish the conditions for organized screening. The pilot experiment should start at the beginning of 2025 and last 5 years,” he explains.

This pilot should ultimately make it possible to cover the whole of France with screening centers and allow the target audience to be screened. “We estimate the target population between 3 and 4 million people. These are people aged 50 to 75, smokers for more than 20 pack-years (1 pack-year = one pack per day for one year), or more than 15 cigarettes per day for more than 25 years, or more of 10 per day for more than 30 years. Ultimately, we estimate that the savings in annual direct costs (hospitalization in particular) would be 4 million euros per year. The annual cost of screening has been estimated at around 225 million euros,” specifies the pulmonologist.

Following in the footsteps of other European countries

For him, the obstacles that remained for the launch of this screening are beginning to be removed. “The scientific barrier no longer exists, because lung cancer screening has an impact on overall mortality, this was demonstrated in a randomized study, which is very rare. The other obstacle in principle is linked to the fact that other screenings do not work very well in France, with only 50% participation for breast cancer and 32% for colon cancer. This could discourage some from wanting to relaunch a new front, but lung cancer remains the leading cause of cancer mortality in France, so the interest is certain,” he believes.

Currently, other European countries such as Croatia, Poland and the Czech Republic have already implemented national programs. “In addition, England launched a program in June 2023 and issued one million invitations. This has already allowed them to detect around 3,000 cancers. And Germany has just voted for a project along these lines. France is not ahead, but we are not yet the last,” he assures.

“Go to” strategy

Mob’Ilyad, a traveling truck for lung cancer screening

In Auvergne-Rhône-Alpes, a truck offering lung cancer screening should soon travel the roads to meet vulnerable populations. “It’s a process of “going towards” the population, in order to bring public health intervention to them. The idea is to remove obstacles to social vulnerability, but not only that. There are also notions of time saving and opportunity for the public,” explains Professor Couraud.

This truck will not only include a low-dose scanner, but also a spirometer and will offer a consultation with a tobacco specialist as well as a nurse trained in health promotion, who will be able to take the blood pressure and weigh the participant. “We will be able to look at the state of the coronaries, assess emphysema or even the risk of COPD,” explains Professor Couraud. “We will have real global prevention action.” Funded by the Auvergne-Rhône-Alpes region, the Regional Health Agency, the European Union, the Astra Zeneca laboratory and the Adene group, the truck will cost between 1.6 and 1.9 million euros. It is currently awaiting manufacturing and is expected in the first quarter of 2025.

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