Lung cancer spreads like fire among women. “A 2020 study (KBP-2020) reveals that the share of women among lung cancer patients has more than doubled in twenty years, going from 16% in 2000 to 34.6% in 2020. Currently, lung cancer in women is exploding and from an epidemiological and demographic point of view, it is worrying,” states Dr.r Isabelle Petit. Interventional radiologist at the Nancy-Brabois Adult University Hospital, the practitioner is involved in a national study with her colleague Bruno Ribeiro-Baptista, a pulmonologist, on this cancer which is increasing in the female population, while it tends to stabilize among the male population.
Why this study?
The benefit of screening by low-dose chest CT scan (very low radiation) in terms of reducing mortality is no longer debated since the publication of the results of an American study (NELSON) in January 2020. For its part, the High Authority for Health (HAS) recently encouraged the establishment of pilot lung cancer screening programs to obtain missing data before moving to systematic screening.
The CASCADE study (Cancer of the lung by low-dose thoracic CT scan), with which the Nancy University Hospital is associated, is part of this context. CASCADE is promoted by the AP-HP and conducted by the Pr Marie-Pierre REVEL of Cochin Hospital). It is funded by the Ministry of Health and the National Cancer Institute (INCa) to the tune of two million euros. Its objective is “to provide INCa with essential information on the methods of reading scanners (single or double, role of artificial intelligence) before launching a large pilot study in 2024”, indicates Isabelle Petit.
Data to consolidate
The hospital centers of Paris, Rennes, Grenoble, Béthune, Nancy, Toulouse, Bordeaux and Carcassonne joined forces in this exploration. CASCADE aims to somehow support previous studies. NELSON was, in fact, revealed to be incomplete. His cohort included an insufficient number of women. “In their conclusions,” reports Isabelle Petit, “the editors of the Nelson study say that they do not have enough data on women. Their population was roughly 85% male and 15% female. »
Why this imbalance? “Because smoking really exploded among women in the 1970s,” continues the radiologist. So, women with a high risk of lung cancer arrived in the 2020s. However, the NELSON study is based on retrospective data dating from before 2020. » CASCADE therefore focuses on these generations of smokers who are overtaking, today today, fifty. A threshold from which they enter, just like men, the red zone of lung cancer.
2,400 participants
The establishments thus recruit 2,400 participants who must meet three criteria detailed by the Dr Bruno Ribeiro-Baptista: “They must be smokers or former smokers and be between 50 and 74 years old. If they want to be screened for lung cancer, they call a platform
. We will check if they are eligible for the study. The inclusion criteria are very simple, it is the quantity of tobacco consumed. If they are eligible, they obtain an appointment in the pulmonology department of the Nancy CHRU. »
The pulmonologist will talk to them about their “life history, their smoking”. “If it is still active, we will offer them everything we can to try to stop smoking,” continues Bruno Ribeiro-Baptista. Finally, if the inclusion criteria are met, they will go directly for a scan to detect possible pathologies linked to or caused by smoking.”
A man-machine tandem
An examination which can, obviously, be feared in the absence of symptoms. However, you should know that the scanner detects the disease at an early stage. “The earlier the disease is caught, the more effective and curative the treatment will be,” insists Isabelle Petit. Finally, CASCADE’s other ambition is to demonstrate the effectiveness of artificial intelligence (AI) in the analysis of images taken from a scanner. Today, medical imaging centers do not always have sufficient resources to respond to mass screening. Screening for lung cancer requires a joint opinion from a general radiologist and a radiation oncologist. A rare specialty. CASCADE will therefore test AI (artificial intelligence) as an aid to the general radiologist trained in screening. Objective, to prove that this man-machine tandem can be as reliable as an expert radiologist in thoracic radiology.
Participate in the CASCADE study by calling 06 15 06 58 35 or by sending an e-mail to [email protected]. In Lorraine you will be redirected to the pulmonology and radiology services of the Nancy-Brabois Adults CHRU.
