Implementing Low-dose ct Lung Cancer Screening in France.

Implementing Low-dose ct Lung Cancer Screening in France.

The main objective is to estimate the detection rate of lung cancer in the population screened by low-dose chest CT scans.

Low-dose CT screening (LDCT) allows for the detection of lung cancer at an early stage, enabling curative treatment. Large randomized controlled trials have demonstrated that LDCT reduces mortality in smokers.

The objective of the current research is not to confirm a reduction in mortality, but to show that screening can be safely implemented at a population level. Different modes of recruitment and invitation will be tested to ensure that LDCT can be implemented equitably. The role of artificial intelligence as an alternative to double human reading will also be assessed.

Screening strategy includes baseline, followed by 1-year LDCT, and a third LDCT 2 years later. Current smokers will be offered smoking cessation support.

The management of screen-detected lung nodules will follow the 2025 guidelines from the European Society of Thoracic imaging.

Inclusion Criteria:

• Adults aged 50-74 years
• Active or former smoker having quit less than 15 years ago
• Smoking history of at least 20 pack-years, or 15 cigarettes/day for 25 years or 10 cigarettes/day for 30 years
• Affiliation with a social security scheme
• Written informed consent prior to study participation

Temporary exclusion Criteria

• Chest CT scan performed within the previous 12 months
• Signs of respiratory infection (fever, productive cough)

Exclusion Criteria:

• Severe co-morbidities contraindicating exploration and/or management (including stereotactic surgery or radiotherapy) of lung cancers
• Poor general status (PS2 and above)
• Rest dyspnea (mMRC4)
• Cancer under active surveillance by thoracic computed tomography (CT pr PET-CT)
• Personal history of lung cancer
• Symptoms raising suspicion of lung cancer (hemoptysis, unexplained weight loss, recent onset or modification of respiratory symptoms,…)