Department of Pulmonology, Center Hospitalier d'Abbeville, Abbeville, France.
Department of Pulmonology, CHU Amiens, Amiens, France.
Clin Lung Cancer. 2020 Mar;21(2):145-152. doi: 10.1016/j.cllc.2019.10.014. Epub 2019 Oct 31.
Lung cancer mortality has been found to decrease significantly with low-dose (LD) computed tomographic (CT) screening among current or former smokers. However, such a screening program is not implemented in France. This study assessed the feasibility of a lung cancer screening program using LD CT scan in a French administrative territory. We report here the results of the first screening round.
DEP KP80 was a single-arm prospective study initiated in May 2016. Participants aged 55 to 74 years, current or former smokers of ≥ 30 pack-years, were recruited. An annual LD CT scan was scheduled. Our algorithms considered nodules < 5 mm as negative findings and nodules > 10 mm as positive; for intermediate nodules between 5 and 10 mm, 3-month CT scan with doubling time measurement was recommended. All general practitioners, pulmonologists, and radiologists from the Somme department were solicited to participate. Subjects were selected by general practitioners or pulmonologists who checked the inclusion criteria and prescribed the CT scan.
Over a 2.5-year period, 1307 subjects were recruited. Screening was negative in 733 cases (77.2%), positive in 54 (5.7%), and indeterminate in 162 (17.1%). After the 3-month scans, 57 subjects screened positive: 26 patients exhibited 31 lung cancers (67.7% of stage 0 to I), of whom 76.9% underwent surgical resection, and 29 had no cancer (false-positive rate = 3.1%). The prevalence of lung cancer was 2.7%.
This study demonstrated the feasibility of organized lung cancer screening using LD CT scan within a real-life context in the general population.
在当前或曾经的吸烟者中，低剂量（LD）计算机断层扫描（CT）筛查已被发现可显著降低肺癌死亡率。然而，这种筛查计划并未在法国实施。本研究评估了在法国行政区域使用 LD CT 扫描进行肺癌筛查计划的可行性。我们在此报告首轮筛查的结果。
DEP KP80 是一项于 2016 年 5 月启动的单臂前瞻性研究。招募年龄在 55 至 74 岁之间、吸烟≥30 包年的当前或曾经的吸烟者。每年安排一次 LD CT 扫描。我们的算法将<5 毫米的结节视为阴性发现，将>10 毫米的结节视为阳性；对于 5 至 10 毫米之间的中间结节，推荐进行 3 个月的 CT 扫描并测量倍增时间。我们邀请了索姆省的所有全科医生、肺科医生和放射科医生参与。由全科医生或肺科医生选择受试者，他们检查纳入标准并开出 CT 扫描单。
在 2.5 年的时间里，共招募了 1307 名受试者。733 例（77.2%）筛查结果为阴性，54 例（5.7%）为阳性，162 例（17.1%）为不确定。在进行 3 个月的扫描后，有 57 名受试者筛查呈阳性：26 名患者出现 31 例肺癌（0 期至 I 期的 67.7%），其中 76.9%接受了手术切除，29 例无癌症（假阳性率为 3.1%）。肺癌的患病率为 2.7%。
本研究在一般人群中真实环境下使用 LD CT 扫描进行有组织的肺癌筛查的可行性。
