Lung cancer: the test that can save 7,500 lives a year

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    , November 18, 2018, as amended at
                    2:19 p.m.
    November 18, 2018

"Today, we have a plane crash a day, 200 dead tobacco", likes to repeat Agnès Buzyn. Charles-Hugo Marquette, head of the department of pneumology at Nice University Hospital, smiles every time he hears the Minister of Health spin this aerial metaphor. His, the fruit of a calculation as trivial as it is astonishing, pronounced three years ago at a conference in Paris. But the doctor does not claim any copyright, too happy that shock figures become prevention tools. Moreover, here is a new, even more catchy: "Campaign against the dead on the road, it's good," he said, but by passing a simple scanner to heavy smokers, we could save 7,500 lives each year "

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With about thirty French lung experts, Charles-Hugo Marquette decided to put pressure on the authorities. These pulmonologists, oncologists or radiologists claim "the immediate management of a CT scan", from 50 or 55 years, for heavy smokers or former heavy smokers. Why take the opinion to witness? "There is an urgent need to raise awareness, argues Professor Gérard Zalcman, an oncologist at Bichat Hospital (AP-HP) in Paris, which is being reimbursed by insurance companies in the US Throughout Europe, many experiments have been Organized and financed, we feel a little bit cautious, there are very few. "

CT scans decrease lung cancer mortality by 25% to 60%

In Toronto in September, the presentation of a work done in Belgium and the Netherlands finally convinced these specialists that it was time to change the practice. According to its authors – the detailed results have not yet been published – this large-scale study (10,000 people), named Nelson, demonstrates that low-radiation CT screening reduces lung cancer mortality by 25%. men and 40 to 60% among women. These figures confirm the interest of the measure, brought to light by American research which, in 2011, estimated this decrease at 20%.


The number of false diagnoses is reduced by two-thirds


"In the Belgian-Dutch study, the definition of suspicious images was more effective than in the US study, there is no doubt," says professor Zalcman, who has not digested, as number of Lung specialists, the decision made in 2016 by the High Authority for Health (HAS) to refuse screening. This case argued that rays could be dangerous to health and that the risk of false diagnosis was significant. For Charles-Hugo Marquette, the European work can only convince French experts: "The number of false diagnoses is reduced by two-thirds, and these excellent results have been obtained in health systems comparable to ours."

In the Somme, screening for breast and colon cancers

Responsible for the screening department at the National Cancer Institute (Inca), Frédéric de Bels also vibrated to echo the announcement made in Toronto. "These results will be studied in detail," he explains, "and then the interest of setting up a screening program will be reassessed by the High Health Authority." Target population, choice of frequency and equipment, cost of examinations, possible addition of biological tests … All these questions will be explored by the HAS but, according to Frédéric de Bels, conclusions will not be made before 2020.

Because he can not bring himself to perpetually diagnose inoperable tumors the size of a grapefruit, Dr. Olivier Leleu, head of the pneumo-oncology department of the hospital of Abbeville (Somme), launched in 2016 a pioneering experience in his department. It associates generalists and radiologists carrying out screenings of breast and colon cancers. "It works in real life as well as in major international studies," says the practitioner, who has had a lot to do to find funding, we operated on people and healed them! " Another benefit of screening: it encourages some heavy smokers to drop out. On this, no doubt: quitting can save.