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According to the unveiled results of the French KBP-2020 study on the profile and survival of patients with lung cancer in France, an improvement in survival has clearly been emerging for 20 years. This progress is based in particular on the effectiveness of immunotherapy.
It is rare that we get good news when we talk about lung cancer. So, when this is the case, it seems important to point it out. Thus, the preliminary results of the last part of the French KPB study (an epidemiological follow-up conducted for 20 years on lung cancer in France) unveiled last Sunday at the Congress of French-speaking pneumology in Marseilles, are hopeful.
Two-year survival has doubled over the past 20 years
Since 2000, and every 10 years, the College of Pneumologists of General Hospitals (CPHG) has been conducting a multicenter observational study on new cases of primary lung cancer (called PBC) diagnosed in most pulmonology centers in the country. This regular monitoring over time is always subject to the same methodology, and therefore allows a regular comparison between the studies carried out in 2000 (KBP-2000), 2010 (KBP-2010) and KBP-2020, the most recent. According to the latest information, the survival rate would be considerably higher than twenty years ago.
- At one year, this survival rate actually improves, going from 40% in 2000 to 55% in 2020;
- At 2 years, this survival rate itself has practically doubled compared to the year 2000.
The frequency of cases decreases among those under 50
Another idea which tends to fade for 20 years: the frequency of this cancer which would increase in the youngest. However, of the 9,000 cases reported in 2020 in the 82 centers of the study, the frequency in people under 50 would also be in sharp decline, falling in 20 years, from 11% in 2000 to 4% in 2020.
Immunotherapy and targeted therapies in the first line
What are these positive developments due to? For Dr. Charbel Al Zreibi, thoracic surgeon at Georges Pompidou Hospital and Inserm researcher, contacted on the subject, this development is based in particular on technological and medical advances which have also revolutionized care in recent years.
“Today, we detect lung cancer more and more quickly and earlier, in particular thanks to more efficient scanners which detect lesions of only 1 mm. However, we know that the earlier a cancer is detected, the better the patient’s chances of being cured.”
Advances in treatment and surgery also allow better management of lung cancer.
“We can now count on techniques such as immunotherapy, which reactivates the immune system and which proves to be effective, coupled with chemotherapy. But also on what are called targeted therapies, that is to say treatments that directly block the ability of cancer to develop. Surgical techniques are also changing, thanks to robots which reduce the gesture and make lung surgeries “easier” for the patient”.
Can screening be further improved?
However, an effort still needs to be made to improve screening, such as a low-dose scan repeated regularly in risk groups (smokers over 50). According to scientists, this implementation would be able to prevent 10,000 deaths per year. In February 2022, the Haute Autorité de Santé recommended the implementation of a small-scale trial of lung cancer screening in smokers.
“But above all, people need to smoke less!” reminds the surgeon before even talking about screening. The first thing to do to avoid lung cancer is to quit smoking. Certainly, there are sporadic forms, certainly pollution contributes to lung cancer, but it does not make us forget it: in 9 out of 10 cases, this cancer is linked to smoking”.
Currently, lung cancer accounts for 45,000 cases and approximately 33,000 deaths per year in France.