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As part of a pilot study, the Assistance Publique des Hôpitaux de Paris is looking for smokers and ex-smokers to validate early detection of lung cancer before symptoms appear.
The AP-HP is seeking to recruit new women for the CASCADE pilot study to test the effectiveness of a screening method for lung cancer using low-dose CT. It could result in screening organized on a national scale, if it shows good results. In France, this type of country-wide screening program exists for colon cancer, breast cancer and cervical cancer.
Demonstrate the feasibility of early detection of lung cancer
Several studies have demonstrated that performing a low-dose chest CT scan in at-risk subjects (smokers aged 50 and over) allows the detection of early lung tumors and reduces the risk of death from lung cancer. This 10-year risk is reduced by 24% in men and 33% in women in the NELSON study published in January 2020.
This screening is already in place in several countries, but in France it was not until February 2022 that the High Authority of Health in France issued a favorable opinion regarding the carrying out of pilot studies on lung cancer screening , to obtain missing data before moving on to organized screening. It is in this context that the APHP launched the CASCADE study in 2022, co-funded by the Ministry of Health and Solidarity and by INCA (National Cancer Institute).
Searching for 2,400 women smokers or ex-smokers
The objective of this study is to demonstrate that the reading of screening scanners can be done by a single radiologist, trained in screening and aided by detection software, whose conclusions will be validated by two experts. For this, it is planned to invite for screening 2,400 women, smokers or ex-smokers, between 50 and 74 years old, to benefit from a chest scan carried out with a low dose of rays. This scanner will allow the detection of several pathologies linked to or favored by tobacco: early lung cancer but also coronary heart disease, emphysema or even osteoporosis.
Nearly 3,000 women have already contacted the CASCADE team, and 1,450 are in the process of being included in the study. These participants also benefit from help with smoking cessation and the detection of pathologies associated with or favored by tobacco: lung cancer but also coronary heart disease and osteoporosis, the risk of which is increased after menopause in smoking women.
The finalization of the study will provide the Inca with essential information on the methods of reading scanners (single or double, role of artificial intelligence) before the launch of a large pilot study in 2024.
Women who meet the following criteria are eligible to participate in this study:
- Be aged 50 to 74;
- Have smoked at least 20 pack-years (the calculation depends on the number of cigarettes smoked per day and the duration of smoking, it will be carried out during contact with the CASCADE team) and have stopped less than 15 years ago;
- Have given consent and accepted the need for follow-up over two years;
- Be affiliated with social security;
- Do not have chest symptoms (recent cough, sputum, shortness of breath) as they require rapid consultation with the attending physician.
- Women with a history of lung cancer or extra-pulmonary cancer that is still evolving will not be able to participate.
After a telephone pre-selection and information on the methods of the study, its benefits and disadvantages, an inclusion visit will be organized with a pulmonologist.
If you wish to participate in the CASCADE study, you can contact the Clinical Research Technicians:
‣ By telephone: 06.15.06.58.35 from Monday to Friday between 9 a.m. and 5 p.m.
‣ By email: via the address [email protected]