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For the High Authority for Health, the establishment of a small-scale experiment in screening for lung cancer in smokers is desirable. A change in the position of the health authority due to the publication of new studies on screening but also on tobacco, the main risk factor.
“The state of knowledge is still incomplete for the implementation of a systematic and organized screening program for bronchopulmonary cancer in France., estimated the High Authority for Health (HAS) in an opinion. However, she is in favor of setting up an experiment at “limited scale of lung cancer screening in smokers, by launching a pilot program now”.
Towards generalized screening?
The goal of cancer screening is to find people who are at higher risk of developing a disease or health problem, so that a treatment or intervention can be more effective.
In the case of lung cancer, screening is based on a low-dose chest CT scan without injection (or computed tomography). In the event of an anomaly, the diagnostic assessment would include a clinical examination, additional medical imaging or nuclear medicine examinations and a biopsy of the tumour.
A change of position of the HAS
This new opinion from the HAS contradicts the previous one on the question, which dates from 2016. At the time, the body was opposed to screening organized by CT scan for lung cancer. These are several studies published on the subject, demonstrating the interest of screening and emphasizing the responsibility of tobacco in this type of cancer, which have changed the position of the health authority.
But today, the HAS “recommends that the INCA initiate a pilot program and support the implementation of additional studies based on the recommendations of the HAS in order to obtain the answers that are still missing and essential for the implementation of an effective organized screening program and on“. An essential first step before generalized screening.
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This screening is already in place in several countries around the world, such as the United States or Canada, for example. In France, the reluctance vis-à-vis the false positives and the “overdiagnosis” that the examination would generate in particular, as we already mentioned in our article “Lung cancer screening: for or against?”, have long slowed down the development of such a program.
The HAS concludes that large-scale French experiments will be “necessary to respond to the various outstanding points and decide on the most suitable screening methods for the French system”.