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. 2024 Nov:109:105396.
doi: 10.1016/j.ebiom.2024.105396. Epub 2024 Oct 12.

Lung cancer screening by low-dose CT scan in France: final results of the DEP KP80 study after three rounds

Olivier Leleu  1 , Nicolas Storme  2 , Damien Basille  3 , Marianne Auquier  4 , Valerie Petigny  5 , Pascal Berna  6 , Alexia Letierce  7 , Sebastien Couraud  8 , Julie de Bermont  8 , Bernard Milleron  9 , Vincent Jounieaux  3
Affiliations

Lung cancer screening by low-dose CT scan in France: final results of the DEP KP80 study after three rounds

Olivier Leleu et al. EBioMedicine. 2024 Nov.

Abstract

Background: In prior randomised controlled trials, lung cancer screening using low-dose computed tomography (LDCT) has been shown to reduce lung cancer mortality and overall mortality. Despite these results, organised screening in France remains a challenge. This study assessed the feasibility and efficacy of lung cancer screening within a real-life context in a French administrative territory.

Methods: DEP KP80 was a single-arm prospective study. Participants aged between 55 and 74 years, smokers or former smokers of ≥30 pack-years, were recruited. An annual LDCT scan was scheduled and three rounds were performed. Subjects were selected by general practitioners or pulmonologists, who checked the inclusion criteria and prescribed the CT scan.

Findings: Between March 2016 and February 2020, 1254 participants were enrolled. Overall, 945 (75.4%) participants underwent baseline LDCT (T0), 376 (42.8%) completed the first round (T1) and 270 (31%) the second (T2) one. Forty-two lung cancers were diagnosed, 30 cancers (71.4%) were stage I or II and 34 cancers (80.9%) were treated surgically. In this study, the overall positive predictive value for a positive screening was 48% (95% CI 37-59) and the negative predictive value 100% (95% CI 100-100).

Interpretation: This study demonstrated the feasibility and efficacy of lung cancer screening in a real-life context with most lung cancers diagnosed at an early stage and surgically removed. Our results also highlighted the importance of participation in each round, underlining the fact that optimising organisation is a major goal.

Funding: Agence Régionale de Santé de Picardie, La Ligue contre le cancer, le Conseil Départemental de la Somme, and AstraZeneca.

Keywords: Early detection; Low-dose computed tomography (LDCT) scan; Lung cancer; Real life; Screening.

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Conflict of interest statement

Declaration of interests NS, DB, VJ, JdB, VP, BM, PB, MA and AL declare no potential conflicts of interest. SC declares grants from AstraZeneca, Amgen, Adene, BDbioscience, BMS, Boeringher, Chugai, Janssens, Laidet, Lilly, MSD, Novartis, Roche, Pfizer, Takeda, Volition and Transdiag, royalties from Volition, payment for expert testimony from Amgen, Astra Zeneca, Boeringher, Health Event, MSD, Novartis, Pfizer and Sanofi, and support for attending meetings from Amgen, Astra Zeneca, BMS, Chugai, Janssens, Laidet and Takeda. OL declares grants from Chiesi, AstraZeneca, BMS and Amgen, and support for attending meetings from France Oxygene and Aeris.

Figures

Fig. 1
Fig. 1
Organisation of lung cancer screening in the DEP KP80 study.
Fig. 2
Fig. 2
Diagram showing flow of participants through the screening service. T0 = baseline screen, T1 = year 1 screen, T2 = year 2 screen.
Fig. 3
Fig. 3
Cancer stages diagnosed in the three rounds (n = 42).
Fig. 4
Fig. 4
Screening results at T0, T1, and T2 for 42 patients with lung cancer. LDCT: low-dose computed tomography.
Fig. 5
Fig. 5
Treatments for cancers diagnosed in the three rounds (n = 42).
See this image and copyright information in PMC

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