Lung Cancer Screening in France: A Collaborative Approach

The Cascade Study and National Pilot

France has made significant strides in lung cancer screening with the successful
completion of the Cascade study, which followed women participants for two years. Building on this success, INCA (the French National Institute of Cancer) is developing a national pilot program that will
include both men and women. This initiative aims to establish a comprehensive screening program within the existing healthcare system.

Roles of Healthcare Professionals

The proposed model emphasizes collaboration between different specialists. Radiologists
will conduct the initial screenings, referring individuals with comorbidities like osteoporosis or high calcium scores to general practitioners (GPs). GPs play a crucial role in identifying eligible
participants by considering factors like age and tobacco exposure, which may not be readily available through social security records.

Pulmonologists will primarily focus on managing positive screening results. However, the
limited number of pulmonologists in France poses a challenge. The Cascade study demonstrated this issue, with significant wait times for inclusion visits due to high patient volume.

Resource Allocation and Implementation Strategies

While radiologists and GPs are readily available, the shortage of pulmonologists may
require creative solutions, such as streamlined referral pathways or training initiatives.

Successful implementation hinges on promoting participation, combating stigmatization associated with lung cancer screening, and ensuring sustained patient engagement throughout the process. This includes
encouraging annual or biannual screenings and providing robust support for smoking cessation programs.