Organized Lung Cancer Screening of Subjects Occupationally Exposed to Lung Carcinogens: The LUng Cancer Screening...

The LUng Cancer Screening Occupational exposure (LUCSO) program was designed as a feasibility study of organized screening for lung cancer in subjects with occupational exposure to lung carcinogens in France. Herein, we report the program's entry-level (baseline) findings.

The inclusion criteria were subjects aged 55 to 74 years, with sufficient exposure to International Agency for Research on Cancer group 1 occupational carcinogens and smoker or ex-smoker for less than 15 years. The first phase of the study addressed subjects aged 65 to 74 years in two French regional counties to test feasibility. Lung cancer screening was based on a low-dose computed tomography (CT) scan at baseline and spirometry, followed by an annual CT scan for 2 years and telephone follow-up at 3 years.

Letters were sent to 247,152 subjects from the Regional Cancer Screening Coordination Center inviting them to participate, allowing eligibility screening by letter. Among the 21,502 respondents (8.7%), 311 (1.4%) were included. Asbestos exposure predominated (92%), but co-exposures were also frequent (73% crystalline silica and 48% welding fumes); 45% were active smokers at inclusion, and 37% of them agreed to consult a smoking-cessation specialist. Baseline CT scans revealed anomalies in 19 (6.1%); seven (2.4%) were diagnosed with the following stages of lung cancer: three stage IA, three stage IIA, and one stage IIB; the false-positive rate was 4.2%.

Before considering nationwide implementation, this feasibility study provided new real-life insights finding that the selected population was indeed at high risk of lung cancer and that screening effectively detected early stages.