Why is this important?
Lung cancer is the leading cause of cancer death in France and the 5-year survival rate is only 20%. However, early detection of cancer would increase this survival rate to 80%. Several studies have shown that the use of low-dose chest CT scans (or computed tomography or fdCT) might help reduce overall mortality. The DEP P80 pilot study, conducted in 2016, provided proof of the feasibility of screening by including 228 general practitioners from the Somme department (Hauts-de-France) who requested 949 low-dose lung scans. This screening made it possible to diagnose lung cancer in 2.7% of the subjects, including 68% at a localized stage. In the absence of organized screening for lung cancer, the study presented here has the advantage of evaluating the knowledge and practices of general practitioners, pillars of the care pathway during opportunistic screenings. versus a supervised pilot project.
Methodology
This observational study described screening practices via a questionnaire sent to 1,013 general practitioners practicing in the Hauts-de-France region. The objectives of the study were to assess the knowledge and practices of general practitioners in this region regarding lung cancer screening by low-dose CT scan. She then had to compare these practices with those of general practitioners from the Somme department who participated in the screening experiment and their colleagues from the rest of the region.
Principle results
Overall, 190 general practitioners responded (i.e. 18.8% of the doctors contacted, average age 52 years). Although the vast majority of general practitioners were unaware of the potential value of organized screening for lung cancer by low-dose CT scan, more than 7 out of 10 had already offered screening for this cancer opportunistically. Nearly half (49.5%) of all physicians who had ever offered screening took into account the individual’s smoking history and age.
Faced with an asymptomatic individual, aged over 55 who had smoked at least 30 pack-years, 40% of doctors suggested a chest X-ray and 36.3% a chest CT scan, for which only half specified “low dose”. Thus, only 18% of the general population of physicians prescribed low-dose CT scans (n=34/190).
Among the doctors working in the Somme department, 61% had taken part in the DEP KP80 pilot study on lung cancer screening. They had a better knowledge of the value of low-dose CT scans in the context of early detection of lung cancer, and more often offered screening by this technique (61.1% versus 13,4%).