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Development of a Woman-Specific Risk Model for Participation in Lung Cancer CT Screening

Principal Investigator
Name
Marie-Pierre Revel
Degrees
M.D., Ph.D.
Institution
APHP
Position Title
Head of Radiology Department
Email
About this CDAS Project
Study
NLST (Learn more about this study)
Project ID
NLST-1237
Initial CDAS Request Approval
Apr 29, 2024
Title
Development of a Woman-Specific Risk Model for Participation in Lung Cancer CT Screening
Summary
Lung cancer screening is aimed at individuals aged between 50 and 80 who have smoked the equivalent of 20 pack-years according to the USPSTF (United States Preventive Services Task Force) 2021 recommendations. However, these criteria do not allow us to select all individuals likely to develop cancer, and several risk models have been developed to optimise the selection of participants, such as LLPv3 or PLCOm2012. Although certain models such as Bach or LLPv3 account for the sex at birth, they have not been specifically developed to optimise the selection of female participants. In particular, the criterion of exposure to asbestos is probably of little relevance in a female population.
Our hypothesis is that by taking into account the characteristics of women diagnosed with lung cancer in the NLST study and comparing them with women without cancer, we could obtain a more effective risk model. This model could be tested on the cohort of the CASCADE study, which is exclusively recruiting women (ClinicalTrials.gov Identifier: NCT05195385), as well as in the female population of the SOLACE project, (https://health.ec.europa.eu/non-communicable-diseases/cancer/europes-beating-cancer-plan-eu4health-financed-projects/projects/solace_en) which aims to collect data from over 10,000 European women. Optimising the selection of participants for screening would improve the cost-effectiveness of screening, reduce the number of people screened and improve the quality of care.
The epidemiology of lung cancer in the European female population is a cause for concern, particularly in France. The data from the French general hospitals taking part in the KBP 2020 study were published in 2022 (Debieuvre Det al. Lung cancer trends and tumor characteristic changes over 20 years (2000-2020): Results of three French consecutive nationwide prospective cohorts' studies. The Lancet Regional Health - Europe 2022;22:100492). They show that the proportion of women among lung cancer patients has more than doubled in 20 years, from 16% in 2000 to 34,6% in 2020, and even 41% before the age of 50.
Aims

The specific aims are as follows:
- To assess the impact of the age at which women started smoking
- To assess the impact of the number of pack-years smoked on the risk of lung cancer in women
- To assess the impact of smoking duration on the risk of lung cancer in women
- To assess the impact of a family history of lung cancer on the risk of lung cancer in women
- To assess the impact of BMI on the risk of lung cancer in women
- To assess the impact of the level of education on the risk of lung cancer in women
- To assess the impact of the number of children on the risk of lung cancer in women
- To assess the impact of the age of menopause on the risk of lung cancer in women
- To assess the impact of COPD on the risk of lung cancer in women
- To assess the impact of coronary heart disease on the risk of lung cancer in women
- To assess the impact of a history of radiotherapy on the risk of lung cancer in women
- To assess the impact of a history of other cancer on the risk of lung cancer in women

Collaborators

Sandrine Katsahian, APHP
Sarah Zohar, INRIA
Armelle Arnoux, APHP
Clarie de Moüy, INRIA