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S. Couraud
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P1.06 - Poster Session/ Screening and Early Detection (ID 218)
- Event: WCLC 2015
- Type: Poster
- Track: Screening and Early Detection
- Presentations: 1
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.06-004 - Common Misconceptions About Lung Cancer Screening: A Nationwide Survey (ID 1755)
09:30 - 09:30 | Author(s): S. Couraud
- Abstract
Background:
The National Lung Cancer Screening Trial has demonstrated the efficacy of lung cancer screening based on annual low-dose computed tomography (CT) scanning in both former and current smokers. Nationwide lung cancer screening programs are therefore expected to be implemented. Adhesion to these programs will depend largely on public information regarding lung cancer screening. Here, we report on widespread beliefs regarding lung cancer screening in the general population prior to any information campaigns on lung cancer screening.
Methods:
The EDIFICE French nationwide observational surveys, conducted every 3 years since 2005, set out to characterize behaviors related to cancer screening. The 4th edition, EDIFICE 4, was conducted by phone interviews of a representative sample of 1602 subjects aged between 40 and 75 years, using the quota method, from June 12 to July 10, 2014. Attitudes and opinions regarding colorectal, prostate, breast, cervical and lung cancer screening were assessed.
Results:
For 43% of the French population, lung cancer screening is more reassuring than distressing. This figure is lower than those reported for perceptions of other screening programs, including colorectal cancer screening (51%) and breast cancer screening (63% vs. 46.7% for lung cancer screening in the female population). Eleven percent of the respondents (N=162) declared having already undergone a lung cancer screening test. For the vast majority (87%, N=140), this comprised a chest X-ray and for 63%, (N=101) the chest X-ray was not associated with another type of examination. Respondent-declared reasons for not undergoing screening included absence of risk factors (36%), absence of respiratory symptoms (34%), absence of physician recommendations for screening (29%) and futility (11%). Seven percent of current smokers and 32% of former smokers did not undergo screening because they did not consider themselves at risk for lung cancer. Fear of the results pushed 9% of current smokers to avoid lung cancer screening. However, 22% of all respondents and 38% of current smokers declared their intention to undergo a lung cancer screening test in the future.
Conclusion:
The general population has many misconceptions of lung cancer screening. Implementation of nationwide lung cancer screening programs should include information for the general public regarding selection criteria, techniques used and the benefits of lung cancer screening using low-dose CT scanning.
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P2.04 - Poster Session/ Biology, Pathology, and Molecular Testing (ID 234)
- Event: WCLC 2015
- Type: Poster
- Track: Biology, Pathology, and Molecular Testing
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.04-039 - A World of EGFR Screening Test (ID 2406)
09:30 - 09:30 | Author(s): S. Couraud
- Abstract
Background:
EGFR mutation status has emerged as a crucial issue in the management of lung cancer. In France, the national cancer institute has launched a network of EGFR screening test facilities for daily practice. There is however very little information about EGFR screening test and TKI drugs availability in routine at a worldwide level. We also hypothesized that inequalities might occur in the EGFR test availability regarding country development. Thus, the aim of this study was to edit a map of routine EGFR test and drugs availability and cost subsequently associated to development indicators.
Methods:
We conducted a prospective expert opinion survey. An electronic questionnaire, edited in French or English, was addressed to experts in thoracic oncology in each country of the world. Experts were selected by three different ways: (i) email lists of partner institutions (the European Respiratory Society, the Asian Pacific Society of Respiratory, the Asociacion Latinoamericana del Torax, the Thoracic society of Australia and New Zealand), (ii) manual research on the internet, and (iii) the IASLC member. Interpretation of multiple answers was performed according to an a priori determined algorithm. Questionnaire contained 10 multiple-choice questions on availability, and cost of EGFR screening test and EGFR tyrosine kinases inhibitors (TKI). Country development was estimated by the human development index (HDI) provided by UN development program.
Results:
We obtained answer from 74 countries, covering 78% of world population according to UN data. Experts (n=100) were mainly clinicians and worked in hospitals or cancer centers. Non-responding countries were mainly from Africa and Asia, and had a significantly lower HDI than responding countries. EGFR screening test was routinely available in whole the country or only in some region for 57 countries (70% of the world population; figure 1). The remaining-cost of the test was less than 500 US$ in 49 countries (42.5% of the population). Availability and cost of the test were both significantly linked to HDI. The delay to obtain test result was less than 30 working-days in 71% of the population. Erlotinib, Gefitinib, Afatinib and Icotinib were routinely available in 75%, 66%, 31% and 23% of the world population respectively. Availability and cost of erlotinib, gefitinib and afatinib were also associated to HDI. Figure 1
Conclusion:
EGFR screening test and EGFR TKI are widely accessible in routine worldwide. However, there are large discrepancies in the access and the cost of this innovative process regarding development index.
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P2.05 - Poster Session/ Prevention and Tobacco Control (ID 216)
- Event: WCLC 2015
- Type: Poster
- Track: Prevention and Tobacco Control
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.05-009 - Tobacco Addiction and Perception of Risk of Lung Cancer in Vulnerable Populations (ID 1415)
09:30 - 09:30 | Author(s): S. Couraud
- Abstract
Background:
Social indicators of vulnerable populations are associated with increased rates of comorbidities and risk factors for cancer but not with screening attendance, as previously shown by the French EDIFICE surveys. The present work sought to determine whether living in poor economic social conditions is associated with specific behavior or beliefs that increase exposure to the risk factors for lung cancer.
Methods:
The 4th French nationwide observational survey, EDIFICE 4, was conducted by phone from June 12 to July 10, 2014 among a representative sample of 1602 individuals aged between 40 and 75 years, using the quota method. Individuals were questioned about their smoking habits. Tobacco addiction was evaluated in current smokers using the Fagerström Test for Cigarette Dependence (FTCD) score, which ranks participants into one of four groups: no dependence, low, moderate, and high dependence. Risk perception compared to the average-risk population was self-assessed. Data were analyzed according to the validated EPICES vulnerability score.
Results:
Vulnerable individuals (N=455) were more frequently current smokers than non-vulnerable individuals (N=941) (34.1% vs 19.9%; P≤0.01) and less frequently former smokers (25.9% vs. 35.8%; P≤0.01). Compared to the non-vulnerable population, current and former cigarette smokers in the vulnerable population were more likely to have started smoking before the age of 15 (33.8% vs. 25.5%, P≤0.05), and had a higher average consumption (16.6 pack-years [SD 16.25] vs. 13.59 pack-years [SD 16.44]; P≤0.01). Vulnerable individuals were also more likely to stop smoking for periods of less than 1 year or for 1-9 years (18.6% vs. 10.4% and 29.2% vs. 19.4%, respectively; P≤0.05) but were less likely to quit for longer periods (10-19 years, 17.6% vs. 27.1%, P≤0.05; 20-29 years, 17.2% vs. 22.5% and ≥30 years, 17.5% vs. 20.3%, not statistically different). Likewise, vulnerable individuals had higher average FTCD scores (3.24 [SD 2.38] vs. 2.55 [SD 2.16], P≤0.01) and were more frequently ranked as moderately or highly dependent on cigarettes (32.0% vs. 21.5%, P≤0.05). Respondents were asked about the number of cigarettes per day they considered to be associated with no risk of lung cancer; average replies were 3.01 (SD 5.40) in the vulnerable population vs. 1.93 (SD 3.90, P≤0.01) in the non-vulnerable population. The former were also less likely to spontaneously cite a number of lung cancer risk factors (unhealthy life-style 93.8% vs. 97.5%, active smoking 91.3% vs. 95.5%; passive smoking 60.4% vs. 72.0%; P≤0.01). But they were more likely to rank their own risk of lung cancer as higher than that of the average population (22.6% vs. 16.6%, P≤0.01) and to consider screening as more distressing than reassuring (25.9% vs 18.3%, P≤0.01).
Conclusion:
Because they develop a heavy, long-lasting consumption of tobacco and are less likely to quit smoking permanently, vulnerable individuals are more exposed to the tobacco-consumption-related risks of lung cancer. Paradoxically, they also appeared both less concerned and more anxious about the risks of lung cancer than non-vulnerable populations. These results highlight the urgency of implementing information campaigns, prevention messages, and smoking cessation support specifically targeting this vulnerable population.
