First round of lung cancer screening among patients with atheromatous cardiovascular disease exposed to tobacco: a prospective cohort study - 25/09/26

Doi : 10.1016/j.resmer.2026.101324

Elsa Armand ^a,^b,^e,^⁎ , Clarisse Buton ^b,^e, Caroline Caramella ^c, Paul Habert ^d,^e, Ilyes Hamouda ^f, Zeinab Hamidou ^f, Justin Issard ^c, Pauline Pradère ^c, Gaëlle Dauriat ^c, Sacha Mussot ^c, Delphine Mitilian ^c, Océane Hache ^c, Lilia Lamrani ^c, Jérôme Le Pavec ^c, Marc Zins ^c, Marine Fidelle ^g,^j, Johan Pluvy ^h, Geoffrey Brioude ^a, Alban Todesco ^a,^b,^e, Jean-Baptiste Lovato ^h, Julie Tronchetti ^h, Herve Dutau ^e,^h, Laurent Greillier ^b,^e,^h, Jean-Yves Gaubert ^d,^e,^k, Alexis Jacquier ^e,^k, Delphine Trousse ^a,^e, Xavier-Benoit D’journo ^a,^e, Pascal-Alexandre Thomas ^a,^e, Elie Fadel ^c,ⁱ, Stephan Haulon ^c,ⁱ, Dominique Fabre ^c,ⁱ, Saïd Ghostine ^c, Martin Kloeckner ^c, Pamela Abdayem ^g, Guido Kroemer ^g,ⁱ, Laurence Zitvogel ^g,^i,^j, Benjamin Besse ^g,ⁱ, Olaf Mercier ^c,ⁱ, David Boulate ^a,^b,^c

^a Thoracic Surgery Department, Nord Hospital, Assistance Publique – Hôpitaux de Marseille (APHM), Marseille, France

^b Computational Pharmacology and Clinical Oncology Laboratory, CRCM, Inserm-Inria, Marseille, France

^c Marie Lannelongue Hospital, International Center for Thoracic Cancers, Groupe Hospitalier Paris Saint-Joseph, Le Plessis Robinson, France

^d Radiology Department, APHM, Nord Hospital, Marseille, France

^e LIIE, CERIMED, Aix-Marseille université, Marseille, France

^f Epidemiology and Health Economy Department, Assistance Publique – Hôpitaux de Marseille, Marseille, France

^g Gustave Roussy Cancer Campus, Villejuif, France

^h Department of Pulmonology, Allergology and Oncology, Assistance Publique – Hôpitaux de Marseille, Marseille, France

ⁱ University Paris-Saclay, Medecine Faculty, Le Kremlin-Bicêtre, France

^j Inserm UMR1015, Tumor Immunology and Cancer Immunotherapy, F-94805, Villejuif, France

^k Radiology Department, Timone Hospital, Assistance Publique – Hôpitaux de Marseille, Marseille, France

^⁎ Corresponding author: Aix-Marseille Université, Thoracic Surgery Department, Nord Hospital, Assistance Publique – Hôpitaux de Marseille, Chemin des Bourrely, 13015, Marseille, France. Aix-Marseille Université Thoracic Surgery Department Nord Hospital Assistance Publique – Hôpitaux de Marseille Chemin des Bourrely Marseille 13015 France

Highlights

•	Patients aged 45–75, exposed to tobacco and aCVD history have a high risk of lung cancer.
•	These criteria increase of 31% of eligibility for lung cancer screening in our study.
•	We found 75% of early stage (I and II) lung cancer at diagnostic.
•	There was no severe morbidity induced by diagnostic and therapeutic procedures.

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Graphical abstract

Image, graphical abstract

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Abstract

Introduction

Identification of populations eligible for lung cancer screening (LCS) is a priority question in this field. The primary objective of this study was to quantify lung cancer prevalence after a first round of LCS among patients with history of atheromatous cardiovascular disease (aCVD) and tobacco exposure.

Methods

We performed a prospective bi-centric descriptive quantification of lung cancer prevalence among patients aged 45–75 years old with minimal history of 10 years of daily smoking and aCVD who underwent a chest computed tomography (CT) in an intend to screen. We also described lung cancer stage at diagnosis and treatments, we evaluated the eligibility of our population to the National Lung Screening Trial (NLST) and the Dutch-Belgian randomized controlled trial (NELSON) and described main quality metrics of LCS clinical path.

Results

Among 505 participants who underwent a chest CT 159/505 (31%) did not met NLST nor NELSON eligibility criteria, 19/505 (3.8%) participants presented a positive screening. We diagnosed 16 cancers in 15 patients resulting in a LC prevalence of 2.97% (15/505). Among 16 lung cancers, 11 were stage I or II (75%). All patients with lung cancer received specific treatments including 12 surgeries alone, 2 surgeries with adjuvant systemic therapy, 1 radiation with systemic therapy and one systemic therapy alone; there was no postoperative severe morbidity (i.e. Clavien Dindo ≥ 3).

Conclusions

Our exploratory descriptive prospective study suggests that age 45–75 years-old, daily smoking for 10 years and aCVD may be evaluated in future studies as additional LCS eligibility criteria to existing LCS eligibility criteria.

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Keywords : Lung cancer screening, Lung cancer, Atheromatous cardiovascular diseases, Tobacco, Prevalence