Professor Marie-Pierre Revel, SOLACE Project lead for France and Head of the Radiology Department at Cochin Hospital in Paris, is working at the forefront of efforts to improve lung cancer screening in France.
With plans to implement a national screening programme by the end of 2025, important groundwork has been laid thanks to Prof Revel’s leadership in the CASCADE study. Watch to learn about her team’s approach:
Prof Revel’s team decided to focus on women to address rising rates of lung cancer among women and because of the lack of evidence about how best to engage them in screening.
The study focused exclusively on women aged 50 to 74 years who were current or former smokers, aiming to recruit over 2,500 participants through family doctors, radiology centres, specialist clinics and media promotion. Prof Revel’s team sought to understand how to reach women more effectively, and how to adapt lung cancer screening programmes to their specific needs.
One notable finding was the unexpectedly high rate of positive screening results. Nearly 16% of women screened had findings requiring further investigation, which is higher than in earlier mixed-gender studies. Importantly, more than half of the cancers detected were at an early stage (stage 1 or 2), when treatment is most effective.
The results showed that women who smoke or have smoked in the past can benefit greatly from lung cancer screening. Taking part while feeling healthy can help find cancer earlier, when it is easier to treat and more likely to lead to better outcomes.
Identifying who should be invited to screening is not always straightforward, as it is intended only for people at higher risk. This usually includes those aged 55 to 74 years with a history of smoking 20 pack years or more, which means smoking the equivalent of one pack of 20 cigarettes a day for 20 years.
While age criteria are clear and easier for healthcare providers to track, gathering accurate information about smoking history can be difficult, especially for people who stopped smoking many years ago.
Another key challenge is encouraging women to take part without fear or stigma. Many initially hesitate, worried that a positive finding will mean a poor prognosis or because they feel ashamed about being a current or former smoker.
SOLACE’s message is that no one should blame themselves for nicotine addiction. Tobacco products are highly addictive, which the tobacco industry has exploited using aggressive marketing for decades. Instead, the focus should be on doing the best thing for your health by attending screening. It can save lives by finding cancer early, and support and resources to help people quit smoking will be provided during the process.
“It’s very important to share the message that when lung cancer is diagnosed early, it is curable,” Prof Revel says.
One of SOLACE’s key goals is to identify which strategies work best for engaging people at the highest risk of lung cancer and encouraging them to attend screening, even if they feel well or are nervous about a possible diagnosis. What works in one country may not be as effective elsewhere.
“In Greece, it was the strategy of online news,” Prof Revel explains. “What worked better in France was to combine it with breast cancer screening.”
Because both types of screening rely on imaging, women attending breast cancer screening appointments could be informed about lung screening during the same visit. This approach helped normalise lung checks as part of routine preventive care.
France continues to work towards establishing a national lung cancer screening programme. The experience gained through CASCADE and SOLACE will play a vital role in shaping how screening is designed and delivered in the future.
By sharing lessons through SOLACE, Prof Revel hopes more countries will find effective ways to reach people at risk, help reduce fear and stigma around lung cancer screening, and give more people the chance of early diagnosis and treatment.
