[Why screen for lung cancer in patients with arterial disease?].
Lung cancer remains the leading cause of cancer death in France. Such a prognosis is explained by late diagnosis at a metastatic stage for half of the patients. Tobacco is the main risk factor for lung cancer, as it is for peripheral arterial disease. A review of literature shows that between 2.3% and 19% of patients with arterial disease also have lung cancer. When lung cancer is detected after treatment of arterial disease, it is at an advanced stage. But it can be diagnosed at an early stage when it is searched simultaneously with arterial disease treatment. There is no recommendation for lung cancer screening specifically for patients with arterial disease. However individual screening based on an annual low-dose chest scan is proposed for smokers meeting the criteria defined by the study of the National Lung Screening Trial (NLST). Such screening has two disadvantages : the high number of false positives and the irradiation induced by the accumulation of examinations. The ISET method would alternatively help to identify circulating tumor cells on a simple blood test for subjects not yet at solid tumor stage, provided this method be subject to multicentric validation. Thus one could consider that the management of a patient with arterial disease meeting NLST criteria should be accompanied with screening for lung cancer by searching for tumor cells associated with low-dose scanner.
Service des urgences, centre hospitalier de Rambouillet, 5, rue Pierre-et-Marie-Curie, 78120 Rambouillet, France.
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Lederlin
Service d'oncologie thoracique, groupe hospitalier Paris Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France.
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Trédaniel
Service de médecine vasculaire, groupe hospitalier Paris Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France. Electronic address: ppriollet@hpsj.fr.
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Priollet
D017544:Aortic Aneurysm, Abdominal / Q000453:epidemiology / Q000209:etiology; D015897:Comorbidity; D003584:Cytological Techniques; D057210:Delayed Diagnosis; D004198:Disease Susceptibility; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008175:Lung Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D008297:Male; D009360:Neoplastic Cells, Circulating; D058729:Peripheral Arterial Disease / Q000453:epidemiology* / Q000209:etiology; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D011829:Radiation Dosage; D000069079:Radiation Exposure; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D014057:Tomography, X-Ray Computed / Q000379:methods
Artériopathie; Cancer du poumon; Cellules tumorales circulantes; Circulating tumor cells; Dépistage; Low-dose scan; Lung cancer; Peripheral arterial disease; Scanner faiblement irradiant; Screening