Jérôme Salomon, Chief Medical and Science Officer at Zoī, shared a post on LinkedIn:
“Cancer screening: what the science says
An early cancer:
- it is a different biology,
- localized tumor, not yet disseminated into blood vessels, lymph nodes, or organs in the form of metastases
- treatment options are broader and often simpler.
Early dépistage précoce results in gaps of survie to 5 years that speak for themselves:
- sein cancer: 99% in stage I vs. 29% in stage IV
- col cancer: 92% vs. 17%
- Cancer colorectal: 90% vs. 14%
- poumon cancer: 63% vs. 7%
What the large trials established:
Breast
Biennial mammographie in all femmes aged 50 to 74 years reduces specific mortality by 15 to 20% (Cochrane meta-analyses, USPSTF).
The IRM is recommended from the age of 30 for BRCA1/2 women (sensitivity ~90% vs. ~75% for mammography).
Cervix
The first-line HPV test, adopted in France since 2020, achieves 94–96% sensitivity for high-grade lesions, compared to 55–80% for cytology alone (Lancet, Ronco et al., 2014).
Cytology-based screening programs have reduced mortality by more than 80% in the Nordic countries in 40 years.
Colorectal
Immunological tests for occult saignement are the first line from the age of 50.
coloscopie goes further than detection: it prevents cancer by removing polypes. The NordICC trial (NEJM, 2022) shows an 18% reduction in incidence and 50% mortality in participants
Lung
Low-dose scanner in high-risque fumeurs (≥ 20 pack-years, 50–80 years) reduces mortality from 20% (NLST, NEJM 2011) to 33% in females (NELSON, NEJM 2020).
This year, France is launching an organized national screening program for the leading cause of cancer mortality. (33,000 deaths/year).
We study the sensitivity, specificity, and predictive values of the thoracic CBCT
The scientific rigor imposes nuances, depending on the relevance and quality of screening, the rigorous analysis of results, and the appropriate diagnostic and curative management.
In the interest of public health, the programs must be validated by clinical trials with good outcomes and analysis of quality of life, morbidity, mortality, survival.
Participating in screening is a choice, an approach, a trade-off, not a guarantee, but it is one of the few preventive medicine interventions where the individual can modify their own risk of cancer death.
OLD: CIRC@60 – Cancer Research in Action.”
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