Organized Lung Cancer Screening of Subjects Occupationally Exposed to Lung Carcinogens: The LUng Cancer Screening Occupational exposure Study Entry Findings

Our plain-English summary of Organized Lung Cancer Screening of Subjects Occupationally Exposed to Lung Carcinogens: The LUng Cancer Screening Occupational exposure Study Entry Findings, by F. Delva, S. Gendarme, L. Boudet, et al (JTO Clinical and Research Reports, 2026).

The study

• Authors: F. Delva, S. Gendarme, L. Boudet, M. Zysman, C. Fuhrman, P.Y. Brillet, P. Brochard, C. Paris, O. Bylicki, V. Le Denmat, B. Loddé, M. Belacel, N. Abdessemed, M. Despagne, K. Jaunas, A. Lacourt, B. Clin, J.F. Gehanno, F. Laurent, G. Dournes, S. Mathoulin-Pélissier, C. Chouaïd, J.C. Pairon
• Journal: JTO Clinical and Research Reports
• Published: 2026;7(6):100995
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Introduction: The LUng Cancer Screening Occupational exposure (LUCSO) program was designed as a feasibility study of organized screening for lung cancer in subjects with occupational exposure to lung carcinogens in France. Herein, we report the program's entry-level (baseline) findings.

Methods: The inclusion criteria were subjects aged 55 to 74 years, with sufficient exposure to International Agency for Research on Cancer group 1 occupational carcinogens and smoker or ex-smoker for less than 15 years. The first phase of the study addressed subjects aged 65 to 74 years in two French regional counties to test feasibility. Lung cancer screening was based on a low-dose computed tomography (CT) scan at baseline and spirometry, followed by an annual CT scan for 2 years and telephone follow-up at 3 years.

Results: Letters were sent to 247,152 subjects from the Regional Cancer Screening Coordination Center inviting them to participate, allowing eligibility screening by letter. Among the 21,502 respondents (8.7%), 311 (1.4%) were included. Asbestos exposure predominated (92%), but co-exposures were also frequent (73% crystalline silica and 48% welding fumes); 45% were active smokers at inclusion, and 37% of them agreed to consult a smoking-cessation specialist. Baseline CT scans revealed anomalies in 19 (6.1%); seven (2.4%) were diagnosed with the following stages of lung cancer: three stage IA, three stage IIA, and one stage IIB; the false-positive rate was 4.2%.

Conclusion: Before considering nationwide implementation, this feasibility study provided new real-life insights finding that the selected population was indeed at high risk of lung cancer and that screening effectively detected early stages.

© 2026 The Authors.

In plain English

This article reported baseline results of LUCSO, a French feasibility study of low-dose CT lung cancer screening for smokers, or ex-smokers who quit under 15 years earlier, with sufficient workplace exposure to specified lung carcinogens; required pack-years depended on the exposure. Between February 2022 and June 2023, letters went to 247,152 people aged 65 to 74 in two departments. Of 21,451 who returned questionnaires, 513 were judged eligible and 311 were included; 306, nearly all men, were analyzed. Asbestos exposure was found in 278 of the 306 (90.8%). At baseline, 16 scans were positive and 73 uncertain, and four uncertain scans became positive at 3 months. Seven people (2.3% of the 306 screened) were diagnosed with lung cancer, at stages IA to IIB; the false-positive rate was 4.2%. Scans also showed emphysema in 139 people and pleural plaques in 9. The authors concluded that the findings confirmed high lung cancer risk in this population and that screening detected early-stage cancers. They noted that recruitment probably highly selected the population and that more concerned people may have responded more, possibly raising the cancer rate.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Prospective, multicenter cohort study (feasibility study of organized lung cancer screening). This report covers the baseline (entry) screening round only.
• Who was studied: Residents aged 65 to 74 years in two French departments (Gironde and Val-de-Marne) were invited by letter between February 2022 and June 2023. Of 247,152 invited, 311 were included and 306 were analyzed. Nearly all were men, with a median age of 69.0 years. All were smokers, or ex-smokers who had quit less than 15 years earlier, with sufficient exposure to IARC group 1 occupational lung carcinogens. The minimum pack-years required depended on the type and level of exposure (Table 1).
• Exposure: Occupational exposure to IARC group 1 lung carcinogens, together with tobacco smoking. Among the 306 participants, 90.8% were exposed to asbestos and 69.9% were exposed for more than 10 years. Fiber types are not specified. Other common exposures were crystalline silica (70%), welding fumes (48%) and painter's materiel (35%). At inclusion, 45% were active smokers, with an average of 38.9 pack-years (range 10 to 112).
• Main results:
  • Recruitment: of 247,152 people invited, 21,451 returned questionnaires (8.7%) and 513 were deemed eligible (2.4%). Of these, 311 were included (60.6% of eligible people).
  • Baseline CT results among the 306 participants scanned: 217 negative (70.9%), 16 positive (5.2%) and 73 indeterminate (23.9%). Four of the indeterminate scans were deemed positive at 3-month follow-up.
  • Seven of the 20 participants with positive findings were diagnosed with lung cancer: three at stage IA, three at stage IIA and one at stage IIB. The authors give the lung cancer diagnosis rate as 2.3%, which corresponds to the 306 participants screened.
  • The false-positive rate was 4.2%.
  • Other abnormalities seen on the 306 screening scans included emphysema in 139 (45.4%), severe coronary artery calcifications in 85 (27.8%), interstitial lung disease in 24 (7.8%) and pleural plaques in 9 (2.9%). One lymphoma was also diagnosed. On spirometry, 20% had an obstructive ventilatory disorder.
  • Of the 139 smokers, 52 (37.4%) agreed to schedule a stop-smoking consultation, and 45 of those 52 (86.5%) attended.
• The authors' conclusion: The authors concluded that the entry-level findings confirmed a high risk of lung cancer in the selected population. They also concluded that the screening was effective in detecting early-stage cancers and in revealing other previously unknown abnormalities, especially relevant to cardiovascular disease prevention.
• Limitations the authors state:
  • The recruitment method (inviting everyone by age) probably highly selected the population, which does not reflect the general population's workplace exposure to lung carcinogens.
  • The authors described as possible that people who felt most concerned responded more often. They said this could have selected higher-risk subjects and raised the lung cancer rate found.
  • No data were yet available on how many smokers actually quit.

Topics

Medical terms in this study, explained in our Lexicon: Low-Dose CT Screening, Occupational Exposure, Lung Cancer, Spirometry, CT Scan, Asbestos Exposure, Crystalline, Stage IA.

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• Interstitial Lung Abnormalities Detected by CT in Asbestos-Exposed Subjects Are More Likely Associated to Age — F. Laurent, I. Benlala, et al. (2021)
• Deep Learning for the Automatic Quantification of Pleural Plaques in Asbestos-Exposed Subjects — I. Benlala, B.D. De Senneville, et al. (2022)
• CT scan screening is associated with increased distress among subjects of the APExS — C. Paris, M. Maurel, et al. (2010)
• AI-Driven Automated Detection of Pleural Plaques on Chest CT Scans in Retired Asbestos-Exposed Workers — Y. Petitpas, I. Benlala, et al. (2026)
• Absence of multiplicative interactions between occupational lung carcinogens and tobacco smoking: a systematic review involving asbestos, crystalline silica and diesel engine exhaust emissions — M. El Zoghbi, P. Salameh, et al. (2017)

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