Lung cancer screening using low-dose CT (LDCT) has been shown to reduce mortality in high-risk populations. In 2022, the French National Cancer Institute (INCa) issued guidelines recommending screening for individuals aged 50-74 with a history of heavy smoking, including current smokers or those who quit less than 15 years ago. A national pilot program (IMPULSION) will be launched in 2025. Lung cancer incidence is strongly correlated with socioeconomic status, yet underserved populations remain difficult to engage in screening programs. Mobile health units using a "reach-out" strategy have demonstrated effectiveness in other countries (UK, Brazil, USA). In France, this approach has been used for breast cancer screening via mobile mammography units. The MobILYAD project aims to compare two screening modalities- a mobile demedicalized unit (CT-equipped van with trained nurses) and a conventional hospital-based unit- to assess the effectiveness of mobile screening in reaching socially disadvantaged populations.
Study Type
OBSERVATIONAL
Enrollment
4,312
Participants undergo a low-dose chest CT scan to screen for early lung cancer and assess associated conditions (emphysema, coronary calcifications, osteoporosis).
Assessment of lung function through spirometry, with optional plethysmography and diffusion testing to detect COPD and PRISM patterns.
Cardiovascular risk is evaluated using SCORE2/SCORE2-OP tools, based on blood pressure and cholesterol levels.
Active smokers receive a structured smoking cessation intervention, including a baseline consultation and up to two follow-up sessions (which may be remote).
Optional collection of blood and exhaled breath condensate for future analysis of biomarkers in lung cancer detection.
" Centre de dépistage mobile " - Hôpital Lyon Sud
Pierre-Bénite, France
RECRUITINGService de Pneumologie " Centre de dépistage non mobile " - Hôpital Lyon Sud
Pierre-Bénite, France
RECRUITINGProportion of socially deprived participants included in the mobile screening group
The percentage of participants with an EPICES score ≥ 4 (indicating social vulnerability) in the mobile screening arm, compared to the non-mobile arm.
Time frame: Baseline (Day 0)
Participation by socio-demographic profile
Comparison of participants' characteristics between the two modalities (smoking status, age, sex, socio-professional category, income level, education, perceived ethnic identity, geographic isolation, presence of a general practitioner).
Time frame: Inclusion
Mobile feasibility
Feasibility of the mobile screening pathway, assessed by the attendance rate (proportion of invited participants who attend the mobile unit) and the completion rate (proportion of those attendees who complete the full screening process). Both will be reported separately as percentages. Unit of Measure: Percentage of participants (%)
Time frame: Throughout inclusion period
Feasibility of task-shifting to nurses
Rate of recourse to a physician and participant satisfaction in each modality.
Time frame: Throughout inclusion period
Adherence to intermediate CT scans
Proportion of participants who undergo intermediate follow-up CTs when required.
Time frame: Month 1, Month 3, Month 6 if clinically indicated
Adherence to 12-month CT scan
Proportion of participants who complete the scheduled CT scan at one year.
Time frame: At Month 12
Adherence to tobacco cessation consultations
Proportion of active smokers who attend the initial and, if applicable, follow-up cessation visits.
Time frame: Over 12 months
Smoking cessation success
Self-reported complete tobacco cessation at 12 months.
Time frame: At 12 months
Rate of positive screening
Proportion of participants with positive CT findings and subsequent medical workup.
Time frame: Up to 3 months post-initial CT
Lung cancer incidence
Number and percentage of participants diagnosed with lung cancer during the 12-month follow-up.
Time frame: Over 12 months
COPD detection relevance
Rate of new COPD diagnoses and associated therapeutic modifications; respiratory morbidity and mortality over 12 months.
Time frame: Baseline and 12 months
Cardiovascular risk detection relevance
Rate of high-risk participants identified, therapeutic implications, cardiovascular events over follow-up.
Time frame: Baseline and 12 months
Creation of biobank (Bio-ILYAD)
Proportion of participants consenting to blood and exhaled air sample collection for future biomarker research.
Time frame: At inclusion
Lung cancer staging
Distribution of lung cancer cases by stage at diagnosis (I-IV), as recorded in clinical reports. Number of participants per stage
Time frame: Within 12 months
Histological type of diagnosed lung cancers
Categorization of diagnosed lung cancers by histological type (e.g., adenocarcinoma, squamous cell carcinoma, small cell). Number of participants per histological category
Time frame: Within 12 month
Initial treatment of diagnosed lung cancers
Description and frequency of initial treatment modalities (e.g., surgery, radiotherapy, systemic therapy). Number of participants per treatment type
Time frame: Within 3 months of diagnosis
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