Introduction: Lung cancer screening by Low-Dose CT scan (LDCT) demonstrated in prior randomized controlled trials a decrease in lung cancer mortality as in overall mortality. Despite these results, organized screening in France remains challenged.

Objectives: Assess in real life the feasibility and efficacy of lung cancer screening in a French administrative territory. 

Patients and Methods: DEP KP80 was a single-arm, prospective study. Participants aged 55-74 years, current or former smokers of ?30 pack-years, were recruited. An annual LD CT scan was scheduled and 3 rounds completed. Our algorithms considered nodules <5mm as negative findings, and nodules >10mm as positive; for intermediate nodules between 5 and 10mm, 3-month CT scan with doubling time measurement was recommended. Subjects were selected by general practitioners or pulmonologists who checked the inclusion criteria and prescribed the LD CT scan.

Results: Between March 2016 and February 2020 we enrolled 1369 participants (mean age 61.1 ± 5.4 years, sex ratio M/F 1.94). One thousand twenty nine subjects (75.1%) underwent baseline LDCT (T0), 396 (38.4%) completed the first round (T1) and 286 (28.4%) the second (T2). LDCT was positive in 6.5% at T0, 4.5% at T1 and 1.7% at T2. At baseline, 31 cancers were found, 10 at T1 and 2 at T2. The cumulative incidence of lung cancer was 2.5% and the false positive rate 2.74%. Thirty one lung cancers (72.1%) were stage I or II and 35 cancers (81.4%) were treated with surgery alone or combined.

Conclusion: This study demonstrated the feasibility and efficacy of lung cancer screening in a real-life context but also the importance of raising awareness of participation at all rounds.