1
|
Fervers B, Pérol O, Lasset C, Moumjid N, Vidican P, Saintigny P, Tardy J, Biaudet J, Bonadona V, Triviaux D, Marijnen P, Mongondry R, Cattey-Javouhey A, Buono R, Bertrand A, Marec-Bérard P, Rousset-Jablonski C, Pilleul F, Christophe V, Girodet M, Praud D, Solodky ML, Crochet H, Achache A, Michallet M, Galvez C, Miermont A, Sebileau D, Zrounba P, Beaupère S, Philip T, Blay JY. An Integrated Cancer Prevention Strategy: the Viewpoint of the Leon Berard Comprehensive Cancer Center Lyon, France. Cancer Prev Res (Phila) 2024; 17:133-140. [PMID: 38562091 PMCID: PMC10985472 DOI: 10.1158/1940-6207.capr-23-0386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 01/02/2024] [Accepted: 02/12/2024] [Indexed: 04/04/2024]
Abstract
This article describes some of the key prevention services in the Leon Berard Comprehensive Cancer Center (CLB) Lyon, France, which are based on clinical prevention services, outreach activities, and collaboration with professional and territorial health communities. In addition, research is embedded at all stages of the prevention continuum, from understanding cancer causes through to the implementation of prevention interventions during and after cancer. Health promotion activities in the community and dedicated outpatient primary cancer prevention services for individuals at increased risk have been implemented. The CLB's experience illustrates how prevention can be integrated into the comprehensive mission of cancer centers, and how in turn, the cancer centers may contribute to bridging the current fragmentation between cancer care and the different components of primary, secondary, and tertiary prevention. With increasing cancer incidence, the shift toward integrated prevention-centered cancer care is not only key for improving population health, but this may also provide a response to the shortage of hospital staff and overcrowding in cancer services, as well as offer opportunities to reduce carbon emissions from cancer care.
Collapse
Affiliation(s)
- Beatrice Fervers
- Department of Prevention, Cancer and Environment, Léon Bérard Cancer Center, Lyon, France
- Inserm U1296 Radiations: Defense, Health, Environment, Léon Bérard Cancer Center, Lyon, France
| | - Olivia Pérol
- Department of Prevention, Cancer and Environment, Léon Bérard Cancer Center, Lyon, France
- Inserm U1296 Radiations: Defense, Health, Environment, Léon Bérard Cancer Center, Lyon, France
| | - Christine Lasset
- Department of Prevention and Public Healthcare, Léon Bérard Cancer Center, Lyon, France
| | - Nora Moumjid
- Department of Prevention, Cancer and Environment, Léon Bérard Cancer Center, Lyon, France
- UR 4129, P2S, Université Lyon 1, Lyon, France
| | - Pauline Vidican
- Department of Prevention, Cancer and Environment, Léon Bérard Cancer Center, Lyon, France
- Inserm U1296 Radiations: Defense, Health, Environment, Léon Bérard Cancer Center, Lyon, France
| | - Pierre Saintigny
- Department of Medical Oncology, Léon Bérard Cancer Center, Lyon, France
- CRCL, University Lyon, Claude Bernard Lyon 1 University, Inserm 1052, CNRS 5286, Centre Léon Bérard, Cancer Research Center, Lyon, France
| | - Juliette Tardy
- Department of Prevention, Cancer and Environment, Léon Bérard Cancer Center, Lyon, France
- Inserm U1296 Radiations: Defense, Health, Environment, Léon Bérard Cancer Center, Lyon, France
| | - Julien Biaudet
- Department of Prevention, Cancer and Environment, Léon Bérard Cancer Center, Lyon, France
- Inserm U1296 Radiations: Defense, Health, Environment, Léon Bérard Cancer Center, Lyon, France
| | - Valérie Bonadona
- Department of Prevention and Public Healthcare, Léon Bérard Cancer Center, Lyon, France
| | - Dominique Triviaux
- Interdisciplinary Department of Supportive Care in Oncology, Léon Bérard Cancer Center, Lyon, France
| | - Philippe Marijnen
- Department of Prevention, Cancer and Environment, Léon Bérard Cancer Center, Lyon, France
| | - Rodolf Mongondry
- Department of Prevention, Cancer and Environment, Léon Bérard Cancer Center, Lyon, France
| | | | - Romain Buono
- Department of Prevention, Cancer and Environment, Léon Bérard Cancer Center, Lyon, France
| | - Amandine Bertrand
- Department of Pediatric Oncology, Institut d'Hématologie et d'Oncologie Pédiatrique, Léon Bérard Cancer Center, 69008 Lyon, France
- INSERM U1290 RESearch on HealthcAre PErformance (RESHAPE), University Claude Bernard Lyon 1, Lyon, France
- Département de Sciences Humaines et Sociales (SHS), Léon Bérard Cancer Center, Lyon, France
| | - Perrine Marec-Bérard
- Department of Pediatric Oncology, Institut d'Hématologie et d'Oncologie Pédiatrique, Léon Bérard Cancer Center, 69008 Lyon, France
| | - Christine Rousset-Jablonski
- INSERM U1290 RESearch on HealthcAre PErformance (RESHAPE), University Claude Bernard Lyon 1, Lyon, France
- Department of Surgery, Léon Bérard Cancer Center, Lyon, France
| | - Frank Pilleul
- Department of Radiology, Léon Bérard Cancer Center, Lyon, France
- CREATIS, UMR CNRS 5220 – INSERM 1206, Université Claude Bernard Lyon 1, Lyon, France
| | - Veronique Christophe
- CRCL, University Lyon, Claude Bernard Lyon 1 University, Inserm 1052, CNRS 5286, Centre Léon Bérard, Cancer Research Center, Lyon, France
- Département de Sciences Humaines et Sociales (SHS), Léon Bérard Cancer Center, Lyon, France
| | - Magali Girodet
- INSERM U1290 RESearch on HealthcAre PErformance (RESHAPE), University Claude Bernard Lyon 1, Lyon, France
- Département de Sciences Humaines et Sociales (SHS), Léon Bérard Cancer Center, Lyon, France
| | - Delphine Praud
- Department of Prevention, Cancer and Environment, Léon Bérard Cancer Center, Lyon, France
- Inserm U1296 Radiations: Defense, Health, Environment, Léon Bérard Cancer Center, Lyon, France
| | - Marie-Laure Solodky
- Department of Medecine of Health Care Workers, Léon Bérard Cancer Center, Lyon, France
| | | | | | - Mauricette Michallet
- Department of Prevention, Cancer and Environment, Léon Bérard Cancer Center, Lyon, France
- Department of Medical Oncology, Léon Bérard Cancer Center, Lyon, France
| | | | | | | | | | | | | | - Jean-Yves Blay
- Department of Medical Oncology, Léon Bérard Cancer Center, Lyon, France
- Unicancer, Paris, France
- Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, Lyon, France
| |
Collapse
|
2
|
Dessemon J, Perol O, Chauvel C, Noelle H, Coudon T, Grassot L, Foray N, Belladame E, Fayette J, Fournie F, Swalduz A, Neidhart EM, Saintigny P, Tabutin M, Boussageon M, Gomez F, Avrillon V, Perol M, Charbotel B, Fervers B. Survival of bronchopulmonary cancers according to radon exposure. Front Public Health 2024; 11:1306455. [PMID: 38328545 PMCID: PMC10847230 DOI: 10.3389/fpubh.2023.1306455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/18/2023] [Indexed: 02/09/2024] Open
Abstract
Introduction Residential exposure is estimated to be responsible for nearly 10% of lung cancers in 2015 in France, making it the second leading cause, after tobacco. The Auvergne-Rhône-Alpes region, in the southwest of France, is particularly affected by this exposure as 30% of the population lives in areas with medium or high radon potential. This study aimed to investigate the impact of radon exposure on the survival of lung cancer patients. Methods In this single-center study, patients with a histologically confirmed diagnosis of lung cancer, and newly managed, were prospectively included between 2014 and 2020. Univariate and multivariate survival analyses were carried out using a non-proportional risk survival model to consider variations in risk over time. Results A total of 1,477 patients were included in the analysis. In the multivariate analysis and after adjustment for covariates, radon exposure was not statistically associated with survival of bronchopulmonary cancers (HR = 0.82 [0.54-1.23], HR = 0.92 [0.72-1.18], HR = 0.95 [0.76-1.19] at 1, 3, and 5 years, respectively, for patients residing in category 2 municipalities; HR = 0.87 [0.66-1.16], HR = 0.92 [0.76-1.10], and HR = 0.89 [0.75-1.06] at 1, 3, and 5 years, respectively, for patients residing in category 3 municipalities). Discussion Although radon exposure is known to increase the risk of lung cancer, in the present study, no significant association was found between radon exposure and survival of bronchopulmonary cancers.
Collapse
Affiliation(s)
- Juliette Dessemon
- Département Prévention Cancer Environnement, Center Léon Bérard, Lyon, France
- Faculté de Médecine Lyon Est, Université de Lyon, Lyon, France
| | - Olivia Perol
- Département Prévention Cancer Environnement, Center Léon Bérard, Lyon, France
- Inserm UMR1296, “Radiation: Defense, Health Environment,” Center Léon Bérard, Lyon, France
| | - Cécile Chauvel
- Center of Excellence in Respiratory Pathogens (CERP), Hospices Civils de Lyon, Lyon, France
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Hugo Noelle
- Département Prévention Cancer Environnement, Center Léon Bérard, Lyon, France
- Faculté de Médecine Lyon Est, Université de Lyon, Lyon, France
| | - Thomas Coudon
- Département Prévention Cancer Environnement, Center Léon Bérard, Lyon, France
- Inserm UMR1296, “Radiation: Defense, Health Environment,” Center Léon Bérard, Lyon, France
| | - Lény Grassot
- Département Prévention Cancer Environnement, Center Léon Bérard, Lyon, France
- Inserm UMR1296, “Radiation: Defense, Health Environment,” Center Léon Bérard, Lyon, France
| | - Nicolas Foray
- Inserm UMR1296, “Radiation: Defense, Health Environment,” Center Léon Bérard, Lyon, France
| | - Elodie Belladame
- Département Prévention Cancer Environnement, Center Léon Bérard, Lyon, France
- Inserm UMR1296, “Radiation: Defense, Health Environment,” Center Léon Bérard, Lyon, France
| | - Jérôme Fayette
- Département de Cancérologie Médicale, Center Léon Bérard, Lyon, France
| | - Françoise Fournie
- Département Interdisciplinaire de Soins de Support du Patient en Oncologie, Center Léon Bérard, Lyon, France
| | - Aurélie Swalduz
- Département de Cancérologie Médicale, Center Léon Bérard, Lyon, France
| | | | - Pierre Saintigny
- Département de Cancérologie Médicale, Center Léon Bérard, Lyon, France
| | - Mayeul Tabutin
- Département de Chirurgie Cancérologique, Center Léon Bérard, Lyon, France
| | - Maxime Boussageon
- Inserm UMR1296, “Radiation: Defense, Health Environment,” Center Léon Bérard, Lyon, France
| | - Frédéric Gomez
- Département de Santé Publique, Center Léon Bérard, Lyon, France
| | - Virginie Avrillon
- Département de Cancérologie Médicale, Center Léon Bérard, Lyon, France
| | - Maurice Perol
- Département de Cancérologie Médicale, Center Léon Bérard, Lyon, France
| | - Barbara Charbotel
- Université de Lyon, Université Lyon 1, Université Gustave Eiffel-Ifsttar, Umrestte, UMR, Lyon, France
- CRPPE-Lyon, Center Régional de Pathologies Professionnelles et Environnementales de Lyon, Center Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Béatrice Fervers
- Département Prévention Cancer Environnement, Center Léon Bérard, Lyon, France
- Inserm UMR1296, “Radiation: Defense, Health Environment,” Center Léon Bérard, Lyon, France
| |
Collapse
|