Abstract
Occupational lung cancers are under-reported and under-compensated worldwide. We assessed systematic screening for occupational exposure to carcinogens combining a self-administered questionnaire and an occupational consultation to improve the detection of occupational lung cancers and their compensation. Social deprivation and the costs of this investigation were estimated. Patients with lung cancer received a self-administered questionnaire to collect their job history, potential exposure to carcinogens and deprivation. A physician assessed the questionnaire and recommended an occupational consultation if necessary. During the consultation, a physician assessed if the lung cancer was work-related and, if it was, delivered a medical certificate to claim for compensation. Over 18 months, 440 patients received the self-administered questionnaire: 234 returned a completed questionnaire and a consultation was required for 120 patients. Compensation was judged possible for 41 patients. Among the 35 medical certificates delivered, 19 patients received compensation. Nearly half the patients (46%) were assessed as socially deprived and these patients took significantly longer to return the questionnaire compared with those who were not deprived. The mean cost of the process was €62.65 per patient. Our results showed a systematic self-administered questionnaire can be used to identify patients potentially exposed to carcinogens and to improve compensation.
Highlights
Lung cancer is the most common cancer (12.9% of all cancers) with 1.8 million new cases diagnosed worldwide annually [1]
Between March 2014 and September 2015, 588 of the 1028 patients who were screened by the weekly Center Léon Bérard (CLB) multidisciplinary lung cancer board did not meet the inclusion criteria: managed in another hospital (N = 340); not lung cancer (N = 81); only radiotherapy in the CLB (N = 46); already had had an occupational consultation (N = 39); no histological confirmation (N = 25); benign pathology (N = 24); second opinion (N = 14); deceased (N = 10); severe general health deterioration (N = 8); and did not speak French (N = 1)
Our study evaluated a systematic approach to identify occupational exposure in lung cancer patients attending a comprehensive cancer center in France to improve the reporting of occupational lung cancers
Summary
Lung cancer is the most common cancer (12.9% of all cancers) with 1.8 million new cases diagnosed worldwide annually [1] It is the most common cause of cancer death worldwide with. Tobacco consumption accounts for 80–85% of lung cancers [2,3] and secondhand smoking is an established risk factor [4,5]. Synergistic carcinogenic effects of tobacco smoke with occupational exposure have been reported [11]. Lung cancer patients have a lower socio-economic status compared with the general population [12] related to a higher prevalence of risk factors such as smoking and exposure to occupational lung carcinogens [4,13,14]
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