Inserm U1290, Université Claude Bernard Lyon 1, Research on Healthcare Performance (RESHAPE)
Bristol Myers Squibb, Paris, France
Thèse : Health economic evaluation and sustainability of lung cancer screening in France, as part of the IMPULSION program
Année d'inscription : 2026
Co-directeurs : Pr Sébastien Couraud, Pr Isabelle Durand-Zaleski, Dr Emmanuel Grolleau, Dr François-Emery Cotté
Résumé :
Background
Lung cancer represents the leading cause of cancer-related mortality in France and worldwide. Due to late-onset symptomatology, nearly three-quarters of diagnoses occur at advanced stages (III–IV), associated with poor prognosis and high management costs. Conversely, cancers diagnosed at an early stage now benefit from effective curative treatments, with five-year survival rates reaching up to 90%. In this context, targeted screening by low-dose computed tomography (LDCT) in high-risk populations has emerged as a promising strategy. Several international randomized trials have demonstrated a significant reduction in lung cancer-specific mortality, primarily attributable to stage migration at diagnosis (stage-shift). However, implementation of organized screening in France raises major organizational and economic challenges.
Objectives
The primary objective of this thesis is to estimate the cost-effectiveness ratio of lung cancer screening in France within the framework of the national pilot program IMPULSION. Secondary objectives include assessment of the budget sustainability of this strategy, the organizational impact on French healthcare system, and the influence of therapeutic innovations according to stage at diagnosis. Exploratory analyses may also examine the medical and ecological impact of implementing such a strategy.
Methods
A health economic analysis will be conducted using a simulation model developed or adapted to the French context. This model will be based on data from the IMPULSION program, which plans to enroll 20,000 participants aged 50 to 74 years, current or former smokers at risk, as well as on national reference cohorts and the literature. The LDCT screening strategy will be compared to a no-screening scenario. Outcomes will be expressed in life-years gained and quality-adjusted life-years (QALYs), with estimation of the incremental cost-effectiveness ratio and sensitivity analyses.
Perspectives
This work aims to provide robust evidence to support decision-making for health authorities, by evaluating the efficiency and sustainability of organized lung cancer screening in France, prior to potential nationwide implementation.
Lucie SIMON is a PhD candidate in public health, specializing in health economic evaluation applied to oncology. She holds a bachelor’s degree in mathematics and computer science, which she complemented with a master’s degree in public health, giving her strong dual expertise in quantitative methods and epidemiology.
Prior to beginning her doctoral studies, she worked for four years as a Clinical Research Associate in the Thoracic Oncology department at Hôpital Lyon Sud, where she gained extensive hands-on experience in clinical trial management and the care of patients with lung cancer.
Her PhD research focuses on the health economic evaluation and financial sustainability of lung cancer screening in France, conducted within the national IMPULSION program. Her work aims to assess the cost-effectiveness of a large-scale organized screening deployment, integrating economic modeling and budget impact analyses within the French healthcare system.
