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Brief Title: Randomized Trial to Assess the Impact of a Screening Program on Upper Aerodigestive Tract Cancer Mortality in a High Risk Population
Official Title: DEPISTORL - THANCS (Trial of Head And Neck Cancer Screening) Randomized Multicenter Trial to Assess the Impact of a Screening Program for Heavy Alcohol Drinkers and Smokers Treated in Alcohol Addiction Clinics on Upper Aerodigestive Tract Cancer Mortality.
Study ID: NCT00359645
Brief Summary: Randomized multicenter trial to assess the impact of a screening program for heavy alcohol drinkers and smokers treated in alcohol addiction clinics on upper aerodigestive tract cancer mortality.
Detailed Description: Upper aerodigestive tract (UADT) carcinomas (oral cavity and pharynx (63%), larynx (17%) and esophagus (20%)), are frequent in France with 25.000 new cases annually estimated in 2000, representing 13% of men cancer (3rd rank). Five-year specific survival rate is approximately 50% (11.000 deaths per year) and has not improved in over three decades, primarily due to the advanced stage at presentation. UADT cancers are also associated with profound disease- and treatment-related morbidity, with alterations in speech and feeding functions, aesthetic disability, with familial and social consequences. The high-risk population is well characterized. A synergistic effect of tobacco smoking and alcohol drinking increases the risk of developing a carcinoma by more than 100 fold. Each year, 30.000 alcohol drinkers are treated in alcohol addiction clinics and could benefit from cancer detection. Nonrandomized pilot studies have showed that a UADT cancers screening trial could be undertaken in these clinics. Study design: prospective randomized trial comparing an observation group and a screening group. Subjects in the screening group will undergo annual screening test including head and neck clinical examination with a fiberoptic nasolaryngoscopy and an oesopharyngeal brush biopsy with cytological examination during a 3-years period. In case of a positive test, patients will undergo head and neck panendoscopy and/or digestive flexible endoscopy and/or biopsy. After the screening period, subjects will be followed during 2 additional years by annual health questionnaires. Subjects of the observation group will be followed during 5 years by annual health questionnaires. Recruitment will be performed in alcohol addiction clinics and screening tests and confirmation exams in the closest specialized head and neck clinics. The primary objective is to demonstrate a decrease in the UADT cancer mortality after a screening strategy, including head and neck clinical examination with a fiberoptic nasolaryngoscopy and an oesopharyngeal brush biopsy with cytological examination repeated annually during 3 years. Subjects will be followed during 5 years. A sample size of 10.000 subjects in each group allows the detection of a 33% reduction in the specific mortality rate, with a power of 80% and with a one sided a-risk of 5%.
Minimum Age: 40 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: Yes
Centre Hospitalier MONTPERRIN, Aix en Provence, , France
CHIAB Annemasse Bonneville, Annemasse, , France
Centre Hospitalier d'ARRAS, Arras, , France
CHS de L'Yonne, Auxerre, , France
Chg Beziers, Beziers, , France
CHU H么pital Gabriel Montpied, Clermont-ferrand, , France
C.A.S.A., Clermont, , France
Centre Hospitalier de DIEPPE, Dieppe, , France
CHU le Bocage, Dijon, , France
Centre Hospitalier Louis Sevestre, La Membrolle Sur Choisille, , France
Centre Hospitalier du Mans, Le Mans, , France
Centre Hospitalier de LENS, Lens, , France
CHU de Lille, Lille, , France
CHBS Lorient, Lorient, , France
Centre hospitalier Lyon sud, Lyon, , France
Centre Hospitalier des Chanaux, Macon, , France
CHU de Nancy, Nancy, , France
CHU de Nantes, Nantes, , France
H么pital ARCHET II, Nice, , France
Centre ANPAA d'Orl茅ans, Orl茅ans, , France
Centre Paul C茅zanne, Orl茅ans, , France
H么pital de la Source, Orl茅ans, , France
Clinique Philae, Pont Pean, , France
Centre Hospitalier du Centre Bretagne, Pontivy, , France
Centre ANPAA 51 de Reims, Reims, , France
CHU H么pital Pontchaillou, Rennes, , France
Hopital de Saint Cloud, Saint Cloud, , France
CHR de la R茅union, Saint-denis de La Reunion, , France
Ch Saint-Egreve, Saint-egreve, , France
Centre de soins de suite Marienbronn, Soultz-sous-forets, , France
CHU de Strasbourg - H么pital Hautepierre, Strasbourg, , France
H么pitaux du Leman, Thonon Les Bains, , France
Chba Vannes, Vannes, , France
Hopital Paul Brousse, Villejuif, , France
Institut_Gustave-Roussy, Villejuif, , France
Name: St茅phane TEMAM, PhD
Affiliation: Gustave Roussy, Cancer Campus, Grand Paris
Role: PRINCIPAL_INVESTIGATOR