OBJECTIVES: Since 2004, France has implemented several national environmental health plans aimed at addressing the effects of environmental changes on public health, with a specific focus on prevention and risk reduction, including the incidence of cancer, particularly lung cancer (LC). This study seeks to assess the influence of socio-environmental factors on occurrence of metastatic LC and to estimate the additional burden associated with exposure to these factors.

METHODS: In this retrospective study, we merged the French national hospital claims databases (PMSI) with open data on environmental and socio-economic factors between 2017 and 2022. Via multivariate logistic regression (LR), we will assess the influence of socio-economic and environmental factors on the diagnosis of mLC in adult patients and estimate the additional burden associated with exposure to each socio-environmental factor using attributable fractions methodology. The project has received approval from the French regulatory authorities.

RESULTS: Out of 277,287 LC patients, 19% were diagnosed with mLC, with a mean age of 64.7 years (±10 years), 36.1% female. Upon completion of the on-going analyses, we will estimate the risk (odds ratios) of developing metastases associated with each factor to clarify their association with progression to mLC. Then, we will calculate the proportion of metastatic lung cancers attributable to each socio-environmental factor (greenhouse gas emission, radon, atmospheric pollution), along with the annual number attributable to each factor. Finally, the study will estimate the additional burden, defined as the extra number of hospitalizations and associated costs due to exposure to socio-environmental factors.

CONCLUSIONS: This pioneering study merges French open-access environmental data with national hospital claims data in lung cancer research to estimate the additional burden and costs associated with socio-environmental factors. The findings could provide valuable insights to policymakers on prioritization of preventive measures aimed at reducing exposure to environmental factors and lower their impact on the development of mLC.