2023-07-03 23:59:17
First cause of death in men and second in women, cancer continues to progress in metropolitan France. In 2023, 433,136 new cases were diagnosed, compared to 382,000 in 2018, according to estimates released on Tuesday July 4 by Public Health France, the National Cancer Institute (Inca), the Hospices Civils de Lyon and the French network of cancer registries. If we go back to 1990, this corresponds to a doubling of cases in both men and women.
An expected phenomenon, according to Professor Norbert Ifrah, President of the Inca: “This increase is mainly linked to the increase in the population and its aging as well as to the improvement of diagnostic methods”, he pointed out during the presentation of the study, which shows a more surprising trend: a faster progression of cancers in women than in men.
Smoking on the front line
Although the latter represent 57% of the cases diagnosed, the increase in the incidence rate in this population remains contained (+0.3% per year since 1990), with a tendency to stabilize since 2010. Among women, on the other hand, the increase has been 0.9% per year since 1990 and this on a continuous basis.
How to explain this difference? Mainly by avoidable risk factors such as tobacco, alcohol, overweight, physical inactivity. While they are to blame in 20% of cases in men, these factors are involved in nearly half of cancers in women.
“Anti-tobacco campaigns have had an impact on men’s consumption, but the reduction is much less for women. Today, one in four continues to smoke,” recalls Doctor Nicolas Bertrand, medical oncologist at the University Hospital of Lille. As a result, lung cancer, long considered a male cancer, is affecting more and more women: in 2023, 19,339 cases were diagnosed, making it the third most common cancer, behind breast cancer and colon-rectal cancer.
“Do everything so that young girls do not start to smoke”
This increase is all the more worrying “that lung cancer is one of those for which we still have very poor survival rates, unlike breast cancer”emphasizes Nicolas Bertrand. “This trend was already taking shape and follows that observed in the United States: a stagnation then a slight decrease in mortality among men, while among women, there is a slight increase”, observes for his part Professor Christos Chouaid, pulmonologist at the intercommunal hospital center of Créteil.
Hence the need, according to him, to strengthen prevention against smoking, especially among young people. “It takes years of tobacco intoxication to develop cancer, it is now that it is played, he insists. Everything must be done to prevent young girls from starting to smoke and young women to stop. »
While cigarettes are not responsible for all lung cancers – 10% of those affected have never smoked – they are also involved in other cancers which are also increasingly affecting women, such as bladder, or cancers of the upper aerodigestive tract (larynx, esophagus, etc.), also linked to alcohol consumption.
Women are more quickly dependent than men
From there to “gendered” prevention? Sociologist Caroline de Pauw is in favor of it. “The fact is that when it comes to addictions we are not equalemphasizes the researcher, recalling that “Biologically, women are more quickly dependent than men. Add that to the fact that they live longer and you can see why they are targeted by alcoholics and the tobacco industry. »creaks Caroline de Pauw, still bewildered by the marketing on the Internet of candy pink laughing gas cartridges – nitrous oxide – with strawberry flavor. “It is not in France’s DNA, but the authorities must decide to carry out differentiated campaigns, explaining why the risks of alcohol and tobacco are even more serious among women.she pleads. In terms of prevention, it is not equality but equity that we must aim for. »
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The leading cause of death in France
In mainland France, the number of cancer cases has doubled between 1990 and 2023 in both sexes. This trend is observed in the majority of European countries in 2020.
Cancer remains the leading cause of death in France, with 157,400 deaths in 2018.
In man, the most common cancer remains that of the prostate (59,885 cases), followed by the lung (33,438 cases) and the colon-rectum (26,212 cases).
In the woman, it is still breast cancer (61,214 cases), then colorectal cancer (21,370 cases) and lung cancer (19,339 cases).
Median age at diagnosis is 70 years for men and 68 years for women.
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