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In around thirty years, the number of new cases of cancer has almost doubled in mainland France, a more marked increase among women due in particular to an increase in smoking.
For 2023, the number of new cancers is estimated at 433,136 cases, indicates this work by Public Health France, the National Cancer Institute (Inca), the network of cancer registries Francim and the biostatistics-bioinformatics service of the Hospices Civils of Lyons (HCL).
“Between 1990 and 2023, the number of new cases of cancer doubled, with a 98% increase in cancers in men and 104% in women, all locations combined”according to this study published in the weekly epidemiological bulletin of SpF.
Men and women, different cancers
The median age at diagnosis is 70 years in men and 68 years in women, specifies this work on the 19 most common cancers and only invasive tumors. The increase in the incidence of cancers is linked to a large extent to the demographic evolution of France (growth and aging of the population), but also to an increase in the risk linked to behavior and lifestyles, note the researchers.
Among women, demographic changes explain only half of the increase in new cancers, much less than among men. The study’s estimates, based on cancer registries, are partly based on projections for the period 2019-2023, due to a lack of consolidated data. They therefore do not take into account the possible effects of the Covid crisis.
In France, cancer is the first cause of death in men, the second in women after cardiovascular diseases. Cancers of the prostate, breast, lung and colon-rectum remain the most frequent there, as in most European countries. If, in men, the most frequent cancers have seen their incidence drop or stabilize between 1990 and 2023, it is the opposite for women.
“For men, there are a lot of rather favorable evolutions, except for skin melanoma, pancreatic and kidney cancer which continue to increase. For women, the evolutions are unfavorable for more locations”, summed up Dr. Florence Molinié, president of Francim, during a press conference.
On the difference in incidence between men and women, “the major factor is tobacco consumption, which has increased from certain generations of women after those of men”she pointed.
Half of preventable cancers
Thus, in women, the incidence of cancers induced in part by tobacco (lip-mouth-pharynx, esophagus or lung) “increases considerably”, while it decreases in men, points out the study.
“There is a big signal of attention on mortality from lung cancer in women, which, in the next two to three years, will exceed mortality from breast cancer”underlined Pr Norbert Ifrah, president of the Inca, during a press conference.
Over the years, cancer-related mortality has generally decreased thanks to earlier diagnoses and therapeutic progress. But “nearly half of cancers could be avoided thanks to changes in our behavior and our lifestyles”, notes the preamble to the 2023 panorama of cancers released by the Inca.
Physical inactivity, obesity, smoking, alcohol consumption, exposure to ultraviolet rays are among these “avoidable causes”. The experts also insist on the screening programs (breast, colorectal and cervix cancer), the president of the Inca regretting a “very measured membership” for colorectal cancer. “We are working on lung cancer screening”, to calibrate (frequency, age, etc.) and to “associate with weaning assistance”he also said.
Detecting cancer at an early stage makes it easier to treat it, but also limits the after-effects of certain treatments. But the Covid has also weakened this fight. The impact of the pandemic crisis on the incidence of cancers, with delays in diagnosis and care, is not integrated into the work published on Tuesday, for lack of data. Hospitalizations for a new cancer alone would have been 5% lower in 2020 than the number expected outside the health crisis, 1% in 2021, according to a study published at the same time.