Épidémiologie du cancer bronchique en France, Belgique et Suisse – Principaux facteurs de risque environnementaux et professionnels

Abstract

In France, Belgium and Schwizerland, respectively, lung cancer is the 3rd most common cancer and the 1st cause of cancer-related death. While incidence and mortality rates in men have stabilized, they are demonstrating an alarming growth in women, linked to the increase in female tobacco consumption. Combined, close to 90% of lung cancer cases are attributable to modifiable factors, offering numerous levers for prevention policies. While tobacco smoking is indeed the main risk factor for lung cancer, responsible for 80% of cases, the risk factors and exposures are numerous, such as a diet low in fruit (10% of cases), occupational exposures (15% of cases), and environmental exposures, such as radon (almost 10% of cases) and outdoor air pollution (3.6% of cases). The proportion of environmental exposures are probably underestimated. In 2024, the International Agency for Research on Cancer identified more than 30 definite carcinogen agents (and carcinogenic exposure situations from all sources) for which there is an excess of lung cancer in occupational settings. In the clinical management of pneumology patients, it is important to identify any exposure to carcinogenic agents. Recognition of lung cancer as an occupational disease is a major medical and social issue for patients. Several approaches can be used to identify exposure to occupational carcinogens: occupational interview (with specific questionnaires or self-questionnaires), biometrological analysis for certain agents, or imaging. Once an occupational exposure has been identified, the clinician may or may not advise the patient to file an occupational disease claim.