In 2023, 52,777 new cases of lung cancer were diagnosed. Malignant pulmonary tumors were also responsible for more than 30,000 dead in 2022, or nearly 600 deaths per week. This makes it the first cause of cancer death in the country. Awareness and prevention remain the best weapons against the disease, as explained by Dr. Leleu.
– Why doctor: the 2024 panorama of the National Cancer Institute, published last January, noted a worrying increase in lung cancers among women in France. How to explain this increase?
Dr Olivier Leleu: We have indeed noticed, and it is really notable, an increase in the incidence of lung cancer in women. For the past ten years, it has climbed approximately 5 % per year. Thus, the distribution of cases is now 60 % man, 40 % woman. If there is still a predominance of lung cancer among the male sex with 32,000 cases, we approach the 20,000 female cancers per year.
And how to explain this increase? It is quite classic, it is linked to the increase in smoking in women. In the 1970s, women began to follow men on their smoking habits. Unfortunately, we end up with the consequences: that is to say an increase in lung cancers within this population. Conversely, in men, we begin to note a stagnation, even a certain decrease in the incidence of lung cancer. There, it is linked to a drop in male smoking.
Lung cancer, 8 times out of 10, is tobacco. It is important to be aware of it.
Lung cancer: “More recent risk factors have been identified, in particular pollution”
– Have other risk factors been identified?
More recent risk factors have been identified, including pollution. A study that came out last year in the Nature scientific journal, showed a strong link between lung cancer and fine particle pollution. This can also partly explain the increase in cancer, especially in non-smoking women.
Some professions can also represent a risk with exposures to professional toxic. The first was asbestos.
Then there are environmental exhibitions. In some regions, notably in Brittany, in the South West and the East, there is radon, a natural, inoro, colorless and inert radioactive gas, present in the soil, and more particularly the granitic and volcanic subsoils.
Impulse project: “a scanner of the lungs once a year the first two years, then every two years”
– Breast cancer and colorectal cancer, for example, benefit from screening programs that make it possible to identify tumors at an early stage. How can we prevent lung cancer ?
The lung is a little special organ. Unlike the breast, we cannot palpate it and locate the appearance of small nodules. It is a deep organ that is not innervated, which therefore does not hurt. This is quite problematic in the case of lung cancer, because as in many cancers, the more it is diagnosed early, the better the chances of healing.
Thus, studies have been carried out on lung cancer screening, including screening by low -dose scanner. The results are excellent. And therefore, the Cancer Institute (Inca) launched in January 2025, the Pulse Project. This is a pilot step before a national screening program for lung cancer.
The project is to offer a lung scanner to populations at risk of lung cancer. That is to say people between 50 and 74 years old, who smoke or who have smoked one package per day for twenty years. This will make it possible to diagnose small nodules, small cancers that we can operate and where we can consider healing. The pilot program will be launched in October or November in five regions: Île-de-France, Hauts-de-France, PACA, Pays-de-Loire and Auvergne-Rhône-Alpes.
There will be several terms to benefit from this screening. There will either be the possibility of going through general practitioners who participate in this screening campaign, or specialists, such as pneumo-oncologists. They will orient patients towards radiology centers labeled to make their scanner. Screening will rest on a scanner of the lungs once a year the first two years, then every two years.
It is a real advance. As I said, the more the lung cancer is discovered at an early stage, the greater the chances of healing. For small cancers of less than 2 cm, we have 9 out of 10 chances to heal and be alive at 5 years. On the other hand, after, once cancer is more advanced, it is a little more complicated in terms of treatment … Although we have made excellent progress in therapeutics, especially with immunotherapy, which has revolutionized the management of cancers, and especially that of the lung.
There are also targeted therapies, which, as their name suggests, are individualized treatments according to the types of cancer, possibly even their mutation. There are great advances on treatments, but it is true that when you are moving towards metastatic stages, it remains more complicated. For the moment, even if we can sometimes talk about healing, this is mainly to try to chronicize the disease as long as possible.
Symptom of lung cancer: “You have to be wary of any weight loss, all fatigue that lasts”
– For people who will not be able to benefit immediately from the prevention program, what are the signs that must alert them?
First, there are respiratory signs. That is to say an unusual shortness of breath or a cough which intensifies or which does not disappear. Among smokers, cough can be considered as usual, but a modification of the latter is the sign which must lead to consult. Spitting a little blood should also be alert as well as chest pain.
Then there are general signs. You have to be wary of any weight loss, any fatigue that lasts or that is unusual. These symptoms should lead to consulting a doctor.
Lung cancer: “There is nothing like a healthy air to have healthy lungs”
– Do you have any advice to improve your respiratory health?
Practice regular physical activity. This is valid for everything that is cardiovascular, but also for everything that is respiratory. It is said that a physical activity – 30 min 4 to 5 times a week – allows you to improve your state of health, knowing that we are not necessarily talking about sport, but physical activity: 30 minutes of walking work too.
And moreover, even before physical activity, I will say to pay attention to its environment, its personal environmental pollution. We are talking about smoking of course, but also of electronic cigarettes. If you are not a smoker, you shouldn’t start to vapor. It can be used as a weaning mode, but as much to avoid it if you are not a smoker. There is nothing like a healthy air to have healthy lungs.
Lung cancer mortality: “He could pass breast cancer”
– What would you like people to retain this world day against lung cancer?
There are real advances in the fight against smoking, it’s true: young people smoke less and less. However, it is necessary to re -insist on the importance of not smoking. Tobacco still remains a scourge. You should know that it is the only over -the -counter product that kills more than 50 % of its consumers, whether due to lung cancer or by cardiovascular disease.
It should also be remembered that lung cancer is the first killer cancer in France. It is the first in men, it is the second in women, behind breast cancer. But there are signals that make us say that in the years to come, he could pass before that of the breast. This is already the case in the countries of North America, where lung cancer has become the leading cause of death in women. The fight against tobacco and the implementation of screening could go against the phenomenon.
Indeed, this screening for lung cancer that will be launched in France, will improve survival. Patients diagnosed with lung cancer thanks to early screening live longer than those who have not benefited from screening. And the explanation is simple, when cancers are detected, they are mild, and therefore easier to treat.
