Épidémiologie et facteurs de risques professionnels et environnementaux du cancer bronchopulmonaire

Abstract

In France, lung cancer is the 3rd most common cancer (52,777 new cases in 2023) and the 1st cause of cancer-related death (30,896 cases in 2022). 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 (attributable fraction: higher than 80 %), the risk factors and exposures are numerous, such as a diet low in fruit (10%), occupational exposures (16%), and environmental exposures, such as radon (10%) and outdoor air pollution (3.6 %). In 2025, the International Agency for Research on Cancer identified 31 definite carcinogenic agents and carcinogenic exposure situations from occupational or environmental sources, for which there is sufficient evidence of an excess of lung cancer in humans. In the clinical management of patients, it is important to identify any occupational 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 (for asbestos and crystalline silica). Once an occupational exposure has been identified, the clinician may or may not advise the patient to file an occupational disease claim.