Smoking - no matter how much - drinking too much and eating badly is the cause of almost half of all cancers in France. Here are the French now aware of the risks they take.

Cancer, a fatality? Not so much after the publication yesterday of a study published yesterday in the Weekly Epidemiological Bulletin, since about 40% of cancers could be preventable.

Tobacco first, then alcohol, poor diet, and finally obesity are the four main factors in France of 40% of cancers.

Of the 346,000 cancer cases diagnosed in 2015 among those aged 30 and over, "142,000 could have been avoided if the entire population had not been exposed to the risk factors studied, or if exposure had been limited ".

Cancer is the leading cause of death in France, in front of cardiovascular diseases. Tumors killed 164,000 people in 2013. "Too few French people are aware of the risks they are taking," said Minister Agnès Buzyn.

She defended her policy against tobacco, which in 2015 was responsible for 20% of new preventable cases. This represented 68,000 diagnoses.

Smoking-related cancers (mainly, but not only lung cancers) mainly affect the working classes, with a risk "1.5 to 2 times higher among the 20% most disadvantaged, compared to the 20% most favored ".

If men smoke less and less since the 1950s, the mass entry of women into smoking in the baby-boom generation (born between 1945 and 1965).

In terms of number of cancers, this appeal of smoking among women "will have harmful consequences that will increase" until around 2045.

Alcohol: can do better

Alcohol causes 8% of new preventable cancer cases (28 000), cancers of different parts of the digestive system, but also breast.

In France there is a problem and we could do a lot better in the prevention of alcoholism.

"Prevention actions are not so far as developed as those aimed at reducing smoking", highlighting the preponderance of wine in the country's alcohol consumption (59% of volume), far ahead of the strong alcohols (21%) and beer (19%).

Unbalanced diet and obesity are each responsible for 5.4% of new cancer cases.

On the "junk food" side, a "low consumption of fruits, vegetables, dietary fiber and dairy products, as well as a high consumption of red meats and processed meats", a phenomenon that affects men more.

Unlike obesity where there are women are more concerned.

Other risk factors
There are "infectious agents" (4% of new cases) such as human papillomavirus (in cases of uterine cancer) or H. pylori bacteria, and "occupational exposures" (3.6%) , asbestos or pesticides for example. Then there are other factors: radon in indoor air, air pollution, chemicals in the environment, and so on. Just as alarming: a certain ignorance of the risks. "For too many people still drinking sodas or eating hamburgers would be as bad for you as drinking alcohol."

Cyrille Delpierre, head of the Inserm team at the Toulouse Oncopole and contributor to the study
"Everyone can reduce risks"
Does the result of this study mean that there is not enough vigilance? Of prevention ?

The conclusions say that there is a lot of effort to be made in prevention actions. The health barometer pointed out that, in 2017, smoking has decreased, especially among heavy smokers, but alcohol consumption remains high compared to our neighboring countries. As for vigilance, we do not imply that the French are solely responsible for their behavior: the environment, the quality of food, public policies and the social environment can help to promote risks.

Why are the working classes more affected?

Studies show that less favored populations have greater access to tobacco and less access to sports activities. Trades condition salaries, places where we live also condition our consumption habits ...

What about air pollution and endocrine disruptors that are not mentioned in the report?

It is more difficult to measure these exposures that are multiple and spread over long periods. Occupational exposure, ie the handling of chemicals is responsible for 3.6% of cancers. Air pollution contributes to 0.4% of cancers and chemical substances in the environment cause 0.1% of cancers. These proportions are more marginal.

Solution: no longer smoke, no longer drink and eat better?

This would be the utopian solution. The study is not intended to incriminate the French, everyone can play on these factors at his level. It is even rather good news because it is possible to intervene on these factors without this being an exclusively individual question. The ideal is of course to reduce alcohol consumption, to smoke less or to stop smoking and to eat healthily.

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