Pancreatic cancer is set to become, in the 2030s, the second leading cause of cancer death following lung cancer, in Europe and the United States. And this mortality is perfectly correlated with the increase in the number of cases. “In France, the incidence is galloping, a doubling has already taken place between 2000 and 2006 then between 2006 and 2012. And while mortality from all other cancers has decreased, this one has not benefited from current progress »alerted Vinciane Rebours, head of the pancreatology department at the Beaujon hospital (AP-HP), in Clichy, in the Hauts-de-Seine, during a special pancreatic cancer day organized, Friday, February 17, by the National Academy of Surgery.
While it is still relatively rare compared to lung, breast, prostate or colon cancer, each year the number of new cases increases by 3%. In 2018, according to the National Cancer Institute (INCA), it stood at 7,301 in men and 6,883 in women, with the number of deaths reaching 5,790 for the former and 5,666 for the latter.
Could this increase be linked to better screening? “There is not yet organized screening as for breast or colon cancer, which would allow it to be detected at an early stage (without symptoms)”says David Malka, digestive oncologist at the Institut mutualiste Montsouris.
Pollutants and pesticides
Among the risk factors are smoking (implied in 20% to 30% of pancreatic cancer-related deaths), diabetes, obesity (in France, 49% of the population is overweight or obese), aging ( the median age at diagnosis is 70 years) and, to a lesser extent, inflammation (chronic pancreatitis). Ultra-processed food and exposure to pollution play a role in this “epidemic”. “Toenail scans show more traces of airborne pollutants and pesticides in people who will develop pancreatic cancer,” observes Vinciane Rebours.
The peculiarity of pancreatic cancer is that it can remain silent for years. In eight out of ten cases, when symptoms appear (abdominal pain, jaundice, rapid weight loss, recent diabetes, etc.), the disease is generally well advanced, as the cancer cells present in the organ can quickly migrate into the blood. When discovered, the tumor is often around 3 centimeters in size and at this size half of the cases have already metastasized.
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