Cases of pancreatic cancer are rising sharply in France, with diagnoses having risen significantly between 2010 and 2023, at a rate of 2-3% per year, the national cancer institute has warned.
The Institut national du cancer (Inca) said that most of the cases were found in “people over 50 years old” (although increased cases are being found in those under 50) and said that a record 15,991 cases had been confirmed in 2023.
In contrast, there were 3,700 cases diagnosed in 1990.
Between 2010 and 2023, the incidence rate (the percentage of cases in a given population) rose by an average of 1.6% in men and 2.1% in women each year, Inca said.
France is now the fourth-most affected country by pancreatic cancer in the world, reported Le Monde, after Uruguay, Hungary, and Japan.
Why such a rise? Some experts have suggested reasons behind the spike, including:
Obesity
Rising rates of obesity could be partly to blame, said the Centre Léon Bérard (CLB) in Lyon, quoted by La Dépêche, which said that “obesity and pancreatic cancer are strongly associated”.
The Assurance maladie states that “obesity is continuing to increase at a rapid rate” in France, with 8.5% of adults obese in 1997, compared to 17% in 2020. The trend is even more pronounced among the 18-24 age group and the 25-34 age group, it said.
A US study from 2018 found that having a body mass index (BMI) of over 35 is a proven risk factor for pancreatic cancer, with just five extra points in BMI increasing the risk by an estimated 14%.
Pesticides
Pancreatic cancer has been associated with exposure to pesticides. A 2024 study found that “an association, albeit small, was observed between pesticide exposure and the incidence of pancreatic adenocarcinoma [in France] over the period studied”.
The authors of this study have suggested that high use of pesticides in France could be the reason that pancreatic cancer’s “progression in France, at around 3% each year, is around two to three times faster than in most other European countries”, said research co-author, gastroenterologist and epidemiologist Dr Mathias Brugel, Bayonne Hospital, to Le Monde.
The study found that for every 2.6 kilo increase of pesticides used per hectare, the relative risk of pancreatic cancer increases by an average of 1.3%.
“The rate of progression of this cancer in France is faster than in almost any other country, despite the fact that our lifestyles are similar, particularly to those of our European neighbours,” said Dr Brugel to Le Figaro.
However, he admitted that the study is not 100% conclusive.
“An association exists, but causality still needs to be demonstrated, which the methodology of the study does not allow us to do,” he said. “Nevertheless, this is an important signal that leads us to continue our work in this direction.”
Pesticide exposure and its health risks has long been a contentious issue in France. Some areas of the country most affected by pesticide use are Paris, central France, and the Mediterranean coast.
Read also: Farm pesticides: Map claims to show the French areas most and least exposed
Read more: French rural residents ‘must be protected from pesticides’
Read also: Dangerous pesticides found in areas around French vineyards
Sales of “plant protection products for agricultural use increased by 14% between 2009-2011 and 2018-2020”, said specialist website Nature France.
The authors of the 2024 study also suggested that the use of pesticides that are now banned could be having a delayed effect on rising pancreatic cancer cases today.
For example, the use of the herbicide chlordane was banned in the 1970s, but exposure in people then could be causing the cancer to appear now as they grow older, suggested Dr Brugel.
However, some researchers disagree over this apparent link between pesticides and pancreatic cancer.
“Our initial analyses suggest that there is no excess of pancreatic cancer among farmers compared with the general population,” said Pierre Lebailly, lecturer and researcher in epidemiology, to Le Figaro.
Similarly, Dr Anne-Marie Bouvier, an epidemiologist and Inserm research director, said: “The study is very well conducted, but the data used only allow estimates to be made. There are a lot of approximations, for what ultimately appears to be a low risk.”
Smoking and diet?
Other possible factors suggested include smoking, alcohol consumption, and a diet high in red meat, said the CLB in Lyon. Similarly, researchers at Inca have suggested that increased consumption of processed food, lower physical activity levels, and the gradual aging of the population could play a role.
The CLB website states: “Smoking is the main recognised environmental risk factor for pancreatic cancer…alcohol consumption increases the risk by at least 15%”.
‘Lack of good data’
However, while the CLB also adds that “red meat could also be involved”, it states that “the results are contradictory and the studies are not unanimous on the existence of a link” between high red meat consumption and pancreatic cancer.
Similarly, government farming statistics agency Agreste said that red meat consumption in France stagnated between 2000 and 2024. Health authority Santé publique France states that tobacco use has also stagnated, and alcohol consumption has fallen.
This has led some researchers to remain cautious over supposed ‘causes’ of higher cancer rates.
“The usual risk factors - smoking, obesity, in particular - are not increasing as rapidly as the incidence of pancreatic cancer. It feels as though there is an explanation that we don't [yet] understand,” said Dr Matthieu Delaye, digestive oncologist at the Institut Curie.
"Like other multifactorial cancers, pancreatic cancer may have other causes,” said Dr Claire Morgand, medical epidemiologist and director of observation, data science and evaluation at Inca. “But at the moment, the lack of good quality data means that we can't establish them.”
Cancer in France
Cases of cancer in France are rising more generally, too.
Read more: Cancer cases in France have doubled since 1990
Read also: Cancer deaths rising among under 65s in France, says specialist
Cancer has been the most common cause of death in France for several years now (as well as cardiovascular disease).
The number of new cases of cancer is also rising year on year (although some are falling, such as colorectal cancer in men and cervical cancer in women).
Read also: Why some cancer rates are rising more in women than men in France
Read more: Why are more young people in France getting cancer?
Typically, increased cases are usually attributed to lifestyle habits such as smoking, poor diet, obesity, less physical exercise, as well as factors such as an aging population, increased air pollution and pesticide use.
Read also: Cancer expert alarmed by ignorance of risk factors in France
