The most common cancer among women in France, with declining mortality rates

Breast cancer accounts for one-third of all new cancer cases in women and is the leading cause of cancer death among women. Mortality (age-standardized rate) has been declining since the 1990s, while incidence (age-standardized rate) has been rising. However, this trend in incidence has not been consistent.
Survival rates for people with breast cancer have improved over time.

The study below covers the incidence of the 19 most common cancers (17 solid tumors and 2 hematologic malignancies) and all cancers. For the incidence of other cancer sites and cancer mortality, see the report on national estimates of cancer incidence and mortality in metropolitan France between 1990 and 2018.

Breast cancer can be detected at an early stage through mammography screening. In France, an organized screening program is offered to all women aged 50 to 74. The incidence of this cancer is therefore influenced by changes in screening practices.

• Among the known risk factors for breast cancer, modifiable lifestyle factors have been identified, notably alcohol consumption and smoking

In this context, Santé publique France’s priorities are:

• To participate in the epidemiological surveillance of breast cancer

• To evaluate the performance of the national organized breast cancer screening program

• To assess the impact of screening on breast cancer mortality and morbidity

• To promote the fight against preventable risk factors

Key figures produced by the agency and its partners:

(Francim Network of Cancer Registries, Hospices Civils de Lyon, National Cancer Institute, Regional Cancer Screening Coordination Centers)

Various identified risk factors

The main known risk factors for breast cancer are:

• Age

• Genetic predisposition

• A personal history of breast disease

• A personal history of high-dose medical radiation to the chest.

Other risk factors are suspected to be related to endogenous hormonal exposures (age at puberty, number of children, age at first pregnancy, breastfeeding, overweight/obesity) and exogenous exposures (hormone replacement therapy during menopause).

• An increasing number of studies point to alcohol consumption and smoking

• : in 2015, it was estimated that in mainland France, approximately 15.1% of breast cancers in women over 30 were attributable to alcohol consumption and 4.4% to smoking [Circ 2018]. According to the same study, 10.6% of postmenopausal breast cancers (women over 50) were attributable to overweight and obesity.

Organized Screening

Since 2004, the nationwide rollout of organized breast cancer screening has been supported by a national screening program that currently involves a clinical breast exam and a mammogram performed every two years for women aged 50 to 74 who have no symptoms or specific risk factors.

Until 2018, the organized breast cancer screening program was coordinated at the departmental level by a management structure. Since January 1, 2019, the program has been coordinated at the regional level by the regional cancer screening coordination centers (CRCDC), which rely on the management structures of their respective departments.

Little geographical variation

Within France, regional and departmental disparities in breast cancer incidence are not very pronounced, whereas disparities in mortality are more pronounced.