Introduction: In France, lung cancer is the second most common cancer among men and the fourth most common among women. In the Bas-Rhin department, the incidence is increasing by 0.1% per year among men and by 4.4% among women. The objective is to analyze and predict trends in lung cancer incidence in the Bas-Rhin region for both women and men from 1975 to 2014. Methods: Incidence data from 1975 to 1999 were extracted from the Bas-Rhin cancer registry. Population numbers (ages 25–94) were estimated for the period 1975–2014. The prediction is based on a Bayesian age-period-cohort model. Results: From 1975 to 1999, the incidence of lung cancer increased among women (4.5% per year). Among men, it rose from 1975 to 1989 (1.6% per year) and then declined. For the periods 2000–2004, 2005–2009, and 2010–2014, respectively, rates are projected to reach 25.6, 32.9, and 42.8 per 100,000 among women and 117.5, 111.6, and 110.1 per 100,000 among men. Conclusions: The increasing prevalence of smoking among women and the decreasing prevalence among men could be one of the causes of the increase in incidence among women and the decrease among men.