Lung cancer is the leading cause of cancer death in Europe and worldwide. It is not a cheerful topic — but understanding the risks, the signs and the options precisely changes a lot. Without dramatising, without minimising.

The figures, no detours

In France, around 52,000 new cases of lung cancer are diagnosed each year (33,000 in men and 19,000 in women — INCa 2023 data). Comparable figures hold for the United Kingdom (~49,000), Germany (~57,000), Spain (~30,000), Italy (~43,000) and Poland (~22,000). Lung cancer is the leading cause of cancer death in men (ahead of prostate and colon) and the second in women (right behind breast cancer, which it could overtake in the coming years).

An important nuance, often forgotten: while 8 out of 10 lung cancers are linked to smoking, 1 in 10 strikes a person who has never smoked (radon, air pollution, occupational asbestos exposure, family history). If you face a lung cancer without having smoked, your disease is neither your fault nor 'rare'.

Why smoking causes lung cancer

When you smoke, more than 70 carcinogenic substances settle on the lining of your bronchi (see the article on cigarette composition). These substances damage the DNA of pulmonary cells. Bit by bit, some cells accumulate enough mutations to escape the body's natural controls and start dividing chaotically. That is the start of a tumour.

This process takes time — often 20 to 40 years between the first cigarettes and the appearance of the cancer. That is why smokers from the 1980s and 1990s are being diagnosed today.

The takeaway: the duration of smoking matters 4 times more than the quantity. Smoking 10 cigarettes for 30 years is more dangerous than smoking 30 for 10 years. That is why quitting early — even after a long history of smoking — really changes the picture.

The two main types of lung cancer

Not all lung cancers look alike. This distinction guides treatment.

Symptoms: what should send you to the doctor

The big trap with lung cancer is that, at the start, it makes itself unfelt. Most of the time, the first signs appear when the tumour is already well established. Here is what should make you consult, especially if you smoke or have smoked.

• A cough that lasts more than 3 weeks with no obvious reason.

• A change in your usual cough if you are a smoker (rhythm, intensity, different sputum).

• Blood in your sputum, even small amounts.

• A new shortness of breath, or one that gets worse.

• Persistent chest pain.

• A hoarse voice that does not go away.

• Repeated respiratory infections (pneumonia, bronchitis).

• Unexplained fatigue or weight loss.

The screening that changes everything

For a long time, there was no organised lung cancer screening in most European countries. That is changing in 2026.

In practice, a low-dose CT scan can detect tumours just a few millimetres in size, at a stage where surgery can still cure. If you are eligible, talk to your doctor.

Prognosis and benefits of quitting — the truth

Let us be clear: overall, the prognosis of lung cancer remains guarded. The 5-year survival rate, all stages combined, is around 20%. The main reason: 40 to 55% of diagnoses are made at stage IV (with metastases), where survival drops to 4-10%.

But this overall figure hides a much more nuanced reality:

1. Stage IA (tumour < 3 cm, no invasion): 5-year survival between 75 and 90%.
2. Stage II around 50%.
3. Stage III around 30%.
4. Stage IV 4 to 10%.

The earlier the cancer is detected, the higher the chances. That is why screening matters — and why you should check in with your GP at the slightest red flag if you are at risk.

In United Kingdom

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