[Cancer causes: what levers for primary prevention?]

CANCER CAUSES:WHAT LEVERS FOR PRIMARY PREVENTION? Facing the continuous increase in cancer incidence, mobilizing efficient levers to act upstream of the disease is a major public health issue. Accelerating the transfer into practice of the continuous enrichment of the understanding of the multifactorial causes of cancers constitutes a first lever of prevention. This also requires a strengthening of the involvement of all actors and stakeholders, beyond the health and medico-social sectors. In order to guide practices, this article reviews the proportion of cancers attributable to the main lifestyle and environmental factors and causes, provides an update on cancers linked to heredity and the French oncogenetic organisation, addresses the specific issue of work related exposures and occupational cancers, proposes a prioritization of actions to break with the current fragmentation of prevention, in particular through improving the articulation of population-based interventions with targeted and personalized approaches, and better considering individuals in their environments.