Faire reconnaître un cancer professionnel : un parcours administratif complexe pour le patient.Dragon Claws / iStock / Getty Images Plus / via Getty Images
A new investigation in France is highlighting the challenges in linking workplace exposures to cancer diagnoses. Researchers are finding that occupational cancers may be significantly underestimated, and the process for patients to have their cancer recognized as work-related is often complex and arduous.
The inquiry, conducted by the Groupement d’intérêt scientifique sur les cancers d’origine professionnelle et environnementale du Vaucluse (Giscope 84) in Avignon, began in 2018 as a “research-action” program – the second of its kind in France, following the Giscope 93 in Seine-Saint-Denis. The initial question driving the research was a concerning trend: why were so many cases of blood cancers appearing in the Vaucluse region?
Pr Borhane Slama, head of the Oncology-Hematology department at the Avignon hospital center, explained that while demographics and an aging population play a role, they don’t fully account for the observed increase. “There are more and more patients, younger patients, and increasingly aggressive diseases,” he said. Importantly, individual risk factors like tobacco and alcohol consumption appear to have limited impact on the development of these blood cancers.
Underestimation of Workplace-Related Cancers
Sociologist Moritz Hunsmann, co-director of the program from the Centre national de la recherche scientifique (CNRS), emphasized the “absolutely massive” underestimation of cancers with a professional origin. While official figures suggest that workplace exposures are responsible for only 4% to 8% of cancer cases, data from the Giscope 94 investigation paints a different picture. Among over 500 patients with lymphoma, 94% had been exposed to at least one carcinogenic agent during their careers.
However, accurately measuring the full extent of the problem remains difficult. Current estimates only consider substances for which sufficient information is available, and the frequent exposure to multiple carcinogenic agents is often not factored in. As an example, one patient treated for lymphoma and formerly a technician at EDF was found to have been exposed to 17 different carcinogenic products over a 40-year period, a revelation that was new to the patient as well.
Administrative Hurdles and Limited Funding
Even after establishing a link between a patient’s occupation and their cancer, navigating the system for official recognition can be a significant challenge. Obtaining recognition as an occupational disease often requires extensive administrative procedures – and sometimes legal action – a process described as “between a Stations of the Cross and a labyrinth,” particularly for individuals already battling illness.
The difficulty stems in part from the fact that official tables of occupational diseases, which link specific professions to certain agents, do not cover the majority of cases. This lack of clear categorization creates obstacles for patients seeking compensation and support.
Annie Thébaud-Mony of the Institut national de la santé et de la recherche médicale (Inserm), who founded Giscope 93, noted the persistent belief that individual behaviors are primarily responsible for cancer. “A contrario, the role of professional exposure to carcinogens is largely understudied,” she said. This understudy translates to a lack of funding for research in this area, prompting the Giscops to establish a fundraising foundation, “Agir contre les cancers du travail” (“Act Against Work Cancers”), relying on contributions from victims, affected groups, and the public. The foundation aims to expand this approach to other regions.
Thébaud-Mony concluded with a sobering assessment: “Today, I still encounter the same loneliness, and the same distress of patients put in danger at work. The lessons of the asbestos health disaster have not been learned.” This finding underscores the demand for continued investigation into the link between occupational exposures and cancer risk.
