Cancer is the second leading cause of death worldwide. Current estimates on the burden of cancer are needed for cancer control planning.
To estimate mortality, incidence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 32 cancers in 195 countries and territories from 1990 to 2015.
Cancer mortality was estimated using vital registration system data, cancer registry incidence data (transformed to mortality estimates using separately estimated mortality to incidence [MI] ratios), and verbal autopsy data. Cancer incidence was calculated by dividing mortality estimates through the modeled MI ratios. To calculate cancer prevalence, MI ratios were used to model survival. To calculate YLDs, prevalence estimates were multiplied by disability weights. The YLLs were estimated by multiplying age-specific cancer deaths by the reference life expectancy. DALYs were estimated as the sum of YLDs and YLLs. A sociodemographic index (SDI) was created for each location based on income per capita, educational attainment, and fertility. Countries were categorized by SDI quintiles to summarize results.
In 2015, there were 17.5 million cancer cases worldwide and 8.7 million deaths. Between 2005 and 2015, cancer cases increased by 33%, with population aging contributing 16%, population growth 13%, and changes in age-specific rates contributing 4%. For men, the most common cancer globally was prostate cancer (1.6 million cases). Tracheal, bronchus, and lung cancer was the leading cause of cancer deaths and DALYs in men (1.2 million deaths and 25.9 million DALYs). For women, the most common cancer was breast cancer (2.4 million cases). Breast cancer was also the leading cause of cancer deaths and DALYs for women (523 000 deaths and 15.1 million DALYs). Overall, cancer caused 208.3 million DALYs worldwide in 2015 for both sexes combined. Between 2005 and 2015, age-standardized incidence rates for all cancers combined increased in 174 of 195 countries or territories. Age-standardized death rates (ASDRs) for all cancers combined decreased within that timeframe in 140 of 195 countries or territories. Countries with an increase in the ASDR due to all cancers were largely located on the African continent. Of all cancers, deaths between 2005 and 2015 decreased significantly for Hodgkin lymphoma (-6.1% [95% uncertainty interval (UI), -10.6% to -1.3%]). The number of deaths also decreased for esophageal cancer, stomach cancer, and chronic myeloid leukemia, although these results were not statistically significant.
As part of the epidemiological transition, cancer incidence is expected to increase in the future, further straining limited health care resources. Appropriate allocation of resources for cancer prevention, early diagnosis, and curative and palliative care requires detailed knowledge of the local burden of cancer. The GBD 2015 study results demonstrate that progress is possible in the war against cancer. However, the major findings also highlight an unmet need for cancer prevention efforts, including tobacco control, vaccination, and the promotion of physical activity and a healthy diet.
JAMA oncology. 2016 Jan 03 [Epub ahead of print]
Global Burden of Disease Cancer Collaboration , Christina Fitzmaurice, Christine Allen, Ryan M Barber, Lars Barregard, Zulfiqar A Bhutta, Hermann Brenner, Daniel J Dicker, Odgerel Chimed-Orchir, Rakhi Dandona, Lalit Dandona, Tom Fleming, Mohammad H Forouzanfar, Jamie Hancock, Roderick J Hay, Rachel Hunter-Merrill, Chantal Huynh, H Dean Hosgood, Catherine O Johnson, Jost B Jonas, Jagdish Khubchandani, G Anil Kumar, Michael Kutz, Qing Lan, Heidi J Larson, Xiaofeng Liang, Stephen S Lim, Alan D Lopez, Michael F MacIntyre, Laurie Marczak, Neal Marquez, Ali H Mokdad, Christine Pinho, Farshad Pourmalek, Joshua A Salomon, Juan Ramon Sanabria, Logan Sandar, Benn Sartorius, Stephen M Schwartz, Katya A Shackelford, Kenji Shibuya, Jeff Stanaway, Caitlyn Steiner, Jiandong Sun, Ken Takahashi, Stein Emil Vollset, Theo Vos, Joseph A Wagner, Haidong Wang, Ronny Westerman, Hajo Zeeb, Leo Zoeckler, Foad Abd-Allah, Muktar Beshir Ahmed, Samer Alabed, Noore K Alam, Saleh Fahed Aldhahri, Girma Alem, Mulubirhan Assefa Alemayohu, Raghib Ali, Rajaa Al-Raddadi, Azmeraw Amare, Yaw Amoako, Al Artaman, Hamid Asayesh, Niguse Atnafu, Ashish Awasthi, Huda Ba Saleem, Aleksandra Barac, Neeraj Bedi, Isabela Bensenor, Adugnaw Berhane, Eduardo Bernabé, Balem Betsu, Agnes Binagwaho, Dube Boneya, Ismael Campos-Nonato, Carlos Castañeda-Orjuela, Ferrán Catalá-López, Peggy Chiang, Chioma Chibueze, Abdulaal Chitheer, Jee-Young Choi, Benjamin Cowie, Solomon Damtew, José das Neves, Suhojit Dey, Samath Dharmaratne, Preet Dhillon, Eric Ding, Tim Driscoll, Donatus Ekwueme, Aman Yesuf Endries, Maryam Farvid, Farshad Farzadfar, Joao Fernandes, Florian Fischer, Tsegaye Tewelde G/Hiwot, Alemseged Gebru, Sameer Gopalani, Alemayehu Hailu, Masako Horino, Nobuyuki Horita, Abdullatif Husseini, Inge Huybrechts, Manami Inoue, Farhad Islami, Mihajlo Jakovljevic, Spencer James, Mehdi Javanbakht, Sun Ha Jee, Amir Kasaeian, Muktar Sano Kedir, Yousef S Khader, Young-Ho Khang, Daniel Kim, James Leigh, Shai Linn, Raimundas Lunevicius, Hassan Magdy Abd El Razek, Reza Malekzadeh, Deborah Carvalho Malta, Wagner Marcenes, Desalegn Markos, Yohannes A Melaku, Kidanu G Meles, Walter Mendoza, Desalegn Tadese Mengiste, Tuomo J Meretoja, Ted R Miller, Karzan Abdulmuhsin Mohammad, Alireza Mohammadi, Shafiu Mohammed, Maziar Moradi-Lakeh, Gabriele Nagel, Devina Nand, Quyen Le Nguyen, Sandra Nolte, Felix A Ogbo, Kelechi E Oladimeji, Eyal Oren, Mahesh Pa, Eun-Kee Park, David M Pereira, Dietrich Plass, Mostafa Qorbani, Amir Radfar, Anwar Rafay, Mahfuzar Rahman, Saleem M Rana, Kjetil Søreide, Maheswar Satpathy, Monika Sawhney, Sadaf G Sepanlou, Masood Ali Shaikh, Jun She, Ivy Shiue, Hirbo Roba Shore, Mark G Shrime, Samuel So, Samir Soneji, Vasiliki Stathopoulou, Konstantinos Stroumpoulis, Muawiyyah Babale Sufiyan, Bryan L Sykes, Rafael Tabarés-Seisdedos, Fentaw Tadese, Bemnet Amare Tedla, Gizachew Assefa Tessema, J S Thakur, Bach Xuan Tran, Kingsley Nnanna Ukwaja, Benjamin S Chudi Uzochukwu, Vasiliy Victorovich Vlassov, Elisabete Weiderpass, Mamo Wubshet Terefe, Henock Gebremedhin Yebyo, Hassen Hamid Yimam, Naohiro Yonemoto, Mustafa Z Younis, Chuanhua Yu, Zoubida Zaidi, Maysaa El Sayed Zaki, Zerihun Menlkalew Zenebe, Christopher J L Murray, Mohsen Naghavi
Division of Hematology, Department of Medicine, University of Washington, Seattle2Institute for Health Metrics and Evaluation, University of Washington, Seattle., Institute for Health Metrics and Evaluation, University of Washington, Seattle., University of Gothenburg, Gothenburg, Sweden., Aga Khan University, Pakistan., German Cancer Research Center, Heidelberg, Germany., University of Occupational and Environmental Health, Fukuoka, Japan., Public Health Foundation of India, New Delhi, India., International Foundation for Dermatology, London, England., Department of Epidemiology and Population Health, Global Health Center, Albert Einstein College of Medicine, New York, New York., Department of Ophthalmology, Ruprecht-Karls-University Heidelberg, Mannheim, Germany., Ball State University, Muncie, Indiana., National Cancer Institute, Rockville, Maryland., London School of Hygiene and Tropical Medicine, London, England., Chinese Center for Disease Control and Prevention, Beijing, China., School of Population and Global Health, University of Melbourne, Melbourne, Australia., University of British Columbia, Vancouver, British Columbia., Department of Global Health and Population, Harvard University, Cambridge, Massachusetts., School of Medicine, Marshall University, Huntington, West Virginia., University of KwaZulu-Natal, Durban, South Africa., Fred Hutchinson Cancer Research Center, Seattle, Washington., University of Tokyo, Tokyo, Japan., Queensland University of Technology, Brisbane, Queensland, Australia., University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan., Norwegian Institute of Public Health, Bergen, Norway., Federal Institute for Population Research, Hessen, Germany., Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany., Department of Neurology, Cairo University, Cairo, Egypt., College of Health Sciences, Department of Epidemiology, Jimma University, Jimma, Ethiopia., College of Health Sciences, Department of Epidemiology, University of Sheffield, Sheffield, England., Queensland Health Herston, Brisbane, Queensland, Australia., Department of Otolaryngology-Head and Neck Surgery, King Saud University, Riyadh, Saudi Arabia., Debre Markos University, Debre Markos, Ethiopia., School of Public Health, Mekelle University, Mekelle, Ethiopia., Cancer Epidemiology Unit, University of Oxford, Oxford, England., Public Health Directorate, Department of Preventive Medicine, Ministry of Health, Jeddah, Makkah, Saudi Arabia., School of Medicine, University of Adelaide, Adelaide, Australia37Bahir Dar University, College of Medicine and Health Sciences, Bahir Dar, Ethiopia., Department of Medicine, Komfo Anokye Teaching Hospital Ghana, Kumasi, Ghana., Department of Community Health Science, University of Manitoba, Winnipeg, Manitoba, Canada., Department of Medical Emergency, School of Paramedic, Qom University of Medical Sciences, Qom, Iran., College of Medicine and Health Sciences, Department of Nursing, Mizan Tepi University, Mizan Teferi, Ethiopia., Department of Biostatistics, Nayati Multi Super Speciality Hospital, Mathura, India., Department of Community Medicine, Aden Cancer Registry, and Research Center Faculty of Medicine and Health Sciences, Aden University, Aden, Yemen., Clinic for Infectious and Tropical Diseases, Clinical Center of Serbia, Faculty of Medicine University of Belgrade, Belgrade, Serbia., Department of Epidemiology, Tropical Disease Unit, College of Public Health and Tropical Medicine, Jazan, Saudi Arabia., Department of Internal Medicine, University of São Paul, São Paul, Brazil., College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia)., Division of Population and Patient Health, King's College London Dental Institute, London, England., Mekelle University, Tigray, Ethiopia., University of Global Health Equit, Kigali, Rwanda51Department of Global Health and Social Medicine, Harvard Medical School, Harvard University, Cambridge, Massachusetts., National Institute of Public Health, Morelos, Mexico., Instituto Nacional de Salud Bogota, Bogota, Colombia., Department of Medicine, University of Valencia/INCLIVA Health Research Institute and CIBERSAM, Valencia, Spain55Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada., Clinical Governance Unit, Gold Coast Health, Southport, Queensland, Australia., National Center for Child Health and Development, Tokyo, Japan., Ministry of Health, Baghdad, Iraq., Seoul National University Hospital, Seoul, South Korea., WHO Collaborating Centre for Viral Hepatitis, Doherty Institute, Melbourne, Australia., School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia)., i3S-Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal., Indian Institute of Public Health-Delhi, Public Health Foundation of India, Gurgaon, India., Department of Community Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka., Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Gurgaon, India., Department of Nutrition, Harvard University, Boston, Massachusetts., Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia., Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia., Arba Minch University, Arba Minch, Ethiopia., Department of Nutrition, T.H. Chan School of Public Health, Boston, Massachusetts71Harvard/MGH Center on Genomics, Vulnerable Populations, and Health Disparities, Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, Massachusetts., Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran., Center for Biotechnology and Fine Chemistry-Associate Laboratory, Faculty of Biotechnology, Catholic University of Portugal, Porto, Portugal., Bielefeld University, Bielefeld, Germany., Department of Epidemiology and Biostatistics, Jimma University, Jimma, Ethiopia., Mekelle University, Mekelle, Ethiopia., Government of the Federated States of Micronesia, Palikir, Federated States of Micronesia., Addis Ababa University, Addis Ababa, Ethiopia., Nevada Division of Public and Behavioral Health, Carson City., Yokohama City University Graduate School of Medicine, Yokohama, Japan., Institute of Community and Public Health, Birzeit University, Birzeit, Palestine., International Agency for Research on Cancer, Lyon, France., Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia., University of Kragujevac, Kragujevac, Serbia., Emergency Medicine, Denver Health/University of Colorado, Denver., Health Economics Group, Institute of Health and Society, Newcastle University, Newcastle Upon Tyne, England., Yonsei University, Seoul, South Korea., Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran., Department of Pharmacy, College of Health Sciences, Mizan Tepi University, Mizan Teferi, Ethiopia., Department of Community Medicine, Public Health and Family Medicine, Jordan University of Science and Technology Irbid, Irbid, Jordan., Department of Health Policy and Management, Seoul National University, Seoul, South Korea92Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, South Korea., Department of Health Science, Northeastern University, Boston, Massachusetts., Asbestos Disease Research Institute, University of Sydney, Sydney, Australia., School of Public Health, Faculty of Social Welfare and Health, University of Haifa, Haifa, Israel., Aintree University Hospital National Health Service Foundation Trust, Liverpool, England., Surgery Department, Mansoura Faculty of Medicine, Mansoura, Egypt., Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Fars, Iran., Universidade Federal de Minas Gerais, Belo Horizonte, Brazil., College of Health Sciences, Arsi University, Assela, Ethiopia., Department of Epidemiology, College of Health Science, School of Public Health, Mekelle University, Mekelle, Ethiopia., Peru Country Office, United Nations Population Fund, Lima, Peru., Comprehensive Cancer Center, Breast Surgery Unit, Helsinki University Hospital, Helsinki, Finland., Pacific Institute for Research and Evaluation, Calverton, Maryland105Center for Population Health Research, The Curtin University, Calverton, Maryland., Faculty of Education, Ishik University, Erbil, Iraq107Faculty of Education, University of Salahaddin, Erbil, Iraq., Neuroscience Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran., Ahmadu Bello University, Zaria, Nigeria., Department of Community Medicine, Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran., Ulm University, Ulm, Germany., Ministry of Health, Suva, Fiji., Duy Tan University, Da Nang Vietnam., Charité Universitätsmedizin, Berlin, Germany., Centre for Health Research, Western Sydney University, Sydney, Australia., Department of Public Health Medicine, College of Health Science, Howard College Campus, University of KwaZulu-Natal, Durban, South Africa., Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health University of Arizona, Tucson., Department of Pulmonary Medicine, JSS Medical College, JSS University, Mysore, India., Kosin University, Busan, South Korea., Universidade do Porto, Porto, Portugal., Department of Environmental Hygiene, German Environment Agency, Berlin, Germany., Alborz University of Medical Sciences, Karaj, Iran., College of Graduate Heath Study, A. T. Still University, Kirksville, Missouri., Epidemiology and Biostatistics, Contech International Health Consultants, Lahore Pakistan., BRAC, Dhaka, Bangladesh., Contech School of Public Health, Lahore, Pakistan., Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway128Department of Clinical Medicine, University of Bergen, Bergen, Norway., Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India., Department of Public Health, College of Health Professions, Marshall University, Huntington, West Virginia., Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran., Independent consultant, Karachi Pakistan., Fudan University Shanghai, China., Northumbria University, Newcastle Upon Tyne, England., College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia., Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts., Asian Liver Center, Stanford University, Palo Alto, California., The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire139Norris Cotton Cancer Center, Dartmouth Medical School, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire., Attikon University Hospital, Athens, Greece., Alexandra General Hospital of Athens, Athens, Greece., Department of Community Medicine Faculty of Medicine, Ahmadu Bello University, Zaria, Nigeria., Department of Criminology, Law & Society, University of California Irvine, Irvine., Department of Medicine, University of Valencia/INCLIVA Health Research Institute and CIBERSAM, Valencia, Spain., Department of Public Health, Wollo University, Dessie, Ethiopia., University of Gondar, Gondar, Ethiopia., Institute of Public Health, University of Gondar, Gondar, Ethiopia147School of Public Health, University of Adelaide, Adelaide, Australia., Post Graduate Institute of Medical Education and Research, Chandigarh, India., Johns Hopkins University Baltimore, Maryland., Department of Medicine, Federal Teaching Hospital, Abakaliki Nigeria., Institute of Public Health, College of Medicine, University of Nigeria Nsukka, Enugu, Nigeria., Center for Health Policy, National Research University, Higher School of Economics, Moscow, Russia., Department of Research, Group of Etiological Cancer Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo154Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden155Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland156Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway., Department of Public Health, St. Paul's Hospital Millenium Medical College, Addis Ababa, Ethiopia., Mizan Tepi University, Mizan Teferi, Ethiopia., Kyoto University, Kyoto, Japan., Department of Health Policy and Management, Jackson State University, Jackson, Mississippi., Wuhan University, Wuhan, Hubei, China., Department of Epidemiology, University Hospital of Setif, Algeria., Clinical Pathology Department, Mansoura Faculty of Medicine, Mansoura, Egypt., College of Health Sciences, Department of Midwidery, Mekelle University, Mekelle, Ethiopia.