Cancer is the second leading cause of death worldwide. Current estimates on the burden of cancer are needed for cancer control planning.
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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]
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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, 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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.