JAMA Oncol. 2016 Dec 3.
Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-years for 32 Cancer Groups, 1990 to 2015: A Systematic Analysis for the Global Burden of Disease Study.
Global Burden of Disease Cancer Collaboration, Fitzmaurice C1, Allen C2, Barber RM2, Barregard L3, Bhutta ZA4, Brenner H5, Dicker DJ2, Chimed-Orchir O6, Dandona R7, Dandona L2, Fleming T2, Forouzanfar MH2, Hancock J2, Hay RJ8, Hunter-Merrill R2, Huynh C2, Hosgood HD9, Johnson CO2, Jonas JB10, Khubchandani J11, Kumar GA7, Kutz M2, Lan Q12, Larson HJ13, Liang X14, Lim SS2, Lopez AD15, MacIntyre MF2, Marczak L2, Marquez N2, Mokdad AH2, Pinho C2, Pourmalek F16, Salomon JA17, Sanabria JR18, Sandar L2, Sartorius B19, Schwartz SM20, Shackelford KA2, Shibuya K21, Stanaway J2, Steiner C2, Sun J22, Takahashi K23, Vollset SE24, Vos T2, Wagner JA2, Wang H2, Westerman R25, Zeeb H26, Zoeckler L2, Abd-Allah F27, Ahmed MB28, Alabed S29, Alam NK30, Aldhahri SF31, Alem G32, Alemayohu MA33, Ali R34, Al-Raddadi R35, Amare A36, Amoako Y37, Artaman A38, Asayesh H39, Atnafu N40, Awasthi A41, Saleem HB42, Barac A43, Bedi N44, Bensenor I45, Berhane A46, Bernabé E47, Betsu B48, Binagwaho A49, Boneya D32, Campos-Nonato I50, Castañeda-Orjuela C51, Catalá-López F52, Chiang P53, Chibueze C54, Chitheer A55, Choi JY56, Cowie B57, Damtew S58, das Neves J59, Dey S60, Dharmaratne S61, Dhillon P62, Ding E63, Driscoll T64, Ekwueme D65, Endries AY66, Farvid M67, Farzadfar F68, Fernandes J69, Fischer F70, G/Hiwot TT71, Gebru A72, Gopalani S73, Hailu A74, Horino M75, Horita N76, Husseini A77, Huybrechts I78, Inoue M21, Islami F79, Jakovljevic M80, James S81, Javanbakht M82, Jee SH83, Kasaeian A84, Kedir MS85, Khader YS86, Khang YH87, Kim D88, Leigh J89, Linn S90, Lunevicius R91, El Razek HM92, Malekzadeh R93, Malta DC94, Marcenes W47, Markos D95, Melaku YA72, Meles KG96, Mendoza W97, Mengiste DT72, Meretoja TJ98, Miller TR99, Mohammad KA100, Mohammadi A101, Mohammed S102, Moradi-Lakeh M103, Nagel G104, Nand D105, Le Nguyen Q106, Nolte S107, Ogbo FA108, Oladimeji KE109, Oren E110, Pa M111, Park EK112, Pereira DM113, Plass D114, Qorbani M115, Radfar A116, Rafay A117, Rahman M118, Rana SM119, Søreide K120, Satpathy M121, Sawhney M122, Sepanlou SG123, Shaikh MA124, She J125, Shiue I126, Shore HR127, Shrime MG128, So S129, Soneji S130, Stathopoulou V131, Stroumpoulis K132, Sufiyan MB133, Sykes BL134, Tabarés-Seisdedos R135, Tadese F136, Tedla BA137, Tessema GA138, Thakur JS139, Tran BX140, Ukwaja KN141, Uzochukwu BS142, Vlassov VV143, Weiderpass E144, Wubshet Terefe M145, Yebyo HG72, Yimam HH146, Yonemoto N147, Younis MZ148, Yu C149, Zaidi Z150, Zaki ME151, Zenebe ZM152, Murray CJ2, Naghavi M2.
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.
Conclusion and relevance
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.