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Original Investigation
November 2018

Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2016: A Systematic Analysis for the Global Burden of Disease Study

Global Burden of Disease Cancer Collaboration
JAMA Oncol. 2018;4(11):1553-1568. doi:10.1001/jamaoncol.2018.2706
Key Points

Question  What is the cancer burden over time at the global and national levels measured in incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs)?

Findings  In this systematic analysis, in 2016 there were 17.2 million incident cancer cases, 8.9 million deaths, and 213.2 million DALYs due to cancer worldwide. Between 2006 and 2016, incident cases increased by 28%, with the largest increase occurring in the least developed countries.

Meaning  To achieve the Sustainable Development Goals as well as targets set in the World Health Organization Global Action Plan on noncommunicable diseases, cancer control planning and implementation as well as strategic investments are urgently needed.

Abstract

Importance  The increasing burden due to cancer and other noncommunicable diseases poses a threat to human development, which has resulted in global political commitments reflected in the Sustainable Development Goals as well as the World Health Organization (WHO) Global Action Plan on Non-Communicable Diseases. To determine if these commitments have resulted in improved cancer control, quantitative assessments of the cancer burden are required.

Objective  To assess the burden for 29 cancer groups over time to provide a framework for policy discussion, resource allocation, and research focus.

Evidence Review  Cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs) were evaluated for 195 countries and territories by age and sex using the Global Burden of Disease study estimation methods. Levels and trends were analyzed over time, as well as by the Sociodemographic Index (SDI). Changes in incident cases were categorized by changes due to epidemiological vs demographic transition.

Findings  In 2016, there were 17.2 million cancer cases worldwide and 8.9 million deaths. Cancer cases increased by 28% between 2006 and 2016. The smallest increase was seen in high SDI countries. Globally, population aging contributed 17%; population growth, 12%; and changes in age-specific rates, −1% to this change. The most common incident cancer globally for men was prostate cancer (1.4 million cases). The leading cause of cancer deaths and DALYs was tracheal, bronchus, and lung cancer (1.2 million deaths and 25.4 million DALYs). For women, the most common incident cancer and the leading cause of cancer deaths and DALYs was breast cancer (1.7 million incident cases, 535 000 deaths, and 14.9 million DALYs). In 2016, cancer caused 213.2 million DALYs globally for both sexes combined. Between 2006 and 2016, the average annual age-standardized incidence rates for all cancers combined increased in 130 of 195 countries or territories, and the average annual age-standardized death rates decreased within that timeframe in 143 of 195 countries or territories.

Conclusions and Relevance  Large disparities exist between countries in cancer incidence, deaths, and associated disability. Scaling up cancer prevention and ensuring universal access to cancer care are required for health equity and to fulfill the global commitments for noncommunicable disease and cancer control.

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