Global, Regional, and National Cancer Incidence, Mortality, Years of LifeLost, Years Lived With Disability, and Disability-Adjusted Life-Years for 29Cancer Groups, 1990 to 2017
2021
IMPORTANCE Cancer and other noncommunicable diseases (NCDs) are now widely
recognized as a threat to global development. The latest United Nations high-level meeting
on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the
2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and
the third Sustainable Development Goal. Lack of situational analyses, priority setting, and
budgeting have been identified as major obstacles in achieving these goals. All of these have
in common that they require information on the local cancer epidemiology. The Global
Burden of Disease (GBD) study is uniquely poised to provide these crucial data.
OBJECTIVE To describe cancer burden for 29 cancer groups in 195 countries from 1990
through 2017 to provide data needed for cancer control planning.
EVIDENCE REVIEW We used the GBD study estimation methods to describe cancer incidence,
mortality, years lived with disability, years of life lost, and disability-adjusted life-years
(DALYs). Results are presented at the national level as well as by Socio-demographic Index
(SDI), a composite indicator of income, educational attainment, and total fertility rate. We
also analyzed the influence of the epidemiological vs the demographic transition on cancer
incidence.
FINDINGS In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million
without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of
cancer DALYs came from years of life lost (97%), and only 3% came from years lived with
disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and
the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident
cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL)
cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most
common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and
28.4 million DALYs), liver cancer (572 000 deaths and 15.2 million DALYs), and stomach
cancer (542 000 deaths and 12.2 million DALYs). For women in 2017, the most common
incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident
cases), and colorectal cancer (819 000 incident cases). The leading causes of cancer deaths
and DALYs for women were breast cancer (601 000 deaths and 17.4 million DALYs), TBL
cancer (596 000 deaths and 12.6 million DALYs), and colorectal cancer (414 000 deaths and
8.3 million DALYs).
CONCLUSIONS AND RELEVANCE The national epidemiological profiles of cancer burden in the
GBD study show large heterogeneities, which are a reflection of different exposures to risk
factors, economic settings, lifestyles, and access to care and screening. The GBD study can be
used by policy makers and other stakeholders to develop and improve national and local
cancer control in order to achieve the global targets and improve equity in cancer care.
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