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 2017: A Systematic Analysis for the Global Burden of Disease Study

Abstract

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.

Conflict of interest statement

Conflict of Interest Disclosures: Dr Goulart reports receiving grants from the National Council for Scientific and Technological Development. Dr Haro reports being a contractor for Eli Lilly and Company and receiving personal fees from Lundbeck. Mr Hidru reports receiving grants, personal fees, nonfinancial support, and other support from Adigrat University. Dr Iseh reports receiving nonfinancial support from the Usmanu Danfodiyo University Teaching Hospital and the Institute of Human Virology, Nigeria. Dr Jakovljevic reports receiving grants from the Ministry of Education, Science and Technological Development of the Republic of Serbia. Dr James reports receiving grants from Sanofi Pasteur. Dr Lazarus reports receiving grants and personal fees from AbbVie, Gilead Sciences, and MSD. Dr Meretoja reports receiving grants from the Cancer Foundation Finland. Dr Moradi-Lakeh reports being a consultant for a project funded by Novartis. Dr Postma reports receiving grants from Quintiles and Bayer; personal fees from AbbVie, Astellas, and Pharmerit; grants and personal fees from Bristol-Myers Squibb, AstraZeneca, Sanofi, Novartis, Janssen, GlaxoSmithKline, Pfizer, MSD, and Asc Academics, as well as serving as an advisor for the organization; and earnings from stock in Ingress Health and PAB BV. Dr Savic reports being an employee of the GlaxoSmithKline group of companies and holds restricted shares in the GlaxoSmithKline group of companies. Dr J. Singh reports receiving personal fees from serving as a consultant for Crealta/Horizon, Medisys, Fidia, UBM LLC, Medscape, WebMD, the National Institutes of Health, and the American College of Rheumatology; earnings from stocks in the Amarin Corporation and Viking Therapeutics; and nonfinancial support from serving as a member of OMERACT, the US Department of Veterans Affairs Rheumatology Field Advisory Committee, and committees of the American College of Rheumatology. No other disclosures are reported.

Figures

Figure 1.. Average Annual Percentage Change in Age-Standardized Incidence Rate in Both Sexes for All Cancers From 2007 to 2017

ATG indicates Antigua and Barbuda; BRB, Barbados; COM, Comoros; DMA, Dominica; E Med., Eastern Mediterranean; FJI, Fiji; FSM, Federated States of Micronesia; GRD, Grenada; KIR, Kiribati; LCA, Saint Lucia; MDV, Maldives; MLT, Malta; MUS, Mauritius; MHL, Marshall Islands; SGP, Singapore; SLB, Solomon Islands; SYC, Seychelles; TLS, Timor-Leste; TON, Tonga; TTO, Trinidad and Tobago; VCT, Saint Vincent and the Grenadines; VUT, Vanuatu; W Africa, West Africa; WSM, Samoa.

Figure 2.. Average Annual Percentage Change in Age-Standardized Mortality Rate in Both Sexes for All Cancers From 2007 to 2017

ATG indicates Antigua and Barbuda; BRB, Barbados; COM, Comoros; DMA, Dominica; E Med., Eastern Mediterranean; FJI, Fiji; FSM, Federated States of Micronesia; GRD, Grenada; KIR, Kiribati; LCA, Saint Lucia; MDV, Maldives; MLT, Malta; MUS, Mauritius; MHL, Marshall Islands; SGP, Singapore; SLB, Solomon Islands; SYC, Seychelles; TLS, Timor-Leste; TON, Tonga; TTO, Trinidad and Tobago; VCT, Saint Vincent and the Grenadines; VUT, Vanuatu; W Africa, West Africa; WSM, Samoa.

Figure 3.. Cancers Ranked by Absolute Years of Life Lost (YLLs) Among Both Sexes Between 2007 and 2017a

UI indicates uncertainty interval. aExcluding other cancer.

Figure 4.. Change in the Absolute Number of Disability-Adjusted Life-Years (DALYs) Between 1990 and 2017 for Both Sexes at the Global Level for Global Burden of Disease Level 2 Causesa

The cause neoplasms includes all cancers as defined under International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) causes C00 through C96, as well as myelodysplastic, myeloproliferative, and other hematopoietic neoplasms (ICD-10 codes D45-D47.9). aAll diseases are grouped into 22 mutually exclusive and collectively exhaustive causes.