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, Christina Fitzmaurice, Christine Allen, Ryan M Barber, Lars Barregard, Zulfiqar A Bhutta, Hermann Brenner, Daniel J Dicker, Odgerel Chimed-Orchir, Rakhi Dandona, Lalit Dandona, Tom Fleming, Mohammad H Forouzanfar, Jamie Hancock, Roderick J Hay, Rachel Hunter-Merrill, Chantal Huynh, H Dean Hosgood, Catherine O Johnson, Jost B Jonas, Jagdish Khubchandani, G Anil Kumar, Michael Kutz, Qing Lan, Heidi J Larson, Xiaofeng Liang, Stephen S Lim, Alan D Lopez, Michael F MacIntyre, Laurie Marczak, Neal Marquez, Ali H Mokdad, Christine Pinho, Farshad Pourmalek, Joshua A Salomon, Juan Ramon Sanabria, Logan Sandar, Benn Sartorius, Stephen M Schwartz, Katya A Shackelford, Kenji Shibuya, Jeff Stanaway, Caitlyn Steiner, Jiandong Sun, Ken Takahashi, Stein Emil Vollset, Theo Vos, Joseph A Wagner, Haidong Wang, Ronny Westerman, Hajo Zeeb, Leo Zoeckler, Foad Abd-Allah, Muktar Beshir Ahmed, Samer Alabed, Noore K Alam, Saleh Fahed Aldhahri, Girma Alem, Mulubirhan Assefa Alemayohu, Raghib Ali, Rajaa Al-Raddadi, Azmeraw Amare, Yaw Amoako, Al Artaman, Hamid Asayesh, Niguse Atnafu, Ashish Awasthi, Huda Ba Saleem, Aleksandra Barac, Neeraj Bedi, Isabela Bensenor, Adugnaw Berhane, Eduardo Bernabé, Balem Betsu, Agnes Binagwaho, Dube Boneya, Ismael Campos-Nonato, Carlos Castañeda-Orjuela, Ferrán Catalá-López, Peggy Chiang, Chioma Chibueze, Abdulaal Chitheer, Jee-Young Choi, Benjamin Cowie, Solomon Damtew, José das Neves, Suhojit Dey, Samath Dharmaratne, Preet Dhillon, Eric Ding, Tim Driscoll, Donatus Ekwueme, Aman Yesuf Endries, Maryam Farvid, Farshad Farzadfar, Joao Fernandes, Florian Fischer, Tsegaye Tewelde G/Hiwot, Alemseged Gebru, Sameer Gopalani, Alemayehu Hailu, Masako Horino, Nobuyuki Horita, Abdullatif Husseini, Inge Huybrechts, Manami Inoue, Farhad Islami, Mihajlo Jakovljevic, Spencer James, Mehdi Javanbakht, Sun Ha Jee, Amir Kasaeian, Muktar Sano Kedir, Yousef S Khader, Young-Ho Khang, Daniel Kim, James Leigh, Shai Linn, Raimundas Lunevicius, Hassan Magdy Abd El Razek, Reza Malekzadeh, Deborah Carvalho Malta, Wagner Marcenes, Desalegn Markos, Yohannes A Melaku, Kidanu G Meles, Walter Mendoza, Desalegn Tadese Mengiste, Tuomo J Meretoja, Ted R Miller, Karzan Abdulmuhsin Mohammad, Alireza Mohammadi, Shafiu Mohammed, Maziar Moradi-Lakeh, Gabriele Nagel, Devina Nand, Quyen Le Nguyen, Sandra Nolte, Felix A Ogbo, Kelechi E Oladimeji, Eyal Oren, Mahesh Pa, Eun-Kee Park, David M Pereira, Dietrich Plass, Mostafa Qorbani, Amir Radfar, Anwar Rafay, Mahfuzar Rahman, Saleem M Rana, Kjetil Søreide, Maheswar Satpathy, Monika Sawhney, Sadaf G Sepanlou, Masood Ali Shaikh, Jun She, Ivy Shiue, Hirbo Roba Shore, Mark G Shrime, Samuel So, Samir Soneji, Vasiliki Stathopoulou, Konstantinos Stroumpoulis, Muawiyyah Babale Sufiyan, Bryan L Sykes, Rafael Tabarés-Seisdedos, Fentaw Tadese, Bemnet Amare Tedla, Gizachew Assefa Tessema, J S Thakur, Bach Xuan Tran, Kingsley Nnanna Ukwaja, Benjamin S Chudi Uzochukwu, Vasiliy Victorovich Vlassov, Elisabete Weiderpass, Mamo Wubshet Terefe, Henock Gebremedhin Yebyo, Hassen Hamid Yimam, Naohiro Yonemoto, Mustafa Z Younis, Chuanhua Yu, Zoubida Zaidi, Maysaa El Sayed Zaki, Zerihun Menlkalew Zenebe, Christopher J L Murray, Mohsen Naghavi, Global Burden of Disease Cancer Collaboration, Christina Fitzmaurice, Christine Allen, Ryan M Barber, Lars Barregard, Zulfiqar A Bhutta, Hermann Brenner, Daniel J Dicker, Odgerel Chimed-Orchir, Rakhi Dandona, Lalit Dandona, Tom Fleming, Mohammad H Forouzanfar, Jamie Hancock, Roderick J Hay, Rachel Hunter-Merrill, Chantal Huynh, H Dean Hosgood, Catherine O Johnson, Jost B Jonas, Jagdish Khubchandani, G Anil Kumar, Michael Kutz, Qing Lan, Heidi J Larson, Xiaofeng Liang, Stephen S Lim, Alan D Lopez, Michael F MacIntyre, Laurie Marczak, Neal Marquez, Ali H Mokdad, Christine Pinho, Farshad Pourmalek, Joshua A Salomon, Juan Ramon Sanabria, Logan Sandar, Benn Sartorius, Stephen M Schwartz, Katya A Shackelford, Kenji Shibuya, Jeff Stanaway, Caitlyn Steiner, Jiandong Sun, Ken Takahashi, Stein Emil Vollset, Theo Vos, Joseph A Wagner, Haidong Wang, Ronny Westerman, Hajo Zeeb, Leo Zoeckler, Foad Abd-Allah, Muktar Beshir Ahmed, Samer Alabed, Noore K Alam, Saleh Fahed Aldhahri, Girma Alem, Mulubirhan Assefa Alemayohu, Raghib Ali, Rajaa Al-Raddadi, Azmeraw Amare, Yaw Amoako, Al Artaman, Hamid Asayesh, Niguse Atnafu, Ashish Awasthi, Huda Ba Saleem, Aleksandra Barac, Neeraj Bedi, Isabela Bensenor, Adugnaw Berhane, Eduardo Bernabé, Balem Betsu, Agnes Binagwaho, Dube Boneya, Ismael Campos-Nonato, Carlos Castañeda-Orjuela, Ferrán Catalá-López, Peggy Chiang, Chioma Chibueze, Abdulaal Chitheer, Jee-Young Choi, Benjamin Cowie, Solomon Damtew, José das Neves, Suhojit Dey, Samath Dharmaratne, Preet Dhillon, Eric Ding, Tim Driscoll, Donatus Ekwueme, Aman Yesuf Endries, Maryam Farvid, Farshad Farzadfar, Joao Fernandes, Florian Fischer, Tsegaye Tewelde G/Hiwot, Alemseged Gebru, Sameer Gopalani, Alemayehu Hailu, Masako Horino, Nobuyuki Horita, Abdullatif Husseini, Inge Huybrechts, Manami Inoue, Farhad Islami, Mihajlo Jakovljevic, Spencer James, Mehdi Javanbakht, Sun Ha Jee, Amir Kasaeian, Muktar Sano Kedir, Yousef S Khader, Young-Ho Khang, Daniel Kim, James Leigh, Shai Linn, Raimundas Lunevicius, Hassan Magdy Abd El Razek, Reza Malekzadeh, Deborah Carvalho Malta, Wagner Marcenes, Desalegn Markos, Yohannes A Melaku, Kidanu G Meles, Walter Mendoza, Desalegn Tadese Mengiste, Tuomo J Meretoja, Ted R Miller, Karzan Abdulmuhsin Mohammad, Alireza Mohammadi, Shafiu Mohammed, Maziar Moradi-Lakeh, Gabriele Nagel, Devina Nand, Quyen Le Nguyen, Sandra Nolte, Felix A Ogbo, Kelechi E Oladimeji, Eyal Oren, Mahesh Pa, Eun-Kee Park, David M Pereira, Dietrich Plass, Mostafa Qorbani, Amir Radfar, Anwar Rafay, Mahfuzar Rahman, Saleem M Rana, Kjetil Søreide, Maheswar Satpathy, Monika Sawhney, Sadaf G Sepanlou, Masood Ali Shaikh, Jun She, Ivy Shiue, Hirbo Roba Shore, Mark G Shrime, Samuel So, Samir Soneji, Vasiliki Stathopoulou, Konstantinos Stroumpoulis, Muawiyyah Babale Sufiyan, Bryan L Sykes, Rafael Tabarés-Seisdedos, Fentaw Tadese, Bemnet Amare Tedla, Gizachew Assefa Tessema, J S Thakur, Bach Xuan Tran, Kingsley Nnanna Ukwaja, Benjamin S Chudi Uzochukwu, Vasiliy Victorovich Vlassov, Elisabete Weiderpass, Mamo Wubshet Terefe, Henock Gebremedhin Yebyo, Hassen Hamid Yimam, Naohiro Yonemoto, Mustafa Z Younis, Chuanhua Yu, Zoubida Zaidi, Maysaa El Sayed Zaki, Zerihun Menlkalew Zenebe, Christopher J L Murray, Mohsen Naghavi

Abstract

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

Objective: 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.

Evidence review: 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.

Findings: 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.