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, 3 (4), 524-548

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 CollaborationChristina Fitzmaurice  1 Christine Allen  2 Ryan M Barber  2 Lars Barregard  3 Zulfiqar A Bhutta  4 Hermann Brenner  5 Daniel J Dicker  2 Odgerel Chimed-Orchir  6 Rakhi Dandona  7 Lalit Dandona  2 Tom Fleming  2 Mohammad H Forouzanfar  2 Jamie Hancock  2 Roderick J Hay  8 Rachel Hunter-Merrill  2 Chantal Huynh  2 H Dean Hosgood  9 Catherine O Johnson  2 Jost B Jonas  10 Jagdish Khubchandani  11 G Anil Kumar  7 Michael Kutz  2 Qing Lan  12 Heidi J Larson  13 Xiaofeng Liang  14 Stephen S Lim  2 Alan D Lopez  15 Michael F MacIntyre  2 Laurie Marczak  2 Neal Marquez  2 Ali H Mokdad  2 Christine Pinho  2 Farshad Pourmalek  16 Joshua A Salomon  17 Juan Ramon Sanabria  18 Logan Sandar  2 Benn Sartorius  19 Stephen M Schwartz  20 Katya A Shackelford  2 Kenji Shibuya  21 Jeff Stanaway  2 Caitlyn Steiner  2 Jiandong Sun  22 Ken Takahashi  23 Stein Emil Vollset  24 Theo Vos  2 Joseph A Wagner  2 Haidong Wang  2 Ronny Westerman  25 Hajo Zeeb  26 Leo Zoeckler  2 Foad Abd-Allah  27 Muktar Beshir Ahmed  28 Samer Alabed  29 Noore K Alam  30 Saleh Fahed Aldhahri  31 Girma Alem  32 Mulubirhan Assefa Alemayohu  33 Raghib Ali  34 Rajaa Al-Raddadi  35 Azmeraw Amare  36 Yaw Amoako  37 Al Artaman  38 Hamid Asayesh  39 Niguse Atnafu  40 Ashish Awasthi  41 Huda Ba Saleem  42 Aleksandra Barac  43 Neeraj Bedi  44 Isabela Bensenor  45 Adugnaw Berhane  46 Eduardo Bernabé  47 Balem Betsu  48 Agnes Binagwaho  49 Dube Boneya  32 Ismael Campos-Nonato  50 Carlos Castañeda-Orjuela  51 Ferrán Catalá-López  52 Peggy Chiang  53 Chioma Chibueze  54 Abdulaal Chitheer  55 Jee-Young Choi  56 Benjamin Cowie  57 Solomon Damtew  58 José das Neves  59 Suhojit Dey  60 Samath Dharmaratne  61 Preet Dhillon  62 Eric Ding  63 Tim Driscoll  64 Donatus Ekwueme  65 Aman Yesuf Endries  66 Maryam Farvid  67 Farshad Farzadfar  68 Joao Fernandes  69 Florian Fischer  70 Tsegaye Tewelde G/Hiwot  71 Alemseged Gebru  72 Sameer Gopalani  73 Alemayehu Hailu  74 Masako Horino  75 Nobuyuki Horita  76 Abdullatif Husseini  77 Inge Huybrechts  78 Manami Inoue  21 Farhad Islami  79 Mihajlo Jakovljevic  80 Spencer James  81 Mehdi Javanbakht  82 Sun Ha Jee  83 Amir Kasaeian  84 Muktar Sano Kedir  85 Yousef S Khader  86 Young-Ho Khang  87 Daniel Kim  88 James Leigh  89 Shai Linn  90 Raimundas Lunevicius  91 Hassan Magdy Abd El Razek  92 Reza Malekzadeh  93 Deborah Carvalho Malta  94 Wagner Marcenes  47 Desalegn Markos  95 Yohannes A Melaku  72 Kidanu G Meles  96 Walter Mendoza  97 Desalegn Tadese Mengiste  72 Tuomo J Meretoja  98 Ted R Miller  99 Karzan Abdulmuhsin Mohammad  100 Alireza Mohammadi  101 Shafiu Mohammed  102 Maziar Moradi-Lakeh  103 Gabriele Nagel  104 Devina Nand  105 Quyen Le Nguyen  106 Sandra Nolte  107 Felix A Ogbo  108 Kelechi E Oladimeji  109 Eyal Oren  110 Mahesh Pa  111 Eun-Kee Park  112 David M Pereira  113 Dietrich Plass  114 Mostafa Qorbani  115 Amir Radfar  116 Anwar Rafay  117 Mahfuzar Rahman  118 Saleem M Rana  119 Kjetil Søreide  120 Maheswar Satpathy  121 Monika Sawhney  122 Sadaf G Sepanlou  123 Masood Ali Shaikh  124 Jun She  125 Ivy Shiue  126 Hirbo Roba Shore  127 Mark G Shrime  128 Samuel So  129 Samir Soneji  130 Vasiliki Stathopoulou  131 Konstantinos Stroumpoulis  132 Muawiyyah Babale Sufiyan  133 Bryan L Sykes  134 Rafael Tabarés-Seisdedos  135 Fentaw Tadese  136 Bemnet Amare Tedla  137 Gizachew Assefa Tessema  138 J S Thakur  139 Bach Xuan Tran  140 Kingsley Nnanna Ukwaja  141 Benjamin S Chudi Uzochukwu  142 Vasiliy Victorovich Vlassov  143 Elisabete Weiderpass  144 Mamo Wubshet Terefe  145 Henock Gebremedhin Yebyo  72 Hassen Hamid Yimam  146 Naohiro Yonemoto  147 Mustafa Z Younis  148 Chuanhua Yu  149 Zoubida Zaidi  150 Maysaa El Sayed Zaki  151 Zerihun Menlkalew Zenebe  152 Christopher J L Murray  2 Mohsen Naghavi  2
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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 et al. JAMA Oncol.

Erratum in

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.

Conflict of interest statement

Conflict of Interest Disclosures: None reported.

Figures

Figure 1
Figure 1
Age-Specific Global Contributions of Cancer Types to Total Cancer Incidence and Mortality For Both Sexes, 2015
Figure 2
Figure 2. Relative Changes in Age-Standardized Cancer Incidence Rates in Both Sexes for All Cancers in 195 Countries or Territories From 2005 to 2015
Data reflect both sexes for all cancers excluding nonmelanoma skin cancer in 195 countries or territories from 2005 to 2015. The 95% UIs are reported in Web Table 1. 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; KS, Kaposi sarcoma; LCA, Saint Lucia; MDV, Maldives; MLT, Malta; MUS, Mauritius; MHL, Marshall Islands; NMSC, nonmelanoma skin cancer; 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
Figure 3. Relative Changes in Age-Standardized Cancer Mortality Rates in Both Sexes for All Cancers in 195 Countries or Territories From 2005 to 2015
Data reflect both sexes for all cancers excluding nonmelanoma skin cancer in 195 countries or territories from 2005 to 2015. The 95% UIs are reported in Web Table 2. 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; KS, Kaposi sarcoma; LCA, Saint Lucia; MDV, Maldives; MLT, Malta; MUS, Mauritius; MHL, Marshall Islands; NMSC, nonmelanoma skin cancer; 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 4
Figure 4
Cancers Ranked by Number of Incident Cases in Both Sexes, Global, by Region, by Sociodemographic Index (SDI), and in the 50 Most Populous Countries, 2015
Figure 5
Figure 5
Cancers Ranked by Number of Deaths in Both Sexes, Global, by Region, by Sociodemographic Index (SDI), and in the 50 Most Populous Countries, 2015
Figure 6
Figure 6. Cancers Ranked Globally and for Both Sexes by Absolute Years of Life Lost (YLLs)
Illustrated data include the percentage change in absolute YLLs (A-YLLs) and the percentage change in the age-standardized YLL (AS-YLL) rate between 2005 and 2015;. The “other cancers” group is not included in these data because it contains multiple different types of cancers. Solid lines connecting the 2005 and 2015 charts indicate increased or unchanged rank for the connected cancers; dotted lines indicate decreased rank.
Figure 7
Figure 7. Trends in Age-Standardized Incidence Rates for Breast Cancer, 1990–2015
The y-axes differ in scale between male and female graphs to reflect differing incidence rates between sexes. The colored section of the higher-scale y-axis represents the entirety of the lower-scale y-axis.
Figure 8
Figure 8. Trends in Age-Standardized Incidence Rates for Tracheal, Bronchus, and Lung Cancer, 1990–2015
The y-axes differ in scale between male and female graphs to reflect differing incidence rates between sexes. The colored section of the higher-scale y-axis represents the entirety of the lower-scale y-axis.
Figure 9
Figure 9. Trends in Age-Standardized Incidence Rates for Colon and Rectum Cancer, 1990–2015
The y-axes differ in scale between male and female graphs to reflect differing incidence rates between sexes. The colored section of the higher-scale y-axis represents the entirety of the lower-scale y-axis.
Figure 10
Figure 10
Trends in Age-Standardized Incidence Rates for Prostate Cancer, 1990–2015
Figure 11
Figure 11. Trends in Age-Standardized Incidence Rates for Stomach Cancer, 1990–2015
The y-axes differ in scale between male and female graphs to reflect differing incidence rates between sexes. The colored section of the higher-scale y-axis represents the entirety of the lower-scale y-axis.
Figure 12
Figure 12. Trends in Age-Standardized Incidence Rates for Liver Cancer, 1990–2015
The y-axes differ in scale between male and female graphs to reflect differing incidence rates between sexes. The colored section of the higher-scale y-axis represents the entirety of the lower-scale y-axis.
Figure 13
Figure 13. Trends in Age-Standardized Incidence Rates for Non-Hodgkin Lymphoma, 1990–2015
The y-axes differ in scale between male and female graphs to reflect differing incidence rates between sexes. The colored section of the higher-scale y-axis represents the entirety of the lower-scale y-axis.
Figure 14
Figure 14. Trends in Age-Standardized Incidence Rates for Leukemia, 1990–2015
The y-axes differ in scale between male and female graphs to reflect differing incidence rates between sexes. The colored section of the higher-scale y-axis represents the entirety of the lower-scale y-axis.
Figure 15
Figure 15. Trends in Age-Standardized Incidence Rates for Bladder Cancer, 1990–2015
The y-axes differ in scale between male and female graphs to reflect differing incidence rates between sexes. The colored section of the higher-scale y-axis represents the entirety of the lower-scale y-axis.
Figure 16
Figure 16
Trends in Age-Standardized Incidence Rates for Cervical Cancer, 1990–2015

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