Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life Years for 29 Cancer Groups From 2010 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019

Abstract

Importance: The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) provided systematic estimates of incidence, morbidity, and mortality to inform local and international efforts toward reducing cancer burden.

Objective: To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic Index (SDI) quintiles from 2010 to 2019.

Evidence review: The GBD 2019 estimation methods were used to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs) in 2019 and over the past decade. Estimates are also provided by quintiles of the SDI, a composite measure of educational attainment, income per capita, and total fertility rate for those younger than 25 years. Estimates include 95% uncertainty intervals (UIs).

Findings: In 2019, there were an estimated 23.6 million (95% UI, 22.2-24.9 million) new cancer cases (17.2 million when excluding nonmelanoma skin cancer) and 10.0 million (95% UI, 9.36-10.6 million) cancer deaths globally, with an estimated 250 million (235-264 million) DALYs due to cancer. Since 2010, these represented a 26.3% (95% UI, 20.3%-32.3%) increase in new cases, a 20.9% (95% UI, 14.2%-27.6%) increase in deaths, and a 16.0% (95% UI, 9.3%-22.8%) increase in DALYs. Among 22 groups of diseases and injuries in the GBD 2019 study, cancer was second only to cardiovascular diseases for the number of deaths, years of life lost, and DALYs globally in 2019. Cancer burden differed across SDI quintiles. The proportion of years lived with disability that contributed to DALYs increased with SDI, ranging from 1.4% (1.1%-1.8%) in the low SDI quintile to 5.7% (4.2%-7.1%) in the high SDI quintile. While the high SDI quintile had the highest number of new cases in 2019, the middle SDI quintile had the highest number of cancer deaths and DALYs. From 2010 to 2019, the largest percentage increase in the numbers of cases and deaths occurred in the low and low-middle SDI quintiles.

Conclusions and relevance: The results of this systematic analysis suggest that the global burden of cancer is substantial and growing, with burden differing by SDI. These results provide comprehensive and comparable estimates that can potentially inform efforts toward equitable cancer control around the world.

Figure 1.. Ranking of Total Cancer Absolute Disability-Adjusted Life Years (DALYs) in 2019 Among the 22 Level 2 Categories of Disease in the Global Burden of Disease (GBD) Study by Quintile of Sociodemographic Index (SDI)

Total cancers excludes nonmelanoma skin cancer. The GBD study organized diseases and injuries into a hierarchy that was mutually exclusive and collectively exhaustive. More details of this hierarchy were previously published. Colors represent the ranking of the cause within a given location group (eg, high SDI quintile) from red (highest ranking) to green (lowest ranking). The other noncommunicable diseases include congenital birth defects; urinary diseases and male infertility; gynecological diseases; hemoglobinopathies and hemolytic anemias; endocrine, metabolic, blood, and immune disorders; oral disorders; and sudden infant death syndrome. The other infectious diseases include meningitis; encephalitis; diphtheria; whooping cough; tetanus; measles; varicella and herpes zoster; acute hepatitis; and other unspecified infectious diseases. NMSC indicates nonmelanoma skin cancer; UI, uncertainty interval.

Figure 2.. Cancer Group Rankings by Disability-Adjusted Life Years (DALYs) in 2019 and Percentage Change From 2010 to 2019

Rankings are by absolute DALYs and exclude the other malignant neoplasms cancer group. Cancers are ordered by rank in 2019, with lines connecting to their rank in 2010. Absolute DALYs and age-standardized DALY rates for 2010 can be found online at https://vizhub.healthdata.org/gbd-compare/. Colors refer to the directional change in cancer rank from 2010 to 2019: red signifies an increase in rank, blue signifies no change in rank, and green signifies a decrease in rank. UI indicates uncertainty interval.

Figure 3.. Annualized Rate of Change in Age-Standardized Total Cancer Incidence Rate From 2010 to 2019 in Both Sexes

Total cancer excludes nonmelanoma skin cancers. Annualized rate of change from 2010 to 2019 represents the average percentage change per year during this period, with negative values indicating decreasing incidence rates and positive values indicating increasing incidence rates. There were several geographic locations where estimates were not available (eg, Western Sahara and French Guiana), as they were not modeled locations in the Global Burden of Disease 2019 Study.

Figure 4.. Annualized Rate of Change in Age-Standardized Total Cancer Mortality Rate From 2010 to 2019 in Both Sexes

Total cancer excludes nonmelanoma skin cancers. Annualized rate of change from 2010 to 2019 represents the mean percentage change per year during this period, with negative values indicating decreasing mortality rates and positive values indicating increasing mortality rates. There were several geographic locations where estimates were not available (eg, Western Sahara and French Guiana) as they were not modeled locations in the Global Burden of Disease 2019 Study.

Figure 5.. Total Cancer Incidence and Mortality Age-Standardized Rates and Absolute Counts in 2019 and Annualized Rate of Change for Incidence and Mortality in Age-Standardized Rates and Absolute Counts From 2010 to 2019 by Sociodemographic Index (SDI) Quintile

Panels provide global estimates for total cancers, except nonmelanoma skin cancer, stratified by SDI quintile. Annualized rate of change from 2010 to 2019 represents the mean percentage change per year during this period. Black bars represent 95% uncertainty intervals.