The global, regional, and national burden of cancer, 1990-2023, with forecasts to 2050: a systematic analysis for the Global Burden of Disease Study 2023
- PMID: 41015051
- DOI: 10.1016/S0140-6736(25)01635-6
The global, regional, and national burden of cancer, 1990-2023, with forecasts to 2050: a systematic analysis for the Global Burden of Disease Study 2023
Abstract
Background: Cancer is a leading cause of death globally. Accurate cancer burden information is crucial for policy planning, but many countries do not have up-to-date cancer surveillance data. To inform global cancer-control efforts, we used the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 framework to generate and analyse estimates of cancer burden for 47 cancer types or groupings by age, sex, and 204 countries and territories from 1990 to 2023, cancer burden attributable to selected risk factors from 1990 to 2023, and forecasted cancer burden up to 2050.
Methods: Cancer estimation in GBD 2023 used data from population-based cancer registration systems, vital registration systems, and verbal autopsies. Cancer mortality was estimated using ensemble models, with incidence informed by mortality estimates and mortality-to-incidence ratios (MIRs). Prevalence estimates were generated from modelled survival estimates, then multiplied by disability weights to estimate years lived with disability (YLDs). Years of life lost (YLLs) were estimated by multiplying age-specific cancer deaths by the GBD standard life expectancy at the age of death. Disability-adjusted life-years (DALYs) were calculated as the sum of YLLs and YLDs. We used the GBD 2023 comparative risk assessment framework to estimate cancer burden attributable to 44 behavioural, environmental and occupational, and metabolic risk factors. To forecast cancer burden from 2024 to 2050, we used the GBD 2023 forecasting framework, which included forecasts of relevant risk factor exposures and used Socio-demographic Index as a covariate for forecasting the proportion of each cancer not affected by these risk factors. Progress towards the UN Sustainable Development Goal (SDG) target 3.4 aim to reduce non-communicable disease mortality by a third between 2015 and 2030 was estimated for cancer.
Findings: In 2023, excluding non-melanoma skin cancers, there were 18·5 million (95% uncertainty interval 16·4 to 20·7) incident cases of cancer and 10·4 million (9·65 to 10·9) deaths, contributing to 271 million (255 to 285) DALYs globally. Of these, 57·9% (56·1 to 59·8) of incident cases and 65·8% (64·3 to 67·6) of cancer deaths occurred in low-income to upper-middle-income countries based on World Bank income group classifications. Cancer was the second leading cause of deaths globally in 2023 after cardiovascular diseases. There were 4·33 million (3·85 to 4·78) risk-attributable cancer deaths globally in 2023, comprising 41·7% (37·8 to 45·4) of all cancer deaths. Risk-attributable cancer deaths increased by 72·3% (57·1 to 86·8) from 1990 to 2023, whereas overall global cancer deaths increased by 74·3% (62·2 to 86·2) over the same period. The reference forecasts (the most likely future) estimate that in 2050 there will be 30·5 million (22·9 to 38·9) cases and 18·6 million (15·6 to 21·5) deaths from cancer globally, 60·7% (41·9 to 80·6) and 74·5% (50·1 to 104·2) increases from 2024, respectively. These forecasted increases in deaths are greater in low-income and middle-income countries (90·6% [61·0 to 127·0]) compared with high-income countries (42·8% [28·3 to 58·6]). Most of these increases are likely due to demographic changes, as age-standardised death rates are forecast to change by -5·6% (-12·8 to 4·6) between 2024 and 2050 globally. Between 2015 and 2030, the probability of dying due to cancer between the ages of 30 years and 70 years was forecasted to have a relative decrease of 6·5% (3·2 to 10·3).
Interpretation: Cancer is a major contributor to global disease burden, with increasing numbers of cases and deaths forecasted up to 2050 and a disproportionate growth in burden in countries with scarce resources. The decline in age-standardised mortality rates from cancer is encouraging but insufficient to meet the SDG target set for 2030. Effectively and sustainably addressing cancer burden globally will require comprehensive national and international efforts that consider health systems and context in the development and implementation of cancer-control strategies across the continuum of prevention, diagnosis, and treatment.
Funding: Gates Foundation, St Jude Children's Research Hospital, and St Baldrick's Foundation.
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Conflict of interest statement
Declaration of interests C Agostinis Sobrinho reports grants or contracts from the Fundação para a Ciência e a Tecnologia (CEECINST/00093/2021/CP2815/CT0001), outside the submitted work. R Ancuceanu reports consulting fees from AbbVie and Merck Romania; payment or honoraria for lectures, presentations, speakers' bureaus, manuscript writing, or educational events from AbbVie, Laropharm, Reckitt, and Merck Romania; support for attending meetings or travel from Merck Romania and Reckitt, outside the submitted work. R Bai reports support for this Article from the Social Science Fund of Jiangsu Province (grant number 21GlD008). S Bhaskar reports grants or contracts from the Japan Society for the Promotion of Science (JSPS), Japanese Ministry of Education, Culture, Sports, Science and Technology, Grant-in-Aid for Scientific Research (KAKENHI; grant 23KF0126), JSPS and the Australian Academy of Science, and JSPS International Fellowship (grant P23712); and leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid as: district chair of the Diversity, Equity, Inclusion & Belonging of Rotary District 9675 (Sydney, Australia); chair, founding member, and manager of the Global Health & Migration Hub Community, Global Health Hub Germany (Berlin, Germany); editorial board member of PLOS One, BMC Neurology, Frontiers in Neurology, Frontiers in Stroke, Frontiers in Public Health, Journal of Aging Research, and Neurology International, Diagnostics, & BMC Medical Research Methodology; member of the College of Reviewers, Canadian Institutes of Health Research, Government of Canada; Director of Research of World Headache Society (Bengaluru, India); expert adviser and reviewer of Cariplo Foundation (Milan, Italy); visiting director of National Cerebral and Cardiovascular Center, Department of Neurology, Division of Cerebrovascular Medicine and Neurology, Suita (Osaka, Japan); member of the Scientific Review Committee of Cardiff University Biobank (Cardiff, UK); chair of Rotary Reconciliation Action Plan; and Healthcare and Medical Adviser at Japan Connect (Osaka, Japan), outside the submitted work. M Carvalho reports other support from the Laboratório Associado para a Química Verde, University of Porto, Porto, Portugal, under the scope of the project UIDP/50006/2020, outside the submitted work. E C Dee reports support for this Article from the Prostate Cancer Foundation (Young Investigator Award) and the National Cancer Institute (P30 CA008748). A Faro reports support for the this Article from the Brazilian National Council for Scientific and Technological Development. L M Force reports support for this Article from the Gates Foundation, St Jude Children's Research Hospital, St Baldrick's Foundation; grants or contracts from Conquer Cancer Foundation, US National Institutes of Health (NIH) Loan Repayment Program; leadership or fiduciary role in other board, society, committee or advocacy group, unpaid with the Lancet Oncology International Advisory Board, outside the submitted work. C Herteliu reports grants or contracts from the project “analysis of the impact of COVID-19 on the main demographic indicators in Romania and the Republic of Moldova by using econometric modeling” (code PN-IV-P8–8·3-ROMD-2023–0208) funded by the Romanian Ministry of Research, Innovation and Digitalization (MCID) through the Executive Agency for Higher Education, Research, Development and Innovation Funding, from a grant of the European Commission Horizon 4P-CAN (personalised cancer primary prevention research through citizen participation and digitally enabled social innovation), grants or contracts from the project “societal and economic resilience within multi-hazards environment in Romania” funded by the EU (NextgenerationEU and Romanian Government), under National Recovery and Resilience Plan for Romania (contract number 760050/ 23.05.2023' code PNRR-C9-I8-CF 267/ 29.11.2022) through the Romanian Ministry of Research, Innovation and Digitalization, within Component 9, Investment I8, grants or contracts from the project “a better understanding of socio-economic systems using quantitative methods from physics” funded by the EU (NextgenerationEU and Romanian Government), under National Recovery and Resilience Plan for Romania (contract number 760034/ 23.05.2023; code PNRR-C9-I8-CF 255/ 29.11.2022), through the Romanian Ministry of Research, Innovation and Digitalization, within Component 9, Investment I8, outside the submitted work. I Ilic reports support for this Article from the Ministry of Science, Technological Development and Innovation of the Republic of Serbia (number 451–03–137/2025–03/200110). M Ilic reports support for this Article from the Ministry of Science, Technological Development and Innovation of the Republic of Serbia (number 451–03–47/2023–01/200111). T Joo reports support for this Article from National Research, Development and Innovation Office in Hungary (RRF-2.3.1–21–2022–00006, Data-Driven Health Division of National Laboratory for Health Security. J Khubchandani reports grants or contracts from Merck Pharma and the National Science Foundation, outside the submitted work. J Kocarnik reports support for this Article from the Institute for Health Metrics and Evaluation (employee), the Gates Foundation (funding to institution), and the American Lebanese Syrian Associated Charities (funding to institution). A Konstas reports grants or contacts from Thea Pharmaceuticals, Omni Vision, Vianex, Santen, Intermed, and Bayer; consulting fees from Thea Pharmaceuticals and Santen; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Thea Pharmaceuticals, Vianex, Intermed, and Esteve Pharmaceuticals; support for attending meetings or travel from Thea Pharmaceuticals, Vianex, and Intermed, outside the submitted work. K Krishan reports non-financial support from the UGC Centre of Advanced Study, CAS II, awarded to the Department of Anthropology, Panjab University, Chandigarh, India, outside the submitted work. M-C Li reports grants or contracts from the National Science and Technology Council, Taiwan (NSTC 113–2314-B-003–002) and the Higher Education Sprout Project of National Taiwan Normal University, outside the submitted work. W-Z Li reports support for this Article from the Postdoctoral Fellowship Program of China Postdoctoral Science Foundation (GZB20230179) and the Grant of State Key Laboratory of Respiratory Disease (SKLRD-Z-202401). J Liu reports support for this Article from the National Natural Science Foundation (72474005) and Beijing Natural Science Foundation (Z24004). E Lytvyak reports grants or contracts from University of Alberta, Advanz Pharma, WCB Alberta, and China Postdoctoral Science Foundation; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Alberta Obesity Society; other financial or non-financial support from University of Alberta and Alberta Health Services, outside the submitted work. H R Marateb reports grants or contracts from Universitat Politècnica de Cataluny, outside the submitted work. D Menges reports grants or contracts from Swiss Cancer Foundation, Dr Arnold U und Susanne Huggenberger–Bischoff Stiftung, one further, private, not-for-profit research foundation from Switzerland (requested anonymity), all outside the submitted work. A-F Mentis reports grants or contracts from “MilkSafe: a novel pipeline to enrich formula milk using omics technologies”, a research co-financed by the European Regional Development Fund of the European Union and Greek national funds through the Operational Program Competitiveness, Entrepreneurship and Innovation, under the call Research-Create-Innovate (project code T2EDK-02222), as well as from ELIDEK (Hellenic Foundation for Research and Innovation, MIMS-860; both outside of the submitted work); payment or expert testimony as external peer-reviewer for Fondazione Cariplo, Italy; leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid as editorial board member for Systematic Reviews and Annals of Epidemiology, and as associate editor for Translational Psychiatry, outside the submitted work. 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F B Omage reports support for this Article from Sao Paulo Research Foundation (Fundacão de Amparo à Pesquisa do Estado de São Paulo; grant number 2023/02691–2). S K Panda reports support for this Article from Siksha ‘O' Anusandhan (deemed to be University); grants or contracts from File number 17–59/2023–24/CCRH/Tech./Coll./ICMR-Diabetes/960 as co-investigator; participation on a data safety monitoring board or advisory board as associate editor of Heliyon, outside the submitted work. S Rege reports leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid as operational lead of International Society for Pharmacoeconomics and Outcomes Research's Medication Adherence and Persistence's Special Interest Group, review editor of Editorial Board of Pharmacoepidemiology section within Frontiers in Pharmacology, Academic Editor of PLOS ONE's Editorial Board, Editorial Board member of Pain Management, outside the submitted. 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D Trico reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AstraZeneca, Eli Lilly, Novo Nordisk; Support for attending meetings or travel from AstraZeneca; participation on a data safety monitoring board or advisory board with Amarin, Boehringer Ingelheim, Novo Nordisk; leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid EASD Early Career Academy and EASD Committee on Clinical Affairs; receipt of equipment, materials, drugs, medical writing, gifts or other services paid to the institution from Abbott and PharmaNutra, outside the submitted work. E Vounzoulaki reports grants or contracts from NIHR DSE Award (until July 2026), outside the submitted work. P Willeit reports consulting fees from Novartis Pharmaceuticals, outside the submitted work. J F Wu reports grants or contracts from the National Heart, Lung, and Blood Institute (R38HL167238) and acknowledges previous funding from the American Society of Hematology Hematology Opportunities for the Next Generation of Research Scientists (HONORS) Award, outside the submitted work. S N Zafar reports grants or contracts from the NIH/NCI Early-Stage Surgeon Scientist Program (grant P30 CA014520–48S4), outside the submitted work. M Zielińska reports other support as an Alexion, AstraZeneca Rare Disease employee, outside the submitted work.
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