A Systematic Analysis of the Global Burden of Disease from 2010 to 2019 Suggests Increase in New Cancer Cases, Cancer Deaths and Disability-Adjusted Life Years

The results of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 demonstrate the substantial and growing global burden of cancer, with patterns of burden differing by Sociodemographic Index (SDI) quintile. Between 2010 and 2019, the number of new global cancer cases increased by 26.3% and number of deaths by 20.9%. However, the largest percentage increases in cancer incidence and mortality during the last decade occurred in the lower SDI quintiles, likely reflecting ongoing epidemiologic transitions, demographic shifts, and disparities in cancer prevention, care, and control. In 2019, cancer-related disability-adjusted life years (DALYs) were second only to cardiovascular diseases in their contribution to global disease burden, and in the high SDI quintile, cancer overtook cardiovascular disease to become the leading cause of DALYs.

The results provide comprehensive and comparable estimates that can potentially inform efforts for equitably reducing the evolving burden of cancer globally according to report published by Jonathan M. Kocarnik, PhD, MPH, Institute for Health Metrics and Evaluation, University of Washington in Seattle, WA, US and colleagues in the JAMA Oncology.

The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 framework enabled the comparable assessment of cancer burden across locations and time in terms of cancer incidence, mortality, years of life lost, years lived with disability, and DALYs. The latest three complement incidence and mortality estimates by incorporating morbidity and mortality contributions to total cancer burden over the lifetime. Because the study estimated disease burden across a mutually exclusive and collectively exhaustive hierarchy of diseases and injuries, it was possible to systematically compare cancer burden with and rank against other causes of disease burden.

In their report, the authors present the results for 29 cancer groups for 204 countries and territories from 2010 through 2019. The results are also provided by SDI quintiles, a summary indicator of social and economic development that allows for analyses of disease burden patterns across different resource contexts; it is a composite measure of educational attainment, income per capita, and total fertility rate for those younger than 25 years. These estimates update results from the 2017 study.

In 2019, there were an estimated 23.6 million new cancer cases (17.2 million when excluding non-melanoma skin cancer) and 10.0 million cancer deaths globally, with an estimated 250 million DALYs due to cancer. Since 2010, these represented a 26.3% increase in new cases, a 20.9% increase in deaths, and a 16.0% increase in DALYs.

Among 22 groups of diseases and injuries in the Global Burden of Diseases, Injuries, and Risk Factors Study 2019, cancer was second only to cardiovascular diseases for the number of deaths, years of life lost, and DALYs globally in 2019. Cancer had greater overall and fatal burden globally in 2019 than other major groups of diseases, such as maternal and neonatal disorders, musculoskeletal disorders, and respiratory infections and tuberculosis.

The 5 leading causes of cancer-related DALYs for both sexes combined, excluding other malignant neoplasms, were tracheal, bronchus, and lung cancer with 18.3% of total cancer-related DALYs, colon and rectal cancer with 9.7%, stomach cancer with 8.9%, breast cancer with 8.2%, and liver cancer with 5.0%.

Cancer burden differed across SDI quintiles. The proportion of years lived with disability that contributed to DALYs increased with SDI, ranging from 1.4% in the low SDI quintile to 5.7% 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.

The results of this systematic analysis suggest that the global burden of cancer is substantial and growing, with burden differing by SDI. These estimates varied substantially by SDI quintile, highlighting global inequities in cancer burden. While the high SDI quintile had the highest estimated number of incident cases in 2019, the middle SDI quintile had the highest estimated number of deaths and DALYs. During the last decade, cancer burden has grown the fastest in the low and low-middle SDI quintiles.

The authors commented that such estimates are essential for improving equity in global cancer outcomes and meeting key targets for reducing cancer and other non-communicable diseases burden.

Reference

Global Burden of Disease 2019 Cancer Collaboration. 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. JAMA Oncol 2022;8(3):420-444.

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