The Global Burden of Cancer 2013

Global Burden of Disease Cancer Collaboration, Christina Fitzmaurice, Daniel Dicker, Amanda Pain, Hannah Hamavid, Maziar Moradi-Lakeh, Michael F. MacIntyre, Christine Allen, Gillian Hansen, Rachel Woodbrook, Charles Wolfe, Randah R. Hamadeh, Ami Moore, Andrea Werdecker, Bradford D. Gessner, Braden Te Ao, Brian McMahon, Chante Karimkhani, Chuanhua Yu, Graham S. CookeDavid C. Schwebel, David O. Carpenter, David M. Pereira, Denis Nash, Dhruv S. Kazi, Diego De Leo, Dietrich Plass, Kingsley N. Ukwaja, George D. Thurston, Kim Yun Jin, Edgar P. Simard, Edward Mills, Eun Kee Park, Ferrán Catalá-López, Gabrielle DeVeber, Carolyn Gotay, Gulfaraz Khan, H. Dean Hosgood, Itamar S. Santos, Janet L. Leasher, Jasvinder Singh, James Leigh, Jost B. Jonas, Juan Sanabria, Justin Beardsley, Kathryn H. Jacobsen, Ken Takahashi, Richard C. Franklin, Luca Ronfani, Marcella Montico, Luigi Naldi, Marcello Tonelli, Johanna Geleijnse, Max Petzold, Mark G. Shrime, Mustafa Younis, Naohiro Yonemoto, Nicholas Breitborde, Paul Yip, Farshad Pourmalek, Paulo A. Lotufo, Alireza Esteghamati, Graeme J. Hankey, Raghib Ali, Raimundas Lunevicius, Reza Malekzadeh, Robert Dellavalle, Robert Weintraub, Robyn Lucas, Roderick Hay, David Rojas-Rueda, Ronny Westerman, Sadaf G. Sepanlou, Sandra Nolte, Scott Patten, Scott Weichenthal, Semaw Ferede Abera, Seyed Mohammad Fereshtehnejad, Ivy Shiue, Tim Driscoll, Tommi Vasankari, Ubai Alsharif, Vafa Rahimi-Movaghar, Vasiliy V. Vlassov, W. S. Marcenes, Wubegzier Mekonnen, Yohannes Adama Melaku, Yuichiro Yano, Al Artaman, Ismael Campos, Jennifer MacLachlan, Ulrich Mueller, Daniel Kim, Matias Trillini, Babak Eshrati, Hywel C. Williams, Kenji Shibuya, Rakhi Dandona, Kinnari Murthy, Benjamin Cowie, Azmeraw T. Amare, Carl Abelardo Antonio, Carlos Castañeda-Orjuela, Coen H. Van Gool, Francesco Violante, In Hwan Oh, Kedede Deribe, Kjetil Soreide, Luke Knibbs, Maia Kereselidze, Mark Green, Rosario Cardenas, Nobhojit Roy, Taavi Tillmann, Yongmei Li, Hans Krueger, Lorenzo Monasta, Subhojit Dey, Sara Sheikhbahaei, Nima Hafezi-Nejad, G. Anil Kumar, Chandrashekhar T. Sreeramareddy, Lalit Dandona, Haidong Wang, Stein Emil Vollset, Ali Mokdad, Joshua A. Salomon, Rafael Lozano, Theo Vos, Mohammad Forouzanfar, Alan Lopez, Christopher Murray, Mohsen Naghavi

Research output: Contribution to journalArticle

1660 Citations (Scopus)


IMPORTANCE: Cancer is among the leading causes of death worldwide. Current estimates of cancer burden in individual countries and regions are necessary to inform local cancer control strategies.

OBJECTIVE: To estimate mortality, incidence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 28 cancers in 188 countries by sex from 1990 to 2013.

EVIDENCE REVIEW: The general methodology of the Global Burden of Disease (GBD) 2013 study was used. Cancer registries were the source for cancer incidence data as well as mortality incidence (MI) ratios. Sources for cause of death data include vital registration system data, verbal autopsy studies, and other sources. The MI ratios were used to transform incidence data to mortality estimates and cause of death estimates to incidence estimates. Cancer prevalence was estimated using MI ratios as surrogates for survival data; YLDs were calculated by multiplying prevalence estimates with disability weights, which were derived from population-based surveys; YLLs were computed by multiplying the number of estimated cancer deaths at each age with a reference life expectancy; and DALYs were calculated as the sum of YLDs and YLLs.

FINDINGS: In 2013 there were 14.9 million incident cancer cases, 8.2 million deaths, and 196.3 million DALYs. Prostate cancer was the leading cause for cancer incidence (1.4 million) for men and breast cancer for women (1.8 million). Tracheal, bronchus, and lung (TBL) cancer was the leading cause for cancer death in men and women, with 1.6 million deaths. For men, TBL cancer was the leading cause of DALYs (24.9 million). For women, breast cancer was the leading cause of DALYs (13.1 million). Age-standardized incidence rates (ASIRs) per 100 000 and age-standardized death rates (ASDRs) per 100 000 for both sexes in 2013 were higher in developing vs developed countries for stomach cancer (ASIR, 17 vs 14; ASDR, 15 vs 11), liver cancer (ASIR, 15 vs 7; ASDR, 16 vs 7), esophageal cancer (ASIR, 9 vs 4; ASDR, 9 vs 4), cervical cancer (ASIR, 8 vs 5; ASDR, 4 vs 2), lip and oral cavity cancer (ASIR, 7 vs 6; ASDR, 2 vs 2), and nasopharyngeal cancer (ASIR, 1.5 vs 0.4; ASDR, 1.2 vs 0.3). Between 1990 and 2013, ASIRs for all cancers combined (except nonmelanoma skin cancer and Kaposi sarcoma) increased by more than 10% in 113 countries and decreased by more than 10% in 12 of 188 countries.

CONCLUSIONS AND RELEVANCE: Cancer poses a major threat to public health worldwide, and incidence rates have increased in most countries since 1990. The trend is a particular threat to developing nations with health systems that are ill-equipped to deal with complex and expensive cancer treatments. The annual update on the Global Burden of Cancer will provide all stakeholders with timely estimates to guide policy efforts in cancer prevention, screening, treatment, and palliation.

Original languageEnglish
Pages (from-to)505-527
Number of pages23
JournalJAMA Oncology
Issue number4
Publication statusPublished - 1 Jul 2015
Externally publishedYes

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    Global Burden of Disease Cancer Collaboration, Fitzmaurice, C., Dicker, D., Pain, A., Hamavid, H., Moradi-Lakeh, M., MacIntyre, M. F., Allen, C., Hansen, G., Woodbrook, R., Wolfe, C., Hamadeh, R. R., Moore, A., Werdecker, A., Gessner, B. D., Te Ao, B., McMahon, B., Karimkhani, C., Yu, C., ... Naghavi, M. (2015). The Global Burden of Cancer 2013. JAMA Oncology, 1(4), 505-527.