Cancer
is a major burden of disease worldwide. Each year, tens of millions of
people are diagnosed with cancer around the world, and more than half of
the patients eventually die from it. In many countries, cancer ranks
the second most common cause of death following cardiovascular diseases.
With significant improvement in treatment and prevention of
cardiovascular diseases, cancer has or will soon become the number one
killer in many parts of the world. As elderly people are most
susceptible to cancer and population aging continues in many countries,
cancer will remain a major health problem around the globe.
In
this review, we summarized published data to describe the severity of
the burden. We also analyzed the GLOBOCAN 2002 database to evaluate the
morbidity and mortality of cancer in various geographic regions around
the world. The GLOBOCAN 2002 database was put together using the huge
amount of data available in the Descriptive Epidemiology Group of the
International Agency of Research on Cancer (IARC), a World Health
Organization agency in Lyon, France [
1].
Incidence data are available from cancer registries. They cover either
entire national populations or samples of such populations from selected
regions. Cancer registries also provide statistics on cancer survival.
Mortality data by cause are available for many countries through the
registration of vital events.
Cancer data are
always collected and compiled sometime after the events to which they
relate, so the most recent statistics available are always “late.”
GLOBOCAN 2002 was first made available in September 2005 and presented
estimates for 2002. These estimates are based on the most recent
incidence, mortality, and survival data available at IARC, but more
recent figures may be available directly from local sources. The
Age-Standardized Rate (ASR, world standard) is calculated using the five
age groups of 0 to 14, 15 to 44, 45 to 54, 55 to 64, and ≥ 65 years.
The weights of the world standard population for the five age groups
were 0.31, 0.43, 0.11, 0.08, and 0.07, respectively.
Overall Burden of Cancer Worldwide
Based
on the GLOBOCAN database, there were about 10,862,496 new cancer cases
(excluding skin cancer) in the world in 2002. Of these, 5,801,839 (53.4
percent) were male and 5,060,657 (46.6 percent) were female. Nearly 45
percent of the new cases were diagnosed in Asia, 26 percent in Europe,
15 percent in North America, 7 percent in Latin America, and 6 percent
in Africa. For males and females combined, the most common cancer site
worldwide was lung (965,446 male and 386,875 female cases per year). The
second most common site was colon (550,513 males and 472,743 females),
followed by stomach (603,003 males and 330,290 females). Among women,
the number one cancer site was breast (1,152,161 new cases per year),
followed by cervix (493,100 cases), and colon (472,743 cases). Among
men, the three most common cancer sites were lung (965,446 cases),
prostate (679,060 cases), and stomach (603,003 cases).
The
number of deaths caused by cancer worldwide in 2002 was 6,723,887,
among which 3,795,991 were male and 2,927,896 were female. Lung cancer
led to most cancer deaths in the world. In 2002, the total death toll
due to lung cancer was 1,179,074, of which 848,321 were male and 330,753
were female. The second on the list was stomach cancer, which resulted
in a total of 699,803 deaths, including 445,691 in males and 254,112 in
females. Liver cancer was the number three cause of cancer mortality. A
total of 598,412 deaths (416,926 male and 81,486 female) were attributed
to liver cancer in 2002. For women, the top three sites for cancer
mortality were breast (411,093 deaths), lung (330,753 deaths), and
cervix uteri (273,449 deaths), while lung (848,321), stomach (445,691),
and liver (416,926) constituted the top three sites for cancer mortality
in men.
Incidence of Cancer by Geographic Regions
Of
the 21 regions listed in the GLOBOCAN 2002 database, East Asia had the
largest number of incident cancer cases (all ages, all sites except
skin) in 2002 (n = 2,890,311); North America and South Central Asia were
second (n = 1,570,520) and third (n = 1,261,527) on the list,
respectively [].
The pattern of cancer sites varied substantially from region to region.
For example, the three most common cancer sites among individuals 15
years or older in East Asia were stomach (18.9 percent), lung (17.1
percent), and liver (14.3 percent), whereas those in North America were
prostate (16.5 percent), breast (14.7 percent), and lung (14.5 percent)
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