The Global Burden of Cancer

Transcription

1 The Global Burden of Cancer Dr Christopher P Wild PhD Freddie Bray Section of Cancer Surveillance International Agency on Research on Cancer International Agency for Research on Cancer Lyon, France Freddie Bray International Agency on Research on Cancer

2 Epidemiologic transition and the rise of cancer Magnitude How and why is the cancer burden increasing? Profile How and why are cancer profiles changing? Deviations Diversity and inequality: need for local planning Data Global data for action across the cancer continuum

3 Bills of Mortality Death tally of all city parishes - August Plague:3880 deaths Fever: 353 deaths Typhus:190 deaths Cancer: 2 deaths

4 Year ??- Life Exp >50 >70 Omran s mortality transition Age of pestilence and famine Pre-transition Age of receding pandemics of infection Mortality falls with reductions of death from infectious disease Age of degenerative & man-made disease Mortality dominated heart disease, stroke and cancer Late-stage transition(s) Delayed mortality from degenerative diseases Emergence and re-emergence of diseases Omran, 1971, 1983, 1998; Olshansky and Ault, 1986; Rogers and Hackenburg, 1987.

5 Ranking of cancer: mortality (ages 0-69)

6 Source: UNDP Human Development Index (HDI)

7 Lifetime risk of cancer

8 Epidemiologic transition and the rise of cancer Magnitude Why is the cancer burden increasing?

9 INDICATORS DIMENSIONS Human Development Index (HDI) Long and healthy life Knowledge Health Life expectancy at birth Mean / expected years of schooling GNI per capita (PPP $) Source: UNDP

10 Number of new cancer cases 14.1 Million 29.4 Million

11 Total fertility rate Life expectancy Source: UNPD

12 Cases 2012 and 2035 by HDI demographic effect million cancer cases in million million million million

13 Cases 2012 and 2035 by HDI demographic effect 14.1 Million 23.3 Million

14 32.5 M 8.2 M 14.1 M M M M

15 Epidemiologic transition and the rise of cancer Degree Why is the cancer burden increasing? Profile How and why are cancer profiles changing? Deviations Signals the need for local cancer planning Data To showcase long-term prevention approaches

16 WHO mortality

17 WHO mortality

18 14.1 Million 29.4 Million

19 32.5 M 8.2 M 14.1 M 29.4 M M M

20 Epidemiologic transition and the rise of cancer Degree Why is the cancer burden increasing? Distribution How and why are cancer profiles changing? Deviations Diversity & inequality - need for local cancer planning Data To showcase long-term prevention approaches

21 Parkin et al, 2014; Chokunonga et al, 2013.

22 Trends in cervical cancer incidence

23 Moore et al, Lancet Oncol 2015.

24 Epidemiologic transition and the rise of cancer Availability Degree of basic surveillance data in every country of the world Why is the cancer burden increasing? Expand measures of cancer surveillance for cancer control action Distribution Use How surveillance and why are approaches cancer profiles to demonstrate changing? long-term success of prevention Deviations Signals the need for local cancer planning Data Global data for action across the cancer continuum

25 Evolving while staying the same.. Data availability: Worldwide INCIDENCE Dr Calum Muir Only Dr Hrafn 67 of Tulinius 184 countries report ( ) high ( ) quality incidence data to IARC 1 36% MORTALITY Only 34 of 178 countries report high quality mortality data to WHO 2 19% validating cancer estimates against high quality recorded data + = supporting in-country investments in data collection = in-country consultancies 40 regional courses delivered 17 agreements with countries improved global cancer estimates robust data to governments to develop cancer control strategies Development of populationbased cancer registries in 50 LMIC by Cancer Incidence in Five Continents Volume X 2 WHO Mortality Database

26 Measures & strategies for cancer surveillance Piñeros et al, in preparation; after Wingo et al, 2005; Jemal et al, 2014.

27 Global burden of cancer attributable to high BMI % of all new cancer cases in adults attributable to high BMI. PAFs greater in women than in men (5.4% vs 1.9%). Arnold et al, 2015.

28 Cervical cancer incidence: observed & forecasted Impact of no intervention vs. effective screening beginning 2017 Effective screening implementation: a 50-60% reduction of the projected rates circa 2040 Prevention of cervical cancer in 1,500 women in Estonia to over 150,000 women in the Russian Federation. Vaccarella et al, submitted

29 Changes in Inflation-Adjusted Price of Cigarettes and in Cigarette Consumption Trends Observed in the & observed projected and lung expected cancer number mortality of lung rates, cancer US, deaths in US men, Jha and Peto 2014; Thun and Jemal, 2006.

30 Magnitude World in epidemiologic transition: 14 million to a projected 23m cancer cases by 2035 based on demographic changes. Magnitude highly dependent on extent of transition in a given country. Profile Cancer risk and profiles altering, over 29m cases taking into account recent trends. Displacement of infection to cancers that predominate in the west. Impact of medical intervention leading to a subset of cancers with high incidence and low case fatality. Profile highly dependent on extent of transition in a given country. Deviations As many transition models as societies; cervical cancer rising in low and high HDI countries; a double burden in Africa, Clear disparities in HIC as well as LMIC. Data Most countries not served by good surveillance. Better data and an expanded set of indicators needed to ask the right questions.

31 Acknowledgments IARC/CSU M Arnold B Cao J Ferlay M Laversanne M Piñeros I Soerjomataram K Canfell A Jemal A Pearce S Vaccarella