Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived with Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2017: A Systematic Analysis for the Global Burden of Disease Study

Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572000 deaths and 15.2 million DALYs), and stomach cancer (542000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601000 deaths and 17.4 million DALYs), TBL cancer (596000 deaths and 12.6 million DALYs), and colorectal cancer (414000 deaths and 8.3 million DALYs). Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care

The global, regional, and national burden of pancreatic cancer and its attributable risk factors in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017

Background Worldwide, both the incidence and death rates of pancreatic cancer are increasing. Evaluation of pancreatic cancer burden and its global, regional, and national patterns is crucial to policy making and better resource allocation for controlling pancreatic cancer risk factors, developing early detection methods, and providing faster and more effective treatments. Methods Vital registration, vital registration sample, and cancer registry data were used to generate mortality, incidence, and disability-adjusted life-years (DALYs) estimates. We used the comparative risk assessment framework to estimate the proportion of deaths attributable to risk factors for pancreatic cancer: smoking, high fasting plasma glucose, and high body-mass index. All of the estimates were reported as counts and age-standardised rates per 100 000 person-years. 95% uncertainty intervals (UIs) were reported for all estimates. Findings In 2017, there were 448 000 (95% UI 439 000-456 000) incident cases of pancreatic cancer globally, of which 232 000 (210 000-221 000; 51.9%) were in males. The age-standardised incidence rate was 5.0 (4.9-5.1) per 100 000 person-years in 1990 and increased to 5.7 (5.6-5.8) per 100 000 person-years in 2017. There was a 2.3 times increase in number of deaths for both sexes from 196 000 (193 000-200 000) in 1990 to 441 000 (433 000-449 000) in 2017. There was a 2.1 times increase in DALYs due to pancreatic cancer, increasing from 4.4 million (4.3-4.5) in 1990 to 9.1 million (8.9-9.3) in 2017. The age-standardised death rate of pancreatic cancer was highest in the high-income super-region across all years from 1990 to 2017. In 2017, the highest age-standardised death rates were observed in Greenland (17.4 [15.8-19.0] per 100 000 person-years) and Uruguay (12.1 [10.9-13.5] per 100 000 person-years). These countries also had the highest age-standardised death rates in 1990. Bangladesh (1.9 [1.5-2.3] per 100 000 person-years) had the lowest rate in 2017, and Sao Tome and Principe (1.3 [1.1-1.5] per 100 000 person-years) had the lowest rate in 1990. The numbers of incident cases and deaths peaked at the ages of 65-69 years for males and at 75-79 years for females. Age-standardised pancreatic cancer deaths worldwide were primarily attributable to smoking (21.1% [18.8-23.7]), high fasting plasma glucose (8.9% [2.1-19.4]), and high body-mass index (6.2% [2.5-11.4]) in 2017. Interpretation Globally, the number of deaths, incident cases, and DALYs caused by pancreatic cancer has more than doubled from 1990 to 2017. The increase in incidence of pancreatic cancer is likely to continue as the population ages. Prevention strategies should focus on modifiable risk factors. Development of screening programmes for early detection and more effective treatment strategies for pancreatic cancer are needed. Copyright (C) 2019 The Author(s). Published by Elsevier Ltd. Keywords KeyWords Plus:BODY-MASS INDEX; POOLED-ANALYSIS; POPULATION; EPIDEMIOLOGY; PREVALENCE; STATISTICS; DISABILITY; INJURIES; SMOKING; DEATH

The global, regional, and national burden of colorectal cancer and its attributable risk factors in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017

Background Data about the global, regional, and country-specific variations in the levels and trends of colorectal cancer are required to understand the impact of this disease and the trends in its burden to help policy makers allocate resources. Here we provide a status report on the incidence, mortality, and disability caused by colorectal cancer in 195 countries and territories between 1990 and 2017. Methods Vital registration, sample vital registration, verbal autopsy, and cancer registry data were used to generate incidence, death, and disability-adjusted life-year (DALY) estimates of colorectal cancer at the global, regional, and national levels. We also determined the association between development levels and colorectal cancer age-standardised DALY rates, and calculated DALYs attributable to risk factors that had evidence of causation with colorectal cancer. All of the estimates are reported as counts and age-standardised rates per 100 000 person-years, with some estimates also presented by sex and 5-year age groups. Findings In 2017, there were 1.8 million (95% UI 1.8-1.9) incident cases of colorectal cancer globally, with an age-standardised incidence rate of 23.2 (22.7-23.7) per 100 000 person-years that increased by 9.5% (4.5-13.5) between 1990 and 2017. Globally, colorectal cancer accounted for 896 000 (876 300-915 700) deaths in 2017, with an age-standardised death rate of 11.5 (11.3-11.8) per 100 000 person-years, which decreased between 1990 and 2017 (-13.5% [-18.4 to -10.0]). Colorectal cancer was also responsible for 19.0 million (18.5-19.5) DALYs globally in 2017, with an age-standardised rate of 235.7 (229.7-242.0) DALYs per 100 000 person-years, which decreased between 1990 and 2017 (-14.5% [-20.4 to -10.3]). Slovakia, the Netherlands, and New Zealand had the highest age-standardised incidence rates in 2017. Greenland, Hungary, and Slovakia had the highest age-standardised death rates in 2017. Numbers of incident cases and deaths were higher among males than females up to the ages of 80-84 years, with the highest rates observed in the oldest age group (>= 95 years) for both sexes in 2017. There was a non-linear association between the Socio-demographic Index and the Healthcare Access and Quality Index and age-standardised DALY rates. In 2017, the three largest contributors to DALYs at the global level, for both sexes, were diet low in calcium (20.5% [12.9-28.9]), alcohol use (15.2% [12.1-18.3]), and diet low in milk (14.3% [5.1-24.8]). Interpretation There is substantial global variation in the burden of colorectal cancer. Although the overall colorectal cancer age-standardised death rate has been decreasing at the global level, the increasing age-standardised incidence rate in most countries poses a major public health challenge across the world. The results of this study could be useful for policy makers to carry out cost-effective interventions and to reduce exposure to modifiable risk factors, particularly in countries with high incidence or increasing burden. Copyright (C) 2019 The Author(s). Published by Elsevier Ltd. Keywords KeyWords Plus:SEX-SPECIFIC MORTALITY; QUALITY-OF-LIFE; TRENDS; AGE; STATISTICS; EXPECTANCY; DISABILITY; INJURIES; OBESIT

Predict the future incidence and mortality of breast cancer in Iran from 2012-2035

Global Breast Cancer (BC) is the most common non-skin malignancy, nearly a third of newly diagnosed cancers in the United States and the second leading cause of mortality in women throughout the world was BC (1, 2). Between 1975 and 2000 the burden of BC has doubled, that is attributable to the increase in life expectancy and spread of unhealthy lifestyle (3). Nevertheless, these trends are not visible in early onset of BC, as the rates have been more or less stable in most countries in the past 20 yr (4). As for mortality rates, they have been progressively decreasing, particularly in younger women, due to the improved treatment and primary detection (5). In Iran with increasing life expectancy and the aging of the residents, the incidence and mortality of BC will increase in the future years (6). In GLOBOCAN project, the expected number of new cancer cases or deaths in a country or region in 2015–2035 is computed by multiplying the age-specific incidence/mortality rates estimated for 2012, by the corresponding expected population for 2015–2035. In Iran, based on the GLOBOCAN project in 2012, the number of BC in woman was 9795 case and the number of new case have an increase in the next few years, so in 2015, 2020, 2025, 2030 and 2035 the number of new cases were 10982, 12684, 14920, 17346 and 19328, respectively. Therefore, in 2035 compare 2012 the numbers of new case were nearly 2 times. In addition, in 2012, the numbers of death from BC was 3304 and in the next few years, we have increase in the number of death from BC, so in 2015, 2020, 2025, 2030 and 2035 the numbers of deaths were 3742, 4394, 5248, 6220 and 7138. We expect that Iranian population structure, the greatest increase in the number of new cases and deaths from BC observe in age group (ages >= 65), so in 2035 compared to 2012, the number of new case and mortality will be 3 times, while in the age group below 65 yr, the increase is about 1.8 time

Physical activity and colorectal cancer

Colorectal cancer is one of the most common cancers in the world. In developed countries 60% of the populations are at risk of this cancer, and colorectal cancer is considered as 10% and 11% of newly diagnosed cancers among men and women, respectively (1). The Europe Society of Gastroenterology declared that colorectal cancer is the most common cancer in 2000. The incidence of colorectal cancer varies in different parts of the world, so that the highest incidence is visible in developed countries such as America, Australia, West Europe and New Zealand and lowest in countries such as South of America, Africa and Asia (2, 3). Colorectal cancer is a multifactorial disease with a set of genetic and environmental factors. In this disease a series of factors such as lifestyle, nutrition and physical activity play a key role in susceptibility to cancer. The role of physical activity in susceptibility to colorectal cancer has received special attention; so that the findings resulted out of most of these studies indicate the effect of physical activity in reducing the risk of suscptibility to colorectal cancer (4, 5). In fact, there is a reverse relationship between physical activity and colorectal cancer, in such a way that the risk of colorectal cancer in people with physical activity in their free time is 27% less than people without physical activity are (6). Severe physical activity is associated with the reduced risk of colon cancer, so that the relative risk of proximal and distal colon cancer in severe physical activity group compared with no physical activity group was 0.73(95% CI, 0.66–0.81), and 0.74 (95% CI, 0.68–0.80), respectively (7). People who have a history of continuous physical activity during the past 20 yr have more benefits from the protective effects of exercise in reducing the risk of occurrence of colon cancer (4). In men and women with high physical activity, incidence of colorectal cancer compared to those with little or no physical activity reduced by 40%–50% (8). In people that during their leisure time had at least 60 min of daily physical activity compared to those who had physically active for 10 min or less, the hazard ratio of colorectal cancer was 0.57 (95% CI, 0.41–0.79). Hazard ratio for colon cancer was 0.56 (95% CI, 0.37–0.83) and for rectal cancer was 0.59 (95% CI, 0.34–1.02) (9). In recent years, mechanisms by which physical activity reduces the risk of colorectal cancer, were not entirely clear, albeit assumptions such as changes in the material in gastrointestinal transmit time, changes in immune function as well as changes in prostaglandin levels, insulin, insulin-like growth factors, bile acid secretion, serum cholesterol as well as pancreatic and gastrointestinal hormone profiles are presented. There is currently limited empirical data in epidemiologic studies on humans and animals in order to approve each of these mechanisms in reducing the risk of colorectal cancer; therefore, it is probable that beneficial effect of physical activity in reducing colorectal cancer has been due to the combined effects of these factors and other unknown factors (10). Doctors recommend physical activity for the general population with the aim of reducing the burden related to colorectal cancer. However, doctors do not need a full understanding of this mechanism. Therefore, in health education programs and medical advice for reducing the risk of colorectal cancer, physicians must pay particular attention to the protective effect of exercise and physical activity, and at the same time conduct scientific and biological surveys to achieve a clearer understanding of the beneficial mechanisms of physical activity in reducing risk of colorectal cancer

The Incidence and Mortality of Colorectal Cancer and Its Relationship With the Human Development Index in Asia

BackgroundColorectal cancer is the second most common cancer in women and the third most common cancer among men, and its incidence is increasing in Asia. Awareness about the status of this cancer incidence and mortality is necessary for a better plan.ObjectivesThe present study was done with the aim to investigate the incidence and mortality of colorectal cancer and its relationship with the Human Development Index (HDI) in Asia in 2012.MethodsThis study was an ecological study, which was conducted based on the GLOBOCAN project of the World Health Organization for Asian countries. We assessed the correlation between standardized incidence rates (SIR) and standardized mortality rates (SMR) of colorectal cancer with HDI and its components using SPSS software, version 18 (SPSS Inc., Chicago, IL).ResultsA total of 592,563 incidences of and 325,752 deaths from colorectal cancer were recorded in Asian countries in 2012. The 5 countries with the highest SIR were Republic of Korea (45 per 100,000), Israel (35.9 per 100,000), Singapore (33.7 per 100,000), Japan (32.2 per 100,000), and Jordan (25.6 per 100,000). The 5 countries with the highest SMR for colorectal cancer were Jordan (15.5 per 100,000), Kazakhstan (12.8 per 100,000), Democratic Republic of Korea (12 per 100,000), Brunei (12 per 100,000), and Japan (11.9 per 100,000). Correlation between HDI and SIR was 0.709 overall ('P' ≤ .001)— 0.667 in men ('P' ≤ .001) and 0.759 in women ('P' ≤ .001). Also, correlation between HDI and SMR overall was 0.517 ('P' ≤ .001)— 0.447 in men ('P' = .002) and 0.593 in women ('P' ≤ .001).ConclusionsCancer incidence and mortality are higher in countries with more development. A positive and statistically significant correlation was found between standardized incidence and mortality rate of colorectal cancer and the Human Development Index and its components

Disparity and trends in the incidence and mortality of lung cancer in the world

Background: Lung Cancer (LC) is one of the most common cancers in the international arena. The aim of this study was to investigate the geographical distribution of LC incidence and mortality in the world in 2012, as well as the trend of incidence and mortality of LC during 1975 to 2010 based on the gender. Material and methods: In the present study, we extracted the information on the incidence and mortality of LC in 184 countries from the International Agency for Research on Cancer (IARC) (Project GLOBOCAN, 2012). The present study categorized and presented the information on the Age-Standardized Incidence Rate (ASIR) and Age Standardized Mortality Rate (ASMR) of LC based on the continents, world regions based on the development level and Human Development Index (HDI). ASIR and ASMR of LC expressed per 100,000 people. Results: The highest ASIR and ASMR of LC occurred in North America (ASIR=38.3 and ASMR=28.6), more developed regions (ASIR=30.8 and ASMR=24.2), and the WPRO region of the WHO (ASIR=32.8 and ASMR=28.5), and those regions with very high HDI (ASIR=31 and ASMR=23.9). Furthermore, the lowest ASIR and ASMR of LC occurred in Africa (ASIR=5 and ASMR=4.5), the less developed regions (ASIR=20 and ASMR=18), the AFRO region (ASIR=3.9 and ASMR=3.5), and regions with low HDI (ASIR=5.4 and ASMR=4.8). Conclusion: The highest ASIR and ASMR of LC occurred in North America, more developed regions, and the WPRO region of the WHO, and those regions with very high HDI. Most regions of the world had decreasing incidence and mortality of LC in men and increasing trend in women

Factors associated with cigarette smoking in central parts of Iran

This study aims to assess factors associated with cigarette smoking in central parts of Iran. Materials and methods: We used the data of the post intervention phase of Isfahan Healthy Heart Program (IHHP) that was conducted in 2007. Logistic regression was used for calculating crude and adjusted Odds Ratios (OR). The group with the least prevalence of smoking was considered as the Reference Group (RG) and the OR for other parts of the variable was calculated based on the RG and reported with a confidence interval of 95%. Findings: Generally, 9513 individuals participated in the study, of which 13.5% were smokers (26.2% of men and 0.8% of women). The OR for cigarette smoking in men compared with women in (RG) was 13.89 (95% Confidence Interval (CI) 7.44-24.82). Among rural areas, compared with urban areas in (RG), the OR was 0.98 (95% CI 0.82-1.15); and among elementary education level compared to illiterate individuals the OR was 4.37 (95% CI 1.68-10.76). The OR in individuals in the age group 35-44, compared with the age group of 65 and older in (RG) was 2.49 (95% CI 1.81-3.45). The place most used for cigarette smoking was streets (72.1%); and the main reason for starting or continuing cigarette smoking, according to smokers' opinions, was pleasure and fun. Conclusion: The highest number of smokers was in 35-44 years men, in rural areas, with elementary education level; so, they are the ones who need more attention through implementation of educational programs for awareness, improved attitudes and practices, and smoking cessation programs

Disparities in incidence and mortality of pancreatic cancer in the world

Background: Pancreatic cancer (PC) is as the twelfth most frequent cancer and the seventh most important cause of mortality by reason of cancer in the world. Being informed about the incidence and mortality of this cancer and the potential role of development is useful in health policy. The aim of this research is investigating disparities in the incidence and mortality of PC in the world countries in the year 2012. Methods: This study was an ecologic study in the World for assessing the correlation between Human Development Index (HDI) and its details (Gross national income (GNI) per capita, average years of schooling and life expectancy at birth) with age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) of PC. Results: In total, 337872 new cases of PC occurred in 2012 around the world, that 178116 and 159711 cases take happen in men and women respectively, also at the same year 330391 deaths of PC occurred, that 173,827 and 156564 cases were in men and women. In assessment the relationship between HDI and ASIR and ASMR of PC there is significant positive correlation equal to 0.767 (p < 0.001) between HDI and ASIR of PC, and a significant positive correlation equal to 0.776 (p < 0.001) between HDI and ASMR of PC. Conclusion: The incidence and mortality of PC has a significant positive correlation with the Human Development Index