Recent Mortality Patterns and Time Trends for the Major Cancers in 47 Countries Worldwide

Cancer is a leading cause of death worldwide, including in most low and middle-income countries (1). According to estimates from the World Health Organization (WHO) in 2019 (2), cancer is the first or second leading cause of death before the age of 70 years in 112 of 183 countries and ranks third or fourth in an additional 23 countries. The burden is expected to increase worldwide because of growing and aging populations alongside changes in risk profiles, with an increasing prevalence of smoking, obesity, physical inactivity, and reduced fertility rates in transitioning economies. Previous studies have reported cancer mortality trends across countries; however, these studies have mainly addressed individual cancer types (3–7). This article describes the most recent cancer mortality rates and time trends in 47 countries worldwide (except Africa) for the eight common forms of cancer according to the Global Cancer Observatory (GLOBOCAN) estimates of the International Agency for Research on Cancer (8); these cancers account for almost two-thirds (63%) of cancer-related deaths in both sexes in 2020 (8).

Mortality data for cancers of the female breast, lung, colon and rectum, prostate, stomach, liver, cervix uteri, and esophagus, classified according to the 10th International Classification of Diseases (ICD-10; ref. 9) were extracted for 47 countries from the WHO mortality database, where high-quality data series were available (34 were represented nationally and 13 sub-nationally; Supplementary Table S1); no country was included from Africa given the paucity of robust death registration systems on the continent. Given data availability differed by country (Supplementary Table S1), we examined the most recent 5-year and 10-year periods for each country, spanning from 2005 to 2019. We calculated age-standardized mortality rates using the direct method and the world standard population developed by Segi (10, 11) and modified by Doll and Cook (12). Cross-sectional age-standardized mortality rates were calculated for the most recent 5 years. Temporal trends were examined by estimating the average annual percent change (AAPC) and 95% confidence intervals (CI) for the most recent 5-year and 10-year periods. AAPCs were computed as a weighted average of the annual percent changes based on Joinpoint regression (13) with the weights equal to the length of the annual percent change interval. Trends were described as “increasing” or “decreasing” if the AAPC was statistically significantly different from zero (P < 0.05) and “stable” otherwise. All analyses were performed using Stata version 17.

The data analyzed in this study were obtained from WHO mortality database at https://gco.iarc.fr/overtime/en/database.

Figure 1 shows age-standardized mortality rates per 100,000 person-years (ASR) of breast cancer and recent 10-year trends in the ASR in 47 countries. Mortality rates varied by more than 3-fold across countries, with the highest rates found in Uruguay (19.1), Ireland (17.9), and Argentina (17.6) and the lowest rates found in the Republic of Korea (5.5), Ecuador (7.1), and Japan (9.0). Mortality rates were generally higher in countries in Europe, Northern America, and Oceania but lower in countries in Asia (except Israel and Singapore) and in Latin America and the Caribbean (other than Uruguay, Argentina, Cuba, and Brazil).

During the most recent 10 years, breast cancer mortality rates decreased in 34 of 47 countries by 0.3%–3.3% per year with the most rapid decreases seen in Malta (3.3% per year), Denmark (3.1% per year), and Norway (2.8% per year). Five-year trends were consistent with 10-year trends in all these countries except Canada and Austria where five-year trends indicate stabilization of previously decreasing trends (Supplementary Table S2). In contrast, rates, increased by 0.3%–1.5% annually in six Asian (the Republic of Korea and Japan) and Latin America/ Caribbean countries (Colombia, Ecuador, Mexico, and Brazil). Countries with stabilizing rates included those in Asia (Kyrgyzstan and Singapore), Southern/Eastern Europe (Slovakia, Romania, and Bulgaria), and Latin America/Caribbean (Costa Rica and Cuba).

Figure 2 shows corresponding recent patterns and trends in lung cancer ASR. Mortality rates varied by approximately 12-fold in males and 9-fold in females across the countries. In males, mortality rates per 100,000 were highest in Hungary (62), Croatia (51.1), and Greece (48.2), and lowest in Ecuador (5.1), Costa Rica (6.4), and Mexico (7.5). In females, the highest rates were seen in Hungary (28.7), Denmark (24.2), and Canada (22.5), and the lowest were in Costa Rica (3.2), Ecuador (3.8), and Mexico (3.8). In both sexes, the highest mortality rates tended to be seen in European countries, while the lowest rates were observed in certain Latin American and Asian countries.

During the most recent 10 years, lung cancer mortality rates in males decreased in 45 of 47 countries by 0.2%–4.2% annually with the most rapid decline seen in Mexico (4.2% per year), Iceland (4.0% per year), and Czechia (3.9% per year). Rates stabilized in Portugal and Kyrgyzstan, although the decreasing trend stabilized in Colombia during the most recent five-year period. In females, lung cancer mortality rates increased in 24 countries by 0.3%–4.3% annually with the most rapid increase seen in Spain (4.3% per year), Uruguay (3.7% per year), and Greece (3.2% per year). Of the 24 countries for which mortality rates increased among females, 22 were in Europe. Nevertheless, increasing trends leveled off in several countries in Europe (Germany, Poland, and Belgium) as well as Latin America/ Caribbean (Mexico and Brazil) in the last five years (Supplementary Table S2). Rates decreased by 0.2%–3.8% per year in 13 of the 47 countries, largely located in Asia and Latin America, whereas rates stabilized in the remaining 10 countries in Asia (Israel and Kyrgyzstan), Latin America/Caribbean (Cuba, Argentina, Chile, and Ecuador), Northern/Western Europe (Ireland, Austria, and Switzerland), and Oceania (New Zealand).

Figure 3 depicts colorectal cancer mortality ASR in 47 countries by sex. Mortality rates varied by approximately 7-fold in males and 4-fold in females across countries. Male mortality rates in the last five-year period were highest in Hungary (31.2), Slovakia (28.6), and Croatia (26.8) and lowest in Ecuador (4.4), Mexico (5.4), and Kyrgyzstan (5.7). In females, the highest rates were in Hungary (14.6), Croatia (12.7), and Slovakia (12.6), and the lowest were in Mexico (4.0), Ecuador (4.4), and Kyrgyzstan (4.5). Mortality rates in both males and females were highest in Eastern Europe and lowest in countries in Latin America/Caribbean and Asia.

In the last decade, colorectal cancer mortality rates decreased in 29 of 47 countries by 0.5%–3.6% per year, with the most rapid decreases in Slovenia (3.6% per year), Austria (3.1% per year), Czechia (2.9% per year), and the Republic of Korea (2.9% per year). Rates, however, increased by 0.4%–3.4% annually in nine countries, all of which were located in Latin America/ Caribbean (other than Romania and Greece). Countries with stabilizing rates include those in Southern/Eastern Europe (Croatia, Poland, Bulgaria, and Spain), Latin America/Caribbean (Uruguay and Argentina), and Northern/Western Europe (Estonia, Latvia, and Iceland). In females, colorectal cancer mortality rates decreased in 35 countries by 0.1%–4% annually with the most rapid decreases in Slovenia (4.0% per year), Israel (3.3% per year), and Austria (3.1% per year). Five-year trends however were stable following prior declines in trends in Australia and Latvia. In contrast, rates increased by 0.6%–2.4% per year in seven countries in Latin America/Caribbean (Chile, Costa Rica, Brazil, Ecuador, and Mexico) and Southern/Eastern Europe (Croatia and Greece). During the same period, rates stabilized in countries in the same regions of Southern/Eastern Europe (Slovakia, Romania, and Malta) and Latin America/Caribbean (Cuba and Colombia), although Colombia saw a steep increase during the most recent years (3.5% per year; Supplementary Table S2). Mexico had the highest increase in both sexes, with an annual increase of 3.4% in males and 2.4% in females during the last decade, and the trends accelerated in both males (3.9% per year) and females (3.1% per year) in the most recent five years (Supplementary Table S2).

Prostate cancer mortality rates varied by approximately 6-fold across the countries (Fig. 4), with the highest ASR found in Cuba (24.3), Latvia (20.4), and Estonia (20.2) and the lowest rates found in Kyrgyzstan (4.0), the Republic of Korea (4.1), and Japan (4.5). Within the most recent 10-year period, prostate cancer mortality rates decreased in 37 of 47 countries by 0.4%–3.5% per year with the pace of decline greatest in Israel (3.5% per year), the United States, and France (3.2% per year). Rates, however, increased by 0.8%–4% annually in five countries, including Kyrgyzstan (with the most rapid increase of 4.0%), Slovakia, Bulgaria, Romania, and Cuba. Countries with stabilizing rates included those in Asia (Singapore), Southern/Eastern Europe (Croatia and Poland), and Northern/Western Europe (Latvia and Estonia). Five-year trends were consistent with 10-year trends, except in Canada, Austria, and Greece, where previously decreasing trends leveled off in recent years.

ASR varied approximately 10-fold in males and 6-fold in females (Supplementary Fig. S1). In males, mortality rates were highest in Kyrgyzstan (23.9), Chile (17.5), and Latvia (15.1), and lowest in the United States (2.4), Iceland (2.5), Sweden (3.0), and Australia (3.0). In females, the highest rates were found in Kyrgyzstan (8.2), Ecuador (7.6), and Costa Rica (7.1), although the lowest rates were recorded in the United States (1.3), France (1.6), Belgium (1.6), and Australia (1.6). In both sexes, mortality rates were generally high in Southern/Eastern Europe and some Latin America/Caribbean countries. The lowest rates were in North America, Oceania, and most Northern/Western European countries.

During the most recent 10 years, male stomach cancer mortality rates decreased in all 47 countries by 0.9%–7.2% annually (except in Kyrgyzstan and Denmark), with the most rapid decreases in the Republic of Korea (7.2% per year), Iceland (6.5% per year), and Singapore (5.0% per year). In females, stomach cancer mortality rates during the corresponding period decreased in all countries (except Costa Rica) by 0.6%–6.0% annually with the most rapid decreases in the Republic of Korea (6.0% per year), the Netherlands (5.2% per year), and Austria and Iceland (4.3% per year). During the most recent 5 years, decreasing trends stabilized in Mexico in both sexes, Colombia in females, and Argentina, Belgium, Canada, and Norway in males (Supplementary Table S2).

Figure 5 depicts the liver cancer patterns and trends in ASR across 47 countries by sex. Mortality rates varied 6-fold in males and 4-fold in females across the countries. In males, mortality rates were highest in the Republic of Korea (18.3), Singapore (12.8), and Romania (11.3), and lowest in Norway (3.1) and Uruguay (3.3). In females, the highest rates were in Kyrgyzstan (5.1), the Republic of Korea (4.7), Mexico (4.7), and Romania (4.3), and the lowest were in Malta (1.2), Norway (1.6), and Iceland (1.6). Mortality rates were generally higher in countries in Asia in both sexes and those in Southern/Eastern Europe (in males) and Latin America/Caribbean (in females).

During the most recent 10 years, male liver cancer mortality rates increased in 23 of 47 countries, including many in Europe, North America, and Oceania, by 0.8%–5.8% annually with the most rapid increases in Ireland (5.8% per year), Norway (5.3% per year), and Malta (4.8% per year). Five-year trends however indicated a stabilization of previously increasing trends in Ireland. In contrast, rates decreased by 0.7%–4.9% annually in 11 countries with the most rapid declines in Japan (4.9% per year) and the Republic of Korea (3.3% per year). Countries with stabilizing rates include those in Asia (Singapore and Israel), Southern/Eastern Europe (Italy, Spain, Hungary, and Greece), Latin America/Caribbean (Costa Rica, Chile, Mexico, Argentina, and Cuba), and Northern/Western Europe (Estonia and Germany). In females, liver cancer mortality rates increased in 15 countries by 0.9%–4.5% annually with the most rapid increases in the United Kingdom (4.5% per year), Norway (3.4% per year), Denmark (3.1% per year), and Australia (3.1% per year). Rates decreased by 1.0%–4.8% per year in 15 countries across regions, with the most rapid decreases in the Republic of Korea and Japan. Rates stabilized in countries in Asia (Singapore and Israel), Southern/Eastern Europe (Bulgaria, Greece, Spain, and Hungary), Latin America/Caribbean (Costa Rica, Chile, and Brazil), and Northern/Western Europe (Ireland, France, Estonia, Finland, Belgium, Germany, Latvia, and Iceland).

The ASR varied 11-fold worldwide, with mortality rates in the most recent five years highest in Romania (8.6), Kyrgyzstan (8.5), and Lithuania (6.6), and lowest in Italy (0.8), Switzerland (0.9), Malta (1.1), and Finland (1.1; Supplementary Fig. S2). Mortality rates were generally higher in countries in Latin America/Caribbean and some Southern/Eastern European countries, and lower in countries in Asia (except Kyrgyzstan), North America, Oceania, and in those countries in Northern/Western Europe (other than the Baltic countries).

During the most recent 10 years, cervical cancer mortality rates decreased in 28 of 47 countries by 0.4%–5.2% per year with the most rapid decreases in Singapore (5.2% per year), Switzerland (4.7% per year), and the Republic of Korea (4.4% per year). Rates, nonetheless, increased by 0.5%–2.5% annually in six countries across different regions of the world (Kyrgyzstan, Japan, Greece, Italy, Argentina, and Latvia). Greece had the greatest increase of 2.5% annually, followed by Italy (2.0% per year). Countries with stabilizing rates in the recent decade included those in Asia (Israel), Southern/Eastern Europe (Bulgaria and Croatia), Latin America/Caribbean (Ecuador and Brazil), Northern/Western Europe (Ireland, Iceland, Germany, Norway, and France), and Oceania (New Zealand and Australia). However, a significant rise of 1.8% per year was seen in Brazil, while a stabilization of a previously decreasing trend in Chile was observed during the period 2014–2018 (Supplementary Table S2).

Figure 6 depicts the recent ASR of esophageal cancer alongside trends in ASR in 47 countries by sex. Mortality rates varied 7-fold in males and 9-fold in females. In males, ASRs in the recent 5-year period were highest in the United Kingdom (8.0), the Netherlands (7.6), and Lithuania (7.3) and lowest in Ecuador (1.2), Israel (1.3), Costa Rica (1.4) and Mexico (1.4). In females, the highest rates were in Ireland and the United Kingdom (2.7), the Netherlands (2.2), and Kyrgyzstan (2.1) and lowest in the Republic of Korea (0.2), Greece (0.3), Costa Rica (0.3), and Ecuador (0.3). In all countries, mortality rates were higher in males than in females, although the male-to-female ratio varied from 2.6 in Kyrgyzstan to 15.0 in the Republic of Korea.

During the most recent 10 years, in males, esophageal cancer mortality rates decreased in 33 of 47 countries by 0.4%–5.0% per year with the fastest decreases in Chile (5.0% per year), the Republic of Korea (4.3% per year), and Singapore (4.1% per year). Rates, however, increased by 0.3%–3% annually in Cuba and five Northern/Western European countries (Latvia, Lithuania, Norway, Finland, and Sweden). Countries with stabilizing rates include those in Southern/Eastern Europe (Romania, Malta, and Greece), Latin America/the Caribbean (Uruguay and Argentina), and Northern/Western Europe (The Netherlands, Estonia, Belgium, and Iceland). In females, esophageal cancer mortality rates decreased in 28 countries by 0.3%–5.4% annually with the fastest decreases in Singapore (5.4% per year), Bulgaria (5.1% per year), and Chile (5.1% per year). Rates increased by 0.4%–5% per year in 11 countries, all of which are located in Europe, with the fastest increases in Estonia (5% per year) and Latvia (4% per year). Rates stabilized in countries in Asia (the Republic of Korea), Eastern/Southern Europe (Slovenia, Italy, Spain, and Greece), Latin America/the Caribbean (Cuba), and Northern/Western Europe (Finland).

On the basis of high-quality WHO mortality data, the study has comprehensively examined recent trends in mortality rates for the eight leading forms of cancer death for 47 countries by sex across five continents. We found substantial variations in rates across countries for each cancer type, especially for lung and cervical cancer, where rates varied around 10-fold. During the past decade, cancer mortality rates decreased for all major cancers in most of the studied countries, except lung cancer in females and liver cancer in males, where increasing rates were observed in most countries. Rates decreased or stabilized in all countries for lung cancer in males and stomach cancer in both sexes.

The variations in lung cancer–related death rates and trends across countries and between the sexes largely reflect differences in the degree and stage of the tobacco epidemic (14). Among men, the decline in lung cancer rates in almost all countries included in the study was due to a continuous reduction in smoking prevalence (14). For example, adult smoking prevalence among men in the United States decreased from approximately 52% in early 1965 to 16% in 2018 (15). In contrast, lung cancer–related death rates in women increased in half of the countries included in the study, mainly within Europe, whereas Spain exhibited the most rapidly increasing rate, in line with women taking up the smoking habit some decades after men (14). Specifically, smoking prevalence in most European countries peaked in the 1950s in men and in the 1960s and 1970s in women. In Spain, however, cigarette smoking prevalence in women remained low (<6%) until it began to increase rapidly following the liberalization and democratization of the country in the mid-1970s alongside widespread tobacco advertising (16). The decline in lung cancer–related death rates among women in many Asian countries may reflect improved tobacco control efforts and a reduction in passive smoking in the region over the past decades (17, 18).

In contrast to smoking prevalence, other major cancer risk factors associated with socioeconomic transitions include excess body weight, unhealthy diets, a sedentary lifestyle, and excess alcohol consumption, all of which have tended to be more prevalent in Western countries. The increases in mortality rates of colorectal cancer and breast cancer in the most recent decade, as observed in many countries in Latin America/Caribbean, may in part reflect the increasing prevalence of such contributory factors. Excess body weight has increased at an alarming pace throughout most countries in Latin America, with Mexico experiencing the second-highest prevalence (64%) in the region in 2016, following the Bahamas (69%; ref. 19). In many middle-income countries, changes in food supply with increased urbanization and integration of the region into global markets have shifted dietary patterns toward increased consumption of ultraprocessed energy-dense products, fat, animal-source foods, and sugar, which in turn has likely increased the risk of numerous types of cancer (20, 21).

Profound changes in female reproductive patterns associated with political and societal shifts, including increasing age at first birth, fewer births per woman, and less breastfeeding, are also likely in part responsible for the rise in breast cancer mortality seen in several countries in Latin America/Caribbean (Brazil, Colombia, Mexico, and Ecuador) and high-income Eastern Asian countries (e.g., the Republic of Korea). The number of births per woman fell markedly from approximately 6 per woman in the early-1960s to less than 2 in 2020 in these countries with the Republic of Korea having the lowest fertility rate of 0.8 (22). Mortality increases in both colorectal and breast cancer in several Latin American countries (Mexico, Ecuador, Colombia, and Brazil) may also reflect poorer health infrastructure and limited access to optimal screening and advanced treatment (23, 24), highlighting the urgent need for expanding cancer control programs to halt the rising mortality rates from these cancers in the region.

Underlying explanations for the continued decline in esophageal cancer mortality in most regions of the world are not in evidence (25–27), though they may include a decreasing prevalence of tobacco use and heavy alcohol consumption in the past few decades, the two main risk factors for esophageal squamous cell carcinoma (SCC) in Western settings (28, 29). In contrast, esophageal cancer mortality rates mostly increased in Northern/Western European countries closely mirroring the increasing incidence of esophageal adenocarcinoma, as reported in other high-income countries including the United States, Australia, and the United Kingdom (30–32). The increase in adenocarcinoma in these countries has largely been attributed to increasing levels of central obesity, the main cause of gastroesophageal reflux disease (GERD) and its late complication, Barrett esophagus, a precursor to esophageal adenocarcinoma (33). In addition, the continuing decline in the prevalence of Helicobacter pylori (H. pylori) has been postulated to decrease gastric acid production and therefore decrease the risk of GERD and esophageal adenocarcinoma development may have contributed to the rising mortality (34, 35).

During the most recent decade, death rates from liver cancer increased in most countries in Northern/Western Europe, Northern America, and Oceania, and in parts of Eastern Europe (Romania, Slovenia, and Portugal), which are low-risk areas for hepatitis B infection that accounts for the majority of liver cancer deaths in most parts of Asia and Africa (36). The increase in death rates in these regions is thought to largely reflect the high prevalence of hepatitis C infection (United States) and nonviral etiology, such as obesity, diabetes, metabolic syndrome, and nonalcoholic fatty liver disease as well as heavy alcohol consumption (37). Although relative risks associated with nonviral factors are not as high as those for viral infections, the proportions of liver cancer–related deaths attributable to these factors are substantial in these regions due to a high prevalence of excess body weight and related metabolic conditions (38, 39). For example, an estimated 33% of liver cancer–related deaths in 2014 were attributable to excess body weight, and 20% to alcohol consumption in the United States (40). Although death rates remain high, mortality trends decreased dramatically in high-risk countries such as the Republic of Korea and Japan, reflecting the countries’ long-established vaccination programs against hepatitis B Virus (41, 42) and progressive policy efforts to promote screening and treatment for hepatitis C virus (HCV) infection (43). However, progress against liver cancer likely remains limited in high-risk areas such as Africa and Southeastern Asia, whereas hepatitis B immunization coverage in 2021 remain lower (Africa, 71%; South-East Asia, 82%) compared with Europe (91%; ref. 44).

The decline in stomach cancer mortality rates over the past 10 years in most populations worldwide is a continuation of a past trend that began in the middle of the last century (45, 46). This decline has been touted as an “unplanned triumph”, highlighting the lack of planned and directed interventions in preventing this disease; instead, the decline parallels the decreased prevalence of H. pylori following improved sanitation, hygiene, and antibiotic use as well as improvements in nutrition and preservation of foods in the last century (47). Furthermore, nationwide screening programs in some high-risk countries, such as Japan and the Republic of Korea, have contributed to the accelerated decline in stomach cancer mortality rates in these countries (48).

A marked downward trend in cervical cancer mortality has been apparent for many years in those countries with established cervical cancer screening programs, notably in North America and Northern/Western Europe. In contrast, mortality rates increased in countries such as Greece, Latvia, and Japan because of a lack of high-quality or high-coverage population-based screening programs or low screening uptake (49–52). For instance, in Japan, although cytology screening was systematized in the early 1980s (51), cervical cancer screening participation is still low (43.7% in 2019) compared to countries such as the United States (72.6%) and the United Kingdom (74.4%; ref. 53). However, there have also been increasing cervical cancer incidence trends in recent generations of women in Europe (54, 55), the United States (56), and Japan (57), which may reflect changing sexual behaviors, increasing transmission, and higher risk of persistent high-risk human papilloma virus (HPV) genotypes associated with increased risk of cervical cancer.

In contrast to the other major cancers, few potentially modifiable risk factors are known for prostate cancer. Advancing age, African ancestry, family history, and genetic susceptibility are the only well-established risk factors for the disease (58). The highest prostate cancer mortality rate in Cuba may in part reflect the ethnic diversity on the island, with African ancestry modulating prostate cancer risk (59, 60). Reasons for the increasing mortality trends in Kyrgyzstan and other Eastern European countries in recent years remain unclear, but may in part reflect the lack of screening and curative treatment interventions available, contrasting with the declining prostate cancer mortality rates in many high-income countries despite increasing incidence (5). The decline in mortality rates appears to have slowed in the most recent years in the United States, possibly reflecting the steep rise in advanced-stage disease since the early 2010s, temporally coinciding with the U.S. Preventive Services Task Force (USPSTF) recommendation against routine PSA-based screening in 2011 (61, 62).

A strength of our study is the use of high-quality WHO mortality data to describe recent mortality rates and trends for eight major cancers across 47 countries. Nevertheless, the interpretation of our findings can be influenced by various factors. First, our study was limited to countries able to provide high-quality mortality data, representing primarily high- or upper-middle-income countries that included only three of the ten countries with the world's largest populations. Second, the most recent year for which mortality data were available for the 5-year and 10-year trend analyses varied across countries. For those countries with slightly dated data, the mortality patterns presented here may not reflect current patterns. Third, trends in magnitude and direction based on Joinpoint model may change with the addition or removal of one-year data. Fourth, significant improvements in cancer and death registrations are still required in many transitioning countries of the world, without which attempts to characterize and address the global burden of cancer will remain limited. The WHO is implementing a strategic plan to strengthen well-functioning civil registration and vital statistics (CRVS) system to register all deaths in Member States (63). To ensure high-quality cancer incidence data are available routinely to support national cancer planning, the International Agency for Research on Cancer (IARC) established the Global Initiative for Cancer Registry Development (GICR, https://gicr.iarc.fr) in 2011 as a partnership to build the capacity of population-based cancer registries through training, consultancies, and the building of networks.

The burden of cancer for the eight leading cancers under study is substantial in countries irrespective of human development levels. Although mortality rates for most of these cancers are in a general decline in high-income countries, trends tend to be increasing in middle-income countries that are in part related to increasing incidence of cancers related to the adoption of unhealthy Western lifestyles such as smoking, the consumption of high-calorie food, and reduced fertility rates, accompanied with limited access to early detection and effective treatment. Cancers that were once known as diseases of Western countries such as breast, lung, and colorectal cancer, are now becoming common in these countries. Also, these countries continue to be disproportionately burdened by infection-related cancers including cervical, liver, and stomach cancers. A large proportion of the cancer burden can be prevented through concerted efforts towards tobacco control, vaccination (e.g., Hepatitis B Virus and HPV), promotion of healthy lifestyle behaviors, and systematic screening (e.g., breast cancer, cervical cancer, or colorectal cancer). Further research is needed to elucidate the changing mortality patterns and to plan for effective and resource-sensitive preventative and curative interventions. In the meantime, the findings reinforce the importance of strengthening the health systems of resource-limited countries in all parts of the world to further mitigate the rising cancer burden and reduce cancer disparities worldwide.

No disclosures were reported.

E. Sedeta: Conceptualization, resources, formal analysis, writing–original draft, writing–review and editing. H. Sung: Conceptualization, data curation, software, formal analysis, methodology, writing–review and editing. M. Laversanne: Data curation, software, methodology. F. Bray: Writing–review and editing. A. Jemal: Conceptualization, resources, data curation, formal analysis, supervision, methodology, writing–review and editing.

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