Introduction

Changes in fertility and life expectancy are leading to major changes in the structure of the global population and, in turn, in the scale of the cancer problem worldwide and at every resource level (WHO 2011b). In addition to the increasing burden of cancer is a changing spectrum of common cancers that is in different regions correlated with levels of human development (Bray and others 2012). The ongoing cancer transition includes a reduction in infection-related cancers (for example, stomach and cervical cancer) that is offset by increases in cancers linked to a Westernization of lifestyle (for example, breast, prostate, and colorectal cancer). The transition also encompasses changes in risk behavior, including tobacco uptake, with a delayed but large impact on the burden from lung and other tobacco-related cancers (Bray and others 2012). The cancer transition is not uniform, however: in Sub-Saharan Africa, recent increases in cervical cancer are observed in Uganda and Zimbabwe; in many countries, a residual burden of cancers associated with infectious agents accompanies the increasing burden of cancers associated with economic transition (Parkin and others 2014).

This chapter presents a global overview of the cancer burden, patterns and profiles, recent trends in common cancers, and the expected future scale of the disease by 2030.

We link geographical and temporal patterns of cancer to corresponding levels of economic progress to provide an overview of the key characteristics of the global cancer transition. We use gross national income (GNI) per capita as a national indicator of societal as well as economic development (http://data.worldbank.org/news/new-country-classifications), and corresponding rates of cancer incidence and mortality as markers of the extent of the global cancer transition. We draw attention to geographical variations and trends in cancer-specific rates according to differing economic profiles and in each of the world’s regions. In addition, we provide a global, trends-based projection of the likely cancer burden in 2030, based on historical trends refined by incorporating an indicator of level of development.

We also examine the number of potentially avoidable new cases and cancer deaths, assuming a reduction in risk factors (Hanley 2001). Even today, tobacco smoking is by far the most important risk factor for cancer (Lim and others 2012). Although the smoking habit is in decline in many high-income countries (HICs), tobacco consumption is still rising in many low- and middle-income countries (LMICs) (Thun and others 2012). As part of the global socioeconomic transition, many countries presently classified as low- or middle-income are increasingly adopting Westernized diets and more sedentary and less physically active lifestyles, leading to a rapid shift in the profile of common cancers in these populations (Bray and others 2012). In view of these developments, this chapter also reviews the main causes of cancer, with an emphasis on the sources of disparities that contribute to an increasingly greater proportional burden from cancer in LMICs, and the prospects for cancer control in different settings.

We conclude by pointing to how the high-level political commitment to reduce the rising burden of cancer and other noncommunicable diseases (NCDs) can advance the measurement of cancer to inform cancer control action. There remains an overwhelming need to improve the quality and coverage of population-based cancer registration in most LMICs, as an essential component in planning and evaluating national cancer control activities.

This chapter uses the World Health Organization’s (WHO) geographical regions: Africa, the Americas, South-East Asia, Europe, Eastern Mediterranean, and Western Pacific.

Cancer in Context: Comparisons with Other Noncommunicable Diseases by Development Level

Worldwide, an estimated 38 million deaths—almost two-thirds of the annual 56 million total deaths—are caused by NCDs, principally from cardiovascular disease, diabetes, chronic respiratory disease, and cancer (WHO 2011b). In 2012, nearly 80 percent of all NCD deaths (28 million) occurred in LMICs; almost 30 percent of deaths occurred before age 60 years in these countries. Among NCDs, cancer is a leading cause of death (figure 2.1).

Figure 2.1

Top 10 Causes of Death Worldwide, 2012. (millions of deaths)

This observation is consistent with the global socioeconomic transitions. Between 1990 and 2010, there was a 17 percent reduction in communicable maternal and neonatal and nutritional deaths, offset by a 30 percent increase in NCD-related deaths (Lozano and others 2012). This increase was greater in LMICs, compared with HICs (39 percent versus 15 percent, respectively). The shift is largely driven by population growth and improved longevity. Although the number of NCD-related deaths increased from 27 million to 34 million between 1990 and 2010, death rates declined by 19 percent (646 to 520 per 100,000) over the same period (Lozano and others 2012).

The overall statistics conceal variations among countries. Cancer is an even larger component of the NCD burden in HICs. In Japan, cancer represents over half of all NCD deaths combined; in approximately 40 countries, age-adjusted cancer mortality rates are equal to or above those of cardiovascular disease in premature mortality at ages under 70 years (WHO 2013).

Key Indicators of the Global Cancer Burden

Comparisons of incidence rates can be used to investigate cancer risk factors, aid planning and prioritizing of cancer control resources, as well as facilitate monitoring and evaluating of the impact of specific primary prevention interventions. Mortality has often been considered the best means of evaluating overall success in reducing the cancer burden. An assessment of cancer-specific mortality rates is particularly useful in evaluating the effectiveness of secondary prevention, particularly where the goal is early detection of malignant tumors; it is also useful in tertiary prevention in determining the impact of cancer management and treatment. Combined successes in cancer prevention, early detection, screening, and treatment have resulted in a reduction in overall cancer mortality rates in some more developed countries, predominantly as a result of declines in the incidence and/or mortality from a number of specific types of common cancer (Doll 1990, Karim-Kos and others 2008). The broad spectrum of interventions and their tendency to produce real or artifactual changes in cancer incidence, mortality, or survival, however, lends support to combining analyses of all three measures.

Cancer is complex to monitor accurately because of its biological diversity; the underlying coding and classification issues are considerably more intricate than the other NCD categories. There has been a long history of cancer registration in many areas of the world, however, and a tradition of maintaining comparable accurate and complete global cancer incidence data that spans half a century. The serial publication, Cancer Incidence in Five Continents (CI5, http://ci5.iarc.fr), published by the International Agency for Research on Cancer (IARC) and the International Association of Cancer Registries, is regarded as the definitive source of local cancer data. The 10th volume of CI5, published in 2013, compiles incidence data from high-quality population-based cancer registries (PBCRs) for 2003–07.

The IARC is also the key reference source for statistics on the global, regional, and national burden of cancer; it publishes estimates of the core indicators for cancer at the country level as part of the GLOBOCAN series (http://globocan.iarc.fr). The most recent database contains estimates of the cancer incidence, mortality, prevalence, and disability-adjusted life years for all cancers combined for 2012, as well as for 27 cancer sites in 184 countries and 20 regions (Ferlay and others 2013).

The methods used to compile the GLOBOCAN estimates have evolved, but the underlying principle remains the use of the best available observed data within a country to build up the global picture. Details are provided by Ferlay and others (2015). Estimation of cancer-specific incidence and mortality rates are dependent on local data sources, and the cancer registry data from CI5 provide a key input into the compilation. Unfortunately, there remains a paucity of high-quality cancer incidence and mortality data in low-resource and medium-resource areas, and hence the accuracy of the estimates from these regions is generally lower; an alphanumeric scoring system has been introduced to provide a broad indication of the robustness of the estimation within each country (Ferlay and others 2015).

The definitions, sources, and mode of estimation of the key indicators used in this chapter are provided. Counts and rates of cancer incidence and mortality are presented; rates per 100,000 were age-standardized using the world standard population (Doll, Payne, and Waterhouse 1966).

Global Cancer Burden and Distribution According to Income Group

For 2012, GLOBOCAN estimates indicate that there were 9.1 million new cases of cancer and 4.4 million cancer deaths between the ages of 0 and 69 years (figure 2.2). Female breast cancer is the most frequently diagnosed cancer globally (1.3 million new cases, 14.7 percent of all cancer cases), but it ranks third as the most common cause of cancer death (358,000 deaths, 8.2 percent of all cancer deaths). Lung cancer is the leading cause of death (767,000 deaths, 17.5 percent) and ranks second in incidence (1 million deaths, 10.8 percent). In terms of incidence, the most frequent cancer types thereafter are colorectal (744,000 cases, 174,000 deaths), prostate (556,000 cases, 56,000 deaths), stomach (539,000 cases, 242,000 deaths), and liver (503,000 cases, 336,000 deaths).

Figure 2.2

Global Burden of Cancer: Estimated Counts of Cancer Incidence and Mortality, by Region, 2012.

Four cancers constitute nearly 50 percent of the total cancer burden in HICs; for cancers of the prostate, lung, and colorectum, comparable numbers (between 350,000 and 400,000 new cases) of each type are estimated in 2012, with female breast cancer accounting for 550,000 cases (figure 2.3). Female breast cancer is also the most common form of cancer in LMICs, with almost 770,000 estimated cases in 2012. In combination, eight cancers (breast, lung, liver, cervix, stomach, colorectum, esophagus, and leukemia) account for almost two-thirds of the estimated cancer burden in LMICs. It is noteworthy that several types of cancer, more commonly associated with infection and poverty, less commonly diagnosed in HICs, are major cancers in LMICs; they include stomach and liver cancer—which are more frequently diagnosed than colorectal or prostate cancer in lower-income economies—as well as cancers of the cervix and esophagus.

Figure 2.3

Global Burden of Cancer: Cancer Incidence and Mortality by Income Level, 2012.

In terms of risk of developing specific neoplasms worldwide, the lifetime incidence of breast cancer is highest (2.8 percent), with the lifetime risk of the next four most common cancers varying from 1 to 1.5 percent. In HICs, however, the lifetime risk exceeds 2 percent for cancers of the breast (female), prostate, lung, and colorectum.

In terms of mortality, the most frequent causes of cancer death in HICs are lung, colorectum, female breast, and pancreas, which together account for about 48 percent of the total cancer deaths in 2012. Relative to incidence, a greater proportion of the mortality burden occurs in LMICs, particularly for those cancers more frequently diagnosed in LMICs, including liver and stomach (figure 2.3). Together with lung, female breast, and colorectal cancer, these neoplasms constitute half of the total cancer mortality burden in these areas. In terms of risk of death, the lifetime cumulative mortality from lung cancer and female breast cancer ranks highest in HICs (1.8 and 1.2 percent, respectively) and LMICs (1.3 and 1 percent, respectively). Colorectal cancer ranks third in HICs, and liver and cervical cancer rank third and fourth, respectively, in LMICs.

Diversity of Cancer by Type: Geographical Variations by Region

The classification of cancer patterns by broad levels of economic development draws attention to some of the key macroeconomic determinants of inequality and the variations in the risk of developing cancer globally. To underscore the diversity of cancer, it is important to show the extent to which cancer-specific patterns vary. Map 2.1, panel a, outlines the most common form of cancer among men in 184 countries in 2012. Worldwide, 10 types of cancer rank highest, with prostate cancer the most frequent cancer form in 68 countries, chiefly in HICs, but also in parts of Latin America and the Caribbean and in the southern regions of the African continent. Lung cancer is the most common neoplasm in 42 countries, mainly in Eastern Europe, Northern Africa, and Asia, including China and Indonesia. Liver cancer is the most common form in 27 countries, particularly in Western Africa and South-East Asia.

Map 2.1

Most Common Cancers Diagnosed in Men and Women in 184 Countries, 2012, Ages 0–69 Years.

Among men, the incidence and mortality patterns vary most markedly by region in Africa (Jemal and others 2012), with liver cancer the most common cancer in 18 of the 47 Sub-Saharan African countries. Clusters of very high incidence of Kaposi sarcoma are observed in 13 countries in Eastern Africa; prostate cancer is the most frequently observed tumor in nine countries (Parkin and others 2014). In women—and in some contrast to the diversity of the highest ranking cancers in men—either breast cancer (143 countries) or cervical cancer (39 countries) ranks as the most frequent cancer diagnosed in almost all countries worldwide; exceptions include the very high female incidence rates of thyroid cancer in the Republic of Korea and liver cancer in Mongolia (map 2.1, panel b).

Global Cancer Transitions: Recent Trends and Future Burden Circa 2030

The high-quality cancer registry data from CI5 (http://ci5.iarc.fr) illustrate temporal aspects of the global cancer transition: increases in breast and prostate cancer are apparent in countries that have transitioned from low-income to middle-income or middle-income to high-income (figures 2.4 and 2.5); for colorectal cancer, the increases are more evident in registries transitioning from middle-income countries; those countries that have reached very high levels of income tend to have also attained very high incidence rates of this cancer, and a recent peak in incidence is observed in several countries (figure 2.6). Nevertheless, the trends point to a Westernization effect in countries undergoing transition. Increasing average levels of economic progress serve as a proxy for a changing population prevalence of reproductive, dietary, metabolic, and hormonal risk factors (toward levels more akin to those more commonly observed in the West) that correspondingly increase the risk of these cancers (Bray 2014).

Figure 2.4

Trends in Age-Standardized (World) Incidence Rates of Female Breast Cancer, by Income Level, 1980–2010.

Figure 2.5

Trends in Age-Standardized (World) Incidence Rates of Prostate Cancer, by Income Level, 1980–2010.

Figure 2.6

Trends in Age-Standardized (World) Incidence Rates of Male Colorectal Cancer, by Income Level, 1980–2010.

Evidently, better diagnosis, earlier detection, and screening may have inflated the incidence burden in many settings, particularly where precursor lesions are not the target of the intervention. This includes prostate and breast cancers where prostate-specific antigen testing and mammographic screening have impacted the increasing incidence of the respective cancers in many populations (Bleyer and Welch 2012; Bray and others 2010; Bray, McCarron, and Parkin 2004). Nevertheless, such increases are countered by another hallmark of cancer transition: a reduction in infection-based neoplasms (Forman and others 2012; Vaccarella and others 2013). Most of the registries record declines in cervical and stomach cancer incidence (Bray and others 2012) (figures 2.7 and 2.8). There have been rapid increases in the incidence of breast, prostate, and colorectal cancer documented in countries in Sub-Saharan Africa with good quality incidence data; for example, rates of breast cancer have increased by 3.6 percent annually in Kampala, Uganda, and by 4.9 percent in the black population of Harare, Zimbabwe. There is little evidence of another hallmark of cancer transition—declining cervical cancer—in these populations: rather, rates exhibit persistent increases in incidence in recent years (Chokunonga and others 2013; Wabinga and others 2014).

Figure 2.7

Trends in Age-Standardized (World) Incidence Rates of Cervical Cancer, by Income Level, 1980–2010.

Figure 2.8

Trends in Age-Standardized (World) Incidence Rates of Men with Stomach Cancer, by Income Level, 1980–2010.

The importance of lung cancer in the overall global burden from cancer is a reflection of the prevalence of tobacco smoking. The differences in lung cancer incidence by national income level reflect the historical and current variations of smoking habits in the underlying populations. Lung cancer rates are decreasing in men in most countries, notably in HICs and in countries where the habit has long been established, but they are increasing in women (Jemal and others 2010). Such contrasting male and female trends are consistent with the population-specific rise and fall in adult cigarette utilization over past decades (Lortet-Tieulent and others 2013). The correlation between income and male smoking prevalence has shown a curvilinear trend (Talley 2010) that mimics the smoking epidemic curve (Thun and others 2012). Smoking prevalence tends to be low in countries of low average income but rises as income increases, until it stabilizes and begins to decline as countries attain high mean income levels.

The prevalence of smoking in men has increased sharply in many middle-income countries, including China and Indonesia (Jha 2009). The future burden of lung cancer and other smoking-related cancers (IARC 2004), such as bladder, esophageal, and oral cavity in different regions and countries, will largely depend on gender-specific smoking patterns at the population level, including the duration of smoking, extent of cessation, and types of tobacco smoked (Doll and others 2004; Pirie and others 2013; Thun and others 2012).

A recent study of incidence trends in 1988–2002 for the seven most frequently diagnosed cancers worldwide (constituting more than 58 percent of the global burden) estimated the annual percentage change of trends in age-adjusted incidence using data from 101 cancer registries (Bray and others 2012). The trends were stratified by medium, high, or very high levels of the Human Development Index (HDI), a composite measure of life expectancy at birth, income as GNI per capita, and access to education. Although the HDI is highly correlated with GNI, the latter reflects average national income, whereas the former additionally provides some indication as to how income is spent, at least in the areas of health and education (UNDP 2009).

An estimated 21.6 million new cancer cases are predicted for 2030 (an increase of 53 percent from 2012), based solely on projected demographic changes and unchanged cancer incidence rates (figure 2.9). If the cancer-specific incidence trends up to 2002 continue, an absolute increase of 62 percent in incidence is expected, representing an overall increase of 1.2 million new cases per year in 2012–30. The increases in cancer incidence are proportionally greatest in low HDI settings, with a predicted 77 percent increase in both genders.

Figure 2.9

Cancer Incidence Projected to 2030 with and without Incorporating Recent Changes in Rates by Gender, Income Level, and Age Group.

Although such analyses appear to present a rather pessimistic view of the future burden of cancer, targeted interventions can significantly reduce the projected rise in the number of cancer patients through resource-appropriate interventions. Such actions include primary prevention strategies to control lifestyle factors, including tobacco avoidance and cessation foremost, a reduction in alcohol consumption and obesity, and the promotion of increased levels of physical activity. Vaccination programs for liver and cervical cancer and early detection programs for breast and cervical cancer are important.

Risk Factors, Interventions and Policies, and Potential Impacts on the Burden of Cancer

Approximately 30 percent of all cancers worldwide are considered preventable by modification of the predominant risk factors (Danaei and others 2005; Martin-Moreno, Soerjomataram, and Magnusson 2008). Smoking and dietary risk factors have particularly important roles in potentially reducing the cancer burden in HICs and LMICs (Ezzati and others 2005; Jha 2009; Lim and others 2012; WCRF and AICR 2007). For cancers with strong risk modifiers, trends in risk factors are followed by trends of cancer incidence with a lag of 20–30 years (Doll and others 2004; Jha 2009). Illustrative examples include the temporal patterns of cigarette smoking and lung cancer, and age at first childbirth and breast cancer (Jha 2009; Soerjomataram and others 2008). Unfortunately, for most risk factors, the relation to specific cancer forms is weaker than these associations. In addition, risk factors often interact, making it difficult to link directly the changing prevalence of a single risk factor to the observed trends of specific cancer types.

Persistent Infections

The most recent estimates state that at least 16.1 percent or two million new cases of human malignancies worldwide are attributable to persistent infections with bacteria, viruses, or parasites (de Martel and others 2012). This fraction is higher in LMICs (22.9 percent or 1.6 million new cases) than in HICs (7.4 percent or 410,000 new cases). Helicobacter pylori, hepatitis B and C viruses, and human papilloma viruses (HPVs) are responsible for 1.9 million cases, mainly gastric, liver, and cervical cancers. The remaining 163,000 cases are attributed to Epstein-Barr virus, human herpes virus type 8, human T-cell lymphotropic virus type 1, Opisthorchis viverrini, Clonorchis sinensis, and Schistosoma haematobium. By region, the attributable fraction shows marked variation (figure 2.10), from 33.2 percent of all cancers in Sub-Saharan Africa to 3.3 percent in Australia and New Zealand. The proportion of cancers associated with chronic infections ranges from 1 in 3 in Sub-Saharan Africa and 1 in 4 in China to 1 in 30 in Australia and New Zealand and 1 in 25 in North America. Awareness of the role of infectious agents in cancer has expanded rapidly, leading to the formulation of new strategies, including vaccines against hepatitis B to prevent liver cancer, and against high-risk strains of HPV to prevent cervical and other HPV-related cancer types (Beutels 2001; Harper and others 2004; Herrero and others 2013).

Figure 2.10

Cancer and Infection: Estimated Attributable Fraction, by Region or Country, 2008.

Increasing coverage of hepatitis B virus vaccination has been related to a decrease in the prevalence of chronic hepatitis B virus throughout the world (Goldstein and others 2005). For example, in Taiwan, China, a 75 percent decrease in the incidence of hepatocellular carcinoma in children was reported since the initiation of routine infant hepatitis B vaccination (Chang and others 1997). Gavi, the Vaccine Alliance, has subsidized vaccines in poor countries, leading to a rapid increase in coverage of hepatitis B vaccination, with a similar effort underway in implementing HPV vaccination (Kane and others 2012). Based on current epidemiologic data in 72 countries, it is predicted that we will observe a mean reduction in lifetime risk of cervical cancer of between 31 percent (for example, in Guinea and Senegal) and 60 percent (for example, in Ethiopia), assuming an increase in vaccination coverage to 70 percent (Goldie and others 2008). Differences in the results of vaccination stem from variation in risk factor prevalence and the background incidence of the cancer being targeted. Safe and effective vaccines have proven highly important in reducing infection-related cancers.

Prospects for Enhancing Cancer Surveillance Systems in LMICs

Cancer is already a leading NCD at ages under 70 years worldwide and is the most common cause of death in more than 40 HICs. Global efforts are underway at a high political level to combat the rising cancer and NCD burden. The WHO Action Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases provides a road map for 2013–20 that includes a target for member states of a global reduction of 25 percent in premature mortality from the four main NCD groups by 2025 (“25 by 25”) (WHO 2011b). Adequate surveillance mechanisms at the country level are needed to monitor progress. With a greater number of governments adopting national cancer control plans, attention is increasingly turning to population-based cancer surveillance data as a central component in prioritizing and evaluating interventions.

Vital registration (mortality data) and population-based cancer registries (incidence and survival data) are complementary, and having the availability of both to a high standard is ideal. But for many LMICs, national vital statistics are unavailable, partial, or inaccurate. Where data are available, the coverage and completeness of the mortality data are often poor. It is thus much easier at present to quantify premature cancer mortality for higher resource countries than for those at the lower end. Efforts to develop and improve vital registration systems are being augmented by a number of verbal autopsy studies in countries and communities where many deaths occur at home and without medical attention (for example, the Million Death Study in India [Dikshit and others 2012]).

Population-based cancer registries describe the present scale and profile of cancer in the community and aid planning by assessing past and future trends. Knowing the size and nature of the cancer problem serves as an important stimulus to implement and change policy. However, although it is feasible to implement PBCRs even in the lowest income settings (Bray and others 2014), their availability is limited in most countries undergoing development, with only one in five LMICs currently predisposed with the necessary population-based data for cancer control action. This situation reflects a lack of advocacy for the value of registries historically and the subsequent lack of resources and prioritization of cancer data for cancer control among the competing demands on limited health care services (Wild 2014).

Nevertheless, positive momentum is building through the recognition of the role of cancer and other NCDs in hampering human development, changing priorities within countries at the highest political level. Importantly and as part of the global monitoring framework, WHO member states are being asked to collect cancer incidence, by type of cancer per 100,000 population, one of 25 indicators to monitor progress toward the 25 by 25 target, thereby obliging countries to establish and sustain population-based cancer registries.

Clearly, in aligning registries to cancer control action, technical guidance is needed to empower countries to improve their information systems so that they can be used for their vital purpose. Several technical and funding organizations are now working in a cooperative and coordinated manner under the auspices of the Global Initiative for Cancer Registry Development (http://gicr.iarc.fr) to bring about the needed improvement in the quantity and quality of data on cancer incidence through investment in PBCRs. There is a longstanding and ongoing commitment at IARC to support the development of such registries worldwide, particularly where they are in limited supply and most needed, in most LMICs. The presence of six recently established IARC regional hubs for cancer registration (map 2.2) across LMIC regions is providing the necessary localized support and training for cancer registries in the respective countries, as well as strengthening registry networking in each region to improve data standards and develop joint research activities.

Map 2.2

Implementing the Global Initiative for Cancer Registry through Six IARC Regional Hubs for Cancer Registration.

Conclusions

This chapter has examined the increasing global importance of cancer among the major NCDs, highlighted the extent of the ongoing demographic and epidemiologic transitions, described the key risk factors involved, and highlighted the extent to which cancer deaths may be avoided.

Changing fertility patterns and increasing life expectancy are leading to major changes in the scale of the cancer problem worldwide for populations at all levels of human development. A cancer transition is clearly underway in countries transiting to high levels of income and development whereby reductions in infection-related cancers are offset by concomitant increases in cancers linked to a “Westernization” of lifestyle, including “risky” behavior. Changes in tobacco habits and the expanding tobacco markets in LMICs may have major consequences on the future burden of lung and other tobacco-related cancers in the decades that follow.

The global trends therefore place special emphasis on the need for better cancer control in LMICs and the need for expanding coverage and quality of population-based cancer registration systems in each country. Cancer statistics should also serve as a catalyst for further research on human inequality and the scale and profile of cancer from global and regional perspectives, for better determination of how and why macroeconomic determinants influence cancer indicators. It is imperative that public health clinicians and cancer control specialists are alerted to the increasing magnitude of cancer incidence and mortality worldwide. This analysis serves to highlight the need for global action to reduce the increasing incidence and mortality burden from cancer and alleviate suffering among cancer patients.

Acknowledgment

The authors thank Mathieu Laversanne, IARC, for statistical analysis and generation of the graphics.

Notes

World Bank income classifications as of July 2014 are as follows, based on estimates of gross national income (GNI) per capita for 2013:

• Low-income countries (LICs): US$1,045 or less
• Middle-income countries (MICs) are subdivided:
  • a) lower-middle-income: US$1,046–US$4,125
  • b) upper-middle-income (UMICs): US$4,126–US$12,745
• High-income countries (HICs): US$12,746 or more

Except for figure 2.9 and estimates presented in the section Risk Factors, Interventions and Policies, and Potential Impacts on the Burden of Cancer, the maps and figures in this chapter are based on incidence and mortality estimates for ages 0 to 69, consistent with reporting in all DCP3 volumes. Global cancer statistics are estimates for the year 2012 and have been provided by the International Agency for Research on Cancer from its GLOBOCAN 2012 database. Observable population-based data were derived from Cancer Incidence in Five Continents, 10th edition and for trends over time from CI5 Plus (http://ci5.iarc.fr/CI5plus/Default.aspx). The discussion of burden (including risk factors), however, includes all ages unless otherwise noted. Interventions also apply to all age groups, except where age ranges or cutoffs are specified.

References

1. Agudo A, Bonet C, Travier N, Gonzalez C A, Vineis P., and others. 2012. “Impact of Cigarette Smoking on Cancer Risk in the European Prospective Investigation into Cancer and Nutrition Study.” Journal of Clinical Oncology 30 (36): 4550–57. doi:JCO.2011.41.0183 [Pii] 10.1200/JCO.2011.41.0183. [PubMed: 23169508]
2. Beral V, Bull D, Green J, Reeves G. 2007. “Ovarian Cancer and Hormone Replacement Therapy in the Million Women Study.” The Lancet 369 (9574): 1703–10. doi:S0140-6736(07)60534-0 [Pii] 10.1016/S0140-6736(07)60534-0. [PubMed: 17512855]
3. Beral V, Bull D, Reeves G. 2005. “Endometrial Cancer and Hormone-Replacement Therapy in the Million Women Study.” The Lancet 365 (9470): 1543–51. doi:S0140-6736(05)66455-0 [Pii] 10.1016/S0140-6736(05)66455-0. [PubMed: 15866308]
4. Beral V, Reeves G, Bull D, Green J. 2011. “Breast Cancer Risk in Relation to the Interval between Menopause and Starting Hormone Therapy.” Journal of the National Cancer Institute 103 (4): 296–305. doi:Djq527 [Pii] 10.1093/Jnci/Djq527. [PMC free article: PMC3039726] [PubMed: 21278356]
5. Bergstrom A, Pisani P, Tenet V, Wolk A, Adami H O. 2001. “Overweight as an Avoidable Cause of Cancer in Europe.” International Journal of Cancer 91 (3): 421–30. doi:10.1002/1097-0215(200002)9999:9999<::AID-IJC1053>3.0.CO;2-T [Pii]. [PubMed: 11169969]
6. Beutels P. 2001. “Economic Evaluations of Hepatitis B Immunization: A Global Review of Recent Studies (1994–2000).” Health Economics 10 (8): 751–74. doi:10.1002/Hec.625 [Pii]. [PubMed: 11747055]
7. Bleyer A, Welch H G. 2012. “Effect of Three Decades of Screening Mammography on Breast-Cancer Incidence.” New England Journal of Medicine 367 (21): 1998–2005. doi:10.1056/Nejmoa1206809. [PubMed: 23171096]
8. Boffetta P, Hashibe M, Vecchia C La, Zatonski W, Rehm J. 2006. “The Burden of Cancer Attributable to Alcohol Drinking.” International Journal of Cancer 119 (4): 884–87. doi:10.1002/Ijc.21903. [PubMed: 16557583]
9. Boffetta P, Tubiana M, Hill C, Boniol M, Aurengo A. and others. 2009. “The Causes of Cancer in France.” Annals of Oncology 20 (3): 550–55. doi:Mdn597 [Pii]10.1093/Annonc/Mdn597. [PubMed: 18765462]
10. Bray F. 2014. “Transitions in Human Development and the Global Cancer Burden.” In World Cancer Report 2014, edited by Wild C P, Lyon B A Stewart, editors. . France: International Agency for Research on Cancer.
11. Bray F, Jemal A, Grey N, Ferlay J, Forman D. 2012. “Global Cancer Transitions According to the Human Development Index (2008–2030): A Population-Based Study.” The Lancet Oncology 13 (8): 790–801. doi:10.1016/S1470-2045(12)70211-5. [PubMed: 22658655]
12. Bray F, Lortet-Tieulent J, Ferlay J, Forman D, Auvinen A. 2010. “Prostate Cancer Incidence and Mortality Trends in 37 European Countries: An Overview.” European Journal of Cancer 46 (17): 3040–52. doi:S0959-8049(10)00878-6 [Pii]10.1016/J.Ejca.2010.09.013. [PubMed: 21047585]
13. Bray F, McCarron P, Parkin D M. 2004. “The Changing Global Patterns of Female Breast Cancer Incidence and Mortality.” Breast Cancer Research 6 (6): 229–39. doi:Bcr932 [Pii]10.1186/Bcr932. [PMC free article: PMC1064079] [PubMed: 15535852]
14. Bray F, Znaor A, Cueva P, Korir A, Swaminathan R., and others. 2014. “Planning and Developing Population-Based Cancer Registration in Low- and Middle-Income Settings.” Technical Publication 43, International Agency for Research on Cancer, Lyon, France. [PubMed: 33502836]
15. Brown I J, Tzoulaki I, Candeias V, Elliott P. 2009. “Salt Intakes around the World: Implications for Public Health.” International Journal of Epidemiology 38 (3): 791–813. doi:Dyp139 [Pii] 10.1093/Ije/Dyp139. [PubMed: 19351697]
16. Center M M, Jemal A, Smith R A, Ward E. 2009. “Worldwide Variations in Colorectal Cancer.” CA: A Cancer Journal for Clinicians 59 (6): 366–78. doi:59/6/366 [Pii]10.3322/Caac.20038. [PubMed: 19897840]
17. Center M M, Jemal A, Ward E. 2009. “International Trends in Colorectal Cancer Incidence Rates.” Cancer Epidemiology Biomarkers & Prevention 18 (6): 1688–94. doi:18/6/1688 [Pii]10.1158/1055-9965.EPI-09-0090. [PubMed: 19505900]
18. Chang M H, Chen C J, Lai M S, Hsu H M, Wu T C. and others. 1997. “Universal Hepatitis B Vaccination in Taiwan and the Incidence of Hepatocellular Carcinoma in Children. Taiwan Childhood Hepatoma Study Group.” New England Journal of Medicine 336 (26): 1855–59. doi:10.1056/NEJM199706263362602. [PubMed: 9197213]
19. Chokunonga E, Borok M Z, Chirenje Z M, Nyakabau A M, Parkin D M. 2013. “Trends in the Incidence of Cancer in the Black Population of Harare, Zimbabwe 1991–2010.” International Journal of Cancer 133 (3): 721–29. doi:10.1002/Ijc.28063. [PubMed: 23364833]
20. Cogliano V J, Baan R, Straif K, Grosse Y, Lauby-Secretan B. and others. 2011. “Preventable Exposures Associated with Human Cancers.” Journal of the National Cancer Institute 103 (24): 1827–39. doi:Djr483 [Pii] 10.1093/Jnci/Djr483. [PMC free article: PMC3243677] [PubMed: 22158127]
21. Dallat M A, Soerjomataram I, Hunter R F, Tully M A, Cairns K J., and others. 2013. “Urban Greenways Have the Potential to Increase Physical Activity Levels Cost-Effectively.” European Journal of Public Health 24 (2): 190–95. doi:Ckt035[Pii]10.1093/Eurpub/Ckt035. [PubMed: 23531527]
22. Danaei G, Hoorn S Vander, Lopez A D, Murray C J, Ezzati M. 2005. “Causes of Cancer in the World: Comparative Risk Assessment of Nine Behavioural and Environmental Risk Factors.” The Lancet 366 (9499): 1784–93. doi:S0140-6736(05)67725-2 [Pii]10.1016/S0140-6736(05)67725-2. [PubMed: 16298215]
23. Martel de C, Ferlay J, Franceschi S, Vignat J, Bray F. and others. 2012. “Global Burden of Cancers Attributable to Infections in 2008: A Review and Synthetic Analysis.” The Lancet Oncology 13 (6): 607–15. doi:S1470-2045(12)70137-7 [Pii]10.1016/S1470-2045(12)70137-7. [PubMed: 22575588]
24. de Vries E, Arnold M, Altsitsiadis E, Trakatelli M, Hinrichs B. and others. 2012. “Potential Impact of Interventions Resulting in Reduced Exposure to Ultraviolet (UV) Radiation (UVA and UVB) on Skin Cancer Incidence in Four European Countries, 2010–2050.” British Journal of Dermatology 167 (Suppl. 2):53–62. doi:10.1111/J.1365-2133.2012.11087.X. [PubMed: 22881588]
25. Vries de E, Coebergh J W. 2004. “Cutaneous Malignant Melanoma in Europe.” European Journal of Cancer 40 (16): 2355–66. doi:S0959804904004678 [Pii]10.1016/J.Ejca.2004.06.003. [PubMed: 15519506]
26. Diez Roux A V, Evenson K R, McGinn A P, Brown D G, Moore L., and others. 2007. “Availability of Recreational Resources and Physical Activity in Adults.” American Journal of Public Health 97 (3): 493–99. doi:AJPH.2006.087734 [Pii] 10.2105/AJPH.2006.087734. [PMC free article: PMC1805019] [PubMed: 17267710]
27. Dikshit R, Gupta P C, Ramasundarahettige C, Gajalakshmi V, Aleksandrowicz L. and others. 2012. “Cancer Mortality in India: A Nationally Representative Survey.” The Lancet 379 (9828): 1807–16. doi:10.1016/S0140-6736(12)60358-4. [PubMed: 22460346]
28. Doll R. 1990. “Are We Winning the Fight against Cancer? An Epidemiological Assessment. EACR-Muhlbock Memorial Lecture.” European Journal of Cancer 26 (4): 500–08. [PubMed: 2141517]
29. Doll R, Payne P, Waterhouse A J H. 1966. Cancer Incidence in Five Continents: A Technical Report. New York: Springer.
30. Doll R, Peto R. 1981. “The Causes of Cancer: Quantitative Estimates of Avoidable Risks of Cancer in the United States Today.” Journal of the National Cancer Institute 66 (6): 1191–308. [PubMed: 7017215]
31. Doll R, Peto R, Boreham J, Sutherland I. 2004. “Mortality in Relation to Smoking: 50 Years’ Observations on Male British Doctors.” British Medical Journal 328 (7455): 1519. doi: 10.1136/Bmj.38142.554479.AE Bmj.38142.554479.AE [Pii]. [PMC free article: PMC437139] [PubMed: 15213107]
32. Evans J, Donkelaar A Van, Martin R V, Burnett R, Rainham D G., and others. 2013. “Estimates of Global Mortality Attributable to Particulate Air Pollution Using Satellite Imagery.” Environmental Research 120 33–42. doi:S0013-9351(12)00240-X[Pii]10.1016/J.Envres.2012.08.005. [PubMed: 22959329]
33. Ezzati M, Henley S J, Lopez A D, Thun M J. 2005. “Role of Smoking in Global and Regional Cancer Epidemiology: Current Patterns and Data Needs.” International Journal of Cancer 116 (6): 963–71. doi:10.1002/Ijc.21100. [PubMed: 15880414]
34. Farmer P, Frenk J, Knaul F M, Shulman L N, Alleyne G. and others. 2010. “Expansion of Cancer Care and Control in Countries of Low and Middle Income: A Call to Action.” The Lancet 376 (9747): 1186–93. doi:S0140-6736(10)61152-X [Pii] 10.1016/S0140-6736(10)61152-X. [PubMed: 20709386]
35. Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S. and others. 2013. GLOBOCAN 2012 v1.0. In Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer.
36. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C., and others. 2015. “Cancer Incidence and Mortality Worldwide: Sources, Methods and Major Patterns in GLOBOCAN 2012.” International Journal of Cancer 136 (5): E359–86. doi:10.1002/Ijc.29210. [PubMed: 25220842]
37. Forman D, Martel C de, Lacey C J, Soerjomataram I, Lortet-Tieulent J., and others. 2012. “Global Burden of Human Papillomavirus and Related Diseases.” Vaccine 30 (Suppl. 5): F12–23. doi:S0264-410X(12)01080-8 [Pii] 10.1016/J.Vaccine.2012.07.055.
38. Friedenreich C, Norat T, Steindorf K, Boutron-Ruault M C, Pischon T. and others. 2006. “Physical Activity and Risk of Colon and Rectal Cancers: The European Prospective Investigation into Cancer and Nutrition.” Cancer Epidemiological Biomarkers & Prevention 15 (12): 2398–407. doi: 15/12/2398 [Pii] 10.1158/1055-9965.EPI-06-0595. [PubMed: 17164362]
39. Giles-Corti B, Broomhall M H, Knuiman M, Collins C, Douglas K. and others. 2005. “Increasing Walking: How Important Is Distance to, Attractiveness, and Size of Public Open Space?” American Journal of Preventive Medicine 28 (2 Suppl. 2):169–76. doi:S0749-3797(04)00298-3 [Pii] 10.1016/J.Amepre.2004.10.018. [PubMed: 15694525]
40. Giovannucci E, Ascherio A, Rimm E B, Colditz G A, Stampfer M J., and others. 1995. “Physical Activity, Obesity, and Risk for Colon Cancer and Adenoma in Men.” Annals of Internal Medicine 122 (5): 327–34. [PubMed: 7847643]
41. Goldie S J, O’Shea M, Campos N G, Diaz M, Sweet S. and others. 2008. “Health and Economic Outcomes of HPV 16,18 Vaccination in 72 GAVI-Eligible Countries.” Vaccine 26 (32): 4080–93. doi:S0264-410X(08)00493-3[Pii]10.1016/J.Vaccine.2008.04.053. [PubMed: 18550229]
42. Goldstein S T, Zhou F, Hadler S C, Bell B P, Mast E E., and others. 2005. “A Mathematical Model to Estimate Global Hepatitis B Disease Burden and Vaccination Impact.” International Journal of Epidemiology 34 (6): 1329–39. doi:Dyi206 [Pii]10.1093/Ije/Dyi206. [PubMed: 16249217]
43. Hanley J A. 2001. “A Heuristic Approach to the Formulas for Population Attributable Fraction.” Journal of Epidemiology and Community Health 55 (7): 508–14. [PMC free article: PMC1731931] [PubMed: 11413183]
44. Harper D M, Franco E L, Wheeler C, Ferris D G, Jenkins D. and others. 2004. “Efficacy of a Bivalent L1 Virus-Like Particle Vaccine in Prevention of Infection with Human Papillomavirus Types 16 and 18 in Young Women: A Randomised Controlled Trial.” The Lancet 364 (9447): 1757–65. doi:S0140673604173984 [Pii]10.1016/S0140-6736(04)17398-4. [PubMed: 15541448]
45. Harriss D J, Atkinson G, Batterham A, George K, Cable N T., and others. 2009. “Lifestyle Factors and Colorectal Cancer Risk (2): A Systematic Review and Meta-Analysis of Associations with Leisure-Time Physical Activity.” Colorectal Disease 11 (7): 689–701. doi:CDI1767 [Pii] 10.1111/J.1463-1318.2009.01767.X. [PubMed: 19207713]
46. Herrero R, Quint W, Hildesheim A, Gonzalez P, Struijk L. and others. 2013. “Reduced Prevalence of Oral Human Papillomavirus (HPV) 4 Years after Bivalent HPV Vaccination in A Randomized Clinical Trial in Costa Rica.” Plos One 8 (7): E68329. doi:10.1371/Journal.Pone.0068329 PONE-D-12-40404 [Pii]. [PMC free article: PMC3714284] [PubMed: 23873171]
47. IARC (International Agency for Research on Cancer). 1987. Overall Evaluations of Carcinogenicity: An Updating of IARC Monographs 1–440. Monographs on the Evaluation of Carcinogenic Risks to Humans, IARC, Lyon, France. [PubMed: 3482203]
48. IARC (International Agency for Research on Cancer). 2004. “Tobacco Smoke and Involuntary Smoking.” Monographs on the Evaluation of Carcinogenic Risks to Humans, Volume 83, IARC, Lyon, France. [PMC free article: PMC4781536] [PubMed: 15285078]
49. IARC (International Agency for Research on Cancer). 2010. “Alcohol Consumption and Ethyl Carbamate.” Monographs on the Evaluation of Carcinogenic Risks to Humans, IARC, Lyon, France.
50. Jemal A, Bray F, Forman D, O’Brien M, Ferlay J. and others. 2012. “Cancer Burden in Africa and Opportunities for Prevention.” Cancer 118 (18): 4372–84. doi:10.1002/Cncr.27410. [PubMed: 22252462]
51. Jemal A, Center M M, Desantis C, Ward E M. 2010. “Global Patterns of Cancer Incidence and Mortality Rates and Trends.” Cancer Epidemiology Biomarkers & Prevention 19 (8): 1893–907. doi:1055-9965.EPI-10-0437 [Pii] 10.1158/1055-9965.EPI-10-0437. [PubMed: 20647400]
52. Jha P. 2009. “Avoidable Global Cancer Deaths and Total Deaths from Smoking.” Nature Reviews Cancer 9 (9): 655–64. doi:Nrc2703 [Pii] 10.1038/Nrc2703. [PubMed: 19693096]
53. Jha P, Ramasundarahettige C, Landsman V, Rostron B, Thun M. and others. 2013. “21st-Century Hazards of Smoking and Benefits of Cessation in the United States.” New England Journal of Medicine 368 (4): 341–50. doi:0.1056/Nejmsa1211128. [PubMed: 23343063]
54. Kane M A, Serrano B, Sanjose S De, Wittet S. 2012. “Implementation of Human Papillomavirus Immunization in the Developing World.” Vaccine 30 (Suppl. 5): F192–200. doi:S0264-410X(12)00956-5 [Pii] 10.1016/J.Vaccine.2012.06.075. [PubMed: 23199963]
55. Karim-Kos H E, Vries E de, Soerjomataram I, Lemmens V, Siesling S, Coebergh J W. 2008. “Recent Trends of Cancer in Europe: A Combined Approach of Incidence, Survival and Mortality for 17 Cancer Sites Since the 1990s.” European Journal of Cancer 44 (10): 1345–89. doi: 10.1016/j.ejca.2007.12.015. [PubMed: 18280139]
56. Lim S S, Vos T, Flaxman A D, Danaei G, Shibuya K. and others. 2012. “A Comparative Risk Assessment of Burden of Disease and Injury Attributable to 67 Risk Factors and Risk Factor Clusters in 21 Regions, 1990–2010: A Systematic Analysis for the Global Burden of Disease Study 2010.” The Lancet 380 (9859): 2224–60. doi:10.1016/S0140-6736(12)61766-8. [PMC free article: PMC4156511] [PubMed: 23245609]
57. Lin H H, Murray M, Cohen T, Colijn C, Ezzati M. 2008. “Effects of Smoking and Solid-Fuel Use on COPD, Lung Cancer, and Tuberculosis in China: A Time-Based, Multiple Risk Factor, Modelling Study.” The Lancet 372 (9648): 1473–83. doi:S0140-6736(08)61345-8 [Pii] 10.1016/S0140-6736(08)61345-8. [PMC free article: PMC2652750] [PubMed: 18835640]
58. Lortet-Tieulent J, Renteria E, Sharp L, Weiderpass E, Comber H. and others. 2013. “Convergence of Decreasing Male and Increasing Female Incidence Rates in Major Tobacco-Related Cancers in Europe in 1988–2010.” European Journal of Cancer. doi: S0959-8049(13)00952-0 [Pii] 10.1016/J.Ejca.2013.10.014. [PubMed: 24269041]
59. Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K. and others. 2012. “Global and Regional Mortality from 235 Causes of Death for 20 Age Groups in 1990 and 2010: A Systematic Analysis for the Global Burden of Disease Study 2010.” The Lancet 380 (9859): 2095–128. doi:S0140-6736(12)61728-0 [Pii]10.1016/S0140-6736(12)61728-0. [PubMed: 23245604]
60. Makela P, Tryggvesson K, Rossow I. 2002. “Who Drinks More or Less When Policies Change? The Evidence from 50 Years of Nordic Studies.” In The Effects of Nordic Alcohol Policies: Analyses of Changes in Control Systems, edited by Room R, editor. . Helsinki: Nordic Council for Alcohol and Drug Research.
61. Martin-Moreno J M, Soerjomataram I, Magnusson G. 2008. “Cancer Causes and Prevention: A Condensed Appraisal in Europe in 2008.” European Journal of Cancer 44 (10): 1390–403. doi:S0959-8049(08)00090-7 [Pii] 10.1016/J.Ejca.2008.02.002. [PubMed: 18329264]
62. McCormack V A, Boffetta P. 2011. “Today’s Lifestyles, Tomorrow’s Cancers: Trends in Lifestyle Risk Factors for Cancer in Low- and Middle-Income Countries.” Annals of Oncology 22 (11): 2349–57. doi:Mdq763 [Pii] 10.1093/Annonc/Mdq763. [PubMed: 21378201]
63. McCormack V, Peto J, Byrnes G, Straif K, Boffetta P. 2012. “Estimating the Asbestos-Related Lung Cancer Burden from Mesothelioma Mortality.” British Journal of Cancer 106 (3): 575–84. doi:Bjc2011563 [Pii] 10.1038/Bjc.2011.563. [PMC free article: PMC3273352] [PubMed: 22233924]
64. McCormack V A, Schuz J. 2012. “Africa’s Growing Cancer Burden: Environmental and Occupational Contributions.” Cancer Epidemiology 36 (1): 1–7. doi:S1877-7821(11)00146-9 [Pii] 10.1016/J.Canep.2011.09.005. [PubMed: 21996568]
65. Monninkhof E M, Elias S G, Vlems F A, Tweel I Van Der, Schuit A J. and others. 2007. “Physical Activity and Breast Cancer: A Systematic Review.” Epidemiology 18 (1): 137–57. doi:10.1097/01.Ede.0000251167.75581.98. [PubMed: 17130685]
66. Muir C S, Fraumeni Jr J F, Doll R. 1994. “The Interpretation of Time Trends.” Cancer Surveys 19–20 5–21. [PubMed: 7895222]
67. Murray C J, Abraham J, Ali M K, Alvarado M, Atkinson C. and others. 2013. “The State of US Health, 1990–2010: Burden of Diseases, Injuries, and Risk Factors.” Journal of the American Medical Association 310 (6): 591–606. doi:1710486 [Pii] 10.1001/Jama.2013.13805. [PMC free article: PMC5436627] [PubMed: 23842577]
68. Ng M, Freeman M K, Fleming T D, Robinson M, Dwyer-Lindgren L. and others. 2014. “Smoking Prevalence and Cigarette Consumption in 187 Countries, 1980–2012.” Journal of the American Medical Association 311 (2): 183–92. doi:10.1001/Jama.2013.284692. [PubMed: 24399557]
69. Parkin D M. 2006. “The Evolution of the Population-Based Cancer Registry.” Nature Reviews Cancer 6 (8): 603–12. doi:Nrc1948 [Pii] 10.1038/Nrc1948. [PubMed: 16862191]
70. Parkin D M. 2011. “Cancers Attributable to Dietary Factors in the UK in 2010. IV Salt.” British Journal of Cancer 105 (Suppl. 2): S31–33. doi:Bjc2011480 [Pii] 10.1038/Bjc.2011.480. [PMC free article: PMC3252061] [PubMed: 22158317]
71. Parkin D M, Bray F, Ferlay J, Jemal A. 2014. “Cancer in Africa 2012.” Cancer Epidemilogy Biomarkers & Prevention 23 (6): 953–66. doi:10.1158/1055-9965.EPI-14-0281. [PubMed: 24700176]
72. Pirie K, Peto R, Reeves G K, Green J, Beral V. 2013. “The 21st Century Hazards of Smoking and Benefits of Stopping: A Prospective Study of One Million Women in the UK.” The Lancet 381 (9861): 133–41. doi:S0140-6736(12)61720-6 [Pii]10.1016/S0140-6736(12)61720-6. [PMC free article: PMC3547248] [PubMed: 23107252]
73. Pischon T, Lahmann P H, Boeing H, Friedenreich C, Norat T. and others. 2006. “Body Size and Risk of Colon and Rectal Cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC).” Journal of the National Cancer Institute 98 (13): 920–31. doi:98/13/920 [Pii]10.1093/Jnci/Djj246. [PubMed: 16818856]
74. Raaschou-Nielsen O, Andersen Z J, Beelen R, Samoli E, Stafoggia M. and others. 2013. “Air Pollution and Lung Cancer Incidence in 17 European Cohorts: Prospective Analyses from the European Study of Cohorts for Air Pollution Effects (ESCAPE).” The Lancet Oncology 14 (9): 813–22. doi:S1470-2045(13)70279-1 [Pii]10.1016/S1470-2045(13)70279-1. [PubMed: 23849838]
75. Reeves G K, Pirie K, Green J, Bull D, Beral V. 2012. “Comparison of the Effects of Genetic and Environmental Risk Factors on In Situ and Invasive Ductal Breast Cancer.” International Journal of Cancer 131 (4): 930–37. doi:10.1002/Ijc.26460. [PubMed: 21952983]
76. Rehm J, Shield K D. 2013. “Global Alcohol-Attributable Deaths from Cancer, Liver Cirrhosis, and Injury in 2010.” Alcohol Research 35 (2): 174–83. [PMC free article: PMC3908708] [PubMed: 24881325]
77. Renehan A G, Soerjomataram I, Tyson M, Egger M, Zwahlen M. and others. 2010. “Incident Cancer Burden Attributable to Excess Body Mass Index in 30 European Countries.” International Journal of Cancer 126 (3): 692–702. doi:10.1002/Ijc.24803. [PubMed: 19645011]
78. Rockhill B, Newman B, Weinberg C. 1998. “Use and Misuse of Population Attributable Fractions.” American Journal of Public Health 88 (1): 15–19. [PMC free article: PMC1508384] [PubMed: 9584027]
79. Rosner B, Colditz G A. 1996. “Nurses’ Health Study: Log-Incidence Mathematical Model of Breast Cancer Incidence.” Journal of the National Cancer Institute 88 (6): 359–64. [PubMed: 8609645]
80. Sankaranarayanan R, Swaminathan R, Jayant K, Brenner H. 2011. “An Overview of Cancer Survival in Africa, Asia, the Caribbean and Central America: The Case for Investment in Cancer Health Services.” IARC Scientific Publications 162 257–91. [PubMed: 21675431]
81. Shield K D, Rylett M, Gmel G, Kehoe-Chan T A, Rehm J. 2013. “Global Alcohol Exposure Estimates by Country, Territory and Region for 2005: A Contribution to the Comparative Risk Assessment for the 2010 Global Burden of Disease Study.” Addiction 108 (5): 912–22. doi:10.1111/Add.12112. [PubMed: 23347092]
82. Soerjomataram I, Pukkala E, Brenner H, Coebergh J W. 2008. “On the Avoidability of Breast Cancer in Industrialized Societies: Older Mean Age at First Birth as an Indicator of Excess Breast Cancer Risk.” Breast Cancer Research and Treatment 111 (2): 297–302. doi:10.1007/S10549-007-9778-2. [PMC free article: PMC2491409] [PubMed: 17932743]
83. Stevens G A, Singh G M, Lu Y, Danaei G, Lin J K., and others. 2012. “National, Regional, and Global Trends in Adult Overweight and Obesity Prevalences.” Population Health Metrics 10 (1): 22. doi:1478-7954-10-22 [Pii] 10.1186/1478-7954-10-22. [PMC free article: PMC3543235] [PubMed: 23167948]
84. Stewart B W. 2012. “Priorities for Cancer Prevention: Lifestyle Choices versus Unavoidable Exposures.” The Lancet Oncology 13 (3): E126–33. doi:S1470-2045(11)70221-2 [Pii]10.1016/S1470-2045(11)70221-2. [PubMed: 22381935]
85. Talley M B. 2010. Examining the Impact of Development, Tobacco Taxation, and Tobacco Prices on Global Adult Male Smoking Prevalence. Altanta, GA: Georgia Institute of Technology, Georgia State University.
86. Thun M, Peto R, Boreham J, Lopez A D. 2012. “Stages of the Cigarette Epidemic on Entering Its Second Century.” Tobacco Control 21 (2): 96–101. doi:Tobaccocontrol-2011-050294 [Pii] 10.1136/Tobaccocontrol-2011-050294. [PubMed: 22345230]
87. UNDP (United Nations Develpoment Programme). 2009. Human Development Report 2009: Overcoming Barriers: Human Mobility and Development. New York: UNDP.
88. Vaccarella S, Lortet-Tieulent J, Plummer M, Franceschi S, Bray F. 2013. “Worldwide Trends in Cervical Cancer Incidence: Impact of Screening against Changes in Disease Risk Factors.” European Journal of Cancer 49 (15): 3262–73. doi:S0959-8049(13)00358-4 [Pii]10.1016/J.Ejca.2013.04.024. [PubMed: 23751569]
89. Wabinga H R, Amulen P M, Okello C, Mbus L, Parkin D M. 2014. “Trends in the Incidence of Cancer in Kampala, Uganda 1991–2010.” International Journal of Cancer 135 (2): 432–9. doi: 10.1002/ijc.28661. http://www​.ncbi.nlm.nih​.gov/pubmed/24615279. [PubMed: 24615279]
90. WCRF (World Cancer Research Fund) and AICR (American Institute for Cancer Research). 2007. Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective. Washington, DC: WCRF and AICR.
91. WHO (World Health Organization). 2008. Report on the Global Tobacco Epidemic, 2008: The MPOWER Package. Geneva: WHO.
92. WHO (World Health Organization). 2011a. Global Status Report on Alcohol and Health. Geneva: WHO.
93. WHO (World Health Organization). 2011b. Global Status Report on Non-Communicable Diseases 2010. Geneva: WHO.
94. WHO (World Health Organization). 2013. “Global Health Observatory Data Repository.” WHO, Geneva. http://apps​.who.int/gho/data/node​.main.a859lang=en.
95. Wild C P. 2014. “Foreword.” In Planning and Developing Population-Based Cancer Registration in Low- and Middle-Income Settings, edited by Bray F, Znaor A, Cueva P, Korir A, Swaminathan R, editors. and others Lyon, France: IARC. [PubMed: 33502836]