Professional Documents
Culture Documents
Section of Cancer Information, International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon Cedex 08, France
Department of Measurement and Health Information Systems, WHO, Geneva, Switzerland
3
Clinical Trial Service Unit & Epidemiological Studies Unit, University of Oxford, Oxford OX3 7LF, United Kingdom
2
Data Sources
Incidence
C 2010 UICC
Int. J. Cancer: 127, 28932917 (2010) V
Mortality
Epidemiology
Estimates of the worldwide incidence and mortality from 27 cancers in 2008 have been prepared for 182 countries as part of
the GLOBOCAN series published by the International Agency for Research on Cancer. In this article, we present the results for
20 world regions, summarizing the global patterns for the eight most common cancers. Overall, an estimated 12.7 million
new cancer cases and 7.6 million cancer deaths occur in 2008, with 56% of new cancer cases and 63% of the cancer deaths
occurring in the less developed regions of the world. The most commonly diagnosed cancers worldwide are lung (1.61 million,
12.7% of the total), breast (1.38 million, 10.9%) and colorectal cancers (1.23 million, 9.7%). The most common causes of
cancer death are lung cancer (1.38 million, 18.2% of the total), stomach cancer (738,000 deaths, 9.7%) and liver cancer
(696,000 deaths, 9.2%). Cancer is neither rare anywhere in the world, nor mainly confined to high-resource countries. Striking
differences in the patterns of cancer from region to region are observed.
2894
Epidemiology
third of the world population was covered by mortality statistics. While almost all the European and American countries
have comprehensive death registration systems, most African
and Asian countries (including the populous countries of Nigeria, India and Indonesia) do not. For the GLOBOCAN
2008 estimates, we benetted from the provisional estimates
of the age- and sex-specic deaths from cancer (of all types)
for 2008 in each country of the world (Colin Mathers, personal communication, 2009). These preliminary 2008 mortality
estimates from WHO are based on 2008 life tables (all-cause
mortality) as published in World Health Statistics 2010,15
and cause-of-death distributions from the Global Burden of
Disease study for 2004,16 projected forward and tted to the
2008 all-cause mortality estimates.
Population data
Ferlay et al.
2895
ICD-10 code
C00-08
Nasopharynx
C11
Other pharynx
C09-10, C12-14
Oesophagus
C15
Stomach
C16
Colorectum1
C18-21
Liver
C22
C23-24
Pancreas
C25
Larynx
C32
C33-34
Melanoma of skin
C43
Kaposi sarcoma2
C46B21.0
Breast3
C50
Cervix uteri
C53
Corpus uteri
C54
Ovary
C56
Prostate
C61
Testis
C62
Kidney
C64-66
Bladder
C67
C70-72
Thyroid
C73
Hodgkin lymphoma
C81
Non-Hodgkin lymphoma
Multiple myeloma
C88C90
Leukemia
All cancers excl. nonmelanoma
skin cancer
C91-95
C00-97B21.3-9 excl. C44
availability and the accuracy of data, and fall into one of the
following categories, in priority order:
1. National incidence data: National incidence data were
available in 62 countries. For four of these countries,
reliable estimates of the national incidence in 2008
were available from local sources and these have been
used (1A). When historical data and a sufcient numbers of recorded cases were available (32 countries),
incidence rates were projected to 2008 (1B). Otherwise,
the incidence rates from the most recent period were
applied to the 2008 population (1C, 26 countries).
2. Local incidence data and national mortality data: The
method, as used for estimating the national incidence
in 52 countries, has been described in detail elsewhere.20 Estimates of the incidence to mortality ratios
(IR/MR) were obtained from log-linear models of the
numbers of incident cases based on the aggregation of
local/regional registries offset by the numbers of deaths
in the same registries, adjusted for sex and age.
National incidence (IN) was obtained on applying these
tted ratios to the corresponding national mortality
estimates for 2008 (MN):
IN MN IR =MR
(1)
Epidemiology
Gallbladder
2896
Table 2. Method of estimation of national incidence: population (in millions) and number of countries, by world region (region numbers)
Population in million (number of countries)
Method 1
Method 2
787 (28)
432 (15)
5 (2)
339 (2)
Europe (14-17)
423 (24)
304 (14)
5 (2)
Method 4
Method 5
128 (1)
25 (2)
225 (34)
2139 (37)
2079 (23)
392 (13)
632 (30)
500 (16)
162 (8)
247 (22)
224 (4)
385 (7)
6 (1)
0 (1)
Africa (1-5)
57 (7)
10 (5)
551 (25)
9 (1)
156 (16)
1588 (12)
1570 (6)
2 (6)
Total: population
1012 (15%)
2571 (38%)
2079 (31%)
392 (6%)
637 (10%)
62 (34%)
52 (29%)
23 (13%)
13 (7%)
32 (18%)
Countries
Epidemiology
Method 3
Ferlay et al.
Epidemiology
2897
Figure 3. (ac) Relationship between GDP per capita and 5-year relative survival: colorectal (both sexes), breast and cervical cancers. GDP
values greater than 5000 are provided by Nordic countries, the two outliers with lower values correspond to Indian (Barshi, Chennai,
Karunagappally and Mumbai) and African (The Gambia, Uganda: Kampala and Zimbabwe: Harare) cancer registries.
2898
Epidemiology
Figure 4. Estimate of cancer mortality: ow chart summarizing method 3 (incidence and survival) process.
Ferlay et al.
2899
Table 3. Method of estimation of national mortality: population (in millions) and number of countries,
by world region (region numbers)
Population in million (number of countries)
Method 1
339 (2)
Europe (1417)
724 (37)
128 (1)
Method 2
Method 3
3 (1)
5 (2)
3 (1)
5 (2)
25 (2)
159 (23)
2077 (30)
2 (2)
3230 (84)
963 (51)
63 (10)
490 (19)
17 (2)
94 (9)
1587 (11)
2242 (25)
Oceania (1920)
0 (2)
Total: population
1375 (21%)
2080 (31%)
3235 (48%)
65 (36%)
31 (17%)
86 (47%)
Countries
1216 (42)
C 2010 UICC
Int. J. Cancer: 127, 28932917 (2010) V
8 (6)
Epidemiology
2900
Table 4. Estimated new cancer cases (thousands), ASRs (per 100,000) and cumulative risks (percent) by sex and cancer site worldwide,
2008
Both sexes
Cancer site
Lip, oral cavity
263
(%)
ASR
(world)
2.1
3.9
Cum. Risk
(074)
0.4
Cases
170
(%)
2.6
Female
ASR
(world)
5.3
Cum. Risk
(074)
0.6
Cases
92
(%)
1.5
ASR
(world)
2.6
Cum. Risk
(074)
0.3
Nasopharynx
84
0.7
1.2
0.1
57
0.9
1.7
0.2
26
0.4
0.8
0.1
Other pharynx
135
1.1
2.0
0.2
107
1.6
3.4
0.4
27
0.4
0.8
0.1
Oesophagus
482
3.8
7.0
0.9
326
4.9
10.2
1.3
155
2.6
4.2
0.5
Stomach
989
7.8
14.1
1.7
640
9.6
19.8
2.4
349
5.8
9.1
1.0
1233
9.7
17.3
2.0
663
10.0
20.4
2.3
570
9.4
14.6
1.6
748
5.9
10.8
1.2
522
7.9
16.0
1.8
225
3.7
6.0
0.7
Colorectum
Liver
Gallbladder
145
1.1
2.0
0.2
58
0.9
1.8
0.2
86
1.4
2.2
0.3
Pancreas
277
2.2
3.9
0.4
144
2.2
4.4
0.5
133
2.2
3.3
0.4
Larynx
Lung
Melanoma of skin
Kaposi sarcoma
Breast
Cervix uteri
151
1.2
2.3
0.3
130
2.0
4.1
0.5
21
0.3
0.6
0.1
1608
12.7
23.0
2.8
1095
16.5
34.0
4.1
513
8.5
13.5
1.6
197
1.6
2.8
0.3
101
1.5
3.1
0.3
96
1.6
2.6
0.3
34
0.3
0.5
0.0
22
0.3
0.6
0.1
12
0.2
0.3
0.0
1383
10.9
39.0
4.1
1383
22.9
39.0
4.1
529
4.2
15.2
1.6
529
8.8
15.2
1.6
Corpus uteri
287
2.3
8.2
1.0
287
4.8
8.2
1.0
Ovary
225
1.8
6.3
0.7
225
3.7
6.3
0.7
Prostate
913
7.2
28.5
3.5
913
13.8
28.5
3.5
52
0.4
1.5
0.1
52
0.8
1.5
0.1
Testis
Kidney
271
2.1
3.9
0.5
167
2.5
5.2
0.6
103
1.7
2.8
0.3
Bladder
386
3.0
5.3
0.6
297
4.5
9.1
1.0
89
1.5
2.2
0.2
238
1.9
3.5
0.3
127
1.9
3.9
0.4
110
1.8
3.2
0.3
Thyroid
212
1.7
3.1
0.3
49
0.7
1.5
0.2
163
2.7
4.7
0.5
Hodgkin lymphoma
Non-Hodgkin lymphoma
Epidemiology
Cases
Male
67
0.5
1.0
0.1
40
0.6
1.2
0.1
27
0.4
0.8
0.1
355
2.8
5.1
0.5
199
3.0
6.1
0.6
156
2.6
4.2
0.4
Multiple myeloma
102
0.8
1.5
0.2
54
0.8
1.7
0.2
47
0.8
1.3
0.1
Leukemia
351
2.8
5.1
0.5
195
2.9
5.9
0.6
155
2.6
4.3
0.4
12677
100.0
181.8
18.7
6639
100.0
204.4
21.2
6038
100.0
164.9
16.5
(2)
C 2010 UICC
Int. J. Cancer: 127, 28932917 (2010) V
Table 5. Estimated cancer deaths (thousands), ASRs (per 100,000) and cumulative risks (percent) by sex and cancer site worldwide, 2008
Both sexes
Cancer site
Deaths
(%)
Male
ASR
Cum. Risk
(world) (074)
Deaths
(%)
Female
ASR
Cum. Risk
(world) (074)
Deaths
(%)
ASR
Cum. Risk
(world)
(074)
127
1.7
1.9
0.2
83
2.0
2.6
0.3
44
1.3
1.2
0.1
Nasopharynx
51
0.7
0.8
0.1
35
0.8
1.1
0.1
15
0.4
0.4
0.1
Other pharynx
95
1.3
1.4
0.2
76
1.8
2.4
0.3
19
0.6
0.5
0.1
Oesophagus
406
5.4
5.8
0.7
276
6.5
8.6
1.0
130
3.9
3.4
0.4
Stomach
738
9.7
10.3
1.2
464
11.0
14.3
1.7
273
8.2
6.9
0.8
Colorectum
608
8.0
8.2
0.9
320
7.6
9.7
1.1
288
8.6
7.0
0.7
Liver
695
9.2
10.0
1.1
478
11.3
14.6
1.7
217
6.5
5.7
0.6
Gallbladder
109
1.4
1.5
0.2
42
1.0
1.3
0.1
66
2.0
1.7
0.2
Pancreas
266
3.5
3.7
0.4
138
3.3
4.2
0.5
127
3.8
3.1
0.3
0.3
0.3
0.0
12.8 11.0
1.3
82
1.1
1.2
0.2
70
1.7
2.2
0.3
11
1378
18.2
19.4
2.3
951
22.5
29.4
3.5
427
Melanoma of skin
46
0.6
0.6
0.1
25
0.6
0.8
0.1
20
0.6
0.5
0.1
Kaposi sarcoma
29
0.4
0.4
0.0
18
0.4
0.5
0.1
10
0.3
0.3
0.0
Breast
458
6.0
12.5
1.3
458
Cervix uteri
274
3.6
7.8
0.9
274
8.2
7.8
0.9
Larynx
Lung
13.7 12.5
1.3
74
1.0
2.0
0.2
74
2.2
2.0
0.2
Ovary
140
1.8
3.8
0.4
140
4.2
3.8
0.4
Prostate
258
3.4
7.5
0.6
258
6.1
7.5
0.6
0.1
0.3
0.0
0.2
0.3
0.0
Kidney
116
1.5
1.6
0.2
72
1.7
2.2
0.2
44
1.3
1.1
0.1
Bladder
150
2.0
2.0
0.2
112
2.6
3.3
0.3
37
1.1
0.9
0.1
174
2.3
2.6
0.3
97
2.3
3.0
0.3
77
2.3
2.2
0.2
35
0.5
0.5
0.1
11
0.3
0.3
0.0
24
0.7
0.6
0.1
Corpus uteri
Testis
Thyroid
Hodgkin lymphoma
Non-Hodgkin lymphoma
Multiple myeloma
Leukemia
30
0.4
0.4
0.0
18
0.4
0.6
0.1
11
0.3
0.3
0.0
191
2.5
2.7
0.3
109
2.6
3.3
0.3
81
2.4
2.1
0.2
72
1.0
1.0
0.1
37
0.9
1.2
0.1
34
1.0
0.9
0.1
257
3.4
3.6
0.3
143
3.4
4.3
0.4
113
3.4
3.1
0.3
100.0 106.2
11.2
4225
100.0 128.8
13.5
3346
100.0 87.6
9.1
2902
Results
Epidemiology
2008.
We estimated that 12.7 million new cancer cases and 7.6 million cancer deaths occurred in 2008 worldwide. Tables 4 and
5 show the estimated number of cases and deaths for 27 cancers in men, women and both sexes combined, together with
ASRs and the cumulative risk (to age 74). Lung cancer
remains the most common cancer in the world, both in term
of cases (1.6 million cases, 12.7% of total) and deaths (1.4
million deaths, 18.2%). Breast cancer is the second most
common cancer overall (1.4 million cases, 10.9%) but ranks
5th as cause of death (458,000, 6.1%) followed in terms of
incidence by colorectal cancer (1.2 million cases, 608,000
deaths), stomach cancer (990,000 cases, 738,000 deaths),
prostate cancer (913,000 cases, 261,000 deaths) and liver cancer (748,000 cases and 695,000 deaths).
Figures 5a and 5b show the 15 most common cancers for
men and women as number of new cases and deaths in the
developing and developed regions of the world. Although
lung cancer is the most common cancer worldwide among
men, it ranks second in developed regions (482,000 cases) after prostate cancer (658,000 cases). In women, cervix cancer,
the second most common cancer in developing regions
(452,000 cases), is only the 10th most common cancer in
developed regions (76,000 cases). Cancers of the lung, stomach and liver predominate among males in developing
regions (42% of the new cancer cases, 48% of the total cancer
deaths), while breast and cervical cancers represent 33% of
the new cancer cases in females, but only 25% of the corresponding cancer deaths.
Tables 6 and 7 show the estimated ASRs (world standard)
of incidence and mortality, respectively, by sex and for the
eight most common cancer sites, for the 20 regions of the
world, and for more developed and less developed regions.
Tables 8 and 9 show the estimates of the numbers of cancer
cases and deaths, and Tables 10 and 11 the estimates of cumulative risk (074, percent) for the same categories. A brief
description of the global patterns for the eight most common
cancers follows.
All cancers
Ferlay et al.
2903
Table 6. Estimated ASRs (World standard) of cancer incidence by sex, cancer site and regions, 2008
Stomach
Colorectum
Liver
Lung
(C15)
(C16)
(C18-21)
(C22)
(C33-34)
19.8
9.1
15.2
28.5
204.4
164.9
More developed
regions
6.5
1.3
16.7
7.3
37.6 24.2
8.1
9.0
63.0
301.1
225.5
Less developed
regions
11.9
5.7
9.4 18.9
17.8
12.0
160.3
138.0
Eastern Africa
14.9
6.4
4.7
3.6
4.1
1.4 19.3
34.5
14.5
121.3
125.3
7.2
All sites
(C00-97/C44)
5.8
(C61)
4.2
4.0
(C53)
5.6
(C50)
10.2
World
Middle Africa
1.5
0.8
5.3
4.7
4.3
3.3 18.9
9.6
2.8
0.9 21.3
23.0
16.4
88.1
96.7
Northern Africa
2.0
1.6
3.9
2.4
7.0
5.8
2.5 14.9
2.2 32.7
6.6
8.1
109.2
98.9
Southern Africa
22.3
11.7
4.1
2.2
20.4
8.2 13.9
5.1 29.0
8.0 38.1
26.8
53.9
235.9
161.1
Western Africa
1.4
1.0
4.5
3.3
5.6
4.3 16.5
8.1
1.2 31.8
33.7
22.2
92.0
123.5
Caribbean
5.0
1.4
11.2
6.1
Central America
2.1
0.8
12.7
9.3
South America
6.2
2.1
17.3
Northern America
5.6
1.2
5.8
Eastern Asia
14.4 13.9
7.5
3.1
6.3
20.9
71.1
196.3
153.5
6.4
7.3
7.0 12.8
5.5 26.0
22.2
34.8
136.2
134.4
8.4
13.5 11.9
5.3
3.9 20.4
8.4 44.3
23.9
50.2
186.7
162.9
2.8
35.3 25.7
6.8
5.7
85.7
334.0
274.4
7.2
20.3
8.3
South-Eastern Asia
3.0
1.4
10.9
6.7
9.6
8.2
222.1
158.1
15.8
8.3
143.9
141.7
South-Central Asia
6.8
4.9
6.7
3.9
4.1
Western Asia
3.8
2.8
12.6
6.7
13.1 10.1
3.4
1.6 13.1
3.4 24.0
24.6
4.1
99.7
110.8
4.4
2.3 30.7
5.2 32.5
4.5
13.8
152.8
119.5
5.6
0.8
22.2
9.7
33.0 21.0
4.6
1.9 57.0
9.6 45.3
14.5
28.5
259.2
184.2
Northern Europe
8.1
2.7
8.6
Southern Europe
4.0
0.7
13.9
4.2
36.0 24.6
3.8
8.3
86.4
303.5
249.4
6.8
39.3 24.5
9.8
8.0
50.2
289.9
212.2
Western Europe
6.7
1.6
9.0
4.4
41.2 26.3
7.2
6.9
94.2
337.4
250.9
Australia/
New Zealand
5.2
1.8
7.4
3.4
45.7 33.0
5.0
5.0
104.2
356.8
276.4
Melanesia
6.1
2.7
8.8
5.6
10.7
4.9 22.8
23.7
15.8
146.0
133.4
Micronesia/
Polynesia
5.1
0.6
7.3
6.5
18.8 13.1
13.4
39.9
194.1
184.0
3.7 12.9
9.5
5.0 12.4
Lung cancer has been the most common cancer in the world
for several decades and by 2008, there were an estimated 1.61
million new cases, representing 12.7% of all new cancers (Table 4). It was also the most common cause of death from
cancer, with 1.38 million deaths (18.2% of the total). The majority of the cases now occur in the developing countries
(55%), a large increase since the estimates in 1980, when it
was estimated that only 31% of lung cancer cases occurred in
developing countries.4 Lung cancer is still the most common
Epidemiology
Oesophagus
2904
Table 7. Estimated ASRs (World standard) of cancer mortality by sex, cancer site and regions, 2008
Stomach
Colorectum
Liver
Lung
(C15)
(C16)
(C18-21)
(C22)
(C33-34)
(C53)
(C61)
All sites
(C00-97/C44)
3.4
14.3
6.9
9.7
7.0 14.6
7.8
7.5
128.8
87.6
More developed
regions
5.3
1.0
10.4
4.7
15.1
9.7
3.2
10.6
143.9
87.3
Less developed
regions
10.1
4.7
16.0
8.1
6.9
5.4 17.4
7.2 24.6
9.7 10.8
9.8
5.6
119.3
85.4
Eastern Africa
14.3
6.2
5.4
3.8
4.7
3.8
3.8
4.0
1.3 11.4
25.3
11.7
105.4
95.9
2.7
0.9 13.1
17.0
13.4
78.5
75.6
2.5 14.0
2.0 17.8
4.0
6.2
89.5
68.2
7.3
(C50)
8.6
7.2
World
Middle Africa
1.4
0.8
5.2
4.6
3.5
Northern Africa
2.0
1.5
3.7
2.3
5.5
4.5
Southern Africa
21.4
11.1
3.9
2.0
15.8
6.1 13.9
5.0 27.5
7.4 19.3
14.8
19.3
172.1
108.1
Western Africa
1.4
1.0
4.3
3.1
4.6
3.5 16.5
8.3
1.1 19.0
24.0
18.3
80.1
91.2
Caribbean
4.0
1.2
8.0
4.6
8.8
8.9
6.1
9.4
26.3
116.6
86.2
Central America
1.8
0.6
10.6
7.9
4.5
3.9
7.3
7.0 12.2
5.3
9.6
11.1
12.6
84.7
80.6
South America
5.6
1.6
14.2
6.9
7.8
6.5
5.4
4.1 18.8
7.5 13.2
10.7
16.2
116.6
88.2
Northern America
4.8
1.0
2.8
1.5
10.4
7.9
5.3
1.7
9.9
122.4
91.5
Eastern Asia
Epidemiology
Oesophagus
16.2
6.4
South-Eastern Asia
2.6
1.3
South-Central Asia
6.4
Western Asia
3.6
28.1 13.0
7.4
2.9
9.4
6.3
3.9
2.5
155.5
87.3
8.9
5.6
9.9
8.2 19.7
8.3
5.1
112.3
89.4
4.4
6.3
3.7
3.6
2.9
3.2
1.5 12.0
3.1 12.0
14.1
2.8
78.0
71.7
2.6
11.1
5.8
8.3
6.2
4.5
2.4 28.4
4.6 14.3
2.1
7.5
113.9
74.3
5.1
0.6
19.6
8.1
20.3 12.1
5.6
2.3 51.6
7.9 16.9
6.3
10.9
181.5
94.0
Northern Europe
7.1
2.4
5.7
2.8
14.5
9.7
3.7
2.4
15.7
134.6
99.7
Southern Europe
3.4
0.6
9.7
4.7
16.3
9.4
8.3
2.9 42.3
2.5
10.5
149.9
81.2
8.5 15.3
Western Europe
5.3
1.1
5.8
2.9
15.1
9.3
6.5
2.0
12.4
138.4
84.3
Australia/
New Zealand
4.8
1.5
4.3
2.1
16.1 10.3
3.8
1.4
15.4
125.6
86.0
Melanesia
6.0
2.6
8.6
5.3
8.8
3.3 12.9
5.3 11.7
4.7 13.2
16.6
12.4
119.8
95.9
Micronesia/
Polynesia
3.1
0.0
7.6
3.2
9.8
5.7
4.9
13.0
121.1
79.9
9.1
Breast cancer
Ferlay et al.
2905
Table 8. Estimated numbers of new cancer cases (thousands) by sex, cancer site and regions, 2008
Stomach
Colorectum
Liver
Lung
(C15)
(C16)
(C18-21)
(C22)
(C33-34)
M
World
More developed
regions
Less developed
regions
Eastern Africa
(C50)
(C53)
(C61)
326.6 155.7 640.6 349.0 663.6 570.1 522.4 225.9 1095.2 513.6 1383.5 529.4 913.8
64.0
482.6 241.7
692.2
76.5 658.8
2985.5 2584.8
612.5 272.0
3654.0 3453.8
5.3
4.0
3.3
4.5
81.7
6639.4 6038.5
39.9
10.5
All sites
(C00-97/C44)
4.1
5.8
3.2
2.8
1.2
17.9
31.5
9.1
100.8
120.2
Middle Africa
0.4
0.2
1.7
1.8
1.3
1.2
7.0
3.9
0.8
0.3
8.3
8.2
4.2
29.5
37.4
Northern Africa
1.4
1.3
2.9
1.9
5.4
4.8
5.4
1.9
10.4
1.7
28.0
5.3
5.2
81.5
82.9
Southern Africa
4.0
2.7
0.7
0.5
3.3
1.9
2.6
1.2
4.7
1.8
9.0
6.5
7.8
40.6
38.6
Western Africa
1.1
0.8
3.3
2.6
4.5
3.8
13.9
6.8
2.1
0.9
29.4
28.9
13.3
72.5
111.6
Caribbean
1.1
0.4
2.4
1.6
3.2
3.6
1.3
1.1
5.6
2.9
9.0
4.7
16.0
42.8
36.5
Central America
1.2
0.5
7.7
6.5
4.3
4.4
4.4
4.8
7.6
3.8
17.5
15.6
20.5
84.0
92.6
33.8
47.5
84.1
318.0
332.3
12.5 213.7
831.8
772.1
South America
10.5
4.5
29.3
17.9
23.0
25.1
8.9
8.3
17.2
88.4
Northern America
14.2
4.0
15.1
9.4
91.8
85.3
16.6
6.7
125.9 110.7
205.5
435.8 209.9
240.3
90.8
82.7
86.9
44.4
17.7
172.9 173.7
Eastern Asia
195.2
South-Eastern Asia
6.7
3.8
24.9
18.4
34.4
34.5
50.9
24.0
South-Central Asia
42.4
31.8
41.9
26.2
32.3
27.2
21.7
2.7
2.4
9.2
5.6
9.9
8.6
3.3
10.7
2.5
43.3
30.6
64.5
65.3
Northern Europe
7.0
3.4
7.8
4.9
32.2
Southern Europe
5.1
1.3
20.0
12.9
57.8
Western Europe
11.0
3.4
16.5
10.9
Australia/
New Zealand
1.1
0.5
1.5
0.8
Melanesia
0.1
0.1
0.2
Micronesia/
Polynesia
0.0
0.0
0.0
Western Asia
Central and Eastern
Europe
2135.3 1585.4
66.6
31.7
10.5
80.0
22.4
23.4
651.1
772.0
1.9
22.5
4.4
28.5
3.9
9.4
118.5
104.8
8.9
6.0
109.6
28.3
114.6
31.0
57.6
494.6
490.6
28.0
3.3
1.9
35.4
23.4
69.5
5.3
78.0
258.8
231.8
44.8
13.8
6.6
67.8
16.9
91.3
8.7
79.9
398.8
315.0
74.5
64.1
12.5
4.9
76.6
31.4
149.4
9.3 170.0
569.6
464.7
9.4
7.9
1.0
0.5
6.9
4.6
16.1
0.8
21.0
70.3
56.7
0.1
0.2
0.1
0.3
0.1
0.3
0.1
0.6
0.7
0.3
3.3
3.7
0.0
0.1
0.1
0.0
0.0
0.2
0.1
0.3
0.1
0.2
0.9
0.9
336.7
388.8
Asia, and are intermediate in Latin America (Fig. 8). Incidence rates are substantially higher in men than in women
(overall sex ratio of the ASRs 1.4:1).
About 608,000 deaths from colorectal cancer are estimated
worldwide, accounting for 8% of all cancer deaths, making it
the fourth most common cause of death from cancer. As
observed for incidence, mortality rates are lower in women
than in men, except in the Caribbean. There is less variability
in mortality rates worldwide (sixfold in men, vefold in
women), with the highest mortality rates in both sexes estimated in Central and Eastern Europe (20.3 per 100,000 for
male, 12.1 per 100,000 for female), and the lowest in Middle
Africa (3.5 and 2.7, respectively).
Stomach cancer
About one million new cases of stomach cancer were estimated to have occurred (989,000 cases, 7.8% of the total),
making it currently the fourth most common malignancy in
Epidemiology
Oesophagus
2906
Table 9. Estimated numbers of cancer deaths (thousands) by sex, cancer site and regions, 2008
Oesophagus
Stomach
Colorectum
Liver
Lung
(C15)
(C16)
(C18-21)
(C22)
(C33-34)
M
World
More developed
regions
Less developed
regions
Eastern Africa
(C50)
F
276.1 130.7 464.4 273.6 320.6 288.0 478.3 217.6 951.0 427.4 458.4
(C53)
(C61)
All sites
(C00-97/C44)
M
274.9 258.4
4225.7 3345.8
33.2 136.5
1528.2 1223.2
223.0 115.9 353.5 202.9 154.4 134.1 402.9 177.7 539.0 239.0 268.9
241.7 121.9
2697.5 2122.6
53.1
10.0
14.8 110.9
5.1
3.8
3.1
3.5
3.2
75.4
5.7
3.1
2.7
1.1
10.0
21.6
7.3
85.4
88.3
Middle Africa
0.4
0.2
1.6
1.7
1.1
1.0
6.8
3.8
0.8
0.3
4.7
5.7
3.4
25.6
27.6
Northern Africa
1.4
1.2
2.7
1.8
4.1
3.6
5.2
1.9
9.6
1.6
14.6
3.1
4.0
65.4
55.4
Southern Africa
3.8
2.6
0.6
0.5
2.4
1.4
2.5
1.1
4.3
1.7
4.5
3.5
2.6
29.3
25.5
Western Africa
1.0
0.8
3.1
2.5
3.6
3.0
13.6
6.6
2.0
0.9
16.3
19.4
10.7
61.3
78.0
Caribbean
0.9
0.3
1.8
1.2
2.0
2.4
1.3
1.1
5.2
2.7
3.4
2.2
6.5
26.3
21.5
Central America
1.1
0.4
6.4
5.6
2.7
2.8
4.4
4.8
7.3
3.7
6.5
7.6
8.1
52.5
55.8
9.4
3.5
24.2
15.1
13.5
14.4
9.2
8.6
31.3
15.5
27.1
21.6
29.3
200.6
185.3
12.6
3.4
7.6
5.2
28.7
29.7
13.7
6.5 101.2
79.3
45.6
4.4
32.6
332.5
305.9
South America
Northern America
Eastern Asia
Epidemiology
93.4
61.7
39.7
26.8
1511.8
928.6
South-Eastern Asia
157.2
5.8
3.4
20.1
15.3
22.2
22.2
47.0
22.2
58.0
27.9
36.8
22.5
10.9
258.6
242.4
South-Central Asia
39.3
28.3
39.5
24.1
23.1
19.5
19.8
10.0
72.5
20.4
82.6
95.8
16.7
496.8
483.2
Western Asia
2.6
2.2
8.1
4.9
6.2
5.2
3.3
2.0
20.6
3.9
12.3
1.8
5.2
86.7
64.4
9.7
2.2
38.2
26.6
40.6
41.2
10.8
7.5
99.5
24.3
47.5
15.8
22.9
351.9
283.0
Northern Europe
6.3
3.2
5.4
3.6
13.9
12.8
3.4
2.1
29.8
21.6
18.3
2.1
17.7
126.4
116.3
Southern Europe
4.5
1.1
14.6
9.8
26.1
20.4
12.5
6.7
61.0
14.8
25.6
3.4
20.6
225.0
155.5
Western Europe
9.0
2.7
11.1
7.9
29.8
27.2
11.9
5.3
66.3
26.6
37.3
3.8
28.7
258.9
204.9
Australia/
New Zealand
1.0
0.4
0.9
0.6
3.5
2.8
0.8
0.4
5.6
3.5
3.4
0.3
4.0
27.6
21.4
Melanesia
0.1
0.1
0.2
0.1
0.2
0.1
0.3
0.1
0.2
0.1
0.3
0.5
0.2
2.6
2.5
Micronesia/
Polynesia
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.2
0.1
0.1
0.0
0.1
0.5
0.4
the world, behind cancers of the lung, breast and colo-rectum. This represents a substantive change since the very rst
estimates in 1975, when stomach cancer was globally the
most common neoplasm.3 More than 70% of cases (714,000
cases) occur in developing countries (467,000 in men,
247,000 in women), and half the world total occurs in Eastern Asia (mainly in China). Age-standardized incidence rates
are about twice as high in men as in women, ranging from
3.9 in Northern Africa to 42.4 in Eastern Asia for men, and
from 2.2 in Southern Africa to 18.3 in Eastern Asia for
women (Fig. 9).
Stomach cancer is the second leading cause of cancer
death in both sexes worldwide (738,000 deaths, 9.7% of the
total). The highest mortality rates are estimated in Eastern
Asia (28.1 per 100,000 in men, 13.0 per 100,000 in women),
the lowest in Northern America (2.8 and 1.5, respectively).
Prostate cancer is the second most frequently diagnosed cancer of men (914,000 new cases, 13.8% of the total) and the
fth most common cancer overall. Nearly three-quarters of
the registered cases occur in developed countries (659,000
cases). Incidence rates of prostate cancer vary by more than
25-fold worldwide, the highest rates are in Australia/New
Zealand (104.2 per 100,000), Western and Northern Europe,
Northern America, largely because the practice of prostate
specic antigen (PSA) testing and subsequent biopsy has
become widespread in those regions. Incidence rates are relatively high in certain developing regions such as the Caribbean, South America and sub-Saharan Africa. The lowest
C 2010 UICC
Int. J. Cancer: 127, 28932917 (2010) V
Ferlay et al.
2907
Oesophagus
Stomach
Colorectum
Liver
Lung
Breast
Cervix
Prostate
All sites
(C15)
(C16)
(C18-21)
(C22)
(C33-34)
(C50)
(C53)
(C61)
(C00-97/C44)
World
1.3
0.5
2.4
1.0
2.3
1.6
1.8
0.7
4.1
1.6
4.1
1.6
3.5
21.2
16.5
More developed
regions
0.8
0.1
2.0
0.8
4.4
2.7
1.0
0.3
5.7
2.3
7.1
0.9
7.9
30.1
22.0
Less developed
regions
1.4
0.7
2.5
1.1
1.4
1.1
2.2
0.9
3.3
1.3
2.8
1.9
1.4
17.0
14.0
Eastern Africa
1.8
0.8
0.7
0.5
0.7
0.5
0.8
0.4
0.5
0.2
2.1
3.8
1.8
12.8
13.0
Middle Africa
0.2
0.1
0.5
0.5
0.5
0.4
1.8
0.9
0.3
0.1
2.1
2.5
1.6
8.4
9.4
Northern Africa
0.3
0.2
0.5
0.3
0.8
0.7
0.9
0.3
1.9
0.3
3.2
0.7
1.0
12.0
10.2
Southern Africa
2.6
1.4
0.5
0.2
2.4
0.8
1.2
0.4
3.1
1.0
4.2
2.9
6.2
23.3
16.2
Western Africa
0.2
0.2
0.6
0.4
0.6
0.5
1.8
1.0
0.4
0.2
3.4
3.8
2.8
10.1
13.1
Caribbean
0.6
0.2
1.3
0.7
1.6
1.5
0.8
0.5
3.0
1.4
4.3
2.1
8.3
20.6
15.7
Central America
0.3
0.1
1.5
1.1
0.8
0.7
0.8
0.8
1.5
0.6
2.8
2.2
4.2
14.3
13.7
South America
0.7
0.2
2.0
0.9
1.6
1.3
0.6
0.4
2.5
1.0
4.8
2.5
5.8
19.4
16.2
Northern America
0.7
0.2
0.7
0.3
4.1
2.9
0.8
0.3
6.0
4.6
8.4
0.5
11.0
33.4
26.7
Eastern Asia
2.5
1.0
5.1
2.1
2.5
1.7
4.0
1.5
5.3
2.3
2.6
0.9
0.9
22.9
16.0
South-Eastern Asia
0.4
0.2
1.3
0.7
1.8
1.5
2.4
1.0
3.5
1.4
3.2
1.7
0.9
15.2
14.2
South-Central Asia
0.8
0.6
0.8
0.4
0.6
0.5
0.4
0.2
1.6
0.4
2.5
2.6
0.5
10.9
11.4
Western Asia
0.4
0.3
1.5
0.8
1.5
1.2
0.5
0.3
3.8
0.6
3.4
0.5
1.7
16.4
12.3
0.7
0.1
2.7
1.1
4.0
2.5
0.6
0.2
7.1
1.1
5.0
1.4
3.5
27.0
18.7
Northern Europe
1.0
0.3
1.0
0.5
4.2
2.8
0.4
0.2
4.7
2.7
8.9
0.7
10.6
30.1
24.3
Southern Europe
0.5
0.1
1.6
0.7
4.6
2.8
1.2
0.4
5.9
1.2
7.4
0.8
6.1
28.7
20.5
Western Europe
0.8
0.2
1.0
0.5
4.8
2.9
0.9
0.2
5.4
2.0
9.6
0.6
11.9
33.3
24.2
Australia/
New Zealand
0.6
0.2
0.9
0.4
5.4
3.7
0.6
0.2
3.8
2.5
9.4
0.5
12.8
34.3
26.4
Melanesia
0.9
0.3
1.3
0.8
1.3
0.4
1.2
0.5
1.6
0.6
2.4
2.3
1.8
16.0
13.5
Micronesia/
Polynesia
0.6
0.0
1.0
0.8
2.3
1.7
1.2
0.4
5.7
2.0
6.1
1.4
4.2
20.4
19.1
Liver cancer
Epidemiology
Table 10. Estimated cumulative risk to age 74 (percent) by sex, cancer site and regions, 2008Incidence
2908
Epidemiology
Table 11. Estimated cumulative risk to age 74 (percent) by sex, cancer site and regions, 2008Mortality
Oesophagus
Stomach
Colorectum
Liver
Lung
Breast
Cervix
Prostate
All sites
(C15)
(C16)
(C18-21)
(C22)
(C33-34)
(C50)
(C53)
(C61)
(C00-97/C44)
World
1.0
0.4
1.7
0.8
1.1
0.7
1.7
0.7
3.5
1.3
1.3
0.9
0.6
13.5
9.1
More developed
regions
0.6
0.1
1.2
0.5
1.7
1.0
0.9
0.3
4.7
1.6
1.7
0.3
0.9
15.0
9.1
Less developed
regions
1.2
0.5
1.9
0.9
0.8
0.6
2.0
0.8
2.9
1.1
1.2
1.1
0.5
12.7
9.0
Eastern Africa
1.8
0.7
0.7
0.5
0.5
0.4
0.8
0.5
0.5
0.2
1.3
3.0
1.3
11.1
10.5
Middle Africa
0.2
0.1
0.5
0.5
0.4
0.3
1.8
1.1
0.3
0.1
1.4
1.9
1.1
7.4
7.7
Northern Africa
0.3
0.2
0.5
0.3
0.6
0.5
0.9
0.3
1.8
0.3
1.8
0.5
0.7
10.0
7.4
Southern Africa
2.5
1.3
0.5
0.2
1.8
0.6
1.3
0.4
2.9
0.9
2.1
1.7
1.5
16.6
11.1
Western Africa
0.2
0.1
0.6
0.4
0.5
0.4
1.8
1.1
0.3
0.2
2.1
2.9
2.1
8.7
10.3
Caribbean
0.5
0.1
0.9
0.5
0.9
0.9
0.7
0.5
2.7
1.3
1.6
1.0
2.2
11.6
9.0
Central America
0.2
0.1
1.2
0.9
0.5
0.4
0.8
0.8
1.4
0.6
1.0
1.2
1.1
8.6
8.6
South America
0.7
0.2
1.6
0.7
0.9
0.7
0.6
0.5
2.3
0.9
1.4
1.2
1.4
12.0
9.1
Northern America
0.6
0.1
0.3
0.2
1.1
0.8
0.6
0.2
4.6
3.0
1.6
0.2
0.8
12.8
9.8
Eastern Asia
1.9
0.8
3.3
1.4
1.0
0.7
3.6
1.3
4.4
1.9
0.7
0.4
0.2
16.2
9.1
South-Eastern Asia
0.3
0.1
1.0
0.6
1.1
0.9
2.2
0.9
3.1
1.2
1.4
0.9
0.5
12.0
9.4
South-Central Asia
0.8
0.5
0.8
0.4
0.4
0.3
0.4
0.2
1.5
0.4
1.3
1.6
0.3
8.7
7.8
Western Asia
0.4
0.3
1.3
0.7
0.9
0.7
0.5
0.3
3.6
0.6
1.5
0.3
0.8
12.4
7.9
0.7
0.1
2.4
0.9
2.4
1.4
0.7
0.3
6.5
0.9
1.9
0.7
1.2
19.7
10.2
Northern Europe
0.8
0.3
0.6
0.3
1.6
1.0
0.4
0.2
3.7
2.3
1.9
0.2
1.3
13.5
10.4
Southern Europe
0.4
0.1
1.1
0.5
1.8
1.0
1.0
0.3
5.0
1.0
1.7
0.3
0.8
15.4
8.3
Western Europe
0.6
0.1
0.6
0.3
1.6
0.9
0.8
0.2
4.4
1.5
1.9
0.2
1.0
14.1
8.6
Australia/
New Zealand
0.5
0.2
0.5
0.2
1.8
1.1
0.5
0.2
3.0
1.8
1.7
0.2
1.2
12.6
8.9
Melanesia
0.9
0.3
1.3
0.7
1.1
0.3
1.2
0.6
1.5
0.6
1.4
1.7
1.3
13.2
10.3
Micronesia/
Polynesia
0.3
0.0
1.0
0.4
1.2
0.6
1.1
0.4
4.5
1.6
1.5
0.6
1.3
13.6
9.3
because of its high fatality (overall ratio of mortality to incidence of 0.93), liver cancer is the third most common cause
of death from cancer worldwide. The geographical distribution of the mortality rates is similar to that observed for
incidence.
Cervical cancer
Ferlay et al.
2909
Discussion
The global and region-specic estimates presented here are
built up from those for 182 countries, ranging in size from
1345 million (China) to 178,000 (Samoa). It should be clear
that these estimates are variable in accuracy, depending on
the extent and the validity of available data by country, ranging from real, complete and valid counts of cases and deaths,
through estimates based on samples, to those based on neighboring incidence rates and on survival. The countries in
Northern Europe and America have high quality incidence
and mortality data, while in most African countries and in
some populous countries in Asia there are no data at all, and
the estimates are based on data from neighboring countries.
C 2010 UICC
Int. J. Cancer: 127, 28932917 (2010) V
Epidemiology
Figure 6. Estimated age-standardized incidence and mortality rates for lung cancer.
Epidemiology
2910
Figure 7. (a) Estimated age-standardized incidence rates per 100,000 (World): breast cancer. (b) Breast cancer: relationship between
incidence and Mortality: Incidence ratio (20 regions). (c) Estimated age-standardized incidence and mortality rates for breast cancer.
Figure 8. Estimated age-standardized incidence and mortality rates for colorectal cancer.
Figure 9. Estimated age-standardized incidence and mortality rates for stomach cancer.
Figure 10. Estimated age-standardized incidence and mortality rates for prostate cancer.
Figure 11. Estimated age-standardized incidence and mortality rates for liver cancer.
Ferlay et al.
Figure 12. (a) Estimated cumulative incidence risk (074) percent: cervix uteri cancer. (b) Estimated age-standardized incidence and
mortality rates for cervix uteri cancer.
Epidemiology
2913
Figure 13. Estimated age-standardized incidence and mortality rates for oesophageal cancer.
Ferlay et al.
2915
12,3336
Table 12. Age-standardized incidence rates (World) per 100,000 in Indian and African cancer registries From refs.
Rural
Urban
India
Ahmedabad
Ambilikkai,
Dindigul district
Africa
Barshi
South Africa,
PROMEC
India
The
Gambia
Ahmedabad
Chennai
Africa
Mumbai
Zimbabwe,
Harare city
Male
Oral cavity and pharynx
24.0
12.6
10.1
1.0
33.3
18.6
17.6
3.0
Oesophagus
3.2
3.7
4.2
31.3
1.4
9.1
8.2
5.9
15.1
Stomach
1.1
5.6
1.8
1.5
2.5
2.0
11.4
4.5
9.0
Lung
6.5
3.2
2.1
6.0
5.1
11.5
11.7
8.9
9.5
0.3
4.2
4.6
4.3
71.8
83.5
123.6
101.7
94.2
1.1
7.0
9.8
7.6
Leukemia
All cancers excl. skin
3.3
2.0
2.0
66.7
50.4
43.7
4.4
5.3
2.9
2.6
150.41
Female
Oral cavity and pharynx
Oesophagus
1.7
1.8
2.5
18.0
1.1
5.2
4.7
4.1
5.3
Breast
9.0
10.9
8.8
7.1
7.0
26.5
30.8
28.1
19.0
Cervix
7.7
22.6
20.6
20.2
29.8
14.3
23.8
13.2
47.3
Ovary
3.4
3.3
1.8
0.9
2.0
4.4
5.7
6.9
6.8
2.2
1.4
1.3
0.4
2.4
3.3
3.2
2.0
41.8
61.9
51.9
58.5
82.3
94.3
113.9
99.7
169.7
Leukemia
All cancers excl. skin
Excluding Kaposi sarcoma.
Conclusions
Despite the various provisos concerning data quality and
methods of estimation, we believe that the estimates in GLOBOCAN 2008 are the most accurate that can be made at
present, and may be used in setting of priorities for cancer
control actions in different regions and countries of the
world. The continuing growth and ageing of the worlds population mean that, even with current (2008) rates of
Epidemiology
2.3
2916
Acknowledgements
The authors thank the Cancer Registry personal for their willingness and
contribution, the staff of the Section of Cancer Information at IARC, and
especially Ms. Katiuska Veselinovic for her assistance in abstracting and tabulating the information from cancer registries.
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Epidemiology
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C 2010 UICC
Int. J. Cancer: 127, 28932917 (2010) V
Ferlay et al.
Epidemiology
2917
C 2010 UICC
Int. J. Cancer: 127, 28932917 (2010) V