Cancer in transition: the human development index and the ......Europe Asia 25.3% 48.1% Africa 5.7%...
Transcript of Cancer in transition: the human development index and the ......Europe Asia 25.3% 48.1% Africa 5.7%...
Cancer in transition: the human development index and the global disease burden
2008 and 2030
Freddie Bray
Europe 25.3% Asia
48.1%
Africa 5.7%
12 700 000 new cases
7 600 000 deaths
28 800 000 persons
Incidence Mortality Prevalence (5 years)
Estimated cancer incidence, mortality and 5-year prevalence by continent
Northern
Americas 19.8%
Southern
Oceania 1.1%
Eastern
South-Central
Europe 22.7%
Oceania 0.7%
Africa 7.2%
Asia 53.8%
Europe 29.4%
Americas 23.7%
Oceania 1.4%
Africa 5.1%
Asia 40.4%
South-Eastern Central
Northern
Western
Southern
Eastern
South-Eastern
South-Central
Western
Southern
Northern
Northern
Southern
Southern
Southern
Northern
Northern
Central-Eastern
Eastern
South-Eastern
South-Central
Western
Central
Global Burden of Cancer
Human Development Index 2007(HDI)
United National Development Programme 1990-2011
• A country's average achievements in three basic aspects of human development: – Health
• life expectancy at birth – Knowledge
• adult literacy rate / primary, secondary, tertiary enrolment
– Standard of living • GDP per capita (PPP US$)
A world in transition Norway Sweden
Qatar Uruguay Russia Colombia China
Morocco
Uganda
Kenya
Congo (Dem. Rep.)
1
0 2011 1970
circa 2007
HDI trends 1970-2011 (UNDP 2010)
HDI<0.5
0.4 billion
• Sub-Saharan Africa
0.5≤HDI<0.8
4.4 billion
• Southern & Eastern Asia
• Africa
HDI>0.9
1.0 billion
• North America • Northern & Western
Europe • Australia &
New Zealand
0.9 ≤ HDI<0.8
0.9 billion
• Latin America • Central & Eastern
Europe
Human Development Index 2007 (4 levels)
Incidence by HDI 2008
Bray et al, Lancet Oncol 2012
Bray et al, Lancet Oncol 2012
Incidence by HDI 2008
Bray et al, Lancet Oncol 2012 Jemal et al, Cancer 2012
Females
Males
Incidence by HDI 2008
Most common forms of cancer in Africa 2008.
PAF by site
De Martel et al Lancet Oncol 2012
Cancer and Infection: attributable fraction (%) 2008
Disability-Adjusted Life Years (DALYs) = Years of Life Lost (YLD) + Years of Life with Disability . Soerjomataram et al. Lancet 2012
DEFINE dalyS
DALYs by HDI 2008
World 1950: 2.53 billion World 2010: 6.95 billion World 2050: 9.30 billion
World 2008: 6.8 billion World 2030: 8.3 billion
Bray et al, Lancet Oncol 2012
• Assuming(incidence(rates(in(2008(do(not(change:##– Approx.#20.3#million#new#cases#will#be#diagnosed#in#2030##
• Up#61%#from#12.7#million#in#2008#
Gersten and Wilmoth, Demographic Research 2002
Source: Cancer Incidence in Five Continents Volumes 1-9
*: Colombia (Cali), China (Hong Kong and Shanghai), India (Mumbai and Chennai), Philippines (Manila), Canada (except Quebec and Prince Edward Island), Japan (Miyagi, Osaka and Yamagata)
##Low→#Medium#HDI# #High#→#Very#High#HDI#Female#breast#cancer#incidence#1967M2008#
Prostate#cancer##incidence#1967M2008###Low→#Medium#HDI# #High#→#Very#High#HDI#
Source: Cancer Incidence in Five Continents Volumes 1-9
*: Colombia (Cali), China (Hong Kong and Shanghai), India (Mumbai and Chennai), Philippines (Manila), Canada (except Quebec and Prince Edward Island), Japan (Miyagi, Osaka and Yamagata)
Colorectal#cancer#incidence#1967M2008,#men####Low→#Medium#HDI# #High#→#Very#High#HDI#
Source: Cancer Incidence in Five Continents Volumes 1-9
*: Colombia (Cali), China (Hong Kong and Shanghai), India (Mumbai and Chennai), Philippines (Manila), Canada (except Quebec and Prince Edward Island), Japan (Miyagi, Osaka and Yamagata)
Stomach#cancer##incidence#1967M2008,#men####Low→#Medium#HDI# #High#→#Very#High#HDI#
Source: Cancer Incidence in Five Continents Volumes 1-9
*: Colombia (Cali), China (Hong Kong and Shanghai), India (Mumbai and Chennai), Philippines (Manila), Canada (except Quebec and Prince Edward Island), Japan (Miyagi, Osaka and Yamagata)
Cervical#cancer#incidence#1967M2008####Low→#Medium#HDI# #High#→#Very#High#HDI#
Source: Cancer Incidence in Five Continents Volumes 1-9
*: Colombia (Cali), China (Hong Kong and Shanghai), India (Mumbai and Chennai), Philippines (Manila), Canada (except Quebec and Prince Edward Island), Japan (Miyagi, Osaka and Yamagata)
Age Birth Cohort Calendar Period
Vaccarella et al. Manuscript in preparation
Japan: Miyagi, Osaka and Yamagata
Cervical#cancer##incidence:#ageMadjusted#rates#vs.#cohort#analyses##
KS
Prostate
Oesophagus
Liver
Cervix
Breast
KS
Oesophagus
Males Females
Changing cancer incidence in Kampala, Uganda, 1991–2006.
Parkin et al, Int J Cancer 2010
2000 1992 2005 1992 2005 2000
Jha, Nature Rev Cancer 2009
Bray et al, Lancet Oncol 2012
Bray et al, Lancet Oncol 2012
• Assuming(trend4based(scenarios(for(six(cancers(con8nue:#– Approx.#22.2#million#new#cases#diagnosed#by#2030#
• Up 75% from 12.7 million in 2008
How can we reduce the increasing burden? - the need for evidence-based implementation scenarios
• Impact of reduction in risk factors: • Tobacco • Alcohol • Obesity • Physical activity
• Impact of vaccination programmes (HBV, HPV) • Impact of early diagnosis programmes
• Cervix, breast, colorectal
References
Bray F, Jemal A, Grey N, Ferlay J, Forman D. Global cancer transitions according to the Human Development Index (2008-2030): a population-based study. Lancet Oncol 2012. Bray F, Ren JS, Masuyer E, Ferlay J. Global estimates of cancer prevalence for 27 sites in the adult population in 2008. Int J Cancer 2012. de Martel C, Ferlay J, Franceschi S, Vignat J, Bray F, Forman D, Plummer M. Global burden of cancers attributable to infections in 2008: a review and synthetic analysis. Lancet Oncol 2012. Jemal A, Bray F, Forman D, O'Brien M, Ferlay J, Center M, Parkin DM. Cancer burden in Africa and opportunities for prevention. Cancer 2012. Soerjomataram I, Lortet-Tieulent J, Parkin DM, Ferlay J, Mathers C, Forman D, Bray F. Disability-adjusted life years: country-specific estimates for 27 cancers in 12 world regions. Lancet 2012, in press.
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