Question What was the burden of cancer globally and across Sociodemographic Index (SDI) groupings in 2019, and how has incidence, morbidity, and mortality changed since 2010?
Findings In this systematic analysis, there were 23.6 million new global cancer cases in 2019 (17.2 million when excluding those with nonmelanoma skin cancer), 10.0 million cancer deaths, and an estimated 250 million disability-adjusted life years estimated to be due to cancer; since 2010, these represent increases of 26.3%, 20.9%, and 16.0%, respectively. Absolute cancer burden increased in all SDI quintiles since 2010, but the largest percentage increases occurred in the low and low-middle SDI quintiles.
Meanings The study results suggest that increased cancer prevention and control efforts are needed to equitably address the evolving and increasing burden of cancer across the SDI spectrum.
Importance The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) provided systematic estimates of incidence, morbidity, and mortality to inform local and international efforts toward reducing cancer burden.
Objective To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic Index (SDI) quintiles from 2010 to 2019.
Evidence Review The GBD 2019 estimation methods were used to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs) in 2019 and over the past decade. Estimates are also provided by quintiles of the SDI, a composite measure of educational attainment, income per capita, and total fertility rate for those younger than 25 years. Estimates include 95% uncertainty intervals (UIs).
Findings In 2019, there were an estimated 23.6 million (95% UI, 22.2-24.9 million) new cancer cases (17.2 million when excluding nonmelanoma skin cancer) and 10.0 million (95% UI, 9.36-10.6 million) cancer deaths globally, with an estimated 250 million (235-264 million) DALYs due to cancer. Since 2010, these represented a 26.3% (95% UI, 20.3%-32.3%) increase in new cases, a 20.9% (95% UI, 14.2%-27.6%) increase in deaths, and a 16.0% (95% UI, 9.3%-22.8%) increase in DALYs. Among 22 groups of diseases and injuries in the GBD 2019 study, cancer was second only to cardiovascular diseases for the number of deaths, years of life lost, and DALYs globally in 2019. Cancer burden differed across SDI quintiles. The proportion of years lived with disability that contributed to DALYs increased with SDI, ranging from 1.4% (1.1%-1.8%) in the low SDI quintile to 5.7% (4.2%-7.1%) in the high SDI quintile. While the high SDI quintile had the highest number of new cases in 2019, the middle SDI quintile had the highest number of cancer deaths and DALYs. From 2010 to 2019, the largest percentage increase in the numbers of cases and deaths occurred in the low and low-middle SDI quintiles.
Conclusions and Relevance The results of this systematic analysis suggest that the global burden of cancer is substantial and growing, with burden differing by SDI. These results provide comprehensive and comparable estimates that can potentially inform efforts toward equitable cancer control around the world.
<2019년 현재 전 세계 (204개국) 암질환 부담(발생,사망, 장애보정손실수명) 정도와 2010년과의 비교>
* 2019년 암 부담
- 발생자 : 2,360만명 (비흑색종 피부암 제외 하면 1,720만명) => high SDI 5분위에서 가장 많았다.
- 암사망자 : 1,000만명 => middle SDI 5분위에서 가장 많았다.
- 장애보정생존연수(Disability-Adjusted Life years, DALY) : 2억 5천만년(사회계층이 높을수록 %가 높음) => middle SDI 5분위에서 가장 많았다.
* 장애보정생존연수(DALY) : 질병으로 일찍 사망해 상실하는 '잃어버린 수명연수(YLL)와 장애를 안고 살아가는 '장애생활 연수(YLD)'를 합해 산출한 값
* 사회인구통계지수(Sociodemographic Index , SDI) : 한 나라의 1인당 국민소득, 교육성취도, 합계출산율 등을 종합한 지수. High SDI, High-middle SDI, Middle SDI, Low-middle SDI, Low SDI
* 2010년 이후 변화
- 발생자 26.3% 증가
- 사망자 20.9% 증가
- 장애보정생존연수(DALY) : 16.0% 증가
=> 2010년에서 2019년까지 발생과 사망자는 low SDI 5분위와 low-middle SDI 5분위에서 증가 폭이 더 커졌다.