The global, regional, and national burden of cancer, 1990-2023, with forecasts to 2050: a systematic analysis for the Global Burden of Disease Study 2023

Abstract

Background Cancer is a leading cause of death globally. Accurate cancer burden information is crucial for policy planning, but many countries do not have up-to-date cancer surveillance data. To inform global cancer-control efforts, we used the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 framework to generate and analyse estimates of cancer burden for 47 cancer types or groupings by age, sex, and 204 countries and territories from 1990 to 2023, cancer burden attributable to selected risk factors from 1990 to 2023, and forecasted cancer burden up to 2050. Methods Cancer estimation in GBD 2023 used data from population-based cancer registration systems, vital registration systems, and verbal autopsies. Cancer mortality was estimated using ensemble models, with incidence informed by mortality estimates and mortality-to-incidence ratios (MIRs). Prevalence estimates were generated from modelled survival estimates, then multiplied by disability weights to estimate years lived with disability (YLDs). Years of life lost (YLLs) were estimated by multiplying age-specific cancer deaths by the GBD standard life expectancy at the age of death. Disability-adjusted life-years (DALYs) were calculated as the sum of YLLs and YLDs. We used the GBD 2023 comparative risk assessment framework to estimate cancer burden attributable to 44 behavioural, environmental and occupational, and metabolic risk factors. To forecast cancer burden from 2024 to 2050, we used the GBD 2023 forecasting framework, which included forecasts of relevant risk factor exposures and used Socio-demographic Index as a covariate for forecasting the proportion of each cancer not affected by these risk factors. Progress towards the UN Sustainable Development Goal (SDG) target 3.4 aim to reduce non-communicable disease mortality by a third between 2015 and 2030 was estimated for cancer. Findings In 2023, excluding non-melanoma skin cancers, there were 18 center dot 5 million (95% uncertainty interval 16 center dot 4 to 20 center dot 7) incident cases of cancer and 10 center dot 4 million (9 center dot 65 to 10 center dot 9) deaths, contributing to 271 million (255 to 285) DALYs globally. Of these, 57 center dot 9% (56 center dot 1 to 59 center dot 8) of incident cases and 65 center dot 8% (64 center dot 3 to 67 center dot 6) of cancer deaths occurred in low-income to upper-middle-income countries based on World Bank income group classifications. Cancer was the second leading cause of deaths globally in 2023 after cardiovascular diseases. There were 4 center dot 33 million (3 center dot 85 to 4 center dot 78) risk-attributable cancer deaths globally in 2023, comprising 41 center dot 7% (37 center dot 8 to 45 center dot 4) of all cancer deaths. Risk-attributable cancer deaths increased by 72 center dot 3% (57 center dot 1 to 86 center dot 8) from 1990 to 2023, whereas overall global cancer deaths increased by 74 center dot 3% (62 center dot 2 to 86 center dot 2) over the same period. The reference forecasts (the most likely future) estimate that in 2050 there will be 30 center dot 5 million (22 center dot 9 to 38 center dot 9) cases and 18 center dot 6 million (15 center dot 6 to 21 center dot 5) deaths from cancer globally, 60 center dot 7% (41 center dot 9 to 80 center dot 6) and 74 center dot 5% (50 center dot 1 to 104 center dot 2) increases from 2024, respectively. These forecasted increases in deaths are greater in low-income and middle-income countries (90 center dot 6% [61 center dot 0 to 127 center dot 0]) compared with high-income countries (42 center dot 8% [28 center dot 3 to 58 center dot 6]). Most of these increases are likely due to demographic changes, as age-standardised death rates are forecast to change by -5 center dot 6% (-12 center dot 8 to 4 center dot 6) between 2024 and 2050 globally. Between 2015 and 2030, the probability of dying due to cancer between the ages of 30 years and 70 years was forecasted to have a relative decrease of 6 center dot 5% (3 center dot 2 to 10 center dot 3). Interpretation Cancer is a major contributor to global disease burden, with increasing numbers of cases and deaths forecasted up to 2050 and a disproportionate growth in burden in countries with scarce resources. The decline in age-standardised mortality rates from cancer is encouraging but insufficient to meet the SDG target set for 2030. Effectively and sustainably addressing cancer burden globally will require comprehensive national and international efforts that consider health systems and context in the development and implementation of cancer-control strategies across the continuum of prevention, diagnosis, and treatment. Copyright (c) 2025 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.