Cancer is currently the first or second most common contributor to premature mortality in most countries of the world. The global number of patients with cancer is expected to rise over the next 50 years owing to the strong influence of demographic changes, such as population ageing and growth, on the diverging trends in cancer incidence in different regions. Assuming that the latest incidence trends continue for the major cancer types, we predict a doubling of the incidence of all cancers combined by 2070 relative to 2020. The greatest increases are predicted in lower-resource settings, in countries currently assigned a low Human Development Index (HDI), whereas the predicted increases in national burden diminish with increasing levels of national HDI. Herein, we assess studies modelling the future burden of cancer that underscore how comprehensive cancer prevention strategies can markedly reduce the prevalence of major risk factors and, in so doing, the number of future cancer cases. Focusing on an in-depth assessment of prevention strategies that target tobacco smoking, overweight and obesity, and human papillomavirus infection, we discuss how stepwise, population-level approaches with amenable goals can avert millions of future cancer diagnoses worldwide. In the absence of a step-change in cancer prevention delivery, tobacco smoking will remain the leading preventable cause of cancer, and overweight and obesity might well present a comparable opportunity for prevention, given its increasing prevalence globally in the past few decades. Countries must therefore instigate national cancer control programmes aimed at preventing cancer, and with some urgency, if such programmes are to yield the desired public health and economic benefits in this century.
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The authors thank M. Laversanne and J. Vignat for their support with data management and analysis; K. Canfell and the WHO Cervical Cancer Elimination Modelling Consortium for sharing detailed country-specific results on cervical cancer elimination scenarios; H. Rumgay for comments on an early draft of the paper; and H. Charvat for statistical advice. The authors also thank the population-based cancer registries worldwide for the data used in this article.
The authors declare no competing interests.
Where authors are identified as personnel of the International Agency for Research on Cancer/World Health Organization, the authors alone are responsible for the views expressed in this article and they do not necessarily represent the decisions, policy or views of the International Agency for Research on Cancer/World Health Organization.
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Soerjomataram, I., Bray, F. Planning for tomorrow: global cancer incidence and the role of prevention 2020–2070. Nat Rev Clin Oncol 18, 663–672 (2021). https://doi.org/10.1038/s41571-021-00514-z