Global, Regional, and National Lifetime Probabilities of Developing Cancer in 2020

Abstract

Background: The lifetime risk of cancer is a measure of the cumulative impact of cancer across a defined age span, and has obvious intuitive appeal. There are however few examples of its systematic use in comparative assessments of cancer-specific risk across populations. We therefore sought to estimate and interpret the lifetime and age-conditional probabilities of developing cancer at the country, world region and global level in 2020. Methods: We obtained estimates of sex- and age-specific cancer incidence rates from GLOBOCAN for 185 countries for the year 2020, alongside all-cause mortality and population data from the United Nations. Countries were categorized into quartiles of the Human Development Index (HDI) as developed by the United Nations Development Programme. The lifetime risk of cancer was estimated using the adjusted for multiple primaries (AMP) method, taking into account competing risks of death from causes other than cancer as well as average life expectancy. Findings: In 2020, the estimated global lifetime risk of cancer from birth to death was 25.1% (26.3% in men and 24.0% in women) . There were marked differences in risks between countries within world regions and by level of human development. In very high HDI, high HDI, medium HDI and low HDI countries, the lifetime risk of cancer was 38.5%, 25.4%, 11.4%, and 10.3%, respectively, with cancer risks highest in Ireland (49.7%) and lowest in Central African Republic (6.6%). There was similar heterogeneity according to cancer type by sex. Worldwide, prostate cancer and breast cancer were associated with the greatest lifetime risks among men and women, of 4.6% and 5.9% respectively. The lifetime risk of cancer decreased by age, with a remaining risk of 12.6% from the age 70 years. Interpretation: In 2020, the global lifetime risk of cancer from birth to death translates approximately 1 in 4 persons developing cancer, with men and women having similar levels of lifetime risk. The identified age-specific variations in cancer risk at the population level can provide important information to support the targeted cancer prevention and health systems planning. Funding: National Key R&D Program of China, National Natural Science Foundation of China, and Beijing Nova Program Declaration of Interest: All authors declare no competing interests.