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The Cancer Atlas, Third Edition, unveiled Oct. 16 at the World Cancer Leaders' Summit in Kazakhstan.

Highlights patterns and inequities in cancer burden around the world

The Cancer Atlas aims to open readers' eyes to the facts and figures of cancer: the scale and magnitude globally, the major causes, and the different ways the disease can be prevented and treated. This theme of the current edition is "Access Creates Progress," drawing attention not only to the problem at hand, but also the means of tackling the cancer burden through access to information and services. 

It is grouped into three sections: Risk Factors, The Burden, and Taking Action:

RISK FACTORS highlights regional and international variations in many of the major risk factors for cancer, including tobacco use, infections, excess body weight, and ultraviolet radiation. Tobacco smoking continues to be the predominant cause of cancer in most high-income countries, while infections still play a major role in many sub-Saharan African and Asian countries. The importance of excess body weight as a major risk factor for cancer continues to escalate in most parts of the world, including many economically transitioning countries.

THE BURDEN describes the geographic diversity in cancer occurrence worldwide and, in separate chapters, for each of the major world regions. This burden is also described in terms of the national Human Development Index, the primary measure of a country's societal and economic development used in this book. Profiles of cancer survival and cancer survivorship are expanded in this third edition, and global cancer survival statistics are presented for the first time in print, while pressing issues such as the financial burden of cancer are highlighted. A new chapter on cancer in Indigenous populations describes the specific challenges facing these underserved populations around the world.

The final section, TAKING ACTION, describes major interventions across the cancer continuum, from the prevention of risk factors to early detection, treatment, and palliative care, highlighting disparities in the availability and implementation of these interventions across the world. It also portrays the multiple organizations working in cancer control and the importance of policies and legislation and building synergies between diseases and health systems for broad implementation of known interventions. In this edition, a new chapter on universal health care and "Access Creates Progress" text boxes in chapters throughout the book highlight successful strategies to address the cancer burden.

The Cancer Atlas and its accompanying interactive website (canceratlas.cancer.org) were carefully designed to ensure user-friendly, accessible, and downloadable descriptions and graphics can be easily used by cancer control advocates, government and private public health agencies, and policymakers, as well as patients, survivors, and the general public.  

The report was produced by ACS, the Union for International Cancer Control (UICC), and International Agency for Research on Cancer (IARC). It was released Oct. 16 at the World Cancer Leaders Summit in Nur-Sultan, Kazakhstan. 

Two of its four editors are ACS staffers: Ahmedin Jemal, DVM, PhD, scientific VP of our Surveillance & Health Services Research Program, and Lindsey Torre, MSPH, an epidemiologist in the Surveillance and Health Services Research group.

Highlights of the 3rd Edition: 

  • Cancer is the leading or second-leading cause of premature death (under age 70) in 91 countries worldwide.  Based on expected population growth and aging alone, the number of global cancer cases is expected to increase by 60% in 2040. More widespread distribution of lifestyle factors such as smoking, unhealthy diet, and physical inactivity are likely to make that number considerably larger. 
  • Tobacco causes more preventable cancer deaths than any other risk factor. In 2017 alone, smoking was responsible for an estimated 2.3 million cancer deaths globally, accounting for 24% of all cancer deaths. There are still 1.1 billion smokers worldwide. Progress in tobacco control legislation over the last decade means 1.5 billion people in 55 countries are now protected by smoke-free legislation. 
  • While infectious agents are responsible for an estimated 15% of all new cancer cases worldwide, the proportion ranges from around 4% in many very high-income countries to more than 50% in several sub-Saharan African countries. The four major infectious agents (which together account for more than 90% of all infection-related cancers) are Helicobacter pylori, human papillomavirus (HPV), hepatitis B virus (HBV) , and hepatitis C virus (HCV) . 
  • Excess body weight increases risk of 13 types of cancer, and in 2012 accounted for 3.6% of all new cancer cases among adults worldwide. The prevalence of excess body weight is rising worldwide: in 2016, an estimated 39% of men and 40% of women aged 18 years and older, and 27% of boys and 24% of girls aged 5–18 years, were obese. High amounts of sugar-sweetened beverages and sedentary behaviors, including screen-time, increase risk of excess body weight.  
  • The cancer burden associated with unhealthy diet, excess body weight, and physical inactivity is expected to grow in most parts of the world, particularly in parts of the Middle East and several other low- and middle-income countries in parts of Asia and Oceania because of the obesity epidemic. 
  • Alcohol is responsible for 4.2% of all cancer deaths globally, with marked variation across countries.  
  • Breast cancer is the most common cancer in women in almost all countries worldwide, and accounts for almost one in four new cancer cases among women. Lifetime risk of breast cancer among females in high-income countries can be up to three times that in low-income countries. 
  • Each year, about 270,000 cancer cases are diagnosed in children. Today, 5-year survival from childhood cancer in high-income countries is greater than 80%, but it can be as low as 20% in low-income countries. With interventions to improve early diagnosis and adherence to appropriate treatment, childhood cancer survival can be increased to 60% in low-income countries, saving almost 1 million children's lives over a decade. 
  • Over the next half century, an estimated 44 million cervical cancer cases will occur worldwide if current trends continue. Effective delivery of combined high coverage screening and vaccination could avert over 13 million cervical cancer cases by 2069, and eventually lead to cervical cancer eliminated as a major public health problem. 
  • Approximately 3 to 6% of all cancers worldwide are caused by exposures to carcinogens in the workplace. 
  • Outdoor air pollution causes over half a million lung cancer deaths and millions of deaths from other diseases each year. Outdoor air pollution levels are particularly high in rapidly-growing cities in low- and middle-income countries. Diesel exhaust, classified as a lung carcinogen by IARC, contributes to outdoor air pollution and is also an occupational lung carcinogen. 
  • Radiotherapy is indicated for about 60% of cancer patients to relieve symptoms, shrink tumors before surgery, or kill remaining cancer cells after surgery to avoid recurrence. Radiotherapy coverage is less than optimal in many low- and middle-income countries. In Ethiopia, for example, a population of approximately 100 million is served by a single radiotherapy center. 
  • The growing number of cancer survivors represents a global challenge for survivors and their families, employers, healthcare systems, and governments. In 2018, there were approximately 43.8 million cancer survivors diagnosed within the previous 5 years. Many cancer survivors face late and lasting medical, emotional, and social challenges resulting in 7.8 million years lived with disability globally in 2017.



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