The Changing Global Burden of Cancer: Transitions in Human Development and Implications for Cancer Prevention and Control
Authors: Freddie Bray, Isabelle Soerjomataram
Changes in fertility and life expectancy are leading to major changes in the structure of the global population and, in turn, in the scale of the cancer problem worldwide and at every resource level (WHO 2011b). In addition to the increasing burden of cancer is a changing spectrum of common cancers in different regions correlated with levels of human development (Bray and others 2012). The ongoing cancer transition includes a reduction in infection-related cancers (for example, stomach and cervical cancer) that is offset by increases in cancers linked to a Westernization of lifestyle (for example, breast, prostate, and colorectal cancer). The transition also encompasses changes in risk behavior, including tobacco uptake, with a delayed but large impact on the burden from lung and other tobacco-related cancers (Bray and others 2012). The cancer transition is not uniform, however: in Sub-Saharan Africa, recent increases in cervical cancer are observed in Uganda and Zimbabwe; in many countries, a residual burden of cancers associated with infectious agents accompanies the increasing burden of cancers associated with economic transition (Parkin and others 2014).