Global cancer statistics 2024: GLOBOCAN estimates of incidence and mortality worldwide for 34 cancers in 186 countries.

INTRODUCTION

Cancer is a major public health challenge in the 21st century and an important barrier to increasing life expectancy worldwide. In 2021, it accounted for nearly one in six deaths (17%) globally, and almost one in four deaths (23%) from noncommunicable diseases. The disease also imposes substantial societal and macroeconomic costs 1 ; in 2022, premature deaths from cancer resulted in an estimated US $566 billion in global productivity losses, comprising losses from both paid work (US $305 billion) and unpaid activities (US $260 billion), including caregiving and domestic labor. 2 Nevertheless, decades of advances in cancer research from basic discovery to clinical and population science have enabled considerable progress in global cancer prevention and control, making a substantial proportion of cancers preventable and treatable. Indeed, nearly one half (48%) of all cancer‐related deaths are estimated to be potentially avoidable worldwide, through either primary prevention targeting modifiable risk factors (33%) or early detection and improved access to treatment (15%). Yet the proportion of avoidable deaths varies markedly by world region because of differences in risk factor profiles and the availability of effective interventions. In sub‐Saharan Africa, for example, the proportion estimated to be avoidable exceeds 60%, reflecting the high burden of cancer deaths that are either largely preventable (e.g., cervical cancer) or highly treatable when detected early (e.g., breast cancer). 3

Understanding the magnitude and geographic distribution of the global cancer burden is essential to guide effective and equitable prevention and control efforts. To this end, this article presents updated global cancer statistics for 2024 based on the latest GLOBOCAN estimates produced by the International Agency for Research on Cancer (IARC) and disseminated online through Cancer Today on the Global Cancer Observatory (GCO) website ( http://gco.iarc.who.int ). 4 Consistent with previous reports, 5 , 6 , 7 , 8 , 9 our objectives are three‐fold: (1) to describe the global burden of cancer incidence and mortality, (2) to assess geographic and socioeconomic variation across 20 predefined world regions and according to the Human Development Index (HDI), and (3) to predict the burden of cancer in 2050 based on demographic projections. Focusing on the 10 most common cancer types worldwide, we also briefly discuss current patterns and recent trends together with the underlying determinants, as well as the prospects of equitable and sustainable global cancer control.

DATA SOURCES AND METHODS

The sources and methods used in compiling the GLOBOCAN estimates have been described previously 10 and are freely available online through the GCO. 4 The GCO platform provides tools for tabulating and visualizing the incidence and mortality estimates at the global, regional, and national levels by cancer type, sex, and age group. In brief, national estimates are derived from the best available cancer incidence and mortality data within each country, with validity depending on the quality, representativeness, and timeliness of the underlying data sources. The methods used to produce the 2024 estimates largely follow those developed previously, with an emphasis on the use of short‐term predictions and modeled mortality‐to‐incidence ratios, where applicable. 11 The GCO provides cancer‐specific estimates for 186 countries or territories worldwide by sex and 18 age groups (birth to 4 years, 5–9 years, …, 80–84 years, 85 years and older).

The number of new cancer cases and cancer deaths were extracted for all cancers combined (International Classification of Disease 10th revision [ICD‐10], version 2010; codes C00–C97) and for 34 cancer types: lip, oral cavity (C00–C06); salivary glands (C07–C08); oropharynx (C09–C10); nasopharynx (C11); hypopharynx (C12–C13); esophagus (C15); stomach (C16); colorectum (C18–C21); liver (C22, including intrahepatic bile ducts); gallbladder (C23); pancreas (C25); larynx (C32); lung (C33–C34, including trachea and bronchus); melanoma of skin (C43); nonmelanoma skin cancer (NMSC; C44, excluding basal cell carcinoma for incidence); mesothelioma (C45); Kaposi sarcoma (C46); female breast (C50); vulva (C51); vagina (C52); cervix uteri (C53); corpus uteri (C54); ovary (C56); penis (C60); prostate (C61); testis (C62); kidney (C64–C65, including renal pelvis); bladder (C67); brain, central nervous system (C70–C72); thyroid (C73); Hodgkin lymphoma (C81); non‐Hodgkin lymphoma (C82–C86, C96); multiple myeloma (C88 and C90, including immunoproliferative diseases); and leukemia (C91–C95). For consistency with previous reports, 12 we combine colon (C18), rectum (C19–C20), and anus (C21) as colorectal cancer (ICD‐10 codes C18–C21), whereas NMSC is included in the overall estimation of the total cancer burden (unless otherwise stated) and included within the other category when making comparisons of the relative magnitude of different cancers types. Cancer type–specific, aggregated counts at global, regional, and national levels were used to identify the most common cancer types for incidence and mortality at each level.

We also present two complementary measures that allow comparisons across populations with differing age structures: age‐standardized incidence and mortality rates (ASRs) per 100,000 person‐years, standardized to the 1966 Segi–Doll world standard population, 13 and the cumulative risk of developing or dying from cancer before age 75 years, expressed as a percentage and assuming the absence of competing causes of death.

Geographic and socioeconomic variation in the burden and profile of cancer was examined across 20 aggregated regions defined by the United Nations Population Division (Figure 1A ) and by countries classified according to the HDI (Figure 1B ), based on the 2022 Human Development Report from the United Nations Development Program. Analyses used both the predefined, four‐tier HDI classification (low, medium, high, and very high) and a binary grouping (low and medium HDI vs. high and very high HDI). The cancer profiles for India and China are also presented separately given their large population shares (17.8% and 17.5% globally in 2024, respectively). 14

Finally, we project the global cancer burden to 2050 using demographic projections while assuming constant incidence or mortality rates. Throughout, the terms transitioning , emerging , and lower HDI countries/economies refer to nations classified as low or medium HDI, whereas transitioned or higher HDI countries/economies refer to nations classified as high or very high HDI.

RESULTS

Distribution of cases and deaths by world region and cancer type

Figure 2 presents the distribution of new cases and deaths by world region for both sexes combined and by sex. Overall, an estimated 20.6 million new cases worldwide (19.5 million excluding NMSC) and 9.8 million cancer deaths (9.7 million excluding NMSC) occurred in 2024 (Table 1 ). More than one half of all cancer cases (50.7%) and deaths (56.5%) were in Asia in 2024 (Figure 2 ), where 58.8% of the world’s population resides (Figure 1A ). The cancer mortality burden in Africa and Asia is disproportionately higher than incidence, reflecting both the regional variation in cancer types and a generally lower survival proportion. In contrast, Europe has a disproportionately high burden of both cases (21.0%) and deaths (20.0%) because it comprises only 9.2% of the global population.

Table 2 presents the number of new cancer cases and deaths, age‐standardized incidence and mortality rates, and the cumulative risk of developing and dying from cancer, overall and for the 34 cancer types by sex. The incidence rate for all cancers combined was about 13% higher in men (209.6 per 100,000) than in women (185.8 per 100,000) in 2024, much smaller than the 46% sex difference for mortality (106.2 vs. 72.8 per 1000,000). Approximately one in five men (21.4%) and women (18.5%) will develop cancer before the age of 75, while about one in nine men (11.0%) and one in 12 women (7.6%) will die from the disease.

Figure 3 illustrates the top 10 most common cancer types overall and by sex in 2024 (with NMSC included in the “other” category), which together account for more than 60% of all newly diagnosed cancer cases and cancer deaths. Lung cancer is the most commonly diagnosed cancer worldwide (12.8% of all cases), followed by cancers of the female breast (11.8%), colorectum (9.9%), prostate (7.5%), and stomach (4.7%). Lung cancer is also the leading cause of cancer death (19.1% of all deaths), followed by colorectal (9.4%), liver (7.5%), female breast (7.1%) and stomach (6.6%) cancers. In men, lung cancer ranks first for both incidence and mortality, followed by prostate and colorectal cancer for incidence, and colorectal and liver cancer for mortality. In women, breast cancer ranks first for both incidence and mortality, followed by lung and colorectal cancers.

Global cancer patterns

Figures 4 and 5 present global maps of the most commonly diagnosed cancers and leading causes of cancer death by sex in 186 countries. The maps highlight substantial geographic diversity in common cancer types, particularly for both incidence and mortality in men (in whom eight different cancer types lead in different countries) and mortality in women (in whom seven different cancers lead). In men, prostate cancer is the most frequently diagnosed cancer in 123 countries, followed by lung cancer in 31 countries, with colorectal, liver, and stomach cancers ranking first in 11, nine, and six countries, respectively (Figure 4 ). In contrast, incidence patterns among women are dominated by two cancer types: breast cancer, which ranks first in 164 countries and cervical cancer, which ranks first in 19 of 22 remaining countries, with the exceptions in China and North Korea (lung cancer) and Mongolia (liver cancer). In terms of mortality, lung cancer is the leading cancer in men in 89 countries, followed by prostate cancer in 68 countries and liver cancer in 15 countries (Figure 5 ). In women, breast cancer leads in 122 countries, followed by cervical cancer in 26 countries, and lung cancer in 26 countries.

Cancer incidence and mortality patterns by four‐tier HDI, China and India

Figure 6 presents the five most common cancers in terms of incidence and mortality for countries grouped by HDI: very high, high (excluding China), medium (excluding India), and low HDI, as well as China and India separately. For incidence, female breast cancer is the leading cancer across all HDI levels and in India, whereas lung cancer ranks first in China. For mortality, lung cancer leads across all HDI levels, in China, and in India, except in low HDI countries, where female breast cancer ranks first. Colorectal cancer ranks among the five most common cancers for both incidence and mortality across HDI levels, except in medium HDI countries and India. Prostate cancer is among the top five for incidence across all HDI levels, and among the top five for mortality in very high HDI and in low HDI countries. The five most common cancers account for 43‐51% of total incidence and mortality across each of the four‐tier HDI levels and in India but represent a larger share in China (59% of incidence and 67% of mortality), largely reflecting the high burden of lung cancer in the country.

Marked differences in infection‐related cancers and other regionally prevalent risk factors contribute to distinct cancer profiles across HDI levels. Liver cancer is the second leading cause of cancer death in China, ranking third or fourth in all HDI levels except very high HDI and India. Cervical cancer is the second most commonly diagnosed cancer in low HDI countries, third in medium HDI countries, and fifth in India. In India, lip and oral cavity cancer ranks second for incidence and third for mortality, reflecting one of the world’s highest oral cancer burdens.

The risk of developing cancer tends to rise incrementally with increasing HDI. In 2024, the cumulative risk ranged from about 11% in low HDI countries to more than 30% in very high HDI countries for men, and from approximately 12% to 25% for women (Table 3 ). By contrast, differences in the risk of dying from cancer across HDI levels are much smaller, with a lifetime risk ranging from about 8% in lower HDI countries to 12% in higher HDI countries for men and varying little (around 7‐8% across four‐tier HDI) for women.

Figure 7 compares cancer incidence and mortality ASRs between lower and higher HDI countries in men and women separately. Incidence rates for most cancer types are higher in higher HDI countries in 2024, with the largest variation (greater than seven‐fold) observed for thyroid cancer in both sexes. In contrast, higher incidence rates for cancers of the lip and oral cavity and the cervix are seen in lower HDI countries. Mortality patterns broadly mirror incidence patterns, although differences between incidence and mortality are evident for prostate and female breast cancers. Despite three‐fold greater incidence rates of prostate cancer in higher versus lower HDI countries (34.9 vs. 13.1 per 100,000), corresponding mortality rates are reasonably comparable (7.4 vs. 6.9 per 100,000). Similarly, incidence rates of breast cancer incidence are substantially greater in higher HDI countries (54.1 vs. 33.6 per 100,000), yet mortality rates are greater in lower HDI countries (14.7 vs. 11.7 per 100,000).

Cancer incidence and mortality rates by sex and world region

Cancer incidence varies markedly across regions, with roughly four‐fold differences worldwide (Table 3 ). Rates are highest in Australia/New Zealand for both men (476.8 per 100,000) and women (396.1 per 100,000) and lowest in Eastern Africa among men (99.8 per 100,000) and South‐Central Asia among women (106.0 per 100,000). The regional variation in mortality is smaller at approximately two‐fold. Mortality rates are the highest in Eastern Europe among men (157.5 per 100,000) and in Melanesia among women (108.0 per 100,000) and the lowest in Eastern Africa among men (68.7 per 100,000) and South‐Central Asia among women (58.6 per 100,000). Correspondingly, the cumulative risk of dying from cancer is highest in Eastern Europe for men (17.4%) and in Melanesia for women (12.1%) compared with the lowest risks in Central America for men (7.0%) and South‐Central Asia (6.6%) and Eastern Asia (6.5%) for women.

The regional variations in cancer incidence and mortality largely reflect differences in exposure to major risk factors, the distribution of associated cancer types, and disparities in effective prevention, early detection, and curative treatment. Below, we examine these patterns in greater detail across world regions, focusing on incidence and mortality patterns of the 10 most common cancers, describing these in the context of recent literature. Nine of these cancers rank among the top 10 for both incidence and mortality, whereas thyroid cancer ranks among the top 10 for incidence only (Figures 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ).

Lung cancer

Lung cancer is the most frequently diagnosed cancer and the leading cause of cancer death worldwide, with about 2.6 million new cases and 1.9 million deaths estimated in 2024 (Table 1 ). It ranks first among men and second among women for both incidence and mortality (Figure 3 ). Incidence rates are about two‐fold higher in men than in women, but the male‐to‐female ratios vary widely by region, from close to unity in Northern America and Northern Europe to 4–5 in Northern Africa and Eastern Europe (Figure 8 ). Among men, lung cancer is the most commonly diagnosed cancer in 31 countries (Figure 4A ) and the leading cause of cancer death in 89 countries (Figure 5A ), with the highest incidence rates observed in Eastern Asia, followed by Eastern Europe, and Micronesia/Polynesia (44–52 per 100,000). Among women, lung cancer ranks first for mortality in 26 countries, including China and the United States (Figure 5B ), with the highest incidence rates observed in Eastern Asia, Northern America, and Northern Europe (26–32 per 100,000) (Figure 8 ). Lung cancer incidence is highest among men in Hungary and women in Denmark. The lowest incidence rates are observed in Western, Middle, and Eastern Africa and in Central America (1.9–6.6 per 100,000) in both sexes and in Northern Africa among women (3.4 per 100,000).

The marked geographic and temporal patterns in lung cancer burden largely reflect the stage of the tobacco epidemic as well as differentials in the historic patterns of tobacco exposure: the intensity and duration of smoking, the type of cigarettes consumed, and the degree of inhalation. 15 , 16 , 17 , 18 In those high‐income countries where the tobacco epidemic was established at the turn of the last century (e.g., the United Kingdom, the United States, Australia), lung cancer rates among men have been declining since the 1980s and 1990s, 20–40 years after cigarette smoking prevalence peaked. In most transitioning countries, where the epidemic is at an earlier stage, smoking prevalence has either peaked recently or continues to increase, 19 hence lung cancer rates will likely continue to increase over the next decades. 20 The potential for a substantial rise in the global lung cancer burden is of pressing concern because several populous countries have among the highest current daily smoking prevalence in men (ages >15 years), such as Indonesia (71%) and China (45%) in 2022. 21 , 22 , 23 The tobacco epidemic among women remains at an earlier stage than among men, although the extent to which female smoking trends mirror those previously observed in men varies across regions. 15 , 24 In many transitioned countries, lung cancer rates among women continue to rise, 25 with stabilization or declines observed in a few countries (e.g., the United States, the Netherlands). 25 , 26 , 27 Consequently, in parts of Europe and Northern America, incidence rates among women at younger or middle ages are approaching or even exceeding those among men, signaling a potentially greater lung cancer burden among women in the coming decades. 25 , 28 , 29

Globally, nearly 60% of male lung cancers and 32% of female lung cancers in 2022 have been attributed to smoking 30 and thus are preventable through effective tobacco‐control policies and regulations. To support countries in implementing measures that reduce tobacco demand, the World Health Organization (WHO) Framework Convention on Tobacco Control introduced the MPOWER package in 2005, which outlines six key policy interventions (monitoring tobacco use; protecting people from tobacco smoke; quitting tobacco; warning about the dangers of tobacco; enforcing tobacco advertising, promotion, and sponsorship bans; and raising taxes on tobacco). According to the 2025 WHO report on the global tobacco epidemic, about 6.1 billion people residing in 155 countries (>75% of the global population) are protected by at least one MPOWER measure. 31 Progress in implementing these interventions remains uneven, however. Tobacco taxation, one of the most effective strategies for reducing tobacco demand, has increased in four WHO regions, yet only 40 countries (25 high‐income and 15 middle‐income) met the WHO‐recommended benchmark of taxes accounting for at least 75% of the retail price in 2024. 31 A recent modeling work highlighted the substantial potential impact of stronger tobacco control in the greater Europe region, estimating that more than 1.6 million lung cancer cases could be prevented over 20 years under the highest level of policy implementation. 32 Furthermore, several countries are adopting or proposing endgame strategies aimed at eliminating tobacco use, including reducing nicotine levels in cigarettes and other tobacco products to nonaddictive levels and introducing plain packaging. 33

Smokeless tobacco (e.g., chewed tobacco, snuff, snus) has been neglected in tobacco control and continues to cause life‐threatening diseases, including head and neck cancers. A 2019 study reported that only 41 of 180 countries (23%) mandated pictorial health warnings; 16 (9%) had comprehensive bans on advertising, promotion, and sponsorships; 34 (19%) taxed these products; and just six (3%) regulated their content and emissions of smokeless tobacco products. 34 The rising popularity of noncombusted tobacco products (e.g., nicotine pouch, electronic cigarettes, and heated tobacco products), particularly among youth, poses further challenges in many countries. 35 In response, regulatory efforts are expanding, with 133 countries adopting policies to regulate or ban electronic nicotine delivery systems as of 2024. 31

As smoking prevalence declines, an increasing proportion of lung cancers occur among individuals without a history of smoking. In the United States and the United Kingdom, they account for about 15%–20% of lung cancer deaths, ranking among the top 10 leading causes of cancer death. 36 The changing risk factor profile of lung cancer may also be reflected in the increasing predominance of adenocarcinoma, which accounted for 46% of all lung cancer diagnoses in men and 60% in women in 2022. 37 Incidence rates of adenocarcinoma exceeded those of squamous cell carcinoma in 170 countries in men and in all 186 countries in women, with the highest incidence burden estimated in Eastern Asia, especially in China. 37 The reasons for the increasing predominance of adenocarcinoma are not fully understood, but increasing air pollution documented in many urban areas in countries with a rapidly transitioning economy may contribute to this shift. 38 , 39 , 40 , 41 China alone accounts for nearly 70% of global lung adenocarcinoma cases attributable to ambient particulate matter pollution, underscoring the importance of prioritizing air‐quality management programs and expanding access to clean energy to reduce exposure in high‐burden settings. 37 Lung cancer in never‐smokers further contributes to the elevated risk observed among women in China and among women of Asian descent in the United States, where lung cancer risk is relatively high despite substantially low smoking prevalence in this population. 42 , 43 , 44 , 45 Possible explanations include exposure to household burning of solid fuels for heating and cooking, second‐hand smoking, air pollution, and environmental exposures (e.g., radon and arsenic). 27 , 29 , 46 , 47 Genetic susceptibility may also play a role because EGFR mutations occur in approximately 40%–60% of adenocarcinomas among Asian women without a history of smoking. 43 , 48 In addition, the rapid uptake of lung cancer screening and increasing diagnosis of early stage tumors in urban China has been suggested to partly explain the sharp increase in adenocarcinoma among young women: a 19‐fold rise from 2011 to 2017. 49

Five‐year survival from lung cancer tends to be under 20% in most countries, 50 with relatively modest variation across HDI levels. 51 Because most lung cancer cases are diagnosed at a later stage when curative treatment is not possible, there has been a longstanding focus on screening of high‐risk individuals (smokers and former smokers). The US Preventive Services Task Force currently recommends annual lung cancer screening with low‐dose computed tomography in those aged 50–80 years with a 20–pack‐year smoking history who currently smoke cigarettes or quit within the past 15 years; the 2024 guideline update by the American Cancer Society removed the years since quitting criteria because the influence of age on lung cancer risk among former smokers supersedes that of cessation years. 52 Australia introduced a national lung cancer screening program in July 2025 for smokers and former smokers at high risk 53 ), whereas the European Commission is also proposing the introduction of lung cancer screening to its 27 member states through its Europe's Beating Cancer Plan. 54 However, translating mortality benefits demonstrated in randomized controlled trials to the general population has been challenging 55 , 56 because of high costs and infrastructure requirements; limited awareness; low participation rates, especially among disadvantaged populations; and concerns about false positives, overdiagnosis, and complications. 57 As lung cancer screening becomes more widespread and effective targeted therapies expand in the highest income countries, 58 survival differences by region are likely to widen in the absence of equitable access to such interventions. 59 , 60 , 61

Female breast cancer

With an estimated 2.4 million new cases and 694,000 deaths, female breast cancer is the second most commonly diagnosed cancer and the fourth leading cause of cancer death in 2024, accounting for 11.8% of all cases and 7.1% of all deaths (Table 1 , Figure 3 ). Among women, breast cancer is the most common cancer for both incidence and mortality worldwide, ranking first for incidence in 164 countries (Figure 4B ) and for mortality in 122 countries (Figure 5B ). Incidence rates are 60% greater in higher versus lower HDI countries (54.1 vs. 33.6 per 100,000), whereas mortality rates are 26% greater in lower HDI countries (14.7 vs. 11.7 per 100,000; Figure 7B ). Incidence rates are elevated in Australia/New Zealand, Northern America, and Northern Europe (90–102 per 100,000) and are approximately three times higher than those in Eastern Africa, South Central Asia, and Middle Africa (29–33 per 100,000; Figure 9 ). Mortality rates range from 20 to 25 per 100,000 in Melanesia, Micronesia/Polynesia, and Western Africa and from six to 10 per 100,000 in Eastern Asia and Central America.

The marked geographic variation in female breast cancer incidence largely reflects differences in risk factor prevalence and screening practices, whereas the disproportionately higher mortality rates in transitioning countries highlight persistent inequities in access to timely diagnosis and effective treatment. Since the early 1980s, countries in Northern America, Oceania, and Europe saw consistent and rapid increases in breast cancer incidence rates, 62 , 63 which levelled off by the early 2000s, likely because of a decline in the use of combined estrogen–progesterone menopausal hormone‐replacement therapy and a possible plateau in screening participation. 64 , 65 Driven by the impact of early detection and several treatment breakthroughs (e.g., systemic endocrine, chemotherapy, and HER2‐targeted therapy), mortality rates have declined substantially in most of these regions since around 1990. In the United States, treatment advances contributed to 75% of the 44% reduction in the death rate since its 1989 peak, with the remainder attributed to mammography screening. 58 More recent trend analysis through 2017 indicates that incidence rates in historically high‐risk countries have generally remained stable or increased slowly among both premenopausal and postmenopausal women (e.g., Norway, Canada, England, Australia), although declines have been observed in a few countries, including Germany and Denmark. 66 Mortality rates continued to decline, with the fastest reductions during the latest decade (2%–3% per year) in Denmark, Switzerland, the Netherlands, Norway, Sweden, Australia, the United Kingdom, and New Zealand, whereas increases persist in Romania and Poland. 66

Although female breast cancer incidence rates remain lower in South America, Africa, and Asia, several countries have experienced some of the most rapid increases in risk over the recent 2 decades, particularly those economies undergoing rapid transition. 67 , 68 , 69 Between 2008 and 2017, incidence rose by 3%–5% per year in South Korea, Japan, Bahrain, Thailand, China, and India, with concurrent increases in mortality in South Korea, Brazil, Mexico, and Uruguay. 66 These trends likely reflect changes in reproductive patterns, including declining parity and delayed childbearing, alongside rising excess body weight, reduced physical activity, and increased alcohol consumption, whereas expanded breast cancer screening likely plays an additional role in some higher‐income countries (e.g., South Korea, Japan). 70 In sub‐Saharan Africa, the future burden is expected to grow substantially, with breast cancer deaths projected to nearly quadruple from 2024 to 2050, largely driven by rapid population growth and ageing together with ongoing social transitions.

Given its immense disease burden and the availability of effective screening and treatment, breast cancer accounts for more treatable deaths than any other cancer in 2022 (0.2 million; approximately 15% of all treatable deaths). 3 In terms of early detection, the WHO recommends organized, population‐based mammography every 2 years for women aged 50–69 years at average risk in well resourced settings. 71 In resource‐limited settings, however, mammography screening is often neither feasible or cost‐effective, thus efforts focus on timely diagnosis of symptomatic cases. Despite a lower incidence, sub‐Saharan Africa bears a disproportionately high share of breast cancer deaths, reflecting the high fatality of a largely treatable disease because of late‐stage presentation. In the African Breast Cancer‐Disparities in Outcomes study, a hospital‐based cohort in Namibia, Nigeria, South Africa, Uganda, and Zambia, 50%–90% of women were diagnosed at stage III or IV (2014–2019) compared with about 30% in the United States (2013–2022). 72 , 73 In the same study, the proportion of women with nonmetastatic disease who fully completed guideline‐recommended treatment was low at 3%–6% in Uganda, Nigeria, and Zambia and at 27% in Namibia. 74 Often compounded by stigma, low awareness, and social barriers that delay care seeking, poor survival in these settings reflects both late‐stage diagnosis and limited access to effective treatment. Together with the region's younger population age structure, poor cancer outcomes result in a profound societal and intergenerational impact; a recent study estimated that every 100 maternal deaths leave about 121 children motherless. 75

In response, the WHO established the Global Breast Cancer Initiative in 2021 to unite stakeholders worldwide around the goal of reducing breast cancer mortality by 2.5% per year, an effort projected to save 2.5 million women's lives by 2040. The initiative's operational approach is built on three key pillars: health promotion and early detection, timely diagnosis, and comprehensive breast cancer management. 76 Evidence indicates that shortening the time from the first contact with a health care provider to diagnosis is a critical window for downstaging. 77 In a 2022 study of women in five hospitals in Ethiopia, 45% of women spent more than 2 months, exceeding the Global Breast Cancer Initiative's benchmark of diagnosis, with delays associated with longer travel times, limited social support, and multiple consultations before pathology evaluation. 78 Strengthening breast cancer awareness and establishing fast‐track referral pathways for women with suspicious symptoms are essential to enable earlier diagnosis and improve outcomes in the region. 77

Globally, about 20% of new breast cancer cases are linked to non‐genetic known risk factors, with insufficient physical activity (33%) contributing most, followed by high body mass index (29%), alcohol use (21%), and suboptimal breastfeeding (18%), highlighting the potential of lifestyle changes and breastfeeding promotion to reduce incidence. 30 Maintaining healthy body weight and regular physical activity also improve breast cancer prognosis, making lifestyle promotion increasingly important for the growing population of women with a history of the disease.

Colorectal cancer

Colorectal cancer is the third most commonly diagnosed cancer and the second leading cause of cancer death globally, with more than 2.0 million new cases and 918,000 deaths estimated in 2024 (Table 1 ). Incidence rates are up to four times greater in higher versus lower HDI countries, reflecting the strong link between colorectal cancer and socioeconomic development (Figure 7 ). Nevertheless, mortality rates vary less because of higher case fatality in lower HDI countries. By region, colorectal cancer incidence rates vary by five‐fold to six‐fold in men and women, with the highest rates observed in Europe, Australia/New Zealand, and Northern America (30–40 per 100,000 in men and 24–32 per 100,000 in women; Figure 10 ) and the lowest in Eastern, Western, and Middle Africa and South‐Central Asia (from five to eight per 100,000).

There is strong evidence that tobacco smoking, red or processed meat consumption, alcohol use, and excess body weight increase colorectal cancer risk, whereas higher intake of wholegrains and fiber, dairy consumption, and physical activity reduce risk. 79 Approximately 10% of new colorectal cancer cases in both sexes are attributable to modifiable risk factors worldwide, with smoking the largest contributor (50%), followed by alcohol (32%), high body mass index (10%), and insufficient physical activity (8%) in men. 30 In high‐risk settings, the potential of primary prevention may be even greater; a US study incorporating a broader range of established risk factors estimated that up to 55% of colorectal cancer cases could be prevented. 80

Colorectal cancer incidence and mortality rates have declined for decades in many historically high‐risk countries in Europe, Oceania, and Northern America. The declines reflect both population‐level improvements in lifestyle factors (e.g., reductions in smoking) 81 , 82 and widespread screening, which has accelerated progress since the early 2000s. 83 , 84 , 85 Colonoscopy reduces incidence by removing precancerous polyps and further contributes to mortality reduction through the detection of asymptomatic cancer. Screening has been estimated to account for 79% of averted colorectal cancer deaths in the United States, with the remainder attributable to advances in treatment. 58

However, these gains are being offset by rising colorectal cancer incidence rates among young adults (typically defined as younger than 50 years) that began in the mid‐1990s in the United States and a few years later in other countries, including the United Kingdom, Australia, New Zealand, and Canada, with mortality rates also rising in these countries. 86 , 87 , 88 , 89 A similar pattern of diverging trends in incidence by age group has been shown in other high‐income countries in diverse regions (e.g., France, Germany, Argentina). 86 Part of the observed increase, particularly among young individuals, is likely an artifact of a revision in the behavior code for some carcinoid tumors from borderline malignant (unreported) to malignant, and thus reportable, in the 2013 revision of the WHO International Classification of Diseases for Oncology, third revision. 90 , 91 , 92 In 2016, two thirds of appendiceal cancers in individuals younger than 50 years in the United States were carcinoid tumors, 93 which is one reason many studies of early onset colorectal cancer exclude appendiceal cancer from the analysis. Multiple studies that exclude appendiceal cancers demonstrate a consistent rise in colorectal cancer incidence among young adults predating the classification change that is accompanied by increasing mortality. 87 , 94 , 95 , 96 , 97 The findings support a genuine increase in colorectal cancer burden among young individuals that is unlikely to be explained solely by changing disease classification. Several studies have reported that these trends are the result of a strong birth‐cohort effect associated with increased risk of colorectal cancer among subsequent generations born after the second half of the 20th century, implicating behavioral and/or environmental exposures that remain unclear. 87 , 88 , 89 , 94 , 95 Studies of early onset disease are limited but have linked several factors to increased risk of colorectal cancer or its precursor, including prolonged sitting, poor diet quality, ultraprocessed foods, alcohol consumption, excess body weight, diabetes, and metabolic syndrome, 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 largely implicating metabolic health‐related disruptions as a key underlying mechanism. 89 , 106 , 107 A large, tissue‐based genomic study of nearly 1000 samples from 11 countries reported enriched mutational signatures (SBS88 and ID18) linked to colibactin, a genotoxin produced by Escherichia coli and related microorganisms, in early onset colorectal cancer, supporting a potential role of early life microbial exposures in shaping birth‐cohort risk. 108

To address the elevated risk of colorectal cancer among younger adults, the recommended age to begin screening was lowered from 50 to 45 years in 2018 by the American Cancer Society and in 2021 by the US Preventive Services Task Force. 109 Screening uptake among adults aged 45–49 years increased from 20% in 2019 to 37% in 2024 110 and was accompanied by a 22% annual rise in the diagnosis of local‐stage disease. 111 However, three in four diagnoses before age 50 years are advanced‐stage disease, and colorectal cancer became the leading cause of cancer death among individuals younger than 50 years in the United States in 2023, surpassing breast cancer for the first time. 96 Expanding screening to younger ages remains controversial, even in high‐resource settings, given the low absolute incidence in younger populations and concerns about diverting screening capacity from older or higher‐risk groups who derive greater benefit, albeit fewer life‐years gained. 112 Reflecting setting‐specific considerations, Australia lowered the starting age for its National Bowel Cancer Screening Program from 50 to 45 years in 2024, 113 whereas the European Commission Initiative on Colorectal Cancer suggested no screening of adults younger than 50 years as of 2025 (conditional, very low certainty of the evidence). 114

Colorectal cancer incidence rates in Japan quadrupled between 1970 and 1990 to a level not dissimilar to US Whites, 115 paralleling postwar economic development and changing lifestyle. Today, there are similar rises in colorectal cancer incidence rates in many transitioning countries. 116 Particularly rapid increases have been observed in parts of Latin America and the Caribbean (e.g., Chile, Costa Rica, Ecuador) and across several African countries. 86 , 117 A recent analysis of 12 population‐based registries in 11 countries assessing trends up to 2020 documented consistent increases across all regions of Africa, with the steepest rises, approximately 6% per year, reported in Brazzaville (Congo) and Ibadan (Nigeria). 117

Survival, however, remains poor in many of these settings because of late‐stage presentation and low receipt of guideline‐concordant care; 5‐year relative survival among cases diagnosed in low HDI countries in Africa was 39%, 118 which was substantially poorer compared with about 70% in Australia during the same period. 119 Rapidly increasing incidence and poor survival are likely to increase the death toll, 120 highlighting an urgent need to increase disease awareness and improve access to timely diagnosis and effective treatment in these settings. Population‐based screening is recommended only in settings with adequate capacity to ensure diagnostic follow‐up and treatment; in many low/limited‐resource settings, increasing awareness, early diagnosis, and broader health system strengthening remain higher priorities. 116 , 121

Prostate cancer

Prostate cancer is the second most frequent cancer and the fourth leading cause of cancer death in men worldwide, with about 1.5 million new cases and 420,000 deaths estimated in 2024 (Table 1 , Figure 3 ). It is the most frequently diagnosed cancer in men in nearly two thirds (123 of 186) of the world’s countries (Figure 4A ). Incidence rates are almost three times higher in transitioned than in transitioning countries (34.9 vs. 13.1 per 100,000; Figure 7 ) and vary more than 11‐fold across regions, with the highest rates observed in Northern America, Northern Europe, Australia/New Zealand, and the Caribbean (≥70 per 100,000) (Figure 11 ). In contrast, mortality differs only modestly between countries with higher and lower HDI (7.4 vs. 6.9 per 100,000), and rates are disproportionately higher in the Caribbean, sub‐Saharan Africa, and Micronesia/Polynesia. Prostate cancer is the leading cause of cancer death among men in 68 countries, including many in the Caribbean and sub‐Saharan Africa, as well as several in Central and South America (e.g., Colombia, Peru, Venezuela, and Chile) and Sweden in Europe (Figure 5A ). The lowest incidence and mortality rates are found in South Central Asia, South‐Eastern Asia, Eastern Asia, and Northern Africa (Figure 11 ).

Despite being one of the most commonly diagnosed cancers and a leading cause of cancer death in men, few modifiable risk factors have been firmly established for prostate cancer. Advancing age, family history, and certain inherited genetic mutations remain the only well stablished risk factors, whereas smoking, excess body weight, and some dietary factors have been suggested but remain inconclusive. 122 The higher incidence rates observed in the Caribbean and sub‐Saharan Africa may partly reflect greater genetic susceptibility because multiple genetic variants associated with disease risk are more common among men with Western African ancestry. 123

Much of the international variations in prostate cancer incidence patterns and trends reflects difference in diagnostic practices at the national level. 124 In Northern America, parts of Northern Europe, and Australia, incidence rates rose sharply in the late‐1980s and early‐1990s, coinciding with the widespread introduction of prostate‐specific antigen (PSA) testing. 125 These increases were followed by rapid declines, initially because of a depletion in prevalent cases and later reflecting reduced PSA testing after changes in screening guidelines. 125 , 126 , 127 , 128 , 129 , 130 , 131 , 132 More recent declines in some high‐income countries may also partly reflect greater use of multiparametric magnetic resonance imaging, the integration of which is associated with a reduction in unnecessary biopsies and overdiagnosis. 133

After about 2 decades of decline, prostate cancer incidence in the United States increased by about 3% per year during 2014–2019, with steeper rises for regional and distant‐stage disease (4.6%–4.8% annually) than for localized disease. 134 The increase in advanced‐stage diagnoses is thought to reflect, in part, reduced PSA testing, 135 although reasons for the increases observed across men of all ages remain unclear. 134 The US Preventive Services Task Force has since revised its recommendation to informed decision for men aged 55–69 whereby individualized decisions about PSA screening can be made after discussing potential benefits and harms with health care providers. 136 Trends in incidence in greater Europe, Southern and Central America, and much of Asia have been more modest, reflecting later and less widespread adoption of PSA testing. 124 In contrast, incidence rates continue to increase in China, India, the Baltic countries, and Eastern Europe. 124 Rapid increases have also been reported in parts of sub‐Saharan Africa (1995–2018), 137 likely because of increased awareness and improved access to diagnostic services, including PSA testing and transurethral procedures. 137

In contrast to incidence rates, mortality rates have declined in most high‐income countries since the mid‐1990s, including those in Northern America, Oceania, and Northern and Western Europe, 124 likely reflecting earlier detection and advancements in effective treatment. 138 , 139 During the same period, mortality rates increased in many countries in Central and Eastern Europe, Asia, and Africa 125 and continued until recently in some countries, 140 partly because of rising incidence and limited access to PSA testing and curative treatment. More recent trends show continued declines in transitioned countries across much of Europe outside of the Baltic and Eastern Europe countries. 140 , 141 In the United States, the pace of decline has slowed from over 3% per year during the 1990s to 0.6% per year over the past decade, partly reflecting a steep increase in advanced‐stage diseases. 134

Stomach cancer

Stomach cancer remains the fifth most common cancer and cancer death worldwide, with an estimated 980,000 new cases and 642,000 deaths in 2024 (Table 1 , Figure 3 ). Incidence rates vary four‐fold to six‐fold across regions, with the highest rates in Eastern Asia—ranking highest in Mongolia for both sexes—followed by Eastern Europe and South America, and the lowest in Melanesia, Africa, and Northern America (Figure 12 ). Stomach cancer is the most commonly diagnosed cancer and the leading cause of cancer death among men in six countries (Afghanistan, Bhutan, Kyrgyzstan, Mali, Nepal, and Tajikistan), and it is also the leading cause of cancer death among women in Ecuador, Nepal, Peru, and Tajikistan (Figures 4 and 5 ).

The large geographic variations in stomach cancer rates mainly reflect differences in the prevalence of chronic Helicobacter pylori infection—the principal cause of gastric cancer—which accounts for approximately 90% of noncardia (lower stomach) gastric cancer cases worldwide. 142 , 143 Noncardia gastric cancer is the predominant subtype in high‐incidence countries in Eastern Asia and South America, with exceptions in Iran and in some regions of China. Chronic H. pylori infection is highly prevalent in these regions, infecting up to 79% of adults in Mongolia (2015–2022), compared with a global prevalence of about 44%. 142 , 143 , 144 Nonetheless, only a small fraction of infected individuals develop cancer, likely because of differences in bacterial strain virulence, host genetic susceptibility, timing and duration of infection, and other factors that may synergize with H. pylori to promote carcinogenesis, such as smoking and micronutrient deficiencies. 145 , 146 Additional risk factors for noncardia gastric cancer include alcohol consumption, tobacco smoking, high‐salt or pickled foods, low fruit and vegetable intake, and nitrosamine. 79 In contrast, cardia (upper stomach below the esophageal‐gastric junction) gastric cancer predominates in historically low‐risk countries, such as in the United States and the United Kingdom. 147 Its risk factors resemble those of esophageal adenocarcinoma (EAC), with excess body weight and gastroesophageal reflux disease as major contributors, whereas H. pylori infection accounts for 20% of cardia cases globally but as high as 62% of cases in China. 148 , 149 Globally, nearly 80% of all gastric cancer cases are linked to modifiable risk factors. 30 In the United States, about 71% are attributable to modifiable risk factors, including H. pylori infection (41%), smoking (22%), physical inactivity (18%), and excess body weight (17%). 80

Incidence and mortality rates of stomach cancer have substantially decreased worldwide over the past century and continue to decline in the 21st century, 82 reflecting decreases in H. pylori infection, associated with economic development, as well as declines in smoking and intake of salt‐preserved foods. 144 , 150 , 151 These favorable trends are driven primarily by decreases in noncardia gastric cancer, whereas cardia gastric cancer has shown stable or slowly increasing trends, especially in historically low‐risk countries (e.g., the United Kingdom, the United States, Sweden, and the Netherlands). 152 , 153 , 154 , 155 , 156 Despite overall declines, a projection from a 2025 study for cohorts born in 2008–2017 suggests that 58% of 15.6 million future cases of gastric cancer will occur in historically high‐incidence regions and 42% in lower incidence regions, largely reflecting demographic changes. 157 In particular, the burden in sub‐Saharan Africa is projected to rise sharply, with case numbers up to six times those estimated for 2022. 157 Importantly, an estimated 76% of all future cases are caused by H. pylori infection, for which eradication therapy has consistently been shown to significantly reduce the risk of atrophic gastritis, gastric intestinal metaplasia, and gastric cancer in infected individuals. 158

In line with the evidence, the WHO/IARC Working Group has highlighted population‐based H . pylori screen‐and‐treat approach (screening and eradication) as a feasible primary prevention strategy in high‐incidence settings, considering local disease burden, screening methods and treatment regimens, antibiotic stewardship, outcome measures, and cost‐effectiveness. 159 , 160 For secondary prevention, upper gastrointestinal endoscopy‐based screening has shown to be cost‐effective in high‐incidence countries or high‐risk subpopulations (e.g., non‐Hispanic Black, Hispanic, and Asian populations living in the United States). 161 , 162 , 163 Japan and South Korea have both implemented nationwide organized screening for gastric cancer in 1983 and 1999, respectively. 159 , 164 In South Korea, screening was associated with a 41% mortality reduction 15 years after implementation, 165 primarily through treatment of precancerous lesions and stage downshifting: the proportion of early stage gastric cancers rose from 39% in 2001 to 73% in 2016, 166 and the 5‐year net survival increased from 49% in 2000 to 77% during 2013–2019, 50 , 167 which is substantially higher than the 38% observed in the United States from 2015 to 2021. 168

Thyroid cancer

With close to 959,000 cases worldwide in 2024, thyroid cancer ranks as the sixth most commonly diagnosed cancer overall and the fourth in women (Table 1 , Figure 3 ). Incidence rates are about seven times higher in transitioned versus transitioning countries for both sexes (Figure 7 ). Across regions, incidence rates are three to four times higher in women than in men and vary markedly within each sex, ranging from 39‐fold in men and 36‐fold in women (Figure 13 ). The highest rates occur in Eastern Asia (15.4 per 100,000 men and 42.8 per 100,000 women), followed by women in Micronesia/Polynesia, Northern America, and Southern Europe; whereas the lowest rates are observed in men in sub‐Saharan Africa and South Central Asia (0.4–0.9 per 100,000). With an estimated 48,000 deaths worldwide, thyroid cancer ranks 25th in mortality, substantially lower than its incidence ranking, and mortality rates vary little by sex, region, or HDI level (0.3–0.5 per 100,000) (Figure 7 ).

Thyroid cancer incidence rates have increased substantially over the last 4 decades in many countries, with few exceptions (e.g., Uganda, India, the Philippines, and Thailand), whereas mortality rates have remained largely stable or declined (e.g., Austria and Switzerland). 169 Papillary thyroid carcinoma was the main contributor to the overall increase in incidence rates during the last decades. 165 The steep rises in incidence, particularly during the 2000s, has been largely attributed to the increasing use of ultrasonography and other highly sensitive diagnostic technologies that detect small, clinically indolent tumors. 170 , 171 Incidence continues to rise in many countries (e.g., Cyprus, Ecuador, China, Turkey, and Costa Rica), suggesting that overdiagnosis remains substantial and has rapidly expanded to transitioning countries. 169 Recent evidence suggests that overdiagnosis is likely a major driver of the sharp increases in thyroid cancer incidence among younger populations since the early 2000s. 172 Overall, an estimated 76% of thyroid cancer cases diagnosed during 2013–2017 were attributed to overdiagnosis, ranging from none (e.g., Uganda, Zimbabwe, and Trinidad and Tobago) to more than 85% among women in Cyprus, China, South Korea, and Turkey. 169 Notably, the earlier rapid increase has been followed by declines since around 2010 in several countries, including South Korea, the United States, Canada, Israel, France, Italy, Austria, and Ireland. 169 The declines coincide with growing recognition of substantial overdiagnosis and overtreatment of indolent tumors and the escalating cost associated with treatments of overdiagnosed cases that prompted revisions to national and international clinical guidelines. 12 , 173 , 174 , 175 Contemporary guidelines recommend against routine screening in asymptomatic individuals and support active surveillance for low‐risk papillary thyroid microcarcinoma (<1 cm). 176 , 177 Surveys of clinicians in the United States showed increasing acceptance of observation over intervention for appropriately selected patients, accompanied by more refined risk stratification to minimize unnecessary treatment. 178 , 179

Efforts to reduce overdiagnosis represent an important component of lowering the incidence burden of thyroid cancer and associated costs. Opportunities for primary prevention remain limited because few risk factors are well established, including ionizing radiation, benign thyroid diseases, and excess body weight. 180 Therefore, avoiding unnecessary ionizing radiation exposure (e.g., x‐rays, gamma‐radiation), particularly during childhood and adolescence, and maintaining a healthy body weight are key preventive measures.

Liver cancer

Liver cancer remains highly fatal, with an estimated 843,000 new cases and 732,000 deaths in 2024, ranking seventh in incidence but third in mortality worldwide (Table 1 , Figure 3 ). Incidence and mortality rates are about three times higher in men than in women (Table 2 ), making it the third leading cause of cancer death among men (Figure 3 ). Incidence rates vary about five‐fold across regions in men, with the highest incidence rates in Eastern Asia, Northern Africa, South‐Eastern Asia, and Melanesia (16–21 per 100,000 men) and the lowest in South Central Asia, Western Asia, several African regions, and South America (4.4–5.6 per 100,000 men; Figure 14 ). Among women, rates vary more than four‐fold, with the highest in Melanesia, Eastern Asia, South‐Eastern Asia, Northern Africa, and Central America (5.6–8.1 per 100,000 women). Liver cancer is the leading cause of cancer death in several geographically diverse countries in both sexes in Mongolia, Guatemala, and the Lao People's Democratic Republic, and in men in an additional 12 countries across South‐Eastern Asia (Cambodia, Thailand), Melanesia (Solomon Islands, Fiji, Vanuatu), and Northern and Western Africa (Egypt, Senegal, The Gambia, Guinea‐Bissau, Ghana, Niger, Burkina Faso; Figure 5 ).

Primary liver cancer comprises mainly hepatocellular carcinoma (HCC; 75%–85% of cases) and intrahepatic cholangiocarcinoma (10%–15%). Chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infections account for 21%–55% of HCC globally, 142 , 181 whereas other risk factors include aflatoxin B 1 exposure, alcohol consumption, smoking, excess body weight, type 2 diabetes, and metabolic dysfunction‐associated steatotic liver disease. 182 The relative importance of these risk factors varies by region and over time. For example, in most high‐risk HCC areas (e.g., China and Eastern Africa), chronic HBV infection and aflatoxin exposure predominate, whereas HCV infection is the main contributor in a diverse set of countries, including Egypt, Italy, and Japan. In Mongolia, HBV and HCV viruses, co‐infections of HBV carriers with HCV or hepatitis delta virus, and alcohol consumption collectively drive one of the world’s highest national rates in men and women. Aflatoxin exposure remains a continuing public health concern in some countries (e.g., Guatemala), 183 where corn is a dietary staple and socioeconomic conditions are limited. There is a growing concern that climate change may further increase aflatoxin contamination even in high‐income settings. 184 Major risk factors for intrahepatic cholangiocarcinoma are also region‐specific, including liver flukes (e.g., Opisthorchis viverrini endemic in the northeast region of Thailand) 185 and metabolic conditions (including excess body weight, diabetes, nonalcoholic fatty liver disease), alcohol consumption, smoking, and viral hepatitis. 186 , 187 , 188 , 189

Liver cancer incidence and mortality rates have decreased steadily in many high‐risk countries in East Asia (e.g., China, Taiwan, Japan, and South Korea) since the late 20th century. 82 , 190 , 191 Earlier declines are largely attributable to reductions in aflatoxin exposure, with further reductions after the introduction of HBV vaccination programs in the early 1980s. 192 In contrast, incidence has increased in historically low‐risk countries across Europe, Northern America, Australia/New Zealand, and South America, alongside rising metabolic risk factors. 190 , 193 More recent data suggest that HCC incidence rates may have peaked in the United States and the United Kingdom since the mid‐2010s, coinciding with the introduction of direct‐acting antivirals for HCV treatments, whereas intrahepatic cholangiocarcinoma incidence has continued to increase, likely reflecting the emergence of metabolic conditions. 187 , 188 , 189

Although nonviral risk factors are becoming increasingly important and should be addressed through health promotion strategies, elimination of viral hepatitis remains the cornerstone of primary prevention of liver cancer. Globally, in 2022, an estimated 254 million people were living with HBV infection, and 50 million were living with HCV infection, with men accounting for 58% of all infections and children for 12%. 194 That year, 1.1 million people died from viral hepatitis, and 2.2 new infections occurred (1.2 million HBV and 1 million HCV), disproportionately affecting individuals exposed to unsafe blood supplies or medical procedures, infants vulnerable to mother‐to‐child transmission, indigenous populations, migrant populations from high‐prevalence regions, and specific populations, such as people who inject drugs, incarcerated individuals, sex workers, and men who have sex with men. 194 This pattern underscores the importance of targeted, culturally tailored strategies for effective diagnosis and treatment. The WHO’s global hepatitis strategy aims to reduce new infections by 90% and related deaths by 65% by 2030, potentially preventing 15 million liver cancer cases. As of 2022, the HBV vaccine had been introduced nationally in 190 countries, with 84% global coverage for the three‐dose series, 195 yet the coverage for birth dose within 24 hours remains low at 45%, ranging from 80% in the WHO Western Pacific region to 18% in the WHO African region, where 65% of new HBV infections occur. 195 , 196 The WHO target of reducing HBV infection among children younger than 5 years to <1% by 2020 has been achieved in all regions except Africa. 196

More than 30% of new HCV infections occurred in the Eastern Mediterranean, the region with the highest prevalence. 196 Despite the availability of curative therapy for HCV and effective treatment that reduces mortality from HBV, most infections remain undiagnosed and untreated. 196 Globally, in 2019, diagnostic coverage was only 21% for HCV and 10% for HBV, with treatment coverage at 13% and 2%, respectively. 196 Stronger political commitment and sustained financing are critical in reducing the burden of hepatitis and related diseases 197 through the scale‐up of affordable diagnostics and antivirals, decentralization of care, and the prioritization of screening and linkage to care among high‐risk populations. Egypt provides an exemplary case study in which some of those challenges were overcome, demonstrating that large‐scale national screening and the rapid scale‐up of affordable antiviral treatment can substantially reduce the burden of HCV. 198 , 199

Cervical cancer

With an estimated 604,000 new cases and 280,000 deaths worldwide in 2024, cervical cancer remains the fifth most commonly diagnosed cancer and the fourth leading cause of cancer death among women (Table 1 , Figure 3 ). This preventable cancer is the leading cause of cancer death in women in 26 countries (Figure 5 ), primarily in sub‐Saharan Africa (e.g., Democratic Republic of Congo, Tanzania, and Uganda) and also in parts of South and Central America (Bolivia, Belize, El Salvador), Melanesia (Solomon Islands, Vanuatu), and South‐Eastern Asia (Bhutan). Incidence rates vary by approximately eight‐fold across regions, with the highest rates in sub‐Saharan Africa and Melanesia and the lowest in Western Asia, Australia/New Zealand, and Northern America (Figure 15 ). Mortality patterns broadly mirror incidence. Rates remain higher in transitioning countries than in transitioned countries (incidence, 15.1 vs. 11.6 per 100,000; mortality, 8.3 vs. 4.3 per 100,000; Figure 7 )

As a disease strongly linked to low socioeconomic status, the marked geographic and socioeconomic disparities in cervical cancer rates largely reflect inequities in access to screening and treatment as well as differences in the prevalence of persistent human papillomavirus (HPV) infection and cofactors such as human immunodeficiency virus (HIV) infection. 200 In many high‐income countries in Northern America and Europe, cervical cancer incidence and mortality steadily declined during the latter one half of the 20th century, largely because of the introduction of Papanicolaou cytology‐based screening from the late 1950s to the 1970s, in addition to other factors (e.g., declines in parity), making the disease now relatively uncommon in these regions. 200 , 201 Although these declines have been most notable for women older than 30 years, for whom screening is highly effective, some countries have seen moderations of the declines over the last 10–20 years, 202 , 203 , 204 which are thought to result from the lower sensitivity of cytology screening in detecting adenocarcinomas combined with changes in sexual behaviors. 200 , 205 , 206 Although incidence rates remain relatively high, declines have also been observed in many Asian and Latin American countries despite limited screening, possibly attributable to decreasing parity and safer sexual behaviors. 207 Japan and China are among the few countries where cervical cancer incidence has increased, based on a study examining trends through 2021, which appear to reflect low screening uptake and shifts in sexual mores, such as earlier sexual debut and more partners. 204 , 208 , 209 Cervical cancer incidence remains highest and continues to increase in many sub‐Saharan African countries: Blantyre (Malawi) recorded the fastest rise (7.9% annually), with significant increases also observed in Eastern Cape (South Africa) and Eldoret (Kenya). 210 , 211 Incidence rates increased by 2.2% annually in Kampala (Uganda) until 2006 before declining slightly, whereas Mauritius was the only registry in the region showing a steady 2.5% annual decrease. 210 , 211

HPV is a necessary but not sufficient cause of cervical cancer, with 13 of 118 known HPV types classified as group 1 carcinogens by the IARC Monographs. 212 Other important cofactors include sexually transmitted infections (HIV and Chlamydia trachomatis ), smoking, high parity, immunosuppressive drug use (e.g., transplantation recipients), and low intake of certain micronutrients (including carotenoids and vitamin E). 200 Women living with HIV face an increased risk of cervical cancer and account for 6% of all women newly diagnosed with cervical cancer globally, with the highest proportions in Southern Africa (64%) and Eastern Africa (27%). 211 Overall, 91% of cervical cancer cases are attributable to infections, with the remainder linked to smoking. 30

The WHO launched the CCEI (Cervical Cancer Elimination Initiative) in 2020, aiming to eliminate cervical cancer as a public health problem this century. 213 The strategy centers on the 90–70–90 targets for 2030: 90% HPV vaccination coverage among girls by age 15 years, 70% screening of women with a high‐performance test at ages 35 and 45 years, and 90% treatment of women with precancerous lesions or invasive cancer, with the goal of reducing incidence below four per 100,000 women. 213 Despite these ambitious targets, coverage remains far from sufficient: in 2024, only about 31% of girls had received at least one dose of HPV vaccine globally 195 ; and as of 2019, roughly one third of women aged 30–49 years had ever been screened, 214 with particularly low coverage in low‐income countries where the burden is greatest.

Nevertheless, vaccination coverage has increased substantially, rising from 17% in 2019 to 31% in 2024, driven by an expansion in several high‐risk, highly populated countries and strengthened through program implementation and the adoption of a single‐dose schedule after the WHO's 2022 SAGE (Strategic Advisory Group of Experts on Immunization) recommendation. 215 A single‐dose HPV vaccine lowers logistical barriers and costs, allowing programs to expand secondary screening for women who no longer fully benefit from vaccination. 216 A modeling exercise suggested that, in Ethiopia, an estimated savings of $4 million from a single‐dose schedule could fund screening for approximately 280,000 women in 1 year using primary HPV DNA testing, supporting the scaling‐up of screening and treatment services for women who remain unvaccinated and at the highest risk. 216 , 217 , 218 As of March 2026, 91 of the 194 countries with national HPV vaccination programs have adopted single‐dose schedules. 219 For example, in November 2025, Kenya officially transitioned its national program from a two‐dose to a single‐dose schedule, an intervention expected to double the coverage using existing resources and achieve substantial social and economic impact. 220 Of note, China recently introduced HPV vaccination into its national program, implementing the official two‐dose schedule beginning in November 2025. 221

In parallel, an increasing number of countries recommend HPV testing as the primary screening method: as of 2022, an estimated 48 of 139 countries with cervical cancer screening programs had adopted HPV testing as the primary test, 214 with some also introducing self‐sampling either as a primary screening approach or to reach underscreened populations (e.g., Australia, Malaysia, Denmark, Argentina, and the Netherlands). 222 , 223 , 224 In 2025, the American Cancer Society updated its screening guidelines to incorporate HPV self‐sampling. 225 In Australia, projected to be among the first countries to achieve cervical cancer elimination nationally, 226 incidence rates remain two to three times higher in Indigenous than non‐Indigenous women, 227 and the expansion of self‐collection to all screening‐eligible women through primary care in 2022 is expected to help improve equity in screening participation. 228 Management and treatment of precancerous lesions are critical to effective secondary prevention. Ensuring timely clinical follow‐up after positive screening results remains challenging, particularly in resource‐limited settings. To address this, the WHO recommends a screen‐and‐treat approach, providing treatment immediately or shortly after a positive HPV screening test, which is especially advised for women living with HIV. 229

Pancreatic cancer

With an estimated 531,000 new cases and 491,000 deaths in 2024, pancreatic cancer ranks as the 11th most commonly diagnosed cancer but the sixth leading cause of cancer death (Table 1 ), representing approximately one in 20 cancer deaths in both sexes combined (Figure 3 ). Incidence and mortality rates are about 1.5‐fold higher in men than in women and about three times higher in higher HDI versus lower HDI countries (Figure 7 ). The highest incidence rates are found in Europe, Northern America, and Australia/New Zealand, and the lowest are in South Central Asia, Africa, and South‐Eastern Asia (Figure 16 ).

In many parts of the world, pancreatic cancer incidence and mortality rates have been either stable or slowly rising for the past few decades. 82 , 230 , 231 Geographic variation in pancreatic cancer burden and trends may partly reflect differences in the prevalence of these risk factors as well as access to diagnostic imaging services with varying sensitivities (e.g., high‐quality computed tomography with intravenous contrast, endoscopic ultrasound, magnetic resonance cholangiopancreatography). Although the underlying etiology remains poorly understood, established risk factors include smoking, excess body weight, and diabetes, with limited suggestive evidence for red meat, processed meat, alcohol consumption, and foods and beverages containing fructose and saturated fatty acids. 232 A recent estimate suggests that more than 20% of new cases in women and over 30% in men are attributable to smoking and excess body weight. 30 In addition, part of the increase in pancreatic cancer incidence in some high‐income countries also likely reflects evolving classification of pancreatic neuroendocrine tumors and subsequent changes in registrations and disease reporting, 233 , 234 particularly after revisions in the 2010 WHO tumor classification and coding changes in the WHO International Classification of Diseases for Oncology, third revision. 235

Despite therapeutic advances over the past decade, progress in pancreatic cancer treatment has been incremental, and the population‐level impact remains limited. 236 , 237 Survival for pancreatic cancer remains poor worldwide, reflecting the aggressive biology of the disease and the fact that patients typically present with advanced disease, often because of the absence of specific symptoms. Even in high‐income settings, approximately three quarters (75%) of cases present with either locally advanced or metastatic disease, and the 5‐year relative survival rate is low: 13% in the United States for patients diagnosed in 2015–2021, 8% in the United Kingdom in for those diagnosed in 2014, and 14% in Australia for those diagnosed in 2014. 238 Efforts to reduce the global burden of pancreatic cancer should prioritize reducing exposure to key modifiable risk factors, such as smoking and excess body weight. Complementary strategies include improving the identification of risk factors, surveillance of high‐risk individuals, strengthening health system capacity for timely diagnosis, and continuing research to enhance treatment effectiveness.

Esophageal cancer

Esophageal cancer is the 13th most commonly diagnosed cancer and the seventh leading cause of cancer death worldwide, with an estimated 494,000 new cases and 442,000 deaths in 2024 (Table 1 , Figure 3 ). With more than 70% of cases and deaths occurring in men (Table 2 ), the malignancy ranks seventh for incidence and sixth for mortality in men (Figure 3 ). Overall incidence and mortality rates are about three‐fold higher in men than in women (Table 2 ), although the male‐to‐female ratio varies widely across regions, from 1.4 in Eastern Africa (8.8 vs. 6.3 per 100,000) to 3.9 in Eastern Asia (11.0 vs. 2.8 per 100,000; Figure 17 ). The highest rates occur in Eastern Asia (largely driven by China), Melanesia, Eastern Africa, Northern Europe, and Eastern Europe among men, and in Eastern Africa, South‐Central Asia, and Middle Africa among women; whereas the lowest rates are observed in Western Africa, Central America, Northern Africa, and Western Asia among men and in Micronesia/Polynesia, Central America, and South‐Eastern Asia among women (Figure 17 ).

These geographic and sex differences partly reflect variations in the distribution of histologic subtypes and their underlying etiologies. 239 Globally, esophageal squamous cell carcinoma accounts for approximately 84% of all cases and predominates in high‐risk regions, including parts of the regions called central Asian esophageal cancer belt 240 and Eastern Africa’s esophageal cancer corridor , 241 where consumption of very hot beverages (Southern China, Iran), 242 , 243 , 244 opium smoking (Iran), 245 nutritional deficiencies, 246 , 247 low fruit and vegetable intakes, 248 indoor air pollution, 248 and poor oral hygiene, 249 , 250 have been associated with the disease risk. Esophageal squamous cell carcinoma incidence rates have decreased in many countries, likely due to improved diets in high‐risk regions and reduced tobacco use in high‐income Western settings. 251

In contrast to esophageal squamous cell carcinoma, EAC predominates in high‐income Western countries, representing roughly two thirds of all esophageal cancer cases in Northern Europe and Northern America. 252 Furthermore, incidence rates of EAC have increased steadily over the last decades, partly reflecting increased prevalence of gastroesophageal reflux disease, Barrett esophagus, and excess body weight and also declining prevalence of H. pylori infection, which is inversely associated with the risk of EAC. 253 Recent projections indicate that the incidence of EAC is expected to continue rising, likely becoming the predominant esophageal cancer subtype in an increasing number of high‐income and very high‐income countries. 226 In high‐income Western populations, up to 85% of new cases are estimated to be attributable to cigarette smoking, excess body weight, and alcohol consumption, highlighting the central role of primary prevention in reducing the future disease burden. 80

The future cancer incidence burden in 2050

Based on the projected population growth and aging, and assuming overall cancer incidence rates remain constant, approximately 34.4 million new cancer cases are predicted worldwide in 2050, representing a 67% increase from the 20.6 million cases estimated in 2024 (Figure 18 ). Demographic change is the primary driver of this rise, with the global population projected to grow from 8.2 billion in 2024 to 9.7 billion by 2050. 254 An annual decline of 2% in global incidence rates would be required over the next decades to ensure that the number of new cases predicted in 2050 does not exceed the current incidence burden, as estimated in 2024. Although the largest absolute increases are projected in high HDI (including China) and very high HDI countries, with an additional 4.5 and 3.0 million cases, respectively, the greatest relative increases are expected in lower HDI countries. The number of new cases is projected to rise by 122% from 0.9 to 2.0 million in low HDI countries and by 85% from 2.6 to 4.8 million in medium HDI countries (including India).

STRENGTHS AND LIMITATIONS

This study represents a comprehensive and up‐to‐date assessment of the global cancer incidence and mortality burden, leveraging the latest GLOBOCAN 2024 estimates from the IARC. Geographic variations in 34 distinct cancer types across 186 countries and territories are explored in detail for the 10 most frequent cancer types by world region and level of human development. The results of these cross‐national, regional, and development‐level comparisons are interpreted in the context of recent literature—spanning descriptive studies to policy documents—to identify and document the prospects of delivering equitable global cancer control.

The underlying national cancer incidence and mortality statistics are built up using a tiered estimation process, synthesizing the best available data to project close to current‐year estimates. The GLOBOCAN estimates rely on recorded incidence data from national or subnational population‐based cancer registries (PBCRs), which track new cancer diagnoses within defined geographic areas, and national mortality data made available from civil registration and vital statistics systems. Although the methodologic approach is data‐driven and transparent—the specific sources and methods are described at the country level within the GCO—there are clearly challenges in completing this exercise. A clear limitation is the distinct heterogeneity in the validity of the national estimates given the quality, representativeness, and timeliness of the underlying source information. In many low and medium HDI countries, high‐quality, representative PBCRs and civil registration and vital statistics systems are still lacking: only one in three countries currently reports high‐quality incidence according to IARC’s Cancer Incidence in Five Continents Volume XII 255 ; whereas one in four countries correspondingly reports high‐quality national mortality to the WHO. 256 For consistency with prior reports and comparability between incidence and mortality, 34 ICD‐based cancer site groupings were used. These groupings, however, combine etiologically and clinically distinct cancers (e.g., colorectal cancer includes anal cancer; code C21) and may increase uncertainty for cancer types not routinely collected across PBCRs (e.g., nonmelanoma skin cancer), warranting caution in interpretation.

Irrespective of the availability of high‐quality routine data, such periodic country‐level benchmarks of incidence and mortality offer a valuable exposition of the scale and profile of cancer but are not intended as a substitute for the continuous approaches to routine data collection afforded by PBCRs and civil registration and vital statistics systems. The former institutions are key providers of local statistics on cancer incidence and survival by cancer type and thus are a critical resource to policymakers (and the primary source of these estimates), providing the evidence base from which to plan, monitor, and evaluate the effect of national cancer control programs and the 2030 national targets of the WHO signature cancer initiatives. Given the critical importance of building capacity for local data production, analysis, and dissemination within the countries themselves, the Global Initiative for Cancer Registry Development ( https://gicr.iarc.fr/e‐learning/ ) was launched by the IARC in 2012. That initiative provides the necessary regional infrastructure through IARC hubs and designated centers of expertise to assist registries through a broad set of knowledge‐transfer and capacity‐building activities. 257

The coronavirus disease 2019 pandemic caused over six million deaths in 2020–2022 and severely affected health systems worldwide. While studies reported a substantial decline in cancer incidence, particularly in 2020, available data—mainly from very high HDI countries, showed that after 2022 cancer incidence has returned to its expected rates. Although reductions in screening and diagnoses, treatment delays, and reduced survival have been documented for some cancer sites, 258 , 259 , 260 no clear impact on mortality was seen during the early phase of the pandemic. 258 , 261 The estimates provided here for 2024 however do not reflect the impact of the pandemic as they are largely based on extrapolations of cancer data collected prior to 2020, yet we do not believe this would substantially change the estimates for reasons mentioned above. In addition to the incidence data available through the IARC's Cancer Incidence in Five Continents series, 255 we were able to use recent cancer registry data in collaboration with registry networks and programs worldwide. The estimates in the 40 countries that comprise the EU‐27 and greater Europe were developed in collaboration with the European Commission’s Joint Research Center and the European Network of Cancer Registries ( https://www.encr.eu/ ). The estimates of the cancer burden in China were built up in collaboration with the National Cancer Registry Program and are based on the extensive and up‐to‐date, high‐quality cancer registry data available in the country. 262 Through the Global Initiative for Cancer Registry Development, we have benefited from the availability of recent registry data, including from members of the African Cancer Registry Network ( http://afcrn.org ), we exploited the SURVCAN‐3 (Cancer Survival in Africa, Central and South America, and Asia) survival database 263 to complement estimates derived from mortality‐to‐incidence ratios, where applicable.

Finally, the inclusion of demographic projections of cancer incidence to 2050 seeks to enable actionable foresight, providing a critical tool for policymakers to anticipate future health care demands and resource allocation, particularly in lower HDI countries where the burden is projected to rise markedly. However, because such projections are driven purely by population growth and aging, they operate on the assumption that current incidence and mortality rates will remain constant. This is a limitation because it does not account for the dynamic nature of cancer causes and their control, some of which have been documented in this article. They include future changes in the prevalence of modifiable risk factors, the impact of effective primary prevention strategies, or the introduction of novel early detection and screening modalities.

CONCLUSIONS

Almost 21 million people were newly diagnosed with cancer and nearly 10 million people died from the disease in 2024. Population growth and ageing alone are expected to drive a continued rise in the global cancer burden, with the annual number of new cases projected to reach about 34.4 million by 2050, an increase of 67%. The scale of the disease burden, together with pronounced variation in cancer profiles across world regions and levels of human development, highlights the pressing need to accelerate and strengthen cancer‐control strategies globally. Reducing exposure to preventable risk factors, including tobacco use, cancer‐related infections, alcohol consumption, excess body weight, and physical inactivity, offers the most powerful and sustainable approach to lowering cancer risk and has the potential to prevent millions of future cases and deaths while generating substantial societal and economic benefits. 264 Effective cancer prevention and control are also closely aligned with the United Nations Sustainable Development Goals, particularly those aimed at reducing premature mortality from noncommunicable diseases and strengthening the implementation of health promotion policies. 265 Expanding vaccination programs, organized screening, and early detection initiatives, alongside equitable access to timely diagnosis, effective treatment, and palliative care, is essential to curb the growing cancer burden. Equally, strong political commitments to national investments in surveillance are needed to ensure meaningful and measurable progress in cancer control worldwide.

CONFLICT OF INTEREST STATEMENT

The authors disclosed no conflicts of interest. Hyuna Sung, Rebecca L. Siegel, and Ahmedin Jemal are employed by the American Cancer Society, which receives grants from private and corporate foundations, including foundations associated with companies in the health sector for research outside of the submitted work. The authors are not funded by or key personnel for any of these grants, and their salary is solely funded through American Cancer Society funds.

ACKNOWLEDGMENTS

The authors thank population‐based cancer registries worldwide for their continued collaboration; without their efforts, there would be no global cancer estimates. 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.

REFERENCES

1. Chen S, Cao Z, Prettner K, et al. Estimates and projections of the global economic cost of 29 cancers in 204 countries and territories from 2020 to 2050. JAMA Oncol. 2023;9(4):465‐472. doi: 10.1001/jamaoncol.2022.7826

2. Kong YC, Niyigaba J, Tran PB, et al. Global paid and unpaid productivity losses due to cancer‐related mortality. J Natl Cancer Inst. 2025;117(12):2612‐2620. doi: 10.1093/jnci/djaf193

3. Langselius O, Rumgay H, Vignat J, et al. Avoidable deaths through the primary prevention, early detection, and curative treatment of cancer worldwide: a population‐based study. Lancet Glob Health. 2026;14(3):e356‐e366. doi: 10.1016/S2214-109X(25)00494-2

4. Ferlay J, Ervik M, Lam F, et al. Global Cancer Observatory: Cancer Today. International Agency for Research on Cancer; 2020. Accessed March 13, 2026. https://gco.iarc.fr/today

5. Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55(2):74‐108. doi: 10.3322/canjclin.55.2.74

6. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin.2011;61(2):69‐90. doi: 10.3322/caac.20107

7. Torre LA, Bray F, Siegel RL, Ferlay J, Lortet‐Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015;65(2):87‐108. doi: 10.3322/caac.21262

8. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394‐424. doi: 10.3322/caac.21492

9. Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229‐263. doi: 10.3322/caac.21834

10. Filho AM, Laversanne M, Ferlay J, et al. The GLOBOCAN 2022 cancer estimates: data sources, methods, and a snapshot of the cancer burden worldwide. Int J Cancer. 2025;156(7):1336‐1346. doi: 10.1002/ijc.35278

11. Ferlay J, Colombet M, Soerjomataram I, et al. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int J Cancer. 2019;144(8):1941‐1953. doi: 10.1002/ijc.31937

12. Ferlay J, Colombet M, Soerjomataram I, et al. Global and Regional Estimates of the Incidence and Mortality for 38 Cancers: GLOBOCAN 2018. International Agency for Research on Cancer/World Health Organization; 2018.

13. Doll R, Payne P, Waterhouse J, eds. Cancer Incidence in Five Continents: A Technical Report. Springer; 1966.

14. Population Division, Department of Economic and Social Affairs, United Nations . World Population Prospects 2022/2024 revision. United Nations; 2024. Accessed March 13, 2026. https://population.un.org/wpp/

15. Thun M, Peto R, Boreham J, Lopez AD. Stages of the cigarette epidemic on entering its second century. Tob Control. 2012;21(2):96‐101. doi: 10.1136/tobaccocontrol-2011-050294

16. Weber A, Morgan E, Vignat J, et al. Lung cancer mortality in the wake of the changing smoking epidemic: a descriptive study of the global burden in 2020 and 2040. BMJ Open. 2023;13(5):e065303. doi: 10.1136/bmjopen-2022-065303

17. Song MA, Benowitz NL, Berman M, et al. Cigarette filter ventilation and its relationship to increasing rates of lung adenocarcinoma. J Natl Cancer Inst. 2017;109(12):djx075. doi: 10.1093/jnci/djx075

18. Khuder SA. Effect of cigarette smoking on major histological types of lung cancer: a meta‐analysis. Lung Cancer. 2001;31(2‐3):139‐148. doi: 10.1016/s0169-5002(00)00181-1

19. Jha P. Avoidable global cancer deaths and total deaths from smoking. Nat Rev Cancer. 2009;9(9):655‐664. doi: 10.1038/nrc2703

20. World Health Organization (WHO) . WHO report on the global tobacco epidemic, 2023: protect people from tobacco smoke: executive summary. WHO; 2023. Accessed December 29, 2023. https://www.who.int/publications/i/item/9789240077485

21. World Health Organization . WHO global report on trends in prevalence of tobacco use 2000–2030. World Health Organization. 2024. Accessed May 15, 2026. https://www.who.int/publications/i/item/9789240088283

22. Parkin DM, Bray FI, Devesa SS. Cancer burden in the year 2000. The global picture. Eur J Cancer. 2001;37(suppl 8):S4‐S66. doi: 10.1016/s0959-8049(01)00267-2

23. Alonso R, Pineros M, Laversanne M, et al. Lung cancer incidence trends in Uruguay 1990–2014: an age‐period‐cohort analysis. Cancer Epidemiol. 2018;55:17‐22. doi: 10.1016/j.canep.2018.04.012

24. Miranda‐Filho A, Pineros M, Bray F. The descriptive epidemiology of lung cancer and tobacco control: a global overview 2018. Salud Publica Mex. 2019;61(3):219‐229. doi: 10.21149/10140

25. Lortet‐Tieulent J, Renteria E, Sharp L, et al. Convergence of decreasing male and increasing female incidence rates in major tobacco‐related cancers in Europe in 1988–2010. Eur J Cancer. 2015;51(9):1144‐1163. doi: 10.1016/j.ejca.2013.10.014

26. Thun MJ, Henley SJ, Travis WD. Chapter 28. Lung cancer. In: Thun MJ, Linet MS, Cerhan JR, Haiman CA, Shottenfeld D, eds. Cancer Epidemiology and Prevention. 4th ed. Oxford University Press; 2017:519‐542.

27. Leiter A, Veluswamy RR, Wisnivesky JP. The global burden of lung cancer: current status and future trends. Nat Rev Clin Oncol. 2023;20(9):624‐639. doi: 10.1038/s41571-023-00798-3

28. Jemal A, Schafer EJ, Sung H, et al. The burden of lung cancer in women compared with men in the US. JAMA Oncol. 2023;9(12):1727‐1728. doi: 10.1001/jamaoncol.2023.4415

29. Jemal A, Miller KD, Ma J, et al. Higher lung cancer incidence in young women than young men in the United States. N Engl J Med. 2018;378(21):1999‐2009. doi: 10.1056/NEJMoa1715907

30. Fink H, Langselius O, Vignat J, et al. Global and regional cancer burden attributable to modifiable risk factors to inform prevention. Nat Med. 2026;32(4):1306‐1315. doi: 10.1038/s41591-026-04219-7

31. World Health Organization (WHO) . WHO report on the global tobacco epidemic, 2025: warning about the dangers of tobacco. Executive summary. World Health Organization; 2025. Accessed February 9, 2026. https://escholarship.org/content/qt0cj684r8/qt0cj684r8.pdf

32. Gredner T, Mons U, Niedermaier T, Brenner H, Soerjomataram I. Impact of tobacco control policies implementation on future lung cancer incidence in Europe: an international, population‐based modeling study. Lancet Reg Health Eur. 2021;4:100074. doi: 10.1016/j.lanepe.2021.100074

33. Tamil SS, Yeo XX, van der Eijk Y. Which countries are ready for a tobacco endgame? A scoping review and cluster analysis. Lancet Glob Health. 2024;12(6):e1049‐e1058. doi: 10.1016/S2214-109X(24)00085-8

34. Mehrotra R, Yadav A, Sinha DN, et al. Smokeless tobacco control in 180 countries across the globe: call to action for full implementation of WHO FCTC measures. Lancet Oncol. 2019;20(4):e208‐e217. doi: 10.1016/S1470-2045(19)30084-1

35. Jackson SE, Shahab L, Tattan‐Birch H, Brown J. Vaping among adults in England who have never regularly smoked: a population‐based study, 2016‐24. Lancet Public Health. 2024;9(10):e755‐e765. doi: 10.1016/S2468-2667(24)00183-X

36. LoPiccolo J, Gusev A, Christiani DC, Janne PA. Lung cancer in patients who have never smoked—an emerging disease. Nat Rev Clin Oncol. 2024;21(2):121‐146. doi: 10.1038/s41571-023-00844-0

37. Luo G, Zhang Y, Rumgay H, et al. Estimated worldwide variation and trends in incidence of lung cancer by histological subtype in 2022 and over time: a population‐based study. Lancet Respir Med. 2025;13(4):348‐363. doi: 10.1016/S2213-2600(24)00428-4

38. Vineis P, Hoek G, Krzyzanowski M, et al. Air pollution and risk of lung cancer in a prospective study in Europe. Int J Cancer. 2006;119(1):169‐174. doi: 10.1002/ijc.21801

39. Raaschou‐Nielsen O, Andersen ZJ, Beelen R, et al. Air pollution and lung cancer incidence in 17 European cohorts: prospective analyses from the European Study of Cohorts for Air Pollution Effects (ESCAPE). Lancet Oncol. 2013;14(9):813‐822. doi: 10.1016/s1470-2045(13)70279-1

40. Chen F, Cole P, Bina WF. Time trend and geographic patterns of lung adenocarcinoma in the United States, 1973–2002. Cancer Epidemiol Biomarkers Prev. 2007;16(12):2724‐2729. doi: 10.1158/1055-9965.Epi-07-0455

41. Hill W, Lim EL, Weeden CE, et al. Lung adenocarcinoma promotion by air pollutants. Nature. 2023;616(7955):159‐167. doi: 10.1038/s41586-023-05874-3

42. Sansone N, Yong HH, Li L, Jiang Y, Fong GT. Perceived acceptability of female smoking in China. Tob Control. 2015;24(suppl4):iv48‐iv54. doi: 10.1136/tobaccocontrol-2015-052380

43. Gomez SL, DeRouen M, Chen MS Jr, et al. Elevated risk of lung cancer among Asian American females who have never smoked: an emerging cancer disparity. J Natl Cancer Inst. 2024;117(6):1104‐1109. doi: 10.1093/jnci/djae299

44. DeRouen MC, Canchola AJ, Thompson CA, et al. Incidence of lung cancer among never‐smoking Asian American, Native Hawaiian, and Pacific Islander females. J Natl Cancer Inst. 2022;114(1):78‐86. doi: 10.1093/jnci/djab143

45. Dee EC, Santos PMG, Bray F. The shifting epidemiology of lung cancer in Asian and Asian diaspora populations: implications for clinical and global health policy research. Asia Pac J Clin Oncol. 2022;18(5). doi: 10.1111/ajco.13738

46. Mu L, Liu L, Niu R, et al. Indoor air pollution and risk of lung cancer among Chinese female non‐smokers. Cancer Causes Control. 2013;24(3):439‐450. doi: 10.1007/s10552-012-0130-8

47. Fidler‐Benaoudia MM, Torre LA, Bray F, Ferlay J, Jemal A. Lung cancer incidence in young women vs. young men: a systematic analysis in 40 countries. Int J Cancer. 2020;147(3):811‐819. doi: 10.1002/ijc.32809

48. Nahar R, Zhai W, Zhang T, et al. Elucidating the genomic architecture of Asian EGFR‐mutant lung adenocarcinoma through multi‐region exome sequencing. Nat Commun. 2018;9(1):216. doi: 10.1038/s41467-017-02584-z

49. Wang M, Lin S, He N, et al. The introduction of low‐dose CT imaging and lung cancer overdiagnosis in Chinese women. Chest. 2023;163(1):239‐250. doi: 10.1016/j.chest.2022.08.2207

50. Allemani C, Matsuda T, Di Carlo V, et al. Global surveillance of trends in cancer survival 2000–14 (CONCORD‐3): analysis of individual records for 37,513,025 patients diagnosed with one of 18 cancers from 322 population‐based registries in 71 countries. Lancet. 2018;391(10125):1023‐1075. doi: 10.1016/S0140-6736(17)33326-3

51. Soerjomataram I, Cabasag C, Bardot A, et al. Cancer survival in Africa, Central and South America, and Asia (SURVCAN‐3): a population‐based benchmarking study in 32 countries. Lancet Oncol. 2023;24(1):22‐32. doi: 10.1016/s1470-2045(22)00704-5

52. American Cancer Society . Lung Cancer Screening Guidelines. Accessed February 1, 2024. https://www.cancer.org/health‐care‐professionals/american‐cancer‐society‐prevention‐early‐detection‐guidelines/lung‐cancer‐screening‐guidelines.html

53. Cancer Australia . Lung Cancer Screening. Accessed January 16, 2024. https://www.canceraustralia.gov.au/about‐us/lung‐cancer‐screening

54. European Commission . Questions and answers: a new EU approach to cancer screening. European Commission; 2022. Accessed February 4, 2024. https://ec.europa.eu/commission/presscorner/detail/en/qanda_22_5584

55. Lung cancer incidence and mortality with extended follow‐up in the National Lung Screening Trial. J Thorac Oncol. 2019;14(10):1732‐1742. doi: 10.1016/j.jtho.2019.05.044

56. de Koning HJ, van der Aalst CM, de Jong PA, et al. Reduced lung‐cancer mortality with volume CT screening in a randomized trial. N Engl J Med. 2020;382(6):503‐513. doi: 10.1056/NEJMoa1911793

57. Patz EF Jr, Pinsky P, Gatsonis C, et al. Overdiagnosis in low‐dose computed tomography screening for lung cancer. JAMA Intern Med. 2014;174(2):269‐274. doi: 10.1001/jamainternmed.2013.12738

58. Goddard KAB, Feuer EJ, Mandelblatt JS, et al. Estimation of cancer deaths averted from prevention, screening, and treatment efforts, 1975–2020. JAMA Oncol. 2024;11(2):162. doi: 10.1001/jamaoncol.2024.5381

59. Ermer T, Canavan ME, Maduka RC, et al. Association between Food and Drug Administration approval and disparities in immunotherapy use among patients with cancer in the US. JAMA Netw Open. 2022;5(6):e2219535. doi: 10.1001/jamanetworkopen.2022.19535

60. Skolnick S, Cao P, Jeon J, Meza R. Contribution of smoking, disease history, and survival to lung cancer disparities in Black individuals. J Natl Cancer Inst Monogr. 2023;2023(62):204‐211. doi: 10.1093/jncimonographs/lgad016

61. Liu B, Halpern MT, Doria‐Rose VP, Croswell JM, Lee R, Feuer EJ. Lung cancer screening rates in the United States: contribution of the 2020 NHIS estimates to national and state‐level trends. Am J Prev Med. 2025;69(1):107626. doi: 10.1016/j.amepre.2025.03.006

62. Brinton LA, Gaudet MM, Gierach GL. Chapter 45. Breast cancer. In: Thun M, Linet MS, Cerhan JR, Haiman CA, Schottenfeld D, eds. Cancer Epidemiology and Prevention. 4th ed. Oxford University Press; 2017:861‐888.

63. Torre LA, Islami F, Siegel RL, Ward EM, Jemal A. Global cancer in women: burden and trends. Cancer Epidemiol Biomarkers Prev. 2017;26(4):444‐457. doi: 10.1158/1055-9965.EPI-16-0858

64. Breen N, Gentleman JF, Schiller JS. Update on mammography trends: comparisons of rates in 2000, 2005, and 2008. Cancer. 2011;117(10):2209‐2218. doi: 10.1002/cncr.25679

65. Breen N, Cronin KA, Meissner HI, et al. Reported drop in mammography: is this cause for concern? Cancer. 2007;109(12):2405‐2409. doi: 10.1002/cncr.22723

66. Kim J, Harper A, McCormack V, et al. Global patterns and trends in breast cancer incidence and mortality across 185 countries. Nat Med. 2025;31(4):1154‐1162. doi: 10.1038/s41591-025-03502-3

67. Joko‐Fru WY, Jedy‐Agba E, Korir A, et al. The evolving epidemic of breast cancer in sub‐Saharan Africa: results from the African Cancer Registry Network. Int J Cancer. 2020;147(8):2131‐2141. doi: 10.1002/ijc.33014

68. Ghasemi‐Kebria F, Fazel A, Semnani S, et al. Breast cancer incidence trends in Golestan, Iran: an age‐period‐cohort analysis by ethnic region, 2004–2018. Cancer Epidemiol. 2024;89:102525. doi: 10.1016/j.canep.2024.102525

69. Sun K, Lei L, Zheng R, et al. Trends in incidence rates, mortality rates, and age‐period‐cohort effects of female breast cancer—China, 2003–2017. China CDC Wkly. 2023;5(15):340‐346. doi: 10.46234/ccdcw2023.065

70. Heer E, Harper A, Escandor N, Sung H, McCormack V, Fidler‐Benaoudia MM. Global burden and trends in premenopausal and postmenopausal breast cancer: a population‐based study. Lancet Glob Health. 2020;8(8):e1027‐e1037. doi: 10.1016/S2214-109X(20)30215-1

71. World Health Organization (WHO) . WHO position paper on mammography screening. WHO; 2014. Accessed February 16, 2024. https://www.who.int/publications/i/item/who‐position‐paper‐on‐mammography‐screening

72. Foerster M, Anderson BO, McKenzie F, et al. Inequities in breast cancer treatment in sub‐Saharan Africa: findings from a prospective multi‐country observational study. Breast Cancer Res. 2019;21(1):93. doi: 10.1186/s13058-019-1174-4

73. Mo T, Joffe M, Cubasch H, et al. Breast cancer overall survival, annual risks of death, and survival gap apportionment in sub‐Saharan Africa (ABC‐DO): 7‐year follow‐up of a prospective cohort study. Lancet Glob Health. 2025;13(10):e1681‐e1690. doi: 10.1016/S2214-109X(25)00273-6

74. Boucheron P, Zietsman A, Anele A, et al. Measuring the WHO Global Breast Cancer Initiative pillars' key performance indicators in sub‐Saharan Africa: experience in the African Breast Cancer‐Disparities in Outcomes hospital‐based cohort study. eClinicalMedicine. 2025;81:103104. doi: 10.1016/j.eclinm.2025.103104

75. Galukande M, Schuz J, Anderson BO, et al. Maternally orphaned children and intergenerational concerns associated with breast cancer deaths among women in sub‐Saharan Africa. JAMA Oncol. 2021;7(2):285‐289. doi: 10.1001/jamaoncol.2020.6583

76. World Health Organization (WHO) . The Global Breast Cancer Initiative. WHO; 2023. Accessed December 12, 2023. https://www.who.int/initiatives/global‐breast‐cancer‐initiative

77. Foerster M, McKenzie F, Zietsman A, et al. Dissecting the journey to breast cancer diagnosis in sub‐Saharan Africa: findings from the multicountry ABC‐DO cohort study. Int J Cancer. 2020;148(2):340‐351. doi: 10.1002/ijc.33209

78. Rabe F, Getachew S, Stroetmann CY, et al. Time to pathologic diagnosis of suspicious breast lesions: an institution‐based study in five Ethiopian hospitals. Int J Cancer. 2025;157(5):876‐889. doi: 10.1002/ijc.35436

79. World Cancer Research Fund/American Institute for Cancer Research . The Continuous Update Project Expert Report 2018. Diet, Nutrition, Physical Activity and Cancer: colorectal cancer. World Cancer Research Fund; 2018. Accessed April 12, 2026. https://www.wcrf.org/sites/default/files/Colorectal‐cancer‐report.pdf

80. Islami F, Marlow EC, Thomson B, et al. Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States, 2019. CA Cancer J Clin. 2024;74(5):405‐432. doi: 10.3322/caac.21858

81. Edwards BK, Ward E, Kohler BA, et al. Annual report to the nation on the status of cancer, 1975–2006, featuring colorectal cancer trends and impact of interventions (risk factors, screening, and treatment) to reduce future rates. Cancer. 2010;116(3):544‐573. doi: 10.1002/cncr.24760

82. Arnold M, Abnet CC, Neale RE, et al. Global burden of 5 major types of gastrointestinal cancer. Gastroenterology. 2020;159(1):335‐349e15. doi: 10.1053/j.gastro.2020.02.068

83. Schreuders EH, Ruco A, Rabeneck L, et al. Colorectal cancer screening: a global overview of existing programmes. Gut. 2015;64(10):1637‐1649. doi: 10.1136/gutjnl-2014-309086

84. Siegel RL, Ward EM, Jemal A. Trends in colorectal cancer incidence rates in the United States by tumor location and stage, 1992–2008. Cancer Epidemiol Biomarkers Prev. 2012;21(3):411‐416. doi: 10.1158/1055-9965.EPI-11-1020

85. Cardoso R, Guo F, Heisser T, et al. Colorectal cancer incidence, mortality, and stage distribution in European countries in the colorectal cancer screening era: an international population‐based study. Lancet Oncol. 2021;22(7):1002‐1013. doi: 10.1016/S1470-2045(21)00199-6

86. Sung H, Siegel RL, Laversanne M, et al. Colorectal cancer incidence trends in younger versus older adults: an analysis of population‐based cancer registry data. Lancet Oncol. 2025;26(1):51‐63. doi: 10.1016/S1470-2045(24)00600-4

87. Santucci C, Mignozzi S, Alicandro G, et al. Trends in cancer mortality under age 50 in 15 upper‐middle and high‐income countries. J Natl Cancer Inst. 2025;117(4):747‐760. doi: 10.1093/jnci/djae288

88. Downham L, Laversanne M, Perdomo S, Filho AM, Bray F, Brennan P. Increase of early‐onset colorectal cancer: a cohort effect. J Natl Cancer Inst. 2025;118(4):751‐756. doi: 10.1093/jnci/djaf238

89. Murphy CC, Zaki TA. Changing epidemiology of colorectal cancer—birth cohort effects and emerging risk factors. Nat Rev Gastroenterol Hepatol. 2024;21(1):25‐34. doi: 10.1038/s41575-023-00841-9

90. Jooste V, Nousbaum JB, Alves A, et al. Epidemiological classification changes and incidence of early‐onset colorectal cancer. JAMA Netw Open. 2025;8(11):e2541732. doi: 10.1001/jamanetworkopen.2025.41732

91. Bleyer A, Ries LAG, Cameron DB, Mansfield SA, Siegel SE, Barr RD. Colon, colorectal, and all cancer incidence increase in the young due to appendix reclassification. J Natl Cancer Inst. 2025;117(7):1340‐1349. doi: 10.1093/jnci/djaf038

92. World Health Organization . WHO International Classification of Diseases for Oncology (ICD‐O). 3rd ed., 1st revision. World Health Organization; 2013. Accessed April 3, 2026. https://iris.who.int/handle/10665/96612

93. Siegel RL, Miller KD, Goding Sauer A, et al. Colorectal cancer statistics, 2020. CA Cancer J Clin. 2020;70(3):145‐164. doi: 10.3322/caac.21601

94. Araghi M, Soerjomataram I, Bardot A, et al. Changes in colorectal cancer incidence in seven high‐income countries: a population‐based study. Lancet Gastroenterol Hepatol. 2019;4(7):511‐518. doi: 10.1016/S2468-1253(19)30147-5

95. Siegel RL, Fedewa SA, Anderson WF, et al. Colorectal cancer incidence patterns in the United States, 1974–2013. J Natl Cancer Inst. 2017;109(8):109. doi: 10.1093/jnci/djw322

96. Siegel RL, Wagle NS, Jemal A. Leading cancer deaths in people younger than 50 years. JAMA. 2026;335(7):632. doi: 10.1001/jama.2025.25467

97. Siegel RL, Kratzer TB, Smith RA, Jemal A. RE: Colon, colorectal, and all cancer incidence increase in the young due to appendix reclassification. J Natl Cancer Inst. 2025;117(7):1516‐1517. doi: 10.1093/jnci/djaf095

98. O'Sullivan DE, Sutherland RL, Town S, et al. Risk factors for early‐onset colorectal cancer: a systematic review and meta‐analysis. Clin Gastroenterol Hepatol . 2022;20(6):1229‐1240e5. doi: 10.1016/j.cgh.2021.01.037

99. Li Z, Chen H, Fritz CDL, et al. Type 2 diabetes and risk of early‐onset colorectal cancer. Gastro Hep Advances. 2022;1(2):186‐193. doi: 10.1016/j.gastha.2021.10.009

100. Chen H, Zheng X, Zong X, et al. Metabolic syndrome, metabolic comorbid conditions and risk of early‐onset colorectal cancer. Gut. 2021;70(6):1147‐1154. doi: 10.1136/gutjnl-2020-321661

101. Park JH, Hong JY, Shen JJ, et al. Increased risk of young‐onset digestive tract cancers among young adults age 20–39 years with nonalcoholic fatty liver disease: a nationwide cohort study. J Clin Oncol. 2023;41(18):3363‐3373. doi: 10.1200/JCO.22.01740

102. Archambault AN, Lin Y, Jeon J, et al. Nongenetic determinants of risk for early‐onset colorectal cancer. JNCI Cancer Spectr. 2021;5(3):pkab029. doi: 10.1093/jncics/pkab029

103. Zheng X, Hur J, Nguyen LH, et al. Comprehensive assessment of diet quality and risk of precursors of early‐onset colorectal cancer. J Natl Cancer Inst. 2021;113(5):543‐552. doi: 10.1093/jnci/djaa164

104. Nguyen LH, Cao Y, Hur J, et al. The sulfur microbial diet is associated with increased risk of early‐onset colorectal cancer precursors. Gastroenterology. 2021;161(5):1423‐1432.e4. doi: 10.1053/j.gastro.2021.07.008

105. Wang C, Du M, Kim H, et al. Ultraprocessed food consumption and risk of early‐onset colorectal cancer precursors among women. JAMA Oncol. 2026;12(1):49‐57. doi: 10.1001/jamaoncol.2025.4777

106. Du M, Drew DA, Goncalves MD, Cao Y, Chan AT. Early‐onset colorectal cancer as an emerging disease of metabolic dysregulation. Nat Rev Endocrinol. 2025;21(11):686‐702. doi: 10.1038/s41574-025-01159-z

107. Zepeda‐Rivera M, Minot SS, Bouzek H, et al. A distinct Fusobacterium nucleatum clade dominates the colorectal cancer niche. Nature. 2024;628(8007):424‐432. doi: 10.1038/s41586-024-07182-w

108. Diaz‐Gay M, Dos Santos W, Moody S, et al. Geographic and age variations in mutational processes in colorectal cancer. Nature. 2025;643(8070):230‐240. doi: 10.1038/s41586-025-09025-8

109. Davidson KW, Barry MJ, Mangione CM, et al. Screening for colorectal cancer: US Preventive Services Task Force recommendation statement. JAMA. 2021;325(19):1965‐1977. doi: 10.1001/jama.2021.6238

110. Siegel RL, Wagle NS, Star J, Kratzer TB, Smith RA, Jemal A. Colorectal cancer statistics, 2026. CA Cancer J Clin. 2026;76(2):e70067. doi: 10.3322/caac.70067

111. Star J, Siegel RL, Smith RA, Schafer EJ, Jemal A, Bandi P. Trends in colorectal cancer screening in US adults aged 45 to 49 years. JAMA. 2025;334(9):827. doi: 10.1001/jama.2025.10618

112. Ladabaum U, Mannalithara A, Meester RGS, Gupta S, Schoen RE. Cost‐effectiveness and national effects of initiating colorectal cancer screening for average‐risk persons at age 45 years instead of 50 years. Gastroenterology. 2019;157(1):137‐148. doi: 10.1053/j.gastro.2019.03.023

113. Australian Government, Department of Health, Disability, and Ageing . Who should do the bowel screening test? Australian Government, Department of Health, Disability, and Ageing; 2024. Accessed April 12, 2026. https://www.health.gov.au/our‐work/national‐bowel‐cancer‐screening‐program/doing‐a‐bowel‐screening‐test/who‐should‐do‐the‐bowel‐screening‐test

114. European Commission . European guidelines on colorectal cancer screening and diagnosis. European Commission; 2025. Accessed February 10, 2026. https://cancer‐screening‐and‐care.jrc.ec.europa.eu/en/ecicc/european‐colorectal‐cancer‐guidelines?topic=345&usertype=282&updatef2=1&filter_1=346&filter_2=348&filter_2_selected=348&updatef2=1&updatef20=0&updatef200=0

115. Yiu HY, Whittemore AS, Shibata A. Increasing colorectal cancer incidence rates in Japan. Int J Cancer. 2004;109(5):777‐781. doi: 10.1002/ijc.20030

116. Schliemann D, Ramanathan K, Matovu N, et al. The implementation of colorectal cancer screening interventions in low‐and middle‐income countries: a scoping review. BMC Cancer. 2021;21(1):1125. doi: 10.1186/s12885-021-08809-1

117. Moen L, Liu B, Bukirwa P, et al. Trends in the incidence of colorectal cancer in sub‐Saharan Africa: a population‐based registry study. Int J Cancer. 2024;155(4):675‐682. doi: 10.1002/ijc.34942

118. Joko‐Fru WY, Bardot A, Bukirwa P, et al. Cancer survival in sub‐Saharan Africa (SURVCAN‐3): a population‐based study. Lancet Glob Health. 2024;12(6):e947‐e959. doi: 10.1016/s2214-109x(24)00130-x

119. Arnold M, Rutherford MJ, Bardot A, et al. Progress in cancer survival, mortality, and incidence in seven high‐income countries 1995–2014 (ICBP SURVMARK‐2): a population‐based study. Lancet Oncol. 2019;20(11):1493‐1505. doi: 10.1016/S1470-2045(19)30456-5

120. Araghi M, Soerjomataram I, Jenkins M, et al. Global trends in colorectal cancer mortality: projections to the year 2035. Int J Cancer. 2019;144(12):2992‐3000. doi: 10.1002/ijc.32055

121. Martinez ME, Schmeler KM, Lajous M, Newman LA. Cancer screening in low‐ and middle‐income countries. Am Soc Clin Oncol Educ Book. 2024;44(3):e431272. doi: 10.1200/EDBK_431272

122. World Cancer Research Fund International . Prostate Cancer. World Cancer Research Fund; 2023. Accessed January 16, 2024. https://www.wcrf.org/diet‐activity‐and‐cancer/cancer‐types/prostate‐cancer/

123. Wang A, Shen J, Rodriguez AA, et al. Characterizing prostate cancer risk through multi‐ancestry genome‐wide discovery of 187 novel risk variants. Nat Genet. 2023;55(12):2065‐2074. doi: 10.1038/s41588-023-01534-4

124. Schafer EJ, Laversanne M, Sung H, et al. Recent patterns and trends in global prostate cancer incidence and mortality: an update. Eur Urol. 2025;87(3):302‐313. doi: 10.1016/j.eururo.2024.11.013

125. Center MM, Jemal A, Lortet‐Tieulent J, et al. International variation in prostate cancer incidence and mortality rates. Eur Urol. 2012;61(6):1079‐1092. doi: 10.1016/j.eururo.2012.02.054

126. Kvale R, Auvinen A, Adami HO, et al. Interpreting trends in prostate cancer incidence and mortality in the five Nordic countries. J Natl Cancer Inst. 2007;99(24):1881‐1887. doi: 10.1093/jnci/djm249

127. Zhou CK, Check DP, Lortet‐Tieulent J, et al. Prostate cancer incidence in 43 populations worldwide: an analysis of time trends overall and by age group. Int J Cancer. 2016;138(6):1388‐1400. doi: 10.1002/ijc.29894

128. Pathirana T, Sequeira R, Del Mar C, et al. Trends in prostate specific antigen (PSA) testing and prostate cancer incidence and mortality in Australia: a critical analysis. Cancer Epidemiol. 2022;77:102093. doi: 10.1016/j.canep.2021.102093

129. U.S. Preventive Services Task Force . Screening for prostate cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2008;149(3):185‐191. doi: 10.7326/0003-4819-149-3-200808050-00008

130. Moyer VA; U.S. Preventive Services Task Force . Screening for prostate cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2012;157(2):120‐134. doi: 10.7326/0003-4819-157-2-201207170-00459

131. Tikkinen KAO, Dahm P, Lytvyn L, et al. Prostate cancer screening with prostate‐specific antigen (PSA) test: a clinical practice guideline. BMJ. 2018;362:k3581. doi: 10.1136/bmj.k3581

132. Zargar H, van den Bergh R, Moon D, Lawrentschuk N, Costello A, Murphy D. The impact of the United States Preventive Services Task Force (USPTSTF) recommendations against prostate‐specific antigen (PSA) testing on PSA testing in Australia. BJU Int. 2017;119(1):110‐115. doi: 10.1111/bju.13602

133. Fazekas T, Shim SR, Basile G, et al. Magnetic resonance imaging in prostate cancer screening: a systematic review and meta‐analysis. JAMA Oncol. 2024;10(6):745‐754. doi: 10.1001/jamaoncol.2024.0734

134. Kratzer TB, Mazzitelli N, Star J, Dahut WL, Jemal A, Siegel RL. Prostate cancer statistics, 2025. CA Cancer J Clin. 2025;75(6):485‐497. doi: 10.3322/caac.70028

135. Jemal A, Culp MB, Ma J, Islami F, Fedewa SA. Prostate cancer incidence 5 years after US Preventive Services Task Force recommendations against screening. J Natl Cancer Inst. 2020;113(1):64‐71. doi: 10.1093/jnci/djaa068

136. U.S. Preventive Services Task Force . Final Recommendation Statement. Prostate Cancer: Screening. U.S. Preventive Services Task Force; 2018. Accessed February 1, 2024. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/prostate‐cancer‐screening

137. Seraphin TP, Joko‐Fru WY, Kamate B, et al. Rising prostate cancer incidence in sub‐Saharan Africa: a trend analysis of data from the African Cancer Registry Network. Cancer Epidemiol Biomarkers Prev. 2020;30(1):158‐165. doi: 10.1158/1055-9965.EPI-20-1005

138. Tsodikov A, Gulati R, Heijnsdijk EAM, et al. Reconciling the effects of screening on prostate cancer mortality in the ERSPC and PLCO trials. Ann Intern Med. 2017;167(7):449‐455. doi: 10.7326/M16-2586

139. Etzioni R, Tsodikov A, Mariotto A, et al. Quantifying the role of PSA screening in the US prostate cancer mortality decline. Cancer Causes Control. 2008;19(2):175‐181. doi: 10.1007/s10552-007-9083-8

140. Culp MB, Soerjomataram I, Efstathiou JA, Bray F, Jemal A. Recent global patterns in prostate cancer incidence and mortality rates. Eur Urol. 2020;77(1):38‐52. doi: 10.1016/j.eururo.2019.08.005

141. Vaccarella S, Mengmeng L, Bray F, et al. Prostate cancer incidence and mortality in Europe: a baseline for proposed prostate cancer screening programmes in the European Union. BMJ. 2024;386:e077738. doi: 10.1136/bmj-2023-077738

142. de Martel C, Georges D, Bray F, Ferlay J, Clifford GM. Global burden of cancer attributable to infections in 2018: a worldwide incidence analysis. Lancet Glob Health. 2020;8(2):e180‐e190. doi: 10.1016/S2214-109X(19)30488-7

143. Plummer M, Franceschi S, Vignat J, Forman D, de Martel C. Global burden of gastric cancer attributable to Helicobacter pylori. Int J Cancer. 2015;136(2):487‐490. doi: 10.1002/ijc.28999

144. Chen YC, Malfertheiner P, Yu HT, et al. Global prevalence of Helicobacter pylori infection and incidence of gastric cancer between 1980 and 2022. Gastroenterology. 2024;166(4):605‐619. doi: 10.1053/j.gastro.2023.12.022

145. Kidd M, Lastovica AJ, Atherton JC, Louw JA. Heterogeneity in the Helicobacter pylori vacA and cagA genes: association with gastroduodenal disease in South Africa? Gut. 1999;45(4):499‐502. doi: 10.1136/gut.45.4.499

146. Inoue M. Epidemiology of gastric cancer—changing trends and global disparities. Cancers (Basel). 2024;16(17):2948. doi: 10.3390/cancers16172948

147. Li M, Park JY, Sheikh M, et al. Population‐based investigation of common and deviating patterns of gastric cancer and oesophageal cancer incidence across populations and time. Gut. 2022;72(5):846‐854. doi: 10.1136/gutjnl-2022-328233

148. Yang L, Kartsonaki C, Yao P, et al. The relative and attributable risks of cardia and non‐cardia gastric cancer associated with Helicobacter pylori infection in China: a case–cohort study. Lancet Public Health. 2021;6(12):e888‐e896. doi: 10.1016/s2468-2667(21)00164-x

149. de Martel C, Parsonnet J. Chapter 31. Stomach cancer. In: Thun MJ, Linet MS, Cerhan JR, Haiman CA, Shottenfeld D, eds. Cancer Epidemiology and Prevention. 4th ed. Oxford University Press; 2017:593‐610.

150. Rothenbacher D, Brenner H. Burden of Helicobacter pylori and H. pylori‐related diseases in developed countries: recent developments and future implications. Microbes Infect. 2003;5(8):693‐703. doi: 10.1016/s1286-4579(03)00111-4

151. Ng M, Fleming T, Robinson M, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384(9945):766‐781. doi: 10.1016/S0140-6736(14)60460-8

152. Powell J, McConkey CC. Increasing incidence of adenocarcinoma of the gastric cardia and adjacent sites. Br J Cancer. 1990;62(3):440‐443. doi: 10.1038/bjc.1990.314

153. Devesa SS, Blot WJ, Fraumeni JF Jr. Changing patterns in the incidence of esophageal and gastric carcinoma in the United States. Cancer. 1998;83(10):2049‐2053. doi: 10.1002/(sici)1097-0142(19981115)83:10<2049::aid-cncr1>3.3.co;2-u

154. Sung H, Siegel RL, Rosenberg PS, Jemal A. Emerging cancer trends among young adults in the USA: analysis of a population‐based cancer registry. Lancet Public Health. 2019;4(3):e137‐e147. doi: 10.1016/S2468-2667(18)30267-6

155. Abdulkarim D, Mattsson F, Lagergren J. Recent incidence trends of oesophago‐gastric cancer in Sweden. Acta Oncol. 2022;61(12):1490‐1498. doi: 10.1080/0284186x.2022.2163592

156. Dikken JL, Lemmens VE, Wouters MW, et al. Increased incidence and survival for oesophageal cancer but not for gastric cardia cancer in the Netherlands. Eur J Cancer. 2012;48(11):1624‐1632. doi: 10.1016/j.ejca.2012.01.009

157. Park JY, Georges D, Alberts CJ, Bray F, Clifford G, Baussano I. Global lifetime estimates of expected and preventable gastric cancers across 185 countries. Nat Med. 2025;31(9):3020‐3027. doi: 10.1038/s41591-025-03793-6

158. Ford AC, Yuan Y, Park JY, Forman D, Moayyedi P. Eradication therapy to prevent gastric cancer in Helicobacter pylori‐positive individuals: systematic review and meta‐analysis of randomized controlled trials and observational studies. Gastroenterology. 2025;169(2):261‐276. doi: 10.1053/j.gastro.2024.12.033

159. International Agency for Research on Cancer (IARC) . Population‐based Helicobacter pylori screen‐and‐treat strategies for gastric cancer prevention: guidance on implementation. IARC; 2025. Accessed March 13, 2026. https://www.iarc.who.int/news‐events/population‐based‐helicobacter‐pylori‐screen‐and‐treat‐strategies‐for‐gastric‐cancer‐prevention‐guidance‐on‐implementation/

160. Park JY, Lee YC, Moayyedi P, et al. Helicobacter pylori screen‐and‐treat programs for gastric cancer prevention—IARC Working Group report. N Engl J Med. 2026;394(11):1131‐1137. doi: 10.1056/NEJMsb2515372

161. Areia M, Carvalho R, Cadime AT, Rocha Goncalves F, Dinis‐Ribeiro M. Screening for gastric cancer and surveillance of premalignant lesions: a systematic review of cost‐effectiveness studies. Helicobacter. 2013;18(5):325‐337. doi: 10.1111/hel.12050

162. Saumoy M, Schneider Y, Shen N, Kahaleh M, Sharaiha RZ, Shah SC. Cost effectiveness of gastric cancer screening according to race and ethnicity. Gastroenterology. 2018;155(3):648‐660. doi: 10.1053/j.gastro.2018.05.026

163. Chen R, Liu Y, Song G, et al. Effectiveness of one‐time endoscopic screening programme in prevention of upper gastrointestinal cancer in China: a multicentre population‐based cohort study. Gut. 2021;70(2):251‐260. doi: 10.1136/gutjnl-2019-320200

164. Hamashima C; Systematic Review Group and Guideline Development Group for Gastric Cancer Screening Guidelines . Update version of the Japanese guidelines for gastric cancer screening. Jpn J Clin Oncol. 2018;48(7):673‐683. doi: 10.1093/jjco/hyy077

165. Sun D, Mulder DT, Li Y, et al. The effect of nationwide organized cancer screening programs on gastric cancer mortality: a synthetic control study. Gastroenterology. 2024;166(3):503‐514. doi: 10.1053/j.gastro.2023.11.286

166. Huang RJ, Koh H, Hwang JH, et al. A summary of the 2020 Gastric Cancer Summit at Stanford University. Gastroenterology. 2020;159(4):1221‐1226. doi: 10.1053/j.gastro.2020.05.100

167. Park SH, Kang MJ, Yun EH, Jung KW. Epidemiology of gastric cancer in Korea: trends in incidence and survival based on Korea Central Cancer Registry data (1999–2019). J Gastric Cancer. 2022;22(3):160‐168. doi: 10.5230/jgc.2022.22.e21

168. National Cancer Institute; Surveillance, Epidemiology, and End Results (SEER) Program; Cancer Statistics Explorer Network . SEER*Explorer; An interactive website for SEER cancer statistics [Internet]. Data source(s): SEER Incidence Data, November 2024 Submission (1975–2022), SEER 21 registries (excluding Illinois). Expected Survival Life Tables by Socio‐Economic Standards. Surveillance Research Program, National Cancer Institute; 2026. Accessed March 4, 2026. https://seer.cancer.gov/statistics‐network/explorer/

169. Li M, Dal Maso L, Pizzato M, Vaccarella S. Evolving epidemiological patterns of thyroid cancer and estimates of overdiagnosis in 2013–17 in 63 countries worldwide: a population‐based study. Lancet Diabetes Endocrinol. 2024;12(11):824‐836. doi: 10.1016/S2213-8587(24)00223-7

170. Miranda‐Filho A, Lortet‐Tieulent J, Bray F, et al. Thyroid cancer incidence trends by histology in 25 countries: a population‐based study. Lancet Diabetes Endocrinol. 2021;9(4):225‐234. doi: 10.1016/s2213-8587(21)00027-9

171. Vaccarella S, Franceschi S, Bray F, Wild CP, Plummer M, Dal Maso L. Worldwide thyroid‐cancer epidemic? The increasing impact of overdiagnosis. N Engl J Med. 2016;375(7):614‐617. doi: 10.1056/NEJMp1604412

172. Li M, Dal Maso L, Pizzato M, Rumgay H, Vaccarella S. Thyroid cancer in adolescents and young adults: a population‐based study in 185 countries worldwide. Lancet Diabetes Endocrinol. 2026;14(2):112‐122. doi: 10.1016/s2213-8587(25)00289-x

173. Panato C, Vaccarella S, Dal Maso L, et al. Thyroid cancer incidence in India between 2006 and 2014 and impact of overdiagnosis. J Clin Endocrinol Metab. 2020;105(8):105‐2514. doi: 10.1210/clinem/dgaa192

174. Filetti S, Durante C, Hartl D, et al. Thyroid cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow‐up. Ann Oncol. 2019;30(12):1856‐1883. doi: 10.1093/annonc/mdz400

175. Li M, Meheus F, Polazzi S, et al. The economic cost of thyroid cancer in France and the corresponding share associated with treatment of overdiagnosed cases. Value Health. 2023;26(8):1175‐1182. doi: 10.1016/j.jval.2023.02.016

176. US Preventive Services Task Force ; Bibbins‐Domingo K, Grossman DC, et al. Screening for thyroid cancer: US Preventive Services Task Force recommendation statement. JAMA. 2017;317(18):1882‐1887. doi: 10.1001/jama.2017.4011

177. Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016;26(1):1‐133. doi: 10.1089/thy.2015.0020

178. Ho AS, Kim S, Zalt C, et al. Expanded parameters in active surveillance for low‐risk papillary thyroid carcinoma: a nonrandomized controlled trial. JAMA Oncol. 2022;8(11):1588‐1596. doi: 10.1001/jamaoncol.2022.3875

179. Roman BR, Brito JP, Saucke MC, et al. National survey of endocrinologists and surgeons regarding active surveillance for low‐risk papillary thyroid cancer. Endocr Pract. 2021;27(1):1‐7. doi: 10.1016/j.eprac.2020.11.003

180. Kitahara CM, Schneider AB. Epidemiology of thyroid cancer. Cancer Epidemiol Biomarkers Prev. 2022;31(7):1284‐1297. doi: 10.1158/1055-9965.EPI-21-1440

181. Rumgay H, Ferlay J, de Martel C, et al. Global, regional and national burden of primary liver cancer by subtype. Eur J Cancer. 2022;161:108‐118. doi: 10.1016/j.ejca.2021.11.023

182. McGlynn KA, Petrick JL, Groopman JD. Liver cancer: progress and priorities. Cancer Epidemiol Biomarkers Prev. 2024;33(10):1261‐1272. doi: 10.1158/1055-9965.EPI-24-0686

183. Smith JW, Kroker‐Lobos MF, Lazo M, et al. Aflatoxin and viral hepatitis exposures in Guatemala: molecular biomarkers reveal a unique profile of risk factors in a region of high liver cancer incidence. PLoS One. 2017;12(12):e0189255. doi: 10.1371/journal.pone.0189255

184. Bereziartua A, Huss A, Kers JG, Smit LAM, Vermeulen R, Figueiredo DM. Pre‐harvest aflatoxin contamination in crops and climate change factors: a European overview. Toxins (Basel). 2025;17(7):344. doi: 10.3390/toxins17070344

185. Prueksapanich P, Piyachaturawat P, Aumpansub P, Ridtitid W, Chaiteerakij R, Rerknimitr R. Liver fluke‐associated biliary tract cancer. Gut Liver. 2018;12(3):236‐245. doi: 10.5009/gnl17102

186. Petrick JL, Yang B, Altekruse SF, et al. Risk factors for intrahepatic and extrahepatic cholangiocarcinoma in the United States: a population‐based study in SEER–Medicare. PLoS One. 2017;12(10):e0186643. doi: 10.1371/journal.pone.0186643

187. Petrick JL, Florio AA, Loomba R, McGlynn KA. Have incidence rates of liver cancer peaked in the United States? Cancer. 2020;126(13):3151‐3155. doi: 10.1002/cncr.32794

188. Burton A, Tataru D, Driver RJ, et al. Primary liver cancer in the UK: incidence, incidence‐based mortality, and survival by subtype, sex, and nation. JHEP Rep. 2021;3(2):100232. doi: 10.1016/j.jhepr.2021.100232

189. Alvarez CS, Wojt A, Almeida AA, et al. Rising intrahepatic cholangiocarcinoma rates in the United States are driving liver cancer rates in females. Clin Gastroenterol Hepatol. Published online December 22, 2025. doi: 10.1016/j.cgh.2025.12.013

190. Petrick JL, Florio AA, Znaor A, et al. International trends in hepatocellular carcinoma incidence, 1978–2012. Int J Cancer. 2020;147(2):317‐330. doi: 10.1002/ijc.32723

191. Chen T, Zhang Y, Liu J, et al. Trends in liver cancer mortality in China from 1990 to 2019: a systematic analysis based on the Global Burden of Disease Study 2019. BMJ Open. 2023;13(12):e074348. doi: 10.1136/bmjopen-2023-074348

192. Chang MH, Chen CJ, Lai MS, et al. Universal hepatitis B vaccination in Taiwan and the incidence of hepatocellular carcinoma in children. Taiwan Childhood Hepatoma Study Group. N Engl J Med. 1997;336(26):1855‐1859. doi: 10.1056/nejm199706263362602

193. Florio AA, Ferlay J, Znaor A, et al. Global trends in intrahepatic and extrahepatic cholangiocarcinoma incidence from 1993 to 2012. Cancer. 2020;126(11):2666‐2678. doi: 10.1002/cncr.32803

194. World Health Organization . Global hepatitis report 2024. Action for access in low‐ and middle‐income countries. World Health Organization; 2024. Accessed February 4, 2024. https://www.globalhep.org/sites/default/files/content/resources/files/2024‐04/2024%20Global%20Hepatitis%20Report%20‐%20WHO.pdf

195. World Health Organization . Immunization coverage. World Health Organization; 2025. Accessed February 4, 2024. https://www.who.int/news‐room/fact‐sheets/detail/immunization‐coverage

196. Cui F, Blach S, Manzengo Mingiedi C, et al. Global reporting of progress towards elimination of hepatitis B and hepatitis C. Lancet Gastroenterol Hepatol. 2023;8(4):332‐342. doi: 10.1016/S2468-1253(22)00386-7

197. Hiebert L, Ward JW. Strategic information to guide elimination of viral hepatitis. Lancet Gastroenterol Hepatol. 2023;8(4):291‐292. doi: 10.1016/S2468-1253(22)00433-2

198. Salomon I, Olivier S, Egide N. Advancing hepatitis C elimination in Africa: insights from Egypt. Hepat Med. 2024;16:37‐44. doi: 10.2147/HMER.S470344

199. Waked I, Esmat G, Elsharkawy A, et al. Screening and treatment program to eliminate hepatitis C in Egypt. N Engl J Med. 2020;382(12):1166‐1174. doi: 10.1056/NEJMsr1912628

200. Malagón T, Franco EL, Tejada R, Vaccarella S. Epidemiology of HPV‐associated cancers past, present and future: towards prevention and elimination. Nat Rev Clin Oncol. 2024;21(7):522‐538. doi: 10.1038/s41571-024-00904-z

201. International Agency for Research and Treatment of Cancer (IARC) . Cervix Cancer Screening. IARC Handbooks of Cancer Prevention. Vol. 10. IARC Press; 2005. Accessed April 12, 2026. http://www.iarc.fr/en/publications/pdfs‐online/prev/handbook10/HANDBOOK10.pdf

202. Bray F, Carstensen B, Moller H, et al. Incidence trends of adenocarcinoma of the cervix in 13 European countries. Cancer Epidemiol Biomarkers Prev. 2005;14(9):2191‐2199. doi: 10.1158/1055-9965.epi-05-0231

203. Bray F, Loos AH, McCarron P, et al. Trends in cervical squamous cell carcinoma incidence in 13 European countries: changing risk and the effects of screening. Cancer Epidemiol Biomarkers Prev. 2005;14(3):677‐686. doi: 10.1158/1055-9965.epi-04-0569

204. Utada M, Chernyavskiy P, Lee WJ, et al. Increasing risk of uterine cervical cancer among young Japanese women: comparison of incidence trends in Japan, South Korea and Japanese‐Americans between 1985 and 2012. Int J Cancer. 2019;144(9):2144‐2152. doi: 10.1002/ijc.32014

205. Castanon A, Sasieni P. Is the recent increase in cervical cancer in women aged 20–24 years in England a cause for concern? Prev Med. 2018;107:21‐28. doi: 10.1016/j.ypmed.2017.12.002

206. McDonald SA, Qendri V, Berkhof J, de Melker HE, Bogaards JA. Disease burden of human papillomavirus infection in the Netherlands, 1989–2014: the gap between females and males is diminishing. Cancer Causes Control. 2017;28(3):203‐214. doi: 10.1007/s10552-017-0870-6

207. Munoz N, Franceschi S, Bosetti C, et al. Role of parity and human papillomavirus in cervical cancer: the IARC multicentric case–control study. Lancet. 2002;359(9312):1093‐1101. doi: 10.1016/S0140-6736(02)08151-5

208. Shen X, Cheng Y, Ren F, Shi Z. The burden of cervical cancer in China. Front Oncol. 2022;12:979809. doi: 10.3389/fonc.2022.979809

209. Xiao C, Deng J, Ren F, Zhang C. Cervical cancer burden among females under 40 years in China, Japan, and South Korea, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021. Front Public Health. 2025;13:1695004. doi: 10.3389/fpubh.2025.1695004

210. Jedy‐Agba E, Joko WY, Liu B, et al. Trends in cervical cancer incidence in sub‐Saharan Africa. Br J Cancer. 2020;123(1):148‐154. doi: 10.1038/s41416-020-0831-9

211. Stelzle D, Tanaka LF, Lee KK, et al. Estimates of the global burden of cervical cancer associated with HIV. Lancet Glob Health. 2021;9(2):e161‐e169. doi: 10.1016/S2214-109X(20)30459-9

212. International Agency for Research and Treatment of Cancer (IARC.) Biological Agents . IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Vol. 100B. IARC; 2012. Accessed February 11, 2026. https://publications.iarc.who.int/Book‐And‐Report‐Series/Iarc‐Monographs‐On‐The‐Identification‐Of‐Carcinogenic‐Hazards‐To‐Humans/Biological‐Agents‐2012

213. World Health Organization . Global strategy to accelerate the elimination of cervical cancer as a public health problem. World Health Organization; 2020. Accessed December 18, 2023. https://www.who.int/publications/i/item/9789240014107

214. Bruni L, Serrano B, Roura E, et al. Cervical cancer screening programmes and age‐specific coverage estimates for 202 countries and territories worldwide: a review and synthetic analysis. Lancet Glob Health. 2022;10(8):e1115‐e1127. doi: 10.1016/S2214-109X(22)00241-8

215. World Health Organization . One‐dose human papillomavirus (HPV) vaccine offers solid protection against cervical cancer. World Health Organization; 2022. Accessed March 8, 2026. https://www.who.int/news/item/11‐04‐2022‐one‐dose‐human‐papillomavirus‐(hpv)‐vaccine‐offers‐solid‐protection‐against‐cervical‐cancer

216. Kreimer AR, Watson‐Jones D, Kim JJ, Dull P. Single‐dose human papillomavirus vaccination: an update. J Natl Cancer Inst Monogr. 2024;2024(67):313‐316. doi: 10.1093/jncimonographs/lgae030

217. Slavkovsky R, Mvundura M, Debellut F, Naddumba T. Evaluating potential program cost savings with a single‐dose HPV vaccination schedule: a modeling study. J Natl Cancer Inst Monogr. 2024;2024(67):371‐378. doi: 10.1093/jncimonographs/lgae037

218. Simms KT, Keane A, Nguyen DTN, et al. Benefits, harms and cost‐effectiveness of cervical screening, triage and treatment strategies for women in the general population. Nat Med. 2023;29(12):3050‐3058. doi: 10.1038/s41591-023-02600-4

219. World Health Organization . Immunization, Vaccines, and Biologicals. World Health Organization; 2025. Accessed March 10, 2026. https://www.who.int/teams/immunization‐vaccines‐and‐biologicals/diseases/human‐papillomavirus‐vaccines‐(HPV)/hpv‐clearing‐house/hpv‐dashboard

220. World Health Organization Regional Office for Africa (WHO Africa) . Cervical cancer elimination: Kenya transitions to single‐dose HPV vaccination schedule. WHO Africa; 2025. Accessed March 8, 2026. https://www.afro.who.int/photo‐story/cervical‐cancer‐elimination‐kenya‐transitions‐single‐dose‐hpv‐vaccination‐schedule

221. World Health Organization . China takes historic step to protect women’s health: HPV vaccine joins national immunization programme [news release]. World Health Organization; October 31, 2025. Accessed March 8, 2026. https://www.who.int/china/news/detail/31‐10‐2025‐china‐takes‐historic‐step‐to‐protect‐women‐s‐health‐‐hpv‐vaccine‐joins‐national‐immunization‐programme?utm_source=chatgpt.com

222. Inturrisi F, Aitken CA, Melchers WJG, et al. Clinical performance of high‐risk HPV testing on self‐samples versus clinician samples in routine primary HPV screening in the Netherlands: an observational study. Lancet Reg Health Eur. 2021;11:100235. doi: 10.1016/j.lanepe.2021.100235

223. Smith M, Hammond I, Saville M. Lessons from the renewal of the National Cervical Screening Program in Australia. Public Health Res Pract. 2019;29(2):e2921914. doi: 10.17061/phrp2921914

224. Serrano B, Ibanez R, Robles C, Peremiquel‐Trillas P, de Sanjose S, Bruni L. Worldwide use of HPV self‐sampling for cervical cancer screening. Prev Med. 2022;154:106900. doi: 10.1016/j.ypmed.2021.106900

225. Perkins RB, Wolf AMD, Church TR, et al. Self‐collected vaginal specimens for human papillomavirus testing and guidance on screening exit: an update to the American Cancer Society cervical cancer screening guideline. CA Cancer J Clin. 2026;76(1):e70041. doi: 10.3322/caac.70041

226. Hall MT, Simms KT, Lew JB, et al. The projected timeframe until cervical cancer elimination in Australia: a modelling study. Lancet Public Health. 2019;4(1):e19‐e27. doi: 10.1016/S2468-2667(18)30183-X

227. Moore SP, Antoni S, Colquhoun A, et al. Cancer incidence in indigenous people in Australia, New Zealand, Canada, and the USA: a comparative population‐based study. Lancet Oncol. 2015;16(15):1483‐1492. doi: 10.1016/S1470-2045(15)00232-6

228. Sultana F, Smith M, Saville M, et al. Uptake and performance of self‐collection offered through primary care to all eligible participants in a national cervical screening programme in Australia: a retrospective cohort study. Lancet Public Health. 2026;11(2):e101‐e110. doi: 10.1016/S2468-2667(25)00304-4

229. World Health Organization . WHO guideline for screening and treatment of cervical pre‐cancer lesions for cervical cancer prevention, 2nd ed. World Health Organization; 2021. Accessed April, 12. 2026. https://iris.who.int/server/api/core/bitstreams/329a5f3d‐b423‐48b3‐beb1‐26ee1240c0a3/content

230. Ilic I, Ilic M. International patterns in incidence and mortality trends of pancreatic cancer in the last three decades: a joinpoint regression analysis. World J Gastroenterol. 2022;28(32):4698‐4715. doi: 10.3748/wjg.v28.i32.4698

231. Carioli G, Malvezzi M, Bertuccio P, et al. European cancer mortality predictions for the year 2021 with focus on pancreatic and female lung cancer. Ann Oncol. 2021;32(4):478‐487. doi: 10.1016/j.annonc.2021.01.006

232. World Cancer Research Fund International . Pancreatic cancer statistics. World Cancer Research Fund International; 2018. Accessed April 12, 2026. http://www.wcrf.org/int/cancer‐facts‐figures/data‐specific‐cancers/pancreatic‐cancer‐statistics

233. Dasari A, Wallace K, Halperin DM, et al. Epidemiology of neuroendocrine neoplasms in the US. JAMA Netw Open. 2025;8(6):e2515798. doi: 10.1001/jamanetworkopen.2025.15798

234. Abboud Y, Shah A, Sutariya R, et al. Gastroenteropancreatic neuroendocrine tumor incidence by sex and age in the US. JAMA Oncol. 2025;11(3):345. doi: 10.1001/jamaoncol.2024.5937

235. Bosman FT, Carneiro F, Hruban RH, Theise ND, eds. WHO Classification of Tumours of the Digestive System. 4th ed. International Agency for Research on Cancer; 2010. Accessed April 12, 2026. https://publications.iarc.who.int/Book‐And‐Report‐Series/Who‐Classification‐Of‐Tumours/WHO‐Classification‐Of‐Tumours‐Of‐The‐Digestive‐System‐2010

236. McGuigan A, Kelly P, Turkington RC, Jones C, Coleman HG, McCain RS. Pancreatic cancer: a review of clinical diagnosis, epidemiology, treatment and outcomes. World J Gastroenterol. 2018;24(43):4846‐4861. doi: 10.3748/wjg.v24.i43.4846

237. Mizrahi JD, Surana R, Valle JW, Shroff RT. Pancreatic cancer. Lancet. 2020;395(10242):2008‐2020. doi: 10.1016/S0140-6736(20)30974-0

238. Cabasag CJ, Arnold M, Rutherford M, et al. Pancreatic cancer survival by stage and age in seven high‐income countries (ICBP SURVMARK‐2): a population‐based study. Br J Cancer. 2022;126(12):1774‐1782. doi: 10.1038/s41416-022-01752-3

239. Jackson SS, Marks MA, Katki HA, et al. Sex disparities in the incidence of 21 cancer types: quantification of the contribution of risk factors. Cancer. 2022;128(19):3531‐3540. doi: 10.1002/cncr.34390

240. Semnani SH, Besharat S, Abdolahi N, et al. Esophageal cancer in northeastern Iran. Indian J Gastroenterol. 2005;24(5):224.

241. Van Loon K, Mwachiro MM, Abnet CC, et al. The African Esophageal Cancer Consortium: a call to action. J Glob Oncol. 2018;4:1‐9. doi: 10.1200/JGO.17.00163

242. De Stefani E, Deneo‐Pellegrini H, Ronco AL, et al. Diet patterns and risk of squamous cell oesophageal carcinoma: a case–control study in Uruguay. Asian Pac J Cancer Prev. 2014;15(6):2765‐2769. doi: 10.7314/apjcp.2014.15.6.2765

243. Lin J, Zeng R, Cao W, Luo R, Chen J, Lin Y. Hot beverage and food intake and esophageal cancer in southern China. Asian Pac J Cancer Prev. 2011;12(9):2189‐2192.

244. Islami F, Poustchi H, Pourshams A, et al. A prospective study of tea drinking temperature and risk of esophageal squamous cell carcinoma. Int J Cancer. 2020;146(1):18‐25. doi: 10.1002/ijc.32220

245. Malekzadeh MM, Khademi H, Pourshams A, et al. Opium use and risk of mortality from digestive diseases: a prospective cohort study. Am J Gastroenterol. 2013;108(11):1757‐1765. doi: 10.1038/ajg.2013.336

246. McCormack VA, Menya D, Munishi MO, et al. Informing etiologic research priorities for squamous cell esophageal cancer in Africa: a review of setting‐specific exposures to known and putative risk factors. Int J Cancer. 2017;140(2):259‐271. doi: 10.1002/ijc.30292

247. van Rensburg SJ, Benade AS, Rose EF, du Plessis JP. Nutritional status of African populations predisposed to esophageal cancer. Nutr Cancer. 1983;4(3):206‐216. doi: 10.1080/01635588209513759

248. Sheikh M, Poustchi H, Pourshams A, et al. Individual and combined effects of environmental risk factors for esophageal cancer based on results from the Golestan Cohort Study. Gastroenterology. 2019;156(5):1416‐1427. doi: 10.1053/j.gastro.2018.12.024

249. Dar NA, Islami F, Bhat GA, et al. Poor oral hygiene and risk of esophageal squamous cell carcinoma in Kashmir. Br J Cancer. 2013;109(5):1367‐1372. doi: 10.1038/bjc.2013.437

250. Tran GD, Sun XD, Abnet CC, et al. Prospective study of risk factors for esophageal and gastric cancers in the Linxian general population trial cohort in China. Int J Cancer. 2005;113(3):456‐463. doi: 10.1002/ijc.20616

251. Blot WJ, Tarone RE. Chapter 30. Esophageal cancer. In: Thun MJ, Linet MS, Cerhan JR, Haiman CA, Shottenfeld D, eds. Cancer Epidemiology and Prevention. 4th ed. Oxford University Press; 2017:579‐592.

252. Arnold M, Soerjomataram I, Ferlay J, Forman D. Global incidence of oesophageal cancer by histological subtype in 2012. Gut. 2015;64(3):381‐387. doi: 10.1136/gutjnl-2014-308124

253. Rumgay H, Arnold M, Laversanne M, et al. International trends in esophageal squamous cell carcinoma and adenocarcinoma incidence. Am J Gastroenterol. 2021;116(5):1072‐1076. doi: 10.14309/ajg.0000000000001121

254. United Nations . Our growing population. Accessed February 3, 2024. https://www.un.org/en/global‐issues/population#:~:text=The%20world%20population%20is%20projected,surrounding%20these%20latest%20population%20projections

255. Bray F, Colombet M, Aitken J, et al., eds. Cancer Incidence in Five Continents. Vol. XII (IARC CancerBase No. 19). International Agency for Research on Cancer; 2023. Accessed January 26, 2024. https://ci5.iarc.who.int

256. World Health Organization . WHO methods and data sources for country‐level causes of death 2000‐2019. World Health Organization; 2020. Accessed May 20, 2026. https://iris.who.int/handle/10665/374896

257. International Agency for Research on Cancer/World Health Organization . The Global Initiative for Cancer Registry Development. International Agency for Research on Cancer. Accessed January 28, 2024. https://gicr.iarc.who.int

258. Brennan A, McDevitt J, Heidarian Miri H, et al. The initial impact of COVID‐19 on cancer in Ireland: incidence, stage at diagnosis, mortality and 1‐year survival. National Cancer Registry Ireland; 2025.Accessed April 1, 2026. https://www.ncri.ie/en/reports‐publications/reports/the‐initial‐impact‐of‐covid‐19‐on‐cancer‐in‐ireland‐incidence‐stage‐at

259. Hartman HE, Sun Y, Devasia TP, et al. Integrated survival estimates for cancer treatment delay among adults with cancer during the COVID‐19 pandemic. JAMA Oncol. 2020;6(12):1881. doi: 10.1001/jamaoncol.2020.5403

260. Burus T, Damgacioglu H, Huang B, Tucker TC, Deshmukh AA, Lang Kuhs KA. Survival of patients diagnosed with cancer during the COVID‐19 pandemic. JAMA Oncol. 2026;12(4):356. doi: 10.1001/jamaoncol.2025.6332

261. Johansson A, Skog A, Johannesen TB, et al. Changes in cancer incidence and stage during the COVID‐19 pandemic in 2020–2021 in the Nordic countries. Acta Oncol. 2025;64:257‐266. doi: 10.2340/1651-226X.2025.42079

262. Wei W, Zeng H, Zheng R, et al. Cancer registration in China and its role in cancer prevention and control. Lancet Oncol. 2020;21(7):e342‐e349. doi: 10.1016/S1470-2045(20)30073-5

263. World Health Organization, International Agency for Research on Cancer . SURVCAN Database. Accessed April 1, 2026. https://gco.iarc.who.int/survival/survcan/database

264. Soerjomataram I, Bray F. Planning for tomorrow: global cancer incidence and the role of prevention 2020–2070. Nat Rev Clin Oncol. 2021;18(10):663‐672. doi: 10.1038/s41571-021-00514-z

265. World Health Organization (WHO) , eds. Noncommunicable Diseases Progress Monitor. Noncommunicable Diseases, Rehabilitation and Disability (NCD), Surveillance, Monitoring and Reporting (SMR). WHO; 2025. Accessed March 13, 2026. https://www.who.int/publications/i/item/9789240105775