Rongshou Zheng

Objective: Colorectal cancer (CRC) is the third most common cancer and the second leading cause of cancer-related mortality worldwide. This study was aimed at estimating regional and national variations in lifetime CRC risk worldwide. Methods: CRC data were extracted from GLOBOCAN 2022, including 185 countries, and population and all-cause mortality data were sourced from the United Nations. The world was divided into 20 geographical regions and categorized by Human Development Index (HDI). Lifetime CRC risk was estimated with the life table method, adjusted for multiple primary cancers. Results: In 2022, the lifetime risks of developing and dying from CRC were 2.69% [95% confidence interval (CI): 2.68–2.70] and 1.39% (95% CI: 1.39–1.40), respectively. Men had a higher risk of colon cancer than rectal cancer, and higher CRC risk than women. Lifetime risk varied by region and HDI: regions with very high, high, moderate, and low HDI had incidence risks of 5.17%, 2.75%, 0.72%, and 0.57%, respectively, and mortality risks of 2.48%, 1.50%, 0.44%, and 0.41%, respectively. Australia/New Zealand had the highest incidence risk (7.41%, 95% CI: 7.30–7.52), and Northern Europe the highest mortality risk (3.28%, 95% CI: 3.24–3.32). Risks were stable before 40 years of age, peaked in middle age, and declined after 70 years of age. Temporally, Thailand had the highest increasing trend in lifetime risk, whereas the United States and Austria showed a decreasing trend. Conclusions: Lifetime CRC risk differs by subtype, sex, HDI, and geography, and residual risk gradually decreases with age. Targeted primary prevention strategies should be implemented in various countries and regions to mitigate CRC burden.

Objective: Breast cancer is the most frequently diagnosed cancer among women worldwide and is a leading cause of cancer-related deaths. Comparative assessments of breast cancer lifetime risks across populations are limited. This study estimated the global, regional, and national lifetime risks, temporal trends, and socioeconomic inequalities in the burden of breast cancer. Methods: Using incidence and mortality data from GLOBOCAN 2022 (185 countries) and United Nations population and all-cause death data, lifetime risks were calculated using the adjusted for multiple primaries (AMP) method, which could adjust for multiple primary cancers, competing risks of other causes death, and life expectancy. Longitudinal data of breast cancer incidence from 2003–2017 were retrieved from the Cancer Incidence in Five Continents (CI5) Plus database. The temporal trends for breast cancer deaths were abstracted from the WHO Mortality Database. The lifetime risk of developing and dying from breast cancer were analyzed by socioeconomic characteristics, 20 predefined geographic regions and menopausal status. Results: The overall worldwide lifetime risk of developing and dying from breast cancer was 5.51% (95% CI: 5.50%–5.52%) and 1.82% (95% CI: 1.82%–1.83%) in 2022, respectively. The estimated lifetime risks of developing breast cancer had a positive relationship with Human Development Index (HDI) levels and corresponding risks of 10.37%, 4.42%, 2.96%, and 2.91% in very high, high, middle, and low HDI regions, respectively. Very high HDI regions presented the highest lifetime risk of breast cancer death (2.70%), followed by low HDI (1.70%), medium HDI (1.54%), and high (1.38%) HDI regions. A significant correlation was identified between lifetime risks and health economics capacity. The lifetime risk of developing and dying from breast cancer primarily involved individuals ≥ 55 years of age with remaining risks of 3.77% (developing) and 1.43% (dying) from 55 years to death. The proportion of lifetime risks among individuals 0–44 years of age was higher in Africa regions compared to other regions. In surveillance data from 36 countries, a significant increasing trend in the average annual percentage change (AAPC) was noted in 32 countries, which ranged from 0.17% in the United States to 5.84% in the Republic of Korea. Conclusions: Globally, an estimated 1 in 18 individuals were diagnosed with breast cancer during their lifetime and approximately 1 in 55 died from the disease in 2022. Lifetime risk of breast cancer disparities reveal the socioeconomic inequalities of breast cancer. Therefore, country-tailored intervention plans for breast cancer require prioritization within precision prevention to mitigate global breast cancer inequities and burden.

Background: Peptic ulcer disease (PUD) is a common digestive system disorder and an important risk factor for gastric cancer. While previous studies have extensively focused on using traditional indicators, lifetime risks of PUD remain relatively scarce. Methods: Using Global Burden of Disease (GBD) 2021 data, we estimated lifetime risks of developing and dying from PUD by lifetable method.Trends were assessed by calculating the average annual percent change (AAPC) from 1990 to 2021. By computing the sex ratios(male to female) of lifetime risks and plotting time-trend graphs, we analyzed the dynamic evolution of sex differences. Results: In 2021, the global lifetime risk of developing from PUD was 3.21% (95% CI, 3.20%-3.22%), declining from 1990 (AAPC: -1.24; 95% CI, -1.37 to -1.11), with a more pronounced decrease among males (AAPC: -1.43; 95% CI, -1.53 to -1.33) than females (AAPC: -1.00; 95% CI, -1.10 to -0.89). The lifetime risk of dying from PUD was 0.35% (95% CI, 0.34%-0.35%), with a faster decline (AAPC, -2.25; 95% CI, -2.57 to -1.93), again with greater in males (AAPC: -2.73; 95% CI, -2.86 to -2.60) than in females (AAPC: -1.80; 95% CI, -2.00 to -1.60). Marked socioeconomic disparities were observed: high-SDI regions had the highest lifetime risk of developing but the lowest risk of dying, whereas low-SDI regions showed the opposite pattern. Across different SDI regions, the sex ratios of lifetime risk of PUD exhibited unique inflection points over three decades. Conclusion: Despite substantial global declines in lifetime risks of PUD over the past three decades, our findings reveal persistent inequities by SDI, geography, and sex. These disparities underscore that access to timely diagnosis, eradication therapy, and advanced endoscopic care remains uneven, particularly in low-SDI regions and among females.

Background: Brain and central nervous system (CNS) tumors pose a major global health challenge. However, the distribution of histological subtypes remains limited. We aims to quantify the global, regional, and national incidence of brain and CNS tumors by histological subtype in 2022 and analyze variations across age groups and human development [Human Development Index (HDI)] levels. Methods: Data from GLOBOCAN and Cancer Incidence in Five Continents Volume X–XII were extracted. Nine histological subtypes of brain and CNS tumors were identified. The number of incident cases and age-standardized incidence rates (ASIRs) for each histological subtype, stratified by age group (0–19 vs. ≥20 years) and HDI levels, and ASIR were calculated using the world standard population. Trends in brain and CNS tumor incidence by histological subtypes from 2003 to 2017 were assessed using Joinpoint regression. Findings: In 2022, an estimated 321 370 new cases of brain and CNS tumors were diagnosed globally (ASIR: 34.6 per million population). Astrocytic tumors accounted for the largest proportion (173 763 cases; ASIR: 18.5), followed by meningeal tumors (43 796 cases; ASIR: 4.6), gliomas of uncertain origin (43 094 cases; ASIR: 4.7), and oligodendroglia/mixed gliomas (22 673 cases; ASIR: 2.4). Age-specific distributions revealed astrocytic tumors predominant in both children/adolescents (37.4%) and adults (55.9%), whereas medulloblastoma was the most common subtype in children/adolescents (17.4%) and meningeal tumors in adults (14.6%). Considerable variations in subtype proportions and ASIR were observed across countries and in HDI levels. Temporal trends of brain and CNS tumor ASIR varied considerably among sex, regions and histology types Interpretation: Astrocytic tumors were the most prevalent histological subtype of brain and CNS tumors in 2022. These findings enhance our understanding of the epidemiology of brain tumors and underscore the need for tailored prevention and resource allocation strategies at national levels.

Supplementary Figure 1 shows the geographic distribution and population coverage of 782 counties included in final analyses, along with the population density of China.

Supplementary Figure 2 was a scatter diagram of the age-standardized esophageal cancer mortality rate in 1973-1975 and the absolute change in mortality rates from 1973–1975 to 2015–2017.

Supplementary Table 1 shows three major measures of data quality of cancer registries included in this study.