Cancer statistics for the year 2020: An overview

International Journal of CancerVolume 149, Issue 4 p. 778-789 Cancer EpidemiologyFree Access Cancer statistics for the year 2020: An overview Jacques Ferlay, Corresponding Author Jacques Ferlay [email protected] orcid.org/0000-0003-4927-6932 Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon Cedex, France Correspondence Jacques Ferlay, Cancer Surveillance Branch, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France. Email: [email protected]Search for more papers by this authorMurielle Colombet, Murielle Colombet Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon Cedex, FranceSearch for more papers by this authorIsabelle Soerjomataram, Isabelle Soerjomataram Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon Cedex, FranceSearch for more papers by this authorDonald M. Parkin, Donald M. Parkin orcid.org/0000-0002-3229-1784 School of Cancer & Pharmaceutical Sciences, King's College London, London, UK CTSU, Nuffield Department of Population Health, University of Oxford, Oxford, UKSearch for more papers by this authorMarion Piñeros, Marion Piñeros Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon Cedex, FranceSearch for more papers by this authorAriana Znaor, Ariana Znaor orcid.org/0000-0002-5849-4782 Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon Cedex, FranceSearch for more papers by this authorFreddie Bray, Freddie Bray orcid.org/0000-0002-3248-7787 Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon Cedex, FranceSearch for more papers by this author Jacques Ferlay, Corresponding Author Jacques Ferlay [email protected] orcid.org/0000-0003-4927-6932 Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon Cedex, France Correspondence Jacques Ferlay, Cancer Surveillance Branch, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France. Email: [email protected]Search for more papers by this authorMurielle Colombet, Murielle Colombet Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon Cedex, FranceSearch for more papers by this authorIsabelle Soerjomataram, Isabelle Soerjomataram Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon Cedex, FranceSearch for more papers by this authorDonald M. Parkin, Donald M. Parkin orcid.org/0000-0002-3229-1784 School of Cancer & Pharmaceutical Sciences, King's College London, London, UK CTSU, Nuffield Department of Population Health, University of Oxford, Oxford, UKSearch for more papers by this authorMarion Piñeros, Marion Piñeros Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon Cedex, FranceSearch for more papers by this authorAriana Znaor, Ariana Znaor orcid.org/0000-0002-5849-4782 Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon Cedex, FranceSearch for more papers by this authorFreddie Bray, Freddie Bray orcid.org/0000-0002-3248-7787 Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon Cedex, FranceSearch for more papers by this author First published: 05 April 2021 https://doi.org/10.1002/ijc.33588Citations: 92 As part of the latest International Agency for Research on Cancer (IARC) GLOBOCAN cancer statistics update, here the authors provide a comprehensive description of the data sources and methods used to compute the global incidence and mortality estimates for 38 cancers corresponding to the year 2020. The reported uncertainty intervals incorporate the major sources of error that may contribute to the uncertainty of these estimations. In addition to providing a global snapshot of the cancer burden in 2020, the estimates presented here can support the planning and prioritization of cancer control efforts at the global and national levels. AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Abstract Our study briefly reviews the data sources and methods used in compiling the International Agency for Research on Cancer (IARC) GLOBOCAN cancer statistics for the year 2020 and summarises the main results. National estimates were calculated based on the best available data on cancer incidence from population-based cancer registries (PBCR) and mortality from the World Health Organization mortality database. Cancer incidence and mortality rates for 2020 by sex and age groups were estimated for 38 cancer sites and 185 countries or territories worldwide. There were an estimated 19.3 million (95% uncertainty interval [UI]: 19.0-19.6 million) new cases of cancer (18.1 million excluding non-melanoma skin cancer) and almost 10.0 million (95% UI: 9.7-10.2 million) deaths from cancer (9.9 million excluding non-melanoma skin cancer) worldwide in 2020. The most commonly diagnosed cancers worldwide were female breast cancer (2.26 million cases), lung (2.21) and prostate cancers (1.41); the most common causes of cancer death were lung (1.79 million deaths), liver (830000) and stomach cancers (769000). Abstract What's new? As part of the latest International Agency for Research on Cancer (IARC) GLOBOCAN cancer statistics update, here the authors provide a comprehensive description of the data sources and methods used to compute the global incidence and mortality estimates for 38 cancers corresponding to the year 2020. The reported uncertainty intervals incorporate the major sources of error that may contribute to the uncertainty of these estimations. In addition to providing a global snapshot of the cancer burden in 2020, the estimates presented here can support the planning and prioritization of cancer control efforts at the global and national levels. Abbreviations ASR age-standardised rate CI5 Cancer Incidence in Five Continents CSU Cancer Surveillance Branch GCO Global Cancer Observatory GICR Global Initiative for Cancer Registry Development HDI Human Development Index IARC International Agency for Research on Cancer LMIC low- and middle-income countries NMSC non-melanoma skin cancer PBCR population-based cancer registry UI uncertainty interval UN United Nations WHO World Health Organization 1 INTRODUCTION One of the remits of the Cancer Surveillance Branch (CSU) at the International Agency for Research on Cancer (IARC) is the regular provision of global estimates of the cancer burden. GLOBOCAN 2020 updates the previously published estimates of cancer incidence and mortality for the year 2018.1 As previously, the basic units for estimation are countries, together with aggregated results globally and in 20 world regions, as defined by the United Nations (UN).2 The estimates were developed for 38 cancer sites including other, and unspecified cancers, by sex and for 18 age groups. The methods of estimation together with the computation of uncertainty intervals continue to rely upon the best available data on cancer incidence and mortality nationally. Interactive facilities for the tabulation and graphical visualisation of the GLOBOCAN data set of 185 countries and world regions by sex can be accessed via the Global Cancer Observatory (GCO) (https://gco.iarc.fr). A detailed description of the geographic variability observed across 20 world regions is provided elsewhere.3 Our study aims to summarise the data sources and methods used in compiling the cancer incidence and mortality estimates for 2020 worldwide and presents a summary of the major findings. 2 METHODS Data The basic sources of the estimates are the high-quality cancer registry incidence data, as compiled in the Cancer Incidence in Five Continents (CI5) series,4 as well as new data sources most notably in sub-Saharan Africa via the expansion of the African Cancer Registry Network,5 through targeted searches for new registry data online, and the most recent mortality data from the World Health Organization (WHO).6 As a result, the current estimates for 2020 are more accurate for several countries and some world areas than previously and therefore not fully comparable with previous sets of estimation. The geographical definition of the regions follows the UN country classification, except for Cyprus, which is included in Southern Europe rather than Western Asia. The source(s) of information used to develop corresponding estimates of the national burden of cancer in each country is provided in Annex A. National population estimates for 2020 were extracted from the UN website.2 Methods of estimation Cancer incidence and mortality rates for 2020 by sex and for 18 age groups (0-4, 5-9, 10-14, 15-19, …, 75-79, 80-84, 85 and over) were estimated for the 185 countries or territories of the world with populations of more than 150 000 inhabitants in the same year.2 Results are presented for 38 cancer sites or cancer types as defined by the 10th edition of the International Classification of Diseases (ICD-10, version 2014)7 and for all cancers combined. These are listed in Annex B. The estimates for non-melanoma skin cancers (NMSC) exclude basal-cell carcinoma in incidence, while mortality includes deaths from all types of NMSC. The major difference with previous editions of GLOBOCAN estimates with respect to the rubrics is that gallbladder cancer (ICD-10 C23) now excludes neoplasms of extra hepatic ducts (ICD-10 C24). The methods of incidence and mortality estimation and the computation of uncertainty intervals are similar to those used in the previous estimates.1 These are reproduced in Annex A and summarised later. 2.2.1 Estimates of cancer incidence by country The methods used to estimate the sex- and age-specific incidence rates of cancer in a specific country in 2020 fall into the following broad categories, in order of priority: Observed national incidence rates were projected to 2020 (45 countries). The most recently observed incidence rates (national (2a) or subnational (2b)) were used as proxy for 2020 (54 countries). Rates were estimated from national mortality data by modelling, using mortality-to-incidence ratios derived from: Cancer registries in that country (14 countries). Cancer registries in neighbouring countries (37 countries). These comprised one model for Africa; one for Caribbean; two for Asia; two for Europe and one for Oceania (see Annex C). Age- and sex-specific national incidence rates for all cancers combined were obtained by averaging overall rates from neighbouring countries. These rates were then partitioned to obtain the national incidence for specific sites using available cancer-specific relative frequency data in the country (five countries). Rates were estimated as an average of those from selected neighbouring countries (30 countries). 2.2.2 Estimates of cancer mortality by country Depending on the coverage, completeness and degree of detail of the mortality data available, four methods were utilised to estimate the sex- and age-specific mortality rates of cancer in a country: Observed national mortality rates were projected to 2020 (80 countries). The most recently observed mortality rates (national [2a] or subnational [2b]) were used as proxy for 2020 (21 countries). Rates were estimated from the corresponding national incidence estimates by modelling, using incidence-to-mortality ratios derived from cancer registries in neighbouring countries (81 countries). These comprised two models for Africa; three for Asia and one for Oceania (see Annex C). Rates were estimated as an average of those from selected neighbouring countries (three countries). Random fluctuations in the predicted age-specific incidence and mortality rates were smoothed using a lowess function, a locally weighted regression, by country, sex and cancer site. Estimates for the 20 world regions were obtained by the population-weighted average of the incidence and mortality rates of the component countries. These rates were applied to the corresponding population estimate for the region for 2020 to obtain the estimated numbers of new cancer cases and deaths in 2020. The rates were age-standardised rates (ASRs per 100 000 person-years) using the direct method and the World standard population as proposed by Segi8 and modified by Doll.9 The cumulative risk of developing or dying from cancer before the age of 75 in the absence of competing causes of death was also calculated using the age-specific rates and expressed as a percentage.4 2.2.3 Uncertainty intervals Uncertainty intervals (95% UI) of the estimated sex- and site-specific number of new cancer cases and cancer deaths for all ages were computed using the SE of the crude incidence or mortality rate used in the estimation. The SE is corrected for three major causes of uncertainty in the final estimate: Coverage: the catchment population used in the computations only covers part of the national population (not the entire country/subnational). The lag time: the most recent data are available prior to the year 2020. The quality of the data: the extent to which the data are considered complete and accurate. Penalties were used to correct the SE for each factor above in the UI calculation. The formulae used to compute the corrected SE are provided in Annex D. The values of the penalties are given by country in Annex E. 3 RESULTS Tables 1 and 2 show the estimated number of cases and deaths for all cancers combined and for 38 specific cancers in males, females and both sexes, with the corresponding 95% uncertainty intervals, ASRs and the cumulative risk. We estimated that there were 19.3 million (95% UI: 19.0-19.6 million) new cancer cases (18.1 million excluding NMSC) and 10.0 million (95% UI: 9.7-10.2 million) cancer deaths (9.9 million excluding NMSC) in 2020 worldwide. There is about a 20% risk of getting a cancer in a lifetime (before the age of 75), and a 10% risk of dying from the cancer; one in five persons will get cancer in their lifetimes and one in 10 will die from the disease. With 2.26 million (95% UI: 2.24-2.28) new cases estimated in 2020, female breast cancer has now become the most commonly diagnosed cancer worldwide, followed closely by lung cancer (2.21 million, 95% UI: 2.18-2.24). The most common cause of cancer death remains by far lung cancer (1.80 million deaths, 95% UI: 1.77-1.82), followed by liver (0.83 million, 95% UI 0.81-0.85) and stomach cancer (0.77 million, 95% UI: 0.75-0.79). TABLE 1. Estimated new cancer cases and uncertainty intervals (95% UI, all ages, in thousands), age-standardised rates (ASRs, per 100 000) and cumulative risk to age 75 (percent) by sex and cancer type worldwide, 2020 Both sexes Males Females Cancer Numbers 95% UI ASR (World) Cum. risk (0-74) Numbers 95% UI ASR (World) Cum. risk (0-74) Numbers 95% UI ASR (World) Cum. risk (0–74) Lip, oral cavity 377.7 (362.4-393.7) 4.1 0.46 264.2 (251.2-277.9) 6.0 0.68 113.5 (105.6-122.0) 2.3 0.26 Salivary glands 53.6 (48.2-59.5) 0.6 0.06 29.7 (25.9-34.1) 0.7 0.07 23.9 (20.3-28.1) 0.5 0.05 Oropharynx 98.4 (91.3-106.1) 1.1 0.13 79.0 (72.8-85.9) 1.8 0.22 19.4 (16.3-23.0) 0.4 0.05 Nasopharynx 133.4 (124.7-142.6) 1.5 0.16 96.4 (89.1-104.3) 2.2 0.24 37.0 (32.6-42.0) 0.8 0.09 Hypopharynx 84.3 (76.7-92.6) 0.9 0.11 70.3 (63.5-77.8) 1.6 0.19 14.0 (10.8-18.1) 0.3 0.03 Oesophagus 604.1 (587.1-621.6) 6.3 0.78 418.4 (404.5-432.6) 9.3 1.15 185.8 (176.0-196.0) 3.6 0.44 Stomach 1089.1 (1066.6-1112.1) 11.1 1.31 719.5 (701.4-738.2) 15.8 1.87 369.6 (356.4-383.2) 7.0 0.79 Colon 1148.5 (1138.3-1158.8) 11.4 1.30 600.9 (593.6-608.3) 13.1 1.49 547.6 (540.5-554.8) 10.0 1.12 Rectum 732.2 (724.7-739.8) 7.6 0.91 443.4 (437.7-449.1) 9.8 1.18 288.9 (284.0-293.8) 5.6 0.65 Anus 50.9 (46.0-56.3) 0.5 0.06 21.7 (18.4-25.6) 0.5 0.06 29.2 (25.7-33.1) 0.6 0.07 Liver 905.7 (884.7-927.2) 9.5 1.11 632.3 (615.0-650.1) 14.1 1.65 273.4 (261.7-285.6) 5.2 0.60 Gallbladder 115.9 (108.3-124.1) 1.2 0.13 41.1 (36.6-46.0) 0.9 0.10 74.9 (68.8-81.6) 1.4 0.16 Pancreas 495.8 (489.0-502.7) 4.9 0.55 262.9 (258.0-267.8) 5.7 0.66 232.9 (228.1-237.8) 4.1 0.45 Larynx 184.6 (174.3-195.6) 2.0 0.25 160.3 (150.6-170.5) 3.6 0.45 24.4 (20.8-28.4) 0.5 0.06 Lung 2206.8 (2176.5-2237.4) 22.4 2.74 1435.9 (1410.9-1461.5) 31.5 3.78 770.8 (753.9-788.1) 14.6 1.77 Melanoma of skin 324.6 (314.2-335.4) 3.4 0.37 173.8 (166.4-181.6) 3.8 0.42 150.8 (143.5-158.4) 3.0 0.33 Non-melanoma skin 1198.1 (1056.5-1358.6) 11.0 1.06 722.3 (605.2-862.1) 15.1 1.40 475.7 (397.8-568.9) 7.9 0.75 Mesothelioma 30.9 (27.0-35.3) 0.3 0.03 21.6 (18.4-25.2) 0.5 0.05 9.3 (7.2-12.1) 0.2 0.02 Kaposi sarcoma 34.3 (26.0-45.2) 0.4 0.03 23.4 (17.1-32.0) 0.5 0.05 10.9 (6.0-19.6) 0.3 0.02 Breast 2261.4 (2244.3-2278.7) 47.8 5.20 — 2261.4 (2244.3–2278.7) 47.8 5.20 Vulva 45.2 (40.7-50.3) 0.9 0.09 — 45.2 (40.7–50.3) 0.9 0.09 Vagina 17.9 (14.7-21.8) 0.4 0.04 — 17.9 (14.7-21.8) 0.4 0.04 Cervix uteri 604.1 (582.0-627.1) 13.3 1.39 — 604.1 (582.0–627.1) 13.3 1.39 Corpus uteri 417.4 (410.4-424.4) 8.7 1.05 — 417.4 (410.4–424.4) 8.7 1.05 Ovary 314.0 (300.8-327.6) 6.6 0.73 — 314.0 (300.8–327.6) 6.6 0.73 Penis 36.1 (31.0-42.0) 0.8 0.09 36.1 (31.0–42.0) 0.8 0.09 — Prostate 1414.3 (1395.3-1433.5) 30.7 3.86 1414.3 (1395.3–1433.5) 30.7 3.86 — Testis 74.5 (68.2-81.3) 1.8 0.14 74.5 (68.2–81.3) 1.8 0.14 — Kidney 431.3 (418.1-444.8) 4.6 0.52 271.2 (260.8-282.1) 6.1 0.70 160.0 (152.2-168.3) 3.2 0.36 Bladder 573.3 (557.2-589.8) 5.6 0.64 440.9 (426.8-455.4) 9.5 1.05 132.4 (124.9-140.4) 2.4 0.26 Brain, central nervous system 308.1 (295.7-321.0) 3.5 0.35 168.3 (159.2-178.1) 3.9 0.40 139.8 (131.6-148.5) 3.0 0.31 Thyroid 586.2 (579.1-593.4) 6.6 0.68 137.3 (134.0-140.7) 3.1 0.33 448.9 (442.7-455.3) 10.1 1.02 Hodgkin lymphoma 83.1 (78.8-87.6) 1.0 0.09 49.0 (45.8-52.3) 1.2 0.10 34.1 (31.2-37.3) 0.8 0.07 Non-Hodgkin lymphoma 544.4 (536.0-552.8) 5.8 0.62 304.2 (297.9-310.6) 6.9 0.73 240.2 (234.8-245.8) 4.8 0.52 Multiple myeloma 176.4 (167.9-185.3) 1.8 0.21 98.6 (92.3-105.3) 2.2 0.25 77.8 (72.3-83.7) 1.5 0.17 Leukaemia 474.5 (459.8-489.7) 5.4 0.50 269.5 (258.5-281.0) 6.3 0.59 205.0 (195.5-215.0) 4.5 0.41 Other specified cancers 643.3 (625.2-661.8) 7.0 0.72 357.1 (343.6-371.1) 8.2 0.85 286.2 (274.4-298.5) 6.0 0.61 Unspecified cancers 418.7 (403.1-434.9) 4.3 0.47 227.4 (215.9-239.5) 5.1 0.56 191.3 (181.0-202.3) 3.7 0.39 All cancers 19 292.8 (18 993.0-19 597.3) 201.0 20.44 10 065.3 (9832.4-10 303.7) 222.0 22.60 9227.5 (9035.1-9424.0) 186.0 18.55 All cancers excl. non-melanoma skin cancer 18 094.7 (17 812.8-18 381.1) 190.0 19.59 9343.0 (9126.0-9565.0) 206.9 21.50 8751.8 (8568.9-8938.6) 178.1 17.94 TABLE 2. Estimated cancer deaths and uncertainty intervals (95% UI, all ages, in thousands), age-standardised rates (ASRs, per 100 000) and cumulative risk to age 75 (percent) by sex and cancer type worldwide, 2020 Both sexes Males Females Cancer Numbers 95% UI ASR (World) Cum. Risk (0–74) Numbers 95% UI ASR (World) Cum. Risk (0–74) Numbers 95% UI ASR (World) Cum. Risk (0–74) Lip, oral cavity 177.8 (167.8-188.3) 1.9 0.22 125.0 (116.6-134.1) 2.8 0.32 52.7 (47.7-58.3) 1.0 0.12 Salivary glands 22.8 (19.1-27.1) 0.2 0.03 13.4 (10.7-16.7) 0.3 0.03 9.4 (7.1-12.5) 0.2 0.02 Oropharynx 48.1 (43.3-53.5) 0.5 0.06 39.6 (35.3-44.5) 0.9 0.11 8.6 (6.7-10.9) 0.2 0.02 Nasopharynx 80.0 (72.8-87.9) 0.9 0.10 58.1 (52.1-64.8) 1.3 0.16 21.9 (18.3-26.3) 0.5 0.05 Hypopharynx 38.6 (34.2-43.5) 0.4 0.05 32.3 (28.4-36.8) 0.7 0.09 6.3 (4.7-8.5) 0.1 0.01 Oesophagus 544.1 (526.2-562.5) 5.6 0.68 374.3 (359.9-389.3) 8.3 1.01 169.8 (159.3-180.9) 3.2 0.38 Stomach 768.8 (748.6-789.5) 7.7 0.90 502.8 (486.5-519.6) 11.0 1.29 266.0 (254.3-278.3) 4.9 0.55 Colon 576.9 (569.8-584.0) 5.4 0.55 302.1 (297.1-307.2) 6.4 0.66 274.7 (269.8-279.7) 4.6 0.45 Rectum 339.0 (333.0-345.1) 3.3 0.37 204.1 (200.4-207.9) 4.4 0.50 134.9 (127.1-143.2) 2.4 0.26 Anus 19.3 (16.2-23.0) 0.2 0.02 9.4 (7.3-12.2) 0.2 0.02 9.9 (7.8-12.5) 0.2 0.02 Liver 830.2 (807.1-853.9) 8.7 1.01 577.5 (558.3-597.4) 12.9 1.49 252.7 (240.2-265.8) 4.8 0.55 Gallbladder 84.7 (79.0-90.8) 0.8 0.09 30.3 (27.1-33.8) 0.7 0.07 54.4 (49.8-59.5) 1.0 0.11 Pancreas 466.0 (459.5-472.6) 4.5 0.51 246.8 (242.2-251.5) 5.3 0.62 219.2 (214.6-223.8) 3.8 0.41 Larynx 99.8 (92.8-107.4) 1.0 0.13 85.4 (78.9-92.3) 1.9 0.23 14.5 (11.9-17.6) 0.3 0.03 Lung 1796.1 (1767.6-1825.2) 18.0 2.18 1188.7 (1164.9-1212.9) 25.9 3.08 607.5 (591.6-623.7) 11.2 1.34 Melanoma of skin 57.0 (52.2-62.4) 0.6 0.06 32.4 (28.8-36.4) 0.7 0.07 24.7 (21.5-28.3) 0.4 0.05 Non-melanoma skin 63.7 (58.3-69.7) 0.6 0.05 37.6 (33.5-42.2) 0.8 0.07 26.1 (22.7-30.1) 0.4 0.04 Mesothelioma 26.3 (22.8-30.3) 0.3 0.03 18.7 (15.8-22.1) 0.4 0.04 7.6 (5.8-10.0) 0.1 0.02 Kaposi sarcoma 15.1 (10.2-22.3) 0.2 0.01 9.9 (6.2-16.0) 0.2 0.02 5.2 (2.6-10.2) 0.1 0.01 Breast 685.0 (675.5-694.6) 13.6 1.49 — 685.0 (675.5–694.6) 13.6 1.49 Vulva 17.4 (14.5-20.9) 0.3 0.03 — 17.4 (14.5–20.9) 0.3 0.03 Vagina 8.0 (6.0-10.7) 0.2 0.02 — 8.0 (6.0–10.7) 0.2 0.02 Cervix uteri 341.8 (324.2-360.4) 7.3 0.82 — 341.8 (324.2–360.4) 7.3 0.82 Corpus uteri 97.4 (91.0-104.2) 1.8 0.22 — 97.4 (91.0–104.2) 1.8 0.22 Ovary 207.3 (197.0-218.1) 4.2 0.49 — 207.3 (197.0–218.1) 4.2 0.49 Penis 13.2 (10.7-16.3) 0.3 0.03 13.2 (10.7–16.3) 0.3 0.03 — Prostate 375.3 (367.8-382.9) 7.7 0.63 375.3 (367.8–382.9) 7.7 0.63 — Testis 9.3 (7.5-11.7) 0.2 0.02 9.3 (7.5–11.7) 0.2 0.02 — Kidney 179.4 (175.2-183.7) 1.8 0.20 115.6 (112.3-119.0) 2.5 0.28 63.8 (61.2-66.5) 1.2 0.12 Bladder 212.5 (204.9-220.4) 1.9 0.18 158.8 (150.2-167.9) 3.3 0.30 53.8 (51.2-56.4) 0.9 0.08 Brain, central nervous system 251.3 (244.4-258.4) 2.8 0.30 138.3 (129.5-147.7) 3.2 0.34 113.1 (109.7-116.5) 2.4 0.26 Thyroid 43.6 (40.0-47.6) 0.4 0.05 15.9 (13.6-18.6) 0.3 0.04 27.7 (25.0-30.8) 0.5 0.05 Hodgkin lymphoma 23.4 (20.2-27.1) 0.3 0.02 14.3 (11.9-17.2) 0.3 0.03 9.1 (7.1-11.6) 0.2 0.02 Non-Hodgkin lymphoma 259.8 (254.4-265.2) 2.6 0.27 147.2 (143.2-151.4) 3.3 0.33 112.6 (109.1-116.1) 2.1 0.21 Multiple myeloma 117.1 (109.9-124.7) 1.1 0.13 65.2 (59.9-71.0) 1.4 0.15 51.9 (47.2-57.0) 0.9 0.10 Leukaemia 311.6 (304.3-319.1) 3.3 0.32 177.8 (173.3-182.4) 4.0 0.38 133.8 (125.8-142.2) 2.7 0.26 Other specified cancers 367.3 (353.4-381.7) 3.9 0.39 200.2 (189.8-211.1) 4.5 0.46 167.1 (158.0-176.7) 3.3 0.33 Unspecified cancers 383.1 (370.3-396.4) 3.8 0.40 209.3 (199.8-219.3) 4.6 0.49 173.8 (165.3-182.7) 3.2 0.33 All cancers 9958.1 (9721.1-10 200.9) 100.7 10.65 5528.8 (5351.7-5711.8) 120.8 12.59 4429.3 (4273.6-4590.8) 84.2 8.86 All cancers excl. non-melanoma skin cancer 9894.4 (9658.5-10 136.0) 100.1 10.61 5491.2 (5315.0-5673.3) 120.0 12.53 4403.2 (4248.1-4563.9) 83.7 8.83 Table 3 shows the most common types of cancer in terms of new cases and deaths in each of the 20 world regions in 2020. Prostate cancer was the most frequently diagnosed cancer in males in 12 regions of the world, followed by lung cancer (four regions), NMSC (two regions), lip and oral cavity, and liver cancer in one region. Lung cancer was the most frequent cause of death from cancer in 13 regions of the world, followed by prostate and liver cancer in five and two areas, respectively. In females, breast cancer was the most frequently diagnosed cancer in all regions of the world, except in Eastern Africa and in Australia/New Zealand where cervical cancer and NMSC dominated, respectively. Breast cancer was also the most frequent cause of death from cancer in 12 regions of the world, lung cancer in five regions (including Eastern Asia) and cervical cancer in three sub-Saharan Africa regions. These seven cancers represent almost half of the global incidence and mortality burden in 2020. TABLE 3. Leading types of cancer in terms of new cases (incidence) and deaths (mortality) by sex in each of the 20 world regions in 2020 [Color table can be viewed at wileyonlinelibrary.com] Male Female Incidence Mortality Incidence Mortality First Second Third First Second Third First Second Third First Second Third World Lung Prostate Non-melanoma skin Lung Liver Stomach Breast Lung Cervix uteri Breast Lung Cervix uteri Africa Prostate Liver Lung Prostate Liver Lung Breast Cervix uteri Liver Breast Cervix uteri Liver Eastern Africa Prostate Kaposi sarcoma NHL Prostate Oesophagus Liver Cervix uteri Breast Oesophagus Cervix uteri Breast Oesophagus Middle Africa Prostate Liver NHL Prostate Liver NHL Breast Cervix uteri NHL Cervix uteri Breast Liver Northern Africa Liver Lung Prostate Liver Lung Bladder Breast Liver Cervix uteri Breast Liver Ovary Southern Africa Prostate Lung Non-melanoma skin Lung Prostate Oesophagus Breast Cervix uteri Non-melanoma skin Cervix uteri Breast Lung Western Africa Prostate Liver NHL Prostate Liver NHL Breast Cervix uteri Ovary Breast Cervix uteri Liver Americas Prostate Non-melanoma skin Lung Lung Prostate Colon Breast Non-melanoma skin Lung Lung Breast Colon Northern America Non-melanoma skin Prostate Lung Lung Prostate Pancreas Breast Non-melanoma skin Lung Lung Breast Pancreas Caribbean Prostate Lung Colon Prostate Lung Colon Breast Colon Lung Breast Lung Colon Central America Prostate Stomach Colon Prostate Stomach Liver Breast Cervix uteri Thyroid Breast Cervix uteri Liver South America Prostate Lung Colon Lung Prostate Stomach Breast Cervix uteri Thyroid Breast Lung Cervix uteri Asia Lung Stomach Liver Lung Liver Stomach Breast Lung Cervix uteri Lung Breast Cervix uteri Eastern Asia Lung Stomach Liver Lung Liver Stomach Breast Lung Colon Lung Breast Stomach South-Eastern Asia Lung Liver Prostate Lung Liver Stomach Breast Cervix uteri Lung Breast Cervix uteri Lung South-Central Asia Lip and oral cavity Lung Stomach Lung Lip and oral cavity Oesophagus Breast Cervix uteri Ovary Breast Cervix uteri Ovary Western Asia Lung Prostate Bladder Lung Stomach Prostate Breast Thyroid Lung Breast Lung Stomach Europe Prostate Lung Non-melanoma skin Lung Prostate Colon Breast Lung Colon Breast Lung Colon Eastern Europe Lung Prostate Colon Lung Prostate Stomach Breast Corpus uteri Colon Breast Lung Colon Northern Europe Prostate Non-melanoma skin Lung Lung Prostate Colon Breast Lung Colon Lung Breast Colon Southern Europe Prostate Lung Bladder Lung Colon Prostate Breast Colon Lung Breast Lung Colon Western Europe Prostate Non-melanoma skin Lung Lung Prostate Colon Breast Non-melanoma skin Lung Breast Lung Pancreas Oceania Non-melanoma skin Prostate Melanoma of skin Lung Prostate Colon Non-melanoma skin Breast Melanoma of skin Lung Breast Colon Australia/New Zealand Non-melanoma skin Prostate Melanoma of skin Lung Prostate Colon Non-melanoma skin Breast Melanoma of skin Lung Breast Colon Melanesia Prostate Lip and oral cavity Lung Liver Lung Prostate Breast Cervix uteri Thyroid Breast Cervix uteri Liver Micronesia/Polynesia Prostate Lung Liver Lung Prostate Liver Breast Lung Thyroid Lung Breast Ovary Abbreviation: NHL, non-Hodgkin lymphoma. Figure 1A,B summarises the estimated numbers of new cancer cases and cancer deaths worldwide in 2020 by type of cancer and by sex, while Figure 2 shows the distribution of the global cancer cases and deaths (all cancers combined) by world region. Most cases (6.0 million, 31.1% of the total) and deaths (3.6 million, 36.3%) occurred in Eastern Asia with its vast population (1.7 billion, 22% of the global population in 2020). Northern America ranks second in terms of number of new cases (2.6 million, 13.3%) but third (699 000, 7.0%) in terms of cancer deaths after South-Central Asia (1.3 million, 12.6%). Almost a quarter of the new cases (4.4 million) and one fifth of the deaths (1.9 million) occurred in Europe, despite containing only one-tenth of the global population FIGURE 1Open in figure viewerPowerPoint Distribution of the estimated new cases and deaths for the 10 most common cancers in 2020 in males (A) and females (B). For each sex, the area of the pie chart reflects the proportion of the total number of cases or deaths. NHL, non-Hodgkin lymphoma [Color figure can be viewed at wileyonlinelibrary.com] FIGURE 2Open in figure viewerPowerPoint Estimated global numbers of new cases and deaths with proportions by world regions in 2020 in males (A), females (B) and both sexes (C) [Color figure can be viewed at wileyonlinelibrary.com] 4 DISCUSSION The main aim of our study is to document the data sources and methods used to compile the global and region-specific estimates of the cancer burden. Although IARC's estimation methods have been refined in the last decades to account for the increasing availability and quality of data, the underlying methodological principles have remained unchanged: wherever possible, national estimates are based upon local sources of cancer incidence (from population-based cancer registries) and cancer mortality (mainly from vital registration systems). These methods are objective and easy to reproduce and have been adopted by the Joint Research Centre (JRC) of the European Commission10 for their estimates of the cancer burden in Europe in 2020. The uncertainty intervals (95% UI) that accompany the estimates aim to capture, alongside inherent random variation, the uncertainty in the source information, taking into account three