The global burden of cancer continues to increase largely because of the aging and growth of the world population alongside an increasing adoption of cancer-causing behaviors, particularly smoking, in economically developing countries. Based on the GLOBOCAN 2008 estimates, about 12.7 million cancer cases and 7.6 million cancer deaths are estimated to have occurred in 2008; of these, 56% of the cases and 64% of the deaths occurred in the economically developing world. Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death among females, accounting for 23% of the total cancer cases and 14% of the cancer deaths. Lung cancer is the leading cancer site in males, comprising 17% of the total new cancer cases and 23% of the total cancer deaths. Breast cancer is now also the leading cause of cancer death among females in economically developing countries, a shift from the previous decade during which the most common cause of cancer death was cervical cancer. Further, the mortality burden for lung cancer among females in developing countries is as high as the burden for cervical cancer, with each accounting for 11% of the total female cancer deaths. Although overall cancer incidence rates in the developing world are half those seen in the developed world in both sexes, the overall cancer mortality rates are generally similar. Cancer survival tends to be poorer in developing countries, most likely because of a combination of a late stage at diagnosis and limited access to timely and standard treatment. A substantial proportion of the worldwide burden of cancer could be prevented through the application of existing cancer control knowledge and by implementing programs for tobacco control, vaccination (for liver and cervical cancers), and early detection and treatment, as well as public health campaigns promoting physical activity and a healthier dietary intake. Clinicians, public health professionals, and policy makers can play an active role in accelerating the application of such interventions globally. CA Cancer J Clin 2011;61:69-90.

Background: Previous studies have documented significant variations in colorectal cancer incidence rates and trends regionally and across countries.

Cancer is an emerging public health problem in Africa. About 715,000 new cancer cases and 542,000 cancer deaths occurred in 2008 on the continent, with these numbers expected to double in the next 20 years simply because of the aging and growth of the population. Furthermore, cancers such as lung, female breast, and prostate cancers are diagnosed at much higher frequencies than in the past because of changes in lifestyle factors and detection practices associated with urbanization and economic development. Breast cancer in women and prostate cancer in men have now become the most commonly diagnosed cancers in many Sub-Saharan African countries, replacing cervical and liver cancers. In most African countries, cancer control programs and the provision of early detection and treatment services are limited despite this increasing burden. This paper reviews the current patterns of cancer in Africa and the opportunities for reducing the burden through the application of resource level interventions, including implementation of vaccinations for liver and cervical cancers, tobacco control policies for smoking-related cancers, and low-tech early detection The burden of cancer is increasing in Africa because of the aging and growth of the population as well as increased prevalence of risk factors associated with economic transition, including smoking, obesity, physical inactivity, and reproductive behaviors. 1,2 According to United Nation's population estimates, 2 the population of Africa between 2010 and 2030 is projected to increase by 50% overall (from 1.03 billion to 1.52 billion) and by 90% for those aged !60 years (from 55 million to 105 million), the age at which cancer most frequently occurs.Although current prevalence of adult cigarette smoking is low in Africa, 3 there is a concern that the prevalence will increase because of increased disposable income and adoption of Western lifestyles driven by images such as films that portray smoking as a stylish activity. 4 In most urban populations of African countries, there have also been changes in reproductive factors toward earlier menarche, delayed childbearing, and lower fertility; in dietary patterns toward high animal and hydrogenated fat intake; and in activity patterns toward reduced average energy expenditure. 5 There has already been some limited evidence for the rising burden of cancers associated with these risk factors. For example, breast cancer incidence rates in Uganda (Kampala) have nearly doubled over the past 20 years, 6 although the rates still remain less than half of those seen in black women in Western countries such as the United States.Despite this growing cancer burden, cancer continues to receive a relatively low public health priority in Africa, largely because of limited resources and other pressing public health problems, including communicable diseases such as acquired immunodeficiency syndrome (AIDS)/human immunodeficiency virus (HIV) infection, malaria, and tuberculosis. It may also be in part because of a general lack of awareness amon...

Background: Several previous studies have documented region or country-specific liver cancer incidence trends around the world. However, no study has systematically examined the international pattern using the most recently updated incidence data from the International Agency for Research on Cancer.Methods: We examined recent trends in liver cancer incidence rates from 1993 to 2002 by joinpoint analysis for 32 cancer registries worldwide, using Cancer Incidence in Five Continents. We also examined the male to female rate ratios for these and four additional registries, based on the 1998-2002 incidence data.Results: Liver cancer incidence rates for both men and women statistically significantly increased from 1993 to 2002 for 8 of 32 cancer registries considered in the analysis. Increases were largely confined to economically developed countries of Western Europe, North America, and Oceania. In contrast, rates decreased in both men and women in 5 registries including 3 in Asia. Despite this, the incidence rates in Asian countries are twice as high as those in Africa and more than four times as high as rates in North America. Male to female rate ratios varied from 0.9 in sub-Saharan African and South American registries to 5.0 in France and Egypt.Conclusions: Liver cancer incidence rates continue to increase in some low-risk parts of the world whereas they are decreasing in some of the highest risk countries in Asia. Etiologic studies are required to further elucidate factors contributing to the divergent liver cancer incidence trends worldwide.Impact: Our description of international liver cancer incidence trends may stimulate further etiologic studies. Cancer Epidemiol Biomarkers Prev; 20(11); 2362-8. Ó2011 AACR.

In this chapter, we describe the variability of cancer occurrence by using measures of incidence, mortality, prevalence, and survival, according to demographic characteristics such as age, sex, socioeconomic status, and race/ethnicity, as well as geographic location and time period. We also discuss the variability of cancer occurrence in relation to changes in risk factors, screening rates, and improved treatments. The variation according to risk factors provides strong evidence that much of cancer is caused by environmental factors and is potentially avoidable.