Cancer incidence and mortality worldwide: Sources, methodsand major patterns in GLOBOCAN 2012

Jacques Ferlay1, Isabelle Soerjomataram1, Rajesh Dikshit2, Sultan Eser3, Colin Mathers4, Marise Rebelo5,

Donald Maxwell Parkin6, David Forman1 and Freddie Bray1

1 Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France2 Tata Memorial Hospital, Mumbai, India3 Izmir Cancer Registry, Izmir Hub, Izmir & Hacettepe University Institute of Public Health, Ankara, Turkey4 Department of Measurement and Health Information Systems, WHO, Geneva, Switzerland5 Department of Surveillance and Cancer Information, Brazilian National Cancer Institute, Ministry of Health, Rio de Janeiro, Brazil6 Clinical Trial Service Unit & Epidemiological Studies Unit, University of Oxford, Oxford, United Kingdom

Estimates of the worldwide incidence and mortality from 27 major cancers and for all cancers combined for 2012 are now

available in the GLOBOCAN series of the International Agency for Research on Cancer. We review the sources and methods

used in compiling the national cancer incidence and mortality estimates, and briefly describe the key results by cancer site

and in 20 large “areas” of the world. Overall, there were 14.1 million new cases and 8.2 million deaths in 2012. The most

commonly diagnosed cancers were lung (1.82 million), breast (1.67 million), and colorectal (1.36 million); the most common

causes of cancer death were lung cancer (1.6 million deaths), liver cancer (745,000 deaths), and stomach cancer (723,000

deaths).

According to WHO estimates for 2011, cancer now causesmore deaths than all coronary heart disease or all stroke.1 Thecontinuing global demographic and epidemiologic transitionssignal an ever-increasing cancer burden over the next decades,particularly in low and middle income countries (LMIC), withover 20 million new cancer cases expected annually as early as2025.2 The GLOBOCAN estimates for 20123 aim to providethe evidence and impetus for developing resource-contingentstrategies to reduce the cancer burden worldwide.

We review here the fifth version of GLOBOCAN, thesources and methods used in compiling cancer incidence andmortality estimates for 2012 in 184 countries worldwide, andbriefly describe the key results by cancer site. The basic unitsfor estimation are countries, although we present the resultsglobally, by level of development and for aggregated regions,as defined by the United Nations.4 Such estimates have beenprepared for 27 major cancers and for all cancers combinedand by sex. While the methods of estimation have beenrefined over time, they still rely upon the best available data

on cancer incidence and mortality at the national level inassembling regional and global profiles. Facilities for the tab-ulation and graphical visualisation of the full dataset of 184countries and 30 world regions by sex can be accessed viathe GLOBOCAN homepage (http://globocan.iarc.fr).

To document the methods used in compiling the esti-mates and guide users as to their validity, we introduce analphanumeric scoring system that provides information onthe availability and quality of the incidence and mortalitysources at the country level.

Data

Incidence data derive from population-based cancer registries(PBCR). Although PBCR may cover national populations,more often they cover smaller, subnational areas, and, partic-ularly in countries undergoing development, only selectedurban areas. In 2006, about 21% of the world population wascovered by PBCR, with sparse registration in Asia (8% of thetotal population) and in Africa (11%).5 In terms of what isconsidered data of high quality (for example, those includedin the latest volume (X) of the IARC Cancer Incidence inFive Continents (CI5) series6), these percentages are evenlower: only 14% of the world population is covered by PBCRthat match the CI5 inclusion criteria, with the figures 5% and2% in Asia and Africa, respectively. While cancer registries inlower resource settings may find it difficult to match thestrict criteria of data quality set for inclusion in CI5, theinformation generated by such PBCR remains of criticalimportance to cancer control as a unique and relativelyunbiased source of information on the profile of cancer.Population-based cancer registries can produce survival

Key words: Incidence, mortality, cancer, global estimates,

GLOBOCAN

Additional Supporting Information may be found in the online

version of this article.

DOI: 10.1002/ijc.29210

History: Received 11 June 2014; Accepted 12 Aug 2014; Online 13

Sep 2014

Correspondence to: Jacques Ferlay, Section of Cancer Information

International Agency for Research on Cancer, 150 Cours Albert

Thomas, 69372 Lyon Cedex 08, France, Tel.: 133-(0)4-72-73-84-90,

Fax: +33-(0)4-72-73-86-96, E-mail: ferlay@iarc.fr

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IJC

statistics by following up the vital status of cancer patients. Inthe absence of information on national mortality, it can be esti-mated using incidence and survival probabilities7 and vice versa.

Mortality statistics are collected and made available by theWHO.8 Their great advantage is national coverage and long-term availability in higher income settings, although not alldatasets are of the same quality. For some countries, coverageof the population is incomplete, so that the mortality ratesproduced are implausibly low, and in others, the quality ofcause of death information is poor. By 2005, around one-third of the world population was covered by mortality statis-tics.9 While almost all the European and American countrieshave comprehensive death registration systems, most Africanand Asian countries (including the populous countries ofNigeria, India and Indonesia) do not. The mortality dataused to estimate the burden of cancer in China was obtainedfrom a sample survey based on the “disease surveillancepoints” (DSP) project for the period 2004 to 2010 coveringaround 6% of the total Chinese population.10 These statisticsare considered nationally representative given the samplesinclude both urban and rural areas. As the figures were avail-able for a limited number of cancers, they were supplementedby cancer registry mortality files for certain sites.

National population estimates for 2012 were extractedfrom the United Nations website.4 The geographical defini-tion of the regions follows the rules as defined by the UN,except for Cyprus, which is included in Southern Europeinstead of Western Asia (Fig. 1).

An alphanumeric scoring system has been introducedwith the release of GLOBOCAN 2012 that independentlyclassifies the source availability and estimation methods forincidence and mortality by country. These scores are pro-vided together with the results online, and the classificationof sources and methods is described below.

Sources

Incidence data. Depending on the availability and quality ofthe information, the countries have been classified as follows(Fig. 2a):

A. High quality* national data or high quality regional (cov-erage greater than 50% of the population): 37 countries

B. High quality* regional data (coverage between 10% and50%): 11 countries.

C. High quality* regional data (coverage lower than 10%): 19countries.

D. National data (PBCR): 24 countries.

E. Regional data (PBCR): 18 countries.

F. Frequency data (hospital-based or pathological –basedseries): 13 countries.

G. No data: 62 countries.

*Data included in Cancer Incidence in Five Continents(CI5) volume IX11 and/or X.6

Mortality data. Similar to incidence data, the followingschema has been defined (Fig. 2b):

1. High quality complete vital registration**: 23 countries.

2. Medium quality complete vital registration**: 48 countries.

3. Low quality complete vital registration**: 24 countries.

4. Incomplete or sample vital registration: 2 countries.

5. Other sources (cancer registries, verbal autopsy surveysetc.): 7 countries.

6. No data: 80 countries.

**The criteria defined in points 1–3 are taken from Math-ers et al.9

Methods of estimation

Cancer incidence and mortality rates for 2012 by sex and for10 age groups (0–14, 15–39, 40–44, 45–49,. . ., 75 and over)are estimated for the 184 countries or territories of the worldhaving a total population greater than 200,000.4 Results arepresented for the following cancer sites or cancer types asdefined by the 10th edition of the International Classificationof Diseases (ICD-10):12 lip, oral cavity (ICD-10 C00-08),nasopharynx (C11), other pharynx (C09-10, C12-14), oeso-phagus (C15), stomach (C16), colon and rectum (includinganus C18-21), liver (C22), gallbladder (C23-24), pancreas(C25), larynx (C32), lung (including trachea, C33-34), mela-noma of skin (C43), Kaposi sarcoma (C46), female breast(C50), cervix uteri (C53), corpus uteri (C54), ovary (C56),prostate (C61), testis (C62), kidney (including renal pelvisand ureter, C64-66), bladder (C67), brain and central nervoussystem (C70-72), thyroid (C73), Hodgkin lymphoma (C81),non-Hodgkin lymphoma (C82-85, C96), multiple myeloma(C88 1 C90), leukaemia (C91-95) and all cancers combined,excluding non-melanoma skin cancer (C00-97, except C44).This last category was calculated by summing the estimatedcounts for each individual cancer site, and the residual

What’s new?

In this report, we present the most recent cancer incidence and mortality statistics (for 2012) for the major cancers in 20

regions of the world. Details of the data sources and methods used in GLOBOCAN to compile the estimates at the national

level are provided, and we introduce a novel alphanumeric scoring system to give a broad indication of the robustness of the

estimation within each country. A global snapshot of the patterns by cancer site brings focus to the need for regional prioriti-

sation of cancer control efforts, as well as the ongoing efforts to improve the limited surveillance systems in many low and

middle income countries.

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category “other and unspecified cancers”. Further details ofthe criteria for inclusion are provided in Appendix A.

The methods of incidence and mortality estimationdescribed below are undertaken at the national level andhence their validity depends upon the representativeness andquality of the source information from the country itself. Themethods are largely those developed previously,13 althoughone improvement in the 2012 estimation of both incidenceand mortality is the utilisation of the Human DevelopmentIndex (HDI)14 to predict survival in countries lacking therequisite data, as described in detail in Appendix B. Themethods are summarized below, ranked in descending orderof the probable accuracy of the derived estimates.

Estimates of cancer incidence by country.

1. When incidence data were available historically with suffi-cient numbers of cases, recorded incidence rates were pro-jected to 2012 using models and the 2012 nationalpopulation applied to the fitted rates (38 countries)

2. When recent incidence data were available from a nationalregistry, the 2012 national population was applied to themost recently recorded incidence rates (20 countries)

3. When registries were regional and where national mortalitydata were available, national incidence was estimated fromnational mortality using statistical models, with the fittedmortality to incidence (M:I) ratios derived from recordeddata from one or more cancer registries within the country(13 countries)

4. For Europe, when registries were regional rather thannational, and where national mortality data were available,method (3) was used but with the fitted M:I ratios derived

from recorded data in cancer registries in neighbouringcountries (nine European countries)15

5. When national or regional registries were not available, butwhere national mortality data were available, national inci-dence was estimated from national mortality estimates andmodelled survival (32 countries, see Appendix B formethod)

6. When national or regional registries were available, butwhere national mortality data was not available, nationalincidence was estimated as the weighted average of therecorded incidence rates obtained from multiple cancerregistries within the country (16 countries)

7. When incidence data were available from a single registry, butnational mortality data were not available, national incidencewas estimated from the recorded incidence rates obtained fromone cancer registry within the country (11 countries)

8. When neither national or regional registries, nor nationalmortality data were available, and the within-countrysource information was considered to lack the necessarylevel of accuracy, a set of age- and sex-specific nationalincidence rates for all cancers combined were obtainedaveraging overall rates from selected neighbouring coun-tries. These rates were then partitioned to obtain thenational incidence for specific sites using available cancer-specific relative frequency data (by age and sex, 12 countries).

9. When neither national or regional registries, nor nationalmortality data were available, and the within-countrysource information was either unavailable or useable, aver-age incidence rates from selected neighbouring countries inthe same region were used to derive national incidencewithin the country (33 countries).

Figure 1. Map showing the 20 world regions. [Color figure can be viewed in the online issue, which is available at wileyonlinelibrary.com.]

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Kaposi sarcoma (KS) incidence estimation in Sub-Saharan

Africa. Estimates of the incidence of KS were derived usingone of the methods described above, with the exception ofSub-Saharan Africa, where in certain regions the rates arecorrelated with the HIV epidemic and the prevalence ofHIV/AIDS:

� We first estimated the number of endemic (pre-AIDS) KScases using the percentage frequency of the disease, by sexand age, based on data from Uganda, Kampala (1961–1980) and Nigeria, Ibadan (1971–1990). These percentages

were applied to countries in Eastern and Western Africarespectively. For countries in Middle and Southern Africa,we applied a simple average of these frequencies.

� We calculated the number of epidemic (AIDS-related) KScases, both sexes, for the year 2011, using estimates ofAIDS deaths by country in 2011 (source UNAIDS, http://www.unaids.org/), and an estimate of the ratio of deathsfrom AIDS to incident cases of KS. This ratio was basedon observed KS rates in several countries (from the senti-nel registries listed below, minus the endemic KS), and was

Figure 2. (a) Map showing the availability of incidence data. (b) Map showing the availability of mortality data. [Color figure can be viewedin the online issue, which is available at wileyonlinelibrary.com.]

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specific by region (varying from 0.7% in Western Africa to6% in Eastern Africa). This total number of AIDS-relatedKS was partitioned by sex and age using sex- and age-specific proportions in sentinel registries of Malawi, Blan-tyre, Uganda, Kampala and Zimbabwe, Harare (EasternAfrica), Congo, Brazzaville (Middle Africa), Botswana andNamibia (Southern Africa), Mali, Bamako and Niger, Nia-mey (Western Africa).

Estimates of cancer mortality by country. National statisticsfrom vital registration sources are known to be of variablequality and some corrections were made before they wereused for estimation purposes:

� Where necessary, the overall number of deaths was cor-rected for under-reporting or incompleteness using thepercentages provided by the WHO.8

� The category “ill-defined cause of deaths” (ICD-9 codes780-799 and ICD-10 codes R00-R99) was partitioned, bysex and age into “cancer deaths” and “other” specificcauses of death. The corrected “cancer deaths” categorywas then partitioned into cancer-specific categories usingproportions from the uncorrected data.

� Given the large variations in the accuracy of death certifi-cates related to cancer of the uterus, with many deathsrecorded as “uterus cancer, not otherwise specified” (ICD-10 C55), these proportions were relocated to specified sites.By default, the number of cancer deaths coded as “uterusunspecified” was reallocated to either cervix (C53) or cor-pus (C54) uterine cancer according to age-specific propor-tions in the same population.16 For the countries for whichcountry-specific incidence and survival data were available,mortality for cervix uteri (C53) and corpus uteri (C54)cancers was estimated from incidence and 5-year relativesurvival probabilities.

Depending on the coverage, completeness and degree ofdetail of the mortality data available, six methods were uti-lised, ranked in descending order of the probable accuracy ofthe derived estimates:

1. When mortality data were available historically fromnational sources and a sufficient number of recorded can-cer deaths were available, mortality rates were projected to2012 using models and applied to 2012 national population(69 countries)

2. When recent mortality data were available from nationalsources, the most recent mortality rates were applied to2012 national population (26 countries)

3. When recent mortality data were available from regionalsources, national mortality was estimated as the weightedaverage of the local mortality rates (one country)

4. When recent mortality data were not available fromnational sources but country-specific survival estimateswere available, national mortality was estimated from

national incidence estimates and country-specific survival(two countries)

5. When recent mortality data were not available fromnational sources, national mortality was estimated fromnational incidence estimates using modelled survival asdescribed in Appendix B (83 countries)

6. When recent mortality data were not available fromnational sources, and survival estimates could not bederived using the previous method, the country-specificrates represent simply those of neighbouring countries inthe same region (three countries).

Random fluctuations in the predicted age-specific inci-dence and mortality rates were smoothed using a loess func-tion, a locally weighted regression, by country, sex andcancer site. Estimates for the 20 world regions (Fig. 1) wereobtained by the population-weighted average of the incidenceand mortality rates of the component countries. These rateswere applied to the corresponding population for the regionfor 2012 to obtain the estimated numbers of new cancercases and deaths in 2012. The rates were age-standardized(ASRs per 100,000 person-years) using the direct method andthe World standard population as proposed by Segi17 andmodified by Doll et al.18 The cumulative risk of developingor dying from cancer before the age of 75 in the absence ofcompeting causes of death was also calculated using the age-specific rates and expressed as a percentage. Both of theseindicators allow comparisons between populations that arenot influenced by differences in their age structures.

The list of the 184 countries or territories together withtheir corresponding indicators of data availability and meth-ods of estimation is given in Appendix C. The full descrip-tion of GLOBOCAN 2012 in terms of the data sources andmethods used for each country and further details of the esti-mations are available online (http://globocan.iarc.fr). Similarinformation for Europe has also been described for 40 coun-tries15 and the results are available online at the EuropeanCancer Observatory (ECO) (http://eco.iarc.fr). The overalland cancer-specific results are described and presented hereby world region, and for historical reference, according to thedichotomy of ‘developed’ and ‘developing’ regions: the formercomprising Northern America, Europe, Australia/New Zea-land and Japan, the latter, the remaining regions andcountries.

ResultsGlobal burden of cancer

We estimated that 14.1 million new cancer cases and 8.2 mil-lion cancer deaths occurred in 2012 worldwide. Tables 1and 2 show the estimated number of cases and deaths (inthousands) for all cancers combined (excluding non-melanoma skin cancers) and for 27 specific cancers in men,women and both sexes, together with the correspondingASRs and the cumulative risk. Lung cancer remains the mostcommon cancer in the world, both in term of new cases (1.8

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million cases, 12.9% of total) and deaths (1.6 million deaths,19.4%) because of the high case fatality. Breast cancer is thesecond most common cancer overall (1.7 million cases,11.9%) but ranks 5th as cause of death (522,000, 6.4%)because of the relatively favourable prognosis; these are fol-lowed, in terms of incidence, by colorectal cancer (1.4 millioncases, 694,000 deaths), prostate cancer (1.1 million cases,307,000 deaths), stomach cancer (951,000 cases, 723,000deaths) and liver cancer (782,000 cases and 745,000 deaths).These six cancers represent 55% of the global incidence bur-den in 2012; in more developed regions, just four cancers—female breast, prostate, lung and colorectum (Fig. 3a)—com-prise half of the total incidence, whereas lung, female breast,stomach and colorectal cancers combined with liver and cer-

vical cancers explain over half the incidence burden (54%) inless developed regions (Fig. 3b).

The ranking of the 15 most common cancers are shownfor men (Fig. 4a) and women (Fig. 4b), as numbers of newcases and deaths in more and less developed regions of theworld. Although lung cancer is the most common cancerworldwide among men, it ranks second in more developedregions (490,000 cases) after prostate cancer (759,000 cases).Cancers of the lung (751,000 cases, 682,000 deaths), liver(462,000 cases, 441,000 deaths) and stomach (456,000 cases,362,000 deaths) predominate among males in less developedregions, representing 40% of the new cancer cases and 48%of the total cancer deaths. In women, breast cancer is themost common cancer diagnosed in more and less developed

Table 1. Estimated new cancer cases (thousands), ASRs (per 100,000) and cumulative risks to age 75 (percent) by sex and cancer site world-wide, 2012

Both sexes Male Female

Cancer site Cases (%)ASR(World)

Cum. risk(0–74) Cases (%)

ASR(World)

Cum. risk(0–74) Cases (%)

ASR(World)

Cum.risk(0–74)

Lip, oral cavity 300 2.1 4.0 0.5 199 2.7 5.5 0.6 101 1.5 2.5 0.3

Nasopharynx 87 0.6 1.2 0.1 61 0.8 1.7 0.2 26 0.4 0.7 0.1

Other pharynx 142 1.0 1.9 0.2 115 1.5 3.2 0.4 27 0.4 0.7 0.1

Oesophagus 456 3.2 5.9 0.7 323 4.3 9.0 1.1 133 2.0 3.1 0.4

Stomach 951 6.8 12.1 1.4 631 8.5 17.4 2.0 320 4.8 7.5 0.8

Colorectum 1360 9.7 17.2 2.0 746 10.0 20.6 2.4 614 9.2 14.3 1.6

Liver 782 5.6 10.1 1.1 554 7.5 15.3 1.7 228 3.4 5.4 0.6

Gallbladder 178 1.3 2.2 0.2 77 1.0 2.1 0.2 101 1.5 2.3 0.3

Pancreas 338 2.4 4.2 0.5 178 2.4 4.9 0.6 160 2.4 3.6 0.4

Larynx 157 1.1 2.1 0.3 138 1.9 3.9 0.5 19 0.3 0.5 0.1

Lung 1825 12.9 23.1 2.7 1242 16.7 34.2 3.9 583 8.7 13.6 1.6

Melanoma of skin 232 1.6 3.0 0.3 121 1.6 3.3 0.4 111 1.7 2.8 0.3

Kaposi sarcoma 44 0.3 0.6 0.1 29 0.4 0.8 0.1 15 0.2 0.4 0.0

Breast 1677 11.9 43.3 4.6 1677 25.2 43.3 4.6

Cervix uteri 528 3.7 14.0 1.4 528 7.9 14.0 1.4

Corpus uteri 320 2.3 8.3 1.0 320 4.8 8.3 1.0

Ovary 239 1.7 6.1 0.7 239 3.6 6.1 0.7

Prostate 1112 7.9 31.1 3.8 1112 15.0 31.1 3.8

Testis 55 0.4 1.5 0.1 55 0.7 1.5 0.1

Kidney 338 2.4 4.4 0.5 214 2.9 6.0 0.7 124 1.9 3.1 0.3

Bladder 429 3.1 5.3 0.6 330 4.4 9.0 1.0 99 1.5 2.2 0.2

Brain, nervous system 257 1.8 3.4 0.3 140 1.9 3.9 0.4 117 1.8 3.0 0.3

Thyroid 298 2.1 4.0 0.4 68 0.9 1.9 0.2 230 3.5 6.1 0.6

Hodgkin lymphoma 66 0.5 0.9 0.1 39 0.5 1.1 0.1 27 0.4 0.7 0.1

Non-Hodgkin lymphoma 386 2.7 5.1 0.5 218 2.9 6.0 0.6 168 2.5 4.1 0.4

Multiple myeloma 114 0.8 1.5 0.2 62 0.8 1.7 0.2 52 0.8 1.2 0.2

Leukaemia 352 2.5 4.7 0.4 201 2.7 5.6 0.5 151 2.3 3.9 0.4

All cancers excl.non-melanomaskin cancer

14090 100.0 182.3 18.5 7427 100.0 205.4 21.0 6663 100.0 165.3 16.4

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regions, with more cases occurring in less developed (883,000cases) than more developed regions (794,000). Cervical can-cer, the second most common cancer in less developedregions (445,000 cases), ranks only 11th in more developedregions (83,000 cases). Lung cancer is now the leading causeof cancer death among women in more developed regions(210,000 deaths) followed by breast cancer (198,000 deaths)which ranks as the most frequent in women in less developedregions (324,000 deaths) followed by cancers of the lung(281,000 deaths) and cervix (230,000 deaths).

Figure 5 shows the distribution of the global cancer casesand deaths (all types of cancer, both sexes combined) by worldregion. Most cases (4.1 million, 29.4% of the total) and deaths(2.75 million, 33.6%) occurred in Eastern Asia with its vast

population (1.6 billion, 22% of the global population in 2012).Northern America ranks second in terms of number of newcases (1.78 million, 12.7%) but third (691,000, 6.4%) in termsof cancer deaths after South-Central Asia (1.0 million deaths,12.5%). Almost a quarter of the new cases (3.44 million) andone fifth of the deaths (1.75 million) occurred in the four Euro-pean regions, despite containing 10% of the global population.

Tables 3 and 4 show the estimated incidence and mortalityASRs (world standard), respectively, by sex and cancer site for the20 regions of the world, and for more developed and less devel-oped regions. Tables 5 and 6 portray the estimates of the numbersof cancer cases and deaths, and Tables 7 and 8 the estimates ofcumulative risk (ages 0–74, percent) for the same categories. Abrief description of the patterns for each cancer site follows.

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Table 2. Estimated cancer deaths (thousands), ASRs (per 100,000) and cumulative risks to age 75 (percent) by sex and cancer site world-wide, 2012

Both sexes Male Female

Cancer site Deaths (%)ASR(World)

Cum.risk(0–74) Deaths (%)

ASR(World)

Cum.risk(0–74) Deaths (%)

ASR(World)

Cum.risk(0–74)

Lip, oral cavity 145 1.8 1.9 0.2 98 2.1 2.7 0.3 47 1.3 1.2 0.1

Nasopharynx 51 0.6 0.7 0.1 36 0.8 1.0 0.1 15 0.4 0.4 0.0

Other pharynx 97 1.2 1.3 0.2 78 1.7 2.2 0.3 19 0.5 0.5 0.1

Oesophagus 400 4.9 5.0 0.6 281 6.0 7.7 0.9 119 3.4 2.7 0.3

Stomach 723 8.8 8.9 1.0 469 10.1 12.8 1.4 254 7.2 5.7 0.6

Colorectum 694 8.5 8.4 0.9 374 8.0 10.0 1.0 320 9.0 6.9 0.7

Liver 745 9.1 9.5 1.0 521 11.2 14.3 1.6 224 6.3 5.1 0.6

Gallbladder 142 1.7 1.7 0.2 60 1.3 1.6 0.2 82 2.3 1.8 0.2

Pancreas 331 4.0 4.1 0.4 174 3.7 4.8 0.5 157 4.4 3.4 0.4

Larynx 83 1.0 1.1 0.1 73 1.6 2.0 0.2 10 0.3 0.2 0.0

Lung 1590 19.4 19.7 2.2 1099 23.6 30.0 3.3 491 13.8 11.1 1.2

Melanoma of skin 55 0.7 0.7 0.1 31 0.7 0.9 0.1 24 0.7 0.6 0.1

Kaposi sarcoma 27 0.3 0.4 0.0 17 0.4 0.5 0.1 10 0.3 0.3 0.0

Breast 522 6.4 12.9 1.4 522 14.7 12.9 1.4

Cervix uteri 266 3.2 6.8 0.8 266 7.5 6.8 0.8

Corpus uteri 76 0.9 1.8 0.2 76 2.1 1.8 0.2

Ovary 152 1.9 3.8 0.4 152 4.3 3.8 0.4

Prostate 307 3.7 7.8 0.6 307 6.6 7.8 0.6

Testis 10 0.1 0.3 0.0 10 0.2 0.3 0.0

Kidney 144 1.7 1.8 0.2 91 2.0 2.5 0.3 53 1.5 1.2 0.1

Bladder 165 2.0 1.9 0.2 123 2.6 3.2 0.3 42 1.2 0.9 0.1

Brain, nervous system 189 2.3 2.5 0.3 106 2.3 3.0 0.3 83 2.3 2.1 0.2

Thyroid 40 0.5 0.5 0.1 13 0.3 0.4 0.0 27 0.8 0.6 0.1

Hodgkin lymphoma 25 0.3 0.3 0.0 15 0.3 0.4 0.0 10 0.3 0.3 0.0

Non-Hodgkin lymphoma 200 2.4 2.5 0.3 115 2.5 3.2 0.3 84 2.4 2.0 0.2

Multiple myeloma 80 1.0 1.0 0.1 43 0.9 1.2 0.1 37 1.0 0.8 0.1

Leukaemia 265 3.2 3.4 0.3 151 3.2 4.2 0.4 114 3.2 2.8 0.3

All cancers excl.non-melanomaskin cancer

8201 100.0 102.4 10.5 4653 100.0 126.3 12.7 3548 100.0 82.9 8.4

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All sites combined (excluding non-melanoma skin cancer).

Overall incidence rates are almost 25% higher in men (ASR205 per 100,000) than in women (165 per 100,000), withmale incidence rates varying almost fivefold across the differ-ent regions of the world, from 79 per 100,000 in WesternAfrica to 365 per 100,000 in Australia/New Zealand, withhigh rates of prostate cancer making a significant contribu-tion to the latter (Table 3). There is less variation in femaleincidence, rates ranging from 103 per 100,000 in South-Central Asia to 295 per 100,000 in Northern America (Table3). In terms of mortality, the cumulative risk of dying fromcancer is 20% higher in more developed than less developedregions in men, and 10% higher in women (Table 4). The

risk of dying from cancer among men is highest in Centraland Eastern Europe (19%) and lowest in Western Africa(7%) (Table 8). In contrast, the highest risk of cancer deathin women is in Melanesia and Eastern Africa (both 12%),and the lowest in Eastern Asia (8%) and South-Central Asia(7%).

Lung cancer. Lung cancer emerged as the most commoncancer worldwide several decades ago: with 660,000 newcases estimated in 1980, it had risen to equal stomach can-cer.19 Of the estimated 1.8 million new cases in 2012 (12.9%of the total) (Table 1), 58% occurred in less developedregions. It is the most common cancer in men worldwide

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Figure 3. Estimated global numbers of new cases (thousands) with proportions for (a) more developed and (b) less developed regions,both sexes combined, 2012. The area of the pie is proportional to the number of new cases. [Color figure can be viewed in the onlineissue, which is available at wileyonlinelibrary.com.]

8 Globocan 2012

Int. J. Cancer: 00, 00–00 (2014) VC 2014 UICC

(1.2 million, 16.7% of the total), with the highest rates inCentral and Eastern Europe (53.5 per 100,000) and EasternAsia (50.4 per 100,000). Incidence rates are very low in Mid-dle and Western Africa (2.0 and 1.7 per 100,000, respectively)(Table 3). In women, the incidence rates are generally lowerand the geographical pattern somewhat different, reflecting in

part variations in the uptake and consumption of tobacco.The highest estimated rates are in Northern America (33.8)and Northern Europe (23.7) compared with low rates inWestern and Middle Africa (1.1 and 0.8 respectively) (Table3). The relatively high rate in women in Eastern Asia (19.2)has been of particular interest, since tobacco smoking is

Figure 4. (a) Estimated numbers (thousands) of new cancer cases (incidence) and deaths (mortality) in men in more developed and less developedregions of the world in 2012. (b) Estimated numbers (thousands) of new cancer cases (incidence) and deaths (mortality) in women in more devel-oped and less developed regions of the world in 2012. [Color figure can be viewed in the online issue, which is available at wileyonlinelibrary.com.]

Epi

dem

iolo

gy

Ferlay et al. 9

Int. J. Cancer: 00, 00–00 (2014) VC 2014 UICC

generally very rare in these populations. The disease is themost common cause of death from cancer worldwide,responsible for nearly one cancer death in five (1.59 milliondeaths, 19.4% of the total). Because of the high fatality associ-ated with the disease, the geographical patterns in mortalityclosely follow those of incidence.

Breast cancer. Breast cancer is the second most commoncancer in the world and, by far the most frequent canceramong women with an estimated 1.67 million new cancercases diagnosed in 2012 (25% of all cancers) (Table 1). Aslight majority of cases occur in women in less developedregions (Table 5). Incidence rates vary nearly fourfold acrossthe world regions, with rates ranging from 27 per 100,000 inMiddle Africa and Eastern Asia to 96 in Western Europe(Table 3).

Breast cancer ranks as the fifth cause of death from canceroverall (522,000 deaths) and while it is the most frequentcause of cancer death in women in less developed regions(324,000 deaths, 14.3% of total), it is now the second causeof cancer death in more developed regions (198,000 deaths,15.4%) after lung cancer (Table 6). The range in mortalityrates between world regions is less than that for incidencebecause of the more favourable survival from breast cancer in(high-incidence) developed regions.

Colorectal cancer. Colorectal cancer is the third most com-mon cancer in men (746,000 cases, 10.0% of the total) andthe second in women (614,000 cases, 9.2% of the total)worldwide (Table 1). Almost 55% of the cases occur in moredeveloped regions (Table 5). There is a 10-fold variation in

incidence across the world and the patterns are very similarin men and women, with the highest rates in Australia/NewZealand (ASR 44.8 and 32.2 per 100,000 in men and women,respectively), and lowest in Western Africa (4.5 and 3.8 per100,000) (Table 3).

Mortality is considerably lower (694,000 deaths in bothsexes, 8.5% of the total) with more deaths (52%) in lessdeveloped regions of the world, reflecting poorer prognosis inthese regions (Table 6). There is less variability in mortalityrates worldwide (sixfold in men, fourfold in women), withrates highest in Central and Eastern Europe (20.3 per100,000 for men, 11.7 per 100,000 for women), and lowest inWestern Africa (3.5 and 3.0, respectively) (Table 4).

Prostate cancer. Prostate cancer is the fourth most commoncancer in both sexes combined and the second most commoncancer in men. An estimated 1.1 million cases were diag-nosed worldwide with prostate cancer in 2012, accountingfor 15% of the cancers diagnosed in men, with almost 70%of them (759,000) occurring in more developed regions(Table 5). Prostate cancer incidence varies more than 25-foldworldwide; the rates are highest in Australia/New Zealandand Northern America (ASR 111.6 and 97.2 per 100,000,respectively), and in Western and Northern Europe (ASR94.9 and 85 per 100,000), largely because the widespreadpractice of prostate specific antigen (PSA) testing and subse-quent biopsy in those regions (Table 3). Incidence rates arealso relatively high in certain less developed regions such asthe Caribbean (79.8), Southern Africa (61.7) and SouthAmerica (60.1), but remain low in Asian populations, with

Figure 5. Estimated global numbers of new cases and deaths with proportions by world regions, both sexes combined, 2012. The area of the pie isproportional to the number of new cases or deaths. [Color figure can be viewed in the online issue, which is available at wileyonlinelibrary.com.]

Epi

dem

iolo

gy

10 Globocan 2012

Int. J. Cancer: 00, 00–00 (2014) VC 2014 UICC

Tab

le3

.E

stim

ate

da

ge

-sta

nd

ard

ise

dra

tes

(AS

Rs,

Wo

rld

sta

nd

ard

)o

fca

nce

rin

cid

en

ceb

yse

x,ca

nce

rsi

tea

nd

reg

ion

s,2

01

2

Ora

lca

vity

(C0

0-0

8)

Na

sop

ha

r-yn

x(C

11

)

Oth

er

ph

ary

nx

(C0

9-

10

,C1

2-

14

)O

eso

ph

a-

gu

s(C

15

)S

tom

ach

(C1

6)

Co

lore

ctu

m(C

18

-21

)Li

ver

(C2

2)

Ga

llb

lad

-d

er

(C2

3-

24

)P

an

cre

as

(C2

5)

Lary

nx

(C3

2)

Lun

g(C

33

-3

4)

Me

lan

om

a(C

43

)K

ap

osi

sar-

com

a(C

46

)

MF

MF

MF

MF

MF

MF

MF

MF

MF

MF

MF

MF

MF

Wo

rld

5.5

2.5

1.7

0.7

3.2

0.7

9.0

3.1

17

.47

.52

0.6

14

.31

5.3

5.3

2.1

2.3

4.9

3.6

3.9

0.5

34

.21

3.6

3.3

2.8

0.8

0.4

Mo

red

eve

lop

ed

reg

ion

s7

.02

.60

.60

.24

.70

.86

.41

.21

5.6

6.7

36

.32

3.6

8.6

2.7

2.3

2.0

8.6

5.9

5.1

0.6

44

.71

9.6

10

.29

.30

.30

.1

Less

de

velo

pe

dre

gio

ns

5.0

2.5

2.0

0.8

2.8

0.6

10

.14

.11

8.1

7.8

13

.69

.81

7.8

6.6

2.0

2.4

3.3

2.4

3.5

0.4

30

.01

1.1

0.8

0.7

0.9

0.5

Afr

ica

3.3

2.0

1.5

0.8

1.1

0.6

5.6

3.5

4.5

3.2

7.0

5.8

12

.45

.80

.60

.92

.31

.72

.70

.37

.72

.60

.91

.15

.52

.9

Ea

ste

rnA

fric

a4

.52

.81

.91

.11

.00

.61

1.9

7.8

5.2

3.9

7.1

6.1

4.8

3.3

0.4

1.0

1.5

1.7

2.3

0.3

3.8

2.2

0.8

1.3

15

.17

.6

Mid

dle

Afr

ica

3.5

1.8

1.3

0.6

1.8

0.6

4.2

2.0

4.1

3.9

4.7

4.8

10

.55

.70

.10

.11

.40

.81

.40

.22

.00

.81

.42

.01

.20

.4

No

rth

ern

Afr

ica

2.8

1.8

2.3

1.0

0.8

0.7

2.4

1.5

4.3

2.7

8.5

6.9

18

.07

.01

.21

.93

.31

.84

.20

.41

5.6

3.1

0.3

0.4

0.3

0.1

So

uth

ern

Afr

ica

6.3

2.3

0.4

0.2

3.9

1.5

13

.76

.77

.22

.91

4.2

8.8

6.7

3.3

0.5

0.5

5.3

3.5

5.0

0.9

26

.11

0.2

5.0

3.7

7.6

4.7

We

ste

rnA

fric

a1

.71

.40

.70

.40

.60

.10

.80

.43

.32

.64

.53

.81

6.4

8.1

0.3

0.3

2.0

1.3

1.4

0.1

1.7

1.1

0.6

0.6

0.9

0.6

The

Am

eri

cas

5.9

2.6

0.5

0.2

3.3

0.7

5.5

1.4

9.2

5.0

22

.31

7.6

7.4

3.4

1.7

2.3

6.6

5.3

4.6

0.8

31

.42

1.6

9.0

6.2

0.5

0.1

Ca

rib

be

an

4.8

1.8

0.4

0.2

3.6

0.9

4.6

1.3

8.1

5.1

16

.31

6.6

6.1

4.5

0.8

1.2

4.2

3.6

7.9

0.9

25

.81

3.5

0.8

0.7

0.5

0.1

Ce

ntr

al

Am

eri

ca2

.61

.70

.20

.11

.00

.31

.70

.61

0.6

8.2

8.8

7.2

6.9

6.6

1.1

2.3

3.7

3.7

4.0

0.6

10

.14

.91

.91

.30

.10

.0

So

uth

Am

eri

ca5

.32

.40

.50

.23

.00

.57

.02

.01

4.2

7.0

17

.11

4.6

5.2

3.4

2.1

3.5

5.0

4.4

5.2

0.7

20

.81

0.7

2.9

2.2

0.6

0.1

No

rth

ern

Am

eri

ca7

.33

.20

.70

.34

.20

.95

.41

.15

.52

.83

0.1

22

.79

.32

.71

.61

.68

.56

.44

.00

.94

4.0

33

.81

6.1

12

.20

.50

.1

Asi

a5

.22

.52

.30

.93

.10

.71

1.4

4.3

22

.89

.31

6.5

11

.12

0.0

6.9

2.5

2.7

3.8

2.6

3.3

0.4

35

.21

2.7

0.5

0.4

0.1

0.0

Ea

ste

rnA

sia

2.4

1.1

2.5

1.0

1.3

0.2

17

.05

.43

5.4

13

.82

2.4

14

.63

1.9

10

.23

.43

.25

.53

.62

.20

.25

0.4

19

.20

.60

.50

.00

.0

So

uth

-Ea

ste

rnA

sia

4.0

2.5

6.4

2.4

2.6

0.7

3.6

1.0

8.2

4.1

15

.21

0.2

22

.27

.21

.41

.22

.52

.02

.70

.52

9.6

10

.50

.50

.30

.10

.0

So

uth

-Ce

ntr

al

Asi

a9

.94

.70

.60

.26

.21

.46

.53

.99

.24

.27

.05

.23

.72

.11

.42

.31

.31

.04

.60

.61

1.9

3.4

0.3

0.2

0.0

0.0

We

ste

rnA

sia

2.7

1.6

1.3

0.6

0.8

0.4

2.9

2.1

11

.97

.31

7.6

12

.45

.02

.61

.51

.44

.73

.16

.50

.93

7.6

7.1

1.8

1.6

0.5

0.2

Eu

rop

e7

.52

.50

.60

.25

.20

.95

.81

.21

3.2

6.4

37

.32

3.6

6.8

2.2

1.7

1.8

8.3

5.5

6.3

0.6

46

.61

5.1

8.6

8.9

0.3

0.1

Ce

ntr

al

an

dE

ast

ern

Eu

rop

e9

.12

.00

.60

.25

.30

.55

.60

.82

0.3

8.9

34

.52

1.7

4.8

2.0

1.6

1.9

8.9

5.0

7.8

0.4

53

.51

0.4

4.5

4.7

0.1

0.1

No

rth

ern

Eu

rop

e5

.93

.10

.40

.23

.31

.08

.12

.77

.43

.73

6.5

25

.34

.61

.90

.81

.17

.35

.93

.40

.63

4.6

23

.71

4.0

15

.40

.30

.1

So

uth

ern

Eu

rop

e5

.82

.10

.80

.33

.40

.53

.20

.61

1.7

5.9

39

.52

4.0

9.5

2.9

2.1

2.0

7.6

5.3

7.2

0.6

46

.41

2.8

8.1

8.3

0.8

0.2

We

ste

rnE

uro

pe

7.9

3.2

0.5

0.2

7.5

1.6

6.8

1.6

8.8

4.3

39

.12

4.9

8.0

2.2

2.0

1.9

8.3

6.3

4.8

0.7

44

.02

0.0

11

.51

2.8

0.2

0.0

Oce

an

ia9

.65

.30

.70

.33

.00

.65

.21

.76

.83

.54

1.0

29

.27

.83

.11

.51

.57

.05

.02

.90

.33

1.3

20

.03

4.7

25

.50

.30

.0

Au

stra

lia

/Ne

wZ

ea

lan

d8

.33

.70

.70

.33

.20

.75

.41

.76

.73

.34

4.8

32

.26

.42

.11

.51

.57

.55

.43

.00

.33

2.7

21

.74

0.3

30

.50

.30

.0

Me

lan

esi

a2

2.9

16

.00

.40

.13

.40

.43

.61

.47

.25

.21

1.1

6.9

14

.87

.61

.80

.62

.51

.12

.70

.61

4.3

5.8

3.4

3.8

0.1

0.0

Mic

ron

esi

a/P

oly

ne

sia

4.3

1.0

2.6

1.3

2.0

0.0

3.1

0.2

7.5

2.8

18

.51

1.8

9.1

1.4

0.4

1.3

3.1

1.4

1.7

0.3

42

.71

7.5

4.1

2.4

0.0

0.0

Epi

dem

iolo

gy

Tab

le3

.E

stim

ate

da

ge

-sta

nd

ard

ise

dra

tes

(AS

Rs,

Wo

rld

sta

nd

ard

)o

fca

nce

rin

cid

en

ceb

yse

x,ca

nce

rsi

tea

nd

reg

ion

s,2

01

2(C

on

tin

ue

d)

Bre

ast

(C5

0)

Ce

rvix

ute

ri(C

53

)

Co

rpu

su

teri

(C5

4)

Ova

ry(C

56

)P

rost

ate

(C6

1)

Test

is(C

62

)K

idn

ey

(C6

4-6

6)

Bla

dd

er

(C6

7)

Bra

in,

cns

(C7

0-7

2)

Thyr

oid

(C7

3)

Ho

dg

kin

(C8

1)

NH

L(C

82

-8

5,C

96

)

Mu

ltip

lem

yelo

ma

(C8

81

C9

0)

Leu

ka

em

ia(C

91

-95

)

All

site

sb

ut

C4

4(C

00

-97

/C4

4)

FF

FF

MM

MF

MF

MF

MF

MF

MF

MF

MF

MF

Wo

rld

43

.31

4.0

8.3

6.1

31

.11

.56

.03

.09

.02

.23

.93

.01

.96

.11

.10

.76

.04

.11

.71

.25

.63

.92

05

.41

65

.3

Mo

red

eve

lop

ed

reg

ion

s7

4.1

9.9

14

.79

.16

9.5

5.2

12

.66

.21

6.9

3.7

5.9

4.4

3.6

11

.12

.31

.91

0.3

7.1

3.3

2.2

8.8

5.8

30

8.7

24

0.6

Less

de

velo

pe

dre

gio

ns

31

.31

5.7

5.5

4.9

14

.50

.73

.41

.85

.31

.53

.32

.71

.44

.70

.80

.54

.32

.81

.00

.84

.33

.21

63

.01

35

.8

Afr

ica

36

.22

7.6

3.5

4.8

23

.20

.41

.41

.16

.32

.02

.11

.60

.92

.41

.00

.75

.53

.81

.10

.93

.32

.61

15

.61

32

.4

Ea

ste

rnA

fric

a3

0.4

42

.73

.45

.52

3.3

0.3

1.1

1.3

3.3

2.0

1.3

1.1

1.1

2.7

0.9

0.7

5.6

3.5

1.1

1.0

3.8

3.4

12

0.7

15

4.8

Mid

dle

Afr

ica

26

.83

0.6

3.4

4.1

27

.00

.20

.70

.62

.21

.30

.50

.50

.71

.20

.60

.44

.43

.21

.10

.92

.61

.89

1.8

11

0.7

No

rth

ern

Afr

ica

43

.26

.63

.15

.61

0.6

0.6

2.5

1.6

15

.13

.25

.64

.41

.44

.41

.81

.37

.65

.41

.41

.05

.63

.91

33

.51

27

.7

So

uth

ern

Afr

ica

38

.93

1.5

6.5

5.2

61

.80

.61

.60

.87

.51

.92

.01

.20

.61

.61

.20

.55

.24

.12

.01

.73

.62

.62

10

.31

61

.1

We

ste

rnA

fric

a3

8.6

29

.33

.33

.62

5.1

0.3

0.8

0.7

2.1

1.3

0.4

0.3

0.3

1.0

0.7

0.4

3.7

2.5

0.4

0.4

1.4

1.2

78

.71

12

.4

The

Am

eri

cas

67

.61

4.9

12

.36

.87

5.0

3.2

9.8

5.2

12

.93

.65

.54

.23

.71

2.1

1.8

1.3

9.9

7.0

3.1

2.2

7.8

5.6

26

3.0

22

8.2

Ca

rib

be

an

46

.12

1.0

10

.45

.07

9.8

1.0

2.9

1.5

7.6

1.8

3.3

3.3

1.3

4.2

1.0

0.9

4.9

3.6

2.1

1.7

4.7

3.7

20

7.7

16

8.0

Ce

ntr

al

Am

eri

ca3

2.8

23

.56

.65

.02

8.4

2.3

4.1

2.3

3.4

1.8

4.5

3.4

1.2

3.8

1.3

0.9

4.2

3.3

1.3

1.0

5.8

4.9

12

5.8

14

1.9

So

uth

Am

eri

ca5

2.2

20

.45

.55

.86

0.1

2.3

5.1

2.7

6.9

2.1

5.4

4.3

1.9

8.4

1.1

0.8

6.0

4.3

1.9

1.5

5.3

4.1

20

6.7

18

0.6

No

rth

ern

Am

eri

ca9

1.6

6.6

19

.18

.19

7.2

5.0

15

.58

.31

9.5

5.2

6.1

4.6

6.3

20

.02

.72

.21

4.6

10

.24

.33

.01

0.4

7.2

34

4.2

29

5.4

Asi

a2

9.1

12

.75

.95

.09

.40

.63

.81

.95

.51

.43

.32

.71

.55

.00

.70

.44

.22

.71

.00

.74

.63

.31

74

.11

34

.3

Ea

ste

rnA

sia

27

.07

.98

.64

.71

0.5

0.5

5.8

2.7

5.8

1.6

4.0

3.5

2.0

7.6

0.2

0.2

4.0

2.8

1.0

0.6

5.1

3.8

22

5.4

15

1.9

So

uth

-Ea

ste

rnA

sia

34

.81

6.3

5.1

6.5

11

.20

.91

.90

.94

.31

.02

.62

.11

.84

.50

.50

.35

.73

.80

.90

.84

.94

.01

47

.61

32

.6

So

uth

-Ce

ntr

al

Asi

a2

8.2

19

.32

.74

.94

.50

.61

.40

.73

.60

.82

.41

.50

.71

.81

.00

.53

.31

.80

.80

.53

.42

.39

8.4

10

3.3

We

ste

rnA

sia

42

.84

.47

.65

.32

8.0

1.7

5.0

3.0

19

.03

.15

.35

.02

.49

.82

.41

.57

.85

.62

.31

.76

.84

.81

92

.81

50

.2

Eu

rop

e7

1.1

11

.41

3.9

9.9

64

.05

.61

2.3

5.9

17

.73

.56

.34

.62

.57

.82

.32

.08

.85

.93

.22

.18

.75

.62

98

.92

26

.7

Ce

ntr

al

an

dE

ast

ern

Eu

rop

e4

7.7

16

.31

5.6

11

.43

1.3

3.2

12

.46

.11

5.1

2.7

5.8

4.5

1.8

7.4

1.9

1.9

4.8

3.6

1.6

1.3

7.7

5.1

26

0.0

19

3.5

No

rth

ern

Eu

rop

e8

9.4

8.7

14

.11

1.0

85

.07

.21

1.1

5.8

12

.43

.67

.05

.11

.75

.62

.61

.91

1.5

8.1

4.1

2.7

9.2

6.0

29

8.4

26

3.9

So

uth

ern

Eu

rop

e7

4.5

8.5

12

.99

.15

8.6

5.9

11

.24

.62

1.8

3.8

6.8

4.8

3.8

8.6

2.5

2.1

10

.36

.63

.32

.38

.75

.62

97

.62

20

.4

We

ste

rnE

uro

pe

96

.07

.31

1.6

7.5

94

.98

.71

3.4

6.5

19

.74

.36

.14

.43

.18

.82

.52

.31

0.9

7.7

4.3

2.8

9.6

6.0

34

3.7

26

3.7

Oce

an

ia7

9.2

10

.21

2.4

8.0

10

1.9

5.0

11

.05

.31

0.6

2.7

5.3

3.4

3.4

11

.32

.01

.71

3.3

9.4

4.2

2.7

10

.46

.43

38

.52

64

.8

Au

stra

lia

/Ne

wZ

ea

lan

d8

5.8

5.5

12

.47

.61

11

.66

.81

2.6

6.1

11

.32

.96

.44

.33

.81

1.8

2.5

2.2

14

.31

0.1

4.6

3.0

11

.37

.23

65

.32

77

.9

Me

lan

esi

a4

1.0

33

.31

0.3

8.1

22

.70

.41

.40

.53

.50

.70

.90

.22

.31

0.6

0.6

0.2

6.9

4.8

1.1

0.7

5.3

3.3

15

2.1

18

2.1

Mic

ron

esi

a/P

oly

ne

sia

59

.79

.91

2.3

5.2

72

.30

.43

.60

.96

.40

.90

.80

.33

.01

2.3

0.4

0.0

6.3

3.4

1.6

0.4

5.9

2.1

21

5.2

16

5.3

Epi

dem

iolo

gy

Tab

le4

.E

stim

ate

da

ge

-sta

nd

ard

ise

dra

tes

(AS

Rs,

Wo

rld

sta

nd

ard

)o

fca

nce

rm

ort

ali

tyb

yse

x,ca

nce

rsi

tea

nd

reg

ion

s,2

01

2

Ora

lca

vity

(C0

0-0

8)

Na

so-

ph

ary

nx

(C1

1)

Oth

er

ph

ary

nx

(C0

9-

10

,C1

2-

14

)O

eso

ph

a-

gu

s(C

15

)S

tom

ach

(C1

6)

Co

lore

ctu

m(C

18

-21

)Li

ver

(C2

2)

Ga

llb

lad

-d

er

(C2

3-

24

)P

an

cre

as

(C2

5)

Lary

nx

(C3

2)

Lun

g(C

33

-34

)

Me

la-

no

ma

(C4

3)

Ka

po

sisa

rco

ma

(C4

6)

MF

MF

MF

MF

MF

MF

MF

MF

MF

MF

MF

MF

MF

Wo

rld

2.7

1.2

1.0

0.4

2.2

0.5

7.7

2.7

12

.85

.71

0.0

6.9

14

.35

.11

.61

.84

.83

.42

.00

.23

0.0

11

.10

.90

.60

.50

.3

Mo

red

eve

lop

ed

reg

ion

s2

.30

.60

.20

.12

.20

.35

.20

.99

.14

.21

4.7

9.3

7.1

2.5

1.5

1.4

8.3

5.5

2.2

0.2

36

.81

4.3

2.0

1.2

0.0

0.0

Less

de

velo

pe

dre

gio

ns

2.8

1.4

1.3

0.5

2.2

0.5

9.0

3.6

14

.46

.57

.85

.61

7.0

6.4

1.6

2.0

3.2

2.3

2.0

0.3

27

.29

.80

.40

.30

.60

.3

Afr

ica

2.1

1.3

1.1

0.6

0.9

0.4

5.3

3.3

4.1

3.0

5.1

4.2

11

.95

.60

.50

.92

.31

.61

.50

.27

.02

.40

.50

.64

.92

.2

Ea

ste

rnA

fric

a3

.21

.91

.40

.90

.90

.51

1.2

7.3

5.0

3.7

5.5

4.6

4.6

3.1

0.4

0.9

1.5

1.6

1.5

0.2

3.5

2.0

0.6

0.9

14

.26

.2

Mid

dle

Afr

ica

2.9

1.4

1.1

0.6

1.6

0.6

4.0

1.9

4.0

3.8

3.8

3.9

9.9

5.4

0.1

0.1

1.3

0.8

1.1

0.2

1.8

0.8

1.0

1.5

1.0

0.4

No

rth

ern

Afr

ica

1.3

0.8

1.4

0.6

0.6

0.6

2.3

1.4

3.9

2.4

5.6

4.5

17

.46

.71

.11

.83

.21

.82

.00

.21

4.0

2.8

0.2

0.2

0.2

0.1

So

uth

ern

Afr

ica

2.8

1.0

0.2

0.1

2.2

0.6

12

.86

.25

.22

.51

0.0

5.8

6.7

3.2

0.5

0.5

5.2

3.4

2.5

0.4

23

.89

.11

.60

.84

.32

.8

We

ste

rnA

fric

a1

.21

.00

.60

.30

.50

.10

.80

.43

.22

.53

.53

.01

5.6

7.7

0.3

0.3

1.9

1.2

0.9

0.1

1.5

0.9

0.5

0.4

0.9

0.5

The

Am

eri

cas

1.5

0.6

0.2

0.1

1.5

0.3

4.8

1.1

6.8

3.7

9.8

7.4

6.2

3.3

1.0

1.6

6.4

5.0

2.1

0.3

25

.91

5.9

1.7

0.9

0.1

0.0

Ca

rib

be

an

2.0

0.6

0.3

0.1

2.5

0.6

4.1

1.0

6.8

4.0

9.1

9.1

6.0

4.3

0.5

0.9

4.1

3.6

4.0

0.5

23

.71

2.1

0.3

0.2

0.1

0.0

Ce

ntr

al

Am

eri

ca0

.80

.50

.10

.00

.70

.21

.60

.58

.86

.74

.83

.86

.66

.11

.02

.13

.53

.51

.50

.29

.04

.30

.60

.40

.10

.0

So

uth

Am

eri

ca2

.20

.70

.20

.12

.20

.45

.61

.51

2.0

5.7

9.4

7.7

5.4

3.7

1.7

2.9

5.2

4.4

3.3

0.4

18

.58

.91

.00

.60

.10

.0

No

rth

ern

Am

eri

ca1

.20

.50

.20

.11

.20

.35

.11

.02

.81

.51

1.3

7.8

6.8

2.3

0.6

0.7

8.0

5.9

1.2

0.3

34

.82

3.5

2.6

1.2

0.0

0.0

Asi

a3

.01

.41

.40

.52

.40

.59

.93

.81

6.7

7.2

8.6

6.0

18

.96

.72

.12

.33

.62

.51

.90

.23

1.6

11

.00

.30

.20

.00

.0

Ea

ste

rnA

sia

1.1

0.5

1.5

0.6

0.7

0.1

14

.14

.52

4.0

9.8

10

.26

.82

9.9

9.6

2.8

2.6

5.2

3.4

1.1

0.2

44

.81

6.2

0.4

0.3

0.0

0.0

So

uth

-Ea

ste

rnA

sia

1.9

1.2

3.8

1.4

2.1

0.5

3.3

0.9

7.3

3.5

9.7

6.4

21

.46

.81

.31

.12

.51

.91

.30

.22

6.6

9.4

0.3

0.2

0.0

0.0

So

uth

-Ce

ntr

al

Asi

a6

.33

.00

.40

.15

.31

.26

.03

.68

.53

.95

.13

.83

.62

.11

.32

.11

.20

.93

.00

.41

0.7

3.0

0.2

0.1

0.0

0.0

We

ste

rnA

sia

1.0

0.6

0.7

0.3

0.6

0.3

2.7

1.9

10

.26

.21

0.0

7.1

4.9

2.5

1.4

1.2

4.7

3.0

2.9

0.4

34

.06

.20

.60

.50

.20

.1

Eu

rop

e3

.00

.70

.30

.12

.70

.34

.90

.99

.74

.61

6.2

9.9

6.1

2.2

1.1

1.3

8.2

5.3

3.0

0.2

39

.81

1.8

2.0

1.3

0.0

0.0

Ce

ntr

al

an

dE

ast

ern

Eu

rop

e5

.10

.70

.30

.23

.80

.35

.00

.61

6.8

7.1

20

.31

1.7

5.4

2.2

1.3

1.5

9.0

4.9

4.9

0.2

47

.68

.32

.01

.40

.00

.0

No

rth

ern

Eu

rop

e1

.60

.70

.20

.11

.40

.37

.22

.34

.82

.41

3.4

9.1

4.0

1.8

0.6

0.8

7.1

5.6

1.3

0.2

29

.61

9.0

2.5

1.6

0.0

0.0

So

uth

ern

Eu

rop

e1

.90

.60

.30

.11

.80

.32

.80

.58

.34

.01

5.4

8.7

7.5

2.5

1.5

1.5

7.4

4.9

2.9

0.2

39

.11

0.0

1.6

1.0

0.0

0.0

We

ste

rnE

uro

pe

2.0

0.6

0.2

0.1

2.7

0.5

5.0

1.2

5.1

2.5

13

.38

.36

.52

.10

.91

.08

.05

.81

.50

.23

5.3

14

.82

.01

.30

.00

.0

Oce

an

ia2

.71

.90

.30

.11

.30

.34

.51

.43

.92

.11

1.4

8.2

6.9

2.9

0.6

0.7

5.9

4.6

1.0

0.2

23

.11

4.1

5.4

2.3

0.0

0.0

Au

stra

lia

/Ne

wZ

ea

lan

d1

.40

.60

.20

.11

.20

.34

.71

.33

.61

.71

1.6

8.5

5.4

2.0

0.5

0.7

6.3

4.9

0.9

0.1

23

.51

4.9

5.9

2.4

0.0

0.0

Me

lan

esi

a1

4.4

10

.20

.30

.12

.80

.43

.41

.46

.64

.77

.74

.91

4.4

7.3

1.6

0.6

2.3

1.2

1.9

0.4

13

.35

.02

.12

.30

.10

.0

Mic

ron

esi

a/P

oly

ne

sia

1.7

0.0

0.9

0.4

1.1

0.2

3.2

0.2

6.2

3.0

8.2

5.1

10

.12

.20

.01

.13

.91

.11

.10

.43

8.4

17

.31

.00

.40

.00

.0

Epi

dem

iolo

gy

Tab

le4

.E

stim

ate

da

ge

-sta

nd

ard

ise

dra

tes

(AS

Rs,

Wo

rld

sta

nd

ard

)o

fca

nce

rm

ort

ali

tyb

yse

x,ca

nce

rsi

tea

nd

reg

ion

s,2

01

2(C

on

tin

ue

d)

Bre

ast

(C5

0)

Ce

rvix

ute

ri(C

53

)

Co

rpu

su

teri

(C5

4)

Ova

ry(C

56

)P

rost

ate

(C6

1)

Test

is(C

62

)K

idn

ey

(C6

4-6

6)

Bla

dd

er

(C6

7)

Bra

in,

cns

(C7

0-

72

)Th

yro

id(C

73

)H

od

gk

in(C

81

)

NH

L(C

82

-8

5,C

96

)

Mu

ltip

lem

yelo

ma

(C8

81

C9

0)

Leu

ka

e-

mia

(C9

1-

95

)

All

site

sb

ut

C4

4(C

00

-97

/C

44

)

FF

FF

MM

MF

MF

MF

MF

MF

MF

MF

MF

MF

Wo

rld

12

.96

.81

.83

.87

.80

.32

.51

.23

.20

.93

.02

.10

.30

.60

.40

.33

.22

.01

.20

.84

.22

.81

26

.38

2.9

Mo

red

eve

lop

ed

reg

ion

s1

4.9

3.3

2.3

5.0

10

.00

.34

.21

.74

.51

.14

.02

.70

.30

.40

.40

.33

.52

.01

.81

.24

.62

.81

38

.08

6.2

Less

de

velo

pe

dre

gio

ns

11

.58

.31

.53

.16

.60

.31

.70

.92

.60

.72

.61

.90

.40

.70

.40

.32

.81

.80

.80

.63

.72

.61

20

.17

9.8

Afr

ica

17

.31

7.5

1.3

3.8

17

.00

.31

.10

.93

.51

.21

.61

.30

.61

.30

.80

.54

.32

.90

.90

.83

.12

.59

2.9

88

.7

Ea

ste

rnA

fric

a1

5.6

27

.61

.34

.41

8.7

0.2

1.0

1.1

2.2

1.3

1.1

0.9

0.8

1.8

0.9

0.6

4.6

2.9

1.0

0.9

3.7

3.3

10

3.8

11

0.5

Mid

dle

Afr

ica

14

.92

2.2

1.5

3.3

24

.20

.20

.60

.51

.60

.90

.50

.50

.50

.80

.50

.43

.82

.71

.00

.82

.51

.78

2.3

82

.3

No

rth

ern

Afr

ica

17

.43

.20

.94

.17

.00

.31

.91

.27

.61

.64

.03

.10

.71

.81

.20

.85

.43

.71

.20

.84

.93

.49

9.9

75

.7

So

uth

ern

Afr

ica

15

.51

7.9

1.8

3.8

24

.40

.31

.50

.63

.00

.91

.91

.10

.30

.40

.40

.24

.02

.91

.81

.43

.42

.31

36

.59

8.7

We

ste

rnA

fric

a2

0.1

18

.51

.43

.02

1.2

0.2

0.6

0.6

1.5

0.9

0.4

0.3

0.3

0.7

0.6

0.4

3.0

2.0

0.4

0.4

1.3

1.1

68

.57

5.7

The

Am

eri

cas

14

.05

.92

.04

.31

3.1

0.4

3.1

1.4

3.2

1.0

3.8

2.8

0.3

0.5

0.4

0.3

3.8

2.4

2.0

1.3

5.0

3.4

11

6.4

89

.2

Ca

rib

be

an

15

.18

.63

.33

.02

9.3

0.2

1.4

0.7

3.0

0.9

2.5

2.3

0.2

0.3

0.5

0.3

2.8

1.9

1.7

1.3

3.7

2.7

11

9.8

87

.7

Ce

ntr

al

Am

eri

ca9

.58

.91

.73

.31

2.1

0.6

2.3

1.3

1.2

0.6

2.5

1.9

0.4

0.8

0.6

0.4

2.4

1.9

1.0

0.7

4.2

3.5

76

.67

2.1

So

uth

Am

eri

ca1

4.0

8.6

1.5

3.6

16

.60

.42

.81

.32

.70

.94

.03

.20

.30

.60

.40

.23

.22

.11

.61

.14

.23

.11

18

.08

8.4

No

rth

ern

Am

eri

ca1

4.8

2.6

2.2

5.0

9.8

0.3

3.7

1.6

4.0

1.2

4.1

2.6

0.3

0.3

0.3

0.2

4.5

2.6

2.4

1.5

5.3

3.2

12

3.2

91

.7

Asi

a1

0.2

6.4

1.5

3.0

3.8

0.3

1.7

0.9

2.5

0.6

2.5

1.8

0.3

0.7

0.4

0.2

2.7

1.6

0.8

0.5

3.8

2.6

12

6.3

77

.0

Ea

ste

rnA

sia

6.2

3.3

1.9

2.0

3.1

0.1

2.1

1.0

2.3

0.7

3.2

2.3

0.3

0.4

0.1

0.1

2.3

1.4

0.7

0.5

4.2

2.9

15

9.3

80

.2

So

uth

-Ea

ste

rnA

sia

14

.17

.91

.54

.46

.70

.51

.30

.72

.20

.51

.91

.50

.81

.60

.30

.24

.02

.50

.80

.64

.33

.41

14

.17

9.5

So

uth

-Ce

ntr

al

Asi

a1

3.5

10

.91

.03

.72

.90

.31

.00

.42

.00

.51

.91

.10

.20

.60

.60

.32

.31

.30

.70

.52

.92

.07

4.8

64

.7

We

ste

rnA

sia

15

.12

.01

.93

.71

3.1

0.7

3.2

1.9

8.4

1.3

3.6

3.3

0.7

1.7

1.3

0.8

4.9

3.3

1.7

1.3

5.6

3.8

12

9.3

81

.3

Eu

rop

e1

6.1

3.8

2.6

5.3

11

.30

.44

.81

.95

.21

.14

.63

.00

.30

.40

.50

.33

.11

.81

.71

.24

.62

.81

47

.58

7.6

Ce

ntr

al

an

dE

ast

ern

Eu

rop

e1

6.5

6.2

3.4

6.0

11

.60

.55

.82

.16

.10

.94

.73

.20

.40

.60

.70

.52

.71

.51

.20

.94

.62

.81

73

.49

1.6

No

rth

ern

Eu

rop

e1

6.3

2.2

2.3

5.9

14

.40

.24

.22

.04

.41

.54

.73

.00

.20

.30

.30

.23

.52

.22

.31

.54

.12

.51

25

.99

4.2

So

uth

ern

Eu

rop

e1

4.9

2.4

2.1

4.4

9.1

0.3

3.6

1.3

6.0

1.0

4.7

3.1

0.3

0.3

0.5

0.3

3.2

1.9

1.7

1.3

4.7

2.8

13

7.9

78

.9

We

ste

rnE

uro

pe

16

.11

.81

.94

.71

0.7

0.3

4.6

1.8

4.0

1.1

4.2

2.7

0.3

0.3

0.3

0.2

3.2

1.9

1.9

1.3

4.4

2.7

13

1.3

83

.6

Oce

an

ia1

5.6

4.5

1.9

4.9

13

.00

.22

.81

.33

.21

.04

.02

.60

.30

.80

.30

.24

.12

.62

.11

.44

.92

.91

17

.89

0.0

Au

stra

lia

/Ne

wZ

ea

lan

d1

4.5

1.5

1.5

4.5

12

.90

.23

.01

.43

.31

.04

.63

.00

.20

.30

.30

.23

.82

.32

.31

.54

.42

.71

15

.38

2.6

Me

lan

esi

a1

9.8

20

.63

.86

.51

3.3

0.3

1.1

0.4

2.0

0.4

0.9

0.3

1.5

5.7

0.5

0.2

5.9

3.7

0.8

0.6

4.8

2.9

11

7.9

11

8.5

Mic

ron

esi

a/P

oly

ne

sia

13

.13

.92

.53

.21

3.7

0.0

1.0

0.2

1.2

0.9

0.3

0.7

0.9

0.7

0.0

0.0

2.9

1.6

1.0

0.5

4.6

1.5

11

6.9

76

.2

Epi

dem

iolo

gy

Tab

le5

.E

stim

ate

dn

um

be

rso

fn

ew

can

cer

case

s(t

ho

usa

nd

s)b

yse

x,ca

nce

rsi

tea

nd

reg

ion

s,2

01

2

Ora

lca

vity

(C0

0-0

8)

Na

sop

ha

r-yn

x(C

11

)

Oth

er

ph

ar-

ynx

(C0

9-

10

,C1

2-1

4)

Oe

sop

ha

gu

s(C

15

)S

tom

ach

(C1

6)

Co

lore

ctu

m(C

18

-21

)Li

ver

(C2

2)

Ga

llb

lad

de

r(C

23

-24

)P

an

cre

as

(C2

5)

Lary

nx

(C3

2)

Lun

g(C

33

-34

)M

ela

no

ma

(C4

3)

Ka

po

sisa

r-co

ma

(C4

6)

MF

MF

MF

MF

MF

MF

MF

MF

MF

MF

MF

MF

MF

Wo

rld

19

9.0

10

1.4

60

.92

5.8

11

5.1

27

.33

23

.01

32

.86

31

.33

20

.37

46

.36

14

.35

54

.42

28

.17

6.8

10

1.3

17

8.2

15

9.7

13

8.1

18

.81

24

1.6

58

3.1

12

0.6

11

1.5

29

.01

5.2

Mo

red

eve

lop

ed

reg

ion

s6

8.0

32

.85

.12

.14

4.4

9.2

67

.71

8.4

17

5.1

99

.43

98

.93

38

.09

2.0

42

.32

7.8

34

.89

4.7

92

.85

0.7

7.0

49

0.3

26

7.9

99

.49

1.7

2.6

0.7

Less

de

velo

pe

dre

gio

ns

13

0.9

68

.65

5.8

23

.77

0.7

18

.12

55

.31

14

.44

56

.22

20

.93

47

.42

76

.34

62

.41

85

.84

9.1

66

.58

3.5

66

.98

7.4

11

.87

51

.33

15

.22

1.3

19

.82

6.4

14

.5

Afr

ica

10

.27

.05

.33

.03

.41

.91

6.1

11

.51

3.2

10

.62

1.2

19

.93

8.7

20

.01

.63

.06

.65

.57

.61

.12

1.8

8.6

2.8

3.8

23

.81

3.7

Ea

ste

rnA

fric

a4

.12

.91

.91

.30

.90

.69

.87

.54

.43

.76

.26

.24

.63

.40

.41

.01

.21

.61

.90

.33

.12

.00

.71

.31

9.8

11

.1

Mid

dle

Afr

ica

1.1

0.6

0.5

0.3

0.6

0.2

1.2

0.7

1.4

1.4

1.5

1.8

3.7

2.1

0.0

0.0

0.4

0.3

0.4

0.1

0.6

0.3

0.4

0.7

0.5

0.2

No

rth

ern

Afr

ica

2.2

1.6

2.0

0.9

0.6

0.6

1.9

1.2

3.4

2.3

6.8

6.1

13

.85

.90

.91

.62

.51

.53

.20

.31

1.9

2.6

0.2

0.3

0.2

0.1

So

uth

ern

Afr

ica

1.3

0.6

0.1

0.0

0.8

0.4

2.5

1.7

1.4

0.7

2.6

2.3

1.4

0.9

0.1

0.1

1.0

0.9

1.0

0.2

4.8

2.6

0.9

1.0

2.2

1.4

We

ste

rnA

fric

a1

.51

.40

.80

.50

.50

.20

.70

.32

.82

.44

.03

.61

5.4

7.7

0.2

0.3

1.5

1.2

1.1

0.1

1.4

1.0

0.5

0.6

1.1

0.9

The

Am

eri

cas

31

.91

7.3

2.7

1.2

17

.64

.53

0.4

9.6

51

.73

3.6

12

5.1

12

0.6

40

.32

2.9

9.7

16

.13

7.0

38

.12

5.0

5.0

17

7.9

14

6.4

50

.33

8.0

2.6

0.5

Ca

rib

be

an

1.1

0.5

0.1

0.0

0.8

0.2

1.1

0.3

1.9

1.4

3.9

4.6

1.4

1.2

0.2

0.3

1.0

1.0

1.8

0.2

6.0

3.5

0.2

0.2

0.1

0.0

Ce

ntr

al

Am

eri

ca1

.81

.40

.10

.10

.70

.21

.10

.57

.26

.46

.05

.64

.75

.10

.81

.82

.52

.92

.70

.46

.93

.91

.41

.10

.10

.0

So

uth

Am

eri

ca1

0.1

5.8

0.9

0.4

5.6

1.3

13

.34

.92

7.2

16

.73

3.0

34

.51

0.0

8.0

4.1

8.2

9.5

10

.79

.81

.53

9.5

24

.75

.75

.31

.30

.3

No

rth

ern

Am

eri

ca1

8.9

9.7

1.6

0.7

10

.52

.81

4.9

3.9

15

.39

.28

2.3

75

.92

4.2

8.6

4.7

5.9

23

.92

3.4

10

.72

.81

25

.51

14

.24

3.0

31

.51

.00

.2

Asi

a1

12

.05

6.9

49

.82

0.3

65

.01

5.0

24

0.1

10

0.3

48

0.4

21

9.6

34

7.5

25

9.7

43

0.7

16

3.7

53

.26

3.8

80

.76

2.7

68

.88

.77

42

.73

03

.01

1.6

10

.21

.00

.5

Ea

ste

rnA

sia

25

.51

2.6

25

.91

0.5

13

.41

.91

83

.06

6.9

38

4.3

16

8.6

24

3.2

17

8.2

34

2.2

12

4.2

38

.24

1.7

61

.04

6.4

23

.92

.25

56

.12

40

.46

.45

.70

.30

.1

So

uth

-Ea

ste

rnA

sia

10

.57

.61

8.0

7.6

6.9

2.0

9.4

2.9

21

.31

2.3

38

.53

0.5

58

.52

1.5

3.6

3.6

6.4

5.9

6.9

1.4

74

.03

1.0

1.3

1.0

0.1

0.1

So

uth

-Ce

ntr

al

Asi

a7

3.6

35

.14

.51

.74

3.9

10

.84

5.3

28

.56

4.6

31

.75

0.7

39

.02

5.8

15

.61

0.2

17

.29

.37

.53

2.4

4.4

80

.92

4.8

2.3

1.8

0.2

0.1

We

ste

rnA

sia

2.4

1.6

1.3

0.6

0.7

0.4

2.4

2.0

10

.17

.01

5.1

12

.04

.32

.51

.31

.34

.02

.95

.60

.83

1.7

6.7

1.6

1.6

0.4

0.2

Eu

rop

e4

2.6

18

.82

.91

.22

8.4

5.7

35

.11

0.8

84

.25

5.4

24

1.8

20

5.3

42

.82

0.6

11

.91

7.9

52

.05

1.9

36

.03

.92

90

.91

19

.34

7.3

53

.21

.50

.6

Ce

ntr

al

an

dE

ast

ern

Eu

rop

e1

7.7

6.0

1.1

0.5

10

.21

.41

1.0

2.6

41

.12

8.6

70

.36

9.5

9.5

6.5

3.4

6.6

17

.81

6.9

15

.31

.21

07

.03

1.7

8.6

11

.80

.20

.2

No

rth

ern

Eu

rop

e4

.83

.00

.30

.12

.60

.87

.63

.57

.24

.53

5.3

29

.94

.22

.30

.81

.46

.97

.32

.90

.63

3.5

26

.71

1.2

12

.10

.20

.0

So

uth

ern

Eu

rop

e7

.73

.80

.80

.34

.10

.74

.51

.11

8.3

12

.16

0.0

45

.01

4.1

6.4

3.6

4.5

11

.51

1.5

9.6

0.9

69

.92

1.8

9.3

10

.00

.90

.3

We

ste

rnE

uro

pe

12

.36

.00

.70

.31

1.5

2.7

11

.93

.61

7.6

10

.37

6.2

60

.91

5.0

5.5

4.1

5.4

15

.71

6.2

8.1

1.3

80

.63

9.2

18

.21

9.3

0.2

0.1

Oce

an

ia2

.31

.40

.10

.10

.70

.21

.40

.61

.81

.01

0.7

8.8

1.9

0.8

0.4

0.5

1.9

1.6

0.7

0.1

8.4

5.8

8.6

6.4

0.1

0.0

Au

stra

lia

/Ne

wZ

ea

lan

d1

.70

.90

.10

.00

.60

.11

.30

.51

.60

.91

0.3

8.5

1.4

0.6

0.4

0.4

1.8

1.6

0.7

0.1

7.8

5.5

8.5

6.2

0.1

0.0

Me

lan

esi

a0

.60

.50

.00

.00

.10

.00

.10

.00

.20

.20

.30

.20

.50

.30

.00

.00

.10

.00

.10

.00

.30

.20

.10

.10

.00

.0

Mic

ron

esi

a/P

oly

ne

sia

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.1

0.1

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.2

0.1

0.0

0.0

0.0

0.0

Epi

dem

iolo

gy

Tab

le5

.E

stim

ate

dn

um

be

rso

fn

ew

can

cer

case

s(t

ho

usa

nd

s)b

yse

x,ca

nce

rsi

tea

nd

reg

ion

s,2

01

2(C

on

tin

ue

d)

Bre

ast

(C5

0)

Ce

rvix

ute

ri(C

53

)

Co

rpu

su

teri

(C5

4)

Ova

ry(C

56

)P

rost

ate

(C6

1)

Test

is(C

62

)K

idn

ey

(C6

4-6

6)

Bla

dd

er

(C6

7)

Bra

in,

cns

(C7

0-7

2)

Thyr

oid

(C7

3)

Ho

dg

kin

(C8

1)

NH

L(C

82

-8

5,C

96

)

Mu

ltip

lem

yelo

ma

(C8

81

C9

0)

Leu

ka

em

ia(C

91

-95

)A

llsi

tes

bu

tC

44

(C0

0-9

7/C

44

)

FF

FF

MM

MF

MF

MF

MF

MF

MF

MF

MF

MF

Wo

rld

16

76

.65

27

.63

19

.62

38

.71

11

1.7

55

.32

13

.91

23

.93

30

.49

9.4

13

9.6

11

6.6

68

.22

29

.93

8.5

27

.42

17

.61

68

.16

2.5

51

.82

00

.71

51

.37

42

7.1

66

63

.0

Mo

red

eve

lop

ed

reg

ion

s7

93

.78

3.1

16

7.9

99

.87

58

.73

2.7

12

5.4

74

.61

96

.15

7.8

48

.24

0.7

29

.79

3.1

15

.61

3.3

10

1.9

88

.53

6.5

31

.58

0.3

61

.03

24

3.5

28

32

.4

Less

de

velo

pe

dre

gio

ns

88

2.9

44

4.5

15

1.7

13

9.0

35

3.0

22

.58

8.5

49

.31

34

.34

1.6

91

.47

5.9

38

.51

36

.82

3.0

14

.11

15

.87

9.6

26

.02

0.3

12

0.4

90

.34

18

3.6

38

30

.6

Afr

ica

13

3.9

99

.01

1.4

17

.85

9.5

1.5

5.1

4.9

17

.76

.87

.66

.32

.99

.14

.73

.22

1.1

15

.73

.02

.91

3.3

10

.73

62

.04

84

.9

Ea

ste

rnA

fric

a3

3.5

45

.73

.15

.91

7.2

0.4

1.4

1.8

2.8

2.0

1.5

1.3

1.1

2.8

1.4

1.0

7.0

4.8

0.9

1.0

4.9

4.1

11

6.8

17

0.5

Mid

dle

Afr

ica

10

.91

1.5

1.1

1.6

6.9

0.1

0.4

0.3

0.6

0.4

0.3

0.2

0.2

0.5

0.3

0.2

2.2

1.8

0.3

0.3

1.1

0.8

30

.34

3.8

No

rth

ern

Afr

ica

39

.55

.82

.65

.17

.50

.62

.01

.51

1.2

2.7

4.8

4.1

1.2

4.3

1.8

1.3

6.4

4.8

1.1

0.9

5.0

3.7

10

5.8

11

4.8

So

uth

ern

Afr

ica

10

.38

.71

.71

.41

0.3

0.2

0.3

0.2

1.3

0.5

0.5

0.3

0.1

0.4

0.3

0.2

1.3

1.2

0.4

0.4

0.8

0.7

39

.94

3.0

We

ste

rnA

fric

a3

9.7

27

.32

.83

.81

7.6

0.3

1.0

1.0

1.7

1.2

0.5

0.4

0.3

1.1

1.0

0.5

4.2

3.0

0.3

0.3

1.5

1.3

69

.21

12

.9

The

Am

eri

cas

40

8.3

83

.27

4.3

41

.54

12

.71

6.2

52

.93

2.1

75

.72

5.9

28

.02

3.7

19

.46

6.1

8.8

6.9

54

.34

5.3

17

.21

4.4

41

.23

2.9

14

53

.71

42

8.7

Ca

rib

be

an

11

.35

.02

.61

.21

8.7

0.2

0.7

0.4

1.8

0.5

0.7

0.8

0.3

1.0

0.2

0.2

1.1

0.9

0.5

0.5

1.1

0.9

48

.34

2.5

Ce

ntr

al

Am

eri

ca2

4.9

18

.84

.83

.91

9.0

2.0

2.8

1.7

2.3

1.4

3.3

2.7

0.9

3.0

1.0

0.7

3.1

2.5

0.9

0.7

4.4

3.9

87

.31

10

.3

So

uth

Am

eri

ca1

15

.94

5.0

12

.21

2.8

11

4.7

5.0

9.7

6.0

13

.45

.31

0.5

9.4

3.9

18

.52

.21

.71

1.8

9.7

3.7

3.3

10

.38

.73

97

.54

10

.2

No

rth

ern

Am

eri

ca2

56

.21

4.4

54

.72

3.5

26

0.3

9.0

39

.82

4.0

58

.11

8.7

13

.41

0.9

14

.34

3.6

5.3

4.2

38

.33

2.1

12

.29

.92

5.5

19

.59

20

.68

65

.7

Asi

a6

51

.02

84

.81

31

.81

11

.91

96

.21

5.1

81

.44

2.0

11

5.6

32

.97

2.1

59

.43

2.9

11

1.6

15

.38

.78

9.4

60

.62

0.6

15

.29

7.3

70

.23

69

4.9

30

68

.2

Ea

ste

rnA

sia

27

7.1

78

.08

9.4

48

.31

18

.64

.36

1.5

31

.26

4.7

20

.83

9.6

35

.71

9.9

72

.22

.11

.54

1.5

30

.11

0.5

7.4

47

.63

4.0

24

31

.51

71

3.5

So

uth

-Ea

ste

rnA

sia

10

7.5

50

.61

5.3

19

.92

6.5

2.6

4.9

2.8

10

.83

.07

.56

.35

.01

4.3

1.5

0.9

15

.31

1.3

2.3

2.2

13

.81

2.0

38

2.9

40

3.5

So

uth

-Ce

ntr

al

Asi

a2

23

.91

51

.82

0.0

38

.42

9.3

5.9

10

.45

.12

4.4

6.2

19

.51

2.2

5.5

14

.78

.94

.62

5.2

13

.65

.94

.02

8.9

19

.27

11

.88

02

.3

We

ste

rnA

sia

42

.54

.57

.15

.22

1.8

2.3

4.6

2.9

15

.82

.95

.55

.12

.51

0.5

2.8

1.8

7.5

5.6

2.0

1.6

7.0

5.0

16

8.7

14

8.9

Eu

rop

e4

64

.25

8.4

99

.06

5.6

41

7.1

21

.57

1.8

43

.51

18

.43

2.9

30

.72

6.4

12

.34

0.7

9.3

8.3

49

.64

3.9

20

.51

8.4

46

.43

5.9

18

30

.51

61

1.7

Ce

ntr

al

an

dE

ast

ern

Eu

rop

e1

23

.63

3.9

42

.02

8.3

65

.44

.92

3.8

16

.63

0.9

8.9

9.9

9.7

3.2

16

.03

.03

.18

.89

.33

.24

.01

3.2

11

.75

13

.85

23

.1

No

rth

ern

Eu

rop

e7

8.2

5.4

13

.81

0.0

81

.73

.69

.55

.91

2.7

4.6

4.7

3.8

1.2

3.8

1.4

1.1

9.8

8.3

3.9

3.1

7.3

5.2

27

1.6

25

4.2

So

uth

ern

Eu

rop

e1

00

.89

.31

9.5

12

.99

1.4

4.8

15

.47

.63

4.8

8.0

7.7

6.3

3.8

9.9

2.2

1.8

12

.71

0.4

5.1

4.6

11

.28

.14

30

.53

38

.7

We

ste

rnE

uro

pe

16

1.5

9.8

23

.61

4.4

17

8.7

8.2

23

.01

3.4

40

.01

1.3

8.4

6.6

4.1

11

.02

.62

.31

8.3

15

.98

.46

.71

4.8

10

.86

14

.74

95

.7

Oce

an

ia1

9.3

2.2

3.1

2.0

26

.11

.02

.71

.43

.00

.91

.20

.80

.82

.50

.40

.33

.32

.61

.10

.82

.51

.78

6.0

69

.4

Au

stra

lia

/Ne

wZ

ea

lan

d1

7.6

0.9

2.8

1.7

25

.31

.02

.71

.42

.90

.91

.20

.80

.72

.00

.40

.33

.02

.41

.10

.82

.31

.58

1.0

62

.4

Me

lan

esi

a1

.41

.20

.30

.30

.50

.00

.00

.00

.10

.00

.00

.00

.10

.40

.00

.00

.20

.20

.00

.00

.20

.14

.06

.1

Mic

ron

esi

a/P

oly

ne

sia

0.4

0.1

0.1

0.0

0.4

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.1

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

1.1

1.0

Epi

dem

iolo

gy

Tab

le6

.E

stim

ate

dn

um

be

rso

fca

nce

rd

ea

ths

(th

ou

san

ds)

by

sex,

can

cer

site

an

dre

gio

ns,

20

12

Ora

lca

vity

(C0

0-0

8)

Na

sop

ha

r-yn

x(C

11

)

Oth

er

ph

ar-

ynx

(C0

9-

10

,C1

2-1

4)

Oe

sop

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gu

s(C

15

)S

tom

ach

(C1

6)

Co

lore

ctu

m(C

18

-21

)Li

ver

(C2

2)

Ga

llb

lad

de

r(C

23

-24

)P

an

cre

as

(C2

5)

Lary

nx

(C3

2)

Lun

g(C

33

-34

)M

ela

no

ma

(C4

3)

Ka

po

sisa

rco

ma

(C4

6)

MF

MF

MF

MF

MF

MF

MF

MF

MF

MF

MF

MF

MF

Wo

rld

97

.94

7.4

35

.81

5.1

77

.61

8.5

28

1.2

11

8.9

46

8.9

25

4.1

37

3.6

32

0.3

52

1.0

22

4.5

60

.38

2.5

17

3.8

15

6.6

73

.31

0.1

10

98

.64

91

.23

1.4

24

.11

7.4

9.6

Mo

red

eve

lop

ed

reg

ion

s2

3.4

9.9

2.3

1.1

21

.44

.15

6.1

15

.21

06

.76

8.0

17

5.4

15

7.7

80

.44

2.6

19

.02

5.8

93

.19

1.3

22

.72

.74

16

.62

09

.82

1.3

15

.00

.30

.1

Less

de

velo

pe

dre

gio

ns

74

.53

7.5

33

.51

4.0

56

.21

4.4

22

5.1

10

3.7

36

2.3

18

6.1

19

8.2

16

2.5

44

0.6

18

1.8

41

.35

6.6

80

.76

5.3

50

.67

.56

82

.02

81

.41

0.1

9.1

17

.19

.5

Afr

ica

6.1

4.3

3.5

2.1

2.6

1.5

14

.71

0.5

12

.09

.81

5.1

14

.33

7.0

19

.01

.52

.86

.45

.34

.30

.61

9.4

7.7

1.5

2.1

16

.39

.2

Ea

ste

rnA

fric

a2

.81

.91

.30

.90

.80

.58

.96

.94

.13

.54

.64

.64

.33

.20

.30

.91

.21

.51

.20

.22

.81

.80

.50

.81

3.9

7.5

Mid

dle

Afr

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0.9

0.5

0.4

0.2

0.5

0.2

1.1

0.6

1.3

1.3

1.2

1.4

3.5

2.0

0.0

0.0

0.4

0.3

0.3

0.1

0.5

0.3

0.3

0.5

0.4

0.2

No

rth

ern

Afr

ica

1.0

0.7

1.2

0.5

0.5

0.5

1.7

1.2

3.0

2.1

4.4

3.9

13

.15

.60

.81

.52

.41

.51

.50

.11

0.6

2.4

0.1

0.2

0.1

0.1

So

uth

ern

Afr

ica

0.5

0.2

0.0

0.0

0.4

0.1

2.3

1.6

0.9

0.7

1.8

1.5

1.3

0.8

0.1

0.1

0.9

0.9

0.5

0.1

4.3

2.3

0.3

0.2

1.2

0.9

We

ste

rnA

fric

a1

.00

.90

.60

.30

.40

.10

.60

.32

.62

.33

.12

.81

4.8

7.4

0.2

0.3

1.5

1.1

0.8

0.1

1.2

0.9

0.4

0.4

0.8

0.6

The

Am

eri

cas

8.5

4.3

1.1

0.5

8.4

2.2

27

.08

.03

9.1

26

.05

7.1

55

.13

4.7

23

.25

.91

1.3

36

.53

7.3

11

.72

.11

49

.51

12

.99

.95

.80

.40

.1

Ca

rib

be

an

0.5

0.2

0.1

0.0

0.6

0.2

1.0

0.3

1.6

1.1

2.2

2.7

1.4

1.2

0.1

0.2

1.0

1.0

0.9

0.1

5.6

3.3

0.1

0.1

0.0

0.0

Ce

ntr

al

Am

eri

ca0

.50

.40

.10

.00

.50

.21

.10

.46

.15

.43

.33

.14

.54

.80

.71

.62

.42

.81

.00

.26

.23

.50

.40

.30

.00

.0

So

uth

Am

eri

ca4

.21

.80

.40

.24

.20

.91

0.8

3.7

23

.21

4.0

18

.31

9.0

10

.48

.93

.46

.99

.91

0.8

6.2

1.0

35

.32

0.8

2.0

1.5

0.2

0.1

No

rth

ern

Am

eri

ca3

.31

.90

.60

.33

.11

.01

4.2

3.6

8.2

5.5

33

.23

0.3

18

.48

.21

.72

.62

3.2

22

.73

.50

.81

02

.48

5.3

7.4

3.9

0.1

0.0

Asi

a6

5.0

32

.42

9.7

11

.75

1.0

12

.12

08

.09

0.7

35

3.1

17

4.0

18

5.0

14

6.6

40

7.7

15

9.2

44

.95

5.1

76

.76

0.6

39

.05

.76

68

.82

67

.36

.45

.40

.50

.3

Ea

ste

rnA

sia

12

.26

.21

5.9

6.1

7.9

1.4

15

5.3

59

.92

66

.31

28

.31

15

.59

2.2

32

2.9

12

1.0

31

.83

5.7

58

.04

5.1

12

.41

.95

01

.72

11

.14

.03

.40

.10

.1

So

uth

-Ea

ste

rnA

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5.0

3.5

10

.04

.25

.41

.58

.52

.71

8.6

10

.62

4.1

19

.15

5.8

20

.53

.13

.26

.25

.73

.30

.76

5.8

27

.80

.70

.50

.10

.1

So

uth

-Ce

ntr

al

Asi

a4

6.9

22

.03

.11

.13

7.2

8.9

41

.92

6.4

59

.62

9.0

37

.02

8.4

24

.91

5.2

8.9

15

.18

.67

.02

0.8

2.7

73

.02

2.5

1.1

0.9

0.1

0.1

We

ste

rnA

sia

0.9

0.6

0.7

0.3

0.5

0.3

2.3

1.8

8.6

6.0

8.4

6.9

4.0

2.5

1.1

1.2

3.9

2.8

2.4

0.4

28

.45

.90

.60

.50

.20

.1

Eu

rop

e1

7.6

6.0

1.4

0.7

15

.22

.73

0.3

9.2

63

.64

3.7

11

3.2

10

1.6

39

.92

2.3

7.9

13

.05

2.6

51

.91

8.1

1.7

25

4.6

99

.11

2.1

10

.20

.20

.1

Ce

ntr

al

an

dE

ast

ern

Eu

rop

e1

0.1

2.4

0.6

0.4

7.3

0.9

9.9

2.1

34

.32

4.0

42

.54

1.9

10

.87

.62

.75

.31

8.1

17

.09

.80

.69

5.7

26

.33

.94

.00

.10

.0

No

rth

ern

Eu

rop

e1

.40

.80

.10

.11

.10

.46

.93

.14

.93

.21

4.2

12

.63

.92

.40

.61

.17

.07

.31

.20

.22

9.5

22

.82

.31

.70

.00

.0

So

uth

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Eu

rop

e2

.71

.30

.40

.22

.30

.44

.11

.01

3.8

9.3

27

.12

1.0

12

.26

.42

.63

.61

1.5

11

.24

.40

.46

1.3

18

.32

.31

.70

.10

.1

We

ste

rnE

uro

pe

3.4

1.5

0.3

0.1

4.5

1.0

9.4

2.9

10

.67

.32

9.4

26

.11

3.0

5.9

2.0

3.0

16

.11

6.4

2.8

0.5

68

.13

1.7

3.6

2.8

0.0

0.0

Oce

an

ia0

.70

.50

.10

.00

.30

.11

.20

.51

.10

.63

.22

.71

.70

.80

.20

.21

.61

.50

.30

.16

.34

.31

.50

.70

.00

.0

Au

stra

lia

/Ne

wZ

ea

lan

d0

.30

.20

.00

.00

.30

.11

.10

.40

.90

.52

.92

.51

.20

.60

.10

.21

.51

.50

.20

.05

.84

.11

.40

.60

.00

.0

Me

lan

esi

a0

.30

.30

.00

.00

.10

.00

.10

.00

.10

.10

.20

.10

.40

.20

.00

.00

.10

.00

.00

.00

.30

.10

.10

.10

.00

.0

Mic

ron

esi

a/P

oly

ne

sia

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.1

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.2

0.1

0.0

0.0

0.0

0.0

Epi

dem

iolo

gy

Tab

le6

.E

stim

ate

dn

um

be

rso

fca

nce

rd

ea

ths

(th

ou

san

ds)

by

sex,

can

cer

site

an

dre

gio

ns,

20

12

(Co

nti

nu

ed

)

Bre

ast

(C5

0)

Ce

rvix

ute

ri(C

53

)

Co

rpu

su

teri

(C5

4)

Ova

ry(C

56

)P

rost

ate

(C6

1)

Test

is(C

62

)K

idn

ey

(C6

4-6

6)

Bla

dd

er

(C6

7)

Bra

in,

cns

(C7

0-7

2)

Thyr

oid

(C7

3)

Ho

dg

kin

(C8

1)

NH

L(C

82

-8

5,C

96

)

Mu

ltip

lem

yelo

ma

(C8

81

C9

0)

Leu

ka

em

ia(C

91

-95

)A

llsi

tes

bu

tC

44

(C0

0-9

7/C

44

)

FF

FF

MM

MF

MF

MF

MF

MF

MF

MF

MF

MF

Wo

rld

52

1.8

26

5.7

76

.21

51

.93

07

.51

0.4

90

.85

2.6

12

3.0

42

.01

06

.48

3.0

12

.62

7.1

15

.51

0.0

11

5.4

84

.24

3.1

36

.91

51

.31

14

.14

65

3.1

35

47

.9

Mo

red

eve

lop

ed

reg

ion

s1

97

.53

5.5

34

.76

5.9

14

2.0

2.2

47

.92

7.0

58

.92

1.0

36

.82

9.8

3.7

6.7

3.6

2.7

40

.83

4.3

22

.32

0.7

51

.34

0.3

15

91

.21

28

6.7

Less

de

velo

pe

dre

gio

ns

32

4.3

23

0.2

41

.48

6.0

16

5.5

8.1

42

.92

5.6

64

.12

1.0

69

.65

3.2

9.0

20

.41

1.9

7.3

74

.55

0.0

20

.81

6.2

10

0.0

73

.83

06

1.9

22

61

.2

Afr

ica

63

.26

0.1

4.0

13

.14

2.8

0.9

4.2

4.0

9.4

3.9

5.4

4.6

1.5

4.0

2.8

2.0

15

.01

1.4

2.6

2.5

11

.69

.52

77

.83

13

.3

Ea

ste

rnA

fric

a1

7.0

28

.21

.24

.51

3.9

0.3

1.2

1.6

1.8

1.3

1.2

1.0

0.6

1.5

0.9

0.7

5.1

3.7

0.8

0.9

4.4

3.7

92

.41

16

.1

Mid

dle

Afr

ica

6.0

7.9

0.5

1.2

5.9

0.1

0.3

0.3

0.4

0.3

0.2

0.2

0.1

0.3

0.2

0.1

1.7

1.4

0.3

0.3

1.0

0.8

25

.63

1.2

No

rth

ern

Afr

ica

15

.62

.70

.83

.55

.00

.31

.51

.15

.51

.33

.22

.70

.51

.51

.00

.74

.33

.20

.90

.74

.23

.17

7.0

66

.5

So

uth

ern

Afr

ica

4.0

4.7

0.5

1.0

3.8

0.1

0.3

0.2

0.5

0.2

0.4

0.3

0.0

0.1

0.1

0.1

0.9

0.8

0.3

0.4

0.7

0.6

25

.12

5.9

We

ste

rnA

fric

a2

0.5

16

.51

.12

.91

4.3

0.2

0.8

0.9

1.1

0.8

0.4

0.3

0.2

0.6

0.6

0.4

3.1

2.3

0.3

0.3

1.3

1.2

57

.87

3.6

The

Am

eri

cas

92

.13

5.7

13

.62

8.5

85

.42

.01

7.8

10

.22

0.4

8.4

20

.21

6.8

1.9

3.4

2.1

1.6

22

.01

7.8

11

.49

.62

7.8

22

.16

76

.66

18

.2

Ca

rib

be

an

3.9

2.3

0.9

0.8

8.0

0.0

0.3

0.2

0.8

0.3

0.6

0.6

0.1

0.1

0.1

0.1

0.6

0.5

0.4

0.4

0.8

0.7

29

.52

3.7

Ce

ntr

al

Am

eri

ca7

.36

.91

.32

.69

.00

.51

.51

.00

.90

.51

.81

.50

.30

.60

.40

.31

.71

.50

.70

.63

.12

.85

3.9

56

.8

So

uth

Am

eri

ca3

2.0

19

.43

.78

.13

4.4

0.9

5.3

3.0

5.4

2.3

7.8

7.0

0.6

1.5

0.7

0.5

6.2

5.0

3.0

2.7

8.2

6.9

23

0.5

20

9.0

No

rth

ern

Am

eri

ca4

8.9

7.1

7.8

17

.03

4.1

0.5

10

.76

.01

3.3

5.3

10

.17

.70

.91

.20

.80

.61

3.5

10

.97

.36

.01

5.6

11

.73

62

.83

28

.7

Asi

a2

31

.01

44

.43

4.2

66

.28

2.7

5.8

36

.82

0.3

52

.81

6.5

55

.24

0.5

7.1

15

.37

.94

.45

6.9

36

.61

6.3

12

.28

1.0

57

.32

68

9.5

18

10

.1

Ea

ste

rnA

sia

68

.53

6.3

20

.82

1.9

37

.61

.02

3.7

13

.12

7.3

10

.23

1.5

23

.73

.14

.90

.80

.62

4.6

16

.38

.05

.93

9.8

27

.11

75

6.1

10

02

.2

So

uth

-Ea

ste

rnA

sia

43

.02

4.0

4.4

13

.01

5.8

1.2

3.4

1.9

5.4

1.5

5.2

4.3

1.8

4.7

0.8

0.5

10

.47

.61

.81

.81

1.7

10

.22

90

.22

38

.3

So

uth

-Ce

ntr

al

Asi

a1

04

.78

2.2

7.2

27

.81

8.9

2.8

6.9

3.5

13

.43

.41

5.0

9.3

1.6

4.2

5.0

2.5

17

.69

.55

.13

.42

4.0

16

.05

33

.04

90

.4

We

ste

rnA

sia

14

.81

.91

.83

.51

0.4

0.8

2.8

1.8

6.8

1.3

3.5

3.3

0.6

1.5

1.3

0.8

4.4

3.2

1.4

1.2

5.5

3.9

11

0.1

79

.2

Eu

rop

e1

31

.32

4.4

23

.74

2.7

92

.31

.63

1.3

17

.73

9.5

12

.92

4.6

20

.42

.14

.32

.62

.02

0.3

17

.51

2.2

12

.12

9.5

24

.39

76

.67

79

.2

Ce

ntr

al

an

dE

ast

ern

Eu

rop

e4

8.7

15

.41

0.7

16

.82

5.9

0.9

11

.76

.91

3.2

3.5

8.5

7.9

0.8

2.3

1.3

1.0

5.1

4.6

2.4

2.9

8.6

7.9

35

1.2

28

7.0

No

rth

ern

Eu

rop

e1

7.8

1.9

2.9

6.6

18

.10

.14

.12

.65

.22

.43

.62

.70

.20

.40

.30

.23

.53

.02

.42

.14

.13

.11

29

.01

15

.5

So

uth

ern

Eu

rop

e2

7.5

3.5

4.6

7.8

20

.20

.35

.93

.01

1.7

3.0

5.9

4.8

0.5

0.8

0.6

0.4

5.0

4.2

3.1

3.1

7.6

5.8

22

7.6

16

2.8

We

ste

rnE

uro

pe

37

.23

.55

.51

1.5

28

.10

.39

.65

.39

.54

.06

.55

.10

.50

.80

.50

.36

.75

.84

.34

.09

.27

.52

68

.72

13

.9

Oce

an

ia4

.31

.10

.61

.44

.30

.00

.80

.41

.00

.41

.00

.70

.10

.20

.10

.11

.10

.90

.60

.51

.30

.93

2.5

27

.1

Au

stra

lia

/Ne

wZ

ea

lan

d3

.60

.40

.41

.23

.90

.00

.70

.40

.90

.40

.90

.70

.10

.10

.10

.00

.90

.70

.60

.51

.10

.82

9.0

23

.0

Me

lan

esi

a0

.60

.70

.10

.20

.30

.00

.00

.00

.00

.00

.00

.00

.00

.10

.00

.00

.20

.10

.00

.00

.20

.12

.93

.7

Mic

ron

esi

a/P

oly

ne

sia

0.1

0.0

0.0

0.0

0.1

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.6

0.4

Epi

dem

iolo

gy

Tab

le7

.E

stim

ate

dcu

mu

lati

veri

skto

ag

e7

5(p

erc

en

t)b

yse

x,ca

nce

rsi

tea

nd

reg

ion

s,2

01

2—

Inci

de

nce

Ora

lca

vity

(C0

0-0

8)

Na

sop

ha

r-yn

x(C

11

)

Oth

er

ph

ary

nx

(C0

9-

10

,C1

2-1

4)

Oe

sop

ha

-g

us

(C1

5)

Sto

ma

ch(C

16

)C

olo

rect

um

(C1

8-2

1)

Live

r(C

22

)G

all

bla

dd

er

(C2

3-2

4)

Pa

ncr

ea

s(C

25

)La

ryn

x(C

32

)Lu

ng

(C3

3-

34

)M

ela

no

ma

(C4

3)

Ka

po

sisa

r-co

ma

(C4

6)

MF

MF

MF

MF

MF

MF

MF

MF

MF

MF

MF

MF

MF

Wo

rld

0.6

0.3

0.2

0.1

0.4

0.1

1.1

0.3

2.0

0.8

2.4

1.6

1.7

0.6

0.2

0.3

0.6

0.4

0.5

0.1

3.9

1.5

0.4

0.3

0.1

0.0

Mo

red

eve

lop

ed

reg

ion

s0

.80

.30

.10

.00

.60

.10

.80

.11

.90

.84

.32

.71

.00

.30

.30

.21

.00

.70

.60

.15

.42

.41

.10

.90

.00

.0

Less

de

velo

pe

dre

gio

ns

0.6

0.3

0.2

0.1

0.3

0.1

1.2

0.4

2.0

0.9

1.5

1.1

2.0

0.7

0.2

0.3

0.4

0.3

0.4

0.1

3.3

1.2

0.1

0.1

0.1

0.0

Afr

ica

0.4

0.2

0.2

0.1

0.1

0.1

0.7

0.4

0.5

0.4

0.8

0.7

1.4

0.7

0.1

0.1

0.3

0.2

0.3

0.0

0.9

0.3

0.1

0.1

0.5

0.2

Ea

ste

rnA

fric

a0

.50

.30

.20

.10

.10

.11

.40

.90

.60

.50

.90

.70

.50

.40

.00

.10

.20

.20

.30

.10

.50

.30

.10

.21

.40

.7

Mid

dle

Afr

ica

0.4

0.2

0.1

0.1

0.2

0.1

0.5

0.2

0.5

0.5

0.6

0.6

1.2

0.6

0.0

0.0

0.2

0.1

0.2

0.0

0.2

0.1

0.2

0.3

0.1

0.1

No

rth

ern

Afr

ica

0.3

0.2

0.2

0.1

0.1

0.1

0.3

0.2

0.5

0.3

1.0

0.8

2.2

0.8

0.1

0.2

0.4

0.2

0.5

0.1

1.9

0.4

0.0

0.1

0.0

0.0

So

uth

ern

Afr

ica

0.7

0.3

0.0

0.0

0.4

0.2

1.6

0.8

0.8

0.3

1.6

1.0

0.7

0.4

0.1

0.1

0.6

0.4

0.6

0.1

3.1

1.2

0.6

0.4

0.6

0.4

We

ste

rnA

fric

a0

.20

.20

.10

.00

.10

.00

.10

.00

.40

.30

.50

.41

.80

.90

.00

.00

.30

.10

.20

.00

.20

.10

.10

.10

.10

.0

The

Am

eri

cas

0.7

0.3

0.1

0.0

0.4

0.1

0.7

0.2

1.1

0.6

2.6

2.0

0.9

0.4

0.2

0.3

0.8

0.6

0.6

0.1

3.8

2.7

1.0

0.6

0.0

0.0

Ca

rib

be

an

0.6

0.2

0.1

0.0

0.4

0.1

0.5

0.2

0.9

0.6

1.9

1.9

0.7

0.5

0.1

0.1

0.5

0.4

1.0

0.1

3.1

1.6

0.1

0.1

0.0

0.0

Ce

ntr

al

Am

eri

ca0

.30

.20

.00

.00

.10

.00

.20

.11

.20

.91

.00

.80

.80

.80

.10

.30

.40

.40

.50

.11

.20

.60

.20

.10

.00

.0

So

uth

Am

eri

ca0

.60

.30

.10

.00

.30

.10

.80

.21

.70

.82

.01

.60

.60

.40

.30

.40

.60

.50

.60

.12

.51

.30

.30

.20

.10

.0

No

rth

ern

Am

eri

ca0

.90

.30

.10

.00

.50

.10

.70

.10

.60

.33

.42

.51

.10

.30

.20

.21

.00

.80

.50

.15

.44

.31

.81

.20

.00

.0

Asi

a0

.60

.30

.20

.10

.40

.11

.30

.52

.61

.01

.91

.22

.20

.70

.30

.30

.40

.30

.40

.13

.81

.30

.10

.00

.00

.0

Ea

ste

rnA

sia

0.3

0.1

0.3

0.1

0.2

0.0

2.0

0.6

4.0

1.5

2.5

1.6

3.4

1.1

0.3

0.3

0.6

0.4

0.3

0.0

5.3

2.0

0.1

0.1

0.0

0.0

So

uth

-Ea

ste

rnA

sia

0.4

0.3

0.7

0.3

0.3

0.1

0.4

0.1

1.0

0.5

1.8

1.2

2.5

0.8

0.2

0.2

0.3

0.2

0.3

0.1

3.5

1.3

0.1

0.0

0.0

0.0

So

uth

-Ce

ntr

al

Asi

a1

.10

.60

.10

.00

.80

.20

.80

.51

.10

.50

.80

.60

.40

.20

.20

.30

.20

.10

.60

.11

.50

.40

.00

.00

.00

.0

We

ste

rnA

sia

0.3

0.2

0.1

0.1

0.1

0.0

0.3

0.2

1.4

0.9

2.1

1.4

0.6

0.3

0.2

0.2

0.6

0.4

0.8

0.1

4.6

0.9

0.2

0.2

0.1

0.0

Eu

rop

e0

.90

.30

.10

.00

.60

.10

.70

.11

.60

.74

.52

.70

.80

.30

.20

.21

.00

.60

.80

.15

.71

.80

.90

.90

.00

.0

Ce

ntr

al

an

dE

ast

ern

Eu

rop

e1

.10

.20

.10

.00

.60

.10

.70

.12

.51

.14

.32

.60

.60

.20

.20

.21

.10

.61

.00

.16

.71

.30

.50

.50

.00

.0

No

rth

ern

Eu

rop

e0

.70

.30

.10

.00

.40

.11

.00

.30

.90

.44

.22

.90

.50

.20

.10

.10

.90

.70

.40

.14

.23

.01

.51

.50

.00

.0

So

uth

ern

Eu

rop

e0

.70

.20

.10

.00

.40

.10

.40

.11

.40

.64

.72

.81

.10

.30

.20

.20

.90

.60

.90

.15

.61

.50

.80

.80

.10

.0

We

ste

rnE

uro

pe

0.9

0.4

0.1

0.0

0.9

0.2

0.8

0.2

1.0

0.5

4.7

2.8

1.0

0.3

0.2

0.2

1.0

0.7

0.6

0.1

5.4

2.4

1.3

1.3

0.0

0.0

Oce

an

ia1

.10

.60

.10

.00

.40

.10

.60

.20

.80

.44

.83

.30

.90

.30

.20

.20

.80

.50

.40

.03

.72

.53

.82

.70

.00

.0

Au

stra

lia

/Ne

wZ

ea

lan

d0

.90

.40

.10

.00

.40

.10

.60

.20

.80

.35

.23

.60

.80

.20

.20

.20

.90

.60

.40

.03

.82

.74

.43

.10

.00

.0

Me

lan

esi

a2

.81

.90

.00

.00

.60

.00

.50

.20

.90

.61

.40

.71

.60

.80

.20

.10

.30

.10

.40

.11

.90

.70

.30

.50

.00

.0

Mic

ron

esi

a/P

oly

ne

sia

0.6

0.1

0.3

0.2

0.3

0.0

0.3

0.0

1.1

0.3

2.3

1.5

1.3

0.1

0.1

0.1

0.4

0.2

0.2

0.0

5.4

2.3

0.5

0.2

0.0

0.0

Epi

dem

iolo

gy

Tab

le7

.E

stim

ate

dcu

mu

lati

veri

skto

ag

e7

5(p

erc

en

t)b

yse

x,ca

nce

rsi

tea

nd

reg

ion

s,2

01

2—

Inci

de

nce

(Co

nti

nu

ed

)

Bre

ast

(C5

0)

Ce

rvix

ute

ri(C

53

)

Co

rpu

su

teri

(C5

4)

Ova

ry(C

56

)P

rost

ate

(C6

1)

Test

is(C

62

)K

idn

ey

(C6

4-6

6)

Bla

dd

er

(C6

7)

Bra

in,

cns

(C7

0-7

2)

Thyr

oid

(C7

3)

Ho

dg

kin

(C8

1)

NH

L(C

82

-8

5,C

96

)

Mu

ltip

lem

yelo

ma

(C8

81

C9

0)

Leu

ka

em

ia(C

91

-95

)

All

site

sb

ut

C4

4(C

00

-97

/C

44

)

FF

FF

MM

MF

MF

MF

MF

MF

MF

MF

MF

MF

Wo

rld

4.6

1.4

1.0

0.7

3.8

0.1

0.7

0.3

1.0

0.2

0.4

0.3

0.2

0.6

0.1

0.1

0.6

0.4

0.2

0.2

0.5

0.4

21

.01

6.4

Mo

red

eve

lop

ed

reg

ion

s8

.00

.91

.81

.08

.80

.41

.50

.72

.00

.40

.60

.40

.41

.10

.20

.21

.10

.80

.40

.30

.90

.53

0.9

23

.3

Less

de

velo

pe

dre

gio

ns

3.3

1.6

0.6

0.5

1.6

0.1

0.4

0.2

0.6

0.2

0.3

0.3

0.1

0.4

0.1

0.0

0.4

0.3

0.1

0.1

0.4

0.3

16

.61

3.4

Afr

ica

3.7

3.0

0.4

0.5

2.8

0.0

0.1

0.1

0.8

0.2

0.2

0.2

0.1

0.3

0.1

0.1

0.6

0.4

0.1

0.1

0.3

0.3

12

.31

3.4

Ea

ste

rnA

fric

a3

.24

.60

.40

.62

.80

.00

.10

.10

.40

.20

.10

.10

.10

.30

.10

.10

.60

.30

.20

.10

.40

.31

2.6

15

.6

Mid

dle

Afr

ica

2.8

3.4

0.4

0.4

3.5

0.0

0.1

0.1

0.3

0.2

0.1

0.1

0.1

0.1

0.1

0.0

0.4

0.3

0.2

0.1

0.3

0.2

10

.31

1.6

No

rth

ern

Afr

ica

4.4

0.7

0.4

0.6

1.2

0.1

0.3

0.2

1.8

0.4

0.6

0.4

0.2

0.4

0.2

0.1

0.8

0.6

0.2

0.1

0.5

0.4

14

.21

2.8

So

uth

ern

Afr

ica

4.1

3.1

0.8

0.5

7.3

0.1

0.2

0.1

0.8

0.2

0.2

0.1

0.1

0.2

0.1

0.1

0.5

0.4

0.2

0.2

0.4

0.3

21

.61

5.8

We

ste

rnA

fric

a3

.93

.20

.40

.42

.90

.00

.10

.10

.30

.10

.00

.00

.00

.10

.10

.00

.40

.20

.10

.10

.10

.18

.31

1.3

The

Am

eri

cas

7.4

1.4

1.5

0.8

9.4

0.2

1.1

0.6

1.5

0.4

0.5

0.4

0.4

1.2

0.2

0.1

1.1

0.8

0.4

0.3

0.7

0.5

26

.82

2.5

Ca

rib

be

an

4.9

2.0

1.3

0.5

9.4

0.1

0.3

0.2

0.9

0.2

0.3

0.3

0.1

0.4

0.1

0.1

0.5

0.4

0.3

0.2

0.4

0.3

21

.91

6.8

Ce

ntr

al

Am

eri

ca3

.52

.30

.80

.53

.30

.20

.50

.30

.40

.20

.40

.30

.10

.40

.10

.10

.40

.30

.20

.10

.50

.41

3.0

14

.2

So

uth

Am

eri

ca5

.62

.00

.70

.67

.10

.20

.60

.30

.80

.20

.60

.40

.20

.80

.10

.10

.60

.50

.20

.20

.50

.42

1.3

17

.8

No

rth

ern

Am

eri

ca1

0.0

0.6

2.3

0.9

12

.30

.41

.80

.92

.20

.60

.60

.40

.71

.90

.20

.21

.61

.10

.50

.41

.00

.73

3.9

28

.3

Asi

a3

.01

.30

.70

.51

.00

.10

.40

.20

.60

.10

.30

.30

.20

.50

.10

.00

.40

.30

.10

.10

.40

.31

7.5

13

.2

Ea

ste

rnA

sia

2.8

0.7

0.9

0.5

1.1

0.0

0.6

0.3

0.6

0.2

0.4

0.3

0.2

0.7

0.0

0.0

0.4

0.3

0.1

0.1

0.5

0.3

21

.81

4.5

So

uth

-Ea

ste

rnA

sia

3.7

1.7

0.6

0.7

1.3

0.1

0.2

0.1

0.5

0.1

0.3

0.2

0.2

0.4

0.1

0.0

0.6

0.4

0.1

0.1

0.4

0.3

15

.61

3.5

So

uth

-Ce

ntr

al

Asi

a2

.92

.10

.30

.50

.50

.10

.20

.10

.40

.10

.20

.10

.10

.20

.10

.10

.30

.20

.10

.10

.30

.21

0.8

10

.7

We

ste

rnA

sia

4.5

0.5

0.9

0.6

3.5

0.1

0.6

0.3

2.3

0.4

0.6

0.5

0.3

0.9

0.2

0.1

0.8

0.6

0.3

0.2

0.6

0.4

20

.51

5.2

Eu

rop

e7

.61

.11

.71

.18

.20

.41

.40

.72

.10

.40

.60

.40

.30

.80

.20

.21

.00

.60

.40

.30

.90

.53

0.3

22

.3

Ce

ntr

al

an

dE

ast

ern

Eu

rop

e5

.31

.51

.91

.33

.90

.21

.50

.71

.90

.30

.60

.40

.20

.70

.20

.10

.50

.40

.20

.20

.80

.52

7.2

19

.6

No

rth

ern

Eu

rop

e9

.60

.81

.81

.21

0.6

0.5

1.3

0.7

1.4

0.4

0.7

0.5

0.2

0.5

0.2

0.2

1.3

0.9

0.5

0.3

0.9

0.6

29

.82

5.5

So

uth

ern

Eu

rop

e7

.70

.81

.61

.07

.60

.41

.30

.52

.50

.40

.70

.50

.40

.90

.20

.21

.10

.70

.40

.30

.80

.52

9.8

21

.2

We

ste

rnE

uro

pe

10

.20

.71

.50

.91

2.1

0.6

1.6

0.8

2.3

0.5

0.6

0.4

0.3

0.8

0.2

0.2

1.2

0.9

0.5

0.3

0.9

0.6

34

.12

5.4

Oce

an

ia8

.40

.91

.50

.91

2.4

0.4

1.3

0.6

1.1

0.3

0.6

0.3

0.4

1.1

0.2

0.1

1.5

1.1

0.5

0.3

1.0

0.6

32

.92

5.2

Au

stra

lia

/Ne

wZ

ea

lan

d9

.10

.51

.50

.91

3.6

0.5

1.5

0.7

1.2

0.3

0.7

0.4

0.4

1.1

0.2

0.2

1.6

1.1

0.5

0.3

1.1

0.7

35

.02

6.3

Me

lan

esi

a4

.13

.21

.20

.82

.70

.00

.10

.10

.40

.10

.10

.00

.21

.10

.10

.00

.80

.50

.20

.10

.50

.31

6.5

17

.4

Mic

ron

esi

a/P

oly

ne

sia

6.2

1.0

1.4

0.6

8.5

0.0

0.4

0.1

0.7

0.1

0.1

0.0

0.3

1.2

0.0

0.0

0.7

0.3

0.2

0.1

0.6

0.2

23

.41

6.6

Epi

dem

iolo

gy

Tab

le8

.E

stim

ate

dcu

mu

lati

veri

skto

ag

e7

5(p

erc

en

t)b

yse

x,ca

nce

rsi

tea

nd

reg

ion

s,2

01

2—

Mo

rta

lity

Ora

lca

vity

(C0

0-0

8)

Na

sop

ha

r-yn

x(C

11

)

Oth

er

ph

ary

nx

(C0

9-

10

,C1

2-1

4)

Oe

sop

ha

-g

us

(C1

5)

Sto

ma

ch(C

16

)C

olo

rect

um

(C1

8-2

1)

Live

r(C

22

)G

all

bla

dd

er

(C2

3-2

4)

Pa

ncr

ea

s(C

25

)La

ryn

x(C

32

)Lu

ng

(C3

3-

34

)M

ela

no

ma

(C4

3)

Ka

po

sisa

r-co

ma

(C4

6)

MF

MF

MF

MF

MF

MF

MF

MF

MF

MF

MF

MF

MF

Wo

rld

0.3

0.1

0.1

0.0

0.3

0.1

0.9

0.3

1.4

0.6

1.0

0.7

1.6

0.6

0.2

0.2

0.5

0.4

0.2

0.0

3.3

1.2

0.1

0.1

0.1

0.0

Mo

red

eve

lop

ed

reg

ion

s0

.30

.10

.00

.00

.30

.00

.60

.11

.00

.41

.60

.90

.80

.30

.20

.11

.00

.60

.30

.04

.31

.70

.20

.10

.00

.0

Less

de

velo

pe

dre

gio

ns

0.3

0.2

0.2

0.1

0.3

0.1

1.0

0.4

1.5

0.7

0.8

0.6

1.8

0.7

0.2

0.2

0.3

0.3

0.2

0.0

2.9

1.0

0.0

0.0

0.1

0.0

Afr

ica

0.2

0.2

0.1

0.1

0.1

0.1

0.6

0.4

0.5

0.3

0.6

0.5

1.3

0.6

0.1

0.1

0.3

0.2

0.2

0.0

0.8

0.3

0.1

0.1

0.5

0.2

Ea

ste

rnA

fric

a0

.40

.20

.20

.10

.10

.11

.30

.90

.60

.40

.60

.50

.50

.30

.00

.10

.20

.20

.20

.00

.40

.20

.10

.11

.50

.6

Mid

dle

Afr

ica

0.3

0.2

0.1

0.1

0.2

0.1

0.5

0.2

0.5

0.4

0.4

0.4

1.1

0.6

0.0

0.0

0.2

0.1

0.2

0.0

0.2

0.1

0.1

0.2

0.1

0.1

No

rth

ern

Afr

ica

0.2

0.1

0.2

0.1

0.1

0.1

0.3

0.2

0.4

0.3

0.6

0.5

2.1

0.8

0.1

0.2

0.4

0.2

0.2

0.0

1.7

0.3

0.0

0.0

0.0

0.0

So

uth

ern

Afr

ica

0.3

0.1

0.0

0.0

0.3

0.1

1.5

0.7

0.6

0.3

1.1

0.6

0.7

0.3

0.1

0.1

0.6

0.4

0.3

0.1

2.8

1.1

0.2

0.1

0.4

0.2

We

ste

rnA

fric

a0

.10

.10

.10

.00

.10

.00

.10

.00

.40

.30

.40

.31

.60

.80

.00

.00

.30

.10

.10

.00

.20

.10

.10

.10

.00

.0

The

Am

eri

cas

0.2

0.1

0.0

0.0

0.2

0.0

0.6

0.1

0.8

0.4

1.1

0.8

0.7

0.4

0.1

0.2

0.7

0.6

0.3

0.0

3.0

1.9

0.2

0.1

0.0

0.0

Ca

rib

be

an

0.2

0.1

0.0

0.0

0.3

0.1

0.5

0.1

0.8

0.4

1.0

1.0

0.7

0.5

0.1

0.1

0.5

0.4

0.5

0.1

2.8

1.4

0.0

0.0

0.0

0.0

Ce

ntr

al

Am

eri

ca0

.10

.10

.00

.00

.10

.00

.20

.11

.00

.70

.60

.40

.70

.70

.10

.30

.40

.40

.20

.01

.00

.50

.10

.00

.00

.0

So

uth

Am

eri

ca0

.30

.10

.00

.00

.30

.00

.70

.21

.40

.61

.10

.80

.60

.40

.20

.30

.60

.50

.40

.12

.21

.00

.10

.10

.00

.0

No

rth

ern

Am

eri

ca0

.10

.10

.00

.00

.10

.00

.60

.10

.30

.21

.20

.80

.80

.30

.10

.10

.90

.70

.20

.04

.12

.90

.30

.10

.00

.0

Asi

a0

.30

.20

.20

.10

.30

.11

.10

.41

.80

.70

.90

.62

.00

.70

.20

.20

.40

.30

.20

.03

.31

.10

.00

.00

.00

.0

Ea

ste

rnA

sia

0.1

0.1

0.2

0.1

0.1

0.0

1.5

0.4

2.5

0.9

0.9

0.6

3.1

1.0

0.3

0.2

0.5

0.3

0.1

0.0

4.5

1.6

0.0

0.0

0.0

0.0

So

uth

-Ea

ste

rnA

sia

0.2

0.1

0.4

0.2

0.2

0.1

0.4

0.1

0.8

0.4

1.1

0.7

2.4

0.8

0.2

0.1

0.3

0.2

0.2

0.0

3.2

1.1

0.0

0.0

0.0

0.0

So

uth

-Ce

ntr

al

Asi

a0

.70

.40

.10

.00

.60

.10

.70

.41

.00

.40

.60

.40

.40

.20

.20

.30

.20

.10

.40

.01

.30

.40

.00

.00

.00

.0

We

ste

rnA

sia

0.1

0.1

0.1

0.0

0.1

0.0

0.3

0.2

1.2

0.7

1.2

0.8

0.6

0.3

0.2

0.2

0.6

0.4

0.4

0.1

4.2

0.7

0.1

0.1

0.0

0.0

Eu

rop

e0

.40

.10

.00

.00

.30

.00

.60

.11

.10

.51

.81

.00

.70

.20

.10

.11

.00

.60

.40

.04

.81

.40

.20

.10

.00

.0

Ce

ntr

al

an

dE

ast

ern

Eu

rop

e0

.60

.10

.00

.00

.50

.00

.60

.12

.00

.82

.41

.40

.70

.30

.20

.21

.10

.60

.60

.06

.01

.00

.20

.20

.00

.0

No

rth

ern

Eu

rop

e0

.20

.10

.00

.00

.20

.00

.80

.20

.50

.21

.40

.90

.50

.20

.10

.10

.90

.60

.20

.03

.52

.30

.30

.20

.00

.0

So

uth

ern

Eu

rop

e0

.20

.10

.00

.00

.20

.00

.30

.10

.90

.41

.70

.90

.90

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estimated rates of 10.5 and 4.5 in Eastern and South-CentralAsia. Prostate cancer is the fifth leading cause of death fromcancer in men, with an estimated 307,000 deaths representing6.6% of the total male cancer mortality (Table 2). Unlikeincidence, there is relatively less variation in mortality ratesworldwide (10-fold from approximately 3 to 30 per 100,000)than is observed for incidence, with the number of deathsfrom prostate cancer larger in less than developed regions(165,000 and 142,000, respectively) (Table 6). Mortality ratesare generally high in populations of African descent (Carib-bean, 29 per 100,000 and Sub-Saharan Africa, ASRs 19-24per 100,000), intermediate in the Americas and Oceania, andvery low in Asia (2.9 per 100,000 in South-Central Asia, forexample) (Table 4).

Stomach cancer. Almost one million new cases of stomachcancer were estimated to have occurred in 2012 (951,000cases, 6.8% of the total), making it the fifth most commonmalignancy in the world, after cancers of the lung, breast,colorectum and prostate (Table 1). This represents a sub-stantial change since the very first estimates in 1975,20 whenstomach cancer was the most common neoplasm. Morethan 70% of cases (677,000 cases) occur in developing coun-tries (456,000 in men, 221,000 in women), and half theworld total occurs in Eastern Asia (mainly in China) (Table5). Age-standardized incidence rates are twofold greater inmen than women, with male incidence rates ranging from3.3 in Western Africa to 35.4 in Eastern Asia (Table 3).Stomach cancer is the third leading cause of cancer death inboth sexes worldwide (723,000 deaths, 8.8% of the total)(Table 2). The highest estimated mortality rates are in East-ern Asia (14.0 per 100,000 in men, 9.8 per 100,000 inwomen), the lowest in Northern America (2.8 and 1.5,respectively). High mortality rates are also seen in Centraland Eastern Europe, and in Central and South America(Table 4).

Liver cancer. Liver cancer is a major cancer in less devel-oped regions where 83% of the estimated 782,000 new can-cer cases worldwide occurred in 2012 (Table 5) (50% inChina alone). It is the fifth most common cancer in men(554,000 cases, 7.5% of the total) and the ninth in women(228,000 cases, 3.4%) (Table 1). In men, the regions of highincidence are Eastern and South-Eastern Asia (ASRs 31.9and 22.2 respectively). Intermediate rates are seen in South-ern Europe (9.5) and Northern America (9.3), while the low-est rates are in Northern Europe (4.6) and South-CentralAsia (3.7). In women, the rates are generally much lower,with the highest rates in Eastern Asia and Western Africa(10.2 and 8.1, respectively) (Table 3). Liver cancer is the sec-ond most common cause of death from cancer worldwide,estimated to be responsible for nearly 745,000 deaths in2012 (9.1% of the total) (Table 2). Given the very poor prog-nosis for liver cancer (the ratio of mortality to incidence is0.95), the geographical patterns in incidence and mortalityare quite similar.

Cancer of the cervix uteri. Cervical cancer is the fourth mostcommon cancer in women, and the seventh overall, with anestimated 528,000 new cases in 2012 (Table 1). Although theannual number of cases has increased, cancer of the cervix hasdeclined in relative importance: it was the second most com-mon cancer of women in 1975.20 As with liver cancer, a largemajority (around 85%) of the global burden occurs in the lessdeveloped regions, where it accounts for almost 12% of allfemale cancers (Table 5). High-risk regions, with estimatedASRs over 30 per 100,000, include Eastern Africa (42.7), Mela-nesia (33.3), Southern (31.5) and Middle Africa (30.6). Ratesare lowest in Australia/New Zealand (5.5) and Western Asia(4.4). Cervical cancer remains the most common cancer inwomen in Eastern and Middle Africa (Table 3).

There were an estimated 266,000 deaths from cervicalcancer worldwide in 2012, accounting for 7.5% of all femalecancer deaths (Table 2). Almost nine in 10 (87%) cervicalcancer deaths occur in less developed regions (Table 6). Theaverage risk of dying from cervical cancer before age 75 isthree times higher in the less than in more developed regions(Table 8). Mortality varies 18-fold between the differentregions of the world, ranging from less than 2 per 100,000 inWestern Asia, Western Europe and Australia/New Zealand toabove 20 per 100,000 in Melanesia (20.6), Middle (22.2) andEastern (27.6) Africa (Table 4).

Oesophageal cancer. Oesophageal cancer is the eighth mostcommon cancer worldwide, with an estimated 456,000 newcases in 2012 (3.2% of the total), and the sixth most commoncause of death from cancer with an estimated 400,000 deaths(4.9% of the total) (Tables 1 and 2). These figures includeboth adenocarcinoma and squamous cell carcinoma sub-types. Around 80% of the cases worldwide occur in lessdeveloped regions (Table 5), with global incidence ratesthreefold higher in men compared with women (Table 1). Inboth sexes there are more than 20-fold differences in inci-dence between world regions, with rates ranging from 0.8 per100,000 in Western Africa to 17.0 per 100,000 in EasternAsia in men, and 0.2 per 100,000 in Micronesia/Polynesia to7.8 per 100,000 in Eastern Africa in women (Table 3).

Cancer of the oesophagus has a very poor survival (M:Iratio is 0.88), and the geographical patterns of mortalityclosely follows those of incidence. Mortality rates are elevatedin Eastern Asia (14.1 per 100,000) and Southern Africa (12.8)in men, and in Eastern Africa (7.3) and Southern Africa (6.2)in women (Table 4).

Bladder cancer. An estimated 429,000 bladder cancer casesoccurred in 2012, making the disease the ninth most com-mon cause of cancer for both sexes combined (Table 1).Bladder cancer is relatively common in more developedregions, where 60% of all incident cases occur, and occursamong men more than in women (sex ratio worldwide of3.5:1) (Table 5). Male rates are high in Southern and WesternEurope (ASRs 21.8 and 19.7 per 100,000, respectively) and in

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Ferlay et al. 23

Int. J. Cancer: 00, 00–00 (2014) VC 2014 UICC

Western Asia (19.0) and Northern Africa (15.1) where blad-der cancer is linked to chronic schistosomal infection. Femalerates are much lower, with the highest in Northern America(5.1) and Western Europe (4.3). In both sexes, low incidencerates are seen in South-Eastern and South-Central Asia, andin sub-Saharan Africa (Table 3).

There were an estimated 165,000 deaths from bladdercancer worldwide, with similar numbers in less (85,000) andmore (80,000) developed regions (Table 6). Mortality ratesare much lower than the incidence rates, with the highestASR estimated in Western Asia in men (8.4 per 100,000) andin Northern Africa (1.6) in women (Table 4).

Non-Hodgkin lymphoma. An estimated 386,000 cases ofnon-Hodgkin Lymphoma (NHL) occurred in 2012 (2.7% ofall cancers). NHL is slightly more common in less developedregions (50.5% of cases worldwide, Table 5) although therates are highest in Northern America (ASR 14.6 and 10.2per 100,000 in men and women respectively), in Australia/New Zealand (14.3 and 10.1) and in Europe (except Centraland Eastern Europe). The lowest rates are estimated inSouth-Central Asia (3.3 in male and 1.8 in female) (Table 3).About 200,000 deaths from NHL were estimated worldwide(2.4% of all deaths), two-third 125,000 occuring in the lessdeveloped regions of the world, reflecting a poorer survival inthose regions (Table 6).

Leukaemia. Leukaemia accounted for some 352,000 newcases (2.5% of all new cancer cases) and for 265,000 deaths(3.2% of all deaths) (Tables 1 and 2). The rather high M:Iratio (0.75) reflects the poor prognosis of leukaemia in manyparts of the lower-resource world. The range of incidencerates is about six - to eightfold in women and men respec-tively, with the lowest rates in Middle and Western Africa(less than 3 per 100,000 in men and less than 2 per 100,000in women) and the highest in Northern America and Aus-tralia/New Zealand (over 10 per 100,000 in men and 7 per100,000 in women) (Table 3). Variations in mortality are lessthan for incidence, due to better survival (and hence lowermortality) in more developed regions. Mortality rates rangebetween 1.3 per 100,000 and 6.3 per 100,000 in males, and1.1 and 3.8 in females (Table 4). The low incidence (andhence mortality) rates estimated in Sub-Saharan Africa maybe partly due to failure to diagnose the disease, especially inthe elderly or very young.

Pancreatic cancer. Pancreatic cancer is responsible for331,000 deaths per year, and is the seventh most commoncause of death from cancer in both sexes combined (Table2), a higher relative position than seen for incidence (12th)given the very poor prognosis (M:I ratio is 0.98) (Table 1).The sex ratio is close to one, and the majority of cases anddeaths (55%) occur in the more developed regions (Table 5),with rates varying between 7 and 9 per 100,000 in men and5 and 6.5 per 100,000 in women, with lower rates in the lessdeveloped regions (Table 3). Part of the variation in both

incidence and mortality patterns worldwide may relate tounder diagnosis (particularly among elderly patients), or toimperfect mortality data.

Kidney cancer. The highest rates of kidney cancer incidence(338,000 new cases, 2.4% of the world total) are estimated inNorthern America, Australia/New Zealand and Europe,where rates were over 10 per 100,000 in men and over 5 per100,000 in women (except Southern Europe). Incidence ratesare lowest (below 1.5 per 100,000) in Africa and in thePacific Islands (Table 3). Of the 144,000 deaths from kidneycancer (1.7% of all deaths) estimated in 2012, 75,000 (52%)were in more developed regions (Table 6).

Corpus uteri cancer. Cancer of the corpus uteri appearsmore important as a cause of new cases (320,000 or 4.8% ofcancers in women and 2.3% of the total, Table 1) than in termsof mortality (76,000 deaths or 2.1% of cancer deaths inwomen, Table 2) because of the reasonable prognosis associ-ated with the disease. The highest incidence rates were esti-mated in Northern America (19.1 per 100,000) and Northernand Western Europe (12.9–15.6). Rates are low in South-Central Asia (2.7) and most of Africa (less than 5 per 100,000)(Table 3). Mortality rates ranged between 0.9 per 100,000 inNorthern Africa and 3.8 per 100,000 in Melanesia (Table 4).

Cancer of the lip and oral cavity. These cancers accountedfor 300,000 cases in 2012 (2.1% of the world total), with two-thirds occurring in men (Table 1). The region with the high-est incidence among both males and females was by far Mel-anesia (22.9 per 100,000 and 16.0 per 100,000, respectively).Rates were also relatively high in men in South-Central Asia(9.9) and in Central and Eastern Europe (9.1) (Table 3).Worldwide, 145,000 deaths occurred (1.8% of the worldtotal), of which 77% were in the less developed regions(Table 6).

Thyroid cancer. Cancer of the thyroid (298,000 new cases,2.1% of the total) is considerably more common amongfemales than among males (Female:Male sex ratio 3), com-prising 3.5% of cancers in women (Table 1). Elevated ratesare estimated in Northern America (6.3 per 100,000 in malesand 20.0 per 100,000 in females) and in Oceania (3.4 and11.3, respectively) (Table 3). Relative to incidence, thyroidcancer accounted for rather few deaths (40,000 or 0.5% of allcancer deaths, Table 2), with mortality rates lower than 1 per100,000 in men and 2 in per 100,000 in women (except inMelanesia) (Table 4).

Cancers of brain and central nervous system. Cancers ofthe brain and central nervous system accounted for 256,000new cases and 189,000 deaths in 2012 (1.8% of new cancers;2.3% of cancer deaths) (Tables 1 and 2). The highest inci-dence and mortality rates are in more developed regions(Australia/New Zealand, Europe, and Northern America) andare lowest in Africa and the Pacific (Tables 3 and 4). As forpancreatic cancer, the variation in both mortality and

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24 Globocan 2012

Int. J. Cancer: 00, 00–00 (2014) VC 2014 UICC

incidence patterns worldwide may be in part due to varia-tions in the availability of diagnostic facilities or due to inac-curacy in assigning the underlying cause of death.

Ovarian cancer. Ovarian cancer (239,000 cases and 152,000deaths) is the seventh most common cancer and the eighthcause of death from cancer in women (3.6% of cases and4.3% deaths) (Tables 1 and 2). Incidence rates are highest inmore developed regions, with rates in these areas exceeding7.5 per 100,000 and lowest in Sub-Saharan Africa with ratesbelow 5 per 100,000 (Table 3). The average risk of dyingfrom ovarian cancer before age 75 is twice as high in morethan in less developed regions (Table 8), with deaths fromthe disease ranking as 5th most common among women(Table 6).

Malignant melanoma of skin. Malignant melanoma of skinaccounted for 232,000 new cases (1.6% of new cancers)(Table 1). The regions affected are largely those with whitepopulations (of European origin), with by far the highestincidence in both males and females in Australia/New Zea-land (40.3 per 100,000 and 30.5 per 100,000 respectively) fol-lowed by Northern America and by Northern and WesternEurope (rates over 10 per 100,000 in both sexes). Very lowincidence rates (below 0.5 per 100,000 in both males andfemales) are estimated in South-Eastern Asia and South-Central Asia (Table 3).

Mortality rates ranged from 0.1 in women of South-Central Asia to almost 6 per 100,000 in Australia/New Zea-land men (Table 4). There were an estimated 55,000 deathsin 2012 worldwide (0.7% of cancer deaths), with almost twoof three deaths occurring in more developed regions, andamong men (sex ratio of 1.3) (Table 6).

Cancer of gallbladder. Gallbladder cancer (178,000 newcases, 1.3% of the total) is one of the few malignancies thatare more common in females than males (sex ratio of 0.76)(Table 1). About 65% of the cases were seen in less developedregions (mainly in Eastern and South-Central Asia), with thehighest incidence rates estimated in South America (particu-larly among females of around 3.5 per 100,000) and EasternAsia (3.4 per 100,000 in males, 3.2 per 100,000 in females)(Table 3). Gallbladder cancer accounted for 142,000 deaths(1.7% of all cancer deaths), of which 45,000 are in the moredeveloped regions (Table 6).

Larynx cancer. Larynx cancer (157,000 new cases, 1.1% ofnew cancers) is a cancer that is notably frequent among men,where it comprises 1.9% of male cancer cases. The sex ratio(7:1) is greater than for any other site. It is a rare cancer inwomen with only 19,000 new cases estimated in 2012 (Table1). In men, the regions of high-risk were the Caribbean andCentral and Eastern Europe (7.9 per 100,000), SouthernEurope (7.2) and Western Asia (6.5) (Table 3). Cancer of thelarynx is responsible for 83,000 deaths in 2012 (1.0% of can-cer deaths), of which 73,000 occurred in men (1.6% ofdeaths) (Table 2).

Other pharyngeal cancers. Cancer of the pharynx (exclud-ing nasopharynx) accounted for 142,000 new cases in 2012(1% of the world total), and was much more common amongmales than among females (sex ratio of 4:1) (Table 1). Theregion with the highest incidence for both sexes was WesternEurope (7.5 per 100,000 and 1.6 per 100,000 respectively,with the lowest rates (below 1.0) in Northern and WesternAfrica and Western Asia (Table 3). Worldwide, 97,000 deathsfrom “other pharyngeal” cancers occurred (1.2% of the worldtotal), three-quarters in less developed regions (Table 6).

Multiple myeloma. Multiple myeloma constituted 0.8% ofall cancers worldwide (114,000 new cases) (Table 1). Inci-dence rates varied from 0.4 to almost 5 per 100,000, withrates highest in more developed regions of Northern Amer-ica, Australia/New Zealand and Europe (but Central andEastern). Low rates (below 1.0 per 100,000) were seen in Asia(except Western Asia) (Table 3). Multiple myelomaaccounted for 80,000 deaths worldwide (1.0% of cancerdeaths), the majority in more developed regions (Table 6).

Nasopharyngeal cancer. Nasopharyngeal cancer (NPC) is arelatively rare tumour (87,000 new cases, 0.6% of all cancers),more common in males (sex ratio of 2.3:1) with very distinctgeographic areas of high risk (Table 1). The highest rates arein populations in South-Eastern Asia (ASR 6.4 in men, 2.4 inwomen), and in Micronesia/Polynesia, Eastern Asia andNorthern Africa, where rates are above 2 and 1 in men andwomen respectively (Table 3). An estimated 51,000 deathsfrom NPC were estimated in 2012, representing 0.6% of allcancer deaths (Table 2).

Hodgkin lymphoma. An estimated 66,000 cases of HodgkinLymphoma occurred in 2012 (0.5% of all cancers) (Table 1).Similar to NHL, the incidence rates are high in more devel-oped regions (Northern America, Australia/New Zealand andEurope) but also in Western Asia where the ASR is over 2.0in men and 1.5 in women. Incidence rates are particularlylow (below 0.5) in Eastern and South-Eastern Asia where thedisease is very rare (Table 3). Survival for Hodgkin lym-phoma is reasonable in more developed regions so that ofthe estimated 25,000 deaths worldwide (0.5% of all cancerdeaths), only about one-quarter (6,300) occurred in moredeveloped regions (Table 6).

Testicular cancer. Testicular cancer is relatively rare, with55,000 new cases estimated in 2012 (0.7% of cancers in men,Table 1), but common in younger men (ages 15–39) of whiteCaucasian origin. The highest incidence rates are in moredeveloped regions and particularly in Europe (7.2 and 8.7 inNorthern and Western Europe, respectively), with rates lowin Asia and Africa (rates lower than 1.0) (Table 3). As aconsequence of the very favourable survival from testicularcancer in more developed regions, around 10,000 deathsfrom testicular cancer were estimated in 2012 worldwide,only 2,200 deaths occurring in more developed regions(Table 6).

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Kaposi sarcoma. Kaposi sarcoma (KS) is an extremely rareform of cancer in most regions of the world, but it is one ofthe most common in certain regions of Sub-Saharan Africa,where 84% of the estimated 44,000 cases occurred (29,000 inmen, 15,000 in women) (Table 5), the great majority occur-ring in subjects with HIV-AIDS. About 70% of casesoccurred in Eastern Africa, where the highest incidence ratesare observed (15.1 in men, 7.6 in women) (Table 3) andwhere the disease is the leading cancer in men and thirdranking in women (after cervical and breast cancer) (Table5). KS is extremely rare in Asian populations with only 1,500cases estimated in its population of 4.3 billion in 2012. Ofthe 27,000 estimated deaths from KS (0.3% of all cancerdeaths, Table 2), 25,000 were in sub-Saharan Africa, of which21,000 deaths (84%) were seen in Eastern Africa (Table 6).

DiscussionThe global and region-specific estimates presented here andin more detail online (http://globocan.iarc.fr) provide a keyresource for cancer researchers, policy-makers and the mediaon the burden of cancer in 2012, and the cancer-specific pat-terns in 184 countries worldwide. The primary aim of thisarticle is to clearly document the methods used to build upthese global figures. While IARCs estimation methods havebeen refined in the last decades to account for the increasingavailability and quality of source information, the underlyingmethodological principle has remained a constant: whereverpossible, the country-specific estimates are based upon localsources of cancer incidence (from cancer registries) and mor-tality (mainly from vital registration systems). The results areof course more or less accurate for different countries,depending on the extent and accuracy of the locally availabledata.

To guide users in the validity of the national estimatesand to aid interpretation of the results, an alphanumericscoring system has been introduced for the 2012 estimatesthat describes the availability of incidence and mortality dataat the country level, and the quality of sources ranging fromA1 for the highest (16 countries such as Australia, Finlandor Singapore) to G6 for the lowest (34 countries such asAfghanistan, Central African Republic or Honduras). For theincidence data, results from population-based cancer regis-tries are regularly published through the CI5 series andinclusion in one of the last two volumes sets the standard ofhigh quality incidence data. Beyond the criterion of CI5inclusion, the cancer registries are classified according totheir ability to either produce reasonably accurate incidencerates per 100,000 (e.g. population-based) or simple tabula-tions by cancer type and sex (hospital or pathology-based).The extent of coverage of the catchment population(national or sub-national) is also taken into consideration,since subnational coverage requires extrapolations fromoften limited sample populations. For national mortalitydata available through the WHO mortality database, the per-

centages of completeness and coverage by country are pro-vided alongside the datasets online; the proportions of ill-defined causes of deaths, and of unknown and ill-definedcancer deaths are also used as recognised indicators of thequality of vital registration systems.9

The use of site-, sex- and age-specific M:I ratios from can-cer registries to estimate national incidence rates fromnational mortality has been used extensively over several dec-ades.21 Using data within a country, the method assumesgreater representativeness and lesser variation in case fatalitythan in incidence rates between registry populations, and isrobust to the quality of the mortality data, provided any defi-ciencies are equally present in both national and registrymortality sources. In the absence of cancer registry datawithin the country of interest, M:I ratios from cancer regis-tries in neighbouring countries were used previously(described as method 2B in GLOBOCAN 200813 and forsome European countries for these 2012 estimates.15 Withthis methodology, the national and the regional mortality arenot from the same vital statistics systems, the resultingnational incidence could be distorted, for example when thenational mortality data is over-estimated for some cancersites (such as liver and brain tumours due to the inclusion ofmetastatic or unknown behaviour diagnoses). In addition,regional M:I ratios may be lower than the true national sur-vival if there is under-reporting of cancer deaths, while usingregional M:I ratios for a group of countries with possibly dif-ferent profiles of cancer survival is evidently problematic. Forthese reasons, and for the countries outside Europe, weinstead employed a different method, which scales the M:Iratios between countries according to levels of HDI. As inthe majority of LMIC there are no survival estimates avail-able, we created proxies based on SURVCAN22 and historicaldata from two Nordic countries (Finland and Denmark),assuming that survival is linked to a country’s level of humandevelopment.

Under-reporting and failure of diagnosis could be sourcesof bias in cancer registration particularly in the less devel-oped countries where most of the data do not qualify forCI5, and therefore some of the national estimates based onregional cancer registries may be underestimates for leukae-mia, brain, lung, liver and pancreas depending on the localfacilities available. Conversely, estimates based on a singlecancer registry in an urban setting might result in an overes-timation of the final estimates for some lower income coun-tries with substantial rural populations. Recent data fromrural settings in Sub-Saharan Africa or India6 indicate thatincidence rates for most cancers may be much lower thanthose reported by cancer registries covering urban popula-tions. Contrarily to failure of diagnosis, the high cancer inci-dence estimated in some developed regions is partly due toover-diagnosis of cancers detected by intense sensitive investi-gations, such as prostate cancer in Northern American andWestern European countries as well as thyroid cancer inEastern Asia, especially South Korea.6 This does not affect

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the corresponding mortality estimates which are more com-parable across regions at those sites.

Other possible sources of bias related to the prediction ofcancer rates using the M:I ratio method have been describedelsewhere.15 Of the 34 countries representing 5.6% of the worldpopulation for which no information is available (indexed G6),19 are located in Sub-Saharan Africa, representing 23% of thispopulation. Incidence estimates were computed simply as theaverage of the rates from neighbouring countries.

Evidently the inclusion of uncertainty intervals forcountry-specific estimates would be useful aid where theytruly able to capture the uncertainty in the source informa-tion. Collaborative work is underway to take into accountnot only the inherent statistical uncertainty in the modellingexercises but also the more qualitative relative deficiencies inthe quality and availability of the source information at thenational level.

While comparisons of estimates compiled in this and pre-vious versions of GLOBOCAN seem an instinctively reasona-ble and valid exercise, we would warn again such temporalanalyses: the changes in the incidence and mortality countsor rates may in part be due to an increasing availability andquality of the incidence data from cancer registries worldwideand correspondingly, a more robust set of estimation meth-ods. As an example, the estimates of cancer incidence in Ger-many in 2008 were based on national mortality data andmodelling of local M:I ratios, while those from 2012 werederived from the projection of regional incidence rates.

As well as providing a global snapshot of the cancer bur-den in 2012, these GLOBOCAN estimates bring to a focusthe need for regional and national prioritisation of cancercontrol efforts given the cancer patterns observed today. Ofthe predicted 20 million new cancer cases by 2025,23 thegreatest increases are anticipated in the low income countriesand longer-term planning is needed to reduce the future can-

cer burden through resource-appropriate interventions. Theyinclude the generally applicable targeting of lifestyle factorsamenable to reduction with proven actions that lead totobacco avoidance or cessation, the reduction of alcohol con-sumption and obesity, and increased levels of physical activ-ity. In the less-developed regions, infectious agents are themost important causes of cancer,24 so that the introductionof appropriate vaccination and treatment programmes intoexisting national systems would make a major contributionto future cancer control. There are many critical observationsamong these results that can serve to provide the evidencebase and impetus for developing such resource-contingentstrategies to reduce the cancer burden worldwide in the deca-des that follow.

Finally, estimation of the cancer incidence worldwidewould not be possible without population-based cancer regis-tries (PBCR), yet many LMICs have limited or no such sur-veillance systems in place. The agreed collection by WHOMember States of “cancer incidence, by type of cancer, per100,000 population”—as one of 25 indicators of progress inreducing NCDs—should compel countries to commit appro-priate levels of investment to the planning and developing ofPBCR. Linking in with this, the IARC-led the Global Initia-tive for Cancer Registry Development (GICR, http://gicr.iarc.fr), a concerted, multi-partner international action aims tomarkedly increase the coverage of populations in LMIC bysuch high quality institutions, thus supporting cancer surveil-lance and cancer control where it is needed most.

AcknowledgementsThe authors gratefully acknowledge the many cancer regis-tries worldwide and their staff for their willingness to con-tribute their data to this exercise. The authors alsoparticularly thank the Members of the African Cancer Regis-try Network in this respect.

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