This document summarizes risk factors and determinants of the most malignant cancer types globally based on a literature review. It finds that smoking is the leading cause of cancer deaths worldwide and links various other factors like unhealthy diet, alcohol consumption, infections, and environmental pollution to increased cancer risks. It also examines differences in cancer rates by gender, age, and world region, finding for example that lung cancer deaths are much higher in men than women globally. Future challenges for reducing cancer rates include growth and aging of the population worldwide.

1. Risk factors and determinants of the most malignant cancer
types globally and future challenges for public health
specialists in order to reduce cancer rates.
Literature Review
Author: Athanasios Andriopoulos
Supervisor: Carina Källestål
Global Health course/ IMCH
November 2016, Uppsala/ Sweden

2. 1
INTRODUCTION
Cancer: Cancer is defined as the unreasonable and uncontrollable proliferation of
cells, which occurs by numerous alterations in gene expression of cell division (1)
. Due
to those changes in human genome, which are called DNA mutations and due to the
failure of the vital programmed cell death, which is called apoptosis, tumors are
created in human tissues (2)
.
Cancer is a non communicable disease with high fatality and morbidity rates on a
global basis. According to World Health Organisation (WHO), in 2012, 14 million
people were diagnosed with cancer, while at the same time 8.2 million cancer patients
died. Future cancer rates do not seem to be that auspicious as well. By 2030, scientists
claim that approximately 22 million people will suffer from cancer, which is an
augmentation of 70% (3)
.
Malignancy and Cancer rates: Tumors can be classified into two categories, which
are the benign and malignant ones. The main reason why malignant tumors tend to be
more fatal is because they are much more metastatic than benign tumors. In fact,
benign tumors do not have metastatic properties, which means that cancer cells are
not able to expand to nearby organs. Moreover, another crucial characteristic about
malignant tumors is that they tend to grow in a very short period of time, whilst
benign ones grow at a slower pace (1)
.
Apart from the malignancy, we also have to focus on the number of deaths that have
been caused by each type of cancer. But, the most efficient way to discover how life-
threatening each cancer type is, we must look both at the number of cases and the
number of deaths. The most trustworthy indicator is the ‘’Case Fatality Ratio’’ (CFR)
during a certain period of time. The bigger the quotient, the more life-threatening the
disease is. WHO official data can be seen in the table 2 in the annex (4)
.
Aim of Study: The aim of this literature review is to give an overview of cancer on a
global basis. The research question is : ‘’What are the risk factors and determinants of

3. 2
malignant cancer types and what are the future challenges for global health specialists
in order to reduce cancer rates?” Starting by the risk factors, my main goal is to
prioritize them and highlight their significance by collecting official data that can
prove to what extent they are responsible for cancer mortality. By analyzing
determinants such as gender and age, I expect to obtain a clear view about which
gender and which age group has lower or higher chances of cancer development.
More emphasis will be put on ethnicity, and therefore to poverty, in order to examine
the prevalence of a variety of cancer types and their chances to occur in citizens of
low, middle and high income countries. Finally, the analysis of the global burden of
cancer (DALYs measurement), and the review of current and mainly future
challenges that global health specialists have to face, will give us the opportunity to
regard this research question as a global health issue, which demands universal
attention.
METHODS
The main source of my articles was derived from the internet. More specifically, the
majority of articles were chosen from the online ‘’Bibliotek’’ from ‘’Uppsala
Universitet’’ and from online databases such as PubMed. The keywords that I used
were: ‘’cancer’’, ‘’cancer risk factors’’, ‘’cancer malignancy’’, ‘’tumors’’, ‘’cancer
and gender’’, ‘’cancer and ethnicity’’, ‘’cancer and age’’, ‘’cancer prevalence’’,
‘’burden of cancer’’, ‘’infections and cancer’’, ‘’cancer rates’’, ‘’cancer future rates’’.
I mainly focused on peer reviewed articles, and my exclusion criteria were related to
non-English articles and any articles before the year 2005. Furthermore, I avoided
snowballing. Since my topic was broad, I excluded many articles because they were
too specific, and my initial plan was to give an overview of cancer. I mostly focused
on articles and studies which included the whole population of Earth and more
specifically all cancer patients, which I found it very challenging. At first, I found 60
publications, but the majority of them were rejected since despite the fact that the
topics where exactly what I was asking for, I preferred taking into account the most
recent ones. Lastly, I tried to find articles/ journals/ publications which had a ‘’global/
public health’’ point of view, by checking if authors/ scientists are named as ‘’MPH’’.

4. 3
RESULTS
Smoking. The grand majority of risk factors are preventable. Smoking in general and
tobacco consumption is one of them and is considered as the leading cause of most
cancer types. For instance, in 2010, 18.75% of cancer patients died due to excessive
tobacco use on a global basis (5)
. Smokers are more likely to develop the most
malignant types of cancer such as lung, pancreatic and esophageal cancer. In fact,
individuals who have never smoked in their life are 30 times less likely to suffer from
lung cancer (6)
. Moreover, tobacco can be consumed in various ways, such as snus or
chewing tobacco. These new trends are more familiar in high-income countries, and
despite the fact there is room for improvement in research fields, some researchers
mention that these tobacco types are responsible for esophageal and pancreatic cancer
(7)
.
Unhealthy eating habits. People who adopt an unhealthy lifestyle, without any kind
of physical exercise are more likely to develop various cancer types. Sedentary
lifestyle combined with excessive red meat and trans fat consumption can cause breast
cancer in women, prostate cancer in men and colorectal, esophageal and stomach
cancer in both genders. Even after the diagnosis of cancer, cancer patients who have a
Body Mass Index (BMI) higher than 25 are more likely to die rather than those who
are not overweight. For instance, chances of dying increase by 25% for overweight
men who suffer from colorectal cancer, rather than for those who are not obese. In
addition, pancreatic cancer patients have approximately double chances to survive
than the patients whose BMI is over 35. Consequently, the decrease of BMI is a key
factor for prevention before and after cancer appears. Finally, the distribution of fat in
our body might be an indicator of the likelihood of development of certain types of
cancer in the future (8)
.
Alcohol. Alcohol consumption is a less menacing, but still important risk factor in
terms of cancer. People who exaggerate alcohol consumption are more likely to
develop tumors in 7 human tissue types. Nevertheless, the most common cancer type
for heavy alcohol consumers is liver cancer, which has high fatality rates. In 2012, it
was reported that alcohol consumption was the factor that caused approximately 6%
of deaths related to cancer. Lastly, the average amount of consumed alcohol plays a

5. 4
profound role in which type of cancer is more likely to be developed. For instance,
moderate drinkers are more likely to develop esophageal or pharyngeal cancer, whilst
heavy drinkers are more likely to develop liver or colorectal cancer (9)
.
STDs and Infections. Women who are unaware of safe sexual practices can be
infected by numerous viruses. Nevertheless, only one specific virus named Human
Papillomavirus (HPV) seems to be the one which can cause cervical cancer. The
grand majority of infected women mostly come from low-income countries. On a
global basis, more than half a million women who are infected by HPV, end up
having cervical cancer per year. 50% of those women die on an annual basis due to
this reason (10)
. Furthermore, numerous studies have shown that 8 out of 10 liver
cancer cases have been caused by chronic hepatitis B and C viruses globally. In 2002,
483,000 people died from liver cancer due to HBV and HCV. 68% of those were
HBV patients and 32% of them were HCV patients (11)
.
Environmental Pollution. Lung cancer is not only associated with tobacco use.
Exposure to NO2, O3, PM2.5 and PM10 can be harmful for the human pulmonary
system. Even in high income countries people are exposed to these gases daily. For
instance, European cohort studies have proved that excessive exposure to PM10
increases the odds of lung cancer development by 22%, and excessive exposure to
PM2.5 increases those odds by 18% (12)
Genders. Gender inequality can be observed in many aspects of life. Apparently, this
phenomenon exists also in cancer rates. A research conducted in 2012 showed that
male cancer cases are approximately 1 million more than female ones, whilst, male
victims are more than 1 million than female ones. By examining the total amount of
all cancer type incidents globally, we will see that the CFR for men is 0.62, whilst for
women it is 0.53, which also means that men are less likely to survive cancer than
women. To begin with, recent studies have shown that female related cancer types
such as breast, cervical, corpus uteri and ovary cancer are 4 of the 10 most common
cancers in women. Whilst, male related cancer types are only 2 out 10 of those for
men (prostate and urinary bladder). In 2012, 1 out 4 male cancer patients died due to
lung cancer, while at the same time less than 14% of women cancer patients died due
to the same reason. Liver cancer death rates for men are also much higher than those

6. 5
rates for women (11.2% vs 6.3%) (13)
. Comparing the rates for both occasions, we can
deduce that this is reasonable if we take into account the social trends in many
countries, where men exaggerate alcohol consumption and tobacco use, whilst women
are not so keen on smoking or drinking due to numerous factors (14)
. The only case
where both numbers and percentages come into accordance in terms of death rates for
both sexes can be observed in colorectal cancer (13)
.
Age. Undoubtedly, age plays a major role on disease development. The grand
majority of the most fatal diseases start to appear to individuals aged around 60 years
old, when the human body becomes less and less functional. As a consequence,
cancer is referred as an age-related disease. Cancer is one of the leading reasons why
life expectancy numbers remain relatively stable as years go by. A recent study in
2009, which took place in USA proved that the most threatening age in terms of
cancer development is around 65 years old, with more than 200,000 cases observed.
The second and the third most common age groups in terms of new cancer incidents
are 60-64 years old, and 70-74 years old respectively, with slightly less than 200,000
new patients. Another interesting finding is that individuals aged less than 60 years
old are much more likely to be diagnosed with cancer during their lifetime rather than
those aged more than 60 years old. What we can deduce from that, is that individuals
are at a lower risk developing cancer and eventually die if they are aged more than 70
years old (15)
. But despite this, in most cases, younger patients who are diagnosed with
the majority of cancer types are more likely to have a higher 5-year relative survival
rate than the elderly ones especially in high and upper middle-income countries (16)
.
Population based studies have proved that even in Europe, approximately 25% of
young cancer patients (0-14 years old) die from cancer in a short period of time (17)
.
Sub Saharan Africa. Cancer is considered to be a serious issue for Sub Saharan
Africans, since most of the countries in this area are low-income ones and
consequently not enough money can be spent on health care. In Sub Saharan Africa
infectious diseases are very common, which means that viruses such as HPV result in
the majority of cases of cervical cancer. Moreover, gender related cancers such as
breast and cervical cancer for women and prostate cancer for men are the ones who
cause the biggest number of deaths among cancer patients. Lastly, chances of
developing cancer and finally dying remained stable for many years (18)
.

7. 6
Latin America and the Caribbean. This region contains low and middle income
countries. In 2012, equal percentages (13.9%) were observed for both sexes for
prostate and breast cancer. The rates of those two cancer types are increasing year by
year but luckily they do not appear to be the most common causes of death in terms of
cancer. On the other hand, despite that few new cases appeared for lung and stomach
cancer, death numbers are relatively high. In many large Latin American nations such
as Brazil and Colombia, the incidence of breast cancer has almost doubled since 1980.
Impressive is the fact that Chilean women have the highest gallbladder cancer rates on
a global basis. To conclude with, CFR in this region is 0.59, which is surprisingly
high (19)
.
Northern America. This region includes USA and Canada, which are both high
income countries. Once more, prostate and breast cancers are the two most prevalent
ones. Good news is that the overall CFR in this region is quite low (0.38), mainly due
to the superior health care system, and that is why year by year cervical and lung
cancer rates are decreasing. Nevertheless, approximately 30% of cancer patients died
from lung cancer in 2012. Colorectal cancer rates have been decreasing through years,
especially in white skinned individuals. In USA, where public health insurance policy
does not exist, uninsured people are less likely to survive cancer than those who have
private insurance (18)
.
Eastern and Southern Asia. This region has more than half of Earth’s population,
since China and India belong there. This is one of the few regions, where breast and
prostate cancers are not the most common ones. On the contrary, lung and stomach
cancers are the top two cancer types observed due to air pollution and the high
prevalence of Helicobacter pylori infection, which can potentially cause stomach
cancer. Moreover, according to WHO in 2012 the CFR was 0.9 for lung cancer, which
is an indicator of poor survival rate. But the highest ratio can be seen in stomach
cancer (0.95) despite the fact that stomach cancer victims are 50% less than the lung
cancer ones. To conclude with, bad news is that in less than 10 years estimated cancer
deaths according to multiple studies are about to increase by more than 40% (18)
.
Europe. Europe is a continent that mostly has high income countries and very few
middle income ones. One out of five European cancer patients die from lung cancer
every year. Quite impressive is the fact that in each and every European country, the

8. 7
most common type of cancer among women is breast cancer. Whilst among men,
those who come from higher income countries are mostly suffering from prostate
cancer, while at the same time those who come from relatively lower income
European countries mostly suffer from lung cancer. Moreover, colorectal cancer is the
number two reason for both categories of total estimated cases and deaths in this
region. To sum up, despite the fact that breast cancer incidents are increasing in
Europe, good news is that fatality rates keep on decreasing because of early screening
and because of the advanced level of health care systems (18)
.
Northern Africa and Central and Western Asia. This region contains numerous
countries, most of them being low and middle income ones. As usual, lung cancer is
the number one cause of death in terms of cancer, since tobacco use is rising among
individuals of this region. Breast cancer death rates are relatively high comparing to
other regions, since 1 out of 10 patients die from this type of cancer. Moreover, in
2012 the CFR of liver cancer was 0.95. Furthermore, it has been observed that despite
the fact that all cancer rates due to almost every cancer type are increasing, and that
bladder cancer rates are 3 times higher in some countries such as Lebanon and
Turkey, bladder cancer is the only cancer type whose death numbers keep on
decreasing year by year in both sexes (18)
.
Oceania. Oceania’s main population is derived mainly from high-income countries
like Australia and New Zealand. Prostate and colorectal cancers are the most usual
types among Oceanian people. In 2012, almost 1 out of 5 cancer patients died from
colorectal cancer. Moreover, Oceania is the only region where 1 out of 10 new cancer
incidents have to do with melanoma, mainly due to Southern Europeans who were
previously overexposed to sun and choose to migrate there. To conclude with, due to
effective anti-smoking campaigns and due to the overpriced tobacco products in
Australia, lung cancer incident rates have decreased by almost 50% in males (18)
.
Global Burden of Cancer: Cancer is considered to be an important global health
issue. Technology booming and the increase of cancer research have not contributed a
lot, since currently cancer is the number two cause of death globally, while in 1990 it
was the number three. New incident and estimated death rates are trustworthy enough
tools on public health workers’ hands, but they do not depict ideally the global burden

9. 8
of this disease. DALYS (Disability Adjusted Life Years) provide us with a clearer
view of health loss measurement, since they are able to define mortality and morbidity
in a more effective way. DALYs display the perdition of the equivalent of a healthy
year. In 2013, the total amount of DALYs was 196.3 million. The highest number of
DALYs in men is observed in the case of lung cancer with approximately 25 million.
Among female cancer patients, the main reason of DALYs was breast cancer, with
more than 13 million. Moreover, 7 out of 10 DALYs happened in lower income
countries. Comparing 1990 to 2013, the number of DALYs has increased by 29%.
Lastly, the cancer types that mainly contributed to the augmentation of this high
percentage (29%) of DALYs between 1990 and 2013 are the most malignant ones,
whose DALYs increased unexpectedly high, such as: pancreatic cancer (73.87%),
colorectal cancer (45.57%), liver cancer (42.50%), and lung cancer (34.53%) (20)
.
Future Challenges: The ultimate challenge for public health workers is to act
effectively, so that projected cancer rates will be proved wrong. Unfortunately, anti-
cancer campaigns are not enough. Public health scientists have to collaborate, and
analyse global cancer data and consequently put all their interest in regions where we
can observe the poorest survival rates. Long- term ameliorations in the management
of cancer on a global basis will provide the appropriate knowledge to medical staff
(doctors, nurses, pharmacists). Apart from that, pharmaceutical companies with public
health specialists have to unite their efforts in order to provide individuals with free
vaccinations mainly in low-income countries, so that the rates of cancer types which
are related to viruses will be drastically decreased. All in all, collaboration between
scientists, investigators, medical companies, and both governmental and
nongovernmental organizations is more than important in order to at least eliminate
cancer incidents related to poverty, lack of resources, lack of knowledge and
awareness, malnutrition, and infectious diseases (21)
.
DISCUSSION
Cancer is the second most common disease nowadays. This fact highlights the
importance of research in this field. The purpose of the literature review was to

10. 9
highlight which cancer types are the most life threatening ones, how can we
potentially avoid them, in which parts of the world are more common and examine
cancer rates’ likelihood of increase based on old and current DALYs.
The vast majority of studies include global and official cancer data. Focusing on such
a broad research question, challenges and limitations were expected to be numerous.
For instance, despite the fact that the majority of data is trustworthy, and consequently
challenges and limitations did not have to do with transparency and originality, the
main obstacles for this review were associated with the number of available studies
that covers such a broad topic. Nevertheless, those kinds of global based studies in
such life-threatening diseases are the most essential ones for global health scientists,
because despite the previously mentioned obstacles, only such kind of challenging
projects will potentially lead to solution for global health issues.
Case and Medical Records were mostly used so that the provided information cannot
be doubted and to demonstrate the relevance and magnitude of cancer. So, despite the
difficulties of finding such official records, the interpretation of those can be
processed in a more efficient way. From the data given, we can deduce that lung
cancer is estimated to be the most common type of cancer on a global basis, and one
which has a very poor survival rate. To be more specific, according to the ratios, liver
cancer seems to be the most difficult to handle, while at the same time esophageal,
lung and stomach cancers have poor prognoses. Lastly, despite the fact that there is a
large number of breast and prostate cancer patients, very few of them end up dying
from those reasons (4)
. Moreover, in terms of risk factors, we can deduce that smoking
is the most harmful of the five mentioned ones, since 18.75% of cancer patients die
due to excessive tobacco use (5)
. Quite impressive is the fact that in 2002, 80% of liver
cancer patients were previously infected by HBV or HCV. So, we can claim that
deaths from the most malignant cancer type can be drastically reduced if the target of
elimination of those two viruses will be achieved (11)
. In terms of gender, we can
imply that men have higher chances of developing the most malignant cancer types,
(and consequently dying), than women (13)
. In terms of region (ethnicity), Cancer
Atlas (by ACS and WHO) was chosen due to the credibility of its sources. As
expected, poorer regions had lower survival rates, whilst in relatively higher income
continents (Europe, Oceania), more auspicious CFRs and future predictions were

11. 10
observed (18,19)
. Furthermore, the global burden of cancer article proved that as years
go by cancer mortality will increase, whilst the main contributors of this augmentation
will be the most malignant cancer types (20)
. Lastly, although no bias can be observed
in included articles about age, American and British age-related studies were utilized
due to poor record-keeping in lower-income settings. Both of those conclude that
cancer is an age-related disease and despite the fact that elderly people have lower
chances of cancer development than younger ones, younger people have higher
chances of survivorship (15, 16)
.
Cohort studies were used in either topics where official data was missing, or in topics
whose official data were not enough to prove a certain point or were relatively old.
Additionally, cohort studies were used mostly to justify in a more efficient way the
findings of case records, and consequently add relevant information when needed. For
that purpose, a cohort study was included in order to add some extra information
regarding alcohol consumption. More specifically, it has been reported that even
moderate alcohol consumers have high chances of developing malignant cancer types
(9)
. Furthermore, despite the fact that the cohort study about snus products can be
controversial because it is recent and lacks clinical trials, we can infer that new
tobacco trends are responsible for cancer development (7)
. Moreover, the main reason
why European cohort studies were chosen for environmental pollution was to prove
that even in high-income countries environmental pollution contributes to lung cancer
development (12)
.
To conclude with, this research contains enough evidence which proves that cancer is
an age and gender-related disease, and that behavioral changes can potentially reduce
cancer rates. Cancer makes no discriminations on individuals, but poorer nations have
poorer survival rates. The most menacing factor that contributes to DALYs increase is
population growth. All things considered, such kind of reviews in conjunction with
the mutual cooperation of both governmental and non-governmental organisations can
be considered as a key solution for global health scientists in order to reduce the
global burden of cancer.

12. 11
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297. February 2015. Available from:
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cancer statistics, 2012. CA Cancer J Clin. 2015 Mar 1;65(2):87–108.
5. Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al.
Global and regional mortality from 235 causes of death for 20 age groups in 1990 and
2010: a systematic analysis for the Global Burden of Disease Study 2010. The Lancet.
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cancer in the world: comparative risk assessment of nine behavioural and
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Swedish moist snuff (snus) and risk for cancer of the mouth, lung, and pancreas in
male construction workers: a retrospective cohort study. The Lancet. 2007 Jun
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Weinmayr G, et al. Air pollution and lung cancer incidence in 17 European cohorts:
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14. 13
ANNEX
Table 1
REFERENCES
STUDY
DESIGN/
DATA
SOURCES
RESULTS COMMENTS
Global cancer statistics, 2012
(2015)
Torre LA et al.
Case Records
Medical
Records
Measurement of case fatality
ratio in cancer types.
Liver: 0.95, Esophageal: 0.88,
Breast: 0.31, Prostate: 0.28
Malignant cancer types: Liver, Lung,
Esophagus, Stomach, Colorectal
Non malignant: Breast, Prostate
Global and regional mortality from
235 causes of death for 20 age
groups in 1990 and 2010: a
systematic analysis for the Global
Burden of Disease Study 2010
(2013)
Lozano R. et al.
Case Records
Medical
Records
18.75% of cancer patients
died due to excessive
tobacco use
Tobacco use is one of the leading
causes of cancer development.
Causes of cancer in the world:
comparative risk assessment of
nine behavioral and
environmental risk factors (2005)
Goodarz Danaei et al.
Case Records
Medical
Records
Non smokers are 30 times
less likely to develop lung
cancer
Smoking is the top risk factor of lung
cancer development
Oral use of Swedish moist snuff
(snus) and risk for cancer of the
mouth, lung, and pancreas in male
construction workers: a
retrospective cohort study (2007)
Luo Juhua et a
Retrospective
cohort study
Relative risk of snus users of:
oral (0.8), lung (0.8), and
pancreatic (2.0) cancer.
(Numbers>1 give a positive
effect)
Snus use can potentially cause
pancreatic cancer but not oral and
lung cancer.
Obesity and cancer: An update of
the global impact (2015)
Melina Arnolda et al.
Case Records
Medical
Records
Overweight men with
colorectal cancer are 25%
more likely to die than
thinner ones. Pancreatic
cancer patients with BMI>35
have 50% less chances to live.
BMI plays a profound role on cancer
development and on the outcome
after diagnosis of colorectal and
pancreatic cancer.
Alcohol consumption as a cause of
cancer (2016)
Connor et al.
Case Records
Medical
Records
Cohort
studies
Alcohol consumption causes
6% of cancer deaths. Non
heavy drinkers are more
likely to have esophageal or
pharyngeal cancer. Heavy
drinkers suffer mostly from
liver and colorectal cancer.
Alcohol is responsible for malignant
cancer types and is considered as a
risk factor for various cancer types,
considering the amount of alcohol
that is consumed.
Human papillomavirus prevalence
in paired urine and cervical
samples in women invited for
cervical cancer screening. (2014)
Elena Burroni et al.
Case Records
Medical
Records
<500 million HPV infected
women end up having cervix
uteri cancer
<50% of those die annually.
HPV is the number one cause of
cervix uteri cancer.

15. 14
The contributions of hepatitis B
virus and hepatitis C virus
infections to cirrhosis and primary
liver cancer worldwide (2006)
Joseph F. Perzl et al.
Case Records
Medical
Records
In 2002: 8/10 liver cancer
patients had been previously
infected by either HBV or
HCV
Viruses such as HBV and HCV can be
considered as risk factors for liver
cancer.
Air pollution and lung cancer
incidence in 17 European cohorts:
prospective analyses from the
European Study of Cohorts for Air
Pollution Effects (ESCAPE) (2014)
Cohort
Studies
Lung cancer incidents
increased by 22% due to
PM10 and by 18% due to
PM2.5
Environmental pollution contributes
to lung cancer development even in
higher income countries.
Cancer incidence and mortality
worldwide: sources, methods and
major patterns in GLOBOCAN
2012 (2015)
J Ferlay et al.
Case Records
Medical
Records
Population
based cancer
registries
Male cancer patients in 2012
were 500 thousands more
than the female ones. Case
cancer fatality men VS
women : 0.62 VS 0.53
Men are more likely to suffer and die
from cancer.
Cancer incidence and mortality
worldwide: sources, methods and
major patterns in GLOBOCAN
2012 (2015)
J Ferlay et al.
Case Records
Medical
Records
Population
based cancer
registries
25% of male cancer patients
died from lung cancer
(Women: 14%) Males Liver
Cancer : 11.2%, Females
Liver: 6.5%
Malignant cancer types are more
common in men in terms of
mortality.
Age and Cancer Risk (2014)
Schotterfield David et al.
Case Records
Medical
Records
USA
Most common US age groups
in terms of new cancer
incidents : 1) +-65 years old
2)60-64 y.o , 3) 70-74 y.o
Cancer is an age-related disease.
People aged more than 70 years old
are less likely to develop cancer.
How ageing processes influence
cancer (2013)
De Magalhaes et al.
Case Records
Medical
Records
UK
Young cancer patients are
more likely to achieve 5-year
relative survival than older
ones.
Cancer mortality depends on the age
of cancer patients.
Childhood cancer survival in
Europe 1999-2007: results of
EUROCARE -5 a population based
study (2014)
Gemma Gatta
Population
Based
Studies
Cancer deaths in Europe
among patients aged 0-14
years old:
’99-’01: 23.9%
‘02’-04’: 22.7%
’05-’07: 20.9%
Child cancer mortality increases
through the years even in high
income countries.
Cancer Burden in Latin America
and the Caribbean (2014)
Maria Paula Curado et al.
Case Records
Medical
Records
Population
based study
Overall regional case fatality
ratio: 0.59
This number ranks this region in the
second place of the regions with the
poorest cancer survivorship
The Global Buren of Cancer (2013)
Mohsen Naghavi et al.
Case Records
Medical
Records
Cancer DALYS 1990: 152
million
Cancer DALYS 2013: 196
million
This is a proof that cancer incidents
and cancer mortality rates will
increase as years go by
The Global Buren of Cancer (2013)
Mohsen Naghavi et al.
Case Records
Medical
Records
Cancer DALY odds increase
comparing 1990 with 2013:
Liver:+42.50%, Lung:+34.53%
Colorectal:+45.57%,
Pancreatic:73.87%
The most malignant cancer types
contribute to the increase of DALYS
and therefore to cancer mortality.

16. 15
Table 2
(4)
CANCER TYPE CASES
(THOUSANDS)
DEATHS
(THOUSANDS)
RATIO
Colorectal 1361 694 0.51
Liver 782 746 0.95
Lung 1825 1590 0.87
Esophageal 456 400 0.88
Stomach 952 723 0.76
Breast (females) 1671 522 0.31
Prostate (males) 1095 307 0.28