“The global, regional, and national burden of cancer, 1990–2023, with forecasts to 2050: a systematic analysis for the Global Burden of Disease Study 2023”
The Lancet- GBD 2023 Cancer Collaborators
Published online September 24, 2025, https://doi.org/10.1016/S0140-6736(25)01635-6
Summary of the Publication
The Global Burden of Disease (GBD) 2023 study provides the most comprehensive assessment to date of the worldwide cancer burden, covering 47 cancer types across 204 countries from 1990 to 2023, with forecasts to 2050.
Using cancer registry data, mortality records, verbal autopsies, and advanced modeling frameworks, the study quantified incidence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs). Importantly, it also examined cancer burden attributable to 44 modifiable risk factors and projected cancer trends over the next quarter century.
Global Burden in 2023
In 2023, there were an estimated 18.5 million new cancer cases and 10.4 million deaths, accounting for 271 million DALYs worldwide
Cancer ranked as the second leading cause of death after cardiovascular disease. More than half of incident cases (58%) and nearly two-thirds of deaths (66%) occurred in low- to upper-middle-income countries. The cancers contributing most to incidence were breast, lung, colorectal, prostate, and stomach cancers. In terms of mortality, lung, colorectal, stomach, breast, and esophageal cancers dominated the global burden.
Trends and Risk Factors
Between 1990 and 2023, cancer deaths rose 74%, driven largely by population growth and aging. Nearly 42% of cancer deaths in 2023 were attributable to modifiable risks. Tobacco use was the single largest contributor (21% of cancer deaths), followed by high alcohol consumption, dietary risks, infections, and unsafe sex. Regional disparities were striking while incidence rates were highest in high-income countries, mortality rates rose disproportionately in lower-income regions due to weaker health systems.
Forecasts to 2050
By 2050, global cancer cases are projected to reach 30.5 million and deaths to 18.6 million, representing increases of 61% and 75%, respectively, from 2024 levels.
Low- and middle-income countries (LMICs) are expected to face the steepest rises in deaths (90% increase versus 43% in high-income countries). Age-standardized mortality rates are forecasted to decline modestly (–5.6%), but absolute case numbers will continue to climb due to demographic pressures. The study also projects only a 6.5% relative reduction in premature cancer mortality by 2030—insufficient to meet the UN Sustainable Development Goal (SDG) of a one-third reduction in non-communicable disease mortality.
Clinical Implications
1. Prevention Remains Paramount
The finding that nearly half of cancer deaths are attributable to modifiable risks highlights the ongoing need for primary prevention strategies. Tobacco control, alcohol reduction, vaccination against oncogenic viruses (HPV, HBV), promotion of healthy diets, and environmental protections remain the most impactful public health tools. Clinicians must continue advocating for preventive care alongside patient management.
2. Screening and Early Detection
Despite progress in some regions, disparities in cancer survival reflect gaps in early detection and treatment capacity. Strengthening population-based screening programs for breast, cervical, and colorectal cancers—particularly in LMICs—offers substantial opportunities to reduce mortality. Clinicians should prioritize risk-based screening approaches adapted to local epidemiology and resources.
3. Treatment Equity
The forecasted disproportionate mortality rise in LMICs underscores inequities in treatment access. Many regions lack pathology infrastructure, radiotherapy, systemic therapies, and palliative care. Clinicians in high-income settings should be aware of these disparities, as international collaborations, telemedicine, and global oncology initiatives will be increasingly important to narrow gaps in cancer outcomes.
4. Survivorship and Chronic Care
The growing number of survivors means cancer care is shifting toward a chronic disease model, with attention to long-term complications, secondary malignancies, and quality of life. Exercise oncology, lifestyle medicine, and integrative supportive care are critical tools for managing survivorship, reducing recurrence risk, and improving functional outcomes.
5. System-Level Planning
For clinicians involved in policy or health system design, the study reinforces that cancer control must be integrated across the continuum—from prevention and screening through diagnosis, treatment, and palliative care. Data-driven resource allocation is essential, and health professionals must engage in advocacy for sustainable funding, workforce training, and equitable access to diagnostics and therapies.
Conclusion
The GBD 2023 cancer analysis makes clear that while age-standardized cancer mortality is declining, the absolute global burden is rising steeply. Without urgent, coordinated action, LMICs will bear a disproportionate share of the cancer epidemic by 2050. For clinicians, this translates into a dual responsibility: delivering high-quality, evidence-based care locally, while engaging in prevention, survivorship, and advocacy efforts globally. Achieving the SDG target for cancer mortality reduction will require nothing less than a comprehensive, equity-focused approach to cancer control across all stages of the care continuum.
