When I worked on the latest Global Burden of Disease cancer study, a global project that tracks cancer patterns and deaths across countries, I found myself pausing as the numbers loaded on the screen. Even as a scientist used to large datasets, the scale was hard to process.
Behind every line of code was a family who might lose a parent or child to a cancer that could have been prevented or treated earlier. The projections for South Asia and sub-Saharan Africa were especially stark.
It was clear that millions of people would be living and dying with avoidable cancers in the decades ahead unless something changed.
Infectious outbreaks or antimicrobial resistance are often labelled as global health crises. Yet a quieter crisis has been gathering force for decades. Cancer is rising across every region of the world, and the steepest increases are now occurring in countries with the fewest resources.
As part of the Global Burden of Disease 2023 Cancer collaboration, a worldwide partnership of scientists who produce comprehensive estimates of disease and mortality, I co-authored a large study tracking cancer trends from 1990 to 2023 and projecting what the world could face by 2050.
For many years, cancer was widely viewed as a disease of affluence, concentrated in high-income countries. Scientists now know that it affects all regions and that an increasing proportion of the burden falls on low and middle-income countries.
Many of these countries are now experiencing rapid lifestyle and environmental changes along with ageing populations, but without the parallel development of screening, diagnostic or treatment capacity. Our analysis highlights how quickly this transition is unfolding.
In 2023, our analysis estimated 18.5 million new cancer cases and 10.4 million deaths across 204 countries. Nearly one in six global deaths was caused by cancer. More than two-thirds of these deaths occurred in low- and middle-income countries, reflecting the scale of the challenge in regions where access to screening, pathology and treatment remains limited.
In our study, 41.7% of cancer deaths in 2023 were attributable to modifiable risks. Tobacco, alcohol, unhealthy diets, high body mass index, air pollution and harmful workplace or environmental exposures all contributed.
Millions of cancers could be prevented each year if governments strengthened public health policies and made healthier choices easier. Prevention is not only about people’s actions. It is shaped by political decisions about what people can afford, breathe, eat and encounter in their environments.
Using more than three decades of data, we modelled future cancer trends. By 2050, the world could be facing 30.5 million new cancer diagnoses every year and 18.6 million annual deaths, almost double today’s figures.
Population growth and ageing play a part, but broader shifts in lifestyle, urbanisation, air quality and economic development are also increasing exposure to cancer risks. Without major interventions, these trends will continue.
Addressing this crisis requires more than isolated initiatives. By investing in early diagnosis, governments can proactively offer screening for cancers such as breast, cervical and colorectal cancer saves lives but remains rare in much of the world. Prevention must be treated as a global priority.
Tobacco control, air-quality regulation, obesity prevention and workplace protections are well evidenced and urgently need strengthening. Health systems also require significant expansion, from pathology labs and trained oncology staff to reliable access to affordable treatments. High-quality data is essential too. Countries cannot plan or measure progress without robust cancer registries.
Cancer is no longer a condition that mainly affects older adults. In many regions, younger people are increasingly diagnosed with cancers historically seen later in life. For them, the consequences ripple far beyond health.
Education, employment, relationships and financial stability can all be disrupted overnight. Cancer becomes a societal issue as well as a medical one. It already touches many families and, without action, will affect many more in the coming decades.
The future is not fixed. Our projections are warnings rather than certainties. Policymakers, communities and people still have the chance to influence what the world will face in 2050. The next 25 years are critical. We have the knowledge to change course. What we need now is the collective will to act.
