Editorial: Recently Identified Global Trends in Cancer Incidence and Mortality and Modifiable Cancer Risk Factors

In 2024, analysis of 2022 population-based data from the Global Cancer Observatory (GLOBOCAN) evaluated 36 cancers across 185 countries and territories by gender, age, and geographic location, and projected future cancer trends to 2050 [1]. Estimates showed that by 2050, 35.3 million cancer cases worldwide could be expected, with a 76.6% increase from the previous estimate of 20 million for 2022 [1]. Also, 18.5 million cancer deaths were projected by 2050, which is an 89.7% increase from the 2022 estimate of 9.7 million cancer deaths [1]. Importantly, cancer cases and cancer deaths were projected to triple in low-income countries by 2050, compared to a moderate increase in high-income countries, with men having higher rates for cancer diagnoses and cancer mortality [1].

On February 3, 2026, Fink and colleagues published the findings of a study aimed at identifying modifiable risk factors for cancer [2]. The investigators evaluated data from the 2022 GLOBOCAN estimates of global and national cancer burden data by gender for 36 cancer sites in 185 countries [2,3]. Thirty factors were evaluated, including alcohol consumption, tobacco smoking, increased body mass index (BMI), lack of physical activity, chewing tobacco and areca nut, air pollution, ultraviolet (UV) radiation, 13 occupational exposures, and nine infections (Table 1) [2,3]. The study found that in 2022, among an estimated 18.7 million new cancer cases, 37.8% (7.1 million) were associated with 30 modifiable risk factors: 45.4% (4.3 million) in men and 29.7% (2.7 million) in women [2]. Importantly, lung, stomach, and cervical cancer were the leading preventable cancers, representing almost half of potentially preventable cancers [2]. The leading preventable risk factors for cancer were tobacco smoking (15.1%), infections with oncogenic viruses, including hepatitis B virus (HBV) and human papillomavirus (HPV) (10.2%), and alcohol consumption (3.2%) (Table 1) [2]. This study has shown that, worldwide, up to four out of 10 new cancer cases are attributable to modifiable risk factors, or population-attributable factors (PAFs) derived from modelling estimates, including three out of 10 new cancer cases in women, and 5 out of 10 new cancer cases in men (Table 1) [2]. In women, tobacco smoking and infections were the leading PAFs, mainly resulting in lung and cervical cancers; in men, tobacco smoking and infections contributed mainly to lung, stomach, and liver cancers [2]. The study also showed variations between countries and regions [2]. For example, there were 24.6% of all new cancer cases were associated with modifiable risk factors in Northern and Western Africa [2]. Fink and colleagues have stated the limitations of this study, including variable data quality across countries, limited cancer surveillance in some countries, and simplifications in data modeling that may have underestimated the true burden of preventable cancers globally [2]. Therefore, global cancer prevention should aim to reduce exposure to modifiable factors, including alcohol and smoking, and to improve vaccination programs for infectious causes of cancer, importantly, those associated with HBV and HPV infection.

In 2026, the American Cancer Society (ACS) reported that mortality in the US has now decreased for every leading cancer-related death in people younger than 50 years, except colorectal cancer, which is now the leading cancer death in men and women combined [4,5]. Between 1990 and 2023, a total of 1,267,520 people (53% women) under the age of 50 years died of cancer in the US [4]. The age-standardized death rate decreased by 44%, from 25.5 per 100,000 to 14.2 per 100,000 [4]. Findings from the five leading causes of cancer mortality, the mean annual decline between 2014 and 2023 was 0.3% for brain cancers, 1.4% for breast cancer, 2.3% for leukemia, and 5.7% for lung cancer [4]. However, mortality in this age group for colorectal cancer increased by 1.1% annually, moving from the fifth most common cause of cancer mortality in 1990 to the most common cause of cancer mortality in 2023 [4,5]. During this time and in the younger population, lung cancer dropped from first to fourth, but breast cancer remained the second leading cause of cancer mortality in women in the US, and cervical cancer ranked third in women between 1990 and 2023, despite the implementation of human papillomavirus (HPV) vaccination [4]. In 2021, Rahib and colleagues reported an estimated projection to 2040 for the incidence and mortality from cancer in the US and predicted that colorectal cancer would become the leading cause of mortality from cancer in patients younger than 50 years by 2040 [6]. These findings support previous reports of the increasing incidence and mortality from colorectal cancer in the US [5]. Also, in the US, mortality from breast cancer and leukemia has decreased despite the reported increase in incidence [4,7]. These findings are not replicated in middle-income and low-income countries, and the recent trends in incidence and mortality from colorectal cancer in high-income countries may reflect lifestyle factors, including diet, obesity, and alcohol consumption [2,5,6].

A further important finding regarding mortality from cancer comes from a recent analysis of mortality rates before, during, and after the COVID-19 pandemic. The World Health Organization (WHO) estimated that excess deaths across the six WHO regions for 2020 and 2021 during the COVID-19 pandemic were 14.83 million, including both direct COVID-19 deaths and indirect health impacts, with wide variations across regions [8]. Recent data from the 2024 WHO World Health Statistics show that life expectancies were gradually increasing up to 2019, but then declined as the COVID-19 pandemic halted a decade of progress made in improving healthy lifespan [9]. Between 2000 and 2019, global life expectancy increased from 66.8 years to 73.1 years, and healthy life expectancy increased from 58.1 years in 2000 to 63.5 years in 2019 [9]. By 2020, global life expectancy declined to 72.5 years, and healthy life expectancy declined to 62.8 years [9]. By 2021, global life expectancy declined to 71.4 years, and healthy life expectancy declined to 61.9 years [9]. Therefore, factors other than COVID-19 deaths were associated with pandemic and post-pandemic mortality rates [9,10]. The effects of the COVID-19 pandemic have persisted in health and mortality years after the pandemic ended. Long-term sequelae of SARS-CoV-2 infection have been recognized and are still being studied [11]. Pallari and colleagues recently published findings from an epidemiological study examining the estimated increase in mortality using weekly mortality data from January 2020 to December 2022 across 21 countries and regions, and found sustained excess mortality throughout 2022, with the proportion of COVID-19 deaths relative to total deaths decreasing in most countries in 2022 [12]. Recently, Chen and colleagues reported findings from a cross-sectional study of 34 countries with 352,182,284 deaths from 2015 to 2024 and identified that the post-pandemic decline in mortality in some countries was associated with mortality ‘displacement’, or mortality rates that did not return to their pre-pandemic trajectories by 2024 [13]. Three European countries were identified as having mortality ‘displacement’, Poland, Latvia, and Greece, mainly among adults ≥85 years [13]. However, the US resumed stable pre-pandemic mortality patterns by 2024 [13]. Increased awareness of the displacement of diagnosis and management of cancer patients during epidemics and pandemics could inform future epidemic and pandemic preparedness and raise awareness of the importance of vaccination for oncogenic viruses, cancer screening, diagnosis, and management.

Conclusions

Analysis of global population data from 2022 and 2023 has shown that global trends in all-cause and cancer mortality, and in life expectancy, vary by location, age, gender, and economic factors, and are affected by global events, including pandemics. Analysis of evolving trends in mortality and life expectancy can provide important information for international health and economic monitoring and planning, for national governments and policymakers, and for individuals to identify and prevent factors associated with reduced life expectancy and to improve the health of populations and individuals. Recent identification of preventable factors associated with cancer is of major importance in reducing cancer-associated morbidity and mortality, which may affect individual lifestyle choices and inform global public health policy.