Southern, Eastern, & South-Eastern Asia
Lung, breast, and colorectal cancers are common in this region, in addition to liver and stomach cancers, which are associated with infection.
Southern, Eastern, and South-Eastern Asia is a diverse, densely populated region with 4.2 billion inhabitants, making up 55% of the world population. In 2018, 8.2 million new cancer cases and 5.2 million cancer deaths were estimated in the region, corresponding to around half of the cancer burden worldwide. China alone accounts for 52% of new cancer cases (4.3 million) and 55% of cancer deaths (2.9 million) in the region. Overall, cancers of the lung (1,166,200 new cases, 15% of all cases), colorectum (914,200, 11%) and female breast (845,400, 10%) are the most common cancers. (Figure 1) Lung cancer remains the leading cause of death (1,013,100 deaths, 21% of all deaths), followed by stomach (560,500, 11%) and liver cancer
(554,000, 11%).
Figure 1. Estimated number of new cancer cases vs. deaths and distribution (%) by type (excludes non-melanoma skin cancer) in Southern, Eastern, and South-Eastern Asia, both sexes, 2018. There were an estimated 8.2 million cancer cases. The leading cancer cases are lung (14%), colorectum (11%), breast (10%), stomach (9%), liver (7%), esophagus (5%), thyroid (4%), and other cancers (39%). There were an estimated 5.2 million cancer deaths. The leading cancer deaths are lung (20%), stomach (11%), liver (11%), colorectum (8%), esophagus (8%), breast (6%), pancreas (4%), and other cancers (34%).
Accurate population-based cancer data are a first step to planning prevention, treatment and supportive care programs in countries with an increasing cancer burden like Myanmar.
Cancer rates in the region vary widely, with nearly a fourfold difference across countries. (Map 1) Incidence rates are higher in South-Eastern Asia, and highest in the overall region in the Republic of Korea (314 cases per 100,000 population). In contrast, lower rates are seen in many countries in South Asia, including Bhutan, Sri Lanka, and India (fewer than 90 cases per 100,000). Mortality rates followed a similar pattern by subregion: Mongolia (170 per 100,000) and China (130) had the highest mortality rates, whereas Sri Lanka (51) and India (61) had the lowest rates.
While female breast cancer is the most commonly diagnosed cancer in nearly all countries among women in Asia, marked differences in the cancer profiles are observed among males according to subregion. For example, cancer of the oral cavity is a common cancer in much of South and South-East Asia, and a number of countries in this region (India, Sri Lanka) exhibit among the highest rates in the world, (Figure 2) largely as a result of the high usage of smokeless tobacco products. In South-Eastern and Eastern Asia, two infection-related cancers (liver and stomach cancers) continue to be among the most commonly diagnosed cancers and leading causes of cancer death among males. (Figure 3a & b)
Figure 2. Highest lip and oral cavity cancer incidence rates in Southern, Eastern, and South-Eastern Asia, males, 2018. Age-standardized rate (world) per 100,000. Lip and oral cavity cancer incidence rate is 16.3 cases per 100,000 in Pakistan; 13.9 in India; 12.4 in Bangladesh; 12.3 in Sri Lanka; 9.3 in Afghanistan; 6.9 in Myanmar; 5.9 in Nepal; and 5.8 for worldwide average.
Figure 3a. Incidence and mortality rates for the most common cancers among males in Southern, Eastern, and South-Eastern Asia, 2018. Age-standardized rate (world) per 100,000. Lung cancer incidence rate is 32 and mortality rate is 28.4. Colorectum cancer incidence rate is 21.4 and mortality rate is 10.1. Stomach cancer incidence rate is 20.8 and mortality rate is 15.6. Liver cancer incidence rate is 17.5 and mortality rate is 16.2. Esophagus cancer incidence rate is 12.4 and mortality rate is 11.2. Prostate cancer incidence rate is 10.8 and mortality rate is 4.3. Lip, oral cavity cancer incidence rate is 6.3 and mortality rate is 3.4. Bladder cancer incidence rate is 5.6 and mortality rate is 2.3. Leukemia incidence rate is 5.2 and mortality rate is 4.1. Non-Hodgkin lymphoma incidence rate is 4.7 and mortality rate is 2.9.
Figure 3b. Incidence and mortality rates for the most common cancers among females in Southern, Eastern, and South-Eastern Asia, 2018. Age-standardized rate (world) per 100,000. Breast cancer incidence rate is 33.7 and mortality rate is 11.2. Lung cancer incidence rate is 14.2 and mortality rate is 11.6. Colorectum cancer incidence rate is 14.2 and mortality rate is 6.5. Cervix cancer incidence rate is 12.4 and mortality rate is 6.4. Thyroid cancer incidence rate is 10 and mortality rate is 0.5. Stomach cancer incidence rate is 8.8 and mortality rate is 6.6. Liver cancer incidence rate is 6 and mortality rate is 5.6. Ovary cancer incidence rate is 5.8 and mortality rate is 3.4. Uterus cancer incidence rate is 5.5 and mortality rate is 1.2. Esophagus cancer incidence rate is 5.1 and mortality rate is 4.4.
Cancer burden contribution of this region:
Ferlay J, Ervik M, Lam F, et al. Global Cancer Observatory: Cancer Today. Lyon, France: IARC. Available from: https://gco.iarc.fr/today.
Text:
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018; 68(6): 394–424.
Ferlay J, Ervik M, Lam F, et al. Global Cancer Observatory: Cancer Today. Lyon, France: IARC. Available from: https://gco.iarc.fr/today.
Sinha DN, Gupta PC, Ray C, Singh PK. Prevalence of smokeless tobacco use among adults in WHO South-East Asia. Indian J Cancer. 2012 Oct-Dec;49(4):342–6.
Map and Figures 1–3:
Ferlay J, Ervik M, Lam F, et al. Global Cancer Observatory: Cancer Today. Lyon, France: IARC. Available from: https://gco.iarc.fr/today.