About the Atlas

Over the last several decades, the world has seen incredible progress in the fight against cancer. Thanks to advances  in cancer prevention, early detection, treatment, and support for those facing the disease, more people than ever before have reason to hope. For example, the cancer mortality rate in the United States has declined 27% since 1991, averting more than 2.6 million cancer deaths.

Despite extraordinary advances in what we know about cancer, not everyone has benefited from this progress equally. Cancer is a growing burden among people living in low- and middle-income countries, and many people living in these areas cannot access the information or interventions that could save their lives. By 2040, considering only population growth and aging, the global cancer burden is expected to grow to 27.5 million new cancer cases per year, up from 17 million new cases in 2018. When we consider lifestyle factors such as smoking, unhealthy diet, and physical inactivity, the number of new cancer cases will likely be considerably larger.

This much is clear: we simply must do better to ensure everyone can benefit from advances in the fight against cancer. As you will see in the pages of this Cancer Atlas, Third Edition, progress is not only possible, but also achievable. For example, cervical cancer death rates have declined by 70% or more in many high-income countries that began prioritizing cervical cancer screening in the 1970s. This type of dramatic progress should not be limited to women living in high-income nations. Interventions such as HPV vaccination and cervical cancer screening can be implemented even in low-resource settings, where nearly nine out of 10 deaths from cervical cancer occur. Public and private sector leaders must work to ensure that women have access to screening and girls and boys have access to HPV vaccination. Tobacco control is another area of tremendous potential. Tobacco use remains the leading preventable cause of cancer deaths worldwide, and tobacco control remains vitally important to preventing cancer. We have the tools— taxation, smoke-free environments, restrictions on product marketing, graphic warning labels on packaging, and more—that are proven to reduce tobacco use and save millions of lives. But they can only work if leaders around the world prioritize, embrace, and implement them.

The American Cancer Society is proud to work with partners in the United States and around the globe to save lives, celebrate lives, and lead the fight for a world without cancer. Together with our 1.5 million volunteers, we convene partners to create awareness and impact; fund cancer research breakthroughs; build communities to support people facing cancer; and provide direction by empowering people with the information they need. In the USA, the American Cancer Society Cancer Action Network, our nonprofit, nonpartisan advocacy affiliate, works at the state and federal levels of government to ensure patients can obtain and maintain quality, affordable, and comprehensive health insurance that enables access to cancer care— from prevention through treatment. Globally, we collaborate with our partners to increase access to information that is relevant and culturally appropriate, as well as to increase access to prevention, early detection, treatment, and palliative care that is affordable and universally available. For example, the American Cancer Society collaborates with public and private sector partners to expand access to essential cancer treatment medications across sub-Saharan Africa to make high-quality treatment more affordable and accessible. Only by increasing access to care can we truly realize progress against cancer for all.

While we face great challenges in this work, we also have the proven interventions, dedicated global partners, and momentum we need to truly address the global cancer burden. This Cancer Atlas, Third Edition is an important source of information to help the global cancer community achieve our shared goal of a world without cancer. Working together with leaders around the world, we can ensure that recent progress does not stop, but instead accelerates and benefits everyone.

The last time I wrote a foreword for The Cancer Atlas was in 2014. I started by referencing the landmark High-Level Meeting (HLM) on Noncommunicable Diseases (NCDs) which took place in September 2011 in New York. Since that first meeting, which confirmed the importance of cancer and other NCDs in the global health agenda, there have been new milestones. NCDs have been debated at two further HLMs (2014 and 2018) and, through the concerted advocacy efforts of the cancer and NCD communities, a target to reduce premature deaths caused by NCDs was included in the Sustainable Development Goals (SDGs) adopted in September 2015 by the UN General Assembly. On top of the “25 by 25” target of the Global Action Plan on NCDs, we now have global commitments to reduce premature deaths caused by NCDs by one third by 2030.

At the same time, The Union for International Cancer Control (UICC) and its members around the world advocated for an updated resolution on cancer to guide Member States on the steps they should take to improve cancer control in their own countries. Member States welcomed this view and adopted a Cancer Resolution (70.12) at the 70th session of the World Health Assembly (WHA) in 2017, once more signalling the need to place cancer as a priority in all national health plans. These efforts over the last years appear to be working. In research conducted by UICC with the World Health Organization, NCI, and other partners in late 2017, we discovered that the number of countries with operational cancer plans had increased from 66% in 2013 to 81%—a significant improvement. This progress increases our confidence that 2030 will indeed see more cancers prevented, detected early, and treated successfully.

As I write this piece, the health community is preparing for a HLM on Universal Health Coverage in New York in September 2019. It is imperative that cancer features in that discussion and that countries re-confirm their commitment to improve cancer control globally. Such a commitment on the back of three HLMs on NCDs and the WHA Cancer Resolution will provide the impetus to significantly gear up national responses as we enter what we hope will be a decade of action.

The UICC and its 1100 members in 170 countries continue to press for national action to ensure that the global wins we have secured are properly followed through by national governments. The International Agency for Research on Cancer (IARC) forecasts an increasing cancer burden, primarily due to the aging and growing world population, and that this burden will fall on parts of the world least able to cope with the increase. We will ensure that governments take tobacco control seriously, encourage healthy behaviors, implement vaccination and screening programs, improve cancer registries, and invest in the infrastructure required to treat the most common cancers.

The Cancer Atlas has proved to be an outstanding publication in the past, helping the cancer community communicate the progress we have or have not made, the challenges we face and the areas of focus for future years. Its beautifully crafted presentations of facts and evidence help us construct compelling messages to better articulate the problem and present solutions. This new edition will once again be circulated widely and inspire those of us who want to see change happen.

We all know that there is much to do. The next decade will test the tenacity of the community as we press for change, helping governments fulfill the promise of their global commitments to cancer control. The Cancer Atlas is a key resource for researchers, advocates, patients and cancer planners. My thanks to ACS, IARC and the many others who have contributed to such a wonderful resource for our community.

Cancer is an issue of sustainable development. It is associated with high morbidity, disability, and mortality, and thus places an overwhelming social and economic burden on individuals, communities, and societies. The global burden of cancer is increasing, due to demographic transitions and changes in exposures to risk factors as a result of globalization. In 2018, there were estimated to be more than 17 million new cases of cancer and more than 9 million deaths from cancer worldwide, and about 70% of all cancer deaths occurred in low- and middle-income countries.

Cancer can be treated, but better still, it can be prevented. The cost of treating patients is ballooning, while at least 40% of all cancer cases could be prevented based on current knowledge, by minimizing exposure to risk factors and implementing effective prevention strategies. Cancer mortality can also be reduced through early detection and adequate, affordable, and timely treatment. Apart from economic considerations— prevention is much more cost-effective than treatment alone— a major advantage of prevention lies in the avoidance of suffering altogether.

The International Agency for Research on Cancer (IARC), the specialized cancer agency of the World Health Organization (WHO), has a pivotal role in the production and evaluation of knowledge for cancer prevention worldwide, to guide the formulation of global policies of high public health relevance to fight against cancer. IARC’s overarching objectives are to ensure leadership on interdisciplinary cancer prevention research for the public good, to promote international collaboration, and to contribute to the capacity-building of the international scientific community in cancer prevention research, with the ultimate goal of tackling the global cancer burden. Through a closely interwoven network of collaborations, IARC plays its part in cancer prevention in support of WHO programs in the countries that are most in need.

Building on the success of the second edition of The Cancer Atlas, published in 2014, this third edition along with its website provides an accessible, easily manageable, and comprehensive state-of-the-art resource to shape strategies for cancer prevention. The Cancer Atlas presents a global overview of the latest available data on cancer burden and trends—notably drawing on the IARC Global Cancer Observatory—as well as the associated risk factors and measures of cancer prevention and control that have been proven to be effective. The publication is targeted at cancer researchers, public health professionals and advocates, governments, and society as a whole.

Facing the cancer problem is a prerequisite for addressing social and economic inequities, stimulating economic growth, and accelerating sustainable development. I hope that this book will find widespread use, because prevention is, and should continue to be, the first line of attack in tackling the challenges posed by the global cancer epidemic.