The decrease in global cancer mortality.

1608 Background: A decrease in cancer mortality has been reported in the United States, Europe and other developed regions of the world during the last two decades. Whether similar trends apply to less-developed countries – and globally – is unclear. Methods: We aimed at describing the global patterns of cancer mortality by conducting a systematic analysis of the WHO mortality database for countries for which high- or intermediate-quality data on death certifications are available for a period of at least 10 years (typically 2003-2012). We included 60 countries in the analysis, and calculated age-specific and age-adjusted mortality rates. Results: A decrease in overall cancer mortality of approximately 1% per year was present in both developed and less-developed regions, and in both genders. For cancers of the esophagus, stomach, larynx and thyroid, the average decrease in global mortality rate was greater than 2% per year. Individual cancers which showed an increase in mortality rates on a global scale are limited to pancreas and brain (both genders), lung (women), melanoma and kidney (men) and endometrium. Conclusions: Reasons for the decrease in cancer mortality in less-developed countries may include decrease in cancer incidence, shift in the stage distribution, shift in the proportional contribution of individual cancers, and improved therapy. The increase in the number of cancer deaths, globally and in less-developed countries, is primarily driven by changes in the demographic structure of the population, but the risk of the individual of dying from cancer appears to decrease in all countries with reliable data. Cancers with increasing mortality rates should be given priority for research.