Burden of 30 cancers among men: Global statistics in 2022 and projections for 2050 using population-based estimates
Abstract
Background
Men exhibit higher prevalence of modifiable risk factors, such as smoking and alcohol consumption, leading to greater cancer incidence and lower survival rates. Comprehensive evidence on global cancer burden among men, including disparities by age group and country, is sparse. To address this, the authors analyzed 30 cancer types among men in 2022, with projections estimated for 2050.
Methods
The 2022 GLOBOCAN estimates were used to describe cancer statistics for men in 185 countries/territories worldwide. Mortality-to-incidence ratios (MIRs) were calculated by dividing age-standardized mortality rates by incidence rates.
Results
In 2022, a high MIR (indicating poor survival) was observed among older men (aged 65 years and older; 61%) for rare cancer types (pancreatic cancer, 91%) and in countries with low a Human Development Index (HDI; 74%). Between 2022 and 2050, cancer cases are projected to increase from 10.3 million to 19 million (≥84%). Deaths are projected to increase from 5.4 million to 10.5 million (≥93%), with a greater than two-fold increase among men aged 65 years and older (≥117%) and for low-HDI and medium-HDI countries/territories (≥160%). Cancer cases and deaths are projected to increase among working-age groups (≥39%) and very-high-HDI countries/territories (≥50%).
Conclusions
Substantial disparities in cancer cases and deaths were observed among men in 2022, and these are projected to widen by 2050. Strengthening health infrastructure, enhancing workforce quality and access, fostering national and international collaborations, and promoting universal health coverage are crucial to reducing cancer disparities and ensuring cancer equity among men globally.
INTRODUCTION
Globally, cancer is the second leading cause of premature death after cardiovascular diseases1-3 but is projected to be the leading cause of death by the end of this century.2, 3 Its health, social, and economic effects are significant.1, 4, 5 Cancer causes high demand and stress on health care systems.6 Its economic burden is also high, with an estimated cost of US$25.3 billion globally in 2017 and an estimated cumulative cost of US$25.2 trillion between 2020 and 2050.4
According to Sung and colleagues, the global age-adjusted cancer mortality rate in 2020 was 43.0% greater among men than among women (120.8 vs. 84.2 deaths per 100,000). Similarly, the incidence rate was 19.0% greater among men than among women (222.0 vs. 186 cases per 100,000).7 These disparities could arise from men’s lower participation in cancer prevention activities; underuse of available prevention, screening, and treatment options; increased exposure to cancer risk factors; and biologic differences.8, 9 Early detection and interventions for female-specific cancers, such as breast and cervical cancer, have been beneficial; however, there are no comparable programs for male-specific cancers, such as prostate or testicular cancer.8 Males participate less in shared screening programs like those for colorectal cancer8 and have a higher prevalence of modifiable cancer risk factors, including smoking and alcohol consumption. For instance, 32.6% of men worldwide smoked in 2020 compared with 6.5% of women.9 Males have more cancer cases attributable to occupational carcinogens than women,10 emphasizing the need for comprehensive studies targeting men to enhance evidence-based cancer prevention, which is the focus of the current study.
There is some evidence demonstrating disparities in cancer incidence and outcomes within men by age as well as variations in access to healthcare, socioeconomic status, awareness, and unique needs and interests at different ages.5, 11-14 Compared to young adult men, older men have worse cancer outcomes (e.g., lower survival), which could be attributed to age-related lower tolerance to treatment, diagnosis at more advanced stages, and limited access to health services because of financial constraints.5, 11-14 This disparity among men can be measured using the mortality-to-incidence ratio (MIR), in which higher values signify lower survival rates.15-19 The MIR is useful for measuring disparities in cancer outcomes and has been applied in previous studies17, 18, 20 and in government reports in the United States21 and Australia.22
Existing literature on the MIR in men has often focused on specific age groups (e.g., aged 20–39 years),20 selected cancer types, such as lung,23 stomach,17, 20 kidney,24 liver,25 and bladder26 cancer, or has addressed limited geographic regions.17, 20 In addition, these estimates cover the period before 2020,17, 24-27 whereas cancer care and outcomes could be affected by the ongoing coronavirus disease 2019 pandemic and armed conflicts, their associated global economic effects, as well as a decline in the global Human Development Index (HDI) after 2020.28 This highlights the importance of providing continuous and up-to-date cancer data to support informed decision making worldwide. Hence, in this study, we examined the MIR for 30 cancer types among men across all ages and by specific age groups globally. In addition, the numbers and rates of cancer cases and deaths, the prevalence of cancer in 2022, and their projections for 2050 were estimated. The results of this study will offer a relatively comprehensive view of the burden of cancer in men, empowering policymakers to make informed decisions and allocate resources effectively.
MATERIALS AND METHODS
This study used the 2022 Global Cancer Observatory (GLOBOCAN) estimates produced by the International Agency for Research on Cancer. Detailed descriptions of the GLOBOCAN estimates can be found in previously published studies.7, 29 The GLOBOCAN repository encompasses national-level estimates for cancer cases, deaths and rates for each country/territory worldwide.29-31 Cancer types were identified by their International Classification of Diseases, 10th Revision codes (see Table S1).29, 32 The estimates were further stratified by age, sex, country/territory, World Health Organization (WHO) region, and HDI.7, 29
Estimates by age were available in 5-year groups, totaling 18 age groups. By considering importance for policy, clinical, public health, and epidemiologic use, men’s ages for this study were combined into a working-age group (aged 15–64 years) and an older adult group (aged 65 years and older),33 with the working-age group further subdivided into adolescents and young adults (AYAs; aged 15–39 years)5, 12 and middle-aged adults (aged 40–64 years). In addition, estimates are presented for all ages combined. Cancer statistics are described by 185 countries/territories, six WHO regions (Africa, Southeast Asia, Eastern Mediterranean, the Americas, Europe, and Western Pacific), and four HDI classifications (low, medium, high, and very high).29, 34 The HDI was used to represent each country's development in areas of health, knowledge, and standard of living.34
Rates for incidence and mortality were calculated by dividing the number of cases and deaths over 1 year in each specific population by the total number of persons.29, 35 The 2022 rates were estimated by using short-term estimation when available or by modelling using MIRs.29, 35 To facilitate cross-comparisons and reduce age-related biases, direct standardization using the 1966 Segi–Doll world standard population was used, with the age-standardized incidence rate (ASIR) and the age-standardized mortality rate (ASMR) reported per 100,000 males.7, 29, 35, 36 The prevalence of cancer was calculated by dividing the total number of cancer survivors in 2022 in specific regions by their corresponding total population.37 The MIR, expressed as a percentage, was estimated by dividing the ASMR by the ASIR, and multiplying by 100, with a higher MIR indicating poorer survival and greater mortality.15-19 The MIR was reported for all cancers excluding nonmelanoma skin cancer, and a sensitivity analysis was presented for all cancers including nonmelanoma skin cancer.
The projected cancer cases and deaths in 2050 were derived through demographic projections, assuming that the 2022 estimated rates remain constant.7, 38-40 The projections were calculated every 5 years (2025, 2030, … 2050) by multiplying the 2022 age-specific rates with their corresponding population projections for the target years (2025, 2030, … 2050), with the projected population extracted from the United Nations world population prospects.7, 38-40 We analyzed the MIR, whereas other estimates, such as counts, rates, prevalence, and projections, were estimated by using GLOBOCAN. Consistent with previous studies using similar data sources,7, 19, 41 the GLOBOCAN estimates were extracted from the Global Cancer Observatory website (https://gco.iarc.who.int, Accessed June 27, 2024), which has online tabulation and visualization tools. The tools provide step-by-step selection options for cancer type, age group, region, HDI, and outcome measures (rates, prevalence, and projections), with the specific estimates extracted and merged to achieve the specific study objectives. The analysis was conducted using Microsoft Excel (Microsoft Corporation), Stata version 17 (StataCorp), and the Global Cancer Observatory's online tabulation and visualization tools (e.g., mapping).
RESULTS
Cancer incidence and mortality rates in 2022
In 2022, there were an estimated 10.3 million cancer cases and 5.4 million cancer deaths among men globally (Table 1), with nearly two thirds of cases and deaths occurring among older adults (aged 65 years and older). Lung cancer was the most common cancer in terms of cases and deaths, although slight variations in the leading cancer type were noted across age groups. For instance, testicular cancer cases and leukemia deaths were ranked the highest among AYAs (see Tables S2 and S3). The top 10 ranked cancer types across various age groups are presented in Table 3.
Working-age group | Older adults | All ages combined | ||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
No. of cases | No. of deaths | No. of cases | No. of deaths | No. of cases | No. of deaths | |||||||||||||
2022 | 2050 | Change, %a | 2022 | 2050 | Change, %b | 2022 | 2050 | Change, %a | 2022 | 2050 | Change, %b | 2022 | 2050 | Change, %a | 2022 | 2050 | Change, %b | |
Cancer type | ||||||||||||||||||
All cancers | 4,143,419 | 5,763,278 | 39.1 | 1,944,405 | 2,719,781 | 39.9 | 6,053,502 | 13,122,131 | 116.8 | 3,441,381 | 7,726,482 | 124.5 | 10,311,610 | 19,000,529 | 84.3 | 5,430,284 | 10,490,923 | 93.2 |
All cancers excluding NMSC | 4,003,419 | 5,562,273 | 38.9 | 1,933,302 | 2,704,215 | 39.9 | 5,449,563 | 11,673,808 | 114.2 | 3,413,011 | 7,656,707 | 124.3 | 9,566,825 | 17,350,353 | 81.4 | 5,390,596 | 10,405,366 | 93.0 |
Lip, oral cavity | 168,423 | 227,600 | 35.1 | 80,683 | 109,417 | 35.6 | 99,965 | 205,167 | 105.2 | 49,925 | 103,940 | 108.2 | 268,999 | 433,380 | 61.1 | 130,808 | 213,557 | 63.3 |
Salivary glands | 16,695 | 22,240 | 33.2 | 6379 | 8762 | 37.4 | 13,921 | 30,271 | 117.5 | 7524 | 16,902 | 124.6 | 30,963 | 52,858 | 70.7 | 13,989 | 25,750 | 84.1 |
Oropharynx | 51,803 | 72,037 | 39.1 | 23,545 | 32,970 | 40.0 | 34,365 | 68,972 | 100.7 | 19,259 | 39,649 | 105.9 | 86,339 | 141,181 | 63.5 | 42,818 | 72,633 | 69.6 |
Nasopharynx | 63,852 | 84,012 | 31.6 | 33,992 | 45,929 | 35.1 | 21,416 | 41,504 | 93.8 | 19,758 | 39,316 | 99.0 | 86,289 | 126,542 | 46.7 | 54,104 | 85,600 | 58.2 |
Hypopharynx | 41,452 | 57,690 | 39.2 | 17,497 | 24,415 | 39.5 | 30,577 | 61,695 | 101.8 | 17,054 | 35,269 | 106.8 | 72,077 | 119,433 | 65.7 0 | 34,564 | 59,698 | 72.7 |
Esophagus | 157,590 | 222,323 | 41.1 | 130,892 | 184,325 | 40.8 | 207,523 | 434,756 | 109.5 | 187,493 | 402,373 | 114.6 | 365,225 | 657,192 | 79.9 | 318,433 | 586,747 | 84.3 |
Stomach | 231,664 | 328,504 | 41.8 | 143,501 | 203,042 | 41.5 | 395,410 | 849,791 | 114.9 | 283,894 | 629,087 | 121.6 | 627,458 | 1,178,681 | 87.9 | 427,575 | 832,310 | 94.7 |
Colorectum | 433,659 | 608,726 | 40.4 | 156,184 | 219,689 | 40.7 | 635,200 | 1,371,024 | 115.8 | 343,446 | 789,536 | 129.9 | 1,069,446 | 1,980,340 | 85.2 | 499,775 | 1,009,371 | 102.0 |
Liver | 308,548 | 424,986 | 37.7 | 254,241 | 350,388 | 37.8 | 289,481 | 609,098 | 110.4 | 266,195 | 571,763 | 114.8 | 600,676 | 1,036,750 | 72.6 | 521,826 | 923,551 | 77.0 |
Gallbladder | 15,911 | 22,339 | 40.4 | 10,928 | 15,344 | 40.4 | 27,621 | 61,533 | 122.8 | 20,475 | 46,375 | 126.5 | 43,538 | 83,878 | 92.7 | 31,406 | 61,722 | 96.5 |
Pancreas | 97,051 | 138,005 | 42.2 | 82,009 | 117,283 | 43.0 | 172,549 | 378,456 | 119.3 | 165,560 | 368,663 | 122.7 | 269,709 | 516,570 | 91.5 | 247,589 | 485,966 | 96.3 |
Larynx | 84,357 | 119,278 | 41.4 | 39,933 | 56,969 | 42.7 | 81,334 | 166,658 | 104.9 | 50,419 | 106,894 | 112.0 | 165,794 | 286,039 | 72.5 | 90,384 | 163,895 | 81.3 |
Lung | 567,296 | 815,365 | 43.7 | 394,831 | 570,499 | 44.5 | 1,004,296 | 2,139,081 | 113.0 | 838,206 | 1,831,061 | 118.5 | 1,572,045 | 2,954,902 | 88.0 | 1,233,241 | 2,401,765 | 94.8 |
Melanoma of skin | 73,296 | 100,658 | 37.3 | 11,051 | 15,318 | 38.6 | 106,296 | 237,760 | 123.7 | 22,060 | 51,696 | 134.3 | 179,953 | 338,780 | 88.3 | 33,160 | 67,063 | 102.2 |
NMSC | 140,000 | 201,005 | 43.6 | 11,103 | 15,566 | 40.2 | 603,939 | 1,448,322 | 139.8 | 28,370 | 69,775 | 146.0 | 744,785 | 1,650,176 | 121.6 | 39,688 | 85,557 | 115.6 |
Mesothelioma | 5367 | 7746 | 44.3 | 3804 | 5513 | 44.9 | 16,040 | 36,253 | 126.0 | 14,276 | 33,374 | 133.8 | 21,410 | 44,002 | 105.5 | 18,082 | 38,890 | 115.1 |
Kaposi sarcoma | 19,703 | 23,795 | 20.8 | 8852 | 10,538 | 19.1 | 4126 | 8948 | 116.9 | 1317 | 2908 | 120.8 | 24,620 | 33,537 | 36.2 | 10,629 | 13,908 | 30.9 |
Penis | 18,611 | 25,323 | 36.1 | 6724 | 9266 | 37.8 | 19,006 | 41,596 | 118.9 | 7004 | 16,084 | 129.6 | 37,700 | 67,002 | 77.7 | 13,738 | 25,361 | 84.6 |
Prostate | 387,253 | 582,372 | 50.4 | 40,708 | 62,001 | 52.3 | 1,080,421 | 2,296,948 | 112.6 | 356,698 | 877,508 | 146.0 | 1,467,854 | 2,879,501 | 96.2 | 397,430 | 939,534 | 136.4 |
Testis | 65,336 | 76,712 | 17.4 | 6840 | 8236 | 20.4 | 4202 | 9133 | 117.4 | 1818 | 4048 | 122.7 | 72,040 | 88,362 | 22.7 | 9068 | 12,697 | 40.0 |
Kidney | 140,105 | 193,865 | 38.4 | 33,875 | 48,065 | 41.9 | 131,299 | 276,282 | 110.4 | 64,033 | 144,617 | 125.9 | 277,800 | 476,581 | 71.6 | 100,343 | 195,131 | 94.5 |
Bladder | 134,526 | 193,872 | 44.1 | 29,327 | 42,728 | 45.7 | 336,438 | 752,501 | 123.7 | 136,247 | 329,893 | 142.1 | 471,293 | 946,705 | 100.9 | 165,672 | 372,719 | 125.0 |
Brain, central nervous system | 100,050 | 130,609 | 30.5 | 75,800 | 100,819 | 33.0 | 59,991 | 126,675 | 111.2 | 57,210 | 121,087 | 111.7 | 173,699 | 270,984 | 56.0 | 139,823 | 228,738 | 63.6 |
Thyroid | 171,068 | 215,368 | 25.9 | 5973 | 8329 | 39.4 | 34,727 | 68,733 | 97.9 | 11,155 | 24,917 | 123.4 | 206,485 | 284,794 | 37.9 | 17,241 | 33,360 | 93.5 |
Hodgkin lymphoma | 33,504 | 40,903 | 22.1 | 7259 | 9215 | 27.0 | 9959 | 21,005 | 110.9 | 4893 | 10,706 | 118.8 | 48,774 | 67,226 | 37.8 | 13,674 | 21,444 | 56.8 |
Non-Hodgkin lymphoma | 151,697 | 203,773 | 34.3 | 55,351 | 74,719 | 35.0 | 148,323 | 321,352 | 116.7 | 84,198 | 192,644 | 128.8 | 311,375 | 536,509 | 72.3 | 143,740 | 271,565 | 88.9 |
Multiple myeloma | 39,919 | 56,507 | 41.6 | 21,293 | 30,366 | 42.6 | 63,801 | 137,770 | 115.9 | 45,593 | 102,763 | 125.4 | 103,805 | 194,362 | 87.2 | 66,966 | 133,209 | 98.9 |
Leukemia | 121,343 | 158,802 | 30.9 | 69,911 | 90,826 | 29.9 | 119,266 | 262,985 | 120.5 | 89,265 | 204,630 | 129.2 | 278,120 | 459,432 | 65.2 | 173,289 | 309,616 | 78.7 |
WHO regions | ||||||||||||||||||
Africa | 204,724 | 485,182 | 137.0 | 132,375 | 315,289 | 138.2 | 143,382 | 422,906 | 195.0 | 107,695 | 319,991 | 197.1 | 370,055 | 939,315 | 153.8 | 251,773 | 651,926 | 158.9 |
Southeast Asia | 662,261 | 989,172 | 49.4 | 441,115 | 671,736 | 52.3 | 469,768 | 1,208,896 | 157.3 | 347,775 | 905,484 | 160.4 | 1,156,550 | 2,218,415 | 91.8 | 799,837 | 1,586,308 | 98.3 |
Eastern Mediterranean | 213,473 | 398,588 | 86.7 | 131,584 | 249,389 | 89.5 | 153,135 | 465,951 | 204.3 | 119,142 | 366,478 | 207.6 | 382,443 | 883,492 | 131.0 | 257,873 | 624,402 | 142.1 |
The Americas | 754,797 | 993,472 | 31.6 | 220,716 | 291,275 | 32.0 | 1,431,173 | 2,933,714 | 105.0 | 530,273 | 1,139,953 | 115.0 | 2,204,545 | 3,943,166 | 78.9 | 755,745 | 1,435,328 | 89.9 |
Europe | 871,142 | 877,676 | 0.8 | 344,295 | 349,977 | 1.7 | 1,688,388 | 2,728,157 | 61.6 | 877,549 | 1,488,154 | 69.6 | 2,572,323 | 3,616,782 | 40.6 | 1,224,793 | 1,840,651 | 50.3 |
Western Pacific | 1,435,462 | 1,569,034 | 9.3 | 673,514 | 753,847 | 11.9 | 2,165,203 | 4,379,404 | 102.3 | 1,457,302 | 3,135,686 | 115.2 | 3,621,659 | 5,963,574 | 64.7 | 2,137,806 | 3,894,530 | 82.2 |
HDI | ||||||||||||||||||
Low HDI | 194,244 | 462,706 | 138.2 | 131,602 | 316,437 | 140.5 | 120,839 | 310,651 | 157.1 | 93,898 | 240,617 | 156.3 | 337,841 | 806,151 | 138.6 | 237,970 | 575,001 | 141.6 |
Medium HDI | 663,571 | 1,103,621 | 66.3 | 439,852 | 744,467 | 69.3 | 468,957 | 1,251,329 | 166.8 | 341,685 | 921,359 | 169.7 | 1,162,894 | 2,383,754 | 105.0 | 795,332 | 1,678,918 | 111.1 |
High HDI | 1,708,635 | 2,042,772 | 19.6 | 869,748 | 1,064,384 | 22.4 | 2,076,121 | 4,580,241 | 120.6 | 1,502,309 | 3,495,139 | 132.7 | 3,823,126 | 6,652,363 | 74.0 | 2,385,933 | 4,570,114 | 91.5 |
Very high HDI | 1,575,409 | 1,633,715 | 3.7 | 502,397 | 525,253 | 4.6 | 3,385,132 | 5,833,383 | 72.3 | 1,501,844 | 2,763,357 | 84.0 | 4,983,714 | 7,487,212 | 50.2 | 2,008,592 | 3,292,383 | 63.9 |
- Abbreviations: HDI, Human Development Index; NMSC, nonmelanoma skin cancer; WHO, World Health Organization.
- a The absolute percentage change was calculated by dividing the number of cancer cases between 2022 and 2050 by the number of cases in 2022, with negative values signifying a decrease in cases.
- b The absolute percentage change was calculated by dividing the number of cancer deaths between 2022 and 2050 by the number of deaths in 2022, with negative values signifying a decrease in deaths.
The global ASIR, ASMR, and prevalence of cancer per 100,000 men in 2022 were 212.6, 109.8, and 178.8, respectively, with variations observed across WHO regions (Table 2). The highest and lowest ASIRs were reported in Europe (307.6 per 100,000) and Southeast Asia (110.0 per 100,000), respectively. The ASMR per 100,000 men ranged from 76.4 per 100,000 in Southeast Asia to 136.2 per 100,000 in Europe. The highest prevalence of cancer was observed in Europe (432.5 per 100,000), whereas the lowest was observed in Africa (34.3 per 100,000). The findings for ASIR, ASMR, and prevalence by WHO region among AYAs, middle-aged adults, the working-age group, and older adults were broadly similar to those for all ages combined (Table 2). Crude incidence and mortality rates are provided in Table S4.
Adolescents and young adults | Middle-aged adults | Working-age group | Older adults | All ages combined | ||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
ASIRa | ASMRa | MIR, %b | Prevalencec | ASIRa | ASMRa | MIR, %b | Prevalencec | ASIRa | ASMRa | MIR, %b | Prevalencec | ASIRa | ASMRa | MIR, %b | Prevalencec | ASIRa | ASMRa | MIR, %b | Prevalencec | |
Cancer type | ||||||||||||||||||||
All cancers | 28.9 | 10.6 | 36.7 | 22.9 | 338.9 | 163.3 | 48.2 | 240.2 | 153.9 | 72.2 | 46.9 | 113.5 | 1624.2 | 909.0 | 56.0 | 1137.1 | 212.6 | 109.8 | 51.6 | 178.8 |
All cancers excluding NMSC | 28.3 | 10.6 | 37.5 | 22.4 | 326.8 | 162.4 | 49.7 | 230 | 148.7 | 71.8 | 48.3 | 108.9 | 1470.4 | 901.7 | 61.3 | 991 | 198.6 | 109 | 54.9 | 162.6 |
Lip, oral cavity | 1.3 | 0.56 | 43.1 | 0.98 | 13.5 | 6.6 | 48.9 | 9.5 | 6.2 | 3.0 | 48.4 | 4.5 | 27.7 | 13.8 | 49.8 | 19.4 | 5.8 | 2.8 | 48.3 | 4.7 |
Salivary glands | 0.22 | 0.05 | 22.7 | 0.18 | 1.2 | 0.51 | 42.5 | 0.95 | 0.62 | 0.24 | 38.7 | 0.50 | 3.7 | 2.0 | 54.1 | 2.9 | 0.66 | 0.29 | 43.9 | 0.59 |
Oropharynx | 0.12 | 0.04 | 33.3 | 0.10 | 4.6 | 2.1 | 45.7 | 3.6 | 1.9 | 0.87 | 45.8 | 1.6 | 9.6 | 5.3 | 55.2 | 6.8 | 1.9 | 0.91 | 47.9 | 1.6 |
Nasopharynx | 0.69 | 0.24 | 34.8 | 0.54 | 4.8 | 2.8 | 58.3 | 3.6 | 2.4 | 1.3 | 54.2 | 1.8 | 6.1 | 5.6 | 91.8 | 4.2 | 1.9 | 1.2 | 63.2 | 1.6 |
Hypopharynx | 0.12 | 0.07 | 58.3 | 0.05 | 3.6 | 1.5 | 41.7 | 2.3 | 1.5 | 0.65 | 43.3 | 1.0 | 8.5 | 4.7 | 55.3 | 5.1 | 1.6 | 0.73 | 45.6 | 1.1 |
Esophagus | 0.34 | 0.28 | 82.4 | 0.28 | 13.9 | 11.6 | 83.5 | 9.3 | 5.8 | 4.8 | 82.8 | 4.1 | 56.7 | 50.5 | 89.1 | 32.2 | 7.6 | 6.5 | 85.5 | 5.6 |
Stomach | 0.70 | 0.46 | 65.7 | 0.46 | 20.3 | 12.5 | 61.6 | 12.2 | 8.6 | 5.3 | 61.6 | 5.3 | 106.5 | 75.3 | 70.7 | 60.4 | 12.8 | 8.6 | 67.2 | 8.9 |
Colorectum | 1.9 | 0.76 | 40.0 | 1.5 | 37.1 | 13.3 | 35.8 | 29.6 | 16.1 | 5.8 | 36.0 | 13.2 | 170.8 | 89.5 | 52.4 | 133.4 | 21.9 | 9.9 | 45.2 | 20.7 |
Liver | 1.4 | 1.1 | 78.6 | 0.97 | 26.1 | 21.6 | 82.8 | 15.1 | 11.4 | 9.4 | 82.5 | 6.9 | 79.0 | 72.1 | 91.3 | 40.1 | 12.7 | 10.9 | 85.8 | 8.2 |
Gallbladder | 0.06 | 0.04 | 66.7 | 0.06 | 1.4 | 0.94 | 67.1 | 0.94 | 0.59 | 0.40 | 67.8 | 0.43 | 7.3 | 5.4 | 74.0 | 4.0 | 0.88 | 0.63 | 71.6 | 0.64 |
Pancreas | 0.23 | 0.16 | 69.6 | 0.20 | 8.6 | 7.3 | 84.9 | 4.8 | 3.6 | 3.0 | 83.3 | 2.1 | 46.0 | 43.8 | 95.2 | 19.2 | 5.5 | 5.0 | 90.9 | 3.1 |
Larynx | 0.15 | 0.07 | 46.7 | 0.11 | 7.5 | 3.6 | 48.0 | 5.7 | 3.1 | 1.5 | 48.4 | 2.4 | 22.5 | 13.7 | 60.9 | 16.4 | 3.5 | 1.9 | 54.3 | 3.1 |
Lung | 0.95 | 0.58 | 61.1 | 0.73 | 50.7 | 35.5 | 70.0 | 28.0 | 21.0 | 14.7 | 70.0 | 12.1 | 271.7 | 223.9 | 82.4 | 130.9 | 32.1 | 24.8 | 77.3 | 19.7 |
Melanoma of skin | 0.61 | 0.07 | 11.5 | 0.62 | 5.8 | 0.91 | 15.7 | 5.4 | 2.7 | 0.41 | 15.2 | 2.6 | 28.1 | 5.7 | 20.3 | 26.8 | 3.7 | 0.65 | 17.6 | 4.1 |
NMSC | 0.64 | 0.06 | 9.4 | 0.53 | 12.1 | 0.93 | 7.7 | 10.2 | 5.3 | 0.41 | 7.7 | 4.6 | 153.8 | 7.3 | 4.7 | 146.1 | 14.1 | 0.77 | 5.5 | 16.2 |
Mesothelioma | 0.02 | 0.01 | 50.0 | 0.02 | 0.47 | 0.33 | 70.2 | 0.31 | 0.20 | 0.14 | 70.0 | 0.14 | 4.2 | 3.7 | 88.1 | 2.3 | 0.42 | 0.35 | 83.3 | 0.30 |
Kaposi sarcoma | 0.67 | 0.33 | 49.3 | 0.40 | 0.84 | 0.34 | 40.5 | 0.51 | 0.74 | 0.34 | 45.9 | 0.44 | 1.1 | 0.36 | 32.7 | 0.76 | 0.56 | 0.25 | 44.6 | 0.37 |
Penis | 0.15 | 0.03 | 20.0 | 0.12 | 1.5 | 0.57 | 38.0 | 1.1 | 0.69 | 0.25 | 36.2 | 0.52 | 5.1 | 1.8 | 35.3 | 3.9 | 0.79 | 0.28 | 35.4 | 0.69 |
Prostate | 0.33 | 0.10 | 30.3 | 0.23 | 35.6 | 3.7 | 10.4 | 30.3 | 14.5 | 1.6 | 11.0 | 12.8 | 291.4 | 90.1 | 30.9 | 245.7 | 29.4 | 7.3 | 24.8 | 30.5 |
Testis | 2.7 | 0.25 | 9.3 | 2.5 | 2.1 | 0.27 | 12.9 | 1.8 | 2.5 | 0.26 | 10.4 | 2.2 | 1.1 | 0.49 | 44.5 | 0.86 | 1.7 | 0.21 | 12.4 | 1.6 |
Kidney | 0.63 | 0.11 | 17.5 | 0.58 | 11.9 | 3.0 | 25.2 | 9.7 | 5.2 | 1.3 | 25.0 | 4.4 | 35.8 | 16.9 | 47.2 | 27.4 | 5.9 | 2.0 | 33.9 | 5.4 |
Bladder | 0.36 | 0.06 | 16.7 | 0.31 | 11.9 | 2.6 | 21.8 | 9.7 | 5.0 | 1.1 | 22.0 | 4.2 | 88.6 | 34.7 | 39.2 | 75.8 | 9.3 | 3.1 | 33.3 | 9.6 |
Brain, central nervous system | 1.7 | 1.0 | 58.8 | 1.4 | 6.7 | 5.5 | 82.1 | 5.4 | 3.7 | 2.8 | 75.7 | 3.1 | 16.4 | 15.6 | 95.1 | 12.3 | 3.9 | 3.1 | 79.5 | 3.4 |
Thyroid | 3.8 | 0.04 | 1.1 | 3.4 | 9.9 | 0.49 | 4.9 | 7.9 | 6.3 | 0.22 | 3.5 | 5.2 | 9.8 | 3.0 | 30.6 | 7.0 | 4.6 | 0.35 | 7.6 | 4.1 |
Hodgkin lymphoma | 1.2 | 0.18 | 15.0 | 0.95 | 1.5 | 0.41 | 27.3 | 1.2 | 1.3 | 0.28 | 21.5 | 1.1 | 2.7 | 1.3 | 48.1 | 1.9 | 1.1 | 0.31 | 28.2 | 0.96 |
Non-Hodgkin lymphoma | 1.9 | 0.71 | 37.4 | 1.5 | 11.2 | 4.1 | 36.6 | 8.9 | 5.7 | 2.1 | 36.8 | 4.6 | 39.9 | 22.0 | 55.1 | 30.1 | 6.6 | 3.0 | 45.5 | 5.9 |
Multiple myeloma | 0.11 | 0.06 | 54.5 | 0.09 | 3.5 | 1.9 | 54.3 | 2.8 | 1.5 | 0.79 | 52.7 | 1.2 | 17.1 | 12.0 | 70.2 | 13.3 | 2.1 | 1.3 | 61.9 | 2.0 |
Leukemia | 2.5 | 1.5 | 60.0 | 1.8 | 7.7 | 4.3 | 55.8 | 6.0 | 4.6 | 2.7 | 58.7 | 3.6 | 31.8 | 23.3 | 73.3 | 23.2 | 6.2 | 3.7 | 59.7 | 5.1 |
WHO region | ||||||||||||||||||||
Africa | 24.0 | 14.3 | 61.7 | 13.0 | 185.9 | 124.0 | 68.0 | 94.3 | 89.3 | 58.5 | 67.1 | 35.5 | 863.4 | 661.8 | 78.6 | 440.4 | 118.6 | 84.1 | 72.6 | 34.3 |
Southeast Asia | 20.1 | 10.3 | 51.5 | 13.7 | 210.0 | 145.5 | 69.7 | 123.1 | 96.7 | 64.8 | 67.4 | 56.0 | 673.5 | 498.8 | 74.5 | 370.8 | 110.0 | 76.4 | 69.9 | 64.1 |
Eastern Mediterranean | 23.7 | 11.5 | 49.1 | 16.0 | 221.0 | 143.5 | 65.7 | 128.1 | 103.3 | 64.7 | 63.4 | 54.6 | 859.0 | 674.3 | 79.4 | 483.0 | 128.1 | 89.1 | 70.4 | 59.0 |
The Americas | 36.4 | 9.8 | 27.4 | 32.6 | 442.3 | 130.5 | 32.0 | 375.3 | 200.1 | 58.5 | 31.5 | 179.6 | 2344.3 | 838.8 | 46.6 | 1865.1 | 293.3 | 96.3 | 39.1 | 331.9 |
Europe | 39.8 | 8.4 | 21.5 | 39.2 | 495.0 | 201.7 | 41.9 | 423.3 | 223.3 | 86.4 | 39.7 | 231.1 | 2349.8 | 1165.7 | 54.1 | 1857.2 | 307.6 | 136.2 | 46.9 | 432.5 |
Western Pacific | 36.3 | 9.8 | 27.5 | 32.6 | 378.3 | 185.2 | 49.9 | 264.9 | 174.2 | 80.5 | 47.1 | 149.3 | 1619.2 | 1068.0 | 66.9 | 1030.3 | 225.1 | 125.9 | 56.9 | 240.5 |
HDI | ||||||||||||||||||||
Low HDI | 23.3 | 13.8 | 61.2 | 11.9 | 164.3 | 117.3 | 72.0 | 78.8 | 80.1 | 55.6 | 70.1 | 30.2 | 662.6 | 516.8 | 78.1 | 307.0 | 98.9 | 72.2 | 73.5 | 28.0 |
Medium HDI | 20.6 | 11.0 | 53.7 | 13.8 | 209.0 | 144.1 | 69.3 | 122.1 | 96.6 | 64.6 | 67.3 | 52.9 | 696.5 | 508.0 | 73.5 | 375.2 | 111.6 | 77.0 | 69.5 | 58.5 |
High HDI | 33.1 | 10.5 | 31.8 | 28.0 | 339.0 | 180.9 | 54.0 | 225.1 | 156.5 | 79.2 | 51.2 | 120.3 | 1383.9 | 989.8 | 72.8 | 822.1 | 198.0 | 119.9 | 61.4 | 170.9 |
Very high HDI | 39.8 | 7.8 | 20.0 | 39.9 | 501.1 | 163.8 | 34.8 | 444.1 | 225.8 | 70.7 | 33.2 | 240.3 | 2507.7 | 1050.8 | 48.6 | 2034.8 | 320.6 | 118.3 | 41.1 | 478.2 |
- Abbreviations: ASIR, age-standardized incidence rate; ASMR, age-standardized mortality rate; HDI, Human Development Index; MIR, mortality-to-incidence ratio; NMSC, nonmelanoma skin cancer; WHO, World Health Organization.
- a The ASIR and The ASMR per 100,000 were estimated based on the 1966 Segi–Doll World Standard Population. Crude cancer incidence and mortality rates are available in the online material in Table S4.
- b The MIR by WHO region and the HDI were calculated by excluding nonmelanoma skin cancer. The MIR for all cancers, including nonmelanoma skin cancer, is available in the online material in Table S4.
- c The figure for prevalence is per 100,000 men.
Countries that had a very high HDI had an ASIR that was about three times higher (ASIR, 320.6 per 100,000) compared with countries that had a low HDI (ASIR, 98.9 per 100,000; Table 2). The ASMR in men ranged from 72.2 per 100,000 in countries with a low HDI to 119.9 per 100,000 in countries with a high HDI. The prevalence per 100,000 men ranged from 28.0 per 100,000 in low-HDI countries to 478.2 per 100,000 in countries with a very high HDI. The findings for ASIR, ASMR, and prevalence by HDI among AYAs, middle-aged adults, the working-age group, and older adults were broadly similar to those for all ages combined (Table 2).
ASIR, ASMR, and prevalence of cancers differed widely between countries/territories worldwide. The highest and lowest ASIRs per 100,000 men were estimated to be in Australia (514.3 per 100,000) and Niger (74.2 per 100,000), respectively. Likewise, the highest and lowest ASMRs per 100,000 men were estimated to be in Mongolia (227.5 per 100,000) and Saudi Arabia (81.0 per 100,000), respectively. Australia had the highest prevalence (776.7 per 100,000), whereas Somalia had the lowest prevalence (15.4 per 100,000; see Table S5). Countries/territories with the highest ASIR, ASMR, and prevalence varied by age group. For instance, the highest ASMR was estimated to be in Mozambique for AYAs and in Mongolia for other age groups (middle-aged adults, the working-age group, and older adults). Table 3 lists the top 10 countries/territories for ASIR, ASMR, and prevalence by age group. In terms of the total number of cancer cases and deaths among all ages combined, China ranked first, whereas the top 10 rankings differed among specific age groups across various countries/territories (see Table S3).
Rank |
Adolescents and young adults | Middle-aged adults | Working-age group | Older adults | All ages combined | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
ASIR | ASMR | MIRa | ASIR | ASMR | MIRa | ASIR | ASMR | MIRa | ASIR | ASMR | MIRa | ASIR | ASMR | MIRa | |
Top 10 cancer types in 2022 by ASIR, ASMR and MIR | |||||||||||||||
1 | Thyroid | Leukemia | Esophagus | Lung | Lung | Pancreas | Lung | Lung | Pancreas | Prostate | Lung | Pancreas | Lung | Lung | Pancreas |
2 | Testis | Liver | Liver | Colorectum | Liver | Esophagus | Colorectum | Liver | Esophagus | Lung | Prostate | BNS | Prostate | Liver | Liver |
3 | Leukemia | BNS | Pancreas | Prostate | Colorectum | Liver | Prostate | Colorectum | Liver | Colorectum | Colorectum | Nasopharynx | Colorectum | Colorectum | Esophagus |
4 | Colorectum | Colorectum | Gallbladder | Liver | Stomach | BNS | Liver | Stomach | BNS | NMSC | Stomach | Liver | NMSC | Stomach | Mesothelioma |
5 | NHL | NHL | Stomach | Stomach | Esophagus | Mesothelioma | Stomach | Esophagus | Lung | Stomach | Liver | Esophagus | Stomach | Prostate | BNS |
6 | BNS | Lung | Lung | Esophagus | Pancreas | Lung | Thyroid | Lip, oral cavity | Mesothelioma | Bladder | Esophagus | Mesothelioma | Liver | Esophagus | Lung |
7 | Liver | Lip, oral cavity | Leukemia | Lip, oral cavity | Lip, oral cavity | Gallbladder | Lip, oral cavity | Pancreas | Gallbladder | Liver | Pancreas | Lung | Bladder | Pancreas | Gallbladder |
8 | Lip, oral cavity | Stomach | BNS | NMSC | BNS | Stomach | Esophagus | BNS | Stomach | Esophagus | Bladder | Gallbladder | Esophagus | Leukemia | Stomach |
9 | Hodgkin lymphoma | Kaposi sarcoma | Hypopharynx | Kidney | Leukemia | Nasopharynx | NHL | Leukemia | Leukemia | Pancreas | Leukemia | Leukemia | NHL | Bladder | Nasopharynx |
10 | Lung | Esophagus | Multiple myeloma | Bladder | NHL | Leukemia | NMSC | NHL | Nasopharynx | NHL | NHL | Stomach | Leukemia | BNS | Multiple myeloma |
Top 10 countries/territories in 2022 by ASIR, ASMR, and MIR | |||||||||||||||
1 | Australia | Mozambique | Sao Tome and Principe | Australia | Mongolia | Niger | Australia | Mongolia | Niger | Australia | Mongolia | Yemen | Australia | Mongolia | The Gambia |
2 | New Zealand | Malawi | Sierra Leone | New Zealand | Moldova | The Gambia | New Zealand | Moldova | The Gambia | Denmark | Estonia | Mongolia | New Zealand | Belarus | Niger |
3 | Mozambique | The Gambia | The Gambia | Lithuania | Belarus | Yemen | Hungary | Belarus | Guinea | USA | Croatia | Somalia | USA | Hungary | Yemen |
4 | Italy | Zambia | Guinea | Hungary | Romania | Afghanistan | Lithuania | Romania | Bhutan | New Zealand | Uruguay | The Gambia | Hungary | Lithuania | Somalia |
5 | Croatia | Namibia | Niger | FR-M | Hungary | Bhutan | FR-M | Hungary | Yemen | Norway | Latvia | Niger | Denmark | Romania | Mongolia |
6 | Hungary | Uganda | Congo | Belarus | Serbia | Cambodia | USA | Lithuania | Mali | Ireland | Poland | Djibouti | Lithuania | Latvia | Burkina Faso |
7 | Denmark | Ghana | Guinea-Bissau | France, Guadeloupe | Lithuania | Guinea | Belarus | Serbia | Cambodia | Canada | Slovakia | Libya | FR-M | Moldova | Bhutan |
8 | The Netherlands | Zimbabwe | Burkina Faso | USA | Ukraine | Lao PDR | France, Guadeloupe | Ukraine | Afghanistan | FR-M | Hungary | Tajikistan | Ireland | Poland | Cambodia |
9 | FR-M | Chad | Chad | Romania | Latvia | Mali | Romania | Lao PDR | Burkina Faso | The Netherlands | Belarus | Myanmar | Norway | Croatia | Lao PDR |
10 | Norway | Niger | Vanuatu | Ireland | Lao PDR | Central African Republic | Denmark | Latvia | Lao PDR | Croatia | Lithuania | Burkina Faso | Croatia | Türkiye | Djibouti |
- Abbreviations: ASIR, age-standardized incidence rate; ASMR, age-standardized mortality rate; BNS, brain and central nervous system; FR-M, France (metropolitan); Lao PDR, Lao People's Democratic Republic; MIR, mortality-to-incidence ratio; NHL, non-Hodgkin lymphoma; NMSC, nonmelanoma skin cancer.
- a Countries/territories with a small number of cases or deaths (n < 10) were excluded from ranking because their inclusion could potentially affect the accuracy of MIR estimation by affecting the ASIR or the ASMR.
Prostate cancer was the leading cancer type in terms of cases in about two thirds (n = 117) of the 185 countries/territories (Figure 1A), whereas lung cancer was the leading cancer type in terms of deaths in about one half (n = 93) of countries/territories (Figure 2A). The leading cancer types were similar by age group: prostate cancer cases (n = 75 countries/territories, Figure 1B) and lung cancer deaths (n = 95 countries/territories; Figure 2B) among the working-age group; prostate cancer cases (n = 139 countries/territories, Figure 1C) and lung cancer deaths (n = 90 countries/territories; Figure 2C) among older adults.

The distribution of leading cancer types in numbers for cancer incidence (excluding nonmelanoma skin cancer) in each country/territory among men in 2022 by age group for (A) all ages combined, (B) the working-age group (aged 15–64 years), and (C) older adults (aged 65 years and older). In the map legend, the brackets after the cancer type name indicate the number of countries/territories where the named cancer type was the leading cancer type for cancer incidence. For example, Prostate (140) means that prostate cancer was the leading cancer type for cancer incidence in 140 countries/territories.

The distribution of leading cancer types in numbers for cancer mortality (excluding nonmelanoma skin cancer) in each country/territory among men in 2022 by age group for (A) all ages combined, (B) the working-age group (aged 15–64 years), and (C) older adults (aged 65 years and older). In the map legend, the brackets after the cancer type name indicate the number of countries/territories where the named cancer type was the leading cancer type for cancer mortality. For example, Prostate (79) means that prostate cancer was the leading cancer type for cancer mortality in 79 countries/territories. NHL indicates non-Hodgkin lymphoma.
Cancer mortality-to-incidence ratio in 2022
In 2022, the estimated global cancer MIR among men was 54.9%. The MIR ranged from 7.6% for thyroid cancer to 90.9% for pancreatic cancer, with about one half of cancer types (n = 14) having an MIR between 40% and 70%, and one quarter (n = 7) having an MIR >70% (Table 2). The three cancer types with the highest MIR were cancers of the pancreas, liver, and esophagus (Table 2). This order displayed little variation across the examined age groups (Table 3 shows the highest 10 cancer types for MIR by age).
Of the WHO regions, Africa had the highest MIR (72.6%), followed by the Eastern Mediterranean (70.4%), and this figure was nearly double that in the Americas, which had the lowest MIR (39.1%; Table 2). The region with the highest MIR by age group was Africa for AYAs, Southeast Asia for middle-aged adults and the working-age group, and the Eastern Mediterranean for older adults (Table 2).
The MIR had an inverse relation with the HDI, with the highest estimate among low-HDI countries (73.5%) and the lowest among countries with a very high HDI (41.1%; Table 2). The trend of MIR by HDI among AYAs, middle-aged adults, the working-age group, and older adults was similar to that for all ages combined.
There was a wide disparity (three-fold variation) in the MIR between countries/territories worldwide, ranging from 28.0% in Norway to 86.6% in The Gambia (see Tables S5 and S6). An MIR >50% was observed in three quarters of countries/territories (n = 139 of 185). The countries/territories with the highest MIR varied based on age group (Table 3).
2050 projections of cancer cases and mortality
Incident cancer cases are projected to reach 19 million globally by 2050, an 84.3% increase from the 2022 estimate (Table 1). The number of cancer deaths is projected to reach 10.5 million by 2050, a 93.2% increase from the 2022 estimate. Lung cancer is projected to remain the leading cancer type for both cases and deaths by 2050, with both cases and deaths increasing by greater than 87% compared with the 2022 estimate. Table 3 outlines the top 10 leading cancer types by 2050, which varied across age groups.
Between 2022 and 2050, the cancer type with the highest estimated increase is projected to be mesothelioma for incident cases (105.5% increase from 2022) and prostate cancer for deaths (136.4% increase). Testicular cancer is projected to have the lowest increase for both incident cases (22.7% increase) and deaths (40% increase). Changes in cases and deaths from 2022 to 2050 are projected to differ by age group. For each of the different age groups examined, the percentage increase in cancer cases and deaths is projected to be greater in the oldest age group compared with the youngest (Tables 1 and S3). Between 2022 and 2050, in Africa and the Eastern Mediterranean, the number of incident cases and deaths is projected to increase 2.5-fold. In contrast, Europe is projected to experience an increase of about one half. A decline of 5.0%–18.0% in cases and deaths was projected among AYAs in the regions of Europe, the Western Pacific, and the Americas, whereas there are projected increases for middle-aged adults, the working-age group, older adults, and all ages combined (Tables 1, S3).
Between 2022 and 2050, the percentage increase in cancer cases is projected to range from 50.2% in countries with a very high HDI to 138.6% in those with a low HDI, and the increase in deaths is projected to be 63.9% in countries with a very high HDI to 141.6% in those with a low HDI. The percentage change in cases and deaths across the HDI is projected to differ by age group. Among AYAs, it is projected that the number of cases and deaths will decline by approximately 11% in countries with a high and very high HDI (Tables 1, S3).
The projected cases and deaths between 2022 and 2050 among all ages combined (Figure 3A) and among older adults (Figure 3C) indicate a greater relative increase compared with the working-age group (Figure 3B).

Projected global incident cancer cases and deaths in men between 2022 and 2050 by age group for (A) all ages combined, (B) adolescents and young adults (aged 15–39 years), (C) the working-age group (aged 15–64 years), and (D) older adults (aged 65 years and older).
DISCUSSION
By using population-based estimates from 185 countries/territories worldwide, this study examined the ASIR, ASMR, prevalence, and MIR of 30 cancers among men in 2022 and projections for 2050. Disparities in burden by cancer type, age group, HDI, WHO region, and countries/territories were observed. A high MIR was observed for rare and less common cancer types, including for cancers of the pancreas, liver, esophagus, and mesothelioma. Compared with countries/territories with a very high HDI, those with a low and medium HDI had an MIR about twice as high, indicating unmet service needs for early diagnosis and the best available treatment options. Between 2022 and 2050, cancer cases and deaths in low-HDI countries/territories are estimated to more than double (an increase of about 140%), whereas much smaller increases of 50% for cases and 64% for deaths are projected in very-high-HDI countries/territories, reflecting widening disparities in cancer burden. The MIR was higher in older age groups compared with younger age groups. Between 2022 and 2050, the number of cancer cases and deaths among older adults were projected to increase by 116.8% and 124.5%, respectively, whereas an increase of about two fifths was projected among the working-age group.
This study contributes to global cancer statistics for men, who have no male cancer-specific screening programs (e.g., prostate cancer) and have a higher prevalence of occupational and other modifiable cancer risk factors, which contribute to higher observed cancer incidence and poorer outcomes compared with women.9, 10 For instance, well adapted, male-specific cancer screening programs are unavailable, whereas female-specific cancer screening (e.g., breast and cervical screening) and prevention programs result in lower cancer mortality.8 This study provides comprehensive evidence for understanding the existing disparities in cancer outcomes among men, thereby building a case for collective efforts to reduce inequalities and enhance cancer outcomes.
Enhancing health infrastructure, access, and quality through a coordinated, multisectoral approach and national and international collaboration is essential to improve current cancer outcomes in men and to prepare for the anticipated rise in cancer burden by 2050.31, 42-45 Ensuring a competent and adequate health workforce at the global level is important for reducing cancer disparities.44 Moving forward, expanding publicly funded medical schools and scholarships for training medical staff, providing continuous learning and specialization options, ensuring equitable geographic distribution of medical staff, and retaining medical staff, specifically in low-HDI and medium-HDI countries, are important.44 Ensuring the equitable and adequate implementation of the Sustainable Development Goals, particularly Target 3.c (training medical staff) could positively affect cancer outcomes.46 In addition, it is vital to equip health systems with appropriate infrastructure for cancer diagnosis (e.g., medical laboratories, pathology) and treatment services (e.g., radiation therapy) with affordable and cost-effective options, along with the optimal use of available services.43, 44, 47 Furthermore, emphasis should be given to low-HDI and medium-HDI countries/territories that have existing high unmet cancer service needs despite high cancer burden.31, 42-45
Another strategy to reduce disparities and improve cancer outcomes could be to expand universal health coverage worldwide, which could strengthen efforts to provide basic cancer care options.48 However, there is currently low universal health coverage in low-HDI and medium-HDI countries, which were disproportionately affected by poor cancer outcomes in this study.48 It is crucial to expand the strategies and lessons learned from low-HDI and medium-HDI countries that have been better at achieving universal health coverage (e.g., Rwanda), to further universal health coverage in comparable countries and globally.48 In this study, Rwanda had an overall MIR of 73.6%, which is lower than that in 38 low-HDI and medium-HDI countries. It should be noted that factors other than system-level factors (universal health coverage) may also influence the MIR, including personal and interpersonal (health provider) factors. Expanding universal health coverage is also highlighted under the Sustainable Development Goals (Target 3.8), and implementing this target with an emphasis on low-HDI and medium-HDI countries would improve cancer outcomes and equity.46
The higher MIR (poorer survival) across older adult men and rare/less common cancer types42, 49 indicates the potential necessity of targeted interventions. Despite cancer-related mortality increasing with age, a large proportion of premature deaths among older adults globally could also be attributed to inadequate health service access because of financial barriers, lower participation in prevention activities (e.g., screening), preferences to preserve quality of life rather than longevity, and unmet evidence-based practice because of lower involvement of older people in clinical trials that are used for developing cancer guidelines.14, 27 Hence, improving access to cancer prevention and care options and further targeted research to discover intervention options, including affordable and acceptable prevention, screening, diagnosis, and treatment options, could improve cancer outcomes among older men and for rare cancer types.50, 51 As noted above, precautions should also be taken when interpreting the findings of this study across different age groups; some cancers are more prevalent in younger age groups, e.g., testicular cancer and Hodgkin lymphoma, and others are more prevalent in older age groups, e.g., prostate and bladder cancer.
The disparities in cancer outcomes between low-HDI and medium-HDI countries compared with high-HDI countries could be attributed to many factors, including fewer interventions to address modifiable risk factors of cancer (e.g., smoking, alcohol consumption), demographic transitions (e.g., aging populations), lower investment in cancer prevention and research, and multiple competing priorities to focus resources on cancer (e.g., because of a higher prevalence of infectious disease).9, 50, 51 Additional research is required to better understand the drivers of the projected widening cancer disparity by HDI between 2022 and 2050.
We acknowledge that the findings of this study could be affected by the quality of the GLOBOCAN data set, with some countries/territories providing relatively low-quality data or no data. Estimates in low-HDI and medium-HDI countries could be less accurate because the majority of these jurisdictions have relatively low-quality cancer registries and/or civil and vital statistics registration systems.30, 31 However, GLOBOCAN used best estimation approaches for each specific country/territory, including nationally reported data and modelling based on the data of neighboring countries/territories, to improve the accuracy of estimates.29 It is also important to note that the coverage and quality of cancer registries and civil and vital statistics registration systems have increased over time, and further expanding and maintaining these systems is essential for accurate estimates of cancer outcomes.30, 52 Consistent with previous studies15-20 and government report indicators,21, 22 the MIR was used as an indicator for cancer outcome inequalities, with relatively higher MIR used as a proxy for higher fatality or poorer survival, yet caution should be taken when interpreting the MIR because it does not precisely measure survival. The MIR has been used in reports by many countries, such as the United States21 and Australia,22 to measure cancer outcomes both within a country and for international comparisons.21, 22
This study provides comprehensive worldwide evidence on cancer incidence, mortality, prevalence, and future trends by considering 30 different cancer types among men that were measured using population-based estimates from 185 countries/territories. However, it is important to note that other measures of cancer burden, such as years of life lost or years lived with disability, were not available from our data source and thus were not estimated in the current study. The study considered different statistical measures of cancer outcomes, including ASIR, ASMR, prevalence, and MIR, with each measure having unique as well as complementary interpretations. Moreover, the findings of the current study support those of previous global studies53, 54; for instance, a worldwide study that used population-based estimates from five continents between 2000 and 2014 investigated disparities in cancer survival outcomes between low-HDI/medium-HDI countries indicated poorer survival compared with high-HDI countries.54 Therefore, the results of this study may be used to inform evidence-based decision-making processes with the goal of improving cancer outcomes among men.
CONCLUSION
Disparities in cancer incidence and mortality among men were observed across age groups, countries/territories, and HDI in 2022, with these disparities projected to widen further by 2050. A higher MIR (poorer survival) was observed in older adults, for rare cancer types (e.g., pancreatic), and in low-HDI and medium-HDI countries. Between 2022 and 2050, cancer cases and mortality are projected to more than double in low-HDI countries/territories and also among older adults. Further strengthening the quality and accessibility of health infrastructure; promoting universal health coverage following a human rights approach; addressing modifiable cancer risk factors, including occupational risk factors; funding research into male-specific cancer screening programs worldwide; and fostering collaborative and multidisciplinary approaches between national and international stakeholders could be keys to improving equity in cancer outcomes. These efforts would ultimately reduce disparities in cancer burden and ensure equity in cancer prevention and care for men across the globe.
AUTHOR CONTRIBUTIONS
Habtamu Mellie Bizuayehu: Conceptualization, writing–original draft, writing–review and editing, methodology, visualization, software, and formal analysis. Abel F. Dadi: Conceptualization, methodology, writing–review and editing, visualization, and investigation. Kedir Y. Ahmed: Conceptualization, methodology, and writing–review and editing. Teketo Kassaw Tegegne: Conceptualization, methodology, and writing–review and editing. Tahir Ahmed Hassen: Conceptualization, methodology, and writing–review and editing. Getiye Dejenu Kibret: Conceptualization, methodology, and writing–review and editing. Daniel Bekele Ketema: Conceptualization, methodology, and writing–review and editing. Meless G. Bore: Conceptualization, methodology, and writing–review and editing. Subash Thapa: Conceptualization, methodology, and writing–review and editing. Daniel Bogale Odo: Conceptualization, methodology, and writing–review and editing. Zemenu Y. Kassa: Conceptualization, methodology, and writing–review and editing. Desalegn Markos Shifti: Conceptualization, methodology, and writing–review and editing. Erkihun Amsalu: Conceptualization, methodology, and writing–review and editing. Peter Sarich: Conceptualization, methodology, and writing–review and editing. Rebecca L. Venchiarutti: Conceptualization, methodology, and writing–review and editing. Yohannes Adama Melaku: Conceptualization, methodology, and writing–review and editing. Kelemu Tilahun Kibret: Conceptualization, methodology, and writing–review and editing. Aklilu Habte: Conceptualization, methodology, and writing–review and editing. Yonatan M. Mefsin: Conceptualization, methodology, and writing–review and editing. Abdulbasit Seid: Conceptualization, methodology, and writing–review and editing. Sewunet Admasu Belachew: Conceptualization, methodology, writing–review and editing, validation, visualization, investigation, and supervision
ACKNOWLEDGEMENT
Open access publishing facilitated by The University of Queensland, as part of the Wiley - The University of Queensland agreement via the Council of Australian University Librarians.
CONFLICT OF INTEREST STATEMENT
The authors declared no conflicts of interest.
Open Research
DATA AVAILABILITY STATEMENT
Data that were used in this study can be accessed publicly at https://gco.iarc.fr, with additional information available upon request from the corresponding author.