Premature Cancer Mortality Trends Across 183 Countries

Introduction

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Cancer remains one of the leading causes of premature death worldwide. By 2040, over 30 million new cancer cases are projected, with the largest burden in low-income countries.

In 2015, the United Nations established Sustainable Development Goal 3.4 (SDG 3.4), aiming to reduce premature mortality from non-communicable diseases (NCDs), including cancer, by one-third by 2030. However, comprehensive data on cancer-specific premature mortality trends remain limited.

This study analyzes annual changes in cancer-related premature mortality across 183 countries and evaluates whether countries are on track to achieve SDG 3.4 targets.

Study Methods

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• Design: Retrospective, cross-sectional, population-based study
• Data Source: WHO Global Health Estimates (2000–2019)
• Population: Individuals aged 30–69 years
• Scope: All cancers combined and 13 specific cancer types, analyzed by WHO region, World Bank income group, and sex
• Outcome Measures:
  • Average annual rate of change in premature mortality
  • Likelihood of achieving SDG 3.4 targets by 2030
• Analysis: Standard life table methods to calculate risk, independent of competing causes of death

Key Findings

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1. Global Trends:

   • Premature mortality decreased in 138 of 183 countries (75%) across all income levels and WHO regions.
   • Despite this progress, only 8 countries (4%) are on track to meet SDG 3.4 targets for all cancers combined.

2. Cancer-Specific Insights:

   • Breast and colorectal cancer (with early detection programs):
     • High-income countries: 89% and 83% of countries show declining mortality
     • Low-income countries: 24% and 14% of countries show declining mortality
   • Cancers with primary prevention programs (e.g., cervical cancer):
     • High-income countries: 93% show declining mortality
     • Low-income countries: 90% show declining mortality

3. Sex Disparities:

   • Differences in premature mortality rates exist across sex, region, income level, and cancer type.

Interpretation

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• High-income countries experience greater reductions in premature mortality for both all cancers combined and individual cancer types.
• Most countries, particularly lower-middle and low-income nations, are unlikely to meet SDG 3.4 targets by 2030.
• Cancers with early detection programs (breast, colorectal) are performing worse in low-income regions compared to cancers with primary prevention strategies like cervical cancer.
• Strategic investments in prevention, early detection, and treatment could accelerate declines in premature mortality worldwide.

Conclusion

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The fight against cancer-related premature mortality requires global commitment, equitable healthcare access, and targeted interventions. Strengthening prevention, screening, and treatment programs in low- and middle-income countries is critical to achieving SDG 3.4 and saving millions of lives.