Cancer is the second leading cause of death in the Asia-Pacific region, responsible for an estimated 5 million deaths in 2021.
There are more than 100 different types of cancers, with most named after the organ in which they start. Cancer occurs when abnormal cells divide without control and are able to invade other tissues. While genetics are a risk factor, tobacco use, alcohol consumption, unhealthy diet, physical inactivity and air pollution are much greater risk factors for cancer. Currently, between 30% and 50% of cancers can be prevented by avoiding risk factors and implementing evidence‑based prevention strategies. The cancer burden can also be lessened through early detection, as well as the appropriate treatment and care of patients who develop cancer. Many cancers have a high likelihood of being cured if they are diagnosed early and treated properly (WHO, 2022[1]).
In 2021, cancer accounted for over 4 000 disability-adjusted life years (DALYs) per 100 000 population in high-income countries in the Asia-Pacific region (Figure 3.16). Notably, China and DPRK recorded over 5 000 DALYs per 100 000 population across all ages from cancer. In contrast, the burden of cancer was significantly less in lower-middle- and low-income countries, with an average rate of 2 800 DALYs per 100 000 population – approximately two‑thirds the level of high-income countries and just over half the level seen in OECD countries. For instance, in the Solomon Islands, Pakistan and Nepal, DALYs were under 1900 per 100 000 population in 2021. The burden of cancer is generally less in low-income countries due to several factors, including lower life expectancy, underdiagnosis, and the dominance of infectious diseases.
Cancer also accounted for over 200 years lived with disability (YLDs) per 100 000 population across all ages in high-income countries and territories in the Asia-Pacific in 2021 (Figure 3.17). Japan, New Zealand and Australia experienced more than 280 YLDs per 100 000 population due to cancer in 2021. In comparison, YLDs in upper-middle-, and lower-middle- and low-income countries were significantly lower, at 81 and 42 per 100 000 population, respectively.
Cancer is a generic term for a large group of diseases that can affect any part of the body. Trachea, bronchus, and lung cancer were the leading types of cancer across Asia-Pacific countries and territories (Figure 3.18), accounting for an average of 14% to 18% of all DALYs from cancer in high, upper-middle-, and lower-middle- and low-income countries and territories in 2021. Liver cancer mortality and morbidity was also high in lower-middle- and low-income countries and territories in the region, representing 13% of all cancer-related DALYs on average in 2021. The burden of liver cancer was exceptionally high in Mongolia, where it accounted for 44% of all cancer-related DALYs. Mongolia aims to reduce liver cancer incidence in the coming decades through increased hepatitis immunisation.
Other leading causes of cancer death and disability included stomach, colorectal, and breast cancer. Mortality and morbidity from stomach cancer accounted for 5% to 7% of cancer-related DALYs on average in 2021, largely due to helicobacter pylori infection. The burden of stomach cancer was greatest in China and Mongolia. Japan, New Zealand and Singapore had the highest proportion of DALYs attributable to colorectal cancer when compared to other countries. Breast cancer, the most common cause of cancer death among women, was responsible for over 20% of all cancer-related DALYs in Fiji and 15% or more in the Philippines and the Solomon Islands.
