Global Patterns and Trends in Lifetime Risks of Developing and Dying from Cancer, 1990-2021.

Background: Cancer remains a major contributor to global disease burden, necessitating comprehensive understanding of cancer risk at global, regional, and national scales to inform cancer control planning and resource allocation. Methods: The Adjusted for Multiple Primaries analytical approach was employed to calculate lifetime cancer risks from 1990 to 2021, based on data from the Global Burden of Disease Study 2021. Joinpoint regression analysis was utilized to assess trends in lifetime cancer risks over this period. Results: Globally, the lifetime risks of developing and dying from cancer were 21.70% (95% confidence interval [CI], 21.63 to 21.78) and 14.23% (95% CI, 14.19 to 14.26), respectively, in 2021. Men had higher risks (22.15%, 95% CI: 22.07 to 22.23 for incidence and 15.19%, 95% CI: 15.16 to 15.23 for death) compared to women (21.03%, 95% CI: 20.88 to 21.19 for incidence and 13.06%, 95% CI: 13.00 to 13.12 for death). Both risks showed strong positive correlations with the sociodemographic index (ρ = 0.89 and 0.82, P < 0.001). Moreover, the lifetime incidence risk increased by 14.00% between 1990 (19.04%, 95% CI: 18.97 to 19.12) and 2021, while the death risk decreased by 1.86% between 1990 (14.50%, 95% CI: 14.48 to 14.52) and 2021. During the COVID-19 pandemic, the incidence risk decreased with an average annual percentage change of -4.73% (95% CI, -5.18 to -4.40) and death risk decreased with an average annual percentage change of -6.24% (95% CI, -6.74 to -5.92). The decline was most pronounced in low-sociodemographic-index regions. Conclusions: The global cancer burden is substantial and increasing, with marked geographic and gender disparities. These findings provide comprehensive estimates to guide targeted cancer control strategies and health system strengthening.