Cancer mortality and burden of disease presented in the visualization
The visualization shows mortality (death rates) and disease burden measures (disability-adjusted life years [DALYs], years lived with disability [YLDs], and years of life lost [YLLs]) due to Malignant Neoplasms (All cancers), and 28 types of cancers. Annual rates per 100,000 population are presented as crude rates for all-ages, age-specific rates, and age-standardized rates by sex and location for the period 2000 to 2019.
Crude death rates equal the total number of cancer deaths during a specific year in the population category of interest, divided by the at-risk population for that category and multiplied by 100,000.
Crude rates don't take into account the population's age distribution, so they are influenced by the underlying age distribution of the country’s population. In one location or population group with an older population, the death rate will be higher than a location with a younger population as cancer mortality increases with age. For this reason, crude rates are not a good measure for comparing mortality between two or more countries of population groups. A population's age distribution (the number of people in particular age categories) can change over time and be different in different geographic areas.
Age-standardized death rates ensure that variations in the risk of mortality between geographic areas and from one year to another are not due to differences in the age distribution of the populations being compared. The World Standard Population was used to compute the age-standardized death rates by the direct method of standardization.
The direct method of rate standardization
In the direct method of age standardization, an age-standardized rate is a weighted average of the age-specific (crude) rates, where the weights are the proportions of persons in the corresponding age groups of a standard population. The potential confounding effect of age is reduced when comparing age-standardized rates computed using the same standard population.
Crude, age-standardized, and age-specific death, DALYs, YLDs, and YLLs rates are used to plan for population-based cancer prevention and control interventions.
The data is presented in five discrete classes created using the quantile classification method in the map and horizontal bar chart. Each class contains 20% of countries, which is easy to interpret. The quintile classes are labeled sequentially from Quintile 1 as the first quintile including the lowest fifth (0 to 20%) of the data to Quintile 5, the fifth quintile representing the class with the highest fifth (80% to 100%) of the data.
Measure: Death, Disability-Adjusted Life Years (DALYs), Years Lived with Disability (YLDs), and Years of Life Lost (YLLs) due to premature death.
Unit of measurement: For mortality measures: deaths per 100,000 population. For measures of burden of disease: years per 100,000 population.
Topic: Mortality and burden of disease.
Rationale: Measuring how many people die each year and why they died is one of the most important means – along with gauging how diseases and injuries affect people–to assess the effectiveness of a country’s health system. Statistics of causes of death and disease burden help health authorities focalize and prioritize public health actions.
Definition: Crude (all-ages) death rates due to cancer were calculated as the number of deaths due to cancer in a year, sex, and location divided by the total population in the given year, sex and location and multiplied by 100 000. Death rates were age-standardized by the direct method using the WHO world standard population.
Cancer types and ICD-10 codes:
The full list of cause categories and corresponding ICD-10 codes is included in the WHO methods and data sources for country-level causes of death 2000-2019, Annex A, page 62.
The cause list is organized hierarchically with four levels of aggregation. The cause list is mutually exclusive and collectively exhaustive at every level of aggregation; causes not individually specified are captured in residual categories, such as “Other malignant neoplasms”.
Disaggregation: Age, Sex, Country, and Year.
The categories "All-ages", and "Age-standardized" from the dimension Age, combined with the metric "Rate" have the following meaning:
- All-ages indicate that the rate is crude (without removing the effect of age distribution across population groups).
- Age-standardized indicates that the rate refers to all ages but the rate was age-standardized by the direct method using the WHO world standard population.
Method of estimation: Mortality estimates by cause, age, sex, location (countries, and the region) were extracted from the WHO Global Health Estimates (GHE) 2019. These estimates represent WHO's best estimates, computed using standard categories, definitions, and methods to ensure cross-country comparability, and may not be the same as official national estimates. Due to input data and methods changes, these estimates are not comparable to previously published WHO estimates.
Data sources and methods for estimating causes of deaths and burden of diseases are described in the following documents:
As part of the estimation methods, deaths due to cancers with unspecified sites (ICD10 codes C76, C80, C97) were distributed pro-rata to all sites excluding liver, pancreas, ovary, and lung. Additionally, deaths coded as cancer of the uterus, part unspecified (C55) are distributed pro-rata to cervix uteri (C53) and corpus uteri (C54).
Method of estimation of global and regional aggregates: Computed by aggregating both the absolute measure (number of deaths, DALYs, YLDs, YLLs) as the numerator and population estimates from the World Population Prospect 2019, produced by the UN Population Division, as denominators for all countries included in the region.
Preferred data sources: Civil Registration and Vital Statistics (CRVS) system with complete coverage and medical certification of cause of death.