Cancer incidence and mortality and risk factors in member countries of the Belt and Road initiative

Background At present, Belt and Road (B&R) member states (accounting for about 61.78% of the world's population) face different types of cancer threats to varying degrees. We analyzed the incidence and mortality and risk factors of cancer in the member countries of the B&R to explore the basis of health and medical cooperation between countries and provide a foundation for formulating cancer prevention and control policies for building a healthy B&R. Methods Data were derived from the Global Cancer Observatory and Cancer Country Profiles in 2020. Incidence and mortality were age-standardized rates (ASRs). Population attributable fractions (PAFs) was applied to measure risk factors of cancers in the B&R countries. The mortality-to-incidence ratio (MIR) was calculated by dividing the mortality rate by the incidence rate. Results A total of 26 cancers were included in the study. Lung, breast, colorectal, stomach, liver, prostate, cervical, esophageal, thyroid, and uterine cancers were the most common and highest in age-standardized mortality in the B&R countries. For men, Hungary had the highest cancer age-standardized incidence and mortality (ASR, 289.3 per 100,000 and ASR, 235.7 per 100,000, respectively), followed by Latvia (ASR, 288.6 per 100,000 and ASR, 196.5 per 100,000, respectively). In females, the highest incidence rates were estimated in Greece (ASR, 238.7 per 100,000), and the highest mortality rate was Brunei (ASR, 192.3 per 100,000). All countries were in the middle or high HDI range, with about half (46.88%) of countries achieving high HDI, mostly in Central and Eastern Europe (13 countries) and West Asia (10 countries). The United Arab Emirates had the highest MIR in male and female (1.59 vs 2.19). Tobacco products, infectious factors, and ultraviolet rays were the three main cancer risk factors in the B&R countries. Conclusion The overall burden of cancer in the countries along the B&R remains substantial, while the corresponding cancer prevention and control policies need to be improved. Strengthening health cooperation among member countries will contribute to a joint response to the risks and challenges posed by cancer.

Automated summary

The study analyzed cancer incidence, mortality, and risk factors among Belt and Road countries, finding lung, breast, colorectal, stomach, liver, prostate, cervical, esophageal, thyroid, and uterine cancers to be most common with high mortality rates. Hungary and Latvia had the highest cancer incidence and mortality rates for men, while Greece and Brunei had the highest rates for women. Countries in the region mostly had high HDI levels, with the United Arab Emirates showing the highest mortality-to-incidence ratio. Tobacco, infections, and UV rays were identified as the main cancer risk factors in Belt and Road countries, highlighting the need for improved prevention and control policies. Strengthening health cooperation among member countries is essential for a collective response to cancer risks and challenges.