癌症是全球疾病负担的主要因素。许多国家正在或曾经经历着非感染相关癌症取代感染相关癌症的转变。我们的目标是描述各种主要癌症的负担变化，并确定全球转变模式。我们主要关注全球最常见的10种癌症，并从1990年至2019年通过全球疾病负担研究提取了204个国家和地区的年龄标化发病率和死亡率。我们采用了两阶段建模设计。首先，我们采用增长混合模型（GMMs）来识别每种癌症类型的发病率和死亡率的不同轨迹。接下来，我们执行了潜在类别分析，基于GMMs的分类结果来检测癌症转变模式。我们进行了Kruskal-Wallis H检验，评估转变模式与社会经济指标之间的关联。我们确定了三种不同的模式，分别是不利、中间和有利阶段。肺癌和乳腺癌的发展轨迹在男性和女性中与转变模式有着最强的关联。不利阶段的特点是肺癌、乳腺癌和结直肠癌的快速增加，而胃癌、宫颈癌、食管癌和肝癌的负担保持稳定或下降。相比之下，有利阶段的大多数癌症都经历了快速下降。不利阶段与低社会人口指数、健康支出、人均国内生产总值和较高的孕产妇死亡率相关（所有关联的P值均小于0.001）。我们的研究结果表明存在不利、中间和有利的转变模式。处于不利阶段的国家和地区往往面临社会经济不利条件，需要针对这些资源有限的情况制定定制化的干预策略。© 2023 UICC.

Cancer is a major contributor to global disease burden. Many countries experienced or are experiencing the transition that non-infection-related cancers replace infection-related cancers. We aimed to characterise burden changes for major types of cancers and identify global transition patterns. We focused on 10 most common cancers worldwide and extracted age-standardised incidence and mortality in 204 countries and territories from 1990 to 2019 through the Global Burden of Disease Study. Two-stage modelling design was used. First, we applied growth mixture models (GMMs) to identify distinct trajectories for incidence and mortality of each cancer type. Next, we performed latent class analysis to detect cancer transition patterns based on the categorisation results from GMMs. Kruskal-Wallis H tests were conducted to evaluate associations between transition patterns and socioeconomic indicators. Three distinct patterns were identified as unfavourable, intermediate and favourable stages. Trajectories of lung and breast cancers had the strongest association with transition patterns among men and women. The unfavourable stage was characterised by rapid increases in lung, breast and colorectal cancers alongside stable or decreasing burden of gastric, cervical, oesophageal and liver cancers. In contrast, the favourable stage exhibited rapid declines in most cancers. The unfavourable stage was associated with lower sociodemographic index, health expenditure, gross domestic product per capita and higher maternal mortality ratio (P < .001 for all associations). Our findings suggest that unfavourable, intermediate and favourable transition patterns exist. Countries and territories in the unfavourable stage tend to be socioeconomically disadvantaged, and tailored intervention strategies are needed in these resource-limited settings.© 2023 UICC.