Background: Cancer remains a leading cause of morbidity and mortality worldwide, with growing burden expected in low- and middle-income countries. While mortality remains the largest contributor to cancer burden, improvements in detection and treatment mean that non-fatal outcomes will contribute a growing share. Estimating non-fatal burden has been challenging due to limited global data on cancer survival, particularly in low-resource settings.

Objectives: To estimate the global burden of cancer using disability-adjusted life years (DALYs), with a specific focus on integrating global survival data to better quantify the non-fatal component of cancer burden.

Methods: We estimated absolute and age-standardised DALYs for 30 cancer sites by sex across 185 countries. Years of life lost (YLL) were calculated using age-specific mortality from the GLOBOCAN database and country-specific life tables. Years lived with disability (YLD) were derived from incidence and per-case DALYs, estimated using a novel Bayesian mixture cure model that synthesises survival data across 49 countries. The model incorporated human development index (HDI), mean age at diagnosis, sex, and selected early detection effects to predict cancer survival in all countries. Uncertainty was quantified using Monte Carlo simulation. Estimates have been produced for 2022 but will be updated based on GLOBOCAN 2024 data.

Results: In 2022, cancer accounted for an estimated 167 million DALYs globally (95% UI: 165–173 million), corresponding to an age-standardised rate of 1,662 per 100,000 person-years. Lung, colorectal, breast, liver, and cervical cancer together accounted for 43% of total age-standardised DALYs. YLL comprised 94% of total DALYs, with the proportion of YLD increasing with HDI from 3.1% in low HDI countries to 7.2% in very high HDI countries. Cancers with poor prognosis were dominated by YLL, whereas cancers with higher survival showed substantial non-fatal burden (e.g., YLD comprised 31% and 14% of total burden in thyroid and prostate cancer respectively). Among males, age-standardised burden increased with HDI (2,130 and 1,300 per 100,000 in very high HDI vs low HDI countries) but not in females (1,640 and 1,660 per 100,000 in very high HDI vs low HDI countries respectively).

Conclusions: Cancer imposes a substantial and heterogeneous global burden, with non-fatal outcomes contributing an increasing share. The predominance of YLL in low HDI countries compared to high HDI countries reflects global disparities in the availability and utilisation of cancer care. By integrating global survival data within a unified modelling framework, this study provides more comprehensive estimates of cancer burden.