Cancer is currently the first or second most common contributor to premature mortality in most countries of the world. The global number of patients with cancer is expected to rise over the next 50 years owing to the strong influence of demographic changes, such as population ageing and growth, on the diverging trends in cancer incidence in different regions. Assuming that the latest incidence trends continue for the major cancer types, we predict a doubling of the incidence of all cancers combined by 2070 relative to 2020. The greatest increases are predicted in lower-resource settings, in countries currently assigned a low Human Development Index (HDI), whereas the predicted increases in national burden diminish with increasing levels of national HDI. Herein, we assess studies modelling the future burden of cancer that underscore how comprehensive cancer prevention strategies can markedly reduce the prevalence of major risk factors and, in so doing, the number of future cancer cases. Focusing on an in-depth assessment of prevention strategies that target tobacco smoking, overweight and obesity, and human papillomavirus infection, we discuss how stepwise, population-level approaches with amenable goals can avert millions of future cancer diagnoses worldwide. In the absence of a step-change in cancer prevention delivery, tobacco smoking will remain the leading preventable cause of cancer, and overweight and obesity might well present a comparable opportunity for prevention, given its increasing prevalence globally in the past few decades. Countries must therefore instigate national cancer control programmes aimed at preventing cancer, and with some urgency, if such programmes are to yield the desired public health and economic benefits in this century.

目前，癌症是世界上大多数国家过早死亡的第一个或第二个最常见的原因。由于人口老龄化和增长等人口变化对不同地区癌症发病率的不同趋势的强烈影响，预计未来 50 年全球癌症患者人数将增加。假设主要癌症类型的最新发病率趋势继续保持，我们预测到 2070 年所有癌症的总发病率将比 2020 年增加一倍。预计增幅最大的是资源匮乏地区，即目前人类发展指数较低的国家(HDI)，而随着国家 HDI 水平的提高，预计的国家负担增加会减少。在此处，我们评估了对未来癌症负担建模的研究，这些研究强调了全面的癌症预防策略如何显着降低主要风险因素的流行率，从而减少未来癌症病例的数量。我们专注于对针对吸烟、超重和肥胖以及人乳头瘤病毒感染的预防策略的深入评估，讨论了具有可行目标的逐步、人口水平的方法如何能够避免全球数百万未来的癌症诊断。在癌症预防方面没有发生重大变化的情况下，吸烟仍将是导致癌症的主要可预防原因，而超重和肥胖很可能提供类似的预防机会，因为在过去几十年中，吸烟在全球范围内日益流行。