Background:Most studies have evaluated disability-adjusted life years(DALYs)of colorectal cancer(CRC)patients based on a set of generic disability weights(DWs).This study aimed to apply local CRC-stage-specific DWs to...Background:Most studies have evaluated disability-adjusted life years(DALYs)of colorectal cancer(CRC)patients based on a set of generic disability weights(DWs).This study aimed to apply local CRC-stage-specific DWs to estimate the burden of DALYs for CRC(CRC-DALYs)in populations in China and consider the influence of local screening coverage of CRC.Methods:A prevalence-based model was constructed using data from various sources.Years lived with disability(YLDs)were estimated mainly via cumulative prevalence data(based on CRC incidence rates,population numbers,and survival rates),stage-specific proportions of CRC,and DWs of the local population.Years of life lost(YLLs)were calculated based on the CRC mortality rates and standard life expectancies.CRC incidence and mortality rates for the years 2020,2025,and 2030 were estimated by joinpoint regression,and the corresponding DALYs were predicted.The main assumption was made for CRC screening coverage.Sensitivity analyses were used to assess the impact of population,DWs,and coverage.Results:In 2017,among the Chinese population,the estimated number of CRC-DALYs was 4,303,314(11.9%for YLDs).If CRC screening coverage rate in China(2.3%)remains unchanged,the overall DALYs in 2030 are predicted to increase by 37.2%(45.1%of those aged≥65 years).More optimistically,the DALYs would then decrease by 0.7%in 2030(from 5,902,454 to 5,860,200)if the coverage could be increased to 25.0%.A sensitivity analysis revealed that using local DWs would change the base-case values by 5.7%.Conclusions:The estimated CRC-DALYs in China using population-specific DWs were considerably lower(with a higher percentage of YLDs)than the global burden of disease(GBD)estimates(5,865,004,of 4.6%for YLDs),suggesting the impact extent of applying local parameters.Sustainable scale-up CRC screening needs to be in place to moderate the growth trend of CRC-DALYs in China.展开更多
Background:Approximately 40%of individuals with diabetes worldwide are at risk of developing diabetic kidney disease(DKD),which is not only the leading cause of kidney failure,but also significantly increases the risk...Background:Approximately 40%of individuals with diabetes worldwide are at risk of developing diabetic kidney disease(DKD),which is not only the leading cause of kidney failure,but also significantly increases the risk of cardiovascular disease,causing significant societal health and financial burdens.This study aimed to describe the burden of DKD and explore its cross-country epidemiological status,predict development trends,and assess its risk factors and sociodemographic transitions.Methods:Based on the Global Burden of Diseases(GBD)Study 2021,data on DKD due to type 1 diabetes(DKD-T1DM)and type 2 diabetes(DKD-T2DM)were analyzed by sex,age,year,and location.Numbers and age-standardized rates were used to compare the disease burden between DKD-T1DM and DKD-T2DM among locations.Decomposition analysis was used to assess the potential drivers.Locally weighted scatter plot smoothing and Frontier analysis were used to estimate sociodemographic transitions of DKD disability-adjusted life years(DALYs).Results:The DALYs due to DKD increased markedly from 1990 to 2021,with a 74.0%(from 2,227,518 to 3,875,628)and 173.6%(from 4,122,919 to 11,278,935)increase for DKD-T1DM and DKD-T2DM,respectively.In 2030,the estimated DALYs for DKD-T1DM surpassed 4.4 million,with that of DKD-T2DM exceeding 14.6 million.Notably,middle-sociodemographic index(SDI)quintile was responsible for the most significant DALYs.Decomposition analysis revealed that population growth and aging were major drivers for the increased DKD DALYs in most regions.Interestingly,the most pronounced effect of positive DALYs change from 1990 to 2021 was presented in high-SDI quintile,while in low-SDI quintile,DALYs for DKD-T1DM and DKD-T2DM presented a decreasing trend over the past years.Frontiers analysis revealed that there was a negative association between SDI quintiles and age-standardized DALY rates(ASDRs)in DKD-T1DM and DKD-T2DM.Countries with middle-SDI shouldered disproportionately high DKD burden.Kidney dysfunction(nearly 100.0%for DKD-T1DM and DKD-T2DM),high fasting plasma glucose(70.8%for DKD-T1DM and 87.4%for DKD-T2DM),and non-optimal temperatures(low and high,5.0%for DKD-T1DM and 5.1%for DKD-T2DM)were common risk factors for age-standardized DALYs in T1DM-DKD and T2DM-DKD.There were other specific risk factors for DKD-T2DM such as high body mass index(38.2%),high systolic blood pressure(10.2%),dietary risks(17.8%),low physical activity(6.2%),lead exposure(1.2%),and other environmental risks.Conclusions:DKD markedly increased and varied significantly across regions,contributing to a substantial disease burden,especially in middle-SDI countries.The rise in DKD is primarily driven by population growth,aging,and key risk factors such as high fasting plasma glucose and kidney dysfunction,with projections suggesting continued escalation of the burden by 2030.展开更多
Background:Colorectal cancer(CRC)still ranks the top in morbidity and mortality of cancers worldwide,posing a huge threat and burden to the society.We aimed to determine the age-standardized incidence,mortality,and di...Background:Colorectal cancer(CRC)still ranks the top in morbidity and mortality of cancers worldwide,posing a huge threat and burden to the society.We aimed to determine the age-standardized incidence,mortality,and disability-adjusted life years(DALYs)of CRC and explore potential changes in the temporal trends of the CRC burden in Shanghai during 2002 to 2016.Methods:The cancer statistics and demographics were obtained from the Cancer Registry and the Statistics Bureau of Pudong New Area,respectively.Data from 2002 to 2016 were included and analyzed retrospectively.DALYs were calculated using DisMod and the age-standardized rates(ASRs)were obtained according to Segi world standard population.Joinpoint regression was used to measure the trends in CRC incidence and to estimate the annual percent change.Results:The increasing trend of CRC ASR incidence halted after 2014,coinciding with the introduction of the Shanghai CRC screening program.The ASRs of mortality and DALYs increased,at 0.42%(P<0.05)and 4.07%(P<0.001)per year,respectively,which were mainly driven by men and individuals aged above the CRC screening program target.Conclusions:The disease burden of CRC in Shanghai remains serious,especially among men,and individuals aged>74 years.The benefits of the screening program have been partially proven by the ASRs of CRC incidence,providing important insights into better and wider application of screening programs.展开更多
Background:The patterns of leukemia burden have dramatically changed in recent years.This study aimed to estimate the global trends of leukemiarelated death and disability-adjusted life-years(DALYs)from 1990 to 2017.M...Background:The patterns of leukemia burden have dramatically changed in recent years.This study aimed to estimate the global trends of leukemiarelated death and disability-adjusted life-years(DALYs)from 1990 to 2017.Methods:The data was acquired from the latest version of the Global Burden of Disease(GBD)study.Estimated annual percentage changes(EAPCs)were calculated to estimate the trend of age-standardized rate(ASR)of death and DALYs due to leukemia and its main subtypes from 1990 to 2017.Results:Globally,the numbers of death and DALYs due to leukemia were 347.58×10^(3)(95%uncertainty interval[UI]=317.26×10^(3)-364.88×10^(3))and 11975.35×10^(3)(95%UI=10749.15×10^(3)-12793.58×10^(3))in 2017,with a 31.22% and 0.03% increase in absolute numbers from 1990 to 2017,respectively.Both of their ASR showed decreasing trends from 1990 to 2017 with the EAPCs being−1.04(95%confidence interval[CI]=(−1.10-−0.99)and−1.52(95%CI=−1.59-−1.44),respectively.Globally,the most pronounced decreasing trend of death and DALYs occurred in chronic myeloid leukemia with EAPCs of−2.76(95%CI=−2.88-−2.64)and−2.84(95%CI=−2.97-−2.70),respectively,while the trend increased in acute myeloid leukemia.The death and DALYs of leukemia decreased in most areas and countries with high socio-demographic index(SDI)including Bahrain,Finland,and Australia.Conclusions:The disease burden of death and DALYs due to leukemia decreased globally,and for most regions and countries from 1990 to 2017.However,the leukemia burden is still a substantial challenge globally and required adequate and affordable medical resources to improve the survival and quality of life of leukemia patients.展开更多
Objective:To calculate the burden of road traffic accidents in Kathmandu Valley and then extrapolate this to the national level.Methods:A prospective study was performed to compute the burden of road traffic accidents...Objective:To calculate the burden of road traffic accidents in Kathmandu Valley and then extrapolate this to the national level.Methods:A prospective study was performed to compute the burden of road traffic accidents by quantification of disability-adjusted life years(DALYs)using the Global Burden of Disease Study method on the basis of 1-year data from nine hospitals in Nepal and the Department of Foren-sic Medicine and cross-checked with the Nepal Traffic Directorate.Multiple methods were applied to the extrapolated population metrics of the burden of road traffic accidents in Nepal.Results:The total number of years of life lived in disability,years of life lost,and DALYs in Nepal were 38,848±194,119,935±1464,and 158,783±1658(95% confidence interval)re-spectively.The number of years lost because of morbidity and death was similar in Kathmandu Valley.Most(75%)of the DALYs resulted from years of life lost in Nepal.Males accounted for 73% of DALYs.Almost half(44%)of the DALYs were contributed by the group aged 15-29 years.Conclusion:This study is the first to calculate the burden of road traffic accidents in Nepal using Nepal’s own data.Nepal needs to develop and enhance its own system to identify significant public health issues so as to set national priorities for prevention of road traffic accidents.展开更多
BACKGROUND Mental disorders have become a major contributor to the Global Burden of Disease(GBD),a situation that has worsened with the onset of the coronavirus disease 2019(COVID-19)pandemic.Updated data on their imp...BACKGROUND Mental disorders have become a major contributor to the Global Burden of Disease(GBD),a situation that has worsened with the onset of the coronavirus disease 2019(COVID-19)pandemic.Updated data on their impact and a clear understanding of long-term trends are essential for global and national health authorities to implement effective prevention and intervention strategies for mental well-being.AIM To generate insights that will enhance global awareness of the burden of mental disorders and support the development of targeted,region-specific prevention and intervention strategies tailored to current global and local health challenges.METHODS We extracted data on incidence,disability-adjusted life years(DALYs),agestandardized incidence rate(ASIR),and age-standardized DALY rate(ASDR)for 12 categories of mental disorders from 1990 to 2021 across 204 countries and territories grouped into 21 regions.Trends in ASIR and ASDR were also analyzed during the COVID-19 period(2019-2021).RESULTS From 1990 to 2021,global ASIR rose by 15.23%(12.97%to 17.60%),while ASDR increased by 73.52%(70.24%to 76.71%).All 21 GBD regions saw a rise in cases and DALYs.In 2021,Central sub-Saharan Africa had the highest ASIR(8706.11),and East Asia reported the lowest(3340.99).Australasia recorded the highest ASDR(2787.87).On the national level,Greenland,Greece,United States,and Australia had the greatest ASDR values.During the pandemic years,ASIR and ASDR rose across all five socio-demographic index levels and GBD regions,with the exception of East Asia,where rates remained stable.Females experienced a higher ASDR than males in 2021.Major depressive disorder(557.87)and anxiety disorders(524.33)were the most burdensome among the 12 types,with depressive disorders ranking first in 13 out of the 21 regions.CONCLUSION The GBD study 2021 results highlight a continued and worsening global burden of mental disorders,further intensified by the COVID-19 crisis.This underscores the urgent need to reinforce mental health care systems.Special attention should be directed toward high-middle socio-demographic index areas and female populations.Expanding access to mental health services,enhancing public awareness,and delivering targeted interventions are essential to lessen the growing impact of mental disorders.展开更多
BACKGROUND The burden of mental disorders(MD)in the Western Pacific Region(WPR)re-mains a critical public health concern,with substantial variations across demogra-phics and countries.AIM To analyze the burden of MD i...BACKGROUND The burden of mental disorders(MD)in the Western Pacific Region(WPR)re-mains a critical public health concern,with substantial variations across demogra-phics and countries.AIM To analyze the burden of MD in the WPR from 1990 to 2021,along with associated risk factors,to reveal changing trends and emerging challenges.METHODS We used data from the Global Burden of Disease 2021,analyzing prevalence,incidence,and disability-adjusted life years(DALYs)of MD from 1990 to 2021.Statistical methods included age-standardisation and uncertainty analysis to address variations in population structure and data completeness.RESULTS Between 1990 and 2021,the prevalence of MD rose from 174.40 million cases[95%uncertainty interval(UI):160.17-189.84]to 234.90 million cases(95%UI:219.04-252.50),with corresponding DALYs increasing from 22.8 million(95%UI:17.22-28.79)to 32.07 million(95%UI:24.50-40.68).During this period,the burden of MD shifted towards older age groups.Depressive and anxiety disorders were predominant,with females showing higher DALYs for depressive and anxiety disorders,and males more affected by conduct disorders,attention-deficit hyperactivity disorder,and autism spectrum disorders.Australia,New Zealand,and Malaysia reported the highest burdens,whereas Vietnam,China,and Brunei Darussalam reported the lowest.Additionally,childhood sexual abuse and bullying,and intimate partner violence emerged as significant risk factors.CONCLUSION This study highlights the significant burden of MD in the WPR,with variations by age,gender,and nation.The coronavirus disease 2019 pandemic has exacerbated the situation,emphasizing the need for a coordinated response.展开更多
Objective:Children below 14 years of age are highly vulnerable to dengue infection and are at a greater risk of developing severe dengue illness.This study aimed to investigate the trends in the burden of dengue fever...Objective:Children below 14 years of age are highly vulnerable to dengue infection and are at a greater risk of developing severe dengue illness.This study aimed to investigate the trends in the burden of dengue fever among children below 14 years of age in China from 1990 to 2021 and to project the disease burden from 2022 to 2035.Methods:Based on the datasets derived from the Global Burden of Disease Study 2021,the following data were collected from dengue-affected children aged ≤14 years in China from 1990 to 2021:number and rate of incident dengue cases,number of prevalent dengue cases,number of deaths due to dengue,and disability-adjusted life years(DALYs) lost due to dengue.The trends in disease burden were examined based on average annual percent change(AAPC) and annual percent change,and the burdens were proj ected from 2022 to 2035 by using a Bayesian age-period-cohort model.Results:The incidence and prevalence of dengue fever were increased in children aged ≤ 14 years in China from1990 to 2021(AAPC=5.42 % and 5.44 %,respectively,P <0.001),while the mortality and DALYs rates were reduced(AAPC=-8.21 % and-7.55 %,respectively,P <0.001).The burden was comparable between genders,with numerically lower incidence and prevalence in boys than in girls.The lowest incidence and prevalence and the highest mortality and DALYs rates were observed in children aged <5 years.The incidence and prevalence rates were projected to increase from 2022 to 2035;in contrast,the mortality and DALYs rates were projected to decrease during this period.Conclusions:Although the mortality and DALYs rates of dengue fever decreased significantly in children aged0-14 years in China from 1990 to 2021,the incidence and prevalence increased remarkably.Enhanced surveillance and ample health education programs and preventive interventions are recommended for targeting this high-risk population.展开更多
Objective:This study aimed to assess the global,regional,and national burden of early-onset gastric cancer(EOGC)and the attributable risk factors from 1990-2021 with projections extending to 2040.Methods:The EOGC burd...Objective:This study aimed to assess the global,regional,and national burden of early-onset gastric cancer(EOGC)and the attributable risk factors from 1990-2021 with projections extending to 2040.Methods:The EOGC burden was quantified using incidence,prevalence,mortality,and disability-adjusted life years(DALYs)with calculation of age-standardized rates.The risk factor contributions were analyzed and disparities were evaluated using the slope index of inequality.Future trends for 2021-2040 were estimated using a Bayesian age-period-cohort model.Results:There were approximately 125,000 new cases of EOGC globally in 2021 with an estimated 336,000 individuals living with EOGC and 78,000 associated deaths,contributing to 3.86 million DALYs.The highest EOGC incidence rates existed among individuals 45-49 years of age.The global age-standardized incidence,prevalence,mortality,and DALY rates demonstrated an overall decline between 1990 and 2021.Smoking and high-salt dietary intake were the leading risk factors for DALYs with regional and gender-based variations.Smoking accounted for>10% of DALYs in Central Europe and East Asia,while high-salt dietary intake accounted for approximately 8% of DALYs.Despite the overall decline in the EOGC burden,disparities across geographic regions widened.Projections indicated a continued gradual reduction in EOGC burden through 2040.Conclusion:Although the global burden of EOGC has decreased,significant disparities persist across geographic regions,age groups,and genders.Public health interventions should combine smoking prevention strategies(e.g.,youth education and tobacco taxation)with cessation programs with dietary salt reduction initiatives.展开更多
Background:Blindness and vision impairment(BVI)continue to pose significant global public health challenges,disproportionately impacting vulnerable populations and further widening socioeconomic disparities.This study...Background:Blindness and vision impairment(BVI)continue to pose significant global public health challenges,disproportionately impacting vulnerable populations and further widening socioeconomic disparities.This study conducts a comprehensive evaluation of the global burden of BVI and the socioeconomic inequalities in its distribution from 1990 to 2021,aiming to provide insights for targeted intervention strategies.Methods:Using data from Global Burden of Disease 2021,this study performed a multiscale analysis of BVI burden,examining patterns at the global,regional and national levels.We quantified the disease burden using disability-adjusted life years DALY and prevalence rates.Temporal trends were analyzed by calculating estimated annual percentage changes(EAPC).Stratified assessments were carried out by sex and age group across 21 regions and 204 countries.The study also included comparative analyses of six major eye conditions and evaluated their associations with socio-demographic index(SDI).Results:Globally,the age-standardized prevalence of BVI increased from 12,453.52 per million(95%UI:10,287.58-15,226.09)in 1990 to 15,784.33 per million(12,761.44-19,502.32)in 2021,with an EAPC of 1.09%(95%UI:0.97-1.20).During this period,global DALYs attributable to BVI increased by 37.7%.Disease trends exhibited significant divergence,with near vision loss showing the steepest increase(EAPC:1.47%),while the prevalence of glaucoma declined(EAPC:-0.73%).Geographic disparities were pronounced,with substantial improvements observed in Equatorial Guinea(EAPC:-1.75)and worsening burdens in Benin(+0.54).Disease distribution demonstrated strong regional clustering,with near vision loss being predominant in Sub-Saharan Africa(64.47%)and East Asia(50.97%),while cataract was the most common condition in Oceania(33.86%).Females consistently bore a higher burden,particularly in South Asia(646.3 vs 563.2 DALYs).Moreover,we identified a strong inverse correlation between SDI and BVI burden(Ρ=-0.772 for DALYs).Conclusions:This study highlights the severe global burden of BVI and the significant cross-country inequality,particularly in low-and middle-income countries.It emphasizes the urgent need for targeted interventions and the integration of eye care into universal health policies to promote global health equity in the post-pandemic era.展开更多
Background:The burden of common urologic diseases,including benign prostatic hyperplasia(BPH),urinary tract infections(UTI),urolithiasis,bladder cancer,kidney cancer,and prostate cancer,varies both geographically and ...Background:The burden of common urologic diseases,including benign prostatic hyperplasia(BPH),urinary tract infections(UTI),urolithiasis,bladder cancer,kidney cancer,and prostate cancer,varies both geographically and within specific regions.It is essential to conduct a comprehensive and precise assessment of the global burden of urologic diseases.Methods:We obtained data on incidence,prevalence,mortality,and disability-adjusted life-years(DALYs)for the aforementioned urologic diseases by age,sex,location,and year from the Global Burden of Disease(GBD)2021.We analyzed the burden associated with urologic diseases based on socio-demographic index(SDI)and attributable risk factors.The trends in burden over time were assessed using estimated annual percentage changes(EAPC)along with a 95%confidence interval(CI).Results:In 2021,BPH and UTI were the leading causes of age-standardized incidence rate(ASIR)and age-standardized prevalence rate(ASPR),with rates of 5531.88 and 2782.59 per 100,000 persons,respectively.Prostate cancer was the leading cause of both age-standardized mortality rate(ASMR)and age-standardized DALYs rate(ASDR),with rates of 12.63 and 217.83 per 100,000 persons,respectively.From 1990 to 2021,there was an upward trend in ASIR,ASPR,ASMR,and ASDR for UTI,while urolithiasis showed a downward trend.The middle and low-middle SDI quintile levels exhibited higher incidence,prevalence,mortality,and DALYs related to UTI,urolithiasis,and BPH,while the high and high-middle SDI quintile levels showed higher rates for the three cancers.The burden of these 6 urologic diseases displayed diverse age and sex distribution patterns.In 2021,a high body mass index(BMI)contributed to 20.07%of kidney cancer deaths worldwide,while smoking accounted for 26.48%of bladder cancer deaths and 3.00%of prostate cancer deaths.Conclusions:The global burden of 6 urologic diseases presents a significant public health challenge.Urgent international collaboration is essential to advance the improvement of urologic disease management,encompassing the development of effective diagnostic screening tools and the implementation of high-quality prevention and treatment strategies.展开更多
Background:Subarachnoid hemorrhage(SAH)is a subtype of hemorrhagic stroke characterized by high mortality and low rates of full recovery.This study aimed to investigate the epidemiological characteristics of SAH betwe...Background:Subarachnoid hemorrhage(SAH)is a subtype of hemorrhagic stroke characterized by high mortality and low rates of full recovery.This study aimed to investigate the epidemiological characteristics of SAH between 1990 and 2021.Methods:Data on SAH incidence,mortality,and disability-adjusted life-years(DALYs)from 1990 to 2021 were obtained from the Global Burden of Disease Study(GBD)2021.Estimated annual percentage changes(EAPCs)were calculated to evaluate changes in the age-standardized rate(ASR)of incidence and mortality,as well as trends in SAH burden.The relationship between disease burden and socio-demographic index(SDI)was also analyzed.Results:In 2021,the incidence of SAH was found to be 37.09%higher than that in 1990;however,the age-standardized incidence rates(ASIRs)showed a decreased[EAPC:-1.52;95%uncertainty interval(UI)-1.66 to-1.37].Furthermore,both the number and rates of deaths and DALYs decreased over time.It was observed that females had lower rates compared to males.Among all regions,the high-income Asia Pacific region exhibited the highest ASIR(14.09/100,000;95%UI 12.30/100,000-16.39/100,000)in 2021,with an EPAC for ASIR<0 indicating decreasing trend over time for SAH ASIR.Oceania recorded the highest age-standardized mortality rates(ASMRs)and age-standardized DALYs rates among all regions in 2021 at values of respectively 8.61(95%UI 6.03-11.95)and 285.62(95%UI 209.42-379.65).The burden associated with SAH primarily affected individuals aged between 50-69 years old.Metabolic risks particularly elevated systolic blood pressure were identified as the main risk factors contributing towards increased disease burden associated with SAH when compared against environmental or occupational behavioral risks evaluated within the GBD framework.Conclusions:The burden of SAH varies by gender,age group,and geographical region.Although the ASRs have shown a decline over time,the burden of SAH remains significant,especially in regions with middle and low-middle SDI levels.High systolic blood pressure stands out as a key risk factor for SAH.More specific supportive measures are necessary to alleviate the global burden of SAH.展开更多
Objective Asthma imposes a significant global health burden.This study examines changes in the asthma-related disease burden from 1990 to 2021 and projects future burdens for 2050 under different scenarios.Methods Usi...Objective Asthma imposes a significant global health burden.This study examines changes in the asthma-related disease burden from 1990 to 2021 and projects future burdens for 2050 under different scenarios.Methods Using data from the Global Burden of Disease 2021 study,we analyzed asthma incidence,prevalence,mortality,and disability-adjusted life years(DALYs)from 1990 to 2021.We projected the disease burden for 2050 based on current trends and hypothetical scenarios in which all risk factors are controlled.Temporal trends in age-standardized incidence,prevalence,mortality,and DALY rates were explored using Annual Percent Change.Results In 2021,the age-standardized rates for asthma incidence,prevalence,mortality,and DALYs in China were 364.17 per 100,000(95%uncertainty interval[UI]:283.22-494.10),1,956.49 per 100,000(95%UI:1,566.68-2,491.87),1.47 per 100,000(95%UI:1.15-1.79),and 103.76 per 100,000(95%UI:72.50-145.46),respectively.A higher disease burden was observed among Chinese men and individuals aged 70 years or older.Compared to the current trend,a combined scenario involving improvements in environmental factors,behavioral and metabolic health,child nutrition,and vaccination resulted in a greater reduction in the disease burden caused by asthma.Conclusion Addressing modifiable risk factors is essential for further reducing the asthma-related disease burden.展开更多
Objective:This study aimed to provide a comprehensive overview of the global burden of esophageal cancer(EC)and determine the temporal trends and factors influencing changes in the global burden.Methods:The latest inc...Objective:This study aimed to provide a comprehensive overview of the global burden of esophageal cancer(EC)and determine the temporal trends and factors influencing changes in the global burden.Methods:The latest incidence and mortality data for EC worldwide were obtained from GLOBALCAN 2022.The mortality and disability-adjusted life years(DALYs)rates for EC from 1990±2019 were sourced from the 2019 Global Burden of Diseases.Trends in EC mortality and DALYs attributable to 11 risk factors or clusters of risk were analyzed using the joinpoint regression model.The trends in age-related EC burden were assessed using a decomposition approach.Results:An estimated 511,054 new cases of EC were diagnosed in 2022 with 445,391 deaths worldwide.Approximately 75%of cases and deaths occurred in Asia.Nearly 50%of global EC deaths and DALYs were attributed to tobacco use in men in 2019,while 20%were attributed to high body mass index(BMI)in women.From 1990±2019,EC deaths and DALYs attributable to almost all risk factors had declining trends,while EC deaths and DALYs attributed to high BMI in men had upward trends.The age-related EC burden exhibited an upward trend driven by population growth and aging,which contributed to 307.4 thousand deaths and 7.2 million DALYs due to EC.Conclusions:The EC burden remains substantial worldwide.Effective tobacco and obesity control measures are critical for addressing the risk-attributable burden of EC.Population growth and aging pose challenges for EC prevention and control efforts.展开更多
BACKGROUND Colorectal cancer(CRC)plays a significant role in morbidity,mortality,and economic cost in the Belt and Road Initiative(“B and R”)countries.In addition,these countries have a substantial consumption of pr...BACKGROUND Colorectal cancer(CRC)plays a significant role in morbidity,mortality,and economic cost in the Belt and Road Initiative(“B and R”)countries.In addition,these countries have a substantial consumption of processed meat.However,the burden and trend of CRC in relation to the consumption of a diet high in processed meat(DHPM-CRC)in these“B and R”countries remain unknown.AIM To analyze the burden and trend of DHPM-CRC in the“B and R”countries from 1990 to 2019.METHODS We used the 2019 Global Burden of Disease Study to collate information regarding the burden of DHPM-CRC.Numbers and age-standardized rates(ASRs)of deaths along with the disability-adjusted life years(DALYs)were determined among the“B and R”countries in 1990 and 2019.Using joinpoint regression analysis,the average annual percent change(AAPC)was used to analyze the temporal trends of age-standardized DALYs rate(ASDALR)from 1990 to 2019 and in the final decade(2010–2019).RESULTS We found geographical differences in the burden of DHPM-CRC among“B and R”countries,with the three highest-ranking countries being the Russian Federation,China,and Ukraine in 1990,and China,the Russian Federation,and Poland in 2019.The burden of DHPM-CRC generally increased in most member countries from 1990 to 2019(all P<0.05).The absolute number of deaths and DALYs in DHPM-CRC were 3151.15[95%uncertainty interval(UI)665.74-5696.64]and 83249.31(95%UI 15628.64-151956.31)in China in 2019.However,the number of deaths(2627.57-2528.51)and DALYs(65867.39-55378.65)for DHPM-CRC in the Russian Federation has declined.The fastest increase in ASDALR for DHPM-CRC was observed in Vietnam,Southeast Asia,with an AAPC value of 3.90%[95%confidence interval(CI):3.63%-4.16%],whereas the fastest decline was observed in Kyrgyzstan,Central Asia,with an AAPC value of-2.05%(95%CI:-2.37%to-1.73%).A substantial upward trend in ASR of mortality,years lived with disability,years of life lost,and DALYs from DHPM-CRC changes in 1990-2019 and the final decade(2010-2019)for most Maritime Silk Route members in East Asia,South Asia,Southeast Asia,North Africa,and the Middle East,as well as Central Europe,while those of the most Land Silk Route members in Central Asia and Eastern Europe have decreased markedly(all P<0.05).The ASDALR for DHPM-CRC increased more in males than in females(all P<0.05).For those aged 50-74 years,the ASDALR for DHPM-CRC in 40 members exhibited an increasing trend,except for 20 members,including 7 members in Central Asia,Maldives,and 12 high or high-middle social development index(SDI)members in other regions(all P<0.05).CONCLUSION The burden of DHPM-CRC varies substantially across“B and R”countries and threatens public health.Relevant evidence-based policies and interventions tailored to the different trends of countries in SDIs or Silk Routes should be adopted to reduce the future burden of CRC in“B and R”countries via extensive collaboration.展开更多
Objective:To analyze the impact of global population aging on cancer epidemiology,with a focus on the incidence and mortality rates among individuals aged 60 years and above.Methods:We utilized open-source data,retrie...Objective:To analyze the impact of global population aging on cancer epidemiology,with a focus on the incidence and mortality rates among individuals aged 60 years and above.Methods:We utilized open-source data,retrieving population age estimates from the United Nations Population Division website.The GLOBOCAN 2020 database provided estimates for cancer cases and deaths in 2020 and 2040,while the Global Burden of Disease 2019 database supplied estimates of new cancer cases worldwide from 2000 to 2019.Inclusion criteria considered individuals aged 60 years and over,focusing on the top five deadliest cancers.The cohort-component method was employed for population prediction,with age-specific incidence and mortality rates estimated for 2020 used to forecast the cancer burden.Results:In 2021,the global population aged over 60 years accounted for 13.7%,with Europe/North America and Australia/New Zealand having the highest proportions.The older population is predicted to reach 19.2%by 2040.In 2020,of the 19.3 million new cancer cases worldwide,64%occurred in individuals aged 60 and above,contributing to 71.3%of cancer-related deaths.The five most common cancer sites were the lung,colorectum,prostate,breast,and stomach.Cancer incidence and deaths are projected to rise significantly among older indi-viduals,reaching 20.7 million new cases and 12.7 million deaths by 2040.Older age,tobacco use,dietary factors,alcohol consumption,and high body mass index(BMI)were identified as major risk factors for various cancers in this demographic.Conclusions:This study reveals a significant rise in cancer incidence and mortality among the elderly due to global population aging.The urgency for targeted interventions in cancer prevention,screening,and treatment for older individuals is emphasized.Despite acknowledged limitations,these findings contribute valuable insights to inform strategies for managing cancer in the elderly amidst evolving demographic trends.展开更多
BACKGROUND Although gastrointestinal(GI)cancers have been becoming a great public health concern in China,there is currently a lack of comprehensive literature on the overall burden and changing trends of GI cancers i...BACKGROUND Although gastrointestinal(GI)cancers have been becoming a great public health concern in China,there is currently a lack of comprehensive literature on the overall burden and changing trends of GI cancers in the working-age population.AIM To assess the burden of GI cancers and to examine the overall,age-and genderspecific trends among the working-age population in China from 1990 to 2019.METHODS Data were extracted from the Global Burden of Disease Study 2019.The burden of GI cancers was indicated by incidence,mortality,disability-adjusted life-years(DALYs),age-standardized incidence rate(ASIR),age-standardized mortality rate,and age-standardized DALYs rate.Trends in the burden of GI cancers from 1990 to 2019 were examined using annual percent change and average annual percent change with Joinpoint regression models.RESULTS For overall GI cancers,a declining trend was observed in the ASIR,age-standardized mortality rate,and agestandardized DALYs rate,with reductions of 0.74%,2.23%,and 2.22%,respectively,from 1999 to 2019 in the Chinese working-age population.However,an increasing trend was observed in the ASIR for overall GI cancers from 2016-2019.The number of either incident cases,mortality cases,and DALYs was higher for colon/rectum cancer and liver cancer in younger participants but lower for esophageal,gallbladder,biliary tract,pancreatic,and stomach cancer among older subjects.Moreover,sex disparity in the GI cancers burden was also examined over 30 years.CONCLUSION The total burden of GI cancers remained heavy among the working-age population in China,although declining trends were observed from 1999 to 2019.Disparities in the GI cancers burden existed between sexes,age groups,and cancer types.Population-based precision prevention strategies are needed to tackle GI cancers among working-age individuals,considering the age,sex,and cancer type disparities in China.展开更多
Background:Urinary tract infections(UTI),urolithiasis,and benign prostatic hyperplasia(BPH)are three of the most common nonmalignant conditions in urology.However,there is still a lack of comprehensive and updated epi...Background:Urinary tract infections(UTI),urolithiasis,and benign prostatic hyperplasia(BPH)are three of the most common nonmalignant conditions in urology.However,there is still a lack of comprehensive and updated epidemiological data.This study aimed to investigate the disease burden of UTI,urolithiasis,and BPH in 203 countries and territories from 1990 to 2019.Methods:Data were extracted from the Global Burden of Disease 2019,including incident cases,deaths,disabilityadjusted life-years(DALYs)and corresponding age-standardized rate(ASR)from 1990 to 2019.Estimated annual percentage changes(EAPC)were calculated to evaluate the trends of ASR.The associations between disease burden and social development degrees were analyzed using a sociodemographic index(SDI).Results:Compared with 1990,the incident cases of UTI,urolithiasis,and BPH increased by 60.40%,48.57%,and 105.70%in 2019,respectively.The age-standardized incidence rate(ASIR)of UTI increased(EAPC=0.08),while urolithiasis(EAPC=–0.83)and BPH(EAPC=–0.03)decreased from 1990 to 2019.In 2019,the age-standardized mortality rate(ASMR)of UTI and urolithiasis were 3.13/100,000 and 0.17/100,000,respectively.BPH had the largest increase(110.56%)in DALYs in the past three decades,followed by UTI(68.89%)and urolithiasis(16.95%).The burden of UTI was mainly concentrated in South Asia and Tropical Latin America,while the burden of urolithiasis and BPH was recorded in Asia and Eastern Europe.Moreover,the ASIR and SDI of urolithiasis in high-SDI regions from 1990to 2019 were negatively correlated,while the opposite trend was seen in low-SDI regions.In 2019,the ASIR of UTI in females was 3.59 times that of males,while the ASIR of urolithiasis in males was 1.96 times higher than that in females.The incidence was highest in the 30–34,55–59,and 65–69 age groups among the UTI,urolithiasis,and BPH groups,respectively.Conclusions:Over the past three decades,the disease burden has increased for UTI but decreased for urolithiasis and BPH.The allocation of medical resources should be based more on the epidemiological characteristics and geographical distribution of diseases.展开更多
The occurrence and risks of Giardia in China have been unclear to date,which has made it difficult to properly manage source water as well as to create reasonable drinking water standards.The levels of Giardia in rive...The occurrence and risks of Giardia in China have been unclear to date,which has made it difficult to properly manage source water as well as to create reasonable drinking water standards.The levels of Giardia in river networks of several cities in Zhejiang Province,China were found to be in the range of 0-5 oocysts/10 L in the rainy season in 2008.The mortality due to Giardia infection for people in this region was calculated to be from 0 to 1.95 × 10？8 persons using a conditional probability equation.Based on multiple unboiled water intake routes,the disability-adjusted life years（DALYs） due to Giardia infection for people who consumed conventionally treated water was 0.625（95% CI：0.137-2.05） per 105 persons,with the symptom of hospitalization making the highest contribution to total DALYs（0.56 per 105 persons;95% CI：0.122-1.84）.The DALYs decreased to 0.425（95% CI：0.137-2.05） per 105 persons per year for those consuming water treated with advanced technology.These values were lower than the acceptable risk（1.97 × 10？5 DALYs per year）.This study revealed the risk of Giardia infection to the people in river networks of Zhejiang Province for the first time,and provides a method to evaluate the risk of Giardia infection.The results are useful for the modification of drinking water quality standards based on cost-benefit analysis.展开更多
Objective To estimate the lung cancer burden that may be attributable to ambient fine particulate matter （PM2.5） pollution in Guangzhou city in China from 2005 to 2013. Methods The data regarding PM2.5 exposure were...Objective To estimate the lung cancer burden that may be attributable to ambient fine particulate matter （PM2.5） pollution in Guangzhou city in China from 2005 to 2013. Methods The data regarding PM2.5 exposure were obtained from the ＆#39;Ambient air pollution exposure estimation for the Global Burden of Disease 2013＇ dataset at 0.1° ×0.1° spatial resolution. Disability-adjusted life years （DALYs） were estimated based on the information of mortality and incidence of lung cancer. Comparative risk analysis and integrated exposure-response function were used to estimate attributed disease burden. Results The population-weighted average concentration of PM2.5 was increased by 34.6% between 1990 and 2013, from 38.37 μg/m3 to 51.31 μg/m^3. The lung cancer DALYs in both men and women were increased by 36.2% from 2005 to 2013. The PM2.5 attributed lung cancer DALYs increased from 12105.0 （8181.0 for males and 3924.0 for females） in 2005 to 16489.3 （11291.7 for males and 5197.6 for females） in 2013. An average of 23.1% lung cancer burden was attributable to PM2.5 pollution in 2013. Conclusion PM2.5 has caused serious but under-appreciated public health burden in Guangzhou and the trend deteriorates. Effective strategies are needed to tackle this major public health problem.展开更多
基金supported by grants from the National Natural Science Foundation of China(No.81773521)an Open Competition Grant,Health Policy and System Sciences from the China Medical Board(No.19-340)a Talent Incentive Plan sponsored by the Cancer Hospital,Chinese Academy of Medical Sciences.
文摘Background:Most studies have evaluated disability-adjusted life years(DALYs)of colorectal cancer(CRC)patients based on a set of generic disability weights(DWs).This study aimed to apply local CRC-stage-specific DWs to estimate the burden of DALYs for CRC(CRC-DALYs)in populations in China and consider the influence of local screening coverage of CRC.Methods:A prevalence-based model was constructed using data from various sources.Years lived with disability(YLDs)were estimated mainly via cumulative prevalence data(based on CRC incidence rates,population numbers,and survival rates),stage-specific proportions of CRC,and DWs of the local population.Years of life lost(YLLs)were calculated based on the CRC mortality rates and standard life expectancies.CRC incidence and mortality rates for the years 2020,2025,and 2030 were estimated by joinpoint regression,and the corresponding DALYs were predicted.The main assumption was made for CRC screening coverage.Sensitivity analyses were used to assess the impact of population,DWs,and coverage.Results:In 2017,among the Chinese population,the estimated number of CRC-DALYs was 4,303,314(11.9%for YLDs).If CRC screening coverage rate in China(2.3%)remains unchanged,the overall DALYs in 2030 are predicted to increase by 37.2%(45.1%of those aged≥65 years).More optimistically,the DALYs would then decrease by 0.7%in 2030(from 5,902,454 to 5,860,200)if the coverage could be increased to 25.0%.A sensitivity analysis revealed that using local DWs would change the base-case values by 5.7%.Conclusions:The estimated CRC-DALYs in China using population-specific DWs were considerably lower(with a higher percentage of YLDs)than the global burden of disease(GBD)estimates(5,865,004,of 4.6%for YLDs),suggesting the impact extent of applying local parameters.Sustainable scale-up CRC screening needs to be in place to moderate the growth trend of CRC-DALYs in China.
基金supported by grants from the National Natural Science Foundation of China(Nos.81820108007 and 82070813)Research Plan Project of Hunan Health Commission(No.D202303067196).
文摘Background:Approximately 40%of individuals with diabetes worldwide are at risk of developing diabetic kidney disease(DKD),which is not only the leading cause of kidney failure,but also significantly increases the risk of cardiovascular disease,causing significant societal health and financial burdens.This study aimed to describe the burden of DKD and explore its cross-country epidemiological status,predict development trends,and assess its risk factors and sociodemographic transitions.Methods:Based on the Global Burden of Diseases(GBD)Study 2021,data on DKD due to type 1 diabetes(DKD-T1DM)and type 2 diabetes(DKD-T2DM)were analyzed by sex,age,year,and location.Numbers and age-standardized rates were used to compare the disease burden between DKD-T1DM and DKD-T2DM among locations.Decomposition analysis was used to assess the potential drivers.Locally weighted scatter plot smoothing and Frontier analysis were used to estimate sociodemographic transitions of DKD disability-adjusted life years(DALYs).Results:The DALYs due to DKD increased markedly from 1990 to 2021,with a 74.0%(from 2,227,518 to 3,875,628)and 173.6%(from 4,122,919 to 11,278,935)increase for DKD-T1DM and DKD-T2DM,respectively.In 2030,the estimated DALYs for DKD-T1DM surpassed 4.4 million,with that of DKD-T2DM exceeding 14.6 million.Notably,middle-sociodemographic index(SDI)quintile was responsible for the most significant DALYs.Decomposition analysis revealed that population growth and aging were major drivers for the increased DKD DALYs in most regions.Interestingly,the most pronounced effect of positive DALYs change from 1990 to 2021 was presented in high-SDI quintile,while in low-SDI quintile,DALYs for DKD-T1DM and DKD-T2DM presented a decreasing trend over the past years.Frontiers analysis revealed that there was a negative association between SDI quintiles and age-standardized DALY rates(ASDRs)in DKD-T1DM and DKD-T2DM.Countries with middle-SDI shouldered disproportionately high DKD burden.Kidney dysfunction(nearly 100.0%for DKD-T1DM and DKD-T2DM),high fasting plasma glucose(70.8%for DKD-T1DM and 87.4%for DKD-T2DM),and non-optimal temperatures(low and high,5.0%for DKD-T1DM and 5.1%for DKD-T2DM)were common risk factors for age-standardized DALYs in T1DM-DKD and T2DM-DKD.There were other specific risk factors for DKD-T2DM such as high body mass index(38.2%),high systolic blood pressure(10.2%),dietary risks(17.8%),low physical activity(6.2%),lead exposure(1.2%),and other environmental risks.Conclusions:DKD markedly increased and varied significantly across regions,contributing to a substantial disease burden,especially in middle-SDI countries.The rise in DKD is primarily driven by population growth,aging,and key risk factors such as high fasting plasma glucose and kidney dysfunction,with projections suggesting continued escalation of the burden by 2030.
基金National Natural Science Foundation of China(Nos.81670546,81570544,81772519)General Project of Scientific Research of Shanghai Municipal Commission of Health and Family Planning(No.201540407)+1 种基金Reserve Academic Leaders Training Program of Pudong New Area Center for Disease Control and Prevention(No.PDCDC-HBXD2020-05)Shanghai Public Health System Construction Three-year Action Plan Outstanding Youth Talent Training Program(No.GWV-10.2-YQ43)。
文摘Background:Colorectal cancer(CRC)still ranks the top in morbidity and mortality of cancers worldwide,posing a huge threat and burden to the society.We aimed to determine the age-standardized incidence,mortality,and disability-adjusted life years(DALYs)of CRC and explore potential changes in the temporal trends of the CRC burden in Shanghai during 2002 to 2016.Methods:The cancer statistics and demographics were obtained from the Cancer Registry and the Statistics Bureau of Pudong New Area,respectively.Data from 2002 to 2016 were included and analyzed retrospectively.DALYs were calculated using DisMod and the age-standardized rates(ASRs)were obtained according to Segi world standard population.Joinpoint regression was used to measure the trends in CRC incidence and to estimate the annual percent change.Results:The increasing trend of CRC ASR incidence halted after 2014,coinciding with the introduction of the Shanghai CRC screening program.The ASRs of mortality and DALYs increased,at 0.42%(P<0.05)and 4.07%(P<0.001)per year,respectively,which were mainly driven by men and individuals aged above the CRC screening program target.Conclusions:The disease burden of CRC in Shanghai remains serious,especially among men,and individuals aged>74 years.The benefits of the screening program have been partially proven by the ASRs of CRC incidence,providing important insights into better and wider application of screening programs.
文摘Background:The patterns of leukemia burden have dramatically changed in recent years.This study aimed to estimate the global trends of leukemiarelated death and disability-adjusted life-years(DALYs)from 1990 to 2017.Methods:The data was acquired from the latest version of the Global Burden of Disease(GBD)study.Estimated annual percentage changes(EAPCs)were calculated to estimate the trend of age-standardized rate(ASR)of death and DALYs due to leukemia and its main subtypes from 1990 to 2017.Results:Globally,the numbers of death and DALYs due to leukemia were 347.58×10^(3)(95%uncertainty interval[UI]=317.26×10^(3)-364.88×10^(3))and 11975.35×10^(3)(95%UI=10749.15×10^(3)-12793.58×10^(3))in 2017,with a 31.22% and 0.03% increase in absolute numbers from 1990 to 2017,respectively.Both of their ASR showed decreasing trends from 1990 to 2017 with the EAPCs being−1.04(95%confidence interval[CI]=(−1.10-−0.99)and−1.52(95%CI=−1.59-−1.44),respectively.Globally,the most pronounced decreasing trend of death and DALYs occurred in chronic myeloid leukemia with EAPCs of−2.76(95%CI=−2.88-−2.64)and−2.84(95%CI=−2.97-−2.70),respectively,while the trend increased in acute myeloid leukemia.The death and DALYs of leukemia decreased in most areas and countries with high socio-demographic index(SDI)including Bahrain,Finland,and Australia.Conclusions:The disease burden of death and DALYs due to leukemia decreased globally,and for most regions and countries from 1990 to 2017.However,the leukemia burden is still a substantial challenge globally and required adequate and affordable medical resources to improve the survival and quality of life of leukemia patients.
文摘Objective:To calculate the burden of road traffic accidents in Kathmandu Valley and then extrapolate this to the national level.Methods:A prospective study was performed to compute the burden of road traffic accidents by quantification of disability-adjusted life years(DALYs)using the Global Burden of Disease Study method on the basis of 1-year data from nine hospitals in Nepal and the Department of Foren-sic Medicine and cross-checked with the Nepal Traffic Directorate.Multiple methods were applied to the extrapolated population metrics of the burden of road traffic accidents in Nepal.Results:The total number of years of life lived in disability,years of life lost,and DALYs in Nepal were 38,848±194,119,935±1464,and 158,783±1658(95% confidence interval)re-spectively.The number of years lost because of morbidity and death was similar in Kathmandu Valley.Most(75%)of the DALYs resulted from years of life lost in Nepal.Males accounted for 73% of DALYs.Almost half(44%)of the DALYs were contributed by the group aged 15-29 years.Conclusion:This study is the first to calculate the burden of road traffic accidents in Nepal using Nepal’s own data.Nepal needs to develop and enhance its own system to identify significant public health issues so as to set national priorities for prevention of road traffic accidents.
文摘BACKGROUND Mental disorders have become a major contributor to the Global Burden of Disease(GBD),a situation that has worsened with the onset of the coronavirus disease 2019(COVID-19)pandemic.Updated data on their impact and a clear understanding of long-term trends are essential for global and national health authorities to implement effective prevention and intervention strategies for mental well-being.AIM To generate insights that will enhance global awareness of the burden of mental disorders and support the development of targeted,region-specific prevention and intervention strategies tailored to current global and local health challenges.METHODS We extracted data on incidence,disability-adjusted life years(DALYs),agestandardized incidence rate(ASIR),and age-standardized DALY rate(ASDR)for 12 categories of mental disorders from 1990 to 2021 across 204 countries and territories grouped into 21 regions.Trends in ASIR and ASDR were also analyzed during the COVID-19 period(2019-2021).RESULTS From 1990 to 2021,global ASIR rose by 15.23%(12.97%to 17.60%),while ASDR increased by 73.52%(70.24%to 76.71%).All 21 GBD regions saw a rise in cases and DALYs.In 2021,Central sub-Saharan Africa had the highest ASIR(8706.11),and East Asia reported the lowest(3340.99).Australasia recorded the highest ASDR(2787.87).On the national level,Greenland,Greece,United States,and Australia had the greatest ASDR values.During the pandemic years,ASIR and ASDR rose across all five socio-demographic index levels and GBD regions,with the exception of East Asia,where rates remained stable.Females experienced a higher ASDR than males in 2021.Major depressive disorder(557.87)and anxiety disorders(524.33)were the most burdensome among the 12 types,with depressive disorders ranking first in 13 out of the 21 regions.CONCLUSION The GBD study 2021 results highlight a continued and worsening global burden of mental disorders,further intensified by the COVID-19 crisis.This underscores the urgent need to reinforce mental health care systems.Special attention should be directed toward high-middle socio-demographic index areas and female populations.Expanding access to mental health services,enhancing public awareness,and delivering targeted interventions are essential to lessen the growing impact of mental disorders.
基金Supported by National Key Research and Development Program of China,No.2022YFC3600903Key Discipline Project under Shanghai's Three-Year Action Plan for Strengthening the Public Health System(2023-2025),No.GWVI-11.1-44.
文摘BACKGROUND The burden of mental disorders(MD)in the Western Pacific Region(WPR)re-mains a critical public health concern,with substantial variations across demogra-phics and countries.AIM To analyze the burden of MD in the WPR from 1990 to 2021,along with associated risk factors,to reveal changing trends and emerging challenges.METHODS We used data from the Global Burden of Disease 2021,analyzing prevalence,incidence,and disability-adjusted life years(DALYs)of MD from 1990 to 2021.Statistical methods included age-standardisation and uncertainty analysis to address variations in population structure and data completeness.RESULTS Between 1990 and 2021,the prevalence of MD rose from 174.40 million cases[95%uncertainty interval(UI):160.17-189.84]to 234.90 million cases(95%UI:219.04-252.50),with corresponding DALYs increasing from 22.8 million(95%UI:17.22-28.79)to 32.07 million(95%UI:24.50-40.68).During this period,the burden of MD shifted towards older age groups.Depressive and anxiety disorders were predominant,with females showing higher DALYs for depressive and anxiety disorders,and males more affected by conduct disorders,attention-deficit hyperactivity disorder,and autism spectrum disorders.Australia,New Zealand,and Malaysia reported the highest burdens,whereas Vietnam,China,and Brunei Darussalam reported the lowest.Additionally,childhood sexual abuse and bullying,and intimate partner violence emerged as significant risk factors.CONCLUSION This study highlights the significant burden of MD in the WPR,with variations by age,gender,and nation.The coronavirus disease 2019 pandemic has exacerbated the situation,emphasizing the need for a coordinated response.
基金the Military Program for Clinical Cultivation Specialty and Chinese Preventive Medicine Association.
文摘Objective:Children below 14 years of age are highly vulnerable to dengue infection and are at a greater risk of developing severe dengue illness.This study aimed to investigate the trends in the burden of dengue fever among children below 14 years of age in China from 1990 to 2021 and to project the disease burden from 2022 to 2035.Methods:Based on the datasets derived from the Global Burden of Disease Study 2021,the following data were collected from dengue-affected children aged ≤14 years in China from 1990 to 2021:number and rate of incident dengue cases,number of prevalent dengue cases,number of deaths due to dengue,and disability-adjusted life years(DALYs) lost due to dengue.The trends in disease burden were examined based on average annual percent change(AAPC) and annual percent change,and the burdens were proj ected from 2022 to 2035 by using a Bayesian age-period-cohort model.Results:The incidence and prevalence of dengue fever were increased in children aged ≤ 14 years in China from1990 to 2021(AAPC=5.42 % and 5.44 %,respectively,P <0.001),while the mortality and DALYs rates were reduced(AAPC=-8.21 % and-7.55 %,respectively,P <0.001).The burden was comparable between genders,with numerically lower incidence and prevalence in boys than in girls.The lowest incidence and prevalence and the highest mortality and DALYs rates were observed in children aged <5 years.The incidence and prevalence rates were projected to increase from 2022 to 2035;in contrast,the mortality and DALYs rates were projected to decrease during this period.Conclusions:Although the mortality and DALYs rates of dengue fever decreased significantly in children aged0-14 years in China from 1990 to 2021,the incidence and prevalence increased remarkably.Enhanced surveillance and ample health education programs and preventive interventions are recommended for targeting this high-risk population.
基金funded Chongqing Science and Health Joint Research Project in TCM(Grant No.2024ZYDB002).
文摘Objective:This study aimed to assess the global,regional,and national burden of early-onset gastric cancer(EOGC)and the attributable risk factors from 1990-2021 with projections extending to 2040.Methods:The EOGC burden was quantified using incidence,prevalence,mortality,and disability-adjusted life years(DALYs)with calculation of age-standardized rates.The risk factor contributions were analyzed and disparities were evaluated using the slope index of inequality.Future trends for 2021-2040 were estimated using a Bayesian age-period-cohort model.Results:There were approximately 125,000 new cases of EOGC globally in 2021 with an estimated 336,000 individuals living with EOGC and 78,000 associated deaths,contributing to 3.86 million DALYs.The highest EOGC incidence rates existed among individuals 45-49 years of age.The global age-standardized incidence,prevalence,mortality,and DALY rates demonstrated an overall decline between 1990 and 2021.Smoking and high-salt dietary intake were the leading risk factors for DALYs with regional and gender-based variations.Smoking accounted for>10% of DALYs in Central Europe and East Asia,while high-salt dietary intake accounted for approximately 8% of DALYs.Despite the overall decline in the EOGC burden,disparities across geographic regions widened.Projections indicated a continued gradual reduction in EOGC burden through 2040.Conclusion:Although the global burden of EOGC has decreased,significant disparities persist across geographic regions,age groups,and genders.Public health interventions should combine smoking prevention strategies(e.g.,youth education and tobacco taxation)with cessation programs with dietary salt reduction initiatives.
基金supported by grants from the National Natural Science Foundation of China(82000901,82171084).
文摘Background:Blindness and vision impairment(BVI)continue to pose significant global public health challenges,disproportionately impacting vulnerable populations and further widening socioeconomic disparities.This study conducts a comprehensive evaluation of the global burden of BVI and the socioeconomic inequalities in its distribution from 1990 to 2021,aiming to provide insights for targeted intervention strategies.Methods:Using data from Global Burden of Disease 2021,this study performed a multiscale analysis of BVI burden,examining patterns at the global,regional and national levels.We quantified the disease burden using disability-adjusted life years DALY and prevalence rates.Temporal trends were analyzed by calculating estimated annual percentage changes(EAPC).Stratified assessments were carried out by sex and age group across 21 regions and 204 countries.The study also included comparative analyses of six major eye conditions and evaluated their associations with socio-demographic index(SDI).Results:Globally,the age-standardized prevalence of BVI increased from 12,453.52 per million(95%UI:10,287.58-15,226.09)in 1990 to 15,784.33 per million(12,761.44-19,502.32)in 2021,with an EAPC of 1.09%(95%UI:0.97-1.20).During this period,global DALYs attributable to BVI increased by 37.7%.Disease trends exhibited significant divergence,with near vision loss showing the steepest increase(EAPC:1.47%),while the prevalence of glaucoma declined(EAPC:-0.73%).Geographic disparities were pronounced,with substantial improvements observed in Equatorial Guinea(EAPC:-1.75)and worsening burdens in Benin(+0.54).Disease distribution demonstrated strong regional clustering,with near vision loss being predominant in Sub-Saharan Africa(64.47%)and East Asia(50.97%),while cataract was the most common condition in Oceania(33.86%).Females consistently bore a higher burden,particularly in South Asia(646.3 vs 563.2 DALYs).Moreover,we identified a strong inverse correlation between SDI and BVI burden(Ρ=-0.772 for DALYs).Conclusions:This study highlights the severe global burden of BVI and the significant cross-country inequality,particularly in low-and middle-income countries.It emphasizes the urgent need for targeted interventions and the integration of eye care into universal health policies to promote global health equity in the post-pandemic era.
基金supported(in part)by the National Key Research and Development Program(2022YFC3600700)the Fundamental Research Funds for the Central Universities(2042024YXA008)the Young Top-Notch Talent Cultivation Program of Hubei Province(for Prof.Xian-Tao Zeng).
文摘Background:The burden of common urologic diseases,including benign prostatic hyperplasia(BPH),urinary tract infections(UTI),urolithiasis,bladder cancer,kidney cancer,and prostate cancer,varies both geographically and within specific regions.It is essential to conduct a comprehensive and precise assessment of the global burden of urologic diseases.Methods:We obtained data on incidence,prevalence,mortality,and disability-adjusted life-years(DALYs)for the aforementioned urologic diseases by age,sex,location,and year from the Global Burden of Disease(GBD)2021.We analyzed the burden associated with urologic diseases based on socio-demographic index(SDI)and attributable risk factors.The trends in burden over time were assessed using estimated annual percentage changes(EAPC)along with a 95%confidence interval(CI).Results:In 2021,BPH and UTI were the leading causes of age-standardized incidence rate(ASIR)and age-standardized prevalence rate(ASPR),with rates of 5531.88 and 2782.59 per 100,000 persons,respectively.Prostate cancer was the leading cause of both age-standardized mortality rate(ASMR)and age-standardized DALYs rate(ASDR),with rates of 12.63 and 217.83 per 100,000 persons,respectively.From 1990 to 2021,there was an upward trend in ASIR,ASPR,ASMR,and ASDR for UTI,while urolithiasis showed a downward trend.The middle and low-middle SDI quintile levels exhibited higher incidence,prevalence,mortality,and DALYs related to UTI,urolithiasis,and BPH,while the high and high-middle SDI quintile levels showed higher rates for the three cancers.The burden of these 6 urologic diseases displayed diverse age and sex distribution patterns.In 2021,a high body mass index(BMI)contributed to 20.07%of kidney cancer deaths worldwide,while smoking accounted for 26.48%of bladder cancer deaths and 3.00%of prostate cancer deaths.Conclusions:The global burden of 6 urologic diseases presents a significant public health challenge.Urgent international collaboration is essential to advance the improvement of urologic disease management,encompassing the development of effective diagnostic screening tools and the implementation of high-quality prevention and treatment strategies.
文摘Background:Subarachnoid hemorrhage(SAH)is a subtype of hemorrhagic stroke characterized by high mortality and low rates of full recovery.This study aimed to investigate the epidemiological characteristics of SAH between 1990 and 2021.Methods:Data on SAH incidence,mortality,and disability-adjusted life-years(DALYs)from 1990 to 2021 were obtained from the Global Burden of Disease Study(GBD)2021.Estimated annual percentage changes(EAPCs)were calculated to evaluate changes in the age-standardized rate(ASR)of incidence and mortality,as well as trends in SAH burden.The relationship between disease burden and socio-demographic index(SDI)was also analyzed.Results:In 2021,the incidence of SAH was found to be 37.09%higher than that in 1990;however,the age-standardized incidence rates(ASIRs)showed a decreased[EAPC:-1.52;95%uncertainty interval(UI)-1.66 to-1.37].Furthermore,both the number and rates of deaths and DALYs decreased over time.It was observed that females had lower rates compared to males.Among all regions,the high-income Asia Pacific region exhibited the highest ASIR(14.09/100,000;95%UI 12.30/100,000-16.39/100,000)in 2021,with an EPAC for ASIR<0 indicating decreasing trend over time for SAH ASIR.Oceania recorded the highest age-standardized mortality rates(ASMRs)and age-standardized DALYs rates among all regions in 2021 at values of respectively 8.61(95%UI 6.03-11.95)and 285.62(95%UI 209.42-379.65).The burden associated with SAH primarily affected individuals aged between 50-69 years old.Metabolic risks particularly elevated systolic blood pressure were identified as the main risk factors contributing towards increased disease burden associated with SAH when compared against environmental or occupational behavioral risks evaluated within the GBD framework.Conclusions:The burden of SAH varies by gender,age group,and geographical region.Although the ASRs have shown a decline over time,the burden of SAH remains significant,especially in regions with middle and low-middle SDI levels.High systolic blood pressure stands out as a key risk factor for SAH.More specific supportive measures are necessary to alleviate the global burden of SAH.
文摘Objective Asthma imposes a significant global health burden.This study examines changes in the asthma-related disease burden from 1990 to 2021 and projects future burdens for 2050 under different scenarios.Methods Using data from the Global Burden of Disease 2021 study,we analyzed asthma incidence,prevalence,mortality,and disability-adjusted life years(DALYs)from 1990 to 2021.We projected the disease burden for 2050 based on current trends and hypothetical scenarios in which all risk factors are controlled.Temporal trends in age-standardized incidence,prevalence,mortality,and DALY rates were explored using Annual Percent Change.Results In 2021,the age-standardized rates for asthma incidence,prevalence,mortality,and DALYs in China were 364.17 per 100,000(95%uncertainty interval[UI]:283.22-494.10),1,956.49 per 100,000(95%UI:1,566.68-2,491.87),1.47 per 100,000(95%UI:1.15-1.79),and 103.76 per 100,000(95%UI:72.50-145.46),respectively.A higher disease burden was observed among Chinese men and individuals aged 70 years or older.Compared to the current trend,a combined scenario involving improvements in environmental factors,behavioral and metabolic health,child nutrition,and vaccination resulted in a greater reduction in the disease burden caused by asthma.Conclusion Addressing modifiable risk factors is essential for further reducing the asthma-related disease burden.
基金funded by the National Natural Science Foundation of China(Grant No.82273721)Capital’s Funds for Health Improvement and Research(Grant No.2024-1G-4023)。
文摘Objective:This study aimed to provide a comprehensive overview of the global burden of esophageal cancer(EC)and determine the temporal trends and factors influencing changes in the global burden.Methods:The latest incidence and mortality data for EC worldwide were obtained from GLOBALCAN 2022.The mortality and disability-adjusted life years(DALYs)rates for EC from 1990±2019 were sourced from the 2019 Global Burden of Diseases.Trends in EC mortality and DALYs attributable to 11 risk factors or clusters of risk were analyzed using the joinpoint regression model.The trends in age-related EC burden were assessed using a decomposition approach.Results:An estimated 511,054 new cases of EC were diagnosed in 2022 with 445,391 deaths worldwide.Approximately 75%of cases and deaths occurred in Asia.Nearly 50%of global EC deaths and DALYs were attributed to tobacco use in men in 2019,while 20%were attributed to high body mass index(BMI)in women.From 1990±2019,EC deaths and DALYs attributable to almost all risk factors had declining trends,while EC deaths and DALYs attributed to high BMI in men had upward trends.The age-related EC burden exhibited an upward trend driven by population growth and aging,which contributed to 307.4 thousand deaths and 7.2 million DALYs due to EC.Conclusions:The EC burden remains substantial worldwide.Effective tobacco and obesity control measures are critical for addressing the risk-attributable burden of EC.Population growth and aging pose challenges for EC prevention and control efforts.
基金Supported by National Natural Science Foundation of China,No.82260532,and No.32060208.
文摘BACKGROUND Colorectal cancer(CRC)plays a significant role in morbidity,mortality,and economic cost in the Belt and Road Initiative(“B and R”)countries.In addition,these countries have a substantial consumption of processed meat.However,the burden and trend of CRC in relation to the consumption of a diet high in processed meat(DHPM-CRC)in these“B and R”countries remain unknown.AIM To analyze the burden and trend of DHPM-CRC in the“B and R”countries from 1990 to 2019.METHODS We used the 2019 Global Burden of Disease Study to collate information regarding the burden of DHPM-CRC.Numbers and age-standardized rates(ASRs)of deaths along with the disability-adjusted life years(DALYs)were determined among the“B and R”countries in 1990 and 2019.Using joinpoint regression analysis,the average annual percent change(AAPC)was used to analyze the temporal trends of age-standardized DALYs rate(ASDALR)from 1990 to 2019 and in the final decade(2010–2019).RESULTS We found geographical differences in the burden of DHPM-CRC among“B and R”countries,with the three highest-ranking countries being the Russian Federation,China,and Ukraine in 1990,and China,the Russian Federation,and Poland in 2019.The burden of DHPM-CRC generally increased in most member countries from 1990 to 2019(all P<0.05).The absolute number of deaths and DALYs in DHPM-CRC were 3151.15[95%uncertainty interval(UI)665.74-5696.64]and 83249.31(95%UI 15628.64-151956.31)in China in 2019.However,the number of deaths(2627.57-2528.51)and DALYs(65867.39-55378.65)for DHPM-CRC in the Russian Federation has declined.The fastest increase in ASDALR for DHPM-CRC was observed in Vietnam,Southeast Asia,with an AAPC value of 3.90%[95%confidence interval(CI):3.63%-4.16%],whereas the fastest decline was observed in Kyrgyzstan,Central Asia,with an AAPC value of-2.05%(95%CI:-2.37%to-1.73%).A substantial upward trend in ASR of mortality,years lived with disability,years of life lost,and DALYs from DHPM-CRC changes in 1990-2019 and the final decade(2010-2019)for most Maritime Silk Route members in East Asia,South Asia,Southeast Asia,North Africa,and the Middle East,as well as Central Europe,while those of the most Land Silk Route members in Central Asia and Eastern Europe have decreased markedly(all P<0.05).The ASDALR for DHPM-CRC increased more in males than in females(all P<0.05).For those aged 50-74 years,the ASDALR for DHPM-CRC in 40 members exhibited an increasing trend,except for 20 members,including 7 members in Central Asia,Maldives,and 12 high or high-middle social development index(SDI)members in other regions(all P<0.05).CONCLUSION The burden of DHPM-CRC varies substantially across“B and R”countries and threatens public health.Relevant evidence-based policies and interventions tailored to the different trends of countries in SDIs or Silk Routes should be adopted to reduce the future burden of CRC in“B and R”countries via extensive collaboration.
基金supported by the National Key Research and Devel-opment Program of China(grant number:2021YFF1201300)CAMS Innovation Fund for Medical Sciences(grant number:2021-I2M-1-014).
文摘Objective:To analyze the impact of global population aging on cancer epidemiology,with a focus on the incidence and mortality rates among individuals aged 60 years and above.Methods:We utilized open-source data,retrieving population age estimates from the United Nations Population Division website.The GLOBOCAN 2020 database provided estimates for cancer cases and deaths in 2020 and 2040,while the Global Burden of Disease 2019 database supplied estimates of new cancer cases worldwide from 2000 to 2019.Inclusion criteria considered individuals aged 60 years and over,focusing on the top five deadliest cancers.The cohort-component method was employed for population prediction,with age-specific incidence and mortality rates estimated for 2020 used to forecast the cancer burden.Results:In 2021,the global population aged over 60 years accounted for 13.7%,with Europe/North America and Australia/New Zealand having the highest proportions.The older population is predicted to reach 19.2%by 2040.In 2020,of the 19.3 million new cancer cases worldwide,64%occurred in individuals aged 60 and above,contributing to 71.3%of cancer-related deaths.The five most common cancer sites were the lung,colorectum,prostate,breast,and stomach.Cancer incidence and deaths are projected to rise significantly among older indi-viduals,reaching 20.7 million new cases and 12.7 million deaths by 2040.Older age,tobacco use,dietary factors,alcohol consumption,and high body mass index(BMI)were identified as major risk factors for various cancers in this demographic.Conclusions:This study reveals a significant rise in cancer incidence and mortality among the elderly due to global population aging.The urgency for targeted interventions in cancer prevention,screening,and treatment for older individuals is emphasized.Despite acknowledged limitations,these findings contribute valuable insights to inform strategies for managing cancer in the elderly amidst evolving demographic trends.
基金Nanjing Medical Science and Technique Development Foundation,No.YKK22195National Natural Science Foundation of China,No.52078254.
文摘BACKGROUND Although gastrointestinal(GI)cancers have been becoming a great public health concern in China,there is currently a lack of comprehensive literature on the overall burden and changing trends of GI cancers in the working-age population.AIM To assess the burden of GI cancers and to examine the overall,age-and genderspecific trends among the working-age population in China from 1990 to 2019.METHODS Data were extracted from the Global Burden of Disease Study 2019.The burden of GI cancers was indicated by incidence,mortality,disability-adjusted life-years(DALYs),age-standardized incidence rate(ASIR),age-standardized mortality rate,and age-standardized DALYs rate.Trends in the burden of GI cancers from 1990 to 2019 were examined using annual percent change and average annual percent change with Joinpoint regression models.RESULTS For overall GI cancers,a declining trend was observed in the ASIR,age-standardized mortality rate,and agestandardized DALYs rate,with reductions of 0.74%,2.23%,and 2.22%,respectively,from 1999 to 2019 in the Chinese working-age population.However,an increasing trend was observed in the ASIR for overall GI cancers from 2016-2019.The number of either incident cases,mortality cases,and DALYs was higher for colon/rectum cancer and liver cancer in younger participants but lower for esophageal,gallbladder,biliary tract,pancreatic,and stomach cancer among older subjects.Moreover,sex disparity in the GI cancers burden was also examined over 30 years.CONCLUSION The total burden of GI cancers remained heavy among the working-age population in China,although declining trends were observed from 1999 to 2019.Disparities in the GI cancers burden existed between sexes,age groups,and cancer types.Population-based precision prevention strategies are needed to tackle GI cancers among working-age individuals,considering the age,sex,and cancer type disparities in China.
基金supported by the National Key Research and Development Plan of China(Technology helps Economy 2020)the Fundamental Research Funds for the Central Universities(2042020kf1081)+2 种基金the Nature Science Foundation of Hubei Province(2019CFB760)the Translational Medicine and Interdisciplinary Research Joint Fund of Zhongnan Hospital of Wuhan University(ZNJC201917)the Health Commission of the Hubei Province Scientific Research Project(WJ2019H035)。
文摘Background:Urinary tract infections(UTI),urolithiasis,and benign prostatic hyperplasia(BPH)are three of the most common nonmalignant conditions in urology.However,there is still a lack of comprehensive and updated epidemiological data.This study aimed to investigate the disease burden of UTI,urolithiasis,and BPH in 203 countries and territories from 1990 to 2019.Methods:Data were extracted from the Global Burden of Disease 2019,including incident cases,deaths,disabilityadjusted life-years(DALYs)and corresponding age-standardized rate(ASR)from 1990 to 2019.Estimated annual percentage changes(EAPC)were calculated to evaluate the trends of ASR.The associations between disease burden and social development degrees were analyzed using a sociodemographic index(SDI).Results:Compared with 1990,the incident cases of UTI,urolithiasis,and BPH increased by 60.40%,48.57%,and 105.70%in 2019,respectively.The age-standardized incidence rate(ASIR)of UTI increased(EAPC=0.08),while urolithiasis(EAPC=–0.83)and BPH(EAPC=–0.03)decreased from 1990 to 2019.In 2019,the age-standardized mortality rate(ASMR)of UTI and urolithiasis were 3.13/100,000 and 0.17/100,000,respectively.BPH had the largest increase(110.56%)in DALYs in the past three decades,followed by UTI(68.89%)and urolithiasis(16.95%).The burden of UTI was mainly concentrated in South Asia and Tropical Latin America,while the burden of urolithiasis and BPH was recorded in Asia and Eastern Europe.Moreover,the ASIR and SDI of urolithiasis in high-SDI regions from 1990to 2019 were negatively correlated,while the opposite trend was seen in low-SDI regions.In 2019,the ASIR of UTI in females was 3.59 times that of males,while the ASIR of urolithiasis in males was 1.96 times higher than that in females.The incidence was highest in the 30–34,55–59,and 65–69 age groups among the UTI,urolithiasis,and BPH groups,respectively.Conclusions:Over the past three decades,the disease burden has increased for UTI but decreased for urolithiasis and BPH.The allocation of medical resources should be based more on the epidemiological characteristics and geographical distribution of diseases.
基金supported by the Foundation of Major Science and Technology Program for Water Pollution Control and Treatment (No. 2009ZX07419-002)the National Natural Science Foundation of China (No. 50778171,50809066, 20807013)
文摘The occurrence and risks of Giardia in China have been unclear to date,which has made it difficult to properly manage source water as well as to create reasonable drinking water standards.The levels of Giardia in river networks of several cities in Zhejiang Province,China were found to be in the range of 0-5 oocysts/10 L in the rainy season in 2008.The mortality due to Giardia infection for people in this region was calculated to be from 0 to 1.95 × 10？8 persons using a conditional probability equation.Based on multiple unboiled water intake routes,the disability-adjusted life years（DALYs） due to Giardia infection for people who consumed conventionally treated water was 0.625（95% CI：0.137-2.05） per 105 persons,with the symptom of hospitalization making the highest contribution to total DALYs（0.56 per 105 persons;95% CI：0.122-1.84）.The DALYs decreased to 0.425（95% CI：0.137-2.05） per 105 persons per year for those consuming water treated with advanced technology.These values were lower than the acceptable risk（1.97 × 10？5 DALYs per year）.This study revealed the risk of Giardia infection to the people in river networks of Zhejiang Province for the first time,and provides a method to evaluate the risk of Giardia infection.The results are useful for the modification of drinking water quality standards based on cost-benefit analysis.
基金supported by the Centre for Health Statistics Information,National Health and Family Planning Commission of the People’s Republic of China
文摘Objective To estimate the lung cancer burden that may be attributable to ambient fine particulate matter （PM2.5） pollution in Guangzhou city in China from 2005 to 2013. Methods The data regarding PM2.5 exposure were obtained from the ＆#39;Ambient air pollution exposure estimation for the Global Burden of Disease 2013＇ dataset at 0.1° ×0.1° spatial resolution. Disability-adjusted life years （DALYs） were estimated based on the information of mortality and incidence of lung cancer. Comparative risk analysis and integrated exposure-response function were used to estimate attributed disease burden. Results The population-weighted average concentration of PM2.5 was increased by 34.6% between 1990 and 2013, from 38.37 μg/m3 to 51.31 μg/m^3. The lung cancer DALYs in both men and women were increased by 36.2% from 2005 to 2013. The PM2.5 attributed lung cancer DALYs increased from 12105.0 （8181.0 for males and 3924.0 for females） in 2005 to 16489.3 （11291.7 for males and 5197.6 for females） in 2013. An average of 23.1% lung cancer burden was attributable to PM2.5 pollution in 2013. Conclusion PM2.5 has caused serious but under-appreciated public health burden in Guangzhou and the trend deteriorates. Effective strategies are needed to tackle this major public health problem.
