Disease burden of asbestos-related diseases in China (1990\u20132023) based on GBD estimates: A call for stronger labor protection laws

Asbestos exposure remains a persistent occupational hazard in China, yet updated national estimates of asbestos-related diseases (ARDs) after 2019 are scarce. This study quantified long-term trends and demographic patterns of ARDs from 1990 to 2023 using Global Burden of Disease data and joinpoint regression. We analyzed incidence, prevalence, deaths, and disability-adjusted life years (DALYs) for asbestosis and asbestos-attributable cancers (mesothelioma, tracheal/bronchus/lung cancer, laryngeal cancer, and ovarian cancer). Absolute numbers and age-standardized rates were assessed overall and stratified by sex and age. joinpoint regression identified significant temporal inflection points. The absolute burden of ARDs increased continuously from 1990 to 2023. Age-standardized prevalence and incidence rates of asbestosis peaked in 2001, while mortality and DALY rates peaked in 2004. Major turning points for asbestos-attributable cancers occurred around 2010-2011, marking historical peaks followed by declines. A modeled increase in mortality and DALYs was observed from 2020 to 2022 across nearly all ARDs. Males consistently demonstrated higher burdens than females, and older adults (≥65 years) carried the greatest burden, with a secondary mesothelioma peak at 55-59 years in males. Although ARD indicators have declined from historical peaks, a statistically modeled increase was observed in 2020-2022, warranting continued public-health attention. These findings aim to provide evidence for clinicians, epidemiologists, and policymakers to strengthen occupational disease prevention, reinforce labor protection laws, and improve asbestos-control policies in China.

Global Disease Burden From Acute Glomerulonephritis 1990–2019

Objective: To assess the trends in the burden of periodontal disease among individuals aged 60 years and above in China from 1990 to 2021, thereby providing a scientific foundation for the development of targeted prevention and control strategies for periodontal disease in the elderly. Methods: Utilizing data from the Global Burden of Disease Study 2021 (GBD 2021), key indicators including incidence, prevalence, and disability-adjusted life years (DALY) rates were analyzed. Age-standardized rates were determined using the global standard population. Trends in the disease burden of periodontal disease among the elderly population in China from 1990 to 2021 were analyzed using Joinpoint regression analysis, and an autoregressive integrated moving average (ARIMA) model was applied to forecast the disease burden from 2022 to 2036. Results: The annual average percentage changes (AAPC) in the number of incident cases, prevalent cases, and DALYs due to periodontal disease among individuals aged 60 years and above in China from 1990 to 2021 were 3.215% (95%CI: 3.149%-3.281%, P<0.05), 3.161% (95%CI:3.037%-3.286%, P<0.05), and 3.091%(95%CI: 2.887%-3.296%, P<0.05), respectively. The results indicated that the average annual change trends of the number of incident cases, number of prevalent cases, and number of DALYs were real upward trends. Compared with other age groups, the number of incident cases, prevalent cases, and DALYs were the highest among the population aged 60-69 years. The AAPC for age-standardized incidence rate, prevalence, and DALY rates were -0.012% (95%CI:-0.031%-0.008%, P>0.05), 0.023% (95%CI:-0.070%-0.116%, P>0.05), and 0.013% (95%CI:-0.089%-0.115%, P>0.05), respectively. This indicated that the average annual change trends of the age-standardized incidence rate, age-standardized prevalence rate, and age-standardized DALY rate might be caused by random fluctuations. Males exhibited higher prevalence and DALY rates than females across all age groups (P<0.05), whereas the incidence rates showed minimal differences between males and females across all age groups. The ARIMA forecast model indicated that the age-standardized incidence rate among males in the elderly population in China was relatively stable, while that among females showed a downward trend; the age-standardized prevalence and DALY rates followed a pattern of "decline-rise-decline". Conclusions: The disease burden of periodontal disease among Chinese adults aged 60 and above showed an overall upward trend from 1990 to 2021, with males and individuals aged 60-69 identified as high-risk groups. With the exacerbation of aging, the prevention and control situation remains severe, necessitating the implementation of gender-differentiated interventions to reduce the disease burden.

We recently read the article by Shin YH et al., utilizing the Global Burden of Disease Study (GBD) 2019 to analyze the trends in the global burden of asthma and atopic dermatitis (AD) from 1990 to 2021 [1]. This study found that while the total number of cases has been increasing, the age-standardized prevalence rates have been declining. Given that the GBD has been updated to the 2021 version [2], it is essential to uncover the latest burden of asthma and AD. Therefore, we analyzed the prevalence, incidence, mortality, and disability-adjusted life years (DALYs) for asthma and AD, focusing exclusively on the data from 2021. Specifically, we conducted a cross-sectional analysis of the age-, sex-, and socio-demographic index (SDI)-specific burden, which is crucial for understanding the burden and informing strategies for prevention, control, and treatment. It is important to note that the GBD does not provide mortality data for AD. Consequently, our analysis and the presented figures do not include mortality data for this condition. In 2021, the highest age-standardized prevalence (ASP) and age-standardized incidence rate (ASIR) for asthma were observed in the High-income North America region, whereas the highest age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life years (DALY) rate (ASDR) were reported in the Oceania region. For AD, the highest ASP, ASIR, and ASDR were all recorded in the High-income Asia Pacific region (Figure 1; Figure S1). In terms of age distribution, the ASP and ASIR of asthma are primarily concentrated in children and adolescents, whereas the ASMR and ASDR are predominantly observed in the elderly population. In contrast, the disease burden of AD is mainly concentrated in children and adolescents (Figure 2). Regarding gender differences, no significant disparities are observed in the burden of asthma between males and females. However, the burden of AD is notably higher in females compared with males, which may be attributed to multifaceted etiology, encompassing culturally idealized expectations of appearance for females, hormonal influences such as the impact of sex hormones on immune responses and skin barrier function and genetic predispositions with a spotlight on filaggrin gene mutations (Figure 2) [3-5]. When stratified by SDI, the ASP and ASIR of asthma are significantly higher in high-SDI regions than in low-SDI regions, whereas the ASMR and ASDR of asthma are markedly higher in low-SDI regions than in high-SDI regions, which is due to limited access to and affordability of essential asthma treatment medications, leading to severe morbidity [6]. On the contrary, the disease burden of AD is predominantly concentrated in high-SDI regions (Figure S2). Overall, our study underscores the heterogeneity in the burden of asthma and AD across different age groups, genders, and socio-demographic regions. Addressing these disparities requires targeted strategies that consider the specific drivers of burden in each context. For asthma, this should include improving access to preventive care and treatment in lower-income regions, while for AD, interventions aimed at early childhood may be most effective. Additionally, to effectively manage AD, key interventions include regular moisturization to maintain skin hydration and the use of emollients to repair the skin barrier. It is also crucial to avoid irritants and allergens, modify bathing practices by using lukewarm water and gentle, fragrance-free cleansers, and consider environmental controls such as maintaining optimal indoor humidity levels to prevent skin dryness and irritation. Our findings highlight the importance of context-specific interventions and underscore the need for continued monitoring and research to effectively reduce the burden of these common allergic diseases. We appreciate the excellent works by the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 collaborators. The authors have nothing to report. The authors have nothing to report. The authors declare no conflicts of interest. Data sources and code used in the Global Burden of Disease Study 2021 are available on the internet (http://ghdx.healthdata.org/gbd-results-tool). The data presented is unpublished elsewhere and are not duplicated. Figure S1. Age-standardized rates of prevalence, incidence, mortality and DALYs of asthma and atopic dermatitis in 2021 in 21 GBD regions. Error bars indicate the 95% uncertainty interval for age-standardized rates. Abbreviations: Age-standardized prevalence (ASP); Age-standardized incidence rate (ASIR); Age-standardized mortality rate (ASMR); Age-standardized disability-adjusted life years (DALY) rate (ASDR). Figure S2. Age-standardized rates of prevalence, incidence, mortality and DALYs of asthma and atopic dermatitis in 2021 in five SDI regions. Error bars indicate the 95% uncertainty interval for age-standardized rates. Abbreviations: Age-standardized prevalence (ASP); Age-standardized incidence rate (ASIR); Age-standardized mortality rate (ASMR); Age-standardized disability-adjusted life years (DALY) rate (ASDR). Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

BackgroundDementia, predominantly Alzheimer's disease, poses a growing public health challenge in low- and middle-income countries like Kenya. This is driven by rapid population aging and rising prevalence of non-communicable diseases. Understanding trends in dementia burden is essential for informing healthcare planning and preventive strategies.ObjectiveThis study aimed to analyze trends in dementia burden in Kenya from 1990 to 2021 using the Global Burden of Disease (GBD) data, comparing estimates with sub-Saharan Africa, Africa, and global benchmarks, while assessing modifiable risk factors and projecting to 2050.MethodsSecondary analysis of GBD 2021 data examined age-standardized incidence, prevalence, mortality, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life years (DALYs) for Alzheimer's disease and other dementias in Kenya, disaggregated by age and sex. Joinpoint regression calculated average annual percent changes (AAPC); autoregressive integrated moving average (ARIMA) models forecasted prevalence, mortality, and DALYs to 2050.ResultsIn 2021, Kenya's age-standardized prevalence rate (ASPR) was 605.1 per 100,000 (95% UI: 525.2-689.5), exceeding SSA (529.5) and Africa (590.0) but below global (694.0); incidence was 105.1 (95% UI: 91.6-119.6). Females bore higher burdens across metrics (e.g., ASPR: 697.1 vs. 459.4 in males). From 1990-2021, ASPR and incidence declined (AAPC: -0.14% to -0.21%, p < 0.001), while DALYs (AAPC: 0.19%-0.23%, p < 0.001) and mortality (AAPC: 0.29%-0.36%, p < 0.001) rose, driven by YLLs.ConclusionsDespite declining age-standardized incidence and prevalence, rising mortality and DALYs signal escalating dementia burden in Kenya, amplified by metabolic risks and aging. Females face disproportionate impacts. Urgent integration of risk reduction into primary care, enhanced surveillance, and culturally tailored strategies per the Nairobi Declaration are needed to mitigate future challenges in low- and middle-income countries.

Global, regional and national burden of rheumatoid arthritis 1990–2017: a systematic analysis of the Global Burden of Disease study 2017

Rheumatoid arthritis (RA) significantly drives global morbidity and mortality, yet its evolving impact in low- and middle-income countries remains underexplored. This study harnesses extensive global burden of disease (GBD) data to delineate the temporal trends of RA burden in the Islamic Republic of Pakistan from 1990 to 2021, examine its association with socio-demographic development, and forecast future trajectories through 2036. This retrospective epidemiological study quantified RA disease metrics in Pakistan through GBD data interrogation. Joinpoint regression modeling delineated temporal trajectories, calculating average annual percent change (AAPC) with 95% confidence intervals (CIs). Spearman’s rank correlation assessed the relationship between socio-demographic index (SDI) values and age-standardized rates (ASRs) of RA across 204 regions. A Bayesian age–period–cohort (BAPC) model was employed to project RA burden trends in Pakistan from 2022 to 2036. Stratified comparative assessments revealed age- and sex-specific demographic disparities. Although age-standardized incidence rate (ASIR) and age-standardized prevalence rate (ASPR) exhibited modest declines (AAPC: -0.10% and − 0.09%, respectively), the absolute numbers of incident and prevalent RA cases increased markedly—from 8,606 to 19,454 and from 134,628 to 318,963, respectively—between 1990 and 2021. Mortality rates showed a slight upward trend (AAPC: 0.35%), with total deaths rising from 478 to 1,006, while Disability-adjusted life years (DALYs) nearly doubled, increasing from 27,314 to 62,774. Age-specific analyses revealed peak incidence among younger individuals (20–24 years) and higher mortality and DALYs among older populations, particularly those aged 75 and above. Additionally, females consistently experienced a greater burden across all metrics compared to males. SDI exhibited significant positive correlations with ASIR (r = 0.42), ASPR (r = 0.47), age-standardized mortality rate (ASMR) (r = 0.32), and age-standardized DALYs rate (ASDR) (r = 0.46; all p < 0.001), indicating that higher socio-demographic development was associated with a greater documented RA burden. BAPC projections forecast a gradual decline in age-standardized RA rates through 2036, although absolute case numbers are expected to remain high owing to population growth and demographic aging. The RA burden in Pakistan has escalated over the past three decades, with higher-SDI regions demonstrating disproportionately greater age-standardized rates and documented cases. Despite anticipated per-capita declines in RA incidence, prevalence, mortality, and DALYs by 2036, demographic shifts will likely sustain a substantial absolute burden. These findings emphasize the necessity of precise public health measures to advance early diagnosis, optimize disease management, and reinforce prevention—particularly in rapidly developing areas and among high-risk groups such as women and the elderly.

SummaryObjectivesParkinson’s disease (PD) has become a public health concern with global ageing. With a focus on PD, this study sought to project its burden and trends at the national, regional and worldwide levels between 1990 and 2021.Study designPopulation-based study.MethodsThe Global Burden of Disease (GBD) 2021 provided the PD burden data. The GBD data are considered globally and regionally representative, as it integrates multiple data sources and employs standardised estimation methods. The age-standardised rate (ASR) and estimated annual percentage change (EAPC) were used to estimate trends in the incidence, prevalence, mortality and disability-adjusted life years (DALYs) of PD from 1990 to 2021. ASR was used to calculate the EAPCs using a linear regression model. A Bayesian age-period-cohort model was used to predict future trends up to 2046.ResultsGlobally, the overall ASR of PD incidence, prevalence, DALYs and mortality increased from 1990 to 2021. The EAPCs were 1.09 (95% CI: 1.07 to 1.11) for incidence, 1.52 (95% CI: 1.49 to 1.54) for prevalence, 0.32 (95% CI: 0.28 to 0.36) for DALYs and 0.18 (95% CI: 0.13 to 0.23) for mortality. The incidence, prevalence, mortality and DALYs of PD in 2021 were higher in men than in women. The age-standardized incidence rate (ASIR) was 18.52 per 100 000 in men and 12.92 per 100 000 in women (EAPC: 1.11, 95% CI: 1.09 to 1.13 vs 1.07, 95% CI: 1.05 to 1.09). The age-standardized prevalence rate (ASPR) was 157.42 per 100 000 in men and 121.84 per 100 000 in women (EAPC: 1.70, 95% CI: 1.67 to 1.73 vs 1.25, 95% CI: 1.22 to 1.27). The ASMR was 6.57 per 100 000 in men and 3.59 per 100 000 in women (EAPC: 0.21, 95% CI: 0.14 to 0.28 vs −0.01, 95% CI: −0.04 to 0.03). The ASDR was 97.12 per 100 000 in men and 81.23 per 100 000 in women (EAPC: 0.37, 95% CI: 0.33 to 0.42 vs 0.14, 95% CI: 0.10 to 0.18). From 1990 to 2021, the burden of PD remained consistently higher in men than in women, with the gender difference widening with age. The prevalence, incidence, DALYs and mortality rates of PD increased with age before declining, peaking in the 80–84 age group for prevalence and incidence, while peaking in the 90–94 age group for mortality. DALY rates peaked in the 85–89 age group. The ASR of incidence and prevalence increased significantly in Norway (EAPC=3.39, 95% CI: 3.15 to 3.64; EAPC=5.04, 95% CI: 4.65 to 5.43). Lesotho was the nation with the highest rise in age-standardised DALYs for PD (EAPC=1.67, 95% CI: 1.41 to 1.93). The United Arab Emirates had the fastest increase in age-standardised mortality for PD (EAPC=1.98, 95% CI: 1.24 to 2.71). The global ASPR of PD is projected to show a continuous upward trend.ConclusionsFrom 1990 to 2021, there were rising trends in the prevalence and burden of PD in most areas and nations worldwide. Our research indicates that the management and control of PD need significant improvement, particularly in light of the ageing population.

Objective: To explore the trend of disease burden of degenerative mitral valve disease (DMVD) in the Chinese population from 1990 to 2019. Methods: Based on the 2019 Global Burden of Disease database (GBD 2019), the number of patients, the number of new cases, the number of deaths, the disability-adjusted life years (DALY) as well as the prevalence, incidence and death rate, DALY rate and their age-standardized rates were used to analyze the trend of the burden of DMVD in the Chinese population from 1990 to 2019. Results: In 2019, the number of patients, the number of new cases, and the number of deaths with DMVD in China were 461.2, 27.0 and 0.129 ten thousand, respectively, which increased by 209.0%, 199.1% and 13.2% when compared with 1990. In 2019, the age-standardized prevalence, incidence and death rate were 228.1/100 000, 12.7/100 000 and 0.075/100 000, respectively. Compared with 1990, the change of the age-standardized prevalence, incidence and death rate were 32.6%, 42.8% and -54.1%, respectively. In addition, the 2019 data also showed that the age-standardized prevalence and incidence were higher in females than in males (the age-standardized prevalence was 190.1 (181.5-198.9)/100 000 for males and 262.0 (250.3-273.9)/100 000 for females); the age-standardized incidence was 10.5 (10.0-11.0)/100 000 for males and 14.9 (14.3-15.6)/100 000 for females. The age group with the largest number of DMVD patients was 65 to 69 years old, and the highest incidence was 60 to 64 years old. From 1990 to 2019, DALY caused by DMVD showed an upward trend in China, from 46 439 person-years in 1990 to 69 402 person-years in 2019, with an increase of 49.4%. While the age-standardized DALY rate continued to decline, from 5.5/100 000 in 1990 to 3.8/100 000 in 2019, with a drop of 30.8%. The DALY and the age-standardized DALY rate of females were always higher than that of males in different years. Conclusion: From 1990 to 2019, DALY and the age-standardized prevalence and incidence of DMVD in China shows an increasing trend, and the disease burden caused by DMVD is severe in China.

Analysis of global prevalence, DALY and trends of inflammatory bowel disease and their correlations with sociodemographic index: Data from 1990 to 2019

This study outlines the changes in the age- and sex-specific burden of motor neuron disease (MND) in China from 1990 to 2021, focusing on the prevalence, incidence, number of disability-adjusted life years and mortality. Additionally, these trends are evaluated in comparison to the Global Burden of Disease data. Public data from the Global Burden of Disease database covering the period from 1990 to 2021 were analyzed to explore the burden of motor neuron disease in China and worldwide. Trends in prevalence, incidence, disability-adjusted life years (DALYs) and mortality were examined in the analysis. The average annual percentage change was calculated using Joinpoint, and the relevant 95% confidence intervals (95% CIs) were examined to identify changes in the MND burden over time. Additionally, a thorough comparative analysis was performed to investigate the differences in the MND burden between China and other regions worldwide, considering factors such as age, sex, and time periods. From 1990 to 2021, the age-standardized incidence rate (ASIR) of motor neuron disease (MND) in China declined from 0.65 per 100,000 to 0.46 per 100,000, whereas the global ASIR decreased slightly from 0.81 per 100,000 to 0.77 per 100,000. In contrast, the age-standardized prevalence rate (ASPR) in China increased from 2.131 per 100,000 to 2.298 per 100,000, whereas the global ASPR decreased slightly from 3.356 per 100,000 to 3.31 per 100,000. The age-standardized mortality rate (ASMR) in China increased from 0.151 per 100,000 to 0.181 per 100,000; the global ASMR also increased from 0.38 per 100,000 to 0.46 per 100,000 during this period. Moreover, the age-standardized disability-adjusted life year (ASDR) rate in China decreased slightly from 7.995 per 100,000 to 7.672 per 100,000, whereas the global ASDR increased from 11.221 per 100,000 to 12.167 per 100,000. The average annual percentage changes (AAPCs) for the ASPR, ASIR, ASDR, and ASMR in China were -1.10%, 0.25%, 0.57%, and -0.14%, respectively. In contrast, the global AAPCs were -0.16%, -0.04%, 0.58%, and 0.26%, respectively. Age and sex played distinct roles in shaping MND burden. The ASIR of MND decreased but then increased for both sexes, remaining higher for males. Its ASPR trends differed: a slight increase in males versus an increase then decrease in females. While the ASMR was consistently higher for males, the DALYs for males started to decrease but surpassed those for females. Global MND rates have remained stable. The prevalence, incidence, DALYs and mortality of motor neuron disease in China decreased between 1990 and 2021, suggesting a relative decrease in the total burden of MND in the country. Age influences the burden of MND, with a higher occurrence incidence in children and middle-aged individuals; the prevalence of MND is highest in the younger population, whereas MND-related mortality is the highest within the middle-aged and senior populations. Compared with females, males are more likely to be affected by MND and have a greater likelihood of death. Given the rapid population aging in China, MND is expected to remain a significant public health issue.

Global, regional, and national burden of interstitial lung disease and pulmonary sarcoidosis from 1990 to 2023, and projections to 2050: A systematic analysis for the Global Burden of Disease Study 2023

BackgroundMigraine is a common neurological disorder that has become an increasingly significant public health issue. This study aims to analyze the burden of migraine in China and globally from 1990 to 2021, exploring epidemiological trends and differences, thus providing scientific evidence for migraine prevention and control.MethodsBased on the 2021 Global Burden of Disease (GBD) study, we assessed migraine burden in China and globally from 1990 to 2021 using indicators including incidence, prevalence, disability-adjusted life years (DALYs), and age-standardized rates. The epidemiological trends were analyzed by calculating the estimated annual percentage change (EAPC). Health inequality analysis was conducted to explore the association between migraine burden and the sociodemographic index (SDI). Decomposition analysis quantified contributions of age structure, population growth, and epidemiological changes to migraine burden. Additionally, the Bayesian Age-Period-Cohort (BAPC) model was applied to predict migraine burden in China and globally over the next 10 years.ResultsCompared with 1990, the number of migraine cases, prevalence, and DALYs in both China and globally significantly increased by 2021, though the global growth rate was considerably higher. Between 1990 and 2021, China experienced greater increases in age-standardized incidence rates (ASIR), age-standardized prevalence rates (ASPR), and age-standardized DALYs rates (ASDR) than the global average. Migraine burden was predominantly concentrated among adolescents and young adults, and females consistently exhibited a higher burden than males. Health inequality analysis revealed increasing disparity across 204 countries and regions, with a concentrated migraine burden in high socio-demographic index (SDI) countries, positively correlated with SDI. Decomposition analysis indicated that population growth was the primary driver of migraine burden changes in both China and globally. BAPC modeling predicted that the age-standardized incidence, prevalence, and DALY rates for migraine will continue to rise in China, whereas these rates are expected to slightly decline globally.ConclusionsMigraine burden is rising in both China and globally, driven by multiple factors such as age, gender, population growth, and SDI. There is an urgent need for precise interventions to reduce migraine's public health impact.

BackgroundVector-borne parasitic infectious diseases associated with poverty (referred to as vb-pIDP), such as malaria, leishmaniasis, lymphatic filariasis, African trypanosomiasis, Chagas disease, and onchocerciasis, are highly prevalent in many regions around the world. This study aims to characterize the recent burdens of and changes in these vb-pIDP globally and provide a comprehensive and up-to-date analysis of geographical and temporal trends.MethodsData on the prevalence and disability-adjusted life years (DALYs) of the vb-pIDP were retrieved from the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2021 for 21 geographical regions and 204 countries worldwide, from 1990–2021. The age-standardized prevalence rate and DALYs rate by age, sex, and sociodemographic index (SDI) were calculated to quantify temporal trends. Correlation analysis was performed to examine the relationship between the age-standardized rate and the SDI.ResultsOver the past 30 years, the age-standardized prevalence rate and DALYs rate of these vb-pIDP have generally decreased, with some fluctuations. The distribution of vb-pIDP globally is highly distinctive. Except for Chagas disease, the age-standardized prevalence rate and DALYs rate of other vb-pIDP were highest in low-SDI regions by 2021. Malaria had the highest age-standardized prevalence rate (2336.8 per 100,000 population, 95% UI: 2122.9, 2612.2 per 100,000 population) and age-standardized DALYs rate (806.0 per 100,000 population, 95% UI: 318.9, 1570.2 per 100,000 population) among these six vb-pIDP globally. Moreover, significant declines in the age-standardized prevalence rate and DALYs rate have been observed in association with an increase in the SDI . Globally, 0.14% of DALYs related to malaria are attributed to child underweight, and 0.08% of DALYs related to malaria are attributed to child stunting.ConclusionsThe age-standardized prevalence rate and DALY rates for the vb-pIDP showed pronounced decreasing trends from 1990–2021. However, the vb-pIDP burden remains a substantial challenge for vector-borne infectious disease control globally and requires effective control strategies and healthcare systems. The findings provide scientific evidence for designing targeted health interventions and contribute to improving the prevention and control of infectious diseases.Graphical

Epidemiological trends and burden of gallbladder and biliary tract cancer in Belt and Road Initiative countries: A comprehensive analysis from the Global Burden of Disease 2021 database.