Three-decade trends in risk factor-attributable cancer burden in China: insights from the Global Burden of Disease Study 2023.

Global Disease Burden From Acute Glomerulonephritis 1990–2019

Understanding the current burden of stomach cancer linked to smoking and the variations in trends across different locations, is crucial for developing effective prevention strategies. In this study, we present findings on the age-standardized death rate (ASDR) and age-standardized disability-adjusted life years (DALYs) rate attributed to smoking in 204 countries and territories spanning 21 regions from 1990 to 2019. The data for this study were obtained from the Global Burden of Disease Study (GBD) 2019, which assessed 369 diseases and injuries, as well as 87 risk factors in 204 countries and 21 regions. To assess the trend in ASDR and age-standardized DALYs rate, the estimated annual percentage change (EAPC) was utilized. Between 1990 and 2019, smoking was found to be associated with a decrease in ASDR (EAPC = -2.20) and age-standardized DALYs (EAPC = -2.42) rates for gastric cancer. As the sociodemographic index (SDI) increased, the decline in rates also increased gradually. However, the decline was smallest in regions with low SDI (EAPCASDR = -1.34; EAPCage-standardized DALYs rate = -1.38). In 21 regions, both ASDR and DALYs rates experienced a decline. The smallest decline in ASDR was observed in Western Sub-Saharan Africa, with an EAPC of -0.80, while the smallest decline in DALYs rate was found in Oceania, with an EAPC of -0.81. Among the 204 countries analyzed, the Dominican Republic showed the highest increase in ASDR and age-standardized DALYs rate (EAPCASDR = 1.19; EAPCage-standardized DALYs rate = 1.21), followed by Afghanistan (EAPCASDR = 1.09; EAPCage-standardized DALYs rate = 1.09) and Sao Tome and Principe (EAPCASDR = 1.05; EAPCage-standardized DALYs rate = 1.03). In the year 2019, the highest ASDR and age-standardized DALYs rate was observed in East Asia, with the highest rates occurring in Mongolia. The burden of stomach cancer worldwide, adjusted for age, and related to smoking, has shown a decline from 1990 to 2019. However, regional disparities have been identified, with some areas experiencing an increase in this burden. These regions with a higher burden emphasize the necessity for the implementation of strong tobacco control measures.

Background: A comprehensive evaluation of the burden of injury is an important foundation for selecting and formulating strategies of injury prevention. We present results from the Global Burden of Disease (GBD) 2017 study of non-fatal and fatal outcomes of injury at the national and subnational level, and the changes in burden for key causes of injury over time in China. Methods: Using the methods and results from GBD 2017, we describe the burden of total injury and four key causes of injury (road injuries, falls, drowning and self-harm) based on the rates of incidence, cause-specific mortality, and disability-adjusted life years (DALYs) in China. We additionally evaluate these results at provincial level in 2017, measure the change of injury burden from 1990 to 2017, and compare age-standardized DALY rates of injuries for the 34 subnational locations of China against the expected rates based on the socio-demographic index (SDI), a measure of development combining an equal weighting of lag-distributed income per capita, average years of education in the population over age 15 years, and total fertility rate under 25 years of age. Findings: In 2017, in China, there were 77.1 (95% uncertainty interval 72.5-81.7) million new cases of injury severe enough to warrant health care, and 733,517 (681,254-767,007) deaths due to injuries. Injuries accounted for 7.0% (6.6-7.2) of total deaths, and 10.0% (9.5-10.5) of all-cause DALYs in China. In 2017, there was a three-fold variation in age-standardized injury DALY rates between provinces of China, with the lowest value in Macao and the highest in Yunnan. Between 1990 and 2017, the age-standardized incidence rate of all injuries increased by 50.6% (46.6%- 54.6%) in China, while the age-standardized mortality and DALY rates rapidly decreased, by 44.3% (41.1% - 48.9%) and 48.1% (44.6% - 51.8%), respectively. All provinces of China experienced a substantial decline in DALY rates from all injuries ranging between 16.4% (3.1% - 28.6%) and 60.4% (53.7% - 66.2%) between 1990 and 2017. Age-standardized DALY rates for drowning; fire, heat and hot substances; self-harm; animal contact; adverse effects of medical treatments; environmental heat and cold exposure; and executions and police conflict each declined by more than 60% between 1990 and 2017. Interpretation: China has experienced a decrease in the age-standardized DALY and mortality rates due to injury from 1990 to 2017, despite an increase in the age-standardized incidence rate. These trends have occurred in all provinces. The divergent trends in terms of incidence and mortality indicate that with rapid socio-demographic improvements the case fatality of injuries has declined, which could be attributed to an improving health care system but also to a decreasing severity of injuries over this time period. Funding Statement: Bill & Melinda Gates Foundation Declaration of Interests: All authors have completed the ICMJE uniform disclosure form at icmje.org/coi_disclosure.pdf and declare support from the Bill & Melinda Gates Foundation; no financial relationships with any organizations that might have an interest in the submitted work; no other relationships or activities that could appear to have influenced the submitted work. Ethics Approval Statement: The authors state that there were No patients directly involved in this study.

Detailed, comprehensive, and timely reporting on population health by underlying causes of disability and premature death is crucial to understanding and responding to complex patterns of disease and injury burden over time and across age groups, sexes, and locations. The availability of disease burden estimates can promote evidence-based interventions that enable public health researchers, policy makers, and other professionals to implement strategies that can mitigate diseases. It can also facilitate more rigorous monitoring of progress towards national and international health targets, such as the Sustainable Development Goals. For three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has filled that need. A global network of collaborators contributed to the production of GBD 2021 by providing, reviewing, and analysing all available data. GBD estimates are updated routinely with additional data and refined analytical methods. GBD 2021 presents, for the first time, estimates of health loss due to the COVID-19 pandemic. The GBD 2021 disease and injury burden analysis estimated years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries using 100 983 data sources. Data were extracted from vital registration systems, verbal autopsies, censuses, household surveys, disease-specific registries, health service contact data, and other sources. YLDs were calculated by multiplying cause-age-sex-location-year-specific prevalence of sequelae by their respective disability weights, for each disease and injury. YLLs were calculated by multiplying cause-age-sex-location-year-specific deaths by the standard life expectancy at the age that death occurred. DALYs were calculated by summing YLDs and YLLs. HALE estimates were produced using YLDs per capita and age-specific mortality rates by location, age, sex, year, and cause. 95% uncertainty intervals (UIs) were generated for all final estimates as the 2·5th and 97·5th percentiles values of 500 draws. Uncertainty was propagated at each step of the estimation process. Counts and age-standardised rates were calculated globally, for seven super-regions, 21 regions, 204 countries and territories (including 21 countries with subnational locations), and 811 subnational locations, from 1990 to 2021. Here we report data for 2010 to 2021 to highlight trends in disease burden over the past decade and through the first 2 years of the COVID-19 pandemic. Global DALYs increased from 2·63 billion (95% UI 2·44-2·85) in 2010 to 2·88 billion (2·64-3·15) in 2021 for all causes combined. Much of this increase in the number of DALYs was due to population growth and ageing, as indicated by a decrease in global age-standardised all-cause DALY rates of 14·2% (95% UI 10·7-17·3) between 2010 and 2019. Notably, however, this decrease in rates reversed during the first 2 years of the COVID-19 pandemic, with increases in global age-standardised all-cause DALY rates since 2019 of 4·1% (1·8-6·3) in 2020 and 7·2% (4·7-10·0) in 2021. In 2021, COVID-19 was the leading cause of DALYs globally (212·0 million [198·0-234·5] DALYs), followed by ischaemic heart disease (188·3 million [176·7-198·3]), neonatal disorders (186·3 million [162·3-214·9]), and stroke (160·4 million [148·0-171·7]). However, notable health gains were seen among other leading communicable, maternal, neonatal, and nutritional (CMNN) diseases. Globally between 2010 and 2021, the age-standardised DALY rates for HIV/AIDS decreased by 47·8% (43·3-51·7) and for diarrhoeal diseases decreased by 47·0% (39·9-52·9). Non-communicable diseases contributed 1·73 billion (95% UI 1·54-1·94) DALYs in 2021, with a decrease in age-standardised DALY rates since 2010 of 6·4% (95% UI 3·5-9·5). Between 2010 and 2021, among the 25 leading Level 3 causes, age-standardised DALY rates increased most substantially for anxiety disorders (16·7% [14·0-19·8]), depressive disorders (16·4% [11·9-21·3]), and diabetes (14·0% [10·0-17·4]). Age-standardised DALY rates due to injuries decreased globally by 24·0% (20·7-27·2) between 2010 and 2021, although improvements were not uniform across locations, ages, and sexes. Globally, HALE at birth improved slightly, from 61·3 years (58·6-63·6) in 2010 to 62·2 years (59·4-64·7) in 2021. However, despite this overall increase, HALE decreased by 2·2% (1·6-2·9) between 2019 and 2021. Putting the COVID-19 pandemic in the context of a mutually exclusive and collectively exhaustive list of causes of health loss is crucial to understanding its impact and ensuring that health funding and policy address needs at both local and global levels through cost-effective and evidence-based interventions. A global epidemiological transition remains underway. Our findings suggest that prioritising non-communicable disease prevention and treatment policies, as well as strengthening health systems, continues to be crucially important. The progress on reducing the burden of CMNN diseases must not stall; although global trends are improving, the burden of CMNN diseases remains unacceptably high. Evidence-based interventions will help save the lives of young children and mothers and improve the overall health and economic conditions of societies across the world. Governments and multilateral organisations should prioritise pandemic preparedness planning alongside efforts to reduce the burden of diseases and injuries that will strain resources in the coming decades. Bill & Melinda Gates Foundation.

SummaryBackgroundA comprehensive evaluation of the burden of injury is an important foundation for selecting and formulating strategies of injury prevention. We present results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 of non-fatal and fatal outcomes of injury at the national and subnational level, and the changes in burden for key causes of injury over time in China.MethodsUsing the methods and results from GBD 2017, we describe the burden of total injury and the key causes of injury based on the rates of incidence, cause-specific mortality, and disability-adjusted life years (DALYs) in China estimated using DisMod-MR 2.1. We additionally evaluated these results at the provincial level for the 34 subnational locations of China in 2017, measured the change of injury burden from 1990 to 2017, and compared age-standardised DALYs due to injuries at the provincial level against the expected rates based on the Socio-demographic Index (SDI), a composite measure of development of income per capita, years of education, and total fertility rate.FindingsIn 2017, in China, there were 77·1 million (95% uncertainty interval [UI] 72·5–81·6) new cases of injury severe enough to warrant health care and 733 517 deaths (681 254–767 006) due to injuries. Injuries accounted for 7·0% (95% UI 6·6–7·2) of total deaths and 10·0% (9·5–10·5) of all-cause DALYs in China. In 2017, there was a three-times variation in age-standardised injury DALY rates between provinces of China, with the lowest value in Macao and the highest in Yunnan. Between 1990 and 2017, the age-standardised incidence rate of all injuries increased by 50·6% (95% UI 46·6–54·6) in China, whereas the age-standardised mortality and DALY rates decreased by 44·3% (41·1–48·9) and 48·1% (44·6–51·8), respectively. Between 1990 and 2017, all provinces of China experienced a substantial decline in DALY rates from all injuries ranging from 16·3% (3·1–28·6) in Shanghai and 60·4% (53·7–66·1) in Jiangxi. Age-standardised DALY rates for drowning; injuries from fire, heat and hot substances; adverse effects of medical treatments; animal contact; environmental heat and cold exposure; self-harm; and executions and police conflict each declined by more than 60% between 1990 and 2017.InterpretationBetween 1990 and 2017, China experienced a decrease in the age-standardised DALY and mortality rates due to injury, despite an increase in the age-standardised incidence rate. These trends occurred in all provinces. The divergent trends in terms of incidence and mortality indicate that with rapid sociodemographic improvements, the case fatality of injuries has declined, which could be attributed to an improving health-care system but also to a decreasing severity of injuries over this time period.FundingBill & Melinda Gates Foundation.

Background:The burden of primary brain and other central nervous system (CNS) cancers, collectively termed CNS cancers, has undergone significant changes in recent decades. This study aimed to estimate the burden, trends, and inequalities at the global, regional, and national levels from 1990 to 2021, as well as projections to 2035.Methods:We used 2021 Global Burden of Disease (GBD) Study data and methodologies to describe changes in the burden of CNS cancers from 1990 to 2021, including prevalence, incidence, mortality, and disability-adjusted life years (DALYs). Furthermore, the autoregressive integrated moving average model was used to forecast the future CNS cancer burden until 2035. Finally, we conducted decomposition analysis to identify the key drivers of variation in CNS cancer burden. Frontier analysis was used to visually illustrate the potential for burden reduction in each country or region based on their development levels.Results:From 1990 to 2021, global cases of CNS cancers have increased in prevalence and incidence by 124.50% and 106.53%, respectively, with corresponding increases in related age-standardized rates (ASRs). A similar increase in the number was also observed in CNS cancer-related mortality and DALYs, accompanied by a decline in the ASRs of DALYs and a stable state in the ASRs of mortality. Sex and age data from the GBD 2021 demonstrated an exclusively older male predominance in CNS cancer-related ASRs of prevalence, incidence, mortality, and DALYs. In 2021, regions with a high Socio-Demographic Index (SDI) had the highest ASRs of prevalence, incidence, mortality, and DALYs. By 2035, the estimated global number of prevalent cases, incident cases, deaths, and DALYs is projected to be 1.22 million, 0.43 million, 0.31 million, and 10.27 million, with an increase of 24%, 19%, 19%, and 15% from 2021 to 2035, respectively, though the ASRs of incidence and DALYs decreased to some extent. Decomposition analysis showed the major contributory roles of population growth and aging on the incidence, mortality, and DALYs, although epidemiological changes also contributed to the prevalence to some extent. Frontier analysis of 204 countries and regions indicated that a higher SDI was associated with higher CNS cancer-related ASRs of prevalence, incidence, mortality, and DALYs and that countries or regions with higher SDI levels tended to have greater potential for improvement.Conclusions:Life expectancy for individuals with CNS cancers has increased since the 1990s, coinciding with a substantial reduction in the DALY rate and a stable CNS cancer-related mortality rate. However, mortality and DALYs related to CNS cancers have been particularly high in men across all age groups, those residing in higher SDI regions, and older adults. Considering the continuous increase in the CNS cancer burden by 2035, efficacious management of CNS cancers continues to pose a substantial challenge, highlighting the need for more regionally tailored strategies and guidelines on the sex-specific treatment protocols for older males to alleviate the disease burden, which is largely driven by aging and population growth in different SDI regions.

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

We estimated the global burden of ovarian cancer (OC) in 194 countries and territories between 2007 and 2017. Data were extracted from the Global Burden of Disease (GBD), Injuries, and Risk Factors 2017 study. Globally, 286 126.80 (95% UI=278 075.38-295 311.41) incident cases, 4.67 million (4.53-4.83) disability-adjusted life-years (DALYs), and 175 981.99 (171 384.15-181 198.43) deaths were reported in 2017. The age-standardized incidence and DALY rates increased by 2.05% and 1.34% during 2007-2017, respectively, while the age-standardized mortality rate decreased by -0.14%. The age-standardized incidence, DALY, and mortality rates in 2017 were the highest in the high socio-demographic index (SDI) quintile, but the largest percentage increase during 2007-2017 was in the low-SDI quintile. Among regions, Central Europe showed the highest 2017 age-standardized incidence, DALY, and mortality rates, whereas South Asia and East Asia showed the largest percentage increases in both rates during 2007-2017. Among countries, India showed the largest percentage increase in age-standardized incidence and DALY rates, whereas Iran showed the largest percentage increase in age-standardized mortality rates. Globally, the largest percentage increase in risk-attributable DALYs was associated with metabolic risk factors (e.g., high fasting plasma glucose levels). The global age-standardized incidence, DALYs, and mortality rates of OC remain stable during 2007-2017. However, the low SDI quintile and the greatest burden in South and East Asia, India, and Iran suggested that more targeted strategies should be performed in those regions and countries.

BackgroundYoung chronic obstructive pulmonary disease (COPD) refers to people with COPD between the ages of 20 and 50 years. Current epidemiological studies focus on local geography, and there is a lack of global-level analysis. This study provides in-depth analyses of the disease burden of young COPD at global, regional, and national levels.MethodsThis study used the Global Burden of Disease Study 2021 (GBD). The age-standardised prevalence rate (ASPR), age-standardised incidence rate (ASIR), age-standardised death rate (ASDR), and age-standardised disability-adjusted life years (DALYs) rate were used to describe the disease burden. The estimated annual percentage change (EAPC) during the study period was calculated. Joinpoint regression analysis examined the time trend from 1990 to 2021. Annual percentage change (APC) and average annual percentage change (AAPC) were calculated. Risk factors were reported by region and sex.ResultsIn 2021, the global number of young COPD cases was 30,384,539, and the ASPR, ASIR, ASDR, and age-standardised DALYs rates fell slightly. Oceania reported the highest ASPR, ASDR, and age-standardised DALYs rate. High-income North America has the highest ASIR. In 2021, the prevalence, incidence, death, and DALYs rates exhibited similar trends, increasing with age. From 1990 to 2021, both the prevalence and death rates showed a consistent downward trend across all age groups. Joinpoint regression analysis indicated a slight increase in both the ASPR (APC: 0.13; 95% CI: 0.06 to 0.19) and the ASIR (APC: 0.17; 95% CI: 0.10 to 0.24) during the period from 1990 to 1994. The leading DALYs attributable to risk factors for young COPD are household air pollution from solid fuels (20.4%), ambient particulate matter pollution (17.9%), and smoking (13.5%).ConclusionsThe global burden of ASPR, ASIR, ASDR, and age-standardised DALYs rates in young COPD has decreased, however, the absolute number of patients has increased. The global burden shows noticeable regional differences, with particularly high burdens observed in Oceania. Improving air quality, promoting smoking cessation, and increasing access to lung function tests, raising awareness of young COPD are key strategies for alleviating the burden of young COPD.

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

Our aim was to explore the disease burden caused by gallbladder and biliary tract cancer globally, regionally, and nationally, by age and sex. The absolute number of cases and age-standardized rates (ASR) of incidence, prevalence, mortality, and disability-adjusted life years (DALYs) due to gallbladder and biliary tract cancer were extracted from the Global Burden of Disease (GBD) Study 2019. We estimated the trends in disease burden by calculating the percentage change in the absolute number of cases and the estimated annual percentage change (EAPC) in ASR, by social development index (SDI), region, nation, sex, and age. From 1990 to 2019, the number of incident cases, prevalent cases, deaths, and DALYs worldwide significantly increased by 1.85-fold, 1.92-fold, 1.82-fold, and 1.68-fold, respectively. However, the age-standardized rates of incidence, prevalence, mortality, and DALYs tend to decrease globally over time. Nevertheless, heterogeneous disease burden patterns exist between geographic regions due to different geographical risk factors, distinct epidemiologically predominant gallbladder and biliary tract cancer subtypes, and potential genetic predispositions or ethnicity. Additionally, socioeconomic status mediates the regional variation in disease burden, with increasing SDI or HDI scores associated with downward trends in the age-standardized rates of incidence, prevalence, mortality, and DALYs. Older individuals and females are at higher risk of gallbladder and biliary tract cancer, but the increasing burden of early-onset gallbladder and biliary tract cancer is a cause for concern, especially for those living in lower SDI areas and males. High BMI is the primary risk factors underlying gallbladder and biliary tract cancer, accounted for 15.2% of deaths and 15.7% DALYs globally in 2019. Our study comprehensively elucidated the distribution and dynamic trends of gallbladder and biliary tract cancer burden over the past three decades, from multiple dimensions. These findings emphasize the importance of promoting a healthy lifestyle as a population-level cancer prevention strategy and tailoring cancer control actions based on localized risk factors and the epidemic profiles of gallbladder and biliary tract cancer by anatomical subtype.

BackgroundLower respiratory infections (LRIs) cause substantial mortality and morbidity. The present study reported and analysed the burden of LRIs in the Middle East and North Africa (MENA) region between 1990 and 2019, by age, sex, etiology, and socio-demographic index (SDI).MethodsThe data used in this study were sourced from the Global Burden of Disease (GBD) study 2019. The annual incidence, deaths, and disability-adjusted life-years (DALYs) due to LRIs were presented as counts and age-standardised rates per 100,000 population, along with their 95% uncertainty intervals (UIs). The average annual percent changes (AAPC) in the age-standardised incidence, death and DALYs rates were calculated using Joinpoint software and correlations (Pearson’s correlation coefficient) between the AAPCs and SDIs were calculated using Stata software.ResultsIn 2019, there were 34.1 million (95% UI 31.7–36.8) incident cases of LRIs in MENA, with an age-standardised rate of 6510.2 (95% UI 6063.6–6997.8) per 100,000 population. The number of regional DALYs was 4.7 million (95% UI 3.9–5.4), with an age-standardised rate of 888.5 (95% UI 761.1–1019.9) per 100,000 population, which has decreased since 1990. Furthermore, Egypt [8150.8 (95% UI 7535.8–8783.5)] and Afghanistan [61.9 (95% UI 52.1–72.6)] had the highest age-standardised incidence and death rates, respectively. In 2019, the regional incidence and DALY rates were highest in the 1–4 age group, in both females and males. In terms of deaths, pneumococcus and H. influenza type B were the most and least common types of LRIs, respectively. From 1990 to 2019, the burden of LRIs generally decreased with increasing SDI. There were significant positive correlations between SDI and the AAPCs for the age-standardised incidence, death and DALY rates (p < 0.05). Over the 1990–2019 period, the regional incidence, deaths and DALYs attributable to LRIs decreased with AAPCs of − 1.19% (− 1.25 to − 1.13), − 2.47% (− 2.65 to − 2.28) and − 4.21% (− 4.43 to − 3.99), respectively.ConclusionsThe LRI-associated burden in the MENA region decreased between 1990 and 2019. SDI had a significant positive correlation with the AAPC and pneumococcus was the most common underlying cause of LRIs. Afghanistan, Yemen and Egypt had the largest burdens in 2019. Further studies are needed to investigate the effectiveness of healthcare interventions and programs to control LRIs and their risk factors.

Global burden of non-rheumatic valvular heart disease in older adults (60-89 years old), 1990-2019: systematic analysis of the Global Burden of Disease Study 2019

Background: Data for the global burden of laryngeal cancer (LC) are limited. Methods: We reported the incidence of, disability-adjusted life years (DALYs), and deaths due to LC by age, sex and by social-demographic index (SDI) in all countries and territories during 2007 to 2017, based on data from the Global Burden of Disease (GBD) 2017 study. We also assessed the risk factors for LC-associated DALYs and deaths through a comparative risk assessment framework. Results: Globally, from 2007 to 2017, the age-standardized incidence rate increased by 0.95%, the age-standardized DALY rate decreased by 8.75%, and the age-standardized death rate decreased by 7.66%. The age-standardized incidence, DALY, and death rates in 2017 were all the highest in the low SDI quintile. The middle SDI quintile witnessed the highest percentage changes in age-standardized incidence, DALY, and death rates during 2007–2017. At the GBD regional level, the highest age-standardized incidence, DALY, and death rates in 2017 occurred in the Caribbean, followed by South Asia. East Asia showed the largest increases in age-standardized incidence, DALY, and death rates from 2007 to 2017. At the national level, China and Jamaica reported the largest percentage increases in the age-standardized incidence, DALY, and death rates over the study period. Conclusion: The global age-standardized incidence of LC remain stable. However, the age-standardized DALY and death rates decreased significantly over the study period. Impact: Our findings will be beneficial for developing policies to reduce the disease burden of LC in particular regions or countries.

325 Background: Prostate cancer is the second most common cancer in men globally, posing significant health challenges. Conflicting findings on its global burden and trends necessitate updated analyses. This study provides recent estimates of prostate cancer's global, regional, and national burden from 1990 to 2021, analyzes temporal trends, and offers epidemiological insights for clinicians, researchers, and policymakers. Methods: We analyzed data from the Global Burden of Disease Study 2021 on prostate cancer cases, deaths, and disability-adjusted life years (DALYs) from 1990 to 2021, including age-standardized rates (ASRs) for incidence, mortality, and DALYs. Trend analyses utilized average annual percent change (AAPC) calculations and joinpoint regression models. Age-period-cohort analysis assessed the effects of age, period, and cohort on incidence and mortality trends. Pearson correlation evaluated associations between ASRs and the Socio-demographic Index (SDI) to explore socioeconomic impacts. Results: From 1990 to 2021, global prostate cancer cases, deaths, and DALYs increased, reflecting aging populations. The age-standardized incidence rate (ASIR) showed a slight global increase (AAPC = 0.15, 95% CI: 0.05–0.25), while the age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) decreased (ASMR AAPC = -0.83, 95% CI: -0.92 to -0.74; ASDR AAPC = -0.75, 95% CI: -0.82 to -0.68), indicating improved survival. High-SDI regions had decreasing ASMR and ASDR despite high ASIRs due to better detection and treatment. Low-SDI regions saw increases in ASIR, ASMR, and ASDR, with the highest mortality and DALY rates, indicating rising burden and potential healthcare access issues. Joinpoint regression showed initial increases then decreases in ASIR, ASMR, and ASDR, with regional differences in timing. Age-period-cohort analysis revealed age effects with rising incidence and mortality risks, declining incidence risk in the oldest age groups. Period effects showed incidence risk increasing until 2011–2017, then declining; mortality risk decreased over time. Cohort effects showed stable then increasing incidence risk in younger cohorts, while mortality risk decreased across cohorts, reflecting healthcare improvements. Conclusions: The global absolute burden of prostate cancer has increased, but age-standardized mortality and DALY rates have decreased, especially in high-SDI regions due to advancements in detection and treatment. Low-SDI regions face rising incidence and mortality, highlighting growing disparities. Targeted interventions and resource allocation in low-SDI regions are needed to address the increasing burden and reduce global health inequalities.