Cervical cancer (CC) mortality in the Baltic countries remains high. We explored CC mortality trends and educational inequalities in CC mortality in the Baltics in the context of organized CC screening (introduced in 2004 in Lithuania, 2006 in Estonia and 2009 in Latvia) and compared the results with Finland (where screening started in 1963). Data for the Baltic countries came from longitudinal mortality follow-up studies of population censuses in 2000/2001 and 2011, and data for Finland from the longitudinal register-based population data file of Statistics Finland. CC deaths (ICD-10 code C53) were linked from national mortality registries. Information on education was census- or register-based. Overall and education-specific age-standardized mortality rates (ASMRs) and mortality rate ratios were calculated for 2000-2007 and 2008-2015 for women aged 30-49 and 50-64 years. The Baltic countries had 5-9 times higher overall ASMRs than Finland and much larger inequalities in CC mortality between low- and highly educated women. From 2000-2007 to 2008-2015 absolute inequalities in younger women reduced in all countries, except Latvia and relative inequalities increased in Estonia and Latvia. In older women, absolute inequalities increased in the Baltics but not in Finland; relative inequalities increased in all countries. The reduction in CC mortality and in absolute inequalities in younger women in Estonia and Lithuania may be associated with the introduction of organized screening. However, increasing CC mortality among older low-educated women in the Baltic countries is alarming, indicating that they have not benefitted equally from CC prevention.

Data on time trends in cluster headache epidemiology are sparse. The aim of this study was to report trends in prevalence and incidence of cluster headache in Norway over a 14-year period. We conducted a registry-based study using linked data from the Norwegian Registry for Primary Health Care, the Norwegian Control and Payment of Health Reimbursements Database, the Norwegian Patient Registry, the Norwegian Prescribed Drug Registry, and Statistics Norway from 2009 to 2022. Data included diagnostic codes, prescriptions, and education. Adults (age ≥18 years) were included. Cluster headache prevalence was defined as ≥2 contacts (clinical consults or prescriptions) for cluster headache in a 365-day period. Age-standardized trends in prevalence and incidence by sex and year, and interactions between education and year, were analyzed with negative binomial regression. We estimated prevalence rate ratio (PRR) and incidence rate ratio per calendar year with 95% CIs. The number of patients with cluster headache increased from 1,029 in 2009 (median age 44 years; 39.7% women) to 1,833 patients in 2022 (median age 47 years; 50.1% women). The annual age-standardized prevalence rate increased from 27.0 to 42.5 per 100,000 in the same period. Women had a 3-fold higher annual increase of 6% (PRR 1.06, 95% CI 1.05-1.07) compared with 2% (PRR 1.02, 95% CI 1.02-1.03) in men. The prevalence rate was higher in women than in men by 2022 (43.4 vs 41.7 per 100,000). The annual prevalence of chronic cluster headache and refractory chronic cluster headache varied between 6%-7% and 1%-2% of all cluster headache cases, respectively. The annual age-standardized incidence rate of cluster headache increased in women, from 10.1 to 14.6 per 100,000 from 2012 to 2022 and decreased in men, from 13.5 to 11.0 per 100,000. Incidence and prevalence rates were higher among individuals with lower education. Prevalence increased over 14 years, possibly reflecting improved diagnostic practices and awareness. These findings challenge previous reports of cluster headache predominantly affecting men, illustrating distinct shifts and trends in disease epidemiology. A limitation was the lack of clinical validation of cluster headache diagnostic codes in primary health care.

Trends and future of the disease burden of malignant neoplasms of bone and articular cartilage in China from 1990 to 2023: An analysis based on the Global Burden of Disease 2023.

Global, regional, and national burden of five major mental disorders in working-age population, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021.

The burden of early-onset cancers increases globally, raising major concerns. There is, however, confusion between trends in the number of cases and in age-standardized rates, and a lack of comparison with later-onset cancers. We described trends in cancer burden and risk in early- and later-onset cancers in Switzerland between 1982 and 2021. We used data from the Swiss National Institute for Cancer Epidemiology and Registration, including all primary cancers between 1982 and 2021. A cancer was early-onset if diagnosed between ages 20-49 and later-onset at 50 or older. We calculated mean annual number of cases and deaths, crude and age-standardized incidence and mortality rates per 100,000, by 5-year period, sex, and cancer site. We estimated absolute and relative changes between 1982-1986 and 2017-2021. Between 1982 and 2021, the mean annual number of early-onset cancers increased by 1534 (+48%) and of later-onset cancers by 19,832 (+91%). Age-standardized incidence rates of early-onset cancers increased by 13/100,000 (+11%) and of later-onset by 92/100,000 (+8%). Population growth and ageing explained 73% of the increase of early-onset and 90% of the increase of later-onset cancers. The incidence increased in women (early-onset: +19%; later-onset: +9%) but not in men. For main cancer sites, early- and later-onset incidence showed parallel trends, except for colorectal (early-onset increased while later-onset decreased) and for lung in women (early-onset decreased while later-onset increased). All sites together, age-standardized mortality rates declined substantially (early-onset: -59%; later-onset: -38%). The increase in the burden of early-onset cancers was driven mainly by population growth and ageing, and to a lesser extent by an increased risk, also observed in later-onset cancers.

Global patterns and risk factors of breast cancer in women under 35: a population-based study.

Global burden and trends of depression among women of childbearing age, 1990-2021.

Evolving dynamics of tuberculosis and emerging HIV Co-infection in China: Age-period-cohort analysis and projections to 2035.

Incidence, mortality, and five-year survival of bladder cancer in six population-based cancer registries in Colombia, 2003-2018.

The incidence of thyroid cancer (TC) has increased globally over the last three decades. Overdiagnosis appears to be the primary factor driving an increasing number of TC diagnoses. Most documented TC cases involve small, well-differentiated lesions. This study aimed to evaluate the changing trends in TC diagnoses and mortality over the last 10 years. This retrospective study included patients registered between January 2013 and December 2022. Data on the number of patients diagnosed over 10 years were presented, and data on the types of treatment used were analyzed. This study aimed to investigate possible overdiagnosis and the approach to treatment of TC. The total number of registered cases was 342; the majority of cases were females (295, 86%), and only 47 cases were males (14%), with a female-to-male ratio of 6:1. The age-standardized rate (ASR) has increased over 10 years, from 47 cases to 621 per 1,000,000 people. Between 2013 and 2022, the ASR of TC increased from 58 to 1030 cases/1,000,000 and from 30 to 212 cases among women and men, respectively. Among the 184 patients with micropapillary TC, 173 (94%) underwent total thyroidectomy, whereas only 11 (6%) underwent lobectomy. In 2022, TC became the third most common cancer in this region, following breast and colorectal cancers in females. Of the 80 new cases diagnosed in 2022, only 47% had adjuvant radioactive iodine. The mortality rate over the 10-year period from 2013 to 2022 did not increase and remained relatively stable, with minor variations between 0 and 2 cases per year. This study demonstrated a significant increase in TC diagnosis, especially in early-stage disease, without a corresponding increase in the mortality rate. This finding suggests that the current incidence of TC may be an example of overdiagnosis and overtreatment.

Blindness and vision loss caused by diabetes mellitus remain common complications that significantly impair patients' quality of life. This study aimed to examine global, regional, and national trends in the burden of blindness and vision loss resulting from diabetes mellitus. Data on the prevalence and years lived with disability (YLDs) attributable to blindness and vision loss due to diabetes mellitus between 1990 and 2021 were extracted from the Global Burden of Disease Study (GBD) 2021. Absolute numbers, age-standardized rates (ASR), and average annual percentage changes (AAPC) in prevalence and YLDs were analyzed at global, regional, and national levels. Trends were further analyzed according to age, gender, and Socio-demographic Index (SDI). Joinpoint regression was utilized to detect temporal inflection points and quantify trend changes. Additionally, a Bayesian age-period-cohort (BAPC) model was employed to project the global burden up to 2050. Globally, the age-standardized prevalence of diabetes-related blindness and vision loss increased from 62.69 per 100,000 in 1990 to 111.05 in 2021 (AAPC 1.61), alongside an increase in YLDs. Medium-SDI regions experienced the heaviest and fastest-growing burden, with Central Latin America ranking highest among all regions. Mexico and Mauritius showed the highest national ASPR and YLDs. Rates were consistently higher in women and increased with age. BAPC projections estimate that global ASPR and YLDs will reach 134.98 and 10.91, respectively, by 2050. Blindness and vision loss from diabetes mellitus represent a growing global burden. Preventive strategies, particularly targeting women and older adults, should therefore be prioritized and supported by evidence-based interventions. The online version contains supplementary material available at 10.1007/s40200-026-01917-4.

Patterns of sex differences in cancer mortality in Colombia: a population-based analysis, 1980-2023.

Burden of cancer attributable to occupational asbestos exposure in the Americas, 1990-2023: an analysis using the Global Burden of Disease Study 2023.

This 2025 report from the ESC Atlas project is the fifth in a biennial series. It presents and compares updated cardiovascular disease (CVD) statistics for more than 50 of the ESC member countries. The statistics are for 2024 or latest available year and are stratified by sex and World Bank national income status to identify inequalities in the risk, management, and outcomes of CVD across ESC member countries. A key objective of the ESC Atlas project has been to inform EU-level policy initiatives aimed at reducing the burden of CVD, contributing to the evidence base underpinning the European Union's cardiovascular health plan ("Safe Hearts Plan"), adopted in December 2025. Population ageing is a major contributor to the continuing high prevalence of CVD across ESC member countries. The Atlas reports 68 million disability-adjusted life years attributable to CVD in association with more than 3 million deaths per year. These statistics identify CVD as the leading cause of death across ESC member countries. However, substantial variation exists by national income status, with middle-income countries exhibiting age-standardized mortality rates that are roughly twice those observed in high-income countries. Marked disparities in healthcare delivery-particularly in workforce capacity and access to advanced interventions-are also evident. These inequalities by national income status are recurrent throughout this Atlas report. They highlight clear priorities for policymakers as they develop strategies to reduce the burden of CVD in the regions where the need is greatest. This 2025 report provides a detailed picture of the complex interplay between demography, the environment, socio-economic status, and clinical factors in shaping cardiovascular (CV) risk. It underscores how the progress that has been made in reducing the CVD burden across ESC member countries is at risk of being offset by new challenges, particularly the epidemic of obesity and diabetes that continues to undermine CV health. The findings presented in this report emphasize the need for coordinated policies to combat these challenges in order to sustain the progress that has been made in reducing the burden of CVD across ESC member countries.

Kidney diseases are on the rise and currently affect around 10% of the world population, with high mortality being reported. Available data on kidney disease-related mortality is provided by the Global Burden of Disease, and is based on inferences from several sources. The study aimed to measure highly reliable, real-world data in the Italian population on the trend of kidney disease mortality and to compare them with other chronic diseases. This dynamic population study focusing on mortality was based on data of all Italian residents. Kidney disease mortality was measured for each year from 1992 to 2019 using the National Causes of Death Register. Mortality trend was estimated by the annual percentage changes, while joinpoint-jump models were applied to analyze changes in mortality trends. Between 1992 and 2019, the age-standardized mortality rate related to kidney disease increased by 12.6%; annual percentage changes increased by 0.57% (in females) and 0.93% (in males) due to a sharp rise in the 85 + year age class. The mortality increase in the elderly was observed also for males with hypertension and diabetes but not for other chronic diseases. Kidney disease mortality has increased over time, unlike other chronic diseases. These highly reliable, real-world data findings enhance the awareness of kidney disease mortality and allow to plan public prevention programs aimed to reduce its impact, in particular for the elderly and patients for whom kidney disease is a comorbidity linked to the leading causes of death, such as cardiovascular conditions.

BackgroundAsbestos 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.MethodsWe 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.ResultsThe 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.ConclusionsAlthough 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 access to liver transplantation (LT) remains highly unequal. We analyzed worldwide patterns of LT activity, donor source, and their alignment with disease burden across sociodemographic strata. We combined country-level LT data from the Global Observatory on Donation and Transplantation (2000-2023) with prevalence and mortality estimates for cirrhosis and other chronic liver diseases from the Global Burden of Disease 2021 Study (2000-2021). LT rates and donor source were analyzed across Sociodemographic Index (SDI) categories. LT capacity was benchmarked against age-standardized prevalence rates and age-standardized mortality rates. Associations between LT intensity and the mortality-to-prevalence ratio were evaluated using pooled correlations, within-country analyses, and 2-way fixed-effects models adjusting for country-year and calendar year. From 2000 to 2023, LT activity was concentrated in high-SDI countries, whereas low-SDI countries relied almost exclusively on living donation but had extremely low overall LT rates. When benchmarked against age-standardized prevalence rates and age-standardized mortality rates, LT capacity showed a strong inverse gradient across SDI, with substantial heterogeneity among high- and middle-SDI countries. Within-country and 2-way fixed-effects models demonstrated a small but significant inverse association, indicating that higher LT activity was associated with lower mortality relative to disease prevalence at the population level. Global LT capacity remains poorly aligned with the burden of cirrhosis and other chronic liver diseases and is driven more by health system development than epidemiological need. Although prevention remains central, incremental expansion of equitable LT infrastructure may be associated with modest improvement in population-level mortality relative to disease prevalence.

The World Health Organization identifies 21 neglected tropical diseases (NTDs) affecting millions globally. While their population burden is well recognised, less is known about the long-term trends in severe NTD-related morbidity requiring hospitalization. We analysed national trends and geographic patterns of hospitalizations attributed to NTDs in Ecuador between 2000 and 2024. We analysed hospital discharge data from Ecuador's national registry over a 25-year period. Age-standardized hospitalization rates were estimated, and temporal trends were assessed using Joinpoint regression for the 5 most frequent NTDs. Standardized morbidity ratios (SMRs) were estimated for these NTDs for census years (2001, 2010 and 2022) to explore relative changes in hospitalization rates over time and by geography. A total of 179,439 hospital discharges were attributed to NTDs, representing 0.7% of all hospitalizations. The five most frequent NTDs accounted for 97.1% of hospitalizations: dengue and chikungunya (62.4%), snakebite envenoming (20.1%), soil-transmitted helminthiases (8.7%), taeniasis and cysticercosis (3.9%), and scabies and other ectoparasitoses (2.0%). Only 0.4% of hospitalizations resulted in death. Hospitalizations were more frequent in males (54%) and younger populations (median 19 years, Q1 9 - Q3 37). Overall hospitalizations rates increased over time, driven primarily by arboviral infections, while non-arboviral NTDs showed declining trends: snakebite (from 2014, annual percent change -7.81%, 95% CI -11.27, -5.69, P = 0.006), soil-transmitted helminths (from 2000, -5.62%, 95% CI -6.56, -4.68, P < 0.001), and taeniasis and cysticercosis (from 2003, -10.42%, 95% CI -14.50, -9.68, P = 0.002). Relative morbidity caused by NTDs was consistently greater in Coastal and Amazon provinces, with dynamic shifts over time across regions, although taeniasis and cysticercosis morbidity remained greatest in southern Andean Provinces. Over 25 years in Ecuador, hospitalizations attributed to several non-arboviral NTDs declined, while arboviral infections increasingly contributed to severe NTD-related morbidity. These findings reflect trends in the most severe clinical manifestations requiring inpatient care and highlight persistent geographic inequalities, particularly in the Amazon region. Strengthening surveillance, prevention, and equitable access to timely diagnosis and care will be essential to reduce severe NTD morbidity and support progress towards national and global NTD elimination and control targets.

INTRODUCTIONDementia persists as a critical global health challenge. Smoking is a modifiable behavioral factor associated with dementia, although improvements in healthcare have reduced dementia prevalence and mortality. Evaluating long-term changes in the smoking-attributable dementia burden provides a useful reference for informing and contextualizing dementia prevention efforts.METHODSThis study is a secondary analysis of Global Burden of Disease (GBD) 2021 estimates. We examined smoking-attributable deaths and disability-adjusted life years (DALYs) for dementia among adults aged ≥40 years, across 204 countries and territories from 1990 to 2021. We assessed temporal trends using age-standardized rates and estimated annual percentage changes (EAPC), evaluated inequality across sociodemographic development levels, and projected the burden to 2035 using a Bayesian age–period–cohort (BAPC) model.RESULTSIn 2021, the global burden of dementia attributable to smoking reached 1533214 DALYs (95% UI: 635494–3540712), representing an approximate twofold increase compared with 1990. However, the age-standardized DALY rate (ASDR) declined significantly over the same period, with an EAPC of -0.88 (95% CI: -0.92 – -0.83). Population growth and population ageing were the dominant contributors to the increase in DALYs, accounting for 112.17% and 26.02%, respectively, whereas epidemiological improvements partially offset the burden (-38.19%). In terms of regional variation, East Asia bore the heaviest absolute burden. BAPC projections indicated that despite continued declines in ASDR, smoking-attributable dementia DALYs are expected to keep increasing through 2035.CONCLUSIONSDespite declining age-standardized rates, the absolute burden of smoking-attributable dementia continues to rise, partly because reductions in smoking exposure are insufficient to counter demographic pressures from population ageing and growth. Persistent disparities across sociodemographic index groups further indicate that gains in tobacco control do not consistently translate into proportional reductions in dementia burden. Aligning tobacco control with ageing-responsive health system strategies will be essential to moderating future burden growth.

Acute hepatitis B (AHB), an acute manifestation triggered by hepatitis B virus infection, has emerged as a significant international public health concern, particularly endangering women of childbearing age (WCBA) who are prone to persistent infection, adverse pregnancy outcomes, and mother-to-child transmission threats. However, research on acute hepatitis B lags, mainly focusing on chronic cases or clinical treatments. This study aims to quantify its global disease burden from 1990 to 2021 among women of childbearing age and predict epidemiological trends to inform targeted prevention and control strategies. Data of AHB burden from 1990 to 2021were obtained from the GBD 2021 via Global Health Data Exchange (GHDx). Frontier analysis was utilized to find the unrealized health potential. The age-period-cohort model was applied to analyze trends across different age groups, periods, and birth cohorts. The joinpoint regression model was used to identify significant changes in data trends over time. The Bayesian age-period-cohort model was utilized for forecasting future epidemiological trajectories. A decreasing trend in age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), age-standardized mortality rate (ASMR), and disability-adjusted life-years rates (ASDR) was observed among the women of childbearing age worldwide from 1990 to 2021. The disease burden was disproportionately higher in low socio-demographic index (SDI) regions. The Bayesian age-period-cohort model revealed that by 2050, the ASIR and ASPR show similar downward trends, as do the ASMR and ASDR, but the latter decline less steeply than the former. The global disease burden of AHB in WCBA was declining, which is consistent with the vaccination and perinatal prevention, yet marked geographic disparities persist in low-resource regions. Modeling projections show that continued declines may contribute to progress toward the WHO viral hepatitis elimination goals, but vaccine coverage, safe injection and sufficient prevention of mother-to-child transmission remain essential. Not applicable.