Age-standardized Mortality Research Articles

Global, regional, and national burden of pancreatic cancer from 1990 to 2021, its attributable risk factors, and projections to 2050: a systematic analysis of the global burden of disease study 2021

BackgroundThe incidence and mortality rates of pancreatic cancer are rising globally. This study examines global and regional trends in pancreatic cancer incidence, Disability Adjusted Life Years (DALYs), and mortality from 1990 to 2021, utilizing data from the most recent Global Burden of Disease (GBD) 2021 database.MethodsData were sourced from the GBD database over the period from 1990 to 2021. Age-standardized rates for incidence, DALYs, and mortality were calculated per 100,000 population. We also calculated the proportion of DALYs and mortality attributable to risk factors. The Bayesian age-period-cohort model was applied to project future trends until 2050.ResultsBetween 1990 and 2021, the global incidence of pancreatic cancer increased significantly, with the number of cases rising from approximately 207,905 to 508,533 and the age-standardized incidence rate (ASIR) increasing from 5.47 to 5.96 per 100,000 population. The global burden of pancreatic cancer, measured in DALYs, rose from 5.21 million to 11.32 million. Mortality rates showed a similar upward trend, with the number of deaths increasing from around 211,613 to 505,752, and the age-standardized mortality rate (ASMR) rising from 5.655 to 5.948 per 100,000 population. Notable increases in ASIR and ASMR were observed in low-middle and low sociodemographic index regions with males experienced higher rates compared to females. Age-standardized DALYs rate (ASDR) and ASMR worldwide were attributable to tobacco smoking, high BMI, and high fasting plasma glucose. Furthermore, our projection model estimates that the ASIR and ASMR of pancreatic cancer will significantly decline, while the ASDR is anticipated to maintain a steady downward trend by 2050.ConclusionThis study offers a comprehensive analysis of pancreatic cancer trends, providing crucial insights for public health planning and policy-making. Addressing identified risk factors and targeting high-risk populations are essential for effective strategies to reduce the global burden of pancreatic cancer.

Cancer Mortality by Ethnicity in Colombia Between 2011 and 2022: A Population-Based Study

ObjectivesTo examine cancer mortality rates in Colombia by ethnic groups (Indigenous, Rom, Raizal, Afro-Colombian, and Mestizo) and assess trends from 2011 to 2022.MethodsNational vital statistics from death certificates and the Colombian census data were used. Crude and direct age-standardized mortality rates were determined by ethnicity for the study period, by year, sex, and cancer type and Joinpoint analysis was conducted to examine trends.ResultsAge-standardized cancer mortality of Mestizos (60.1 per 100,000 population) was lower than in Rom and Raizales (557.3 and 77.7 per 100,000), and higher than for Afro-Colombians and Indigenous (37.2 and 20.0 per 100,000). Indigenous people in Colombia had greater proportions of individuals under 45 dying of cancer than Mestizos (18.7% vs. 9.7%, p-value = <0.01). Compared to the Mestizo population, Raizales and Afro-Colombians experienced disproportionately higher age-standardized mortality rates due to prostate cancer (26.6/100,000 and 8.6/100,000 vs. 8.1/100,000), and for Raizales and Rom breast cancer (14.0/100,000 and 103.2/100,000 vs. 9.1/100,000).ConclusionThe disparities in cancer mortality in ethnic minorities in Colombia call for investigating cancer etiology and access to care among the Rom and the Raizal populations.

Trends in Incidence, Mortality and Survival of Gastric Cancer in Xiamen, China from 2011 to 2020: a population-based study

BackgroundGastric cancer remains one of the most common cancers and the leading cause of death in China. This study aims to describe the incidence, mortality, survival rates, and their changing trends of gastric cancer in Xiamen, China from 2011 to 2020. MethodsPopulation-based cancer registry data were used to calculate the incidence, mortality, and survival rates of gastric cancer. The study population consisted of gastric cancer patients diagnosed from January 1, 2011, to December 31, 2020, and followed up until September 30, 2023. The relative survival of gastric cancer was calculated using period methods. The change in trends was analyzed using Joinpoint regression. ResultsFrom 2011 to 2020, a total of 4,716 new cases of gastric cancer and 3,520 related deaths were reported. The crude incidence rate and age-standardized incidence rate (ASIR) were 21.82/100,000 and 16.74/100,000. The crude mortality rate and age-standardized mortality rate (ASMR) were 16.29/100,000 and 12.30/100,000. The ASIR and ASMR in males (ASIR: 24.71/100,000, ASMR: 18.75/100,000) were both more than those in females (ASIR: 9.6/100,000, ASMR: 6.55/100,000). The observed 5-year survival rate was 25.83%, with an age standardized survival of 27.60%. The incidence and mortality of gastric cancer showed a decreasing trend, and the 5-year ARS between 2016 and 2020 (30.03%, 95%CI: 28.07% to 32.12%) was higher than between 2011 and 2015 ( 24.79%, 95%CI: 22.53% to 27.27%). Furthermore, the survival rate decreased with increasing age. ConclusionsFrom 2011 to 2020, the incidence and mortality of gastric cancer in Xiamen City have shown a decreasing trend, and the survival rate has significantly improved. Despite improved survival, the 5-year ARS remains low.

Hepatocellular carcinoma: A 30-year trend analysis of global burden stratified by risk factors, and socio-demographic indexes.

529 Background: Hepatocellular carcinoma (HCC) remains a leading cause of cancer-related morbidity and mortality worldwide, driven primarily by chronic infections with Hepatitis B, Hepatitis C, and alcohol consumption. This study systematically examines global trends of HCC from 1991 to 2021, focusing on age-standardized mortality rates (ASMR) and Disability-Adjusted Life Years (DALYs) according to risk factors across Socio-Demographic Index (SDI) regions. By highlighting these patterns, the study provides insights into the interplay of socio-economic disparities and healthcare advancements on HCC trends. Methods: We utilized data from the Global Burden of Disease database to extract ASMR, and age standardized DALYs for HCC between 1991 and 2021. The data was stratified by etiology (Hepatitis B, Hepatitis C, alcohol consumption) and stratified across five SDI regions: low, low-middle, middle, high-middle, and high SDI. Results: The global HCC ASMR decreased by 4% from 1991 to 2021, with the largest reduction (20.4%) in low SDI regions. Hepatitis B-related HCC ASMR dropped by 16.3%, with reductions across all SDI groups. ASMR of Hepatitis C-related HCC remained stable globally but fell by 15.1% in low SDI regions. Alcohol-related HCC ASMR increased by 10% globally, with the highest rise in high SDI regions (24.5%), and NASH-related HCC ASMR increased by 26.7% globally, with a 42% rise in high SDI regions. Hepatitis B-related HCC DALYs decreased by 22.2%, with the sharpest declines recorded in high (31.4%) and low SDI regions (29%). Hepatitis C-related HCC DALYs saw a 8.8% global reduction, which was consistent across all groups. Alcohol-related HCC DALYs rose by 4.6% globally, with increases of 14.4% in high SDI and 20.5% in low-middle SDI regions. NASH-related HCC DALYs increased by 18.7%, with a 34.7% rise in low-middle SDI regions. Conclusions: The study reveals substantial progress in reducing the global burden of Hepatitis B- and C-related HCC, particularly in low SDI regions. This progress likely reflects advances in vaccination, antiviral treatments, and screening programs. However, the rising mortality and disability associated with alcohol- and NASH-related HCC, especially in high SDI regions, emphasize the growing impact of lifestyle-related risk factors. These findings underscore the need for tailored public health strategies to mitigate the increasing effects of these preventable risk factors on global HCC outcomes.

Incidence, mortality, and global burden of retinoblastoma in 204 countries worldwide from 1990 to 2021: Data and systematic analysis from the Global Burden of Disease Study 2021.

Retinoblastoma (Rb), the primary intraocular malignancy in children, poses significant risks, yet its overall burden remains inadequately assessed. This study aims to analyze global Rb trends using Global Burden of Disease, Injuries, and Risk Factors study (GBD) 2021 data. GBD 2021 data was analyzed to assess Rb incidence, mortality, and disability-adjusted life years (DALYs) from 1990 to 2021. Average annual percentage changes (AAPCs) were calculated across genders, age groups (0-9 years), and geographic regions categorized by socio-demographic index (SDI) quintiles. From 1990 to 2021, the global Rb age-standardized incidence rate (ASIR) increased from 0.08 (per 100,000, range: 0.05 to 0.10) to 0.09 (per 100,000, range: 0.06 to 0.13). ASIR was not significantly correlated with SDI (R = -0.095, P = 0.18), while age-standardized DALYs rate (R = -0.693, P < 0.001) and age-standardized mortality rate (ASMR) (R = -0.71, P < 0.001) were significantly and negatively correlated with SDI. Increases in ASIR were concentrated in Asia, Europe, and northern and southern Africa. The highest standardized DALYs and ASMR were noted in certain countries in Asia, Europe, and South Africa. Among age groups, the highest disease burdens were observed in the "0-6 days" and "2-4 years" groups. There were no significant gender differences in Rb burden globally. Despite global progress, regions with lower SDI face elevated Rb burden and mortality. Females exhibit higher burdens during infancy, necessitating further investigation. Effective Rb management in resource-limited areas requires international collaboration focused on health education, early diagnosis, and prenatal screening for high-risk families.

Global, Regional, and National Burden of Male Breast Cancer, 1990-2021: A Systematic Analysis for the Global Burden of Disease Study 2021.

Male breast cancer (MBC) is rare and often treated using evidence from female breast cancer (BC) trials due to limited male participation. Previous estimates lacked global coverage and completeness. We aimed to quantify the global MBC burden from 1990 to 2021 and evaluate its current status and trends. Based on the global burden of disease (GBD) database, we gathered and analyzed data on the incidence, death, and disability-adjusted life years (DALYs) of MBC while utilizing age-standardized rates (ASRs) as indicators for these measurements. Our study calculated the estimated annual percentage change (EAPC), aiming at measuring the average change in ASRs. Additionally, we evaluated the attributable risk factors (RFs) and trends of MBC across different regions and age groups worldwide. In 2021, the global MBC age-standardized incidence rates (ASIR), age-standardized death rates (ASDR), and age-standardized DALY rates (ASDALY) per 100,000 persons were 0.941 (95% UI, 0.605-1.155), 0.335 (95% UI, 0.232-0.409), and 9.157 (95% UI, 6.116-11.423), respectively. In comparison to 1990, these rates have increased by 2.212 (95% UI, 2.047-2.378), 0.664 (95% UI, 0.562-0.767), and 0.853 (95% UI, 0.750-0.956) respectively. In Uganda 2021, the ASIR and ASDR of MBC were the highest at 4.541 (95% UI, 3.028-6.808) and 3.510 (95% UI, 2.301-5.195) per 100,000 persons, respectively. Moreover, the burden of MBC exhibited an increase with age. Globally, dietary risk was the most important attributable RF for MBC deaths, with a death percentage of 11.690% (95% UI, -0.003%-24.838%), followed by alcohol use and tobacco. From 1990 to 2021, the ASIR, ASDR, and ASDALY of MBC have shown significant disparities and an increasing trend. Committing to healthy lifestyle choices, such as decreasing tobacco and alcohol consumption and making positive changes to dietary habits, can assist in reducing MBC risk. The development and execution of robust and effective public health policies are crucial for alleviating the global disease burden.

The Burden of Hepatitis B and C in Asia, 1990-2019: An Update Analysis From the Global Burden of Disease Study 2019.

This research was aimed to uncover the hepatitis B virus (HBV) and hepatitis C virus (HCV) related diseases burden in Asia over the past 3 decades, estimating from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Age-standardised rates, case numbers of prevalence, disability-adjusted life-years (DALYs), incidence and deaths with 95% uncertainty intervals (UI) for HBV/HCV-related diseases from 1990 to 2019 were derived from GBD 2019 database, with the estimated annual percentage changes (EAPCs) calculated. Our analysis also encompassed the association between the Sociodemographic Index (SDI) and the burden of HBV/HCV-related diseases, future disease burden predictions in six selected countries and various risk factors. A general downward trend in the age-standardised rates of death, disability-adjusted life years (DALYs), prevalence and incidence for both HBV and HCV-related diseases was observed in Asia during the past 30 years. Despite overall declining trends, some analysed diseases experienced an increase. Compared with females, the disease burden was greater in the male population and peaked in the age of 50-54 for both sexes. It is significant for the HBV-related and HCV-related diseases burden in Afghanistan, Cambodia, Mongolia and Pakistan. Drug use and smoking were prominent contributors to HCV and HBV-related diseases. There was a negative relationship between the burden of HCV and HBV-related diseases and SDI. Although decreases were observed in Asia, the HBV- and HCV-associated diseases burden remained high, highlighting that imperative measures for prevention and treatment should be taken by governments in Asia.

Suicides in Czech Republic, Slovakia, Hungary, and Poland in 1990–2019: Epidemiological patterns and trends in European and Global context

Background. Suicides are a major public health problem with serious consequences for societies. Aim. To compare epidemiological patterns and trends of suicides in the Czech Republic, Slovakia, Hungary, and Poland in 1990–2019, and analyze them in the European and Global context. Methods. A trend analysis was conducted in Czech Republic, Slovakia, Hungary, Poland, in Western Europe and on global level for 1990–2019. All data were obtained from the Global Burden of Diseases study 2019. Numbers and age-standardized rates of deaths and Years of Life Lost (YLL) due to suicides were analyzed, stratified by sex and age (0–14 years old, 15–49 years old, 50–69 years old, 70+ years). Results. In 2019, 759,028 suicides occurred globally, 17,408 (2.3%) in Central Europe. The proportion of males was substantially larger, compared to the global and Western European levels (E.g., 82 vs. 69% and 75%, respectively). The highest rates of suicide were in Hungary (19.7 per 100,000), lowest in Slovakia (12.8); the rate in Central Europe was higher than the global rate (15.2 vs. 9.8), and the rate in Western Europe (11.4). A steady decline of rates was observed in all countries, particularly in Hungary. In Czech Republic we found an increasing relative importance of suicides among people 70 years and older. Conclusions. Death rates due to suicides have been declining in the analyzed countries, but some characteristics and trends when compared to global and regional estimates, such as substantially higher proportion of male suicides or high death rates among the elderly warrant specifically tailored preventative action coordinated by governments with community involvement.

Liver cancer in Saudi Arabia: A registry-based nationwide descriptive epidemiological and survival analysis.

Liver cancer is a major worldwide health concern characterized by increasing rates of occurrence. It ranks as the sixth most prevalent form of cancer and is the third highest contributor to cancer-related fatalities globally. This study aimed to describe the epidemiology of liver cancer in Saudi Arabia and to analyze the factors associated with it. This retrospective medical record review included all the patients diagnosed with a liver cancer from January 2014 to December 2020. The incidence data were obtained and collected from the Saudi Cancer registry. The net survival percentage was obtained in global cancer observatory website of the International Agency for Research on Cancer. There were 3066 occurrences of liver cancer among Saudi Nationals during the years 2014 and 2020. The majority of patients consisted of males, accounting for 2105 individuals, which represents 68.7 % of the total. The predominant morphologies are Hepatocellular carcinoma (2520, 82.2 %), choliangocarcinoma (267, 8.7 %), Adenocarcinoma (5.1 %), and malignant neoplasm (3.4 %). The age-standardized incidence rate for males between 2014 and 2020 varied from 4.0 per 100,000 to 4.8 per 100,000, whilst for females it ranged from 1.5 per 100,000 to 2.4 per 100,000. The age-standardized incidence rate among Saudi nationals is 4.7 cases per 100,000, while the age-standardized mortality rate is 4.6 deaths per 100,000. Liver cancer is a significant global health problem, marked by its high occurrence and typically poor survival rates. By emphasizing risk factors, it enhances the implementation practices that may help to provide appropriate care to maximize favourable outcomes.

Global, regional and national burden of lung cancer attributable to occupational carcinogens, 1990-2019: A study of trends, inequalities and predictions based on GBD 2019.

Lung cancer, a leading cause of cancer-related mortality, is significantly influenced by occupational carcinogens. This study aimed to assess and predict global, regional and national trends of lung cancer burden attributable to occupational carcinogens. Data on the lung cancer burden attributable to nine occupational carcinogens were obtained from the Global Burden of Disease Study 2019. Regions were categorized by the Socio-Demographic Index (SDI). Descriptive statistics, Joinpoint regression, and Age-Period-Cohort (APC) models were employed to analyze trends in mortality and Disability-Adjusted Life Years (DALYs). Using the Slope Index of Inequality and Concentration Index, health inequalities were quantified. The ARIMA-LSTM model was developed to predict the burden from 2020 to 2030. From 1990-2019, lung cancer deaths and DALYs due to occupational carcinogens increased. Global age-standardized mortality (ASMR) and DALY (ASDR) rates declined, while middle and lower SDI regions increased. Joinpoint regression and APC analysis revealed that the local drift, period, and cohort effects exhibited increasingly unfavorable trends in lower SDI regions, while they were decreasing trends in higher SDI regions. Conversely, age effects increased similarly across all SDI regions. Health inequalities worsened over time. The ARIMA-LSTM model demonstrated global ASMR and ASDR would decrease, while low-middle and low SDI regions were expected to experience substantial increases from 2020 to 2030. Health inequality of lung cancer burden attributable to occupational carcinogens remained a critical concern, underscoring the urgent need for targeted occupational health policies for low and low-middle SDI regions.

Global, regional, and national burden of male breast cancer in 204 countries and territories: a systematic analysis from the global burden of disease study, 1990-2021.

Male breast cancer (MBC) is a rare malignancy that has been under-investigated, with limited global epidemiological research dedicated to it. A comprehensive estimate of the global, regional, and national burden of MBC is valuable for policy planning. This study aims to evaluate the burden of MBC across 204 countries and territories. MBC data were collected from the 2021 Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study estimates spanning from 1990 to 2021. The global incidence, prevalence, deaths, and disability-adjusted life-years (DALYs) attributed to MBC, as well as corresponding age-standardized rates, were calculated. Temporal trends, projections of incidence and mortality to 2050, lifetime risk, and risk factors of MBC were also estimated according to regions and countries. In 2021, there were 38,827 (95% uncertainty interval [UI], 24,650-47,846) new cases, 320,459 (95% UI, 220,533-384,317) prevalent cases, 13,274 (95% UI, 9074-16,240) deaths, and 380,917 (95% UI, 252,922-476,417) DALYs attributed to MBC worldwide, with the highest disease burden observed in the Eastern Sub-Saharan Africa region. From 1990 to 2021, the age-standardized incidence and mortality rates of MBC significantly increased, but they are projected to decrease over the next 30 years. High-middle Socio-demographic Index (SDI) quintile had the highest lifetime risk of developing MBC, while the low SDI quintile had the highest lifetime risk of dying from MBC. Dietary risk and alcohol use were identified as important risk factors for MBC deaths and DALYs globally. The global burden of MBC significantly increased from 1990 to 2021, with notable geographic disparities. Efforts aimed at MBC prevention and control strategies should take into account the inequities in its global distribution. This study was supported by the National Natural Science Foundation of China (grant numbers 82372996 and 82202913) and the Chongqing Natural Science Foundation (grant number CSTB2023NSCQ-MSX0480).

Variability and social patterning of cancer mortality in 343 Latin American cities: an ecological study.

Understanding between-city variations in cancer mortality is crucial to inform national and subnational cancer prevention strategies. However, studies at the city level in Latin America are scarce. As part of the Salud Urbana en América Latina (SALURBAL) project, we aimed to describe the variability in cancer mortality rates across 343 cities in nine Latin American countries and the associations of these rates with city-level socioeconomic development. This ecological study used data from cities in Argentina, Brazil, Chile, Colombia, Costa Rica, El Salvador, Guatemala, Mexico, and Panama. Vital registration and population data from Jan 1, 2015 to Dec 31, 2019 were used to estimate sex-specific and age-standardised cancer mortality rates for each city, overall and for seven cancer sites (breast, lung, colorectal, stomach, liver, prostate, and cervical), and the associations of these rates with city-level socioeconomic development. We found wide variability in cancer mortality by city (overall age-adjusted cancer mortality rates varied by almost three times), sex, and cancer site. Variability between cities within the same country was highest for cervical and prostate cancer. The most common causes of cancer deaths were breast cancer (305 cities) for females and prostate cancer (167 cities) and lung cancer (132 cities) for males. Liver and cervical cancer were the primary cause of cancer mortality in fewer than ten cities each, most of which were in Guatemala and Mexico. Lower city-level socioeconomic development was associated with higher mortality from liver, stomach, cervical, and prostate cancers and lower mortality from breast, colorectal, and lung cancers, with variations by sex. We found considerable heterogeneity in cancer mortality between cities, geographical patterning, and associations between cancer mortality rates and socioeconomic development. Our results highlight the need to consider city contexts when planning interventions to reduce cancer mortality and when guiding future cancer prevention and control efforts in urban areas within the region. Wellcome Trust. For the Spanish and Portuguese translations of the abstract see Supplementary Materials section.

Global burden, risk factors, and projections of early-onset dementia: Insights from the Global Burden of Disease Study 2021.

Despite increasing global awareness of dementia, reliable estimates of the disease burden associated with Early-Onset Dementia (EOD) remain insufficiently quantified. This study aims to estimate the disease burden of EOD, analyze the burden attributable to risk factors from 1990 to 2021, and project these trends to 2050 at global, regional, and national levels, providing essential data to inform public health policy. By utilising data from the GBD 2021 database, this study analysed metrics such as age-standardized prevalence (ASPR), mortality (ASMR), and disability-adjusted life years (AS-DALYs) for EOD. Joinpoint Regression analysis was used to calculated average annual percent changes (AAPCs) of ASPR, ASMR, and AS-DALYs. Then, the disease burden attributable to high fasting plasma glucose (FPG), high body-mass index (BMI), and tobacco were also reported. Finally, the Bayesian age-period-cohort (BAPC) model was employed to project global ASPR, ASMR and AS-DALYs, as well as ASMR and AS-DALYs attributed to the three risk factors from 2022 to 2050. In 2021, the global case numbers of prevalence, mortality and DALYs for EOD were 7.75 (95 %UI: 5.82, 10.08) million, 73,386 (14,059, 232,169), and 3.77 (1.69, 8.88) million. Despite large increases in case numbers, AAPCs of ASR (0.08 % [0.02, 0.14], 0.07 % [0.05, 0.1], and 0.08 % [0.05, 0.1]) kept stable. Females exhibited higher case numbers and ASR across all disease burden indicators than males. Region- and country-level geographical heterogeneities were evident. Furthermore, global ASMR and AS-DALYs associated with high BMI and high FPG showed a steady increase, while the growth in ASMR and AS-DALYs attributable to tobacco has declined. To 2050, global case numbers of prevalence, mortality and DALYs for EOD will continue to rise, but ASRs won't change considerably. Females are anticipated to remain at a higher risk. The disease burden associated with high BMI and high FPG are expected to persist in their upward trends, whereas that related to tobacco are projected to decline. The increasing burden of EOD underscores the critical need for tailored public health strategies and policies, a unique challenge underrecognized before.

Ambient air pollution and Alzheimer’s disease and other dementias: a global study between 1990 and 2019

BackgroundEmerging research found air pollution may be associated with incident Alzheimer’s disease (AD) and other dementias. However, few studies have examined these associations at the global scale. This study aimed to assess the dynamic associations between ambient air pollution and the burden of AD and other dementias worldwide.MethodsThis study synthesised 149 countries/territories between 1990 and 2019. These data include age-standardised mortality rate (ASMR) and disability-adjusted life-years (DALYs) of AD and other dementias, ambient air pollution (fine particulate matter [PM2.5], NO2 and O3 concentration) and a series of covariates were from various source. Average annual percentage changes (AAPCs) were calculated to investigate the temporal variations. Linear mixed models were adopted to assess the associations with single- and multi-pollutant separately. The associations between air pollution changes and the AD and other dementias were also examined using linear regression models. Stratified analyses by Global North–South divide and human development index were performed to explore the potential inequity in air pollution impacts.ResultsDuring 1990–2019, the global ASMR, DALYs and O3 increased by 0.11%, 0.09%, and 0.17% per year, respectively. In contrast, PM2.5 and NO2 decreased by 0.33% and 0.14% per year, respectively. Each 10 µg/m3 increase in PM2.5 was associated with a 0.118 (95% confidence interval [CI]: 0.060 − 0.175) higher ASMR and 0.966 (95%CI: 0.321 − 1.611) higher DALYs after adjusting for all the covariates. The ASMR increased by 0.112 and the DALYs increased by 1.068 for each 10 µg/m3 increase in O3. The NO2–dementia associations were relatively weak. Stronger O3–dementia associations were found in the Global South than those in the Global North.ConclusionsThe burden of dementia is expected to increase globally, given the continuously expansion of the ageing population. Air pollution was found to be significantly associated with a higher burden of AD and dementia. As a persistent challenge in urban cities, air pollution demands strict regulatory control.

Global trends in the burden of ischemic heart disease attributable to smoking from 1990 to 2021: A systematic analysis of the Global Burden of Disease Study 2021.

Ischemic heart disease (IHD) remains a leading cause of death and disability worldwide. This study evaluates the trends in IHD burden attributable to smoking, utilizing Global Burden of Disease Study 2021 (GBD 2021) data, across 204 countries and territories from 1990 to 2021. By examining age-standardized death rates (ASDR) and disability-adjusted life years (ASRDALYs), the study provides insights into the spatiotemporal variations associated with smokingattributable IHD in different sociodemographic regions. Data on smoking-attributable IHD mortality and DALYs were obtained from the GBD 2021 database. This secondary analysis examined ASDR and ASRDALYs for IHD as primary outcomes, with active smoking as the primary exposure. Temporal trends were analyzed using estimated annual percentage changes (EAPCs). The burden was stratified by age, sex, and sociodemographic index (SDI) to identify disparities across regions. Over the last three decades, global ASDR and ASRDALYs for smokingrelated IHD have generally declined. High-SDI regions had the largest reductions, with EAPCs of -4.31 (95% CI: -5.73 - -2.87) and -4.02 (95% CI: -5.40 - -2.62), respectively. In contrast, low-SDI regions experienced slower declines, with EAPCs of -0.54 (95% CI: -1.41-0.33) and -0.80 (95% CI: -1.52 - -0.08), respectively. Older age groups and males consistently had a higher burden across all regions. Global death rates for populations aged 15-49, 50-74, and ≥75 years were 4.31, 46.57, and 142.52 per 100000, respectively. The global ASDR for males (30.24) was 8.54 times higher than that for females (3.54). Regional disparities were most pronounced in low- and middle-income areas, particularly in Eastern Europe and Central Asia, where smoking related IHD burden remains high. While global reductions in smoking-related IHD burden are encouraging, sustained disparities remain, particularly in low-SDI regions. Males and older populations continue to have a disproportionately higher burden, emphasizing the need for targeted interventions and sustained efforts to address these inequities.

Global regional and national burden of intracerebral hemorrhage between 1990 and 2021

Intracerebral hemorrhage (ICH) represents one of the most devastating forms of stroke, characterized by spontaneous bleeding into the brain parenchyma. This neurological emergency carries a substantial burden of mortality and long-term disability worldwide. A comprehensive understanding of ICH’s evolving global impact from 1990 to 2021 remains essential for healthcare planning and resource allocation. We conducted a systematic analysis of ICH burden utilizing data from the Global Burden of Disease (GBD) Study 2021. Key epidemiological indicators were extracted, including prevalence, incidence, mortality, and disability-adjusted life-years (DALYs). Temporal trends were quantified through estimated annual percentage changes (EAPCs) in age-standardized rates of prevalence (ASPR), incidence (ASIR), mortality (ASDR), and DALYs across the study period. The association between disease burden and socioeconomic development was examined using the sociodemographic index (SDI) as a metric of societal development. This analytical framework enabled assessment of ICH burden across global, regional, and national scales while accounting for demographic and socioeconomic variations. From 1990 to 2021, while absolute ICH cases increased globally, age-standardized incidence rates declined. Our novel geographic analysis revealed East Asia bearing the highest burden, with Eastern Europe showing the highest age-standardized rates. Gender analysis identified distinct age-specific patterns, with males above 35 showing higher risk, particularly in Eastern Europe, while South Asia demonstrated minimal gender differences. Our innovative analysis during COVID-19 revealed healthcare system strength significantly impacted ICH outcomes, with well-resourced countries maintaining better outcomes. Regional risk factor assessment showed varying impacts of high systolic blood pressure across regions, highest in Southern Sub-Saharan Africa and lowest in Oceania. Future projections through 2030 indicate improving survival rates in most regions, except in low-income areas, highlighting persistent healthcare disparities. While the absolute number of ICH cases, deaths, and DALYs increased globally from 1990 to 2021, age-standardized rates showed a decreasing trend. This suggests improvements in prevention and management strategies over time. However, the burden of ICH remains substantial and unevenly distributed across regions, with lower SDI areas facing a disproportionately higher burden. These findings highlight the need for targeted interventions and resource allocation, particularly in regions with higher ICH burden, to further reduce the global impact of this devastating condition.

Temporal trends and future projections of incidence rate and mortality for asthma in China: an analysis of the Global Burden of Disease Study 2021

BackgroundAsthma poses a significant public health burden in China, affecting millions with substantial incidence and mortality. Understanding the trends and future projections of asthma incidence and mortality is crucial for healthcare planning.MethodsWe analyzed asthma incidence and mortality data sourced from the Global Burden of Disease (GBD) 2021 study from 1990 to 2021, calculated the age-standardized incidence and mortality rates (ASIR and ASMR) and the estimated annual percentage change (EAPC), meanwhile, employed Joinpoint regression model to assess the trends. The age-period-cohort model was applied to estimate the effects of the age, period, and cohort on the incidence and mortality. Finally, future asthma trends for the next 25 years were predicted utilizing the Bayesian age-period-cohort (BAPC) model.ResultsOver the past three decades, the incidence rate declined in waves while the mortality declined steadily. The ASIR of asthma decreased from 524.81 to 364.17 and the ASMR declined from 5.82 to 1.47. ASIR and ASMR are consistently higher in males than females during this period. The effect attributable to age on incidence was higher for the younger age group while the mortality was higher for older. The period ratio rate of incidence and mortality declined with the calendar year, and the corrections between birth cohort and the risk of incidence and mortality were negative. Our projections indicate that the ASIR and ASMR will continue to decrease by 2046, with expected rates of 330 and 0.69, respectively. Instead, the absolute number of asthma incidence cases and deaths may increase to approximately 4.5 million and 80,000, respectively.ConclusionAlthough asthma incidence rates and mortality have generally declined in China, the burden remains significant, especially among vulnerable groups, with higher rates in males. Continuous monitoring and age-targeted interventions are essential. Future healthcare strategies must address the aging population to manage the projected increase in asthma cases and deaths.

The global, regional, and national burden of oral cancer, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

PurposeThis epidemiological study leverages data from the Global Burden of Disease (GBD) database spanning from 1990 to 2021 to analyze the global burden of oral cancer. The research aims to provide a comprehensive assessment of the age-standardized incidence rate (ASIR), age-standardized mortality rate (ASDR), and disability-adjusted life years (DALYs) for oral cancer, examining trends over three decades.MethodsThe study used age standardized rate (ASRs) as an indicator of oral cancer epidemiological data. Trend analysis uses estimated annual percentage change (EAPC) to track changes in oral cancer indicators.ResultsThe study identifies a global increase in oral cancer incidence, mortality, and DALYs. From 1990 to 2021, the global incidence rate increased significantly from 3.26 (95% UI 3.14–3.41) to 5.34 (95% UI 4.94–5.70), the global mortality rate rose from 1.83 (95% UI 1.73–1.92) to 2.64 (95% UI 2.42–2.84), and the global estimate of DALYs increased from 55.05 (95% UI 52.38–57.97) to 74.44 (95% UI 67.50–80.44). High-risk regions include Palau and certain areas in Asia. Middle SDI regions show the most significant growth, while economically underdeveloped areas like parts of Africa show less significant trends.ConclusionThe research underscores the need for heightened awareness, surveillance, and prevention efforts, especially in regions with high oral cancer incidence. Policymakers are urged to implement screening programs and public health education to combat the disease.

Mortality and Years of Life Lost From Cardiometabolic Diseases in Mexico: National and State-Level Trends, 1998-2022.

Cardiometabolic diseases (CMDs) are highly prevalent in Mexico. We analyzed the evolution of mortality from CMDs in Mexico at the national and state level, as well as their contribution to years of life lost (YLL), from 1998 through 2022. We conducted an observational study based on a public database. We calculated age-standardized mortality rates, conducted joinpoint regression analyses to determine changes in the trend and magnitude of mortality over time, and calculated YLL from CMDs among people in Mexico nationally and by state. From 1998 through 2022, the age-standardized mortality rate from CMDs increased by 14.9% in Mexico. These rates reached their highest levels in 2020 and 2021 during the COVID-19 pandemic. In 2022, people aged 0 through 84 years had 3.9 YLL from CMDs, which represented an increase of 0.4 years compared with 1998. From 1998 through 2022, age-standardized mortality rates increased for heart disease, diabetes mellitus, and hypertension but decreased for stroke. Mortality and YLL from CMDs have steadily increased among people in Mexico, driven mainly by heart disease and diabetes mellitus. YLL attributable to CMDs could be prevented by early care and health prevention policies. Decision makers should work to implement robust and enduring health policies focused on shared risk factors underlying these diseases.

Burden of NASH related liver cancer from 1990 to 2021 at the global, regional, and national levels

BackgroundThe global burden of non-alcoholic steatohepatitis (NASH)-related liver cancer (NRLC) is increasing, making NASH the fastest-growing cause of liver cancer worldwide. This study presents a comprehensive analysis of NRLC burden at the global, regional, and national levels, further categorized by age, sex, and sociodemographic index (SDI).MethodData on NRLC from the Global Burden of Disease, Injuries, and Risk Factors (GBD) study 2021 were downloaded at global, regional, and national levels. The numbers and age-standardized rates (ASRs) of incidence, mortality, and disability-adjusted life years (DALYs) were analyzed to quantify the global burden of NRLC. Additionally, percentage changes in ASRs were used to identify trends in NRLC from 1990 to 2021.ResultsGlobally, both the number of cases and ASRs for NRLC increased between 1990 and 2021. In 2021, there were 42,291 new cases, 40,925 deaths, and 995,475 DALYs attributed to NRLC. East Asia, South Asia, and Southeast Asia reported the highest absolute case numbers, while Western, Southern, and Eastern Sub-Saharan Africa exhibited the highest ASRs. From 1990 to 2021, Australasia, Southern Latin America, and High-income North America showed the most significant increases in NRLC incidence. Nationally, Mongolia, Gambia, and Mozambique exhibited the highest ASR in 2021.The greatest percentage increases in ASIR occurred in Australia, the United Kingdom, and New Zealand between 1990 and 2021. NRLC incidence rates were higher in men and increased with age, peaking at 80–89 years. Similar patterns were observed for NRLC-related deaths and DALYs. Regionally, ASRs initially declined but then increased as SDI rose. At the national level, ASRs consistently decreased with higher SDI.ConclusionThis study highlights the substantial burden of NRLC at global, regional, and national levels. Males and older individuals bear a higher disease burden, and considerable variation exists across different regions and countries. These findings provide critical insights for formulating effective strategies to prevent and manage NRLC.