Age-standardized Mortality Research Articles

Global burden of chronic kidney disease due to dietary factors

BackgroundWe aimed to assess the global impact of chronic kidney disease (CKD) attributable to dietary risk factors.MethodsThe research utilized data from the Global Burden of Disease Study 2021 to evaluate age-standardized mortality rates (ASMR), disability-adjusted life years (DALYs), and estimated annual percentage changes (EAPCs) linked to CKD resulting from dietary risk factors.ResultsFrom 1990 to 2021, both the ASMR and age-standardized DALY rate (ASDR) for CKD attributable to dietary risk factors exhibited an overall increasing trend globally. The mortality EAPC was 0.65, while the EAPC for DALYs stood at 0.39. Among dietary risk factors examined, a diet high in sugar-sweetened beverages was associated with the most substantial increase in CKD burden. Notably, Central sub-Saharan Africa bore the highest burden of CKD due to dietary risk factors, with an ASMR of 10.24 and an ASDR of 229.23. The increases in ASMR and ASDR were more pronounced in high-income regions, particularly in Latin America and the Caribbean, where the EAPC values for ASMR were 1.45 and 1.05, respectively, and for ASDR were 1.08 and 0.96. Furthermore, the burden of CKD was notably higher among middle-aged and elderly individuals, especially men aged 65 and above.ConclusionThe global disease burden attributed to dietary risk factors for CKD is increasing. A diet high in sugar-sweetened beverages exerted the most significant impact on CKD. There is a high incidence in Central sub-Saharan Africa, as well as in high-income regions and Latin America and the Caribbean.

The burden of chronic kidney disease attributable to high sodium intake: a longitudinal study in 1990–2019 in China

ObjectiveElevated sodium consumption is associated with increased risk for chronic kidney disease (CKD) and data for this disease burden attributable to high sodium intake in China from 1990 to 2019 are scarce in China. Our study aims to estimate and present the national burden of CKD attributable to high sodium intake, as well as its profile.MethodsThe regional disease burden data from the China Center for Food Safety Risk Assessment (CFSA) from 1990 to 2019 were compiled based on the methodology of GBD 2019. CKD burden [deaths and disability-adjusted life years (DALYs)] was quantified according to population group (age, gender) and regions categories (province, SDI). The estimated annual percentage change (EAPC) in age-standardized mortality rate (ASMR) and age-standardized DALYs rate (ASDR) were calculated to describe long-term trends.ResultsTotally, the number of deaths of CKD attributable to high sodium intake reached 95,000, with DALYs amounting to 2.59 million person-years in 2019, while the trends of ASMR (EAPC: -0.31, 95%CI: −0.46, −0.17%) and ASDR (−0.33, 95%CI: −0.48, −0.18%) were down during the observation period. The age-specific numbers and rates of deaths, as well as DALYs increase with age are higher in males than in females. Significant disparities in CKD burden attributable to high sodium intake were observed across provinces and SDI regions. In both 1990 and 2019, the number of deaths and DALYs were higher in middle SDI regions, while low-middle SDI regions had highest ASMR and ASDR. The EAPC of ASDR was found to be significantly negatively correlated with the 1990 ASDR (ρ = −0.393, p = 0.024), and the EAPC of ASMR and ASDR were also significantly negatively correlated with the 2019 SDI (ASMR:ρ = −0.571, p < 0.001; ASDR:ρ = −0.368, p = 0.035).ConclusionHigh sodium intake accounted for a sizeable burden of disease from 1990 to 2019 in China, also presents sexual and geographic variations. Despite a slight decreasing trend exists, the absolute number increased as much as twofold, particularly among males and seniors. Targeting to reduce sodium intake remains a priority, and progress requires systematic monitoring and evaluation, particularly in middle SDI regions that are experiencing rising trends and low-middle SDI regions being susceptible to approaches.

Challenges in determining the global burden of non-malignant central nervous system tumors: an analysis of international incidence and mortality data sources.

Non-malignant tumors of the CNS contribute substantially to the morbidity and mortality from CNS tumors. It is critical to understand the epidemiology of non-malignant CNS tumors separately from CNS malignancies to inform resource allocation and policy since treatment and prognosis can differ. High quality international data on non-malignant CNS tumor burden are needed to accomplish this goal. We assessed cancer registry and vital registration data available to the Global Burden of Disease study by its inclusion of non-malignant CNS tumors, reporting on the availability of data over time and by World Bank income group. We analyzed preliminary age-standardized incidence rates (ASIRs), age-standardized mortality rates (ASMRs), and proportions of CNS tumors by behavior for adults, children, and all ages. Non-malignant CNS tumors were reported separately in 17·2% (N=66) of registry reports and in aggregate with malignant CNS tumors in 18·0% (N=69) of reports. Only seven low- and middle-income countries (LMICs) had data reporting CNS tumors separately by behavior. Across all ages combined, the median ASIR of non-malignant CNS tumor data was 0·31 (interquartile range: 0·15-0·50) and ASMR was 0·24 (0·10-0·44) per 100,000 in LMICs compared to median ASIR of 3·62 (2·62-4·97) and ASMR of 0·32 (0·16-0·65) in high-income countries (HICs). A larger proportion of incident CNS tumors across were reported as non-malignant in HIC data than LMIC data (p<0.0001). Our study alludes to current challenges in understanding global non-malignant CNS tumor burden and a need for increased international data collection. Further research is needed to comprehensively investigate opportunities for future data inclusion.

Assessing and projecting the global impacts of Alzheimer’s disease

BackgroundThis study aims to assess the global burden of Alzheimer’s disease (AD) from 1990 to 2030, with a focus on incidence, mortality, and disability-adjusted life years (DALY).MethodsData on the incidence rates, DALY rates, and death rates of AD across various geographic populations from 1990 to 2021 were obtained from the Global Burden of Disease (GBD) 2021 study. Generalized Additive Models (GAMs) were employed to forecast the disease burden from 2022 to 2030.ResultsThe projected global burden of Alzheimer’s disease from 2022 to 2030 indicates a decrease in DALYs, with an Estimated Annual Percentage Change (EAPC) of −1.44 (95% CI: −1.45, −1.42). Similarly, death rates and incidence rates also show a decline, with EAPCs of −1.80 (95% CI: −1.83, −1.77) and −1.27 (95% CI: −1.29, −1.26) respectively. Gender-specific analysis reveals that the projected global incidence EAPC from 2022 to 2030 is estimated at −1.73 (95% CI: −1.75, −1.70) for males and −1.03 (95% CI: −1.04, −1.02) for females. Regionally, Andean Latin America and the Caribbean exhibit the highest positive EAPCs for DALYs at 0.94 (95% CI: 0.93, 0.94) and 0.59 (95% CI: 0.59, 0.60) respectively, while Eastern Europe shows the lowest EAPC at −16.31 (95% CI: −18.60, −13.95). Country-specific projections highlight Cyprus and Serbia with the highest positive EAPCs for DALYs at 12.55 (95% CI: 11.21, 13.91) and 9.6416 (95% CI: 8.86, 10.4333) respectively. On the other hand, Bahrain and Armenia exhibit significant negative EAPCs at −87.28 (95% CI: −94.66, −69.70) and −85.41 (95% CI: −92.80, −70.41). An analysis based on the Socio-Demographic Index (SDI) reveals that regions with higher SDI values have greater burdens of AD, with countries having SDI ≥ 0.8 showing significantly higher age-standardized Incidence Rates (ASIR), age-standardized Death Rates (ASDR), and age-standardized DALY rates compared to those with SDI &amp;lt; 0.8.ConclusionFrom 1990 to 2030, global burden of AD is projected to decrease, with significant gender and regional disparities. Regions with higher SDI show higher disease burdens, underscoring the necessity for targeted interventions and customized public health strategies to effectively address AD in varied socio-economic settings.

Global, regional and national burden of pancreatic cancer and its attributable risk factors from 2019 to 2021, with projection to 2044

BackgroundTo estimate the global burden of pancreatic cancer in 2019 and 2021 including incidence, mortality, and disability-adjusted-life-years (DALYs).MethodsData on pancreatic cancer incidence, mortality and DALYs were downloaded from the Global Health Data Exchange. The 95% uncertainty intervals (UIs) were reported for annual numbers and rates (per 100,000 populations).ResultsIn 2021, there were 508,532 (95% UI: 462,09 to 547,208) incident cases of pancreatic cancer globally, of which 273,617 (250,808 to 299,347; 53.8%) were in males. The age-standardized incidence rate was 6.0 (5.5 to 6.5) per 100,000 people in 2019 and decreased to 5.9 (5.4 to 6.4) per 100,000 people in 2021. There was a 3.9% increase in the number of deaths from pancreatic cancer from 486,869 (446,272 to 517,185) in 2019 to 505,752 (461,224 to 543,899) in 2021. There was a 3.5% increase in DALYs due to pancreatic cancer, increasing from 10.9 million (10.1 to 11.7) in 2019 to 11.3 million (10.5 to 12.2) in 2021. In 2021, the highest age-standardized death rates were observed in Greenland and Monaco, and the highest age-standardized DALY rates were observed in Greenland and Uruguay. The numbers of incident cases and deaths peaked at the ages of 70 to 74 years. The pancreatic cancer burden increased as the socio-demographic index increased. To 2044, the number of incident cases and deaths will be more than 875 thousand and 879 thousand, respectively.ConclusionThe disease burden of pancreatic cancer remains high, especially in high-income regions. More cancer prevention measures are needed in the future to reduce the burden of pancreatic cancer.

Stroke Subtypes Mortality Attributable to Smoking in China: A Study Based on the Global Burden of Disease Database 2021

Background: The objective of this study was to analyze long-term trends in ischemic stroke (IS), subarachnoid hemorrhage (SAH), intracerebral hemorrhage (ICH) mortality from smoking in China from 1992 to 2021, to provide scientific advice on stroke prevention and treatment in China. Methods: The mortality data of smoking-related stroke and its subtypes in China during 1992–2021 were collected from the Global Burden of Disease 2021. Joinpoint regression model and Age-period-cohort (APC) model were used for trend analysis. Results: The age-standardized mortality rate of stroke and subtypes caused by smoking showed a decreasing trend in China from 1992 to 2021. The decline was greater for women than for men. According to APC model analysis, the age effect showed that ICH and IS showed an increasing trend, while SAH increased first and then decreased. The results of the cohort effect were similar to those of the period effect, with relative risk decreasing for all subtypes. The local drift showed that the stroke and subtypes in males showed a “U” shaped trend, a relatively stable trend for stroke and is in females, and a downward trend for SAH and ICH. Conclusions: Over the past 30 years, the burden of stroke and stroke subtype deaths attributable to smoking in China has decreased. However, future efforts should focus on preventing ICH. Strengthening tobacco control legislation, particularly targeting older men and young people, is crucial for further reducing smoking-related stroke risk.

The global, regional, and national patterns of change in the burden of bacterial pyoderma from 1990 to 2019 and the forecast for the next decade

Pyoderma, commonly known as impetigo, is a bacterial skin infection causing pus formation, prevalent globally, especially in resource-poor areas. It affects both children and adults, including those with conditions like diabetes. Despite its significant impact and economic burden, research on its global epidemiology is limited. This study aims to address this gap by analyzing pyoderma trends from 1990 to 2019 using GBD data. The study aims to analyze global trends in pyoderma epidemiology from 1990 to 2019 using GBD data. Specifically, it investigates Age-Standardized Incidence Rate (ASIR), Mortality Rate (ASMR), and Disability-Adjusted Life Years Rate (ASDR) across 204 countries. Additionally, it provides insights into demographic and socioeconomic factors influencing pyoderma prevalence. Furthermore, it forecasts pyoderma’s development trends for the next decade to inform public health strategies. Data were sourced from the GBD 2019 database, comprising various sources such as censuses, surveys, and registries. Estimates for pyoderma incidence, mortality, and DALYs, along with their 95% uncertainty intervals (UI), were retrieved. The Sociodemographic Index (SDI) was used to assess socioeconomic status, and statistical calculations were performed using the WHO Health Equity Assessment Toolkit and R software (v4.3.2). From 1990 to 2019, the Age-Standardized Incidence Rate (ASIR) and Age-Standardized Mortality Rate (ASMR) of impetigo increased, while the Age-Standardized Disability-Adjusted Life Years Rate (ASDR) declined. Significant global geographical heterogeneity persists, closely associated with the Sociodemographic Index (SDI). Children under 5 and the elderly are particularly at risk, with lower SDI nations bearing higher burdens. Population growth and aging contribute to this rise, with disparities in impetigo trends persisting among countries and regions with varying SDI levels, expected to continue until 2030. Pyoderma exhibits significant heterogeneity across age, gender, and geography, with pronounced disparities evident in underdeveloped regions or countries. Therefore, prioritizing policy formulation and implementing tailored prevention and treatment strategies for high-risk populations are imperative to alleviate the disease burden effectively. Such targeted approaches are crucial in addressing the global impact of pyoderma.

Trends and analysis of risk factor differences in the global burden of chronic kidney disease due to type 2 diabetes from 1990 to 2021: A population-based study.

Chronic kidney disease (CKD) is a significant contributor to the global burden of disease. Among its causes, chronic kidney disease due to type 2 diabetes (CKD-T2D) is the primary subtype. This study aims to provide an updated assessment of the global disease burden of CKD-T2D from 1990 to 2021. It will analyse the trends in the global burden of CKD-T2D and the differences in risk factors, as well as project changes over the next 15 years. The data for this study were derived from the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2021. Estimates of prevalence, incidence, deaths and disability-adjusted life years (DALYs) for CKD-T2D, along with their 95% uncertainty intervals (UIs), were extracted. The trends in CKD-T2D burden from 1990 to 2021 were analysed from overall and local perspectives. An age-period-cohort model was used to estimate the age, period and cohort effects on the prevalence and incidence of CKD-T2D between 1990 and 2021. A decomposition analysis was conducted to assess the contribution of population size, age structure and epidemiological changes to the burden of CKD-T2D. Population-attributable fractions were determined for each risk factor, and a difference analysis was conducted. Additionally, projections were made regarding changes in the burden of CKD-T2D over the next 15 years. In 2021, the global burden of CKD-T2D remained significant, with a total of 107 559 955 cases. The age-standardized prevalence rate (ASPR) was 1259.63 per 100 000 people. The age-standardized incidence rate (ASIR) was 23.07 per 100 000 people, and the age-standardized death rate (ASDR) was 5.72 per 100 000 people. The age-standardized disability-adjusted life years (DALYs) was 131.08 per 100 000. The global burden of CKD-T2D showed variation across different socio-demographic index (SDI) regions. In 2021, the overall burden of CKD-T2D continued to rise, with the age effect increasing with age. Both prevalence and incidence risks showed an upward trend over time. Decomposition analysis indicated that population growth and ageing were the primary contributors to the global burden of DALYs related to CKD-T2D. Metabolic risk factors such as high fasting plasma glucose and high body mass index (BMI) are the most significant attributable risk factors. It is projected that by 2036, the trends in ASPR, ASIR, ASDR and age-standardized DALYs will stabilize. However, ASIR and age-standardized DALYs are expected to continue rising, and the number of cases of prevalence, incidence, mortality and DALYs will persist in their upward trend. CKD-T2D imposes a significant global disease burden, with health disparities and unequal disease outcomes continuing to worsen across countries and regions due to differences in socio-economic development levels. This burden is primarily driven by population growth, ageing and metabolic risks such as obesity, hyperglycaemia and hypertension. Although the rate of increase in disease burden may slow over the next 15 years, the number of cases is expected to rise substantially. Therefore, enhancing prevention, early screening and effective treatment interventions, particularly in high-risk areas, is crucial for reducing the disease burden and narrowing health disparities.

Global burden and attributable risk factors of inflammatory cardiomyopathy and myocarditis from 1990 to 2019

BackgroundOur understanding of the global burden distribution of inflammatory cardiomyopathy and myocarditis is very limited.ObjectiveTo comprehensively assess the global burden distribution and attributable risk factors of inflammatory cardiomyopathy and myocarditis from 1990 to 2019.MethodsWe extracted the data on death, disability-adjusted life years (DALY), and age-standardized rate (ASR) of inflammatory cardiomyopathy and myocarditis from the 2019 Global Burden of Disease (GBD) study, including the comprehensive data and the data classified by age/sex. Evaluate the epidemic trend by calculating the estimated annual percentage change (EAPC) of the above variables. This paper discusses the spatial differences from four aspects: global, five socio-demographic index regions, 21 GBD regions, and 204 countries and regions. We also estimated the risk factors attributable to inflammatory cardiomyopathy and myocarditis-related deaths.ResultsIn 2019, the global death toll from inflammatory cardiomyopathy and myocarditis was 340,349, and the age-standardized mortality rate (ASDR) was 4.40/100,000, of which the elderly and men were the majority. Although ASR has decreased in developed areas, inflammatory cardiomyopathy and myocarditis are still important health problems in those relatively underdeveloped areas. Similar DALYs burden pattern of inflammatory cardiomyopathy and myocarditis was also observed during the study period. Globally, among men over 60 and women over 65, the proportion of deaths caused by high systolic blood pressure in 2019 was higher than that in 1990.ConclusionsInflammatory cardiomyopathy and myocarditis are still important global public health problems. The changing pattern of the burden of inflammatory cardiomyopathy and myocarditis varies with location, age, and sex, so it is essential to improve resource allocation to formulate more effective and targeted prevention strategies. In addition, the control of blood pressure should be emphasized.

The burden of prostate cancer in the North Africa and Middle East Region from 1990 to 2021

Prostate cancer ranks among the most prevalent malignancies affecting males globally. This study sought to document the incidence, deaths and disability-adjusted life-years (DALYs) that were due to prostate cancer in the Middle East and North Africa (MENA) region, and its 21 countries, from 1990 to 2021. We analysed publicly accessible data from the Global Burden of Disease 2021 study to present findings on the incidence, deaths, and disability-adjusted life years (DALYs) associated with prostate cancer. These metrics were reported as counts and age-standardised rates, each accompanied by 95% uncertainty intervals. In 2021, the age-standardised incidence of prostate cancer in the region was 27.4 per 100,000 population, representing a 125.1% increase from 1990. The age-standardised mortality rate was 10.1, and the age-standardised DALY rate was 173.6, neither of which showed significant increases since 1990. Qatar recorded the highest age-standardised DALY rate in 2021, while Algeria had the lowest. The largest number of incident cases, deaths, and DALYs in 2021 were found in the 65–69, 80–84, and 70–74 age groups, respectively. Additionally, from 1990 to 2021, the burden of prostate cancer largely increased with the socio-demographic index (SDI) at the regional level. The burden of prostate cancer in the MENA region rose markedly between 1990 and 2021. Further studies into the underlying causes of this increasing incidence are essential to devise effective strategies for the early detection and prevention of the disease.

Trends and future predictions of chronic kidney disease due to diabetes mellitus type 2 attributable to dietary risks: insights based on GBD 2021 data

BackgroundThe 2021 Global Burden of Disease (GBD) study shows a continuous increase in the burden of chronic kidney disease due to diabetes mellitus type 2 (CKD-T2DM) from 1990 to 2021. This study examines the influence of dietary risk factors across various populations and socioeconomic groups.MethodsUtilizing the 2021 GBD data, we analyzed age-standardized CKD-T2DM metrics—including mortality, disability-adjusted life years (DALY), and age-standardized rates (ASR)—stratified by age, gender, and region. The study employs estimated annual percentage changes (EAPC) to monitor temporal trends and project future trends from 2022 to 2035 using bayesian age-period-cohort (BAPC) analysis.ResultsThe results indicate that, in 2021, 20.55% of CKD-T2DM mortality and 23.21% of CKD-T2DM DALY were attributed to poor diets, especially those low in fruits and high in red and high processed meat. Throughout this period, both mortality and DALY rates associated with dietary risks increased significantly, with the most rapid increase in diet high in sugar-sweetened beverages, highlighting the considerable impact of dietary factors on the global CKD-T2DM landscape. Geographic disparities in T2DM trends are evident, with the most significant increases in age-standardized mortality rates (ASMR) and age-standardized DALY rates (ASDR) observed in regions such as high-income North America and Central Latin America. Socio-demographic index (SDI) is negatively correlated with the CKD-T2DM burden attributable to dietary risk factors.ConclusionPublic health interventions that target dietary changes can significantly reduce the global burden of CKD-T2DM.

Global and Regional Trends in Paediatric Neuroblastoma Incidence and Mortality, 1990-2021: An Inequality and Projection Analysis.

Neuroblastoma stands as the most prevalent extracranial solid tumour in children, yet its epidemiological profile on global, regional, and national scales remains insufficiently explored. Long-term trends in the incidence and mortality of paediatric neuroblastoma from 1990 to 2021 were analysed globally, regionally, and nationally using estimated annual percentage changes. Cross-national disparities in the burden of paediatric neuroblastoma were quantified through standard health equity methodologies, with projections of burden shifts extending to 2035. From 1990 to 2021, the global age-standardised death rate for paediatric neuroblastoma increased from 0.19 (95% UI, 0.16-0.23) to 0.21 (95% UI, 0.14-0.28) per 100 000 population, with an EAPC of 0.2. Regionally, both mortality and incidence rates were highest in low-middle SDI regions and lowest in Oceania. Mortality rates were highest among males aged 12-23 months and females aged 6-11 months, while incidence rates were most pronounced in children aged 2-4 years. Cross-country inequality analyses indicated a reduction in disparities between high and low SDI countries; however, the concentration index revealed an increase in the inequality of burden distribution. The global burden of paediatric neuroblastoma is projected to continue rising through 2035. Over the past 30 years, global incidence and mortality rates for paediatric neuroblastoma have risen, particularly in low-SDI regions, whereas high-SDI regions have witnessed a downward trend. Although disparities between high- and low-SDI countries have diminished, inequality in burden distribution has grown more pronounced. The global burden of paediatric neuroblastoma is expected to continue its upward trajectory over the next 15 years.

Burden, trends, and predictions of liver cancer in China, Japan, and South Korea: analysis based on the Global Burden of Disease Study 2021.

Liver cancer (LC) is a major concern in the Asia-Pacific region, particularly in China, Korea, and Japan. In this study, we aimed to investigate the burden, trends, and predictions related to LC in these countries. Using data from the Global Burden of Disease Study 2021, the epidemiological characteristics [incidence, deaths, and disability-adjusted life-years (DALYs)] for LC were analysed and stratified by specific etiologies in China, Japan, and South Korea. We examined temporal trends in LC burden over the last 32years and projected changes over the following 25years. The risk factors associated with LC deaths and DALYs were also investigated. In 2021, the highest LC-related incidence, mortality, and DALYs were recorded in China (196,637 incidents, 172,068 mortalities, and 4,890,023 DALYs), and the lowest in South Korea (18,642 incidents, 13,674 deaths, and 326,336 DALYs). South Korea recorded the highest age-standardized rates (ASRs) of incidence, mortality, and DALYs for LC (19.94 per 100,000, 14.53 per 100,000, and 354.57 per 100,000), and Japan the lowest (9.89, 7.29, and 145.74, respectively). From 1990 to 2021, LC incidents and deaths in the three countries increased, and the trends in ASRs decreased. LC incidents and deaths caused by five etiologies also increased in the past 32years, and non-alcoholic steatohepatitis (NASH) was the largest increasing etiologies in China. Infections with hepatitis B virus remained the leading cause of LC in China and South Korea, while hepatitis C virus was the prevailing cause in Japan. High body mass index (BMI) was the most sharply increasing risk factor in China. Alcohol and drug use were the main risk factors for LC in South Korea and Japan, respectively. The LC burden in the three countries was projected to rise steadily between 2022 and 2046. LC remains a significant disease burden in China, Japan, and South Korea now and over the next 25years. Regarding etiologies and risk factors, NASH and high BMI in China, alcohol use in South Korea, and drug use in Japan should receive significant attention.

Unveiling Sociocultural Barriers to Breast Cancer Awareness Among the South Asian Population: Case Study of Bangladesh and West Bengal, India.

Bangladesh and West Bengal, India, are 2 densely populated South Asian neighboring regions with many socioeconomic and cultural similarities. In dealing with breast cancer (BC)-related issues, statistics show that people from these regions are having similar problems and fates. According to the Global Cancer Statistics 2020 and 2012 reports, for BC (particularly female BC), the age-standardized incidence rate is approximately 22 to 25 per 100,000 people, and the age-standardized mortality rate is approximately 11 to 13 per 100,000 for these areas. In Bangladesh, approximately 90% of patients are at stages III or IV, compared with 60% in India. For the broader South Asian population, this figure is 16%, while it is 11% in the United States and the United Kingdom.These statistics highlight the need for an urgent investigation into the reasons behind these regions' late diagnoses and treatment. Early detection is essential for managing BC and reducing its impact on individuals. However, raising awareness in diverse societies is challenging due to differing cultural norms and socioeconomic conditions. We aimed to interview residents to identify barriers to BC awareness in specific regions. We conducted semistructured interviews with 17 participants from West Bengal and Bangladesh through Zoom (Zoom Video Communications). These were later transcribed and translated into English for qualitative data analysis. All our participants were older than 18 years, primarily identified as female, and most were married. We have identified 20 significant barriers to effective BC care across 5 levels-individual, family, local society, health care system, and country or region. Key obstacles include neglect of early symptoms, reluctance to communicate, societal stigma, financial fears, uncertainty about treatment costs, inadequate mental health support, and lack of comprehensive health insurance. To address these issues, we recommend context-specific solutions such as integrating BC education into middle and high-school curricula, providing updates through media channels like talk shows and podcasts, promoting family health budgeting, enhancing communication at cultural events and religious gatherings, offering installment payment plans from health care providers, encouraging regular self-examination, and organizing statewide awareness campaigns. In addition, social media can be a powerful tool for raising mass awareness while respecting cultural and socioeconomic norms. Fighting BC or any fatal disease is challenging and requires support from various dimensions. However, studies showthat raising mass awareness is crucial for theearly detection of BC. By adopting a sensitive and well-informed approach, we aim to improve the early detection of BC and help reduce its impact on South Asian communities.

The global burden of cancer attributable to dietary factors from 1990 to 2019.

To analyze the global cancer burden associated with dietary factors across 204 countries and regions from 1990 to 2019. A population-based study. Global Burden of Disease Study. Using data from the 2019 global burden of disease, we calculated Population Attributable Fractions (PAFs), death and disability-adjusted life years (DALYs). A comparative risk assessment framework was employed, along with estimated annual percentage changes (EAPCs). In 2019, approximately 6.01% of cancer mortality and 5.50% of DALY rates can be attributed to dietary risk factors, particularly low intake of whole grains, milk, and fruits and vegetables. The High Socio-Demographic Index (SDI) region had the highest cancer mortality and DALY PAFs, mainly due to high consumption of red and processed meats, while the Low SDI region showed the highest PAFs from low fruit and vegetable consumption. In 2019, the High-middle SDI region had the highest age-standardized death rate (ASDR) and DALY rate attributable to dietary factors. Among geographic regions, Southern Latin America had the highest ASDR, and Central Europe had the highest age-standardized DALY rate. At the country level, Mongolia exhibited the highest rates for both ASDR and DALYs attributable to dietary risks. From 1990 to 2019, the largest increase in ASDR was observed in Western Sub-Saharan Africa, with Bulgaria showing the largest country-specific increase. Similarly, the largest increase in the age-standardized DALY rate was seen in Western Sub-Saharan Africa, with Lesotho experiencing the highest increase at the country level. Our findings underscored the importance of increasing the consumption of whole grains, milk, and calcium, which can inform global dietary guidelines and cancer prevention strategies.

Global, regional, and national incidence and mortality for enteric infections from 1990 to 2019

BackgroundEnteric infections are among the most common infectious diseases. The aim of this article was to track the global trends in morbidity and mortality from enteric infections in 204 countries or territories from 1990 to 2019.MethodsData were obtained from the Global Burden of Disease 2019 study. Average annual percentage changes (AAPCs) in age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) were calculated to quantify trends in enteric infections. Age-period-cohort models were used to estimate the annual percentage changes from 0 to 4 to 80 − 84 years (local drifts), period and cohort effects between 1990 and 2019 in different socio-demographic index (SDI) regions.ResultsIn 2019, there were 6.59 billion incident cases of enteric infections, and caused 1,748,251 deaths worldwide. From 1990 to 2019, the trend in the global ASIR of enteric infections was relatively stable, but that of ASMR declined (AAPC=-3.30, 95% confidence interval [CI]: -3.54 to -3.07), and global mortality decreased in all age groups. Meanwhile, decreasing trends in ASMR were observed in 173 countries/territories (P < 0.05), particularly in North Macedonia and Kazakhstan. The low and low-middle SDI areas showed decreasing trends in ASIR and ASMR for enteric infections. However, an increasing trend was observed in high SDI regions, especially among older people aged over 60 years.ConclusionsThe global incidence of enteric infections did not change significantly between 1990 and 2019, but the mortality showed a significantly downward trend. The global burden of enteric infections remains serious in children under 5 years and in low and low-middle SDI regions.

Trends in cutaneous melanoma mortality and incidence in European Union 15+ countries between 1990 and 2019.

Cutaneous melanoma (CM) is the leading cause of skin cancer mortality with associated high healthcare costs. Up-to-date reporting of epidemiological trends for CM is required to project future trends, assess the burden of disease and aid evaluation of new diagnostic, therapeutic and preventative strategies. To describe the trends in CM mortality, incidence, mortality-to-incidence indices (MIIs) and disability-adjusted life years (DALYs) over the last three decades. A population-based cross-sectional study of the Global Burden of Disease (GBD) database between 1990 and 2019 was performed. Nineteen high-income countries with similar health expenditure and classified as having high-quality mortality data including the United Kingdom, the United States, Australia and selected European Union countries were included. Annual age-standardized incidence rates (ASIRs), age-standardized death rates (ASDRs) and DALYs for each country were extracted. Mortality-to-incidence indexes were calculated by dividing the ASDR by the ASIR. Trends were described using Joinpoint regression analysis. Almost all countries demonstrated increasing ASDR in males over the observation period with greatest percentage increase in Greece (+87%), and there was greater heterogeneity between countries in females. CM mortality was greater for males than females in all countries. Most recent Joinpoint analysis shows significantly decreasing mortality in all countries except the United Kingdom (+0.5% males between 2007 and 2019, +0.1% females between 2002 and 2019). Incidence rates increased in all countries, with evidence of plateau from 2015 onwards. While MIIs cannot be used as a proxy for survival, statistically significant decreases in MII were observed in all countries. Overall, DALYs remained static. Over the past 30 years, CM mortality and incidence has increased in most EU15+ countries. There is evidence that in recent years, CM mortality is decreasing. The burden of disease as assessed using DALYs has remained mostly unchanged. Future work should not solely focus on expensive innovative therapies, but also on optimizing primary prevention.

Global Burden of Otitis Media Attributable to Secondhand Smoke in 204 Countries and Territories from 1990 to 2019: The Analysis of the Global Burden of Disease Study.

Secondhand smoke (SHS) is a major public health concern. In this study, we evaluated the global burden of otitis media (OM) due to SHS exposure during 1990-2019 and explored the impact of socioeconomic factors on it. With reference to the 2019 Global Burden of Disease (GBD) data, we assessed the OM burden linked to SHS during 1990-2019, stratified by gender, GBD region, and country. Join-point regression models analyzed trends in OM burden by calculating the average annual percent change (AAPC). Spearman's correlation examined the relationship between the Socio-demographic Index (SDI), Healthcare Access and Quality (HAQ) index, and SHS-related OM burden. During 1990-2019, age-standardized disability-adjusted life years (ASDRs) and age-standardized mortality rates (ASMRs) for OM due to SHS declined globally, with AAPCs of -1.45 for ASDR and -7.97 for ASMR. Significant declines in ASMR were noted in low-to-middle SDI regions. Regionally, Eastern Sub-Saharan Africa had the highest OM-related deaths, while South Asia had the highest disability-adjusted life years. OM burden decreased with higher SDI and HAQ. Despite global declines, significant regional and national disparities remained, which emphasizes the need for targeted interventions.

Global and regional burden of cardiovascular diseases due to non-optimal temperature exposure: a systematic analysis with forecasts to 2050.

Cardiovascular diseases (CVD) are leading contributors to global morbidity and mortality, significantly influenced by non-optimal temperatures. This study projects the impact of temperature fluctuations on CVD through 2050, considering environmental and climate changes. Using Global Burden of Disease (GBD) study data, we analysed age-standardized death rates (ASDR) and disability-adjusted life years (ASR DALYs) related to non-optimal temperatures. We applied Estimated Annual Percentage Change (EAPC) for trend analysis and Auto-Regressive Integrated Moving Average (ARIMA) models for forecasting CVD mortality and DALYs from 2022 to 2050. EAPC analysis revealed a decline in CVD mortality rates, with a decrease of -0.32% for males (95% CI: -0.39% to -0.24%) and -0.42% for females (95% CI: -0.48% to -0.36%), indicating reduced mortality from non-optimal temperatures. Regions with higher Socio-Demographic Index (SDI) showed more significant declines. ARIMA forecasts predict a substantial increase in CVD burden with deaths projected to rise from 1.2 million in 2022 to 1.9 million by 2050, and DALYs expected to increase from 2.4 million to over 3 million during the same period. The projected rise in CVD due to temperature variability highlights the need for robust health systems integrated with climate action to mitigate risks. This research underscores the importance of advancing SDG 3.4 to reduce non-communicable disease mortality and emphasizes climate considerations in health planning per SDG 13.

Analysis of hepatitis B mortality trends in China from 2006 to 2021

Objective: To analyze the epidemiological characteristics of hepatitis B mortality among Chinese residents from 2006 to 2021 and predict the mortality trends from 2022 to 2027, providing reference for hepatitis B prevention and control efforts. Methods: A retrospective study was conducted using hepatitis B mortality data from 2006 to 2021 published by the Chinese Center For Disease Control And Prevention. Age-standardized mortality rates (ASMR) were calculated based on the 2000 Chinese population as the standard population. The crude mortality rate (CMR) and ASMR were analyzed for temporal, regional, gender, and age distribution characteristics. The Joinpoint regression model was used to analyze trends, and the grey model was applied to predict CMR and ASMR from 2022 to 2027. Results: From 2006 to 2021, a total of 77 722 hepatitis B deaths were recorded, with an average CMR of 2.69/10 thousands and an ASMR of 2.00/10 thousands. The ASMR showed an overall decreasing trend for both males (AAPC=-5.4%, 95%CI: -8.1 to -2.7, P<0.001) and females (AAPC=-5.7%, 95%CI: -8.4 to -3.0, P<0.001). Declining trends were also observed in urban areas (AAPC=-5.0%, 95%CI: -7.7 to -2.2, P=0.001) and rural areas (AAPC=-5.7%, 95%CI: -9.0 to -2.4, P=0.001). Regional analysis indicated that the western, central, and eastern regions had average ASMRs of 2.86/10 thousands, 2.05/10 thousands, and 1.42/10 thousands, respectively, all showing downward trends. The grey model predicted that from 2022 to 2027, the CMR would decrease annually from 2.36/10 thousands to 2.03/10 thousands, while the ASMR would decline from 1.37/10 thousands to 1.04/10 thousands. Conclusions: Hepatitis B mortality rates in China, reflected by CMR and ASMR, have shown a consistent downward trend, indicating progress in hepatitis B prevention and control. Future efforts should prioritize targeted screening and preventive measures for rural populations, western regions, and males to further reduce mortality.