Despite the declining incidence and mortality of cervical cancer following the introduction of the opportunistic cytological screening, a diagnostic gap persisted, particularly for adenocarcinoma, due to the lower sensitivity of conventional cytology for glandular versus squamous lesions, resulting in a stagnating or modest increase in adenocarcinoma incidence. Since 2020, combined screening with HPV testing and cytology has been recommended in Germany for women aged 35 years and older. The present analysis is based on nationwide data from the German Cancer Registry. Women who received the diagnosis of a cervical adenocarcinoma in situ (ACIS) or invasive adenocarcinoma in the years 2016-2022 were included in the analysis. Trends in age-specific and standardized incidence in three age groups (under age 35, age 35-64, and age 65 and above) were analyzed with joinpoint regression. Data on 4128 women with ACIS and 6244 with invasive adenocarcinoma were evaluated. In women aged 35-64, the introduction of combined screening led to a marked increase in ACIS diagnoses (average annual increase, 17.3%; 95% confidence interval [14.9; 19.6]. The rise was particularly large in 2020, with an annual percentage change (APC) of 27.5%, [17.4; 38.5]. Over the same period, there was a decline in invasive adenocarcinomas from 2021 onward (APC -10.8%, [-22.7; 2.8]). The incidence of ACIS also rose among women aged 65 and above, while that of adenocarcinoma fell slightly. Combined screening for cervical cancer improved the early detection of preinvasive glandular lesions. There is also evidence for a reduction of invasive disease in the screened population. For the full potential of screening to be achieved, there is a need for quality-assured organized programs and additional biomarkers for HPV-negative adenocarcinoma.

Trends and disparities in cancer mortality involving intracerebral hemorrhage in the United States from 1999 to 2020.

Trends in mortality from High-Risk surgical procedures: National burden of Transplants, Implants, and Organ removal from 1999 to 2024 in United States.

A Descriptive Analysis of Suicide Trends by Race/Ethnicity, Sex, and Age Categories in Santa Clara County, California From 2018 to 2023.

Although the recent proliferation of telemental health care has transformed delivery of outpatient mental health care for many patients, little is known about population-level access to telehealth, hybrid, and in-person outpatient mental health care in the US. The objective of this report is to characterize patterns of all telehealth, hybrid, and all in-person outpatient mental health care by US adults. An analysis is presented of 2021-2022 Medical Expenditure Panel Survey data (n=39,561) focusing on annual percentages of adults receiving all telehealth, hybrid, and all in-person outpatient mental health care. Results are presented overall and stratified by sociodemographic characteristics. Differences are reported in average marginal estimates from logistic regressions for each sociodemographic characteristic controlling for age group, sex, and psychological distress (Kessler-6). Approximately 12.0% of adults annually received outpatient mental health care, including 3.3% all telemental health care, 2.6% hybrid, and 6.1% all in-person mental health care. After controlling for age, sex, and distress, unemployed adults 65 years of age or younger were less likely than employed adults to receive all mental health care (-1.0 percentage points, 95% CI: -1.6 to -0.4), and uninsured individuals were less likely than those with private insurance (-2.8 percentage points, 95% CI: -3.6 to -1.9). By contrast, college graduates were 3.2 percentage points (95% CI: 2.3-4.0) more likely than those with less than a high school diploma, higher-income individuals were 1.6 percentage points (95% CI: 0.8-2.30) more likely than those below the poverty level, and urban residents were 1.9 percentage points (95% CI: 1.1-2.7) more likely than rural residents to receive all telemental health care. These national patterns highlight differences in US telemental health care access across employment, education, income, insurance, and geographic groups.

Thirty-year trends in the prevalence and incidence of multiple sclerosis (MS) in Mazandaran Province: Application of advanced statistical methods.

Global Burden of Lip and Oral Cavity Cancer Attributable to Alcohol Use in 204 Countries and Regions.

Trends in dengue incidence and disease burden in South Asia with special reference to India: Insights from the global burden of disease data, 1990-2021.

Burden of primary liver cancer and underlying etiologies among young adults from 1990 to 2021 and modelled Projection to 2050.

The authors investigated trends in U.S. state and local government health employees per million persons at the aggregated 50-state, regional, and state levels. The authors used repeated cross-sectional data from the Annual Survey of Public Employment & Payroll. Joinpoint regression was used to estimate average annual percentage changes and annual percentage changes from 2000 through 2023. State and local full-time and part-time government health employees included public health and several other categories of health workers. State and local government health employees per million persons remained stable in the U.S. from 2000 through 2023. Heterogeneous trends in state and local government health employees were observed by region: Northeast (average annual percentage change=0.5% increase, 95% CI=0.3%, 0.7%), Midwest (average annual percentage change=0.9% increase, 95% CI=0.6%, 1.1%), South (average annual percentage change= -0.7% decrease, 95% CI= -0.9%, -0.5%), and West (average annual percentage change=0.1% increase, 95% CI= -0.1%, 0.2%). The authors observed further variation in state-stratified analyses. Most U.S. states experienced decreasing trends during the Great Recession (2007-2009) and increasing trends during the COVID-19 pandemic (2020-2023). Stable and long-term funding streams are essential to support consistent recruitment, training, and retention of state and local government health employees. Health policies should account for regional variations in health needs and employment trends when planning the state and local government health hiring.

Changing patterns in tongue, oral cavity, laryngeal and hypopharyngeal squamous cell carcinomas in New Zealand: Incidence, trends and survival from 2006 to 2022.

To explore the geographical and risk factor trends associated with type 2 diabetes mellitus using Global Burden of Disease (GBD) data (1990-2021). Age-standardized T2DM incidence, prevalence, mortality and disability-adjusted life years (DALYs) were extracted from the GBD for 204 countries stratified by sociodemographic index (SDI). Trends were analysed using joinpoint regression to compute average annual percentage changes (AAPCs) and mapping. Age-standardized burden estimates were calculated across 5-year age groups. Risk factor attribution was performed using Bayesian meta-regression and spatiotemporal analysis, illustrating the relative importance of each risk factor by bubble plots. From 1990 to 2021, the global age-standardized incidence rate of T2DM increased (AAPC = 1.83%), with the most pronounced rises in low-middle SDI regions. Mortality slightly increased globally (AAPC = 0.30%) but declined in high-SDI regions. The burden was highest in middle-aged and elderly populations, with a concerning increase in adolescent cases. High body mass index (BMI) was the leading risk factor, estimated to account for 44.5% (95% UI: 19.0%-65.2%) of deaths and 51.9% (95% UI: 24.7%-71.5%) of DALYs in 2021, followed by ambient particulate matter pollution and physical inactivity. The contribution of dietary risks and air pollution varied significantly across SDI regions. Our analysis identifies high BMI, ambient air pollution and physical inactivity as the primary risk drivers of the global T2DM burden. All indicators increased most markedly in low-middle SDI regions, with substantial disparities across age and sex groups. These findings underscore the need for risk-specific and region-tailored preventive strategies.

Rising U.S. mortality associated with coexisting obstructive sleep apnea and obesity, 1999-2019.

Renal cell carcinoma incidence and mortality in California: a population-based study of sociodemographic patterns and temporal trends from 1988 through 2019.

Demographic and regional trends in all-cause mortality among adults with coexisting multiple myeloma and cardiovascular disease in the United States, 1999-2023: A CDC WONDER analysis.

Disparities in testing for latent tuberculosis infection in a large US integrated healthcare system.

Substance use (SU) and diabetes mellitus (DM) are major public health concerns and leading causes of mortality in the United States. However, trends examining their combined impact remain limited. This study analyzed mortality trends related to SU and DM from 1999-2022, focusing on demographic disparities, geographic patterns, and substance-specific contributions using Centers for Disease Control and Prevention data. To examine trends in DM-related mortality involving SU in the United States from 1999-2022, focusing on demographic and geographic disparities and to identify high-risk groups to guide equitable public health interventions. Mortality data were obtained from death certificate records. Age-adjusted mortality rates (AAMRs) per 1000000 and annual percentage changes (APCs) with 95% confidence intervals (CIs) were calculated. Temporal trends were assessed using the Joinpoint Regression Program. From the years 1999-2022 127659 adult deaths were disclosed with SU and DM as the primary cause. The overall AAMR rose with an APC of 4.4% (95%CI: 3.6-5.0) from 1999-2016, accelerating to 11.8 (95%CI: 10.2-14.5) from 2016-2022. Gender disparities showed males having higher AAMRs throughout the study period as compared with females. Among racial groups there was a significantly higher AAMR consistently for American Indian/Alaska Natives compared with other races. Geographic analysis showed the highest AAMR in the western states (32/1000000) and pronounced rural increases (APC: 17.6%, 95%CI: 13.2-20.5) after 2018. Alcohol use was the leading contributor (71861 deaths), followed by cocaine and stimulant use. This study revealed alarming increases in mortality linked to SU and DM, with widening demographic and geographic disparities. Targeted strategies addressing SU and DM within vulnerable populations are urgently needed to reduce preventable deaths and health inequities.

Children are a priority group for HIV prevention and control. However, limited data exist regarding disease burden and temporal trends among this population. This study aimed to evaluate the burden of HIV, as well as trends in health inequalities, among children aged 0-14 years between 1990 and 2021. Age-standardised incidence, prevalence, disability-adjusted life years (DALYs) and death rates related to HIV among children aged 0-14 years were examined. Long-term trends and estimated annual percentage changes (EAPC) were calculated. Decomposition, health inequality, and frontier analyses were further conducted by Socio-demographic Index (SDI). From 1990 to 2021, the age-standardised incidence rate (ASIR), age-standardised deaths rate (ASDR), and age-standardised DALYs rate (ASR-DALYs) of HIV among children aged 0-14 years all showed a statistically significant decline, with EAPCs of -4.60 (95% CI: -5.97, -3.21), -2.09 (95% CI: -3.74, -0.41), and -2.14 (95% CI: -3.79, -0.46), respectively. In contrast, the age-standardised prevalence rate (ASPR) increased significantly, with an EAPC of 3.16 (95% CI: 1.66, 4.68). The HIV burden was greatest among children aged 0-5 years, particularly those under 1 year. South Asia experienced the most significant increases in ASPR, ASDR, and ASR-DALYs. The global HIV disease burden in children aged 0-14 years trended downward overall but remained substantial, especially in the 0-5 age group. Health inequalities persisted across SDI regions, underscoring the need for targeted public health interventions in high-burden areas, particularly South Asia.

Road traffic injuries remain a leading cause of death and disability among children and adolescents worldwide, particularly in low- and middle-income countries (LMICs), where rapid motorisation and limited trauma care capacity increase vulnerability. In this study, we aimed to characterise long-term patterns and potential future trajectories of the burden of road traffic injuries among children and adolescents aged 0-19 years in LMICs, using estimates from the Global Burden of Disease (GBD) 2023 study. From the GBD 2023 database, we extracted incidence, prevalence, mortality, and disability-adjusted life years (DALYs) for road traffic injuries across 129 LMICs and stratified them by age, sex, and gross national income. We assessed temporal patterns using estimated annual percentage change and joinpoint regression. Further, we used decomposition analysis to illustrate the relative contributions of population growth, age structure, and epidemiological change to the disease burden. We used autoregressive integrated moving average (ARIMA) models for exploratory and scenario-based projections of future trends. Between 1990 and 2023, the overall burden of road traffic injuries among children and adolescents in LMICs declined across DALYs, mortality, incidence, and prevalence. Declines were most pronounced in upper-middle-income and more modest in low-income countries. Motor vehicle-related injuries accounted for the largest share of DALYs across income groups. Males and older adolescents showed higher estimated rates and slower declines. Decomposition analysis indicated that population growth was the primary driver of the increasing burden in low-income countries, whereas epidemiological improvements were primarily observed in upper-middle-income countries. Exploratory extrapolations of ARIMA suggested that DALYs and mortality might continue to decline, while incidence and prevalence might stabilise or increase modestly under unchanged historical trends. Based on estimates from GBD 2023, the burden of road traffic injuries among children and adolescents in LMICs has declined over the past three decades, despite substantial differences across different income, age, and sex groups. These findings should be interpreted as estimated patterns rather than directly observed epidemiological changes. Strengthening road safety, trauma care, and prevention strategies, particularly in low-income settings, is essential to reduce inequality and mitigate the burden of road traffic injuries in children and adolescents.

Sleep-related infant deaths in the USA have plateaued despite long-standing evidence-based recommendations for safe sleep. Understanding maternal patterns of adherence and associated disparities is critical to improving infant safety. Using nationally representative Pregnancy Risk Assessment Monitoring System (PRAMS) Phase 8 surveillance data (2016-2022), we estimated adherence to four safe sleep recommendations, examined temporal trends and assessed sociodemographic and behavioural correlates of non-adherence. We analysed 125 931 weighted maternal responses (weighted count: 6 372 445) on infant sleep position, location, surface and bedding. Temporal trends were assessed using log-linear regression and expressed as the average annual percentage change (APC). Disparities were examined using multiple logistic regression, reporting adjusted ORs (AORs) and 95% CIs. Adherence was highest for supine sleep position (79.8%; 95% CI 79.4 to 80.2) and lowest for safe bedding (32.8%; 95% CI 32.4 to 33.2). Significant improvements were observed in adherence to safe bedding (APC=11.5%) and safe sleep surfaces (APC=2.8%). Compared with non-Hispanic white mothers, non-Hispanic black mothers had substantially higher odds of unsafe practices, including non-supine position (AOR 3.4; 95% CI 3.2 to 3.7), infant bed-sharing (AOR 2.4; 95% CI 2.3 to 2.6), unsafe sleep surfaces (AOR 1.5; 95% CI 1.4 to 1.6) and loose bedding (AOR 3.6; 95% CI 3.3 to 3.9). Elevated risks were also seen among Hispanic mothers, Medicaid or uninsured, unmarried, smokers and those not receiving healthcare worker advice. Maternal adherence to safe sleep recommendations remains low, with persistent sociodemographic disparities. These findings highlight the need for stronger integration of safe sleep counselling within antenatal and postpartum care.