Disability-adjusted Life Years Rate Research Articles

A comparative analysis of global and Chinese trends in the burden of kidney cancer from 1990 to 2021

Kidney cancer, a prevalent malignant tumor in the urinary system, poses a significant disease burden and remains a crucial public health concern. Utilizing GBD(Global Burden of Disease)2021 data, our study examined the standardized incidence, mortality, prevalence, and DALYs(Disability Adjusted Life Years) rate of renal cancer. We calculated the [1-MIR(Mortality to Incidence Ratio)] value to assess treatment outcomes and survival rates, employed a joinpoint regression model to determine the AAPC(Average Annual Percentage Change), and conducted comparative and longitudinal analyses between China and global trends. The SII(Slope Index of Inequality) and the CI(Concentration Index) were used to assess the DALYs inequality caused by kidney cancer, and the SDI(Socio-demographic Index) was used as the basis for the ranking. Through the joinpoint regression model, we calculated the AAPC and conducted a comprehensive analysis of the disease burden of kidney cancer, evaluating its current status and changing trends. From 1990 to 2021, the age-standardized incidence rate, age-standardized mortality rate, age-standardized prevalence rate, and age-standardized DALYs rate of kidney cancer in China were lower than those the global average. However, the growth rate in China was significantly faster than the global average. The age-standardized incidence rate and prevalence rate of kidney cancer in males showed a greater increase compared to females, both in China and globally. Additionally, the age-standardized rate of kidney cancer in males was notably higher than in females, particularly among middle-aged males. The (1-MIR) of renal cancer increased from 0.36 to 0.62 in China and from 0.49 to 0.58 globally. Overall, the treatment effect of renal cancer has shown some successful outcomes. The SII decreased from 53.47 to 50.19, and the CI decreased from 0.342 to 0.289. The health inequality level of kidney cancer was significant but alleviated. From 1990 to 2021, there was a noticeable increase in the global incidence of kidney cancer. Specifically, the standardized incidence and prevalence of kidney cancer in the Chinese population saw a more rapid rise compared to the global average. Additionally, the disease burden of kidney cancer remained significantly higher in males than in females.

Global, regional, and national disease burden attributable to high systolic blood pressure in youth and young adults: 2021 Global Burden of Disease Study analysis

BackgroundHigh systolic blood pressure (HSBP) can cause adverse cardiovascular events and is therefore associated with a heavy global disease burden. However, this disease burden is poorly understood in youth and young adults. We aimed to explore this population to better understand the evolving trends in HSBP-related disease burden, which is crucial for effectively controlling and mitigating harmful effects.MethodsThis systematic analysis used data from the 2021 Global Burden of Disease Study, spanning 1990–2021. Participants were aged 15–39 years from 204 countries/territories. We analysed HSBP-related disease burden by region, sex, age, and temporal trends. The primary outcomes were disability-adjusted life years (DALYs), mortality rates, and estimated annual percentage change.ResultsGlobally, the number of HSBP-related deaths among youth and young adults has increased by 36.11% (95% uncertainty interval [95% UI], 20.96–52.37%), whereas the number of DALYs has increased by 37.68% (95% UI, 22.69–53.65%); however, global mortality and DALY rates have remained relatively stable. In 2021, the mortality and DALY rates were 4.29 (95% UI, 3.29–5.28) and 263.37 (95% UI, 201.40–324.46) per 100,000 population, respectively. The overall HSBP-related burden was higher in males than in females, with increasing and decreasing trends for males and females, respectively. Regionally, significant improvements in HSBP-related burden were observed in most high-sociodemographic index (SDI) regions, including high-income Asia Pacific (deaths: percentage change, − 72.65%; DALYs: percentage change, − 69.30%) and Western Europe (deaths: percentage change, − 72.89%; DALYs: percentage change, − 67.48%). In contrast, middle-SDI regions had the highest number of deaths and DALYs in 2021, whereas low-middle-SDI regions had the highest mortality and DALY rates. Furthermore, low-SDI regions experienced the largest increase in the number of deaths and DALYs. The HSBP-related burden increased with age; in addition, the proportion of deaths or DALYs due to ischaemic heart disease and stroke increased with age, reaching > 75% for those > 25 years of age.ConclusionsThe increase in global HSBP-related burden among youth and young adults indicates that current preventative efforts are insufficient. Therefore, targeted measures are needed to counter the trends in HSBP-related diseases and reduce disparities across regions and sexes.

Epidemiology of urinary tract infections in the Middle East and North Africa, 1990–2021

ObjectiveThis research reports the incidence, mortality, and disability-adjusted life years (DALYs) associated with urinary tract infections (UTIs) in the Middle East and North Africa (MENA) region, stratified by sex, age, and Socio-demographic Index (SDI) from 1990 to 2021.MethodsData were sourced from the Global Burden of Disease 2021 study, encompassing all 21 countries in the region. Metrics such as absolute counts, age-standardised rates, and percentage changes from 1990 to 2021 are presented with 95% uncertainty intervals (UIs).ResultsIn 2019, the MENA region recorded an incidence rate of 4,033.4 per 100,000 (95% UIs: 3,553.7–4,548.7) and 7,687 deaths (95% UIs: 6,663–8,969). The DALY rate was 41.3 per 100,000 (95% UIs: 36.1–47.2), which was highest among older adults, reaching a peak in the 80–89 age range, and increasing with age, particularly from the 50 + age groups. A non-linear relationship was identified between the burden of UTIs and the SDI, with higher-than-expected rates in lower SDI countries such as Syria and Lebanon.ConclusionDespite a substantial increase in the total number of UTI cases and DALYs in the region from 1990 to 2021, the age-standardised rates remained stable. The larger burden in lower SDI countries highlights the urgent need for targeted public health interventions. Improving healthcare access and antibiotic stewardship is crucial to mitigating the growing burden of UTIs, particularly among older populations in the region.

Evaluation of pulmonary tuberculosis disease burden in Shenyang, China, 2023

BackgroundPulmonary tuberculosis (PTB) is one of the most serious infectious diseases worldwide and poses a great threat to people’s health. China has a vast territory with substantial regional disparities in the PTB disease burden. However, there have been no studies conducted to evaluate the PTB disease burden in Shenyang. The aim was to elucidate the magnitude, composition, and distribution of PTB disease burden in Shenyang.MethodsThe disability-adjusted life years (DALYs) calculated based on Global Burden of Disease (GBD) framework was used to assess the disease burden of PTB in Shenyang in 2023, and descriptive epidemiological methods were employed to elucidate the magnitude, composition, and distribution characteristics of PTB disease burden in Shenyang.ResultsIn 2023, 4,169 PTB cases were reported in Shenyang, including 2,901 males and 1,268 females. The incidence of PTB was 45.50/105, of which 64.29/105 for males and 27.30/105 for females. The incidence among males was higher than that among females (X2 = 688.56, p<0.001). The highest incidence was 107.00/105 in the group of the population aged 80 and above (X2 = 1171.75, p<0.001). In 2023, 189 PTB deaths were reported in Shenyang, including 156 males and 33 females. The mortality of PTB was 2.06/105 of which 3.46/105 for males and 0.71/105 for females. The mortality among males was higher than that among females (X2 = 83.69, p<0.001). The highest mortality was 16.04/105 in the group of the population aged 80 and above (X2 = 285.61, p<0.001). The PTB DALYs rate was 58.25/105, of which 91.73/105 for males and 21.22/105 for females. The DALYs rate among males was higher than that among females (X2 = 44.04, p<0.001). The highest DALYs rate was 149.86/105 in the group of the population aged 80 and above (X2 = 305.35, p<0.001). Years of life lost (YLLs) due to PTB accounted for 71.38% of total DALYs, of which 74.33% for males and 52.89% for females.ConclusionThe PTB DALYs rate in Shenyang was 58.25/105, which was lower than that in China, equivalent to 80% of the national PTB disease burden rate. The disease burden showed a characteristic of increasing with age, and the PTB DALYs rate for males was higher than that for females, being equivalent to 4 times the female rate. The predominant disease burden of PTB was attributed to YLLs, accounting for as much as 71.38%, indicating that PTB primarily results in premature mortality rather than disability. Therefore, the focus should be shifted towards early intervention to reduce transmission, especially for the aged males.

Health loss and economic burden of asthma in China: a qualitative review based on existing literature.

Asthma is a significant public health issue that cannot be ignored in China and around the world, bringing a huge social burden. To evaluate the disease burden of asthma in China, including health loss and cost of illness, and identify its influencing factors. A systematic literature review and qualitative descriptive analysis were conducted, Literature was accessed through PubMed, EMBASE, Web of Science, CNKI, Wangfang Data, and VIP databases, with a cutoff date of April 3, 2024. The analysis focused on two main aspects: health loss burden, measured by disability-adjusted life years (DALYs), including years of life lost (YLLs) and years lived with disability (YLDs); and economic burden, assessed through direct and indirect costs. The risk of bias in economic studies was assessed using an 11-item methodological checklist for cost of illness, while cross-sectional studies were evaluated using the Agency for Healthcare Research and Quality's recommendation rating tool. The analysis included 50 studies, with eight focused on health loss and 42 on economic burden. The health loss studies showed a 51% decrease in asthma's age-standardized DALYs rate over 30 years, from 209.24 to 102.81 per 100,000 person-years. The health loss burden is influenced by factors such as high BMI, smoking, and occupational exposure. Economic burden studies reported annual direct costs from $348 to $1187 per capita, indirect costs from $7 to $1195, and hospitalization costs from $177 to $1547, influenced by frequency and severity of acute exacerbation, comorbidities, and treatment adherence. Quality assessment revealed moderate overall quality, with gaps in sensitivity analyses and cost data transparency. The health loss burden of asthma in China has significantly decreased from 1990 to 2019, with males experiencing a higher burden. However, regional disparities in the economic burden persist, highlighting the need for improved management and adherence to standardized treatment protocols to address these disparities.

The global burden of chronic respiratory diseases attributable to tobacco from 1990 to 2021: a global burden of disease study 2021

BackgroundTobacco is a major risk factor for chronic respiratory diseases (CRDs), yet the global distribution and trends of tobacco-related CRD burdens remain inadequately explored.MethodsThis study extracted data on mortality, disability-adjusted life years (DALYs), age-standardized mortality rate (ASMR), and age-standardized DALY rate (ASDR) related to tobacco-attributable CRDs from the 2021 Global Burden of Disease (GBD) study. Joinpoint regression was used to identify temporal trends in age-standardized rates (ASR), while autoregressive integrated moving average (ARIMA) forecasting was applied to project future trends in ASMR and ASDR for tobacco-related CRDs.ResultsIn 2021, global tobacco-related CRD deaths and DALYs reached 1,545,686 (95% UI: 1,144,476-1,942,541) and 33,014,429 (95% UI: 24,275,462 − 40,930,821), representing increases of 25.43% and 15.64%, respectively, since 1990. Elderly individuals and males showed a higher disease burden. Between 1990 and 2021, ASMR [average annual percentage change (AAPC) = -2.009 (95% CI: -1.8915 to -2.1263)] and ASDR [AAPC = -2.1057 (95% CI: -2.0123 to -2.199)] for tobacco-related CRDs showed a declining trend globally, with autoregressive integrated moving average forecasting suggesting continued declines in ASMR and ASDR in the future. Regionally, South Asia, East Asia, and Oceania had the highest CRD burdens, while country-specific data indicated that Nepal, Myanmar, Papua New Guinea, Kiribati, and the Democratic People’s Republic of Korea bore significant burdens. The ASMR and ASDR of tobacco-related CRDs were highest in regions and countries with Socio-Demographic Index values between 0.4 and 0.5.ConclusionAlthough global tobacco-related CRD deaths and DALYs have continued to increase, ASMR and ASDR are on the decline, with variations across geographic regions. Prevention and control strategies tailored to country-specific disease prevalence are essential to mitigate these burdens.

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.

Fungal Skin Disease Incidence, Prevalence and Disability-Adjusted Life Years in Four Asian Countries (1990-2019).

Fungal skin diseases are a significant burden in Asia, with varying trends from 1990 to 2019, highlighting the need for targeted interventions. To investigate long-term trends in the incidence, prevalence and disability-adjusted life-year rates for fungal skin diseases in China, India, Japan and Singapore from 1990 to 2019. Data were obtained from the 2019 Global Burden of Disease Study. Independent age, period and cohort effects were calculated using age-period-cohort analysis. Age-standardised incidence, prevalence and disability-adjusted life-year rates of fungal skin diseases in China, India, Japan and Singapore decreased from 1990 to 2019. India has the highest standardised incidence, prevalence and disability-adjusted life-year rates. The crude incidence, prevalence and disability-adjusted life-year rates showed an increasing trend in China, Japan and Singapore, and a decreasing trend in India. The age-period-cohort analysis found that the age effect increased in China, Japan and Singapore at ages 45-94 years, and India showed higher risk coefficients at ages 5-20 and 45-94 years. The period effect increased in the four countries, with more pronounced increases in Japan and Singapore. The cohort effect showed a monotonic decline with birth cohort in the four countries, with a slightly slower decline in India. Fungal skin diseases pose a serious burden in Asian countries. We recommend raising awareness and providing specialised interventions for fungal skin diseases, especially for high-risk groups, such as middle-aged and older adults aged ≤ 45 years and young Indians aged ≤ 20 years.

The burden of dengue in South American countries, 1990-2019: Estimates from the Global Burden of Disease study 2019.

To describe the main dengue metrics generated by the Global Burden of Disease (GBD) Study 2019 for South American countries between 1990 and 2019. A descriptive study was carried out using the metrics obtained by the GBD Study 2019. The metrics of incidence, years of life lost due to premature death (YLLs), years lived with disability (YLDs) and disability-adjusted life years (DALYs) were evaluated, grouped by sex and country, between 1990 and 2019. The metrics were presented with age-standardized rates per 100,000 inhabitants and their respective uncertainty intervals (95%UI). The five countries with the highest DALY rates in 2019 were Suriname [78.60 DALYs per 100,000 inhabitants (95%UI 20.06-117.82)], Colombia [57.76 DALYs per 100,000 inhabitants (95%UI 44.35-69.97)], Guyana [29.21 DALYs per 100,000 inhabitants (95%UI 18.21-31.13)], Venezuela [22.58 DALYs per 100,000 inhabitants (95%UI 12.68-31.13)] and Brazil [18.86 DALYs per 100,000 inhabitants (95%UI 12.33-23.43)]. Between 2000 and 2010, there was a relative increase in DALY rates in practically all countries, with the highest percentages in Bolivia (222.5%), Venezuela (158.66%), Brazil (127.50%), Paraguay (90.22%) and Suriname (36.04%). Between 2010 and 2019, all countries showed a relative reduction in DALY rates. This study contributed to the understanding of the dengue burden on the South American continent, pointing to a relative increase between 2000 and 2010 and a relative reduction between 2010 and 2019 in practically all countries.

Assessing human toxicity and ecotoxicity impacts of agricultural pesticide use in Iran based on the USEtox model.

The human health and ecotoxicity impacts of agricultural pesticide use in Iran in 2022 were estimated. The impacts of agricultural pesticide use in Iran by pesticide, crop, and province were assessed based on the USEtox model in terms of disability-adjusted life year (DALY) for human health and potentially disappeared fraction of freshwater ecosystem species (PDF) for ecotoxicity. The annual mass of agricultural pesticide use in Iran in 2022 was 17,188 tons, consisting of herbicides (46.2 %), insecticides (30.0 %), and fungicides (23.8 %). The DALYs and DALY rate (per 100,000 people) of agricultural pesticide use in Iran were determined to be 25,140 and 29.4, respectively. The ecotoxicity impact of agricultural pesticide use in Iran was calculated to be 3.35 × 10+12 PDFm3 d. Over 79 % of the human health and ecotoxicity impacts of agricultural pesticide use were attributed to six pesticides (chlorpyrifos, deltamethrin, ethion, phosalone, thiodicarb, and abamectin) and eight crops (pistachio, apple, fig, vegetables, date, orange, wheat and barley, and cotton). While the contributions of the pesticides to the human health and ecotoxicity impact were not the same, chlorpyrifos ranked highest in both human health (28.8 %) and ecotoxicity (49.9 %) impacts. The highest provincial human health and ecotoxicity impacts of agricultural pesticide use were observed in Tehran (4,201 DALYs) and Fars (3.66 ×10+11 PDFm3 d), respectively. The provincial human health and ecotoxicity impacts were mainly driven by population and cropland area, respectively. Given the considerable human health and ecotoxicity impacts, developing national and provincial action plans for more sustainable use of pesticides in Iran is strongly recommended.

Analysis and prediction of the age-period-cohort model of disease burden of rheumatoid arthritis in China from 1990 to 2019

Using the Global Burden of Disease Study 2019 (GBD 2019) database, the Joinpoint regression model was used to analyze the trend of rheumatoid arthritis (RA) incidence and the standardized disability-adjusted life years (DALY) rate in China. The age, period, and cohort effects were discussed based on the age-period-cohort model. The grey prediction model GM (1, 1) was used to fit the trend of incidence and the standardized DALY rate of RA and predict the incidence and standardized DALY rate of RA in China from 2020 to 2034. From 1990 to 2019, the incidence, standardized incidence, and standardized DALY rate of RA showed a gradual upward trend, with an average annual increase of 1.41% (95%CI 1.32%-1.44%, P<0.001); 0.10% (95%CI 0.01%-0.14%, P<0.001); and 1.91% (95%CI 1.82%-2.12%, P<0.001). The results of the age-period-cohort model showed that the longitudinal age curve of the incidence of RA from 1990 to 2019 showed a trend of increasing first and then decreasing, reaching a peak in the 60-64 years age group. The longitudinal age curve of the standardized DALY rate showed a gradual upward trend, reaching the peak in the 85-89 years age group. The results of period effect showed that the risk of RA increased first and then decreased from 1990 to 2019, with the highest risk from 2010 to 2014, and the risk of incidence was RR=1.03 (95%CI 1.00-1.06). The risk of DALY showed a fluctuating change, with a trend of decreasing first, then increasing, and then decreasing again. The highest risk of DALY in 2005-2009 period was RR=1.03 (95%CI 1.02-1.05). The results of the cohort effect showed that the later the birth, the higher the risk of morbidity and DALY. From 2020 to 2034, the projected incidence and standardized DALY rate of RA in China showed an upward trend. RA remains a major public health challenge. From 1990 to 2019, the incidence, standardized incidence, and standardized DALY rate of RA in China showed an increasing trend, which were affected by age, period effect, and cohort effect to varying degrees. Although the burden of RA in China is lower than the global average, it is still essential to take active preventive measures to reduce the burden of RA and identify and treat RA early.

Global burden and cross-country inequalities of nutritional deficiencies in adults aged 65 years and older, 1990–2021: population-based study using the GBD 2021

Background/objectivesNutritional deficiencies remain significant public health issues in older populations globally. This study evaluates the burden, trends, and cross-country inequalities of four common nutritional deficiencies (protein-energy malnutrition, iodine deficiency, vitamin A deficiency, and dietary iron deficiency) in older adults from 1990 to 2021.MethodsAge-standardised prevalence, disability-adjusted life years (DALYs), and average annual percentage changes (AAPCs) of these deficiencies in people aged ≥ 65 years at global, regional, and national levels were estimated from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021. Cross-country inequalities in disease burden were quantified using the slope index and concentration index, standard health equity methods recommended by the World Health Organization.ResultsGlobally, age-standardised prevalence rates of protein-energy malnutrition increased from 1407.16 per 100 000 population in 1990 to 2015.58 in 2021, with an AAPC of 1.18 (1.08–1.28), showing significant changes in 2015 and 2019, which were turning points in the joinpoint regression. Age-standardised prevalence rates of iodine, vitamin A, and dietary iron deficiencies decreased, with AAPCs of -0.49 (-0.53 to -0.44), -3.24 (-3.27 to -3.20), and − 0.14 (-0.17 to -0.12), respectively. Except for an increase in the DALY rate of vitamin A deficiency (AAPC 0.40), the DALY rates of the other three deficiencies decreased. Inequality in the burden of protein-energy malnutrition and iodine deficiency between high- and low-income countries narrowed, while inequality for vitamin A and dietary iron deficiencies remained stable. Age-standardised DALY rates for all deficiencies decreased as sociodemographic index increased.ConclusionsThe global status of nutritional deficiency among older adults has improved since 1990, but the increasing prevalence of protein-energy malnutrition requires attention. Additionally, cross-country health inequalities persist, necessitating more efficient public health measures.

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.

Evolving landscape of colorectal cancer: Global and regional burden, risk factor dynamics, and future scenarios (the Global Burden of Disease 1990-2050).

Presently, colorectal cancer (CRC) is the second leading cause of cancer-related deaths worldwide. We provided global, regional, and national estimates of the burden of CRC and their attributable risks from 1990 to 2021, aiming to guide screening, early detection, and treatment strategies, optimize healthcare resource allocation, and facilitate the rational management of burden of CRC. Using data derived from the Global Burden of Disease database, we estimated the incidence, mortality, and disability-adjusted life years (DALYs) of CRC. The temporal trends of the age-standardized rate of CRC were quantified by calculating the estimated annual percentage changes (EAPC). Deaths from CRC attributable to each risk factor that had evidence of causation with CRC were estimated. CRC's deaths and DALYs was forecast through 2050 by logistic regression with Socio-Demographic Index as a predictor, then multiplying by projected population estimates. Globally, between 1990 and 2021, the incident cases, death cases, and DALYs attributed to CRC have doubled, the age-standardized incidence rate (ASIR) presented a slightly upward tendency, while the age-standardized death rate (ASMR) and the age-standardized DALYs rate (ASDR) exhibited a decreasing trend. From 1990-2021, the ASIR for males has an increased trend, while females presented a downward trend. The ASIR and ASDR of CRC were higher in high and high-middle sociodemographic index (SDI) countries. The ASIR of CRC in 165 countries and territories showed escalating trend. Globally, for males and both sexes combined, diet low in whole grains was the leading risk factor for age-standardized deaths from CRC in 2021. However, among females, diet low in milk was the leading risk factor. We forecast that 2.18 million (1.53-2.94) individuals will death for CRC worldwide by 2050, and the DALYs achieve 41.7 million (29.9-55.4) by 2050. The doubling of incidence counts and mortality cases and the rising ASIR in most countries indicates a significant burden of CRC. Authorities should devise suitable measures to address the increasing burdens, such as optimizing screening programs, enhancing awareness and screening efforts for males, and reducing exposure to modifiable risk factors.

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 magnitude and temporal trends of stroke attributable to lead exposure from 1990 to 2021.

Lead exposure is associated with an increased risk of stroke, but studies on the global burden of stroke attributable to lead exposure remain limited. This study evaluates the temporal and spatial trends in the disease burden of stroke and its three subtypes attributable to lead exposure in 204 countries and territories from 1990 to 2021. Data from Global Burden of Disease Study (GBD) 2021 were used to estimate annual deaths, disability-adjusted life years (DALYs), age-standardized mortality rate (ASMR), and age-standardized DALY rate (ASDR) of stroke attributable to lead exposure. The estimated annual percentage change (EAPC) was calculated to evaluate trends from 1990 to 2021. Between 1990 and 2021, the global burden of stroke attributable to lead exposure increased significantly, with deaths rising from 341,294 to 556,595 and DALYs from 8.52 million to 12.02 million. However, ASMRs declined from 9.33 to 6.65 per 100,000 population (EAPC = -1.23), and ASDRs fell from 213.99 to 139.82 per 100,000 population (EAPC = -1.51). Among subtypes, ischemic stroke (IS) contributed the most to ASMRs, whereas intracerebral hemorrhage (ICH) accounted for the highest ASDRs. Males had higher ASMRs and ASDRs than females, although females exhibited greater reduction rates. The burden was disproportionately higher in older adults, particularly those over 70 years, with IS and ICH contributing significantly. Socio-demographic and regional disparities were evident, with low- and low-middle SDI regions bearing the highest burden. The stroke burden attributable to lead exposure remains high, with significant variations by age, sex, region, and subtypes. Public health measures and policies are urgently needed to prevent and mitigate lead exposure globally.

The global epidemiology and health burden of the autism spectrum: findings from the Global Burden of Disease Study 2021.

High-quality estimates of the epidemiology of the autism spectrum and the health needs of autistic people are necessary for service planners and resource allocators. Here we present the global prevalence and health burden of autism spectrum disorder from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 following improvements to the epidemiological data and burden estimation methods. For GBD 2021, a systematic literature review involving searches in PubMed, Embase, PsycINFO, the Global Health Data Exchange, and consultation with experts identified data on the epidemiology of autism spectrum disorder. Eligible data were used to estimate prevalence via a Bayesian meta-regression tool (DisMod-MR 2.1). Modelled prevalence and disability weights were used to estimate health burden in years lived with disability (YLDs) as the measure of non-fatal health burden and disability-adjusted life-years (DALYs) as the measure of overall health burden. Data by ethnicity were not available. People with lived experience of autism were involved in the design, preparation, interpretation, and writing of this Article. An estimated 61·8 million (95% uncertainty interval 52·1-72·7) individuals (one in every 127 people) were on the autism spectrum globally in 2021. The global age-standardised prevalence was 788·3 (663·8-927·2) per 100 000 people, equivalent to 1064·7 (898·5-1245·7) autistic males per 100 000 males and 508·1 (424·6-604·3) autistic females per 100 000 females. Autism spectrum disorder accounted for 11·5 million (7·8-16·3) DALYs, equivalent to 147·6 (100·2-208·2) DALYs per 100 000 people (age-standardised) globally. At the super-region level, age-standardised DALY rates ranged from 126·5 (86·0-178·0) per 100 000 people in southeast Asia, east Asia, and Oceania to 204·1 (140·7-284·7) per 100 000 people in the high-income super-region. DALYs were evident across the lifespan, emerging for children younger than age 5 years (169·2 [115·0-237·4] DALYs per 100 000 people) and decreasing with age (163·4 [110·6-229·8] DALYs per 100 000 people younger than 20 years and 137·7 [93·9-194·5] DALYs per 100 000 people aged 20 years and older). Autism spectrum disorder was ranked within the top-ten causes of non-fatal health burden for people younger than 20 years. The high prevalence and high rank for non-fatal health burden of autism spectrum disorder in people younger than 20 years underscore the importance of early detection and support to autistic young people and their caregivers globally. Work to improve the precision and global representation of our findings is required, starting with better global coverage of epidemiological data so that geographical variations can be better ascertained. The work presented here can guide future research efforts, and importantly, decisions concerning allocation of health services that better address the needs of all autistic individuals. Queensland Health and the Bill & Melinda Gates Foundation.

Global, regional and national burden of asthma attributable to NO2 from 1990 to 2021: an analysis from the Global Burden of Disease Study 2021

ObjectivesThis study aims to systematically assess the global, regional, and national burden of asthma attributable to nitrogen dioxide (NO₂) pollution.Design and settingAnalysis of population-level data from 1990 to 2021 obtained...

The global, regional burden of pancreatic cancer and its attributable risk factors from 1990 to 2021

BackgroundPancreatic cancer is the 12th most common type of cancer, and the sixth leading cause of cancer-related mortality, worldwide. Up-to-date statistics on pancreatic cancer would provide us with a better understanding of epidemiology and identify the causative risk factors for the prevention of this disease.MethodsThe degree and change patterns of exposure as well as the attributable cancer burden, including incidence, mortality, disability-adjusted life years (DALYs), and prevalence in global and regional, by sex, age, year, for pancreatic cancer, with the data extracted from the Global Burden of Diseases Study (GBD) 2021. All data analyses were conducted using linear regression analysis and the Joinpoint software (version 5.0.1).ResultsIn 2021, 508,533 new cases of pancreatic cancer have been reported; the mortality and prevalence rate increased to 5.95, and 5.12 respectively; and the global DALYs rate increased to 130.33 this year. Besides, the pancreatic cancer-associated rates of incidence, mortality, DALYs, and prevalence were higher in males than in females. In addition, these indicators in the high SDI (Sociodemographic index) region were higher than the global mean. To date, the high fasting plasma glucose remained the major risk factor that influenced the incidence, mortality, DALYs, and prevalence of pancreatic cancer, followed by tobacco and high body mass index (BMI).ConclusionsResults of this study suggest that the burden of pancreatic cancer is increasing generally, therefore, more attention and measures should be taken to cope with this situation.

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.