Global Burden Of Disease Regions Research Articles

The global burden of disease attributable to high body mass index in 204 countries and territories from 1990 to 2021 with projections to 2050: An analysis of the Global Burden of Disease Study 2021.

Understanding the global burden of disease attributable to high body mass index (BMI) is essential for informing public health strategies and interventions to mitigate the impact of obesity-related conditions. The global deaths and disability-adjusted life years (DALYs) caused by high BMI were examined based on age, sex, year, and geographical location as well as socio-demographic index. Globally in 2021, the deaths and DALYs attributable to high BMI have risen 2.54-fold and 2.68-fold for both sexes when compared to 1990. The number of global deaths linked to high BMI has risen for females from 828 147.16 (95% uncertainty interval [UI] 407 103.20-1 302 480.38) in 1990 to 2 013 089.03 (95% UI 979 000.37-3 076 044.71) in 2021, and for males from 631 386.07 (95% UI 315 452.97-988 213.75) in 1990 to 1 695 974.32 (95% UI 861 972.49-2 635 343.31) in 2021. The number of DALYs related to high BMI worldwide has risen for females from 26 097 463.34 (95% UI 11 042 501.33-42 206 794.07) in 1990 to 67 213 785.86 (95% UI 28 417 735.35-105 552 568.89) in 2021, and for males from 21 944 645.99 (95% UI 10 106 039.21-35 110 379.12) in 1990 to 61 306 297.23 (95% UI 27 566 755.49-94 931 874.52) in 2021. However, the age-standardized rate of high-BMI-related deaths for females increased by 4.06% and 15.06% for males between 1990 and 2021, while the age-standardized rate of high-BMI-related DALYs increased by 21.60% for females and 31.22% for males. Across the 21 Global Burden of Disease regions, in 2021, the highest age-standardized rates of high-BMI-related deaths and DALYs were observed in Southern Sub-Saharan Africa (125.12, 95% UI 71.21-183.13) and Oceania (3712.97, 95% UI 1666.49-5765.84), respectively. Efforts to promote healthy weight management, lifestyle modifications, and early intervention for obesity-related health complications are essential in reducing the morbidity and mortality associated with obesity and improving overall population health.

Global, regional, and national burden of liver cancer due to alcohol use, 1990-2021: results from the Global Burden of Disease study 2021.

Liver cancer is a major global health burden, with alcohol use being a well-established risk factor. This study aims to analyze the global, regional, and national incidence, prevalence, mortality, and disability-adjusted life years (DALYs) attributable to liver cancer due to alcohol use from 1990 to 2021. Data on liver cancer due to alcohol use were collected from the 2021 Global Burden of Disease (GBD) study. The changing trend of liver cancer among alcohol users was described using the linear regression model. In addition, we employed a hierarchical cluster analysis to study the evolving patterns across diverse GBD regions and conducted a frontier analysis to explore the nexus between the burden and sociodemographic progress. In 2021, alcohol-related liver cancer globally accounted for 99 544 incidence cases, 132 033 prevalence cases, 92 228 death cases, and 2 316 027 DALYs cases. Males and middle-aged adults emerged as high-risk populations, while regions with a higher sociodemographic index (SDI) were identified as high-risk areas. From 1990 to 2021, both the number of cases and age-standardized rates (ASRs) increased. Our frontier analysis revealed unattained health gains between 1990 and 2021, highlighting disparities in disease burden among countries with varying SDI levels. This analysis further demonstrated an inverse correlation between SDI and alcohol-related liver cancer ASRs, with the ASRs stabilizing once the SDI exceeded 0.40. Alcohol use is a significant contributor to the global burden of liver cancer. Comprehensive policies and interventions targeting alcohol use are needed to reduce the burden of alcohol-related liver cancer.

Is There an Impending Epidemic of Myopia in Southeast Asia? An Appraisal of the Evidence

Predictions on the future prevalence of myopia suggest one of the Global Burden of Disease regions will develop an epidemic like in East Asia and Singapore in Southeast Asia. This paper analyses the available evidence on prevalence of myopia in this region, concluding that the bulk of the evidence suggests that the prevalence of myopia at the end of schooling is still modest, although two papers suggest that in young adults in Thailand and Indonesia, the prevalence of myopia may be approaching levels typical of the epidemic of myopia. It also analyses an indicator of expected years of education at school entry, as well as current educational levels of adults, using data from the calculation of the UN Human Development Index. It then analyses the results obtained by the countries of the Southeast Asian region in the PISA international surveys of student achievement. Neither of these educational indicators suggests an impending epidemic of myopia. There is a need for more data to clarify this uncertainty. It is suggested that future collection of data concentrate on determining the prevalence of myopia in young adults finishing their schooling. Even methodology as simple as determining levels of lowered visual acuity in senior school students should be sufficient to resolve the uncertainty. This group provides a sound basis for the prediction of future levels of myopia in the adult population, and avoids the impact of the high levels of myopia and high myopia associated with cataract development that occur in much of Southeast Asia.

Global burden and cross-country health inequalities of early-onset colorectal cancer and its risk factors from 1990 to 2021 and its projection until 2036

PurposeTo explore the worldwide, regional, and country-specific burden of early-onset colorectal cancer (EO-CRC) and identify its associated risk factors between 1990 and 2021, and to project its incidence and mortality rates for 2036.MethodsWe acquired data on EO-CRC categorized by gender, socio-demographic index (SDI), and risk factors based on the Global Burden of Disease (GBD) Study 2021. Joinpoint regression analysis was utilized to explore the variation in disease burden. The autoregressive integrated moving average (ARIMA) model was performed to forecast the disease burden up to 2036.ResultsGlobally, the incidence rate, prevalence rate, mortality rate, and disability-adjusted life years (DALYs) rate of EO-CRC were estimated at 5.37 (95%UI: 4.91 to 5.86)/100,000, 34 (95%UI: 30.96 to 37.35)/100,000, 2.01 (95%UI: 1.84 to 2.19)/100,000, and 101.37 (95%: 92.85 to 110.18)/100,000 in 2021. The prevalence and incidence rates of EO-CRC showed an ascending trajectory, whilst the DALYs and mortality rates demonstrated a downward trajectory between 1990 to 2021. The high-middle SDI regions and East Asia exhibited the highest EO-CRC burden among the five SDI regions and 21 GBD regions respectively. A low-whole-grains diet was the chief risk factor contributing to EO-CRC. It was predicted that the age-standardized rate (ASR) of EO-CRC incidence would increase by 5.56%, while the ASR of mortality would decrease by 13.9% globally until 2036.ConclusionThe current and future global burden of EO-CRC is heavy and varies significantly across different regions and countries.

Trends in Global Burden of Alzheimer's Disease and Other Dementias Attributable to High Fasting Plasma Glucose, 1990-2021.

Background and Objectives: Alzheimer's disease and other dementias represent some of the leading public health concerns worldwide. This study aimed to assess the global burden of Alzheimer's disease and other dementias attributable to high fasting plasma glucose in the last decades. Materials and Methods: A descriptive epidemiological study was conducted. The Global Burden of Disease (GBD) study data about deaths and Disability-Adjusted Life Years (DALYs) were used. All figures were presented as age-standardized rates (ASRs). The average annual percent change (AAPC) was computed using the Joinpoint regression analysis. Also, age-period-cohort analysis was performed. Results: A total of 2 million deaths from Alzheimer's disease and other dementias were reported worldwide in 2021, whereby the total number deaths from Alzheimer's disease and other dementias attributable to high fasting plasma glucose was 290,032 (98,900 males and 191,132 females) in 2021. The highest ASRs of burden of Alzheimer's disease and other dementias attributable to high fasting plasma glucose were found in Afghanistan, Iraq, Morocco, Qatar, and the United States of America, while the lowest ASRs were in Belarus and Mongolia. From 1990 to 2021, a significant increase (p < 0.001) was noted in ASRs of deaths and DALYs for Alzheimer's disease and other dementias attributable to high fasting plasma glucose. Looking at the GBD regions, the trends in ASRs for mortality and for DALYs of Alzheimer's disease and other dementias attributable to high fasting plasma glucose between 1990 and 2021 showed a growth 10-fold faster in High-income North America (AAPC = 2.0%, for both equally) and Central Asia (AAPC = 2.4% and AAPC = 2.5%, respectively) than in the region of High-income Asia Pacific (AAPC = 0.1% and AAPC = 0.2%, respectively). The relative risk of mortality and DALYs for Alzheimer's disease and other dementias attributable to high fasting plasma glucose demonstrated statistically significant (p < 0.0001) period and cohort effects, and net drift and local drifts. Conclusions: This study showed an increase in the global burden of Alzheimer's disease and other dementias attributable to high fasting plasma glucose in the last decades. Future successful entire-population strategies targeting high fasting plasma glucose may reduce the burden of a wide range of these diseases.

Global, regional, and national burden and trends of air pollution-related neoplasms from 1990 to 2019: An observational trend study from the Global Burden of Disease Study 2019

BackgroundAir pollution-related neoplasms are a major global public health issue and are one of the leading causes of death worldwide. Air pollution is one of the important risk factors of air pollution-related neoplasms and is associated with a variety of air pollution-related neoplasms.The primary objective of this study was to estimate the epidemiological patterns of death rates and disability-adjusted life years (DALYs) associated with air pollution-related neoplasms on a global scale, covering the period from 1990 to 2019. Furthermore, we aimed to predict the trends in these epidemiological patterns up to 2050. By achieving these goals, our study seeks to provide a comprehensive understanding of the potential causes underlying the observed disparities in neoplasm-related health outcomes, ultimately contributing to the development of effective strategies for addressing this major public health issue. MethodsBased on data from the 2019 Global Burden of Disease (GBD) study, the indicators of the air pollution-related neoplasms disease burden was the numbers and age-standardized rates (ASR) of deaths and disability-adjusted life years (DALYs) from 1990 to 2019. First, we compared the burden of air pollution-related neoplasms and temporal trends by gender, age, socio-demographic index (SDI), region, and country. Furthermore, driving factors and improvement potential were evaluated using decomposition and frontier analysis. Finally, forecasting analyses of the changing trend in the burden of air pollution-related neoplasm up to 2050 was conducted based on time series forecasting models. ResultsIn 2019, air pollution-related neoplasms accounted for 387.45 million (95 % UI 288.04–490.06 million) deaths and 8951.97 million (95 % UI 6680.89–11342.60 million) DALYs globally. Deaths and DALYs demonstrated an upward trend from 1990 to 2019, while their ASR showed a downward trend. The disease burden and the decline degree of males were both significantly higher than that of females, and the high burden was mainly in the elderly groups. The middle SDI region possessed the highest burden with the most significant upward trend, while the high SDI region had the lowest burden with the most significant downward trend. Decomposition analyses represented that the increase in the overall deaths and DALYs of air pollution-related neoplasms was mainly driven by population growth. The predictive analyses expected that the deaths and DALYs of air pollution-related neoplasms will continue to rise, while their corresponding ASR will decrease by 2050. ConclusionThe global burden of air pollution-related neoplasms remained high, and deaths and DALYs will be on upward trends up to 2050, with differences among genders, ages, SDI levels, GBD regions, and countries. It is essential to understand the air pollution-related neoplasm burden and contributing epidemiological factors for implementing effective and factor-tailored interventions to reduce the global burden.

Geographical Differences in Hydrochlorothiazide Associated Risk of Skin Cancer Balanced Against Disability Related to Hypertensive Heart Disease.

Hypertension affects 25%-30% of the world population. Hydrochlorothiazide (HCTZ) is among the most used and cheapest medications but was in 2018 labeled with a warning stating the increased risk of nonmelanoma skin cancer (NMSC). This study describes geographical differences in the association between HCTZ and NMSC from the perspective of hypertensive heart disease (HHD). We conducted a systematic literature search (PubMed, Embase, Clinicaltrial.gov, and Clinicaltrial.eu) using PICO/PECO acronyms, including case-control, cohort, and randomized controlled trials. We constructed a rate ratio of disability-adjusted life years (DALY) for HHD/NMSC in the global burden of disease (GBD) regions. No increased risk of NMSC with the use of HCTZ was found in Taiwan, India, and Brazil. A small (hazard ratio (HR)/odds ratio (OR) ≤1.5) but significantly increased risk was seen in Canada, the United States, and Korea. An increased risk (1.5< HR/OR ≤2.5) in Iceland, Spain, and Japan and a highly increased risk (HR/OR >2.5) in the United Kingdom, Denmark, the Netherlands, and Australia. HHD is associated with a more than tenfold DALY rate compared with NMSC in 13 of 21 GBD regions, corresponding to 77.2% of the global population. In none of these 13 regions was there an increased risk of HCTZ-associated NMSC. Despite limited information from many countries, our data point to large geographical differences in the association between HCTZ and NMSC. In all GBD regions, except Australasia, HHD constitutes a more than fivefold DALY rate compared to NMSC. This disproportionate risk should be considered before avoiding HCTZ from the antihypertensive treatment.

The Role of Vaccination, Testing, and Public Restriction Policies in COVID-19 Mortality and Incidence: Insights from Global Burden of Disease Regions

IntroductionThis study aimed to examine the impacts of vaccination, testing, and government policies on COVID-19 mortality and incidence rates and compare these strategies' effectiveness by seven super regions of the Global Burden of Disease (GBD).Material and methodsThis study used data from January 3, 2020, to March 29, 2023. The incidence and mortality indices were calculated using “daily cases” and “daily deaths” and selected as dependent variables. Vaccination, COVID-19 tests, strictness of a government's policy were explored using corresponding metrics.ResultsDaily cases were four times higher in the high-income region (371.1) than those in the Latin America and the Caribbean region (98.3), but the mortality rate was similar (1.5). The number of vaccinated people did not consistently reduce the mortality across all GBD regions. However, full vaccination was associated with decreased mortality in all regions except Central, Eastern, and Southeastern Europe and Central Asia (CEEECA). Regarding daily testing, a favorable correlation was observed between daily deaths on a global scale, excluding Southeast Asia, East Asia, and Oceania. Overall, vaccination coverage and government policies were effective in reducing the COVID-19 mortality and incidence rates. However, only the high-income region showed a negative association between the stringency index to COVID-19 and incidence and mortality rates.ConclusionsFull vaccination significantly reduced COVID-19 mortality globally, except in the CEEECA region. HI regions showed lower incidence and mortality rates with stricter government measures. Effective vaccination programs and policies are crucial, emphasizing the need for strengthened international cooperation in future pandemics.

Global burden of major depressive disorders attributable to intimate partner violence against women: Magnitude, temporal trends, and regional inequalities

AimsThis study aimed to analyze the temporal trends, spatial heterogeneities, and potential improvements in the burden of major depressive disorders (MDD) attributable to intimate partner violence (IPV) against women across 21 global burden of disease (GBD) regions, and 204 countries and territories from 1990 to 2019. MethodsWe evaluated the burden of MDD attributable to IPV against women, as measured in disability-adjusted life years (DALYs) per 100,000 people across 21 GBD regions and 204 GBD countries and territories, using data from the 2019 GBD Study. The average annual percentage change (AAPC) of the DALY age-standardized rates (ASRs) was used to reflect trends over time. LOESS and quantile regression were used to model the relationship between the five GBD sociodemographic index (SDI) categories and DALY ASRs. Frontier analysis determined the minimum achievable DALY ASR associated with developmental status, as measured by the SDI. ResultsThe overall AAPC in age-standardized DALY rates for MDD attributable to IPV declined globally between 1990 and 2019. Despite the overall global decline (AAPC −0.08 [95 % UI −0.2, 0.03]), certain GBD regions, particularly high-income North America and Central Latin America, have experienced increases in DALY ASRs. The relationship between SDI and MDD burden showed a U-shaped variability, with low-SDI regions consistently exhibiting higher and stable DALY rates. Frontier analysis revealed that several countries, regardless of their SDI, have substantial gaps between observed and potentially achievable DALY rates, indicating areas for targeted intervention to reduce the burden of MDD due to IPV. ConclusionsSignificant spatial and temporal heterogeneity in MDD due to IPV was observed globally from 1990 to 2019, highlighting the substantial potential for improvement in various countries. Protective measures should be customized to suit the unique cultural contexts, developmental statuses, and regional disparities of each country.

Global burden of disease study analysis of thyroid cancer burden across 204 countries and territories from 1990 to 2019.

The purpose of this study is to assess the burden of thyroid cancer over the course of 30 years in 204 countries and territories. Data from the Global Burden of Disease (GBD) 2019 database was analyzed to extract information on prevalence, deaths, DALYs(disability-adjusted life-years), YLL(years of life los), YLD(years lived with disability), and their corresponding age-standardized rates at global, regional, and national levels. The primary focus of the study was to examine trends in thyroid cancer from 1990 to 2019, specifically looking at the Estimated Annual Percentage Change (EAPC) for ASPR, ASDR, and ASDR. Additionally, the study investigated the relationship between cancer burden and the Socio-Demographic Index (SDI). Globally, there will be approximately 18.3 million thyroid cancer (TC) cases in 2019; China and the USA are projected to be the most significant with 310,327 and 220,711 cases (16.17 and 14.82 cases per 100,000 people, respectively).Over the period from 1990 to 2019, age-standardized prevalence rates exhibited a global rise, whereas deaths and DALYs saw a decrease(EAPC:1.63, -0.15- -0.14, respectively). Significantly, the age-standardized prevalence rate increased in 21 GBD regions, affecting 195 out of 204 countries or territories. Over the studied period, thyroid cancer cases, deaths, and DALYs were consistently higher among females than males. Furthermore, a higher Socio-demographic Index was associated with increased age-standardized prevalence rates.

Global Burden and Trends of Primary Liver Cancer Attributable to Comorbid Type 2 Diabetes Mellitus Among People Living with Hepatitis B: An Observational Trend Study from 1990 to 2019

BackgroundType 2 diabetes mellitus (T2DM) increases the risk of liver cancer among people living with hepatitis B virus (HBV). Our study aimed to estimate the global burden and trends of liver cancer attributable to comorbid T2DM among people living with HBV from 1990 to 2019.MethodsWe calculated the population attributable fractions (PAFs) of liver cancer attributable to comorbid T2DM among the burden of HBV-related liver cancer. We applied the PAFs to the burden of HBV-related liver cancer derived from the Global Burden of Disease (GBD) 2019 database to obtain the burden of liver cancer attributable to HBV–T2DM comorbidity. The prevalence, disability-adjusted life year (DALY), and deaths of liver cancer attributable to the comorbidity were assessed at the global, regional, and country levels and then stratified by the sociodemographic index (SDI), sex, and age group. Estimated annual percentage changes (EAPCs) were calculated to quantify the temporal trends.ResultsIn 2019, the global age-standardized prevalence and DALY rates of liver cancer attributable to HBV–T2DM comorbidity were 9.9 (8.4–11.5) and 182.4 (154.9–212.7) per 10,000,000 individuals, respectively. High-income Asia Pacific and East Asia had the highest age-standardized prevalence and DALY rates of liver cancer attributable to HBV–T2DM comorbidity, respectively. From 1990 to 2019, age-standardized prevalence and DALY rates increased in 16 out of 21 GBD regions. High-income North America had the largest annual increases in both age-standardized prevalence rates (EAPC = 6.07; 95% UI, 5.59 to 6.56) and DALY rates (EAPC = 4.77; 95% UI, 4.35 to 5.20), followed by Australasia and Central Asia. Across all SDI regions, the high SDI region exhibited the most rapid increase in age-standardized prevalence and DALY rates from 1990 to 2019. Additionally, men had consistently higher disease burdens than women across all age groups. The patterns of mortality burden and trends are similar to those of DALYs.ConclusionsThe burden of liver cancer attributable to comorbid T2DM among people living with HBV has exhibited an increasing trend across most regions over the last three decades. Tailored prevention strategies targeting T2DM should be implemented among individuals living with HBV.

Chronic lead exposure and burden of cardiovascular disease during 1990-2019: a systematic analysis of the global burden of disease study.

Cardiovascular diseases (CVD) are the leading causes of death and disability worldwide. Lead exposure is an important risk factor for CVD. In our study, we aimed to estimate spatial and temporal trends in the burden of cardiovascular disease associated with chronic lead exposure. The data collected for our study were obtained from Global Burden of Disease (GBD) study 2019 and analyzed by age, sex, cause, and location. To assess the temporal trends in burden of CVD attributable to chronic lead exposure over 30 years, we used Joinpoint regression analysis. In 2019, the number of lead exposure-attributable CVD deaths and disability-adjusted life-years (DALYs) were 0.85 and 17.73 million, 1.7 and 1.4 times more than those observed in 1990, respectively. However, the corresponding age-standardized rates (ASR) of death and DALY gradually decreased from 1990 to 2019, especially from 2013 to 2019. Over the last 30 years, among 21 GBD regions and 204 countries and territories, the High-income Asia Pacific and the Republic of Korea experienced the largest reductions in age-standardized DALY and death rates, while Central Asia and Afghanistan experienced the largest increases. Males and the elderly population suffered higher death rates and DALY burdens than females and the young population. Furthermore, we observed that higher socio-demographic index (SDI) regions demonstrated lower ASR of death and DALY rates. In 2019, the low and low-middle SDI regions, especially South Asia, exhibited the highest burden of CVD attributable to lead exposure. Our study provides a thorough understanding of the burden of CVD attributable to chronic lead exposure. The findings confirm the significance of implementing lead mitigation strategies and increasing investment in CVD prevention and treatment. These measures are crucial in reducing the burden of CVD and promoting public health on a global scale.

Global, regional, and national burden of inguinal, femoral, and abdominal hernias: a systematic analysis of prevalence, incidence, deaths, and DALYs with projections to 2030.

Hernias, particularly inguinal, femoral, and abdominal, present a global health challenge. While the Global Burden of Disease (GBD) study offers insights, systematic analyses of hernias remain limited. This research utilizes the GBD dataset to explore hernia implications, combining current statistics with 2030 projections and frontier analysis. We analyzed data from the 2019 GBD Study, focusing on hernia-related metrics: prevalence, incidence, deaths, and disability-adjusted life years (DALYs) across 204 countries, grouped into 21 GBD regions by the SDI (SDI). Data analysis incorporated relative change calculations, Annual Percentage Change (APC), Average Annual Percentage Change (AAPC), and Joinpoint Regression Analysis. The study also employed frontier analysis and the Bayesian Age-Period-Cohort model for trend prediction up to 2030. Analyses utilized R version 4.2.3. From 1990 to 2019, global hernia cases surged by 36%, reaching over 32.5 million, even as age-standardized rates declined. A similar pattern was seen in mortality and DALYs, with absolute figures rising but age-standardized rates decreasing. Gender data between 1990 and 2020 showed consistent male dominance in hernia prevalence, even as rates for both genders fell. Regionally, Andean Latin America had the highest prevalence, with Qatar and Bulgaria noting significant increases and decreases, respectively. Frontier analyses across 204 countries linked higher SDIs with reduced hernia prevalence. Yet, some high SDI countries, like Qatar and the UK, deviated unexpectedly. Predictions up to 2030 anticipate increasing hernia prevalence, predominantly in males, while death rates are expected to decline. DALYs, after declining, are stabilizing. Our analysis reveals a complex interplay between socio-demographic factors and hernia trends, emphasizing the need for targeted healthcare interventions. Despite advancements, vigilance and continuous research are essential for optimal hernia management globally.

Global, regional and national epidemiology of alopecia areata: a systematic review and modelling study.

Alopecia areata (AA) is a chronic autoimmune disease that leads to a high psychiatric, economic and systemic disease burden. A comprehensive understanding of AA epidemiology is essential for evaluating healthcare source utilization; however, a systematic approach to summarizing epidemiological data on AA is lacking. To investigate systematically the global, regional and national incidence and prevalence of AA. A structured search was conducted using the databases MEDLINE, Embase, Cochrane Library, Web of Science, SciELO and Korean Journal Database from their date of inception to 4 October 2023. Studies that reported the prevalence or incidence of AA were included. We used a Bayesian hierarchical linear mixed model to analyse prevalence estimates. The primary outcomes of our study were the global, regional and national prevalence of physician-diagnosed AA for the overall population, for adults and for children. The incidence data were summarized descriptively. In total, 88 studies from 28 countries were included in the analysis. The reported incidence of AA tended to be higher in adults aged 19-50 years, and this trend was consistent with its estimated prevalence. The reported prevalence in overall populations tended to be higher in men vs. women. The estimated lifetime prevalence rate of AA was 0.10% [95% credible interval (CrI) 0.03-0.39] in the general population worldwide, 0.12% (95% CrI 0.02-0.52) in adults and 0.03% (95% CrI 0.01-0.12) in children. The estimated prevalence of AA was highest in the Asian region and lowest in the African region. In this study, 48% of the Global Burden of Disease regions had insufficient data on the prevalence or incidence of AA. Further studies are needed to provide epidemiological information on middle- and low-income countries. Our study may serve as a crucial reference in terms of healthcare policy decisions.

Global Burden of Pancreatic Cancer Attributable to High Body-Mass Index in 204 Countries and Territories, 1990-2019.

(1) Background: This study aimed to assess the global burden of pancreatic cancer attributable to a high BMI in 1990-2019. (2) Methods: An ecological study was carried out. Data about deaths and Disability-Adjusted Life Years (DALYs) for pancreatic cancer were extracted from the Global Burden of Disease (GBD) study. The age-standardized rates (ASRs, per 100,000) were presented. In order to determine trends of pancreatic cancer burden, joinpoint regression analysis was used to calculate the average annual percent change (AAPC). (3) Results: The highest ASRs of DALYs of pancreatic cancer were found in the United Arab Emirates (47.5 per 100,000), followed by countries with about 25.0 per 100,000 (such as Hungary, Czechia, and Montenegro). From 1990 to 2019, the ASRs of deaths and DALYs of pancreatic cancer attributable to a high BMI significantly increased (p < 0.001) for both sexes in all ages, and across all SDI quintiles and all GBD regions. The highest fraction of DALYs attributable to a high BMI was found in the United States of America and China (equally about 15.0%), followed by the Russian Federation, India, Germany, and Brazil (about 5.0%, equally). (4) Conclusions: Further analytical epidemiological studies are necessary to elucidate the relationship between pancreatic cancer and a high BMI.

The global, regional, and national disease burden of breast cancer attributable to tobacco from 1990 to 2019: a global burden of disease study

ObjectiveTobacco has been identified as a significant contributory element to the development of breast cancer. Our objective was to evaluate the spatiotemporal trends of tobacco-related breast cancer at the global, regional, and national scales during 1990–2019.MethodsWe extracted data on mortality, disability adjusted of life years (DALYs), age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR) from the Global Burden of Disease (GBD) study 2019. Estimated annual percentage change (EAPC) was computed to assess the temporal change in ASDR and ASMR.ResultsIn 2019, the deaths and DALYs attributed to tobacco-related breast cancer were estimated to be 35,439 (95% UI: 22,179–48,119) and 1,060,590 (95% UI: 622,550–1,462,580), respectively. These figures accounted for 5.1% and 5.2% of the total burden of breast cancer. ASMR and ASDR increased in low SDI regions, remained stable in low-middle and middle SDI regions and declined in high and high-middle SDI regions. The burden of breast cancer attributable to tobacco varied notably among regions and nations. Oceania, Southern Latin America, and Central Europe were the GBD regions with the highest number of ASMR and DALYs. There was a positive relationship between age-standardized rate and SDI value in 2019 across 204 nations or territories. A negative association was observed between the EAPC in ASMR or ASDR and the human development index (HDI) in 2019 (R = -0.55, p < 0.01 for ASMR; R = -0.56, p < 0.01 for ASDR).ConclusionTobacco is one important and modifiable risk factor for breast cancer. The heterogeneity in both the spatial and temporal distribution can be attributed to factors such as aging, population growth, and SDI. These findings substantiate the necessity of expediting the enforcement of tobacco-free legislation in order to safeguard populations from the detrimental effects of tobacco.

Epidemiology of gout - Global burden of disease research from 1990 to 2019 and future trend predictions.

Understanding the global burden of gout in the past and future can provide important references for optimizing prevention and control strategies in healthcare systems. This study aimed to report variations in the global disease burden and risk factors of gout in 204 countries and territories from 1990 to 2019. We conducted a retrospective analysis of gout based on the latest Global Burden of Disease (GBD) 2019 database. We collected data on the prevalence, incidence, and disability-adjusted life years (DALYs) of gout from 1990 to 2019. The data were then stratified by age, sex, and economic development level. Decomposition analysis, frontier analysis, and prediction models were used to analyze the changes and influencing factors influencing each indicator. Globally, there were 53,871,846.4 [95% uncertainty interval (UI): 43,383,204.6-66,342,327.3] prevalent cases, 92,228,86.8 (95% UI: 7419,132.1-11,521,165) incident cases, and 1673,973.4 (95% UI: 1,068,061.1-2,393,469.2) cases of DALYs of gout in 2019, more than double those in 1990. Moreover, the pace of increase in the age-standardized prevalence rate (ASPR), age-standardized incidence rate (ASIR), and age-standardized DALY rate (ASDR) accelerated during 1990-2019, with estimated annual percentage changes (EAPC) of 0.94 [95% confidence interval (CI): 0.85-1.03], 0.77 (95% CI: 0.69-0.84), and 0.93 (95% CI: 0.84-1.02), respectively, especially among men. The disease burden of gout has increased in all the other 20 GBD regions in the past 30 years, except Western Sub-Saharan Africa. The highest risk of high body mass index (BMI) and kidney dysfunction was in high-income countries such as North America and East Asia. The global prevalence rate, incidence rate, and DALYs rate of gout in 2030 will reach 599.86, 102.96 per 100,000 population, and 20.26 per 100,000 population, respectively, roughly the same as in 2019. With the development of society, the disease burden of gout will become increasingly severe. It is very important to study the accurate epidemiological data on gout for clinical diagnosis and treatment and health policy.

Global patterns and temporal trends in ovarian cancer morbidity, mortality, and burden from 1990 to 2019

Abstract Objectives Ovarian cancer (OC) is the deadliest gynecological cancer in the world. Deeper knowledge over time is the basis for global studies to design and implement effective measures to reduce inequalities; this study was conducted to investigate the trend of OC incidence and management in the world from 1990 to 2019. Methods We obtained crude numbers and age-standardized rate (ASRs) of OC annually from the 2019 Global Burden of Disease (GBD) study to examine OC’s morbidity, mortality rates, and disability-adjusted life years (DALYs) based on age group, sociodemographic index (SDI), WHO regions, continents, World Bank regions, and GBD regions from 1990 to 2019 in 204 countries and territories. The relative change (%) and average Annual Percent Change (AAPC) were used to display the epidemiological trend. Results Globally, the number of OC incidents increased from 141,706 in 1990 to 294,422 in 2019. Despite the age-standardized incidence rate (ASIR) in regions with high SDI having a downward trend, these areas recorded the highest incidence cases and ASIR in 2019. Although the World Bank high-income level had the most frequent incidence cases and ASIR, the ASIR in these regions decreased from 1990 to 2019. Among the continents, Europe and America have the highest ASIR but experienced a decreasing trend from 1990 until 2019 in ASIR. The age-standardized mortality rate (ASMR) in the World Bank high-income level experienced a decreasing trend in 1990–2019. In contrast, in the middle, low-middle, and low SDI regions, the death number increased approximately 3.5–4.1 times, and the ASMR had a significant increase from 0.5 in the middle to 0.75 in the low-middle SDI. Globally, the DALY cases of OC rose from 2,732,666 in 1990 to 5,359,737 in 2019; almost doubling. A significant decrease in the DALYs ASR was observed in seven GBD regions. The most pronounced decrease was found in Australia. Conclusions The trend of OC incidence and burden and approximate mortality were stable from 1990 to 2019; especially in lower socioeconomic areas and low-income countries; while the incidence ASR of this cancer in the high SDI regions decreased from 1990 to 2019. The key to reducing OC remains in primary prevention. Approaches such as weight loss, a healthy lifestyle and diet, promoting childbearing and breastfeeding, and recommending the use of oral contraceptives in eligible individuals can have a protective effect against this silent killer.

A systematic analysis of chronic kidney disease burden attributable to lead exposure based on the global burden of disease study 2019

AimAs an important toxic heavy metal, lead exposure can lead to the occurrence of chronic kidney disease (CKD). However, the analysis of its disease burden pattern on a global scale is lacking. This study aimed to analyze the CKD burden attributable to lead exposure globally, regionally and temporally, as well as to examine the role of socio-economic factors. MethodThis study used data from the Global Burden of Disease (GBD) study 2019. We obtained the global burden of CKD caused by lead exposure between 1990 and 2019, and stratified this burden according to factors such as gender, age, GBD regions, and countries. From 1990 to 2019, the changing trend of the disease burden of CKD attributed to lead exposure was estimated using Joinpoint regression model with the average annual percent change (AAPC) estimated. Finally, the relationship between country-level socio-economic factors and lead exposure related CKD burden was explored using a panel data model analysis. ResultsIn 2019, worldwide, there were 52.94 thousand deaths (95 % uncertainty interval (UI): 31.64, 76.23) and 1225.2 thousand disability-adjusted life years (DALYs) (95 % UI: 707.88, 1818) of CKD caused by lead exposure, accounting for 3.71 % of total CKD deaths and 2.95 % of total CKD DALYs. The age-standardized death and DALY rates per 100,000 population were 0.68 (95 % UI: 0.40, 0.98) and 15.02 (95 % UI: 8.68, 22.26) respectively, indicating an upward trend and stable trend between 1990 and 2019. However, the age-standardized rates attributed to lead exposure showed a wide variability across regions, with the highest rates in Central Latin America and the lowest in Eastern Europe. Moreover, the results of panel model analysis indicated that GDP growth was positively associated with lead exposure related CKD death rate and DALY rate. However, there were inverse associations between life expectancy at birth and hospital beds (per 1000 people) with lead exposure-related CKD DALY rate. ConclusionIn summary, a significant burden of CKD can be attributed to lead exposure, with noticeable regional discrepancies. Findings here are valuable to deploy efficient measures at curbing lead exposure worldwide.

Global, regional and national burden of traumatic brain injury and spinal cord injury, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

ObjectivesTo evaluate the most up-to-date burden of traumatic brain injury (TBI) and spinal cord injury (SCI) and analyse their leading causes in different countries/territories.DesignAn analysis of Global Burden of Disease...