Low Human Development Index Countries Research Articles

Global burden of thyroid cancer in 2022: Incidence and mortality estimates from GLOBOCAN.

Thyroid cancer (TC) is the most common malignancy of the endocrine system. This study aimed to assess the global distribution of TC incidence and mortality in 2022, as well as to predict the burden for the year 2050. Data from the GLOBOCAN 2022database were used to analyze the age-standardized incidence and mortality rates of TC by sex, age group (<55 years and ≥55 years), country, world region, and level of Human Development Index (HDI) for 185 countries. The predicted incidence and mortality burden for 2050 was calculated based on demographic projections. In 2022, an estimated 821,214 new TC cases and 47,507 TC-related deaths occurred worldwide. The age-standardized incidence rates (ASIRs) and age-standardized mortality rates (ASMRs) were higher in women (ASIR: 13.60 per 100,000; ASMR: 0.53 per 100,000) than in men (ASIR: 4.60 per 100,000; ASMR: 0.35 per 100,000). The ASIR in high HDI countries was approximately ten times higher than that in low HDI countries for both sexes, with relatively similar ASMR across regions. Among 185 countries, China had the largest number of TC cases (accounting for 56.77% of total cases) and TC-related deaths (accounting for 24.35% of global TC-related deaths), with the highest ASIR in men (13.30 per 100,000). Worldwide, approximately 64.63% of TC cases occurred in populations under 55 years old, while nearly 82.99% of TC-related deaths occurred in populations aged 55 years and above. If the rates stay the same as in 2022, it is projected that approximately 1,100,000 new TC cases and 91,000 TC-related deaths will occur in 2050, indicating a 34.15% and 89.58% increase, respectively. TC is a highly frequent cancer worldwide with disparities across regions, genders, and age groups. Our results provide light on the worldwide TC disease burden and facilitate regionally customized prevention measures.

Global burden of gynaecological cancers in 2022 and projections to 2050.

The incidence and mortality of gynaecological cancers can significantly impact women's quality of life and increase the health care burden for organisations globally. The objective of this study was to evaluate global inequalities in the incidence and mortality of gynaecological cancers in 2022, based on The Global Cancer Observatory (GLOBOCAN) 2022 estimates. The future burden of gynaecological cancers (GCs) in 2050 was also projected. Data regarding to the total cases and deaths related to gynaecological cancer, as well as cases and deaths pertaining to different subtypes of GCs, gathered from the GLOBOCAN database for the year 2022. Predictions for the number of cases and deaths in the year 2050 were derived from global demographic projections, categorised by world region and Human Development Index (HDI). In 2022, there were 1 473 427 new cases of GCs and 680 372 deaths. The incidence of gynecological cancer reached 30.3 per 100 000, and the mortality rate hit 13.2 per 100 000. The age-standardised incidence of GCs in Eastern Africa is higher than 50 per 100 000, whereas the age-standardised incidence in Northern Africa is 17.1 per 100 000. The highest mortality rates were found in East Africa (ASMR (age-standardised mortality rates) of 35.3 per 100 000) and the lowest in Australia and New Zealand (ASMR of 8.1 per 100 000). These are related to the endemic areas of HIV and HPV. Very High HDI countries had the highest incidence of GCs, with ASIR (age-standardised incidence rates) of 34.8 per 100 000, and low HDI countries had the second highest incidence rate, with an ASIR of 33.0 per 100 000. Eswatini had the highest incidence and mortality (105.4 per 100 000; 71.1 per 100 000) and Yemen the lowest (5.8 per 100 000; 4.4 per 100 000). If the current trends in morbidity and mortality are maintained, number of new cases and deaths from female reproductive tract tumours is projected to increase over the next two decades. In 2022, gynaecological cancers accounted for 1 473 427 new cases and 680 372 deaths globally, with significant regional disparities in incidence and mortality rates. The highest rates were observed in Eastern Africa and countries with very high and low HDI, with Eswatini recording the most severe statistics. If current trends continue, the number of new cases and deaths from gynaecological cancers is expected to rise over the next two decades, highlighting the urgent need for effective interventions.

Exploring the nexuses between carbon dioxide emissions, material footprints and human development: An empirical study of 151 countries

In order to achieve the Sustainable Development Goals, it is necessary to actively promote a coordinated and balanced relationship between carbon dioxide emissions (CO2e), material footprints (MF) and human development, based on the economic and social development stages of different countries and their material resource endowments. However, the existing research results lack cross-country comparisons and overly focus on the single conclusion of quantifying decoupling while ignoring the impact of coupling coordination nexus. Thus, this study comprehensively evaluated the nexus between CO2e, MF, and human development index (HDI) in 151 countries from 1990 to 2019 based on the modified coupling coordination degree model and the improved decoupling index model. The results show that, both the global MF per capita and HDI have maintained an increasing trend, and the MF per capita has been increasing significantly faster than the HDI. The trend of CO2e per capita is slowly dropping, with very high HDI countries being the main contributors. Besides, global regional differences in CO2e per capita and MF per capita are still expanding. Worldwide differences in per unit of CO2e and per unit of MF for HDI variation are narrowing. Furtherly, there is a more general but short-lived trend of absolute decoupling for very high HDI and low HDI countries, while medium HDI countries show a significant trend of coupling. By combining the endowment characteristics of some typical countries, it can be observed that the net fossil energy importing countries with higher HDI have high degree of coupling coordination, but gradually evolve towards the state of relative decoupling. There is still a significant trend of recoupling between the MF and HDI in the net fossil energy exporting countries with higher HDI, but CO2e is gradually evolving towards decoupling. The coupling coordination state is deepening in some low HDI countries. Due to the huge differences in national endowment characteristics and development stages, targeted energy conservation and emission reduction strategies are important for achieving coordinated development between CO2e, MF and HDI.

Are Doctors Equally Distributed Throughout the World?

As the vital and scarce resource of the health system, physicians are responsible for treating patients and saving lives and the equitable distribution of physicians among the whole population is a prerequisite to achieving health for all. We aimed to investigate inequality in physician distribution in the world using the Gini coefficient. This descriptive-analytical study was conducted in 2021. The number of physicians and the population of countries were obtained from the WHO and United Nations (UN) databases. The Gini coefficient was calculated in three different modes and the distribution of physicians among countries in various Human Development Index (HDI) groups was determined using the physician ratio per 10,000 population. There were generally more than 13 million doctors in the world. About 43% of the world's physicians were available to 20% of the world's population in very high HDI countries, and 12% of the population had access to about 1% of physicians in low HDI countries. An average of 19.5 physicians are distributed per 10,000 population worldwide. The Gini coefficient between the four groups of HDI countries was 0.55, and that of all countries in the world was 0.640. There was a shortage and inequality in the distribution of physicians worldwide. Governments should eliminate inequality in the distribution of the medical workforce, in particular physicians, by redoubling their efforts and accurate planning.

Global prevalence of anemia among women of reproductive age, 2000-2019.

A common disease with significant impacts on health and quality of life, anemia is particularly prevalent in women of reproductive age due to blood losses during menstruation and pregnancy. Data from the World Health Organization (WHO) was analyzed to compare trends in prevalence of anemia in women aged 15-49 among countries and over time with the goal of identifying regions both successful and in need of assistance in combatting anemia. Worldwide from 2000 to 2013 the prevalence of anemia among women aged 15-49 decreased, and then increased from 2013 to 2019; severe anemia decreased throughout the world from 2000 to 2019. Throughout all years, African countries had the highest prevalence of anemia and severe anemia while American and European countries had the lowest. With each decrease in human development index (HDI) category (very high to high, etc.) there was a significant increase in prevalence of total anemia (P < 0.001 for all). This data suggests that although the prevalence of anemia among reproductive age women has decreased over time there is still much work remaining, particularly in low HDI countries. More effort is needed in preventing, recognizing and treating anemia.

Global epidemiological comparison of Streptococcus pyogenes emm-types associated with pharyngitis and pharyngeal carriage

ObjectivesTo test the prevailing dogma that Streptococcus pyogenes emm-types that cause pharyngitis are the same as those associated with the carriage, using a global dataset. MethodsDrawing on our systematic review of the global distribution of S. pyogenes emm-types and emm-clusters from 1990 to 2023, we compared the distribution and diversity of strains associated with pharyngitis and pharyngeal carriage, in the context of local United Nations Development Programme Human Development Index (HDI) values. ResultsWe included 20 222 isolates from 71 studies done in 34 countries, with the vast majority of carriage strain data from studies in ‘Low HDI’ settings (550/1293; 43%). There was higher emm-type diversity for carriage than pharyngitis strains (Simpson Reciprocal Index of diversity 28.9 vs. 11.4). Compared with pharyngitis strains, carriage emm-types were disproportionately from emm-clusters E and D, usually described as ‘generalist’ or ‘skin’ strains. DiscussionA limited number of studies have compared S. pyogenes strains from cases of pharyngitis compared with carriage. Our understanding of strains associated with carriage is the poorest for high-income settings. In low and medium HDI countries, we found greater strain associated with pharyngeal carriage than pharyngitis. Improving our understanding of S. pyogenes carriage epidemiology in the pre-vaccine era will help to decipher the direct and potential indirect effects of vaccines.

The influence of socioeconomic inequity and guidelines compliance on clinical outcomes of patients with acute biliary pancreatitis. An international multicentric cohort study

BackgroundThere is lack of data on the association between socioeconomic factors, guidelines compliance and clinical outcomes among patients with acute biliary pancreatitis (ABP). MethodsPost-hoc analysis of the international MANCTRA-1 registry evaluating the impact of regional disparities as indicated by the Human Development Index (HDI), and guideline compliance on ABP clinical outcomes. Multivariable logistic regression models were employed to identify prognostic factors associated with mortality and readmission. ResultsAmong 5313 individuals from 151 centres across 42 countries marked disparities in comorbid conditions, ABP severity, and medical procedure usage were observed. Patients from lower HDI countries had higher guideline non-compliance (p < 0.001) and mortality (5.0% vs. 3.2%, p = 0.019) in comparison with very high HDI countries. On adjusted analysis, ASA score (OR 1.810, p = 0.037), severe ABP (OR 2.735, p < 0.001), infected necrosis (OR 2.225, p = 0.006), organ failure (OR 4.511, p = 0.001) and guideline non-compliance (OR 2.554, p = 0.002 and OR 2.178, p = 0.015) were associated with increased mortality. HDI was a critical socio-economic factor affecting both mortality (OR 2.452, p = 0.007) and readmission (OR 1.542, p = 0.046). ConclusionThese data highlight the importance of collaborative research to characterise challenges and disparities in global ABP management. Less developed regions with lower HDI scores showed lower adherence to clinical guidelines and higher rates of mortality and recurrence.

Abstract 2212: Global cancers attributable to modifiable risk factors: Dietary factors of animal origin

Abstract Cancer is the leading cause of death worldwide. Modifiable risk factors including diet have been linked to a wide range of malignancies. We estimated the global cancer population-attributable fraction (PAF) to established and suspected dietary cancer risk factors according to the Human Development Index (HDI).Diet-cancer associations were selected from WCRF, GBD and IARC report. Dietary factors of animal origin include red meat, processed meat, fish and dairy products; cancers include nasopharynx, esophageal, stomach, colorectal, pancreatic, lung, prostate, breast cancer. Gender-specific PAF were calculated based on 1) the total and gender-specific 2022 country-specific population from World Bank; 2) the country-specific average daily dietary factors intake (g/day) for 2000-2005 from the Global Dietary Database; 3) relative risks from the meta-analyses and WCRF reports; 4) country-specific 2020 cancer incidence from WHO. Estimates were also stratified by Human Development Index (HDI).Table 1 provides the results. The PAF for red meat and processed meat was higher in high HDI countries, while that for low dairy product intake was higher in low HDI countries. According to results, changes in selected dietary factors can prevent cancer-related incidence, particularly depending on where development status of countries and access to the source of their intake. Table1: Population attributable fractions for incidence of cancer in 2020 by gender. Dietary factors and Related Cancers Relative risk (g/day) AF (N. global) – Both gender AF (N. global)- Female AF (N. global)- Male Red meat Nasopharynx(L) 1.35(100) 0.103(13750.2) 0.102(3734.9) 0.104(10015.3) Colorectal (S) 1.12(100) 0.040(78714.5) 0.040(33981.2) 0.041(44733.2) Pancreatic (L) 1.11(100) 0.037(27420.3) 0.036(8479.8) 0.037(18940.4) Lung (L) 1.22(100) 0.070(155986.9) 0.069(52442.6) 0.070(103544.4) Prostate(L) 1.04(100) 0.014(20665.6) - 0.014(20665.6) Effect on total cancers * 0.016(296537.5) 0.011(98638.5) 0.021 (197898.9) Processed meat Nasopharynx(L) 1.46(30) 0.164(22194.6) 0.154(5637.4) 0.173(16557.1) Esophagus(L) 1.3(100) 0.036(22654.9) 0.034(6345.8) 0.038(16309.2) Stomach(L) 1.21(50) 0.052(60325.8) 0.049(18161.7) 0.055(42164) Colorectal (S) 1.18(100) 0.023(45460.9) 0.021(18522.8) 0.024(26938.1) Pancreatic(L) 1.17(50) 0.043(21900.2) 0.040(9414.4) 0.046(12485.8) Lung (L) 1.14(50) 0.036(82762.9) 0.034(26023.9) 0.038(56739) Effect on total cancers * 0.014(255299.3) 0.010(84106) 0.018(171193.2) Dairy products Colorectal(S) 0.87(400) 0.092(180063.4) 0.091(77598.8) 0.093(102464.6) Breast (L) 0.95(200) 0.068(151960.9) 0.068(151960.9) - Prostate (L) 1.07(400) 0.016(24224.3) - 0.016(24224.3) Effect on total cancers * 0.019(356248.6) 0.026(229559.7) 0.013(126688.9) Fish Colorectal (L) 0.89(100) 0.022(44882.9) 0.022(18705.9) 0.024(26177) Effect on total cancers * 0.002(44882.9) 0.002(18705.9 0.003(26177) Mean (g/day) of global intake Processed meat (B=14.2/M=15.1/F=13.3), red meat (B=36.5/M=36.9/F=36), fish(B=23/M=22.1/F=23.8), dairy products(B=77/M=74.9/F=79)S=strong evidenceL=limited evidence*All cancers excl. non-melanoma skin cancer (B= 18094716/F=8751759/M=9342957) 1 Citation Format: Monireh Sadat Seyyedsalehi, Edward Giovannucci, Paolo Boffetta. Global cancers attributable to modifiable risk factors: Dietary factors of animal origin [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2212.

The role of intellectual and social capital in funding businesses: a cross-country analysis

ObjetivoEl estudio tiene como objetivo examinar el impacto del capital intelectual y social en la financiación de las empresas.Diseño/metodología/enfoqueUtilizamos modelos de datos de panel de efectos fijos con una muestra de 142 países de los cinco continentes durante el periodo 1998-2018.ResultadosEncontramos que el capital humano (CH), el capital relacional, el capital estructural y el capital social juegan un papel en las decisiones de los inversionistas para financiar un negocio. Encontramos que las decisiones de financiamiento de los inversionistas en los países con bajo índice de desarrollo humano se basan principalmente en la educación, mientras que las de los países con alto índice de desarrollo humano se basan principalmente en el componente de creatividad del CH y en el capital relacional, estructural y social.Limitaciones/implicaciones de la investigaciónSugerimos replicar el estudio utilizando datos a nivel de empresa dentro de cada país. Por otra parte, la búsqueda de nuevos indicadores de capital intelectual y social (aunque nuestra lista de variables es exhaustiva) tanto a nivel de país como de empresa, constituye una vía interesante para futuras investigaciones.Implicaciones prácticasLos países deben prestar atención al capital intelectual y social para fomentar la actividad empresarial. En particular, los países con bajo desarrollo humano deberían fortalecer el CH, como la tasa de matriculación escolar, con una formación empresarial temprana y aumentar las inversiones en investigación y desarrollo, mientras que los países con un alto nivel de desarrollo humano deberían seguir fomentando las alianzas estratégicas, proteger la propiedad intelectual y mantener o aumentar el nivel de confianza en el país.Originalidad/valorEl estudio contribuye a la literatura al ser el primero en explorar tal variedad de variables de capital intelectual y social desde una perspectiva a nivel de país.

Global Prevalence of Anemia Among Women of Reproductive Age, 2000-2019

Introduction: A common disease with significant impacts on health and quality of life, anemia is particularly prevalent in women of reproductive age due to blood losses during menstruation and pregnancy. Data from the World Health Organization (WHO) was analyzed to compare trends in prevalence of anemia in women aged 15-49 among countries and over time with the goal of identifying regions both successful and in need of assistance in combatting anemia. Methods: Publicly available data was obtained from the WHO on the prevalence of anemia among women aged 15-49 from 194 countries from 2000-2019, data being reported as percentages. Anemia was defined as hemoglobin &amp;lt; 12 g/dL for non-pregnant women and &amp;lt; 11 g/dL for pregnant women, with severe anemia being defined as hemoglobin &amp;lt; 8 g/dL for non-pregnant women and &amp;lt; 7 g/dL for pregnant women. WHO data was from both individual-level and summary statistics sources and hemoglobin was adjusted for altitude. Human development index (HDI) data and categories (low, medium, high, and very high) were obtained from the United Nations. Data was analyzed based on year, country, geographic region, and HDI, with ANOVA and Tukey HSD tests being used to analyze the relationship between HDI and anemia. Results: Worldwide from 2000 to 2013 the prevalence of anemia decreased, and then increased from 2013 to 2019 though remained lower than at 2000 levels; severe anemia decreased throughout the world from 2000 to 2019. Throughout all years, African countries had the highest prevalence of anemia and severe anemia while American and European countries had the lowest (Figure 1). When analyzed by HDI category, there was a significant difference among HDI categories with both total and severe anemia ( P &amp;lt; 0.001 for both). With each decrease in HDI category (very high to high, etc.) there was a significant increase in prevalence of total anemia (Table 1, P &amp;lt; 0.001 for all). For severe anemia, there was a significant difference in prevalence of anemia between all HDI levels except very high and high ( P = 0.09). Discussion: This data suggests that although the prevalence of anemia among reproductive age women has decreased over time there is still much work remaining, particularly in low HDI countries, where the prevalence of anemia was over twice that of very high HDI countries in 2019, and the prevalence of severe anemia was over three times as high. More research is needed into the relationship of anemia and socioeconomic status as well as preventing, recognizing and treating anemia.

Does the Validity of the Environmental Kuznets Curve Postulation Empirically Depend on the Level of Human Development in Africa?

Purpose: The interconnectedness between human development and environmental degradation is a complex issue that warrants investigation in Africa. Although there are a few studies on the economic growth and environmental degradation nexus for African countries, there is a huge scarcity of empirical research that explores the Environmental Kuznets Curve (EKC) postulation in the context of human development and environmental degradation in Africa. The study therefore empirically explored the relationship between Human Development and Environmental Degradation within the framework of the EKC using 50 African countries subdivided into High Human Development Index Countries (HHDICs), Medium Human Development Index Countries (MHDICs) and Low Human Development Index Countries (LHDICs) from 2000 to 2019. Data for the study were obtained from the World Bank’s development indicators and the Human Development Reports of the United Nations Development Programme (UNDP-HDR).&#x0D; Methodology: The study made use of the Panel Corrected Standard Error (PCSE) model and the Feasible Generalised Least Squares Regression model (FGLS) which are econometrically suitable to handle N &gt; T and T &gt; N panels respectively, and are both robust to cross sectional dependence, contemporaneous correlation, group wise heteroscedasticity and slope heterogeneity. Other econometric techniques such as Descriptive Statistics, Correlation Analysis, Variance Inflation Factor test (Multicollinearity), second generation unit root tests (CADF and CIPS), Durbin Watson, Breusch Godfrey tests (Serial Correlation) and the White Test (Heteroscedasticity) were also employed in the study.&#x0D; Findings: The empirical results produced evidence that the data is integrated of order one I(1) and exhibits cross sectional dependence, slope heterogeneity and cointegration. The data was also found to be serially correlated and heteroscedastic. However, multicollinearity was absent. The panel estimates of the PCSE and the FGLS estimators showed that Human Development is a key driver of Environmental Degradation in Africa, with the greatest proportion of the impact on HHDICs, followed by MHDICs and then finally LHDICs. The results also revealed the validity of the EKC postulation only in the HHDICs, evidenced by the presence of an inverted U-shaped relationship between Environmental Degradation and Human Development. In The LHDICs and MHDICs on the other hand, U-shaped relationships between Environmental Degradation and Human Development were found, signalling the invalidity of the EKC. There was significant evidence for the support of the feedback hypothesis between Human Development and Environmental Degradation in HHDICs, MHDICs, LHDICs and all the 50 African countries at large. Based on the findings, Policymakers were given recommendations that took into consideration the uniqueness of the economic situations in HHDICs, MHDICs, LHDICs and Africa as a whole.&#x0D; Recommendations: The study shows that the degree of environmental degradation is proportional to the level of human development in Africa and indicates that the validity of the EKC postulation in the context of human development) is exclusive to only the HHDICs in Africa. This provides an incentive for policy makers in the MHDICs and LHDICs of Africa to make human development a priority through industrialisation and other profitable economic activities. This is likely to help them afford innovations and technological developments that protect the environment through the greater use of cleaner energy than the naturally abundant fossil fuel as well as the institutionalisation of policies that protect the environment as human development appreciates.

The geographic diversity of authorship in leading general surgery journals; A study of 24,332 authors

BackgroundResearch guides evidence-based general surgery practice, advocacy, policy and resource allocation, but is seemingly lacking representation from those countries with greatest disease burden and mortality. Accordingly, we conducted a geographic study of publications in the most impactful general surgery journals worldwide. MethodsThe six general surgery journals with the highest 2020 impact factors were selected. Only journals specific to general surgery were included. For all original articles over the past five years, the affiliated country and city were extracted for the first, second and last author. Number of publications were adjusted per capita, and compared to Human Development Index (HDI) using logistic regression. Results8274 original articles were published in the top six ranked general surgery journals over 2016–2020, with 24,332 affiliated authors. Authors were most commonly associated with the US (27.88%), Japan (9.09%) and China (8.46%), or per capita, The Netherlands, Sweden and Singapore. There is a linear association between publishing in a top six journal and HDI of country of affiliation. Just four publications were from medium or low HDI countries over the period. ConclusionAuthorship in leading general surgery journals is predominantly from wealthy, Western countries. Authorship is associated with affiliation with a high HDI country, with few authors from medium or low HDI countries. There is a lack of representation in literature from Africa, Russia, and parts of Southeast Asia, and thus a lack of locally relevant evidence to guide surgical practice in these areas of high disease burden and low life expectancy.

Clinical manifestations of respiratory syncytial virus infection and the risk of wheezing and recurrent wheezing illness: a systematic review and meta-analysis.

Respiratory syncytial virus (RSV) infection in infants is a global health priority. We aimed to investigate the common manifestations of RSV infection by age group and human development index (HDI) level and to assess its association with the development of wheezing and recurrent wheezing illness. We searched the literature published between January 1, 2010 and June 2, 2022 in seven databases. Outcomes included common manifestations and long-term respiratory outcomes of RSV infection in children. Random- and fixed-effect models were used to estimate the effect size and their 95% confidence intervals. Subgroup analysis was conducted by age and HDI levels. This review was registered in PROSPERO (CRD42022379401). The meta-analysis included 47 studies. The top five manifestations were cough (92%), nasal congestion (58%), rhinorrhea (53%), shortness of breath (50%), and dyspnea (47%). The clinical symptoms were most severe in infants. In our analysis, compared to very high and high HDI countries, fewer studies in medium HDI countries reported related manifestations, and no study in low HDI countries reported that. The RSV-infected infants were more likely to develop wheezing than the non-infected infants [odds ratio (OR), 3.12; 95% CI, 2.59-3.76] and had a higher risk of developing wheezing illnesses after recovery (OR, 2.60; 95% CI, 2.51-2.70). Cough and shortness of breath are common manifestations of RSV infection. More attention should be given to infants and areas with low HDI levels. The current findings confirm an association between RSV infection and wheezing or recurrent wheezing illness.

Gender Asymmetries in Cross‐National Couples

AbstractWe use census microdata for Spain and the United States to examine gender differences in cross‐national heterosexual couples (marriages and cohabitating unions involving natives and immigrant spouses). We examine whether native men and native women in cross‐national couples exhibit similar patterns regarding the country of birth, age, and educational attainment of their international partners. Countries are ranked by their level of the human development index (HDI). In both Spain and the United States, native men are slightly overrepresented in cross‐national couples. Native men are more likely to be married to individuals from low HDI countries than native women. On the contrary, native women are predominantly married to men born in countries with similar or higher levels of HDI. Unions of native men are characterized by large spousal age differences, which increase with the HDI gap; this pattern reverses among native women. These gender asymmetries do not extend to education level, with cross‐national couples, overall, involving highly educated individuals. These results point to the endurance of certain features of traditional marriage patterns in cross‐national couples, but the patterns differ starkly between native men and native women.

Breast cancer: Global patterns of incidence, mortality, and trends.

10528 Background: The global burden of cancer incidence and mortality including that of female breast cancer continues to increase largely because of the growth and aging of the population and adoption of western lifestyle behaviors that increase cancer risk. In this study, we summarize the current burden, trends, and survivorship of female breast cancer that account for nearly 12% of the cancer burden worldwide. Methods: Estimates of incidence and mortality in the year 2020 were obtained from Global Cancer Observatory (GLOBOCAN) database. GLOBOCAN provides country-specific estimates of cancer incidence, mortality, and prevalence for 185 countries or territories and 36 cancer types by age group and sex. For US rates, data from Surveillance, Epidemiology, and End Results (SEER) program were assessed. Rates are age-standardized (ASRs) (per 100,000 person-years) using the 1966 Segi-Doll World Standard Population. Geographic variability was assessed using 20 predefined world regions, and the 4-tier Human Development Index (HDI). Finally, we provide a prediction of the future burden of female breast cancer in 2040 based on demographic projections. Results: Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death in females worldwide, with an estimated 2.3 million new cancer cases (1 in 4 new cancer cases) and 685,000 cancer deaths (1 in 6 deaths) in 2020. Breast cancer incidence rates varied by nearly 4-fold across WHO areas. The highest incidence rates (per 100,000) were found in Australia/New Zealand (95.5), Western Europe (90.7), and Northern America (89.4), while the lowest rates were in South-Central Asia (26.2), Middle and Eastern Africa (33), and Central America (39.5). In contrast, the highest breast cancer mortality rates were recorded in Melanesia (37.5), Polynesia and Western Africa (22.3), and the Caribbean (18.9), while the lowest rates were found in Eastern Asia (9.8), Central America (10.4), and Australia/New Zealand (12.1), a 2.8-fold difference. In the United States, the age-standardized breast cancer incidence rate (per 100,000) increased from 106 (1975) to 142 (1999), decreased to 128 (2004), and then slowly increased to 137 (per 100,000) in 2019. Similar broad temporal trend patterns were observed in other western countries. Incidence rates are rising in South America, Africa, and Asia where rates were historically low. Worldwide, an estimated 2,964,197 new female breast cancer cases are projected to occur in 2040, a 31% increase from the corresponding 2,260,127 cases in 2020. Conclusions: There is significant variation in female breast cancer incidence and mortality rates worldwide. Breast cancer incidence is increasing at different rates in various regions of the world. Mortality rates in many high HDI countries have been on the decline, in contrast to increasing rates in low HDI countries. This study also shows a substantial increase in new breast cancer diagnoses over the next two decades.

Sustainable environment quality: moderating role of renewable energy consumption in service sector for selected HDR listed countries.

Considering environmental deterioration, an emerging global problem, this study is aimed at determining the impact of the service sector economic activity on environmental quality from the environmental Kuznets curve (EKC) perspective and finding ways to reduce the carbon impact of service sector within the EKC relationship. This study proposes that renewable energy intensity in the economy plays an important role in reducing carbon print of service sector. This study is based on secondary data from 1995 to 2021 for different development-wise categorized country groups leading to 115 countries, according to the Human Development Report (HDR) on the Human Development Index (HDI). Estimated results using panel feasible generalized least squares (FGLS) have confirmed inverted U-shaped for very high HDI and medium HDI and U-shaped EKC for low HDI countries. This study is instrumental in confirming the moderating role of renewable energy in the service sector EKC. Policymakers can plan a gradual reduction of carbon footprint in the service sector by transitioning toward renewable energy.

Risk of psychological distress by decrease in economic activity, gender, and age due to COVID-19: A multinational study.

Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2-virus. COVID-19 has officially been declared as the latest in the list of pandemics by WHO at the start of 2020. This study investigates the associations among decrease in economic activity, gender, age, and psychological distress during the COVID-19 pandemic considering the economic status and education level of countries using multinational surveys. Online self-report questionnaires were administered in 15 countries which were spontaneously participate to 14,243 respondents in August 2020. Prevalence of decrease in economic activity and psychological distress was stratified by age, gender, education level, and Human Development Index (HDI). With 7,090 of female (49.8%), mean age 40.67, 5,734 (12.75%) lost their job and 5,734 (40.26%) suffered from psychological distress. Associations among psychological distress and economic status, age, and gender was assessed using multivariate logistic regression, adjusted for country and education as random effects of the mixed model. We then measured the associations between HDI and age using multivariate logistic regression. Women had a higher prevalence of psychological distress than men with 1.067 Odds ratio, and younger age was significantly associated with decrease in economic activity for 0.998 for age increasing. Moreover, countries with lower HDI showed a higher prevalence of decrease in economic activity, especially at lower education levels. Psychological distress due to COVID-19 revealed a significant association with decrease in economic activity, women, and younger age. While the proportion of decrease in economic activity population was different for each country, the degree of association of the individual factors was the same. Our findings are relevant, as women in high HDI countries and low education level in lower HDI countries are considered vulnerable. Policies and guidelines for both financial aid and psychological intervention are recommended.

Lung cancer mortality in the wake of the changing smoking epidemic: a descriptive study of the global burden in 2020 and 2040

ObjectivesLung cancer (LC) is the leading cause of cancer death in 2020, responsible for almost one in five (18.0%) deaths. This paper provides an overview of the descriptive epidemiology of...

Global incidence and mortality of renal cell carcinoma in 2020

Objective: To analyze the global epidemiology of renal cell carcinoma (RCC) in 2020. Methods: The incidence and mortality data of RCC in the cooperative database GLOBOCAN 2020 of International Agency for Research on Cancer of WHO and the human development index (HDI) published by the United Nations Development Programme in 2020 were collated. The crude incidence rate (CIR), age-standardized incidence rate (ASIR), crude mortality rate (CMR), age-standardized mortality rate (ASMR) and mortality/incidence ratio (M/I) of RCC were calculated. Kruskale-Wallis test was used to analyze the differences in ASIR or ASMR among HDI countries. Results: In 2020, the global ASIR of RCC was 4.6/100 000, of which 6.1/100 000 for males and 3.2/100 000 for females and ASIR was higher in very high and high HDI countries than that in medium and low HDI countries. With the rapid increase of age after the age of 20, the growth rate of ASIR in males was faster than that in females, and slowed down at the age of 70 to 75. The truncation incidence rate of 35-64 years old was 7.5/100 000 and the cumulative incidence risk of 0-74 years old was 0.52%. The global ASMR of RCC was 1.8/100 000, 2.5/100 000 for males and 1.2/100 000 for females. The ASMR of males in very high and high HDI countries (2.4/100 000-3.7/100 000) was about twice that of males (1.1/100 000-1.4/100 000) in medium and low HDI countries, while the ASMR of female (0.6/100 000-1.5/100 000) did not show significant difference. ASMR continued to increase rapidly with age after the age of 40, and the growth rate of males was faster than that of females. The truncation mortality rate of 35-64 years old was 2.1/100 000, and the cumulative mortality risk of 0-74 years old was 0.20%. M/I decreases with the increase of HDI, with M/I as 0.58 in China, which was higher than the global average of 0.39 and the United States' 0.17. Conclusion: The ASIR and ASMR of RCC presented significant regional and gender disparities globally, and the heaviest burden was in very high HDI countries.

Correlation between the Human Development Index and the Incidence and Mortality of Non-Hodgkin Lymphoma.

This study was to examine the relationship between socioeconomic status and the incidence and mortality of non-Hodgkin lymphoma (NHL). We compared the age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and the ASMR to ASIR ratio (MIR) at national and regional levels and studied the correlation between the MIR and the human development index (HDI) in 2012 and 2018. The highest ASIR was in North America in 2012 and in Australia in 2018, and the lowest ASIR was in Central and South Asia in both 2012 and 2018. The highest ASMR was in North Africa in both 2012 and 2018, and the lowest ASMR was in Eastern Asia and South-Central Asia in 2012 and in South-Central Asia in 2018. The lowest MIR was in Australia in both 2012 and 2018, and the highest MIR was in Western Africa in both 2012 and 2018. HDI was strongly negatively correlated with MIR (r: -0.8810, P<0.0001, 2012; r: -0.8895, P<0.0001, 2018). Compared to the 2012 data, the MIR in the intermediate HDI countries significantly deceased and the HDI in low and high HDI countries significantly increased in 2018. The MIR is negatively correlated with HDI. Increasing the HDI in low and intermediate HDI countries may reduce the MIR and increase the survival of patients with NHL.