World Health Organization Mortality Database Research Articles

Global trends in youth suicide from 1990 to 2020: an analysis of data from the WHO mortality database

Suicide is a serious but preventable public health concern at the global level, showing relevant geographical differences. This study aims to monitor global temporal and geographical patterns in suicide mortality in pre-adolescents, adolescents, and young adults (i.e., aged 10-24 years), from 1990 to 2020 or the most recent available year. Using the World Health Organisation mortality database, we conducted an analysis on a subset of 52 countries with valid and high-quality data. We computed age-standardised suicide rates (ASR) by sex, country, and calendar year, and performed a joinpoint regression analysis to identify significant changes in the temporal suicide trends over the studied period. High variability in suicide rates and trends was observed, with a male-to-female ratio of two to five. Between 1990 and 2020, most European countries reported declining suicide trends, with some exceptions. In particular, alarming trends emerged in the United Kingdom, with annual rises of 2.5% (95% CI: 1.6-3.5) since 2005 among males and 8.5% (95% CI: 4.7-12.6) since 2012 among females. The most favorable trends and lowest suicide rates were in Southern Europe, with 3.1/100,000 persons in Italy (2020) and 3.5/100,000 persons in Spain (2021) among males, and 0.9/100,000 persons in Italy (2020) and 1.1/100,000 persons in Romania (2019) among females. Conversely, the highest rates were in Central-Eastern Europe, with 10.2/100,000 males in the Russian Federation (2019) and 10.0/100,000 males in Poland (2002). Higher suicide rates and significant increases were reported in not European areas. The highest ASR was 15.5/100,000 males in the United States of America, with an annual increase of 3.8% (95% CI: 3.1-4.5) among males in 2009-2020 and 6.7% (95% CI: 5.6-7.8) among females in 2007-2017, followed by a levelling off. Temporal and geographical comparisons of suicide mortality should be interpreted with caution due to potential misclassification or under-reporting of suicide deaths in some countries. None.

US exceptionalism? International trends in midlife mortality.

Rising midlife mortality in the USA has raised concerns, particularly the increase in 'deaths of despair' (due to drugs, alcohol and suicide). Life expectancy is also stalling in other countries such as the UK, but how trends in midlife mortality are evolving outside the USA is less understood. We provide a synthesis of cause-specific mortality trends in midlife (25-64years of age) for the USA and the UK as well as other high-income and Central and Eastern European (CEE) countries. We document trends in midlife mortality in the USA, UK and a group of 13 high-income countries in Western Europe, Australia, Canada and Japan, as well as seven CEE countries from 1990 to 2019. We use annual mortality data from the World Health Organization Mortality Database to analyse sex- and age-specific (25-44, 45-54 and 55-64years) age-standardized death rates across 15 major cause-of-death categories. US midlife mortality rates have worsened since 1990 for several causes of death including drug-related, alcohol-related, suicide, metabolic diseases, nervous system diseases, respiratory diseases and infectious/parasitic diseases. Deaths due to homicide, transport accidents and cardiovascular diseases have declined since 1990 but saw recent increases or stalling of improvements. Midlife mortality also increased in the UK for people aged 45-54year and in Canada, Poland and Sweden among for those aged 25-44 years. The USA is increasingly falling behind not only high-income, but also CEE countries, some of which were heavily impacted by the post-socialist mortality crisis of the 1990s. Although levels of midlife mortality in the UK are substantially lower than those in the USA overall, there are signs that UK midlife mortality is worsening relative to that in Western Europe.

Trends in sudden cardiac death mortality in Italy, 2013-2019.

We sought to analyse the incidence of sudden cardiac deaths (SCDs) amongst subjects aged less than 39years in Italy and its time trend between 2013 and 2019. Data regarding cause-specific mortality and population size by sex in 5-year age groups were extracted from the World Health Organization (WHO) mortality database. Decedents reporting the codes I46.1, I45.6, I47.2, I41.9, R09.2 and R96.0 of the International Classification of Disease-10 (ICD-10) coding system, were extracted. The age-adjusted mortality rates (AAMRs), with relative 95% confidence intervals (CIs) stratified by sex, were determined using the direct method. Joinpoint regression analyses were used to identify periods with statistically distinct log linear trends in SCD-related death rates. To calculate nationwide annual trends in SCD-related mortality, we assessed the annual and average annual per cent change (AAPC) and relative 95% CIs. Over the study period, 314 deaths [220 males (70.0%) and 94 females] were due to SCD corresponding to a 0.06 per 100,000 per year (0.10 per 100,000 in males and 0.04 per 100,000 in females, respectively). Proportional mortality slightly increased, without reaching the statistical significance (p = 0.82) from 3.06 to 3.56 per 100 deaths, with a similar trend in both sexes. Joinpoint regression analysis revealed a plateau in age-standardised SCD-related mortality over the period [AAPC: -4.2 (95% CI: -24.0 to 20.8, p = 0.71], which was consistent between males and females. In Italy, SCD remains a public health issue of concern in the last decade after adjusting for age.

Testicular cancer mortality in Latin America and the Caribbean: trend analysis from 1997 to 2019

BackgroundIn the last decades, an increasing incidence of testicular cancer has been observed in several countries worldwide. Although mortality rates have been variable in many countries, little information is available from Latin America and the Caribbean (LAC). Therefore, we examined mortality trends of testicular cancer in the last two decades.MethodsAge-standardized mortality rates (ASMR) of testicular cancer per 100,000 men-years were estimated using the World Health Organization mortality database from 1997 to 2019. We examined the mortality trends and computed annual percent change (APC) for all ages and the following age groups, 15–29, 30–44, 15–44, and ≥ 45 years.ResultsTen countries had mortality rates greater than 0.43 per 100,000 men, with the highest rates for Chile, Mexico, and Argentina. Significant increases in mortality rates were observed in Argentina, Brazil Colombia, and Mexico in all ages, and < 45 years, while Colombia, Ecuador, Mexico, and Peru reported significant downward trends in males aged ≥ 45 years. Only Chile showed significant decreases for all ages and age groups studied.ConclusionMortality by testicular cancer increased among LAC countries in males of all ages and across age groups. A reduction in mortality rates was observed only in Chilean males of all ages and in men ≥ 45 years in several countries. Strengthening of early detection among symptomatic males may decrease the mortality by this neoplasm.

Road traffic death coding quality in the WHO Mortality Database.

To evaluate the precision and dependability of road traffic mortality data recorded in the World Health Organization Mortality Database and investigate how uncorrected data influence vital mortality statistics used in traffic safety programmes worldwide. We assessed country and territory-specific data quality from 2015 to 2020 by calculating the proportions of five types of nonspecific cause of death codes related to road traffic mortality. We compared age-adjusted road traffic mortality and changes in the average annual mortality rate before and after correcting the deaths with nonspecific codes. We generated road traffic mortality projections with both corrected and uncorrected codes, and redistributed the data using the proportionate method. We analysed data from 124 countries and territories with at least one year of mortality data from 2015 to 2020. The number of countries and territories reporting more than 20% of deaths with ill-defined or unknown cause was 2; countries reporting injury deaths with undetermined intent was 3; countries reporting unspecified unintentional injury deaths was 21; countries reporting unspecified transport crash deaths was 3; and countries reporting unspecified unintentional road traffic deaths was 30. After redistributing deaths with nonspecific codes, road traffic mortality changed by greater than 50% in 7% (5/73) to 18% (9/51) of countries and territories. Nonspecific codes led to inaccurate mortality estimates in many countries. We recommend that injury researchers and policy-makers acknowledge the potential pitfalls of relying on raw or uncorrected road traffic mortality data and instead use corrected data to ensure more accurate estimates when improving road traffic safety programmes.

Disparities in breast cancer mortality among Latin American women: trends and predictions for 2030

BackgroundBreast cancer is among the leading cause of cancer-related mortality among Latin American and Caribbean (LAC) women, but a comprehensive and updated analysis of mortality trends is lacking. The objective of this study was to determine the breast cancer mortality rates between 1997 and 2017 for LAC countries and predict mortality until 2030.MethodsWe retrieved breast cancer deaths across 17 LAC countries from the World Health Organization mortality database. Age-standardized mortality rates per 100,000 women-years were estimated. Mortality trends were evaluated with Joinpoint regression analyses by country and age group (all ages, < 50 years, and ≥ 50 years). By 2030, we predict number of deaths, mortality rates, changes in population structure and size, and the risk of death from breast cancer.ResultsArgentina, Uruguay, and Venezuela reported the highest mortality rates throughout the study period. Guatemala, El Salvador, and Nicaragua reported the largest increases (from 2.4 to 2.8% annually), whereas Argentina, Chile, and Uruguay reported downward trends (from − 1.0 to − 1.6% annually). In women < 50y, six countries presented downward trends and five countries showed increasing trends. In women ≥ 50y, three countries had decreased trends and ten showed increased trends. In 2030, increases in mortality are expected in the LAC region, mainly in Guatemala (+ 63.0%), Nicaragua (+ 47.3), El Salvador (+ 46.2%), Ecuador (+ 38.5%) and Venezuela (+ 29.9%).ConclusionOur findings suggest considerable differences in breast cancer mortality across LAC countries by age group. To achieve the 2030 sustainable developmental goals, LAC countries should implement public health strategies to reduce mortality by breast cancer.

Effects of cancer mortality on life expectancy in European high-income countries between 1950 and 2019

This article aims to analyze the effects of cancer mortality on life expectancy at birth in 15 European high-income countries between 1950 and 2019. To establish the 1950–2019 time series of deaths from cancer, mortality data were harmonized from the available datasets of the World Health Organization Mortality database, coded according to the International Classification of Diseases of the 7th, 8th, 9th, and 10th editions. The estimation of the cancer mortality effect on the life expectancy at birth was performed using the algorithm of stepwise replacement for the life expectancy decomposition. The increase in cancer mortality contributed to a decline in overall life expectancy growth until the mid-1990s, coinciding with the aging cohorts of heavy smokers and a long-term reduction in mortality from other non-communicable diseases. Subsequently, since the 1990s, the reduction in cancer mortality has contributed to a significant increase in life expectancy at birth, especially in males. Reduction in cancer mortality was the outcome of various factors, such as alcohol and tobacco control policies, advances in cancer prevention and its treatment, general increase in population well-being, and reduction in risk-factors.

Large Discrepancies in Dementia Mortality Reported in Vital Statistics: The Need for Improved Data to Inform Policy.

There is limited understanding of the intercountry comparability of dementia mortality data. This study compares reported dementia mortality in national vital statistics between countries and over time. In countries with low dementia reporting, this study identifies other causes to which dementia may be misclassified. Using the World Health Organization (WHO) Mortality Database, we calculated the ratio of reported to expected (Global Burden of Disease estimated) age-standardized dementia death rates in 90 countries from 2000 to 2019. Other causes to which dementia may be misclassified were identified as having relatively high cause fractions compared with other countries. No patients were involved. There is a large intercountry variation in reported dementia mortality rates. The ratio of reported to expected dementia mortality exceeded 100% in high-income countries but was below 50% in other super regions. In countries with low reported dementia mortality, cardiovascular diseases, ill-defined causes, and pneumonia have relatively high cause fractions and may be misclassified from dementia. Large discrepancies in dementia mortality reporting between countries, including often implausibly low reported mortality, makes comparison extremely difficult. Improved guidance for and training of certifiers and the use of multiple cause-of-death data can help strengthen the policy utility of dementia mortality data.

Trends in pulmonary tuberculosis mortality between 1985 and 2018: an observational analysis

BackgroundPulmonary tuberculosis (TB) is a major source of global morbidity and mortality. Latent infection has enabled it to spread to a quarter of the world's population. The late 1980s and early 1990s saw an increase in the number of TB cases related to the HIV epidemic, and the spread of multidrug-resistant TB. Few studies have reported pulmonary TB mortality trends. Our study reports and compares trends in pulmonary TB mortality.MethodsWe utilized the World Health Organization (WHO) mortality database from 1985 through 2018 to analyze TB mortality using the International Classification of Diseases-10 codes. Based on the availability and quality of data, we investigated 33 countries including two countries from the Americas; 28 countries from Europe; and 3 countries from the Western Pacific region. Mortality rates were dichotomized by sex. We computed age-standardized death rates per 100,000 population using the world standard population. Time trends were investigated using joinpoint regression analysis.ResultsWe observed a uniform decrease in mortality in all countries across the study period except the Republic of Moldova, which showed an increase in female mortality (+ 0.12 per 100,000 population). Among all countries, Lithuania had the greatest reduction in male mortality (-12) between 1993–2018, and Hungary had the greatest reduction in female mortality (-1.57) between 1985–2017. For males, Slovenia had the most rapid recent declining trend with an estimated annual percentage change (EAPC) of -47% (2003–2016), whereas Croatia showed the fastest increase (EAPC, + 25.0% [2015–2017]). For females, New Zealand had the most rapid declining trend (EAPC, -47.2% [1985–2015]), whereas Croatia showed a rapid increase (EAPC, + 24.9% [2014–2017]).ConclusionsPulmonary TB mortality is disproportionately higher among Central and Eastern European countries. This communicable disease cannot be eliminated from any one region without a global approach. Priority action areas include ensuring early diagnosis and successful treatment to the most vulnerable groups such as people of foreign origin from countries with a high burden of TB and incarcerated population. Incomplete reporting of TB-related epidemiological data to WHO excluded high-burden countries and limited our study to 33 countries only. Improvement in reporting is crucial to accurately identify changes in epidemiology, the effect of new treatments, and management approaches.

Recent Mortality Patterns and Time Trends for the Major Cancers in 47 Countries Worldwide.

Most prior studies have reported cancer mortality trends across countries for specific cancer types. Herein, we examine recent patterns and trends in cancer mortality rates for the eight common forms of cancer in 47 countries across five continents (except Africa) based on the World Health Organization mortality database. Rates were age-standardized to the 1966 Segi-Doll world population, and trends in the age-standardized rates for the most recent 10 years of data were examined using Joinpoint regression. Cancer-specific mortality rates vary substantially across countries, with rates of infection-related (cervix and stomach) and tobacco-related cancers (lung and esophagus) varying by 10-fold. Recent mortality rates for all major cancers decreased in most of the studied countries except lung cancer in females and liver cancer in males, where increasing rates were observed in most countries. Rates decreased or stabilized in all countries for lung cancer in men and stomach cancer in both sexes. The findings reinforce the importance of implementing and strengthening resource-stratified and targeted cancer prevention and control programs in all parts of the world to further reduce or halt the rising cancer burden. The results may inform cancer prevention and treatment strategies and in so doing, reduce the marked global cancer disparities observed today.

Average lifespan shortened due to cancer in selected countries of North America, Europe, Asia and Oceania, 2006 and 2016.

We applied a novel measure of average lifespan shortened (ALSS) to examine changes in lifespan among patients who died of cancer over a 10-year period from 2006 to 2016 in 20 selected high-income countries from North America, Europe, Asia, and Oceania. We retrieved cancer deaths in each country from the World Health Organization mortality database. We calculated ALSS as a ratio of years of life lost to the expected lifespan among patients who died from cancer. Between 2006 and 2016, we observed modest changes in ALSS for overall cancer deaths over the study in many countries. The changes in the ALSS over time due to any cancer ranged between -1.7 and +0.4 percentage points (pps) among men and between -1.9 and +0.6 pps among women. Across countries, overall cancer deaths led to an average loss between 16% and 22% of their lifespan in men, and between 18% and 24% in women. Across cancer sites, patients who died of central nervous system cancers, for instance, lost a large proportion of their lifespan. In this study, we demonstrated the use of ALSS across selected high-income countries, which enables population-level assessment of premature mortality among cancer patients over time.

624 Economic Development and Trends of Cerebrovascular Disease Mortality in Eastern Europe: 1992-2019

INTRODUCTION: Several studies have shown that a country's overall mortality rates are inversely related to it's gross domestic product (GDP). Eastern Europe experienced rapid economic growth after the fall of communism, and as such its public health sector swiftly improved. How this economic growth has affected mortality rates due to cerebrovascular disease has never been studied. METHODS: Eight countries were included in this study, representing the Warsaw Pact founding members: Albania, Bulgaria, Poland, Romania, Hungary, and Czechia, with Russia and Ukraine representing the former Soviet Union. As East Germany joined West Germany in 1990, it was excluded. Age standardized death rates from cerebrovascular disease per 100,000 people from 1992-2019 were taken from the World Health Organization (WHO) Mortality Database using the ICD-10 (International Classification of Disease) codes 160-169. Each country’s GDP per capita (inflation adjusted to 2015 dollar amount) during those years was taken from the World Bank World Development Indicators Database. RESULTS: Cerebrovascular disease mortality decreased from 1992-2019 in every country, despite divergent trends in economic development. Indeed, Ukraine’s cerebrovascular disease mortality rate decreased by 42.9% even though its GDP per capita decreased by 4.8%. The countries with the largest decreases in mortality are Czechia (-78.9%), Hungary (-62.7%), and Russia (-49.3%) while Albania had the smallest decrease (-29.4%). CONCLUSIONS: Rates of cerebrovascular disease mortality among the Warsaw Pact’s founding members decreased after the fall of communism, despite differing rates of economic development. Further research is warranted regarding these countries’ healthcare practices during this period. Hopefully, lessons can be gleaned to improve public health and neurosurgical care in other developing nations.

The contributions of injury deaths to the gender gap in life expectancy and life disparity in Eastern Mediterranean Region

BackgroundInjury deaths constitute a major avoidable cause of death affecting life expectancy to a different degree in men and women. This study quantified the contributions of injury deaths to the gender gap in life expectancy (GGLE) and life disparity (GGLD) in nine Eastern Mediterranean Region (EMR) countries.MethodsWe retrieved annual data on age-sex specific causes of death from the World Health Organization mortality database for EMR countries with at least 2-year consecutive data during 2010–2019. The injury-related deaths were categorized into five groups: transport accidents, other accidental injuries, intentional self-harm, assault and events of undetermined intent. Considering women as the reference, the GGLE and GGLD were decomposed by age and causes of death, using a continuous-change model.ResultsThe largest and smallest GGLE were observed in Kuwait (5.2 years) and Qatar (− 1.2 years), respectively. Qatar (− 2.2 years) and Oman (0.2 years) had the highest and lowest GGLD. The highest contributions of injury deaths to the GGLE/GGLD were seen in Libya (1.8/− 1.2 years), followed by Iran (1.2/− 0.8 years). Among injury causes, transport accidents were the leading cause of GGLE in all countries but Libya and Morocco, with Iran having the greatest contributions (0.6 years). Injury deaths in men aged 15–29 years accounted for 33% [41%] (Kuwait) to 55% [65%] (Oman) of total GGLE [GGLD] attributable to injury deaths.ConclusionsHigh injury deaths, particularly transport accidents, among young men contributed substantially to the GGLE and GGLD across nine EMR countries in this study. This highlights the need for implementing preventing policies to reduce the burden of injury deaths specifically in young men.

Trends in mortality from cardiovascular diseases in Chile, 2000-2020.

To analyze trends in mortality caused by cardiovascular diseases (CVD) in Chile during the period 2000-2020. Data on age-adjusted mortality rates (AAMR) from CVD per 100 000 population in Chile for 2000-2020 were extracted from the World Health Organization Mortality Database. Joinpoint regression was used to analyze the trends and compute the average annual percent change (AAPC) in Chile. In addition, analyses were conducted by sex and type of CVD. Between 2000 and 2020, the AAMR from CVD decreased in Chile from 159.5 to 94.6 per 100 000 population, with a statistically significant decrease in the AAPC of 2.6% (95% CI [-2.8, -2.4]). No joinpoints were identified. The AAMR from CVD decreased annually by 2.6% (95% CI [-2.8, -2.4]) and 2.8% (95% CI [-3.5, -2.6]) in men and women, respectively. The AAMR from ischemic heart disease reduced annually by 3.6% (95% CI [-4.6, -2.7]) with two joinpoints in 2011 and 2015. In the case of stroke, the mortality rate decreased annually by 3.7% (95% CI [-4.5, -3.0]), with two joinpoints in 2008 and 2011. Cardiovascular disease mortality rates have decreased significantly in Chile, in both sexes, especially in women. This decrease could be explained mainly by a significant reduction in the case fatality in recent decades. These results could be a reference for developing primary prevention and acute management of CVD policies focused on populations with higher mortality.

Epidemiology of Non-Hodgkin Lymphoma: Global Patterns of Incidence, Mortality, and Trends

INTRODUCTION The burden of cancer incidence and mortality including non-Hodgkin lymphoma (NHL) is expected to grow worldwide as populations grow, age, and adopt lifestyle behaviors that increase cancer risk, many of which are associated with socioeconomic development. Describing the current and future epidemiologic impact of NHL is crucial to evaluate the therapeutic demand and to inform adequate healthcare resource allocation. However, very few recent studies have described global estimates of non-Hodgkin lymphoma diagnoses, cancer burden, and future projection. In this study, we summarize the current burden, trends, risk factors, prevention, early detection, and survivorship of non-Hodgkin lymphoma that account for approximately 2.9% of the cancer burden among both men and women worldwide. METHODS Estimates of new cancer cases (incidence data) and cancer deaths (mortality data) in the year 2020 were extracted 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. Global geographic variability was assessed using 20 predefined world regions. For US rates, data from National Cancer Institute's (NCI's) Surveillance, Epidemiology, and End Results (SEER) 22 were assessed. All mortality data in the GLOBOCAN database was extracted from the World Health Organization (WHO) mortality database available through 2019. Rates are age-standardized (ASRs) (per 100,000 person-years) using the world Standard Population. We characterize the burden according to the 4-tier Human Development Index (HDI) by the United Nations Development Program. Finally, we provide a prediction of the future burden of NHL in 2040 based on demographic projections, assuming that national rates estimated in 2020 remain constant. RESULTS NHL ranked as the 5th to 9th most common cancer in most countries globally, with an estimated 544,000 new cancer cases and 260,000 cancer deaths in 2020. NHL incidence rates varied by approximately 5-fold in both men and women across WHO areas. The highest age-standardized incidence rates for both sexes (per 100,000) were observed in Australia and New Zealand (12.5) and North America (12), while the lowest rates were in South-Central Asia (2.7), a 4.6-fold difference. Regions with very high HDI had higher rates of NHL (9.3) than regions with medium HDI (3.1) and lower HDI (4.5). However, international variability in NHL mortality rates is smaller: 2.5-fold for both sexes. The lowest mortality rates were in South-Central Asia (1.6) and the highest rates were in Melanesia (4). In the United States, the age-standardized NHL incidence rate (per 100,000) doubled from 1975 (11) to 2007 (21.3) and then stabilized, while the 5-year relative survival rates improved from 47% in 1975 to 73.8% in 2018. These changes have significantly impacted age-adjusted NHL mortality rates (per 100,000), which were 5.6 in 1975, peaked at 8.9 in 1997, and have been decreasing since that time, most recently at 5 in 2019. Similar broad temporal trend patterns were observed in other western countries. In Asia, NHL incidence rates have not plateaued, and have shown rises in Japan during 1993-2010 and in Republic of Korea during 1999-2012. Worldwide, an estimated 779,000 new NHL cases are projected to occur in 2040, a 43% increase from the corresponding 544,000 cases in 2020, assuming national rates remain constant. CONCLUSION There is marked variation in NHL incidence rates among different populations of the world. NHL incidence and mortality rates have steadily increased in the United States and other populations over the past few decades, making NHL an increasingly important contributor to the global cancer burden. This epidemiologic assessment also reveals substantial growth in new NHL diagnoses over the next two decades. Keeping track of new cases, deaths, trends, and survival over time helps us understand where progress is made and where additional research is needed to address challenges. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

PRIMARY IMMUNODEFICIENCY DISEASE MORTALITY TRENDS ACROSS EU15+ COUNTRIES: AN EPIDEMIOLOGICAL ANALYSIS

<h3>Introduction</h3> Primary Immunodeficiency Diseases (PIDDs) are rare genetic conditions that affect the immune system and are associated with high mortality. While the prevalence has been increasing there is a paucity of data on mortality trends from PIDD. The current investigation was to assess the burden of adult PIDD across EU15+ countries. <h3>Methods</h3> We extracted crude mortality data for EU15+ countries from the World Health Organization (WHO) Mortality Database according to the International Classification of Disease 10th Edition codes. We computed adult (age > 20) mortality rates per 1,000,000 population using the World Standard Population between 2000 and 2019. We report current mortality rates per 1,000,000 population as well as percentage change in mortality rates between EU15+ countries. <h3>Results</h3> Data were available for 15 countries for both men and women. The median ASMR for all countries in 2000 was 0.78 and 0.36 for men and women, respectively. By 2019, the median ASMR for men and women was 0.81 and 0.53, respectively. The highest mortality rates in 2019 for men was in Belgium (1.65) and for women in Denmark (1.28). There were 10 (67%) of countries with increasing mortality from PIDD for both men and women. The greatest increases in mortality for men was in Norway (+781%) and for women in Denmark (+258%). <h3>Conclusion</h3> We report significant variation in the burden of PIDD between EU15+ countries. Although the overall mortality rates remain low overall, there are significant increases in PIDD mortality across the majority of countries for both men and women.

Global burden and temporal trends in incidence and mortality of oesophageal cancer

IntroductionOesophageal cancer is a prevalent and deadly cancer around the world. ObjectivesWe aimed to present a comprehensive analysis of the global geographic patterns and temporal trends in the mortality and incidence of oesophageal cancer. MethodsThe mortality and incidence data of oesophageal cancer in 2020 were obtained from the GLOBOCAN database. Based on World Health Organization (WHO) mortality database and the Cancer Incidence in Five Continents (CI5), we also retrieved the mortality and incidence age-standardized rates (ASRs) of oesophageal cancer. The average annual percentage changes (AAPCs) of mortality and incidence were calculated using the joinpoint regression analysis. ResultsGlobally, 0.54 million deaths and 0.6 million new cases were identified in 2020. In the majority of countries of South America and Asia, the mortality and incidence trends have substantially decreased, but trends in European countries have varied. The prevalence in European nations varied, but the incidence in most other continents decreased dramatically. In terms of mortality, the global average rate was 5.6 per 100000, ranging from 16.7 (Malawi) to 0.28 (Belize). European countries varied in mortality, such as Norway (AAPC, male: 0.68; female: 0.89) and Ireland (AAPC, male: −0.96; female: −1.52). Most non-European countries saw large decreases in mortality, such as Singapore (AAPC, male: −4.78; female: −6.89). The elderly had more noticeable trends in mortality and incidence in most countries. ConclusionsWe have identified different trends in mortality and incidence among European countries, whereas declining trends were identified in most non-European countries. However, increasing trends were identified in specific subgroups of some countries, such as men in Thailand. For populations with rising mortality and incidence trends, more preventative efforts are required.

A Review and Analysis of the Impact of Homicide Measurement on Cross-National Research

The number of cross-national homicide studies is increasing rapidly. Many scholars, however, do not consider the details of how individual nations and the four main centralized homicide data sources—raw estimates from the World Health Organization (WHO) Mortality Database, adjusted estimates from the WHO Global Health Observatory, United Nations Office on Drugs and Crime, and World Bank World Development Indicators—generate national homicide rates and the impact this may have on results and the scientific record. We tested whether homicide trends, levels, and structural covariates are dependent on data source. We used 1990–2018 data in 5-year groupings and pooled them over time and nation. We utilized exploratory data analysis techniques to look for differences in homicide rates and trends. Then we employed seemingly unrelated regression (SUR) to determine whether associations with homicide of typical structural covariates were dependent on homicide data source. Finally, we examined Wald Tests to determine whether differences in the sizes of the SUR coefficients from each data source were significantly different from zero. We found differences in homicide trends and rates by data source and that associations with homicide rates of structural covariates varied in significance, magnitude, and even direction depending on homicide data source. Cross-national homicideresearch has a promising future for understanding short- and long-term global and regional trends and population-level covariates and constructing theoretical explanations for geographical and temporal variation. However, researchers must better understand how national homicide data are generated by nations and these four data sources. All four systems possess limitations, but homicide data from the WHO Mortality Database present the most attractive option.

Global burden of gastric cancer in adolescents and young adults: estimates from GLOBOCAN 2020

ObjectivesGastric cancer in adolescents and young adults (GCAYA) has been ignored by both patients and physicians. We examined the disease burden of GCAYA and its secular trends in incidence and mortality. Study designA comprehensive analysis of the global burden of GCAYA based on data provided by GLOBOCAN 2020. MethodsGlobal, regional, sex, and country-specific data of the incidence and mortality of GCAYA were extracted from the GLOBOCAN, the Cancer in Five Continents Plus, and the World Health Organization mortality database, respectively. The associations between the Human Development Index (HDI) and GCAYA burden were also evaluated by Pearson correlation analysis. ResultsThe global incidence of GCAYA was 0.79 per 100,000, and the corresponding mortality was 0.45 per 100,000 in 2020. The mortality-to-incidence ratio (MIR) was lower in AYA (0.61) than in patients aged 40–64 years (0.65) and patients aged 65 years and older (0.75). The age-standardized incidence rates (ASIR) and age-standardized mortality rates (ASMR) were 0.84 and 0.53 per 100,000, respectively, in women, compared with 0.74 and 0.45 per 100,000, respectively, in men. The majority of new cases (17,934) and deaths (10,360) were estimated to occur in Asia. There has a significant negative correlation between the MIR of GCAYA and HDI level (R2 = 0.2707, P < 0.0001). There was a decreasing trend of incidence and mortality in most countries. ConclusionsThe MIR of GCAYA is lower than that among older patients and exhibit a positive association with socio-economic status. The incidence and mortality of GCAYA show a decreasing trend in most countries.

Chronic obstructive pulmonary disease (COPD) mortality trends worldwide: An update to 2019.

Chronic obstructive pulmonary disease (COPD) incidence, prevalence, mortality and socioeconomic burden are considerable and vary across countries. The aim of the present study was to update the analysis of COPD mortality worldwide using data from the World Health Organization (WHO) up to 2019. We obtained COPD mortality and population data for 22 European countries and the European Union (EU) as a whole, 10 American countries and six other countries from the WHO mortality database. We calculated age-standardized mortality rates in both sexes and examined trends by country with joinpoint analysis between 1994 and 2019. Between 2005-2007 and 2015-2017, overall COPD mortality decreased in EU men (-16.3%) but increased in women (12.7%) to reach rates of 14.0/100,000 in men and of 6.4/100,000 in women. In the United States, mortality declined in men to 21.3/100,000 but rose in women to 18.3/100,000. Mortality declined in most Latin American countries and all Asian countries, while an increase in Australian women was observed. A steady decrease in COPD mortality was observed in most of countries for men, whilst a different trend was observed in women in several countries. These trends are largely explained by changes in smoking habits, with an additional contribution of air pollution and occupational exposures. Despite past and ongoing tobacco control initiatives, this condition still remains a leading cause of death, in particular in countries with lower socio-demographic indices.