Background: Epilepsy accounts for a significant portion of the global disease burden. However, little is known about the disease burden of epilepsy in China and its provinces. Methods: We assessed the burden of epilep...Background: Epilepsy accounts for a significant portion of the global disease burden. However, little is known about the disease burden of epilepsy in China and its provinces. Methods: We assessed the burden of epilepsy in China and its provinces, municipalities, and autonomous regions from 1990 to 2019. Burden was measured as incidence, prevalence, deaths, years lived with disability, years of life lost, and disability-adjusted life years (DALYs), by age, sex, year, and province. We used the Socio-Demographic Index (SDI) to determine the association between the provincial development level and age-standardized DALY rates of epilepsy from 1990 to 2019. Results: In 2019, epilepsy caused 1367.51 thousand (95% uncertainty interval [UI]: 979.92–1837.61 thousand) DALYs, and the age-standardized DALY rate was 99.77 (95% UI: 71.33–133.52)/100,000. The age-standardized incidence and prevalence rates for epilepsy in China were 24.65/100,000 and 219.69/100,000, increased by 45.00% (95% UI: 8.03–98.74%) and 35.72% (95% UI: 0.47–86.19%) compared with that in 1990, respectively. From 1990 to 2019, the proportion of DALY caused by epilepsy in the age group under 25 years steadily decreased. The proportion of DALYs caused by epilepsy in people aged 50 years and over increased from 9.45% and 10.22% in 1990 to 29.01% and 32.72% for male and female individuals in 2019, respectively. The highest age-standardized mortality rates were seen in Tibet (4.26 [95% UI: 1.43–5.66]/100,000), Qinghai (1.80 [95% UI: 1.15–2.36]/100,000), and Yunnan (1.30 [95% UI: 0.88–1.62]/100,000), and the lowest mortality rates were in Guangdong (0.48 [95% UI: 0.39–0.64]/100,000), Zhejiang (0.56 [95% UI: 0.44–0.70]/100,000), and Shanghai (0.57 [95% UI: 0.41–0.73]/100,000). The age-standardized DALY rates across the country and in provinces, municipalities, and autonomous regions generally decreased as their SDI increased. Conclusions: The disease burden of epilepsy is still heavy in China, especially in the western provinces. The incidence and prevalence of epilepsy increased between 1990 and 2019, and the burden of epilepsy in the elderly increases gradually. This study provides evidence on epilepsy prevention and care of different regions in China.展开更多
Background:Understanding the changing profiles of cardiovascular disease(CVD)and modifiable risk factors is essential for CVD prevention and control.We aimed to report the comprehensive trends in CVD and risk factors ...Background:Understanding the changing profiles of cardiovascular disease(CVD)and modifiable risk factors is essential for CVD prevention and control.We aimed to report the comprehensive trends in CVD and risk factors in China from 1990 to 2019.Methods:Data on the incidence,death,and disability-adjusted life years(DALYs)of total CVD and its 11 subtypes for China were obtained from the Global Burden of Disease Study 2019.The CVD burden attributable to 12 risk factors was also retrieved.A secondary analysis was conducted to summarize the leading causes of CVD burden and attributable risk factors.Results:From 1990 to 2019,the number of CVD incidence,death,and DALYs considerably increased by 132.8%,89.1%,and 52.6%,respectively.Stroke,ischemic heart disease,and hypertensive heart disease accounted for over 95.0%of CVD deaths in 2019 and remained the top three causes during the past 30 years.Between 1990 and 2019,the age-standardized rate of stroke decreased significantly(percentage of decreased incidence:-9.3%;death:-39.8%;DALYs:-41.6%),while the rate of ischemic heart disease increased(percentage of increased incidence:11.5%;death:17.6%;DALYs:2.2%).High systolic blood pressure,unhealthy diet,tobacco,and air pollution continued to be the major contributors to CVD deaths and DALYs(attributing to over 70%of the CVD burden),and the high body mass index(BMI)-associated CVD burden had the largest increase between 1990 and 2019.Conclusions:The significant increases in the number of CVD incident cases,deaths,and DALYs suggest that the CVD burden is still a concern.Intensified strategies and policies are needed to maintain promising progress in stroke and to reduce the escalating burden of ischemic heart disease.The CVD burden attributable to risk factors has not yet made adequate achievements;even worse,high BMI has contributed to the increasing CVD burden.展开更多
BACKGROUND Inflammatory bowel disease(IBD)is an idiopathic intestinal disease with various levels and trends in different countries and regions.Understanding the current burden and trends of IBD in various geographica...BACKGROUND Inflammatory bowel disease(IBD)is an idiopathic intestinal disease with various levels and trends in different countries and regions.Understanding the current burden and trends of IBD in various geographical locations is essential to establish effective strategies for prevention and treatment.We report the average annual percentage change(AAPC)and estimated annual percentage change(EAPC)in age-standardized rates(ASR)of IBD in different regions based on the Global Burden of Disease(GBD)study from 1990-2019,and the relationships between IBD and the human development index(HDI)and socio-demographic index(SDI).The prevalence trends of IBD were predicted by gender from 2019-2039.AIM To comprehensively investigate IBD data,providing further insights into the management of this chronic disease.METHODS We collected the information on the incidence of IBD from the GBD study from 1990-2019 to calculate the AAPC and EAPC in ASR of IBD in different regions.The relationships between IBD,HDI,and SDI were analyzed.The Nordpred and Bayesian age-period-cohort models were used to predict the prevalence trends of IBD by gender from 2019-2039,and the reliability of the results was validated.RESULTS North America consistently had the highest IBD ASR,while Oceania consistently had the lowest.East Asia had the fastest average annual growth in ASR(2.54%),whereas Central Europe had the fastest decline(1.38%).Countries with a low age-standardized incidence rates in 1990 showed faster growth in IBD while there was no significant correlation in 2019.Additionally,IBD increased faster in countries with a low age-standardized death rates in 1990,whereas the opposite was true in 2019.Analysis of SDI and IBD ASR showed that countries with a high SDI generally had a higher IBD ASR.Finally,the projections showed a declining trend in the incidence of IBD from 2019-2039,but a gradual increase in the number of cases.CONCLUSION As the global population increases and ages,early monitoring and prevention of IBD is important to reduce the disease burden,especially in countries with a high incidence of IBD.展开更多
BACKGROUND Nonalcoholic fatty liver disease(NAFLD)has become the leading cause of cirrhosis and other chronic liver diseases(COCLDs).AIM To conduct a comprehensive and comparable updated analysis of the global,regiona...BACKGROUND Nonalcoholic fatty liver disease(NAFLD)has become the leading cause of cirrhosis and other chronic liver diseases(COCLDs).AIM To conduct a comprehensive and comparable updated analysis of the global,regional,and national burden of COCLDs due to NAFLD in 204 countries and territories from 1990 and 2019 by age,sex,and sociodemographic index.METHODS Data on COCLDs due to NAFLD were collected from the Global Burden of Diseases,Injuries,and Risk Factors Study 2019.Numbers and age-standardized prevalence,death,and disability-adjusted life years(DALYs)were estimated through a systematic analysis of modelled data from the Global Burden of Diseases,Injuries,and Risk Factors Study 2019.The estimated annual percentage change was used to determine the burden trend.RESULTS In 2019,the global age-standardized prevalence rate of COCLDs due to NAFLD was 15022.90 per 100000 population[95%uncertainty interval(UI):13493.19-16764.24],which increased by 24.51%(22.63%to 26.08%)from 1990,with an estimated annual percentage change of 0.78(95%confidence interval:0.74-0.82).In the same year,however,the age-standardized death rate and age-standardized DALYs per 100000 population were 1.66(95%UI:1.20-2.17)and 43.69(95%UI:31.28-58.38),respectively.North Africa and the Middle East had the highest prevalence rates of COCLDs due to NAFLD.The death rate increased with age up to the 95+age group for both sexes.Males had higher numbers of prevalence,death rate,and DALYs than females across all age groups before the 65-69 age group.The sociodemographic index was negatively correlated with the age-standardized DALYs.CONCLUSION Globally,the age-standardized prevalence rate has increased during the past three decades.However,the agestandardized death rate and age-standardized DALYs decreased.There is geographical variation in the burden of COCLDs due to NAFLD.It is strongly recommended to improve the data quality of COCLDs due to NAFLD across all countries and regions to facilitate better monitoring of the burden of COCLDs due to NAFLD.展开更多
Background::Hepatitis B is a viral infection that attacks the liver and can cause both potentially life-threatening acute and chronic liver disease.China has the world’s largest burden of hepatitis B and is considere...Background::Hepatitis B is a viral infection that attacks the liver and can cause both potentially life-threatening acute and chronic liver disease.China has the world’s largest burden of hepatitis B and is considered to be a major contributor toward the goal of World Health Organization(WHO)of eliminating hepatitis B virus(HBV)as a global health threat by 2030.This study aimed to analyze data from the Global Burden of Diseases,Injuries,and Risk Factors Study(GBD)to determine the trends in mortality of liver disease due to hepatitis B in China between 1990 and 2019 and the gap with the WHO’s goal.Methods::Annual deaths and age-standardized mortality rates(ASMRs)of liver disease due to hepatitis B in China between 1990 and 2019 were collected from GBD 2019.We calculated the percentage changes in deaths and estimated annual percentage changes(EAPCs)of ASMRs of liver disease due to hepatitis B.Results::In China,deaths of total liver disease due to hepatitis B decreased by 29.13%from 229 thousand in 2016 to 162 thousand in 2019,and ASMR decreased by an average of 4.92%(95%confidence interval[CI]:4.45–5.39%)per year in this period.For the spectrum of liver disease due to hepatitis B,deaths decreased by 74.83%,34.71%,and 23.34%for acute hepatitis,cirrhosis and other chronic liver diseases,and liver cancer from 1990 to 2019,respectively,and ASMRs of acute hepatitis(EAPC=–7.63;95%CI:–8.25,–7.00),cirrhosis and other chronic liver diseases(EAPC=–4.15;95%CI:–4.66,–3.65),and liver cancer(EAPC=–5.17;95%CI:–6.00,–4.33)decreased between 1990 and 2019.The proportions of older adults aged≥70 years among all deaths of the spectrum of liver disease due to hepatitis B increased from 1990 to 2019.Deaths of liver cancer due to hepatitis B increased by 7.05%from 2015 to 2019.Conclusions::Although a favorable trend in the mortality of liver disease due to hepatitis B was observed between 1990 and 2019,China still faces challenges in achieving the WHO’s goal of eliminating HBV as a public threat by 2030.Therefore,efforts to increase the coverage of diagnosis and treatment of liver disease due to hepatitis B,especially of liver cancer due to hepatitis B,are warranted in China.展开更多
Background:Data on the incidence,mortality,and other burden of oral cancer as well as their secular trends are necessary to provide policy-makers with the information needed to allocate resources appropriately.The pur...Background:Data on the incidence,mortality,and other burden of oral cancer as well as their secular trends are necessary to provide policy-makers with the information needed to allocate resources appropriately.The purpose of this study was to use the Global Burden of Disease(GBD)2017 results to estimate the incidence,mortality,and disability-adjusted life years(DALYs)for oral cancer from 1990 to 2017.Methods:We collected detailed data on oral cancer from 1990 to 2017 from the GBD 2017.The global incidence,mortality,and DALYs attributable to oral cancer as well as the corresponding age-standardized rates(ASRs)were calculated.The estimated annual percentage changes in the ASRs of incidence(ASRI)and mortality(ASRM)and age-standardized DALYs of oral cancer were also calculated according to regions and countries to quantify the secular trends in these rates.Results:We tracked the incidence,mortality,and DALYs of oral cancer in 195 countries/territories over 28 years.Globally,the incidence,mortality,and DALYs of oral cancer increased by about 1.0-fold from 1990 to 2017.The ASRI of oral cancer showed a similar trend,increasing from 4.41 to 4.84 per 100,000 person-years during the study period.The ASRM remained approximately stable at about 2.4 per 100,000 from 1990 to 2017,as did the age-standardized DALYs,at about 64.0 per 100,000 person-years.ASRI was highest in Pakistan(27.03/100,000,95%CI=22.13-32.75/100,000),followed by Taiwan China,and lowest in Iraq(0.96/100,000,95%CI=0.86-1.06/100,000).ASRM was highest in Pakistan(16.85/100,000,95%CI=13.92-20.17/100,000)and lowest in Kuwait(0.51/100,000,95%CI=0.45-0.58/100,000).Conclusions:The ASRI of oral cancer has increased slightly worldwide,while the ASRM and age-standardized DALY have remained stable.However,these characteristics vary between countries,suggesting that current prevention strategies should be reoriented,and much more targeted and specific strategies should be established in some countries to forestall the increase in oral cancer.展开更多
Background:The patterns of leukemia burden have dramatically changed in recent years.This study aimed to estimate the global trends of leukemiarelated death and disability-adjusted life-years(DALYs)from 1990 to 2017.M...Background:The patterns of leukemia burden have dramatically changed in recent years.This study aimed to estimate the global trends of leukemiarelated death and disability-adjusted life-years(DALYs)from 1990 to 2017.Methods:The data was acquired from the latest version of the Global Burden of Disease(GBD)study.Estimated annual percentage changes(EAPCs)were calculated to estimate the trend of age-standardized rate(ASR)of death and DALYs due to leukemia and its main subtypes from 1990 to 2017.Results:Globally,the numbers of death and DALYs due to leukemia were 347.58×10^(3)(95%uncertainty interval[UI]=317.26×10^(3)-364.88×10^(3))and 11975.35×10^(3)(95%UI=10749.15×10^(3)-12793.58×10^(3))in 2017,with a 31.22% and 0.03% increase in absolute numbers from 1990 to 2017,respectively.Both of their ASR showed decreasing trends from 1990 to 2017 with the EAPCs being−1.04(95%confidence interval[CI]=(−1.10-−0.99)and−1.52(95%CI=−1.59-−1.44),respectively.Globally,the most pronounced decreasing trend of death and DALYs occurred in chronic myeloid leukemia with EAPCs of−2.76(95%CI=−2.88-−2.64)and−2.84(95%CI=−2.97-−2.70),respectively,while the trend increased in acute myeloid leukemia.The death and DALYs of leukemia decreased in most areas and countries with high socio-demographic index(SDI)including Bahrain,Finland,and Australia.Conclusions:The disease burden of death and DALYs due to leukemia decreased globally,and for most regions and countries from 1990 to 2017.However,the leukemia burden is still a substantial challenge globally and required adequate and affordable medical resources to improve the survival and quality of life of leukemia patients.展开更多
Recently,the mortality of 240 causes in China including a subnational analysis during 1990-2013 was published in The Lancet.This comprehensive analysis will undoubtedly impact policymaking regarding public health in C...Recently,the mortality of 240 causes in China including a subnational analysis during 1990-2013 was published in The Lancet.This comprehensive analysis will undoubtedly impact policymaking regarding public health in China.However,it is unfavourable in some degree to neglected tropical diseases,which is the subject of this Letter to the Editor.Policymakers,especially those in less developed provinces of China,should fully consider the burden of neglected tropical diseases,which will benefit the control and final elimination of these diseases in the country.展开更多
Background:Antituberculosis-drug resistance is an important public health issue,and its epidemiological patterns has dramatically changed in recent decades.This study aimed to estimate the trends of multidrug-resistan...Background:Antituberculosis-drug resistance is an important public health issue,and its epidemiological patterns has dramatically changed in recent decades.This study aimed to estimate the trends of multidrug-resistant tuberculosis(MDR-TB),which can be used to inform health strategies.Methods:Data were collected from the Global Burden of Disease study 2017.The estimated annual percentage changes(EAPCs)were calculated to assess the trends of MDR-TB burden at global,regional,and national level from 1990 to 2017 using the linear regression model.展开更多
Background::China and the United States(US)ranked first and third in terms of new liver cancer cases and deaths globally in 2020.Therefore,a comprehensive assessment of trends in the incidence of primary liver cancer ...Background::China and the United States(US)ranked first and third in terms of new liver cancer cases and deaths globally in 2020.Therefore,a comprehensive assessment of trends in the incidence of primary liver cancer with four major etiological factors between China and the US during the past 30 years with age-period-cohort(APC)analyses is warranted.Methods::Data were obtained from the Global Burden of Disease 2019,and period/cohort relative risks were estimated by APC modeling from 1990 to 2019.Results::In 2019,there were 211,000 new liver cancer cases in China and 28,000 in the US,accounting for 39.4%and 5.2%of global liver cancer cases,respectively.For China,the age-standardized incidence rate(ASIR)consecutively decreased before 2005 but increased slightly since then,whereas the ASIR continuously increased in the US.Among the four etiological factors of liver cancer,the fastest reduction in incidence was observed in hepatitis B virus-related liver cancer among Chinese women,and the fastest increase was in nonalcoholic steatosis hepatitis(NASH)-related liver cancer among American men.The greatest reduction in the incidence of liver cancer was observed at the age of 53 years in Chinese men(-5.2%/year)and 33 years in Chinese women(-6.6%/year),while it peaked at 58 years old in both American men and women(4.5%/year vs.2.8%/year).Furthermore,the period risks of alcohol-and NASH-related liver cancer among Chinese men have been elevated since 2013.Simultaneously,leveled-off period risks were observed in hepatitis C viral-related liver cancer in both American men and women.Conclusions::Currently,both viral and lifestyle factors have been and will continue to play an important role in the time trends of liver cancer in both countries.More tailored and efficient preventive strategies should be designed to target both viral and lifestyle factors to prevent and control liver cancer.展开更多
Background::Non-transport unintentional injuries(NTUIs)are major public concerns,especially among children and adolescents in low-and middle-income countries.With environmental and cognitive changes,a recent systemati...Background::Non-transport unintentional injuries(NTUIs)are major public concerns,especially among children and adolescents in low-and middle-income countries.With environmental and cognitive changes,a recent systematic description of global trends and regional differences concerning NTUIs is urgently needed for the global agenda of relevant policy-making and intervention target findings.Methods::We used mortality,population,and socio-demographic-index(SDI)data from Global Burden of Disease 2019 to analyze the trends of NTUIs mortality.We applied the slope index of inequality(SII)and relative index of inequality(RII)to measure the absolute and relative inequality between countries and territories.The concentration curve and concentration index(CI)were also used to measure the inequality.We conducted a sensitivity analysis to make our findings credible.Results::In 2019,there were 205,000 deaths due to NTUIs among children and adolescents aged 5 to 24 years,which decreased from 375,000 in 1990.In 2019,the age-standardized mortality rate(ASMR)was 8.13 per 100,000,ranging from the lowest in the Netherlands(0.90 per 100,000)to the highest in the Solomon Islands(29.34 per 100,000).The low-middle SDI group had the highest ASMR of NTUIs,while the low SDI group had the slowest decrease.After excluding the death caused by"exposure to forces of nature"and"other unintentional injuries",drowning accounted for the most deaths in almost every SDI group,gender,and age group,but the major causes of death varied in different subgroups.For example,animal contact was a major cause in low and low-middle SDI groups but less in high SDI groups,while high and high-middle SDI groups had a higher proportion of deaths for foreign body and poisonings.The SII showed a declining trend,but the RII and CI did not,which might indicate that inequality was persistent.Similar results were found in the sensitivity analysis.Conclusions::Despite the declining trend of the mortality rate and the narrowing gap between countries,there were still a large number of children and adolescents dying from NTUIs,and those experiencing social-economic disadvantages remained at high mortality.Embedding the prevention of NTUIs into sustainable development goals might contribute to the progress of reducing death and inequalities,which ensures that no one is left behind.展开更多
Background:The burden of kidney,bladder,and prostate cancers has changed in recent decades.This study aims to investigate the global and regional burden of,and attributable risk factors for genitourinary cancers durin...Background:The burden of kidney,bladder,and prostate cancers has changed in recent decades.This study aims to investigate the global and regional burden of,and attributable risk factors for genitourinary cancers during the past 30 years.Methods:We extracted data of kidney,bladder,and prostate cancers from the Global Burden of Disease 2019 database,including incidence,mortality,disability-adjusted life-years(DALYs),and attributable risk factors from 1990 to 2019.Estimated annual percentage changes(EAPC)were calculated to assess the changes in age-standardized incidence rate,age-standardized mortality rate(ASMR),and age-standardized DALYs rate(ASDR).The associations between cancers burden and socio-demographic index(SDI)were also analyzed.Results:Compared with 1990,the global incident cases in 2019 were higher by 154.78%,123.34%,and 169.11%for kidney,bladder,and prostate cancers,respectively.During the 30-year study period,there was a downward trend in ASMR and ASDR for bladder cancer(EAPC=–0.68 and–0.83,respectively)and prostate cancer(EAPC=–0.75 and–0.71,respectively),but an upward trend for kidney cancer(EAPC=0.35 and 0.12,respectively).Regions and countries with higher SDI had higher incidence,mortality,and DALYs for all three types of cancers.The burden of bladder and prostate cancers was mainly distributed among older men,whereas the burden of kidney cancer increased among middle-aged men.Smoking related mortality and DALYs decreased,but high body mass index(BMI)and high fasting plasma glucose(FPG)related mortality and DALYs increased among kidney,bladder,and prostate cancers during the study period.Conclusions:Kidney,bladder,and prostate cancers remain major global public health challenges,but with distinct trend for different disease entity across different regions and socioeconomic status.More proactive intervention strategies,at both the administrative and academic levels,based on the dynamic changes,are needed.展开更多
BACKGROUND Hepatitis C is the leading cause of chronic liver disease worldwide and it significantly contributes to the burden of hepatocellular carcinoma(HCC).However,there are marked variations in the incidence and m...BACKGROUND Hepatitis C is the leading cause of chronic liver disease worldwide and it significantly contributes to the burden of hepatocellular carcinoma(HCC).However,there are marked variations in the incidence and mortality rates of HCC across different geographical regions.With the advent of new widely available treatment modalities,such as direct-acting antivirals,it is becoming increasingly imperative to understand the temporal and geographical trends in HCC mortality associated with Hepatitis C.Furthermore,gender disparities in HCC mortality related to Hepatitis C are a crucial,yet underexplored aspect that adds to the disease's global impact.While some studies shed light on gender-specific trends,there is a lack of comprehensive data on global and regional mortality rates,particularly those highlighting gender disparities.This gap in knowledge hinders the development of targeted interventions and resource allocation strategies.DISCUSSION The results of our study show an overall decline in the mortality rates of patients with hepatitis C-related HCC over the last two decades.Notably,females exhibited a remarkable decrease in mortality compared to males.Regionally,East Asia and the Pacific displayed a significant decline in mortality,while Europe and Central Asia witnessed an upward trend.Latin America and the Caribbean also experienced an increase in mortality rates.However,no significant difference was observed in the Middle East and North Africa.North America exhibited a notable upward trend.South Asia and Sub-Saharan Africa significantly declined throughout the study period.This raises the hope of identifying areas for implementing more targeted resources.Despite some progress,multiple challenges remain in meeting the WHO 2030 goal of eliminating viral hepatitis[24].展开更多
Objective Adopting a healthy lifestyle,including regular physical activity,is widely believed to decrease cancer risk.This study aimed to quantitatively establish the dose-response relationships between total physical...Objective Adopting a healthy lifestyle,including regular physical activity,is widely believed to decrease cancer risk.This study aimed to quantitatively establish the dose-response relationships between total physical activity and the risk of breast,colon,lung,gastric,and liver cancers.Methods A systematic review and dose-response analysis were conducted using PubMed and Embase from January 1,1980 to March 20,2023.Prospective cohort studies that examined the association between physical activity and the risks of any of the 5 outcomes were included.The search was confined to publications in the English language with a specific focus on human studies.Physical activity is standardized by using the data from US National Health and Nutrition Examination Surveys(NHANES)and the Global Burden of Disease 2019 database.Results A total of 98 studies,involving a combined population of 16,418,361 individuals,were included in the analysis.Among the included studies,57 focused on breast cancer,17 on lung cancer,23 on colon cancer,5 on gastric cancer,and 7 on liver cancer.Overall,elevated levels of physical activity exhibited an inverse correlation with the risk of cancer.The dose-response curve for lung cancer exhibited a non-linear pattern,with the greatest benefit risk reduction observed at 13,200 MET-minutes/week of physical activity,resulting in a 14.7%reduction in risk(relative risk 0.853,uncertainty interval 0.798 to 0.912)compared to the inactive population.In contrast,the dose-response curves for colon,gastric,breast,and liver cancers showed linear associations,indicating that heightened levels of total physical activity were consistently associated with reduced cancer risks.However,the increase in physical activity yielded a smaller risk reduction for colon and gastric cancers compared to breast and liver cancers.Compared to individuals with insufficient activity(total activity level<600 MET-minutes/week),individuals with high levels of activity(≥8,000 MET-minutes/week)experienced a 10.3%(0.897,0.860 to 0.934)risk reduction for breast cancer;5.9%(0.941,0.884 to 1.001)for lung cancer;7.1%(0.929,0.909 to 0.949)for colon cancer;5.1%(0.949,0.908 to 0.992)for gastric cancer;17.1%(0.829,0.760 to 0.903)for liver cancer.Conclusions This study demonstrated a significant inverse relationship between total physical activity and the risk of breast,gastric,liver,colon,and lung cancers.展开更多
Objective To assess the association of socioeconomic status with the burden of cataract blindness in terms of year lived with disability(YLD) rates and to determine whether ultraviolet radiation(UVR) levels modify the...Objective To assess the association of socioeconomic status with the burden of cataract blindness in terms of year lived with disability(YLD) rates and to determine whether ultraviolet radiation(UVR) levels modify the effect of socioeconomic status on this health burden.Methods National and subnational age-standardized YLD rates associated with cataract-related blindness were derived from the Global Burden of Disease(GBD) study 2017. The human development index(HDI) from the Human Development Report was used as a measure of socioeconomic status.Estimated ground-level UVR exposure was obtained from the Ozone Monitoring Instrument(OMI)dataset of the National Aeronautics and Space Administration(NASA).Results Across 185 countries, socioeconomic status was inversely associated with the burden of cataract blindness. Countries with a very high HDI had an 84% lower age-standardized YLD rate [95%confidence interval(CI): 60%–93%, P < 0.001] than countries with a low HDI;for high-HDI countries, the proportion was 76%(95% CI: 53%–88%, P < 0.001), and for medium-HDI countries, the proportion was48%(95% CI: 15%–68%, P = 0.010;P for trend < 0.001). The interaction analysis showed that UVR exposure played an interactive role in the association between socioeconomic status and cataract blindness burden(P value for interaction = 0.047).Conclusion Long-term high-UVR exposure amplifies the association of poor socioeconomic status with the burden of cataract-related blindness. The findings emphasize the need for strengthening UVR exposure protection interventions in developing countries with high-UVR exposure.展开更多
Background: Despite the decline in the incidence and mortality rates of gastric cancer (GC), the impact of demographic transition on the global burden of GC remains unclear. The current study aimed to estimate the glo...Background: Despite the decline in the incidence and mortality rates of gastric cancer (GC), the impact of demographic transition on the global burden of GC remains unclear. The current study aimed to estimate the global disease burden through 2040 by age, sex, and region. Methods: GC data for incident cases and deaths by age group and sex were taken from The Global Cancer Observatory (GLOBOCAN) 2020. The incidence and mortality rates were predicted through 2040 by fitting a linear regression model over the most recent trend period with the Cancer Incidence in Five Continents (CI5) data. Results: The global population will grow to 9.19 billion by 2040, accompanied by increasing population ageing. The incidence and mortality rates of GC will show a persistent decrease, with an annual percent change of -0.57% for males and -0.65% for females. East Asia and North America will have the highest and lowest age standardized rates, respectively. A slowdown in the growth of incident cases and deaths will be observed worldwide. The proportion of young and middle-aged individuals will decline, while the percentage of the elderly will increase, and the number of males will be almost twice the number of females. East Asia and high human development index (HDI) regions will be heavily burdened by GC. East Asia had 59.85% of the new cases and 56.23% of deaths in 2020;these will increase to 66.93% and 64.37% by 2040, respectively. The interaction between population growth, the change in ageing structure and the decline in incidence and mortality rates will lead to an increased burden of GC. Conclusions: Ageing and population growth will offset the decline in the incidence and mortality rate of GC, resulting in a substantial increase in the number of new cases and deaths. The age structure will continue to change, especially in high HDI regions, requiring more targeted prevention strategies in the future.展开更多
Background:Gallbladder and biliary tract cancer(GBTC)has greatly damaged the health of patients and is accompanied by a dismal prognosis.The worldwide distribution of GBTC shows extensive variance and the updated data...Background:Gallbladder and biliary tract cancer(GBTC)has greatly damaged the health of patients and is accompanied by a dismal prognosis.The worldwide distribution of GBTC shows extensive variance and the updated data in China is lacking.This study was to determine the current status,trends,and predictions in the burden of GBTC over the past 30 years in China.Methods:This was a descriptive,epidemiological,secondary analysis of the Global Burden of Disease,Injuries,and Risk Factor Study 2019 data.Data including incidence,prevalence,mortality,and disability-adjusted life years(DALYs)of GBTC in China by year,age,and sex were assessed.Joinpoint regression analysis was conducted to evaluate trends of disease burden due to GBTC from 1990 to 2019.Nordpred age-period-cohort analysis was applied for the projection of mortality and incidence due to GBTC from 2019 to 2044.Results:Nationally,there were 38,634(95%uncertainty interval[UI]:27,350-46,512)new cases and 47,278(95%UI:32,889-57,229)patients due to GBTC,causing 34,462(95%UI:25,220-41,231)deaths,and 763,584(95%UI:566,755-920,493)DALYs in 2019.Both cases and rates of burden owing to GBTC were heavier among males and at old age.From 1990 to 2019,the age-standardized rates of incidence,prevalence,mortality,and DALYs of GBTC generally increased from 1990 to 2019,with average annual percentage change at 0.8%(95%confidential interval[CI]:0.6-1.0%),1.3%(95%CI:1.1-1.5%),0.4%(95%CI:0.2-0.6%),and 0.2%(95%CI:0.1-0.4%),respectively.Even though the age-standardized incidence rate and agestandardized mortality rate in both sexes were predicted to decline gradually from 2019 to 2044,the number of new cases and deaths were expected to grow steadily.Conclusions:GBTC is becoming a major health burden in China,particularly among males and older individuals.Given the aging population and increasing burden,effective strategies and measurements are urged to prevent or reduce the number of new cases and deaths of GBTC.展开更多
Background:Neglected Tropical Diseases(NTDs)afflict around one billion individuals in the poorest parts of the world with many more at risk.Lymphatic filariasis is one of the most prevalent of the infections and cause...Background:Neglected Tropical Diseases(NTDs)afflict around one billion individuals in the poorest parts of the world with many more at risk.Lymphatic filariasis is one of the most prevalent of the infections and causes significant morbidity in those who suffer the clinical conditions,particularly lymphedema and hydrocele.Depressive illness has been recognised as a prevalent disability in those with the disease because of the stigmatising nature of the condition.No estimates of the burden of depressive illness of any neglected tropical disease have been undertaken to date despite the recognition that such diseases have major consequences for mental health not only for patients but also their caregivers.Methods:We developed a mathematical model to calculate the burden of Disability-Adjusted Life Years(DALY)attributable to depressive illness in lymphatic filariasis and that of their caregivers using standard methods for calculating DALYs.Estimates of numbers with clinical disease was based on published estimates in 2012 and the numbers with depressive illness from the available literature.Results:We calculated that the burden of depressive illness in filariasis patients was 5.09 million disability-adjusted life years(DALYs)and 229,537 DALYs attributable to their caregivers.These figures are around twice that of 2.78 million DALYs attributed to filariasis by the Global Burden of Disease study of 2010.Conclusions:Lymphatic filariasis and other neglected tropical diseases,notably Buruli Ulcer,cutaneous leishmaniasis,leprosy,yaws,onchocerciasis and trachoma cause significant co morbidity associated with mental illness in patients.Studies to assess the prevalence of the burden of this co-morbidity should be incorporated into any future assessment of the Global Burden of neglected tropical diseases.The prevalence of depressive illness in caregivers who support those who suffer from these conditions is required.Such assessments are critical for neglected tropical diseases which have such a huge global prevalence and thus will contribute a significant burden of co-morbidity attributable to mental illness.展开更多
Background:Globally,colorectal cancer(CRC)imposes a substantial burden on healthcare systems and confers considerable medical expenditures.We aimed to evaluate the global and regional burden in epidemiological trends ...Background:Globally,colorectal cancer(CRC)imposes a substantial burden on healthcare systems and confers considerable medical expenditures.We aimed to evaluate the global and regional burden in epidemiological trends and factors associated with the incidence and mortality of CRC.Methods:We used data from the GLOBOCAN database to estimate CRC incidence and mortality worldwide in 2020 and their association with the human development index(HDI).Trends of age-standardized rates of incidence and mortality in 60 countries(2000–2019)were evaluated by Joinpoint regression analysis using data of Global Burden of Disease 2019.The association between exposure to country-level lifestyle,metabolic and socioeconomic factors obtained from the World Health Organization Global Health Observatory and World Bank DataBank data and CRC incidence and mortality was determined by multivariable linear regression.Results:CRC incidence and mortality varied greatly in the 60 selected countries,and much higher incidence and mortality were observed in countries with higher HDIs,and vice versa.From 2000 to 2019,significant increases of incidence and mortality were observed for 33 countries(average annual percent changes[AAPCs],0.24–3.82)and 18 countries(AAPCs,0.41–2.22),respectively.A stronger increase in incidence was observed among males(AAPCs,0.36–4.54)and individuals<50 years(AAPCs,0.56–3.86).Notably,15 countries showed significant decreases in both incidence(AAPCs,0.24 to2.19)and mortality(AAPCs,0.84 to2.74).A significant increase of incidence among individuals<50 years was observed in 30 countries(AAPCs,0.28–3.62).Countries with higher incidence were more likely to have a higher prevalence of alcohol drinking,higher level of cholesterol level,higher level of unemployment,and a poorer healthcare system.Conclusions:Some high-HDI countries showed decreasing trends in CRC incidence and mortality,whereas developing countries that previously had low disease burden showed significantly increased incidence and mortality trends,especially in males and populations≥50 years,which require targeted preventive health programs.展开更多
文摘Background: Epilepsy accounts for a significant portion of the global disease burden. However, little is known about the disease burden of epilepsy in China and its provinces. Methods: We assessed the burden of epilepsy in China and its provinces, municipalities, and autonomous regions from 1990 to 2019. Burden was measured as incidence, prevalence, deaths, years lived with disability, years of life lost, and disability-adjusted life years (DALYs), by age, sex, year, and province. We used the Socio-Demographic Index (SDI) to determine the association between the provincial development level and age-standardized DALY rates of epilepsy from 1990 to 2019. Results: In 2019, epilepsy caused 1367.51 thousand (95% uncertainty interval [UI]: 979.92–1837.61 thousand) DALYs, and the age-standardized DALY rate was 99.77 (95% UI: 71.33–133.52)/100,000. The age-standardized incidence and prevalence rates for epilepsy in China were 24.65/100,000 and 219.69/100,000, increased by 45.00% (95% UI: 8.03–98.74%) and 35.72% (95% UI: 0.47–86.19%) compared with that in 1990, respectively. From 1990 to 2019, the proportion of DALY caused by epilepsy in the age group under 25 years steadily decreased. The proportion of DALYs caused by epilepsy in people aged 50 years and over increased from 9.45% and 10.22% in 1990 to 29.01% and 32.72% for male and female individuals in 2019, respectively. The highest age-standardized mortality rates were seen in Tibet (4.26 [95% UI: 1.43–5.66]/100,000), Qinghai (1.80 [95% UI: 1.15–2.36]/100,000), and Yunnan (1.30 [95% UI: 0.88–1.62]/100,000), and the lowest mortality rates were in Guangdong (0.48 [95% UI: 0.39–0.64]/100,000), Zhejiang (0.56 [95% UI: 0.44–0.70]/100,000), and Shanghai (0.57 [95% UI: 0.41–0.73]/100,000). The age-standardized DALY rates across the country and in provinces, municipalities, and autonomous regions generally decreased as their SDI increased. Conclusions: The disease burden of epilepsy is still heavy in China, especially in the western provinces. The incidence and prevalence of epilepsy increased between 1990 and 2019, and the burden of epilepsy in the elderly increases gradually. This study provides evidence on epilepsy prevention and care of different regions in China.
基金supported by a grant from the National Natural Science Foundation of China(No.82073573).
文摘Background:Understanding the changing profiles of cardiovascular disease(CVD)and modifiable risk factors is essential for CVD prevention and control.We aimed to report the comprehensive trends in CVD and risk factors in China from 1990 to 2019.Methods:Data on the incidence,death,and disability-adjusted life years(DALYs)of total CVD and its 11 subtypes for China were obtained from the Global Burden of Disease Study 2019.The CVD burden attributable to 12 risk factors was also retrieved.A secondary analysis was conducted to summarize the leading causes of CVD burden and attributable risk factors.Results:From 1990 to 2019,the number of CVD incidence,death,and DALYs considerably increased by 132.8%,89.1%,and 52.6%,respectively.Stroke,ischemic heart disease,and hypertensive heart disease accounted for over 95.0%of CVD deaths in 2019 and remained the top three causes during the past 30 years.Between 1990 and 2019,the age-standardized rate of stroke decreased significantly(percentage of decreased incidence:-9.3%;death:-39.8%;DALYs:-41.6%),while the rate of ischemic heart disease increased(percentage of increased incidence:11.5%;death:17.6%;DALYs:2.2%).High systolic blood pressure,unhealthy diet,tobacco,and air pollution continued to be the major contributors to CVD deaths and DALYs(attributing to over 70%of the CVD burden),and the high body mass index(BMI)-associated CVD burden had the largest increase between 1990 and 2019.Conclusions:The significant increases in the number of CVD incident cases,deaths,and DALYs suggest that the CVD burden is still a concern.Intensified strategies and policies are needed to maintain promising progress in stroke and to reduce the escalating burden of ischemic heart disease.The CVD burden attributable to risk factors has not yet made adequate achievements;even worse,high BMI has contributed to the increasing CVD burden.
基金Supported by the Key Research and Development Program of Shaanxi,No.2021ZDLSF02-06.
文摘BACKGROUND Inflammatory bowel disease(IBD)is an idiopathic intestinal disease with various levels and trends in different countries and regions.Understanding the current burden and trends of IBD in various geographical locations is essential to establish effective strategies for prevention and treatment.We report the average annual percentage change(AAPC)and estimated annual percentage change(EAPC)in age-standardized rates(ASR)of IBD in different regions based on the Global Burden of Disease(GBD)study from 1990-2019,and the relationships between IBD and the human development index(HDI)and socio-demographic index(SDI).The prevalence trends of IBD were predicted by gender from 2019-2039.AIM To comprehensively investigate IBD data,providing further insights into the management of this chronic disease.METHODS We collected the information on the incidence of IBD from the GBD study from 1990-2019 to calculate the AAPC and EAPC in ASR of IBD in different regions.The relationships between IBD,HDI,and SDI were analyzed.The Nordpred and Bayesian age-period-cohort models were used to predict the prevalence trends of IBD by gender from 2019-2039,and the reliability of the results was validated.RESULTS North America consistently had the highest IBD ASR,while Oceania consistently had the lowest.East Asia had the fastest average annual growth in ASR(2.54%),whereas Central Europe had the fastest decline(1.38%).Countries with a low age-standardized incidence rates in 1990 showed faster growth in IBD while there was no significant correlation in 2019.Additionally,IBD increased faster in countries with a low age-standardized death rates in 1990,whereas the opposite was true in 2019.Analysis of SDI and IBD ASR showed that countries with a high SDI generally had a higher IBD ASR.Finally,the projections showed a declining trend in the incidence of IBD from 2019-2039,but a gradual increase in the number of cases.CONCLUSION As the global population increases and ages,early monitoring and prevention of IBD is important to reduce the disease burden,especially in countries with a high incidence of IBD.
基金National Key research and Development Program,No.2022YFE0131600National Natural Science Foundation of China,No.82160500+3 种基金Special Project of Central Government Guiding Local Science and Technology Development,No.ZY20198011Guangxi Science and Technology Base and Talent Project,No.GuikeAA21220002Natural Science Foundation of Guangxi,No.2022GXNSFAA035642The Liuzhou Science and Technology Plan Project,No.2021CB0101.
文摘BACKGROUND Nonalcoholic fatty liver disease(NAFLD)has become the leading cause of cirrhosis and other chronic liver diseases(COCLDs).AIM To conduct a comprehensive and comparable updated analysis of the global,regional,and national burden of COCLDs due to NAFLD in 204 countries and territories from 1990 and 2019 by age,sex,and sociodemographic index.METHODS Data on COCLDs due to NAFLD were collected from the Global Burden of Diseases,Injuries,and Risk Factors Study 2019.Numbers and age-standardized prevalence,death,and disability-adjusted life years(DALYs)were estimated through a systematic analysis of modelled data from the Global Burden of Diseases,Injuries,and Risk Factors Study 2019.The estimated annual percentage change was used to determine the burden trend.RESULTS In 2019,the global age-standardized prevalence rate of COCLDs due to NAFLD was 15022.90 per 100000 population[95%uncertainty interval(UI):13493.19-16764.24],which increased by 24.51%(22.63%to 26.08%)from 1990,with an estimated annual percentage change of 0.78(95%confidence interval:0.74-0.82).In the same year,however,the age-standardized death rate and age-standardized DALYs per 100000 population were 1.66(95%UI:1.20-2.17)and 43.69(95%UI:31.28-58.38),respectively.North Africa and the Middle East had the highest prevalence rates of COCLDs due to NAFLD.The death rate increased with age up to the 95+age group for both sexes.Males had higher numbers of prevalence,death rate,and DALYs than females across all age groups before the 65-69 age group.The sociodemographic index was negatively correlated with the age-standardized DALYs.CONCLUSION Globally,the age-standardized prevalence rate has increased during the past three decades.However,the agestandardized death rate and age-standardized DALYs decreased.There is geographical variation in the burden of COCLDs due to NAFLD.It is strongly recommended to improve the data quality of COCLDs due to NAFLD across all countries and regions to facilitate better monitoring of the burden of COCLDs due to NAFLD.
基金This work was supported by grants from the National Key Research and Development Program of China(Nos.2021ZD0114104,2021ZD0114105,and 2021ZD0114101).
文摘Background::Hepatitis B is a viral infection that attacks the liver and can cause both potentially life-threatening acute and chronic liver disease.China has the world’s largest burden of hepatitis B and is considered to be a major contributor toward the goal of World Health Organization(WHO)of eliminating hepatitis B virus(HBV)as a global health threat by 2030.This study aimed to analyze data from the Global Burden of Diseases,Injuries,and Risk Factors Study(GBD)to determine the trends in mortality of liver disease due to hepatitis B in China between 1990 and 2019 and the gap with the WHO’s goal.Methods::Annual deaths and age-standardized mortality rates(ASMRs)of liver disease due to hepatitis B in China between 1990 and 2019 were collected from GBD 2019.We calculated the percentage changes in deaths and estimated annual percentage changes(EAPCs)of ASMRs of liver disease due to hepatitis B.Results::In China,deaths of total liver disease due to hepatitis B decreased by 29.13%from 229 thousand in 2016 to 162 thousand in 2019,and ASMR decreased by an average of 4.92%(95%confidence interval[CI]:4.45–5.39%)per year in this period.For the spectrum of liver disease due to hepatitis B,deaths decreased by 74.83%,34.71%,and 23.34%for acute hepatitis,cirrhosis and other chronic liver diseases,and liver cancer from 1990 to 2019,respectively,and ASMRs of acute hepatitis(EAPC=–7.63;95%CI:–8.25,–7.00),cirrhosis and other chronic liver diseases(EAPC=–4.15;95%CI:–4.66,–3.65),and liver cancer(EAPC=–5.17;95%CI:–6.00,–4.33)decreased between 1990 and 2019.The proportions of older adults aged≥70 years among all deaths of the spectrum of liver disease due to hepatitis B increased from 1990 to 2019.Deaths of liver cancer due to hepatitis B increased by 7.05%from 2015 to 2019.Conclusions::Although a favorable trend in the mortality of liver disease due to hepatitis B was observed between 1990 and 2019,China still faces challenges in achieving the WHO’s goal of eliminating HBV as a public threat by 2030.Therefore,efforts to increase the coverage of diagnosis and treatment of liver disease due to hepatitis B,especially of liver cancer due to hepatitis B,are warranted in China.
基金This study was supported by The Interdisciplinary Program of Shanghai Jiao Tong University(ZH2018QNA08)(Zhang Zhiyuan)Academician Workstation Scientific Research Fund(2019)+2 种基金The SHIPM-mu fund No.JC201902 from the Shanghai Institute of Precision Medicine,Ninth People’s Hospital Shanghai Jiao Tong University School of MedicineThe Shanghai Anticancer Association Eyas Project(SACA-CY1B06)the National Social Science Foundation of China(No.16BGL183).
文摘Background:Data on the incidence,mortality,and other burden of oral cancer as well as their secular trends are necessary to provide policy-makers with the information needed to allocate resources appropriately.The purpose of this study was to use the Global Burden of Disease(GBD)2017 results to estimate the incidence,mortality,and disability-adjusted life years(DALYs)for oral cancer from 1990 to 2017.Methods:We collected detailed data on oral cancer from 1990 to 2017 from the GBD 2017.The global incidence,mortality,and DALYs attributable to oral cancer as well as the corresponding age-standardized rates(ASRs)were calculated.The estimated annual percentage changes in the ASRs of incidence(ASRI)and mortality(ASRM)and age-standardized DALYs of oral cancer were also calculated according to regions and countries to quantify the secular trends in these rates.Results:We tracked the incidence,mortality,and DALYs of oral cancer in 195 countries/territories over 28 years.Globally,the incidence,mortality,and DALYs of oral cancer increased by about 1.0-fold from 1990 to 2017.The ASRI of oral cancer showed a similar trend,increasing from 4.41 to 4.84 per 100,000 person-years during the study period.The ASRM remained approximately stable at about 2.4 per 100,000 from 1990 to 2017,as did the age-standardized DALYs,at about 64.0 per 100,000 person-years.ASRI was highest in Pakistan(27.03/100,000,95%CI=22.13-32.75/100,000),followed by Taiwan China,and lowest in Iraq(0.96/100,000,95%CI=0.86-1.06/100,000).ASRM was highest in Pakistan(16.85/100,000,95%CI=13.92-20.17/100,000)and lowest in Kuwait(0.51/100,000,95%CI=0.45-0.58/100,000).Conclusions:The ASRI of oral cancer has increased slightly worldwide,while the ASRM and age-standardized DALY have remained stable.However,these characteristics vary between countries,suggesting that current prevention strategies should be reoriented,and much more targeted and specific strategies should be established in some countries to forestall the increase in oral cancer.
文摘Background:The patterns of leukemia burden have dramatically changed in recent years.This study aimed to estimate the global trends of leukemiarelated death and disability-adjusted life-years(DALYs)from 1990 to 2017.Methods:The data was acquired from the latest version of the Global Burden of Disease(GBD)study.Estimated annual percentage changes(EAPCs)were calculated to estimate the trend of age-standardized rate(ASR)of death and DALYs due to leukemia and its main subtypes from 1990 to 2017.Results:Globally,the numbers of death and DALYs due to leukemia were 347.58×10^(3)(95%uncertainty interval[UI]=317.26×10^(3)-364.88×10^(3))and 11975.35×10^(3)(95%UI=10749.15×10^(3)-12793.58×10^(3))in 2017,with a 31.22% and 0.03% increase in absolute numbers from 1990 to 2017,respectively.Both of their ASR showed decreasing trends from 1990 to 2017 with the EAPCs being−1.04(95%confidence interval[CI]=(−1.10-−0.99)and−1.52(95%CI=−1.59-−1.44),respectively.Globally,the most pronounced decreasing trend of death and DALYs occurred in chronic myeloid leukemia with EAPCs of−2.76(95%CI=−2.88-−2.64)and−2.84(95%CI=−2.97-−2.70),respectively,while the trend increased in acute myeloid leukemia.The death and DALYs of leukemia decreased in most areas and countries with high socio-demographic index(SDI)including Bahrain,Finland,and Australia.Conclusions:The disease burden of death and DALYs due to leukemia decreased globally,and for most regions and countries from 1990 to 2017.However,the leukemia burden is still a substantial challenge globally and required adequate and affordable medical resources to improve the survival and quality of life of leukemia patients.
基金MBQ was financially supported by the Fourth Round of Three-Year Public Health Action Plan(2015-2017)in Shanghai(grant No.GWTD2015S06).The funder had no role in study design,data collection and analysis,decision to publish,or preparation of the manuscript.
文摘Recently,the mortality of 240 causes in China including a subnational analysis during 1990-2013 was published in The Lancet.This comprehensive analysis will undoubtedly impact policymaking regarding public health in China.However,it is unfavourable in some degree to neglected tropical diseases,which is the subject of this Letter to the Editor.Policymakers,especially those in less developed provinces of China,should fully consider the burden of neglected tropical diseases,which will benefit the control and final elimination of these diseases in the country.
文摘Background:Antituberculosis-drug resistance is an important public health issue,and its epidemiological patterns has dramatically changed in recent decades.This study aimed to estimate the trends of multidrug-resistant tuberculosis(MDR-TB),which can be used to inform health strategies.Methods:Data were collected from the Global Burden of Disease study 2017.The estimated annual percentage changes(EAPCs)were calculated to assess the trends of MDR-TB burden at global,regional,and national level from 1990 to 2017 using the linear regression model.
基金The study was sponsored by research grants from the National Natural Science Foundation of China(Nos.81773454 and 82073573)Discipline Construction Funding of Public Health and Preventive Medicine from PekingUniversity Health Science Center(No.BMU2020XY010).
文摘Background::China and the United States(US)ranked first and third in terms of new liver cancer cases and deaths globally in 2020.Therefore,a comprehensive assessment of trends in the incidence of primary liver cancer with four major etiological factors between China and the US during the past 30 years with age-period-cohort(APC)analyses is warranted.Methods::Data were obtained from the Global Burden of Disease 2019,and period/cohort relative risks were estimated by APC modeling from 1990 to 2019.Results::In 2019,there were 211,000 new liver cancer cases in China and 28,000 in the US,accounting for 39.4%and 5.2%of global liver cancer cases,respectively.For China,the age-standardized incidence rate(ASIR)consecutively decreased before 2005 but increased slightly since then,whereas the ASIR continuously increased in the US.Among the four etiological factors of liver cancer,the fastest reduction in incidence was observed in hepatitis B virus-related liver cancer among Chinese women,and the fastest increase was in nonalcoholic steatosis hepatitis(NASH)-related liver cancer among American men.The greatest reduction in the incidence of liver cancer was observed at the age of 53 years in Chinese men(-5.2%/year)and 33 years in Chinese women(-6.6%/year),while it peaked at 58 years old in both American men and women(4.5%/year vs.2.8%/year).Furthermore,the period risks of alcohol-and NASH-related liver cancer among Chinese men have been elevated since 2013.Simultaneously,leveled-off period risks were observed in hepatitis C viral-related liver cancer in both American men and women.Conclusions::Currently,both viral and lifestyle factors have been and will continue to play an important role in the time trends of liver cancer in both countries.More tailored and efficient preventive strategies should be designed to target both viral and lifestyle factors to prevent and control liver cancer.
基金This study was supported by grants from the National Statistical ScientificResearch Program(No.2021LY052)the China Medical Board(21-434 to YS)the National Natural Science Foundation of China(No.82073573).
文摘Background::Non-transport unintentional injuries(NTUIs)are major public concerns,especially among children and adolescents in low-and middle-income countries.With environmental and cognitive changes,a recent systematic description of global trends and regional differences concerning NTUIs is urgently needed for the global agenda of relevant policy-making and intervention target findings.Methods::We used mortality,population,and socio-demographic-index(SDI)data from Global Burden of Disease 2019 to analyze the trends of NTUIs mortality.We applied the slope index of inequality(SII)and relative index of inequality(RII)to measure the absolute and relative inequality between countries and territories.The concentration curve and concentration index(CI)were also used to measure the inequality.We conducted a sensitivity analysis to make our findings credible.Results::In 2019,there were 205,000 deaths due to NTUIs among children and adolescents aged 5 to 24 years,which decreased from 375,000 in 1990.In 2019,the age-standardized mortality rate(ASMR)was 8.13 per 100,000,ranging from the lowest in the Netherlands(0.90 per 100,000)to the highest in the Solomon Islands(29.34 per 100,000).The low-middle SDI group had the highest ASMR of NTUIs,while the low SDI group had the slowest decrease.After excluding the death caused by"exposure to forces of nature"and"other unintentional injuries",drowning accounted for the most deaths in almost every SDI group,gender,and age group,but the major causes of death varied in different subgroups.For example,animal contact was a major cause in low and low-middle SDI groups but less in high SDI groups,while high and high-middle SDI groups had a higher proportion of deaths for foreign body and poisonings.The SII showed a declining trend,but the RII and CI did not,which might indicate that inequality was persistent.Similar results were found in the sensitivity analysis.Conclusions::Despite the declining trend of the mortality rate and the narrowing gap between countries,there were still a large number of children and adolescents dying from NTUIs,and those experiencing social-economic disadvantages remained at high mortality.Embedding the prevention of NTUIs into sustainable development goals might contribute to the progress of reducing death and inequalities,which ensures that no one is left behind.
文摘Background:The burden of kidney,bladder,and prostate cancers has changed in recent decades.This study aims to investigate the global and regional burden of,and attributable risk factors for genitourinary cancers during the past 30 years.Methods:We extracted data of kidney,bladder,and prostate cancers from the Global Burden of Disease 2019 database,including incidence,mortality,disability-adjusted life-years(DALYs),and attributable risk factors from 1990 to 2019.Estimated annual percentage changes(EAPC)were calculated to assess the changes in age-standardized incidence rate,age-standardized mortality rate(ASMR),and age-standardized DALYs rate(ASDR).The associations between cancers burden and socio-demographic index(SDI)were also analyzed.Results:Compared with 1990,the global incident cases in 2019 were higher by 154.78%,123.34%,and 169.11%for kidney,bladder,and prostate cancers,respectively.During the 30-year study period,there was a downward trend in ASMR and ASDR for bladder cancer(EAPC=–0.68 and–0.83,respectively)and prostate cancer(EAPC=–0.75 and–0.71,respectively),but an upward trend for kidney cancer(EAPC=0.35 and 0.12,respectively).Regions and countries with higher SDI had higher incidence,mortality,and DALYs for all three types of cancers.The burden of bladder and prostate cancers was mainly distributed among older men,whereas the burden of kidney cancer increased among middle-aged men.Smoking related mortality and DALYs decreased,but high body mass index(BMI)and high fasting plasma glucose(FPG)related mortality and DALYs increased among kidney,bladder,and prostate cancers during the study period.Conclusions:Kidney,bladder,and prostate cancers remain major global public health challenges,but with distinct trend for different disease entity across different regions and socioeconomic status.More proactive intervention strategies,at both the administrative and academic levels,based on the dynamic changes,are needed.
基金The present study did not require institutional review board oversight because Global Burden of Disease Study 2019 database is de-identified and freely accessible.It does not identify hospitals,health care providers,or patients.
文摘BACKGROUND Hepatitis C is the leading cause of chronic liver disease worldwide and it significantly contributes to the burden of hepatocellular carcinoma(HCC).However,there are marked variations in the incidence and mortality rates of HCC across different geographical regions.With the advent of new widely available treatment modalities,such as direct-acting antivirals,it is becoming increasingly imperative to understand the temporal and geographical trends in HCC mortality associated with Hepatitis C.Furthermore,gender disparities in HCC mortality related to Hepatitis C are a crucial,yet underexplored aspect that adds to the disease's global impact.While some studies shed light on gender-specific trends,there is a lack of comprehensive data on global and regional mortality rates,particularly those highlighting gender disparities.This gap in knowledge hinders the development of targeted interventions and resource allocation strategies.DISCUSSION The results of our study show an overall decline in the mortality rates of patients with hepatitis C-related HCC over the last two decades.Notably,females exhibited a remarkable decrease in mortality compared to males.Regionally,East Asia and the Pacific displayed a significant decline in mortality,while Europe and Central Asia witnessed an upward trend.Latin America and the Caribbean also experienced an increase in mortality rates.However,no significant difference was observed in the Middle East and North Africa.North America exhibited a notable upward trend.South Asia and Sub-Saharan Africa significantly declined throughout the study period.This raises the hope of identifying areas for implementing more targeted resources.Despite some progress,multiple challenges remain in meeting the WHO 2030 goal of eliminating viral hepatitis[24].
基金supported by the Natural Science Foundation of Guangdong Province(2022A1515012347)the Beijing CSCO research fund(Y-2019Roche-157)+2 种基金the Science and Technology Project of Guangdong(2014A020212331)the National Natural Science Foundation of China(82001672)the National High Level Hospital Clinical Research Funding(2022-PUMCH-B-011).
文摘Objective Adopting a healthy lifestyle,including regular physical activity,is widely believed to decrease cancer risk.This study aimed to quantitatively establish the dose-response relationships between total physical activity and the risk of breast,colon,lung,gastric,and liver cancers.Methods A systematic review and dose-response analysis were conducted using PubMed and Embase from January 1,1980 to March 20,2023.Prospective cohort studies that examined the association between physical activity and the risks of any of the 5 outcomes were included.The search was confined to publications in the English language with a specific focus on human studies.Physical activity is standardized by using the data from US National Health and Nutrition Examination Surveys(NHANES)and the Global Burden of Disease 2019 database.Results A total of 98 studies,involving a combined population of 16,418,361 individuals,were included in the analysis.Among the included studies,57 focused on breast cancer,17 on lung cancer,23 on colon cancer,5 on gastric cancer,and 7 on liver cancer.Overall,elevated levels of physical activity exhibited an inverse correlation with the risk of cancer.The dose-response curve for lung cancer exhibited a non-linear pattern,with the greatest benefit risk reduction observed at 13,200 MET-minutes/week of physical activity,resulting in a 14.7%reduction in risk(relative risk 0.853,uncertainty interval 0.798 to 0.912)compared to the inactive population.In contrast,the dose-response curves for colon,gastric,breast,and liver cancers showed linear associations,indicating that heightened levels of total physical activity were consistently associated with reduced cancer risks.However,the increase in physical activity yielded a smaller risk reduction for colon and gastric cancers compared to breast and liver cancers.Compared to individuals with insufficient activity(total activity level<600 MET-minutes/week),individuals with high levels of activity(≥8,000 MET-minutes/week)experienced a 10.3%(0.897,0.860 to 0.934)risk reduction for breast cancer;5.9%(0.941,0.884 to 1.001)for lung cancer;7.1%(0.929,0.909 to 0.949)for colon cancer;5.1%(0.949,0.908 to 0.992)for gastric cancer;17.1%(0.829,0.760 to 0.903)for liver cancer.Conclusions This study demonstrated a significant inverse relationship between total physical activity and the risk of breast,gastric,liver,colon,and lung cancers.
基金supported by a grant from the National Natural Science Foundation of China No. 81673133 and No.81273034。
文摘Objective To assess the association of socioeconomic status with the burden of cataract blindness in terms of year lived with disability(YLD) rates and to determine whether ultraviolet radiation(UVR) levels modify the effect of socioeconomic status on this health burden.Methods National and subnational age-standardized YLD rates associated with cataract-related blindness were derived from the Global Burden of Disease(GBD) study 2017. The human development index(HDI) from the Human Development Report was used as a measure of socioeconomic status.Estimated ground-level UVR exposure was obtained from the Ozone Monitoring Instrument(OMI)dataset of the National Aeronautics and Space Administration(NASA).Results Across 185 countries, socioeconomic status was inversely associated with the burden of cataract blindness. Countries with a very high HDI had an 84% lower age-standardized YLD rate [95%confidence interval(CI): 60%–93%, P < 0.001] than countries with a low HDI;for high-HDI countries, the proportion was 76%(95% CI: 53%–88%, P < 0.001), and for medium-HDI countries, the proportion was48%(95% CI: 15%–68%, P = 0.010;P for trend < 0.001). The interaction analysis showed that UVR exposure played an interactive role in the association between socioeconomic status and cataract blindness burden(P value for interaction = 0.047).Conclusion Long-term high-UVR exposure amplifies the association of poor socioeconomic status with the burden of cataract-related blindness. The findings emphasize the need for strengthening UVR exposure protection interventions in developing countries with high-UVR exposure.
基金supported by a grant from the Summit Talent Plan of Beijing Hospitals Authority(No.DFL20181103).
文摘Background: Despite the decline in the incidence and mortality rates of gastric cancer (GC), the impact of demographic transition on the global burden of GC remains unclear. The current study aimed to estimate the global disease burden through 2040 by age, sex, and region. Methods: GC data for incident cases and deaths by age group and sex were taken from The Global Cancer Observatory (GLOBOCAN) 2020. The incidence and mortality rates were predicted through 2040 by fitting a linear regression model over the most recent trend period with the Cancer Incidence in Five Continents (CI5) data. Results: The global population will grow to 9.19 billion by 2040, accompanied by increasing population ageing. The incidence and mortality rates of GC will show a persistent decrease, with an annual percent change of -0.57% for males and -0.65% for females. East Asia and North America will have the highest and lowest age standardized rates, respectively. A slowdown in the growth of incident cases and deaths will be observed worldwide. The proportion of young and middle-aged individuals will decline, while the percentage of the elderly will increase, and the number of males will be almost twice the number of females. East Asia and high human development index (HDI) regions will be heavily burdened by GC. East Asia had 59.85% of the new cases and 56.23% of deaths in 2020;these will increase to 66.93% and 64.37% by 2040, respectively. The interaction between population growth, the change in ageing structure and the decline in incidence and mortality rates will lead to an increased burden of GC. Conclusions: Ageing and population growth will offset the decline in the incidence and mortality rate of GC, resulting in a substantial increase in the number of new cases and deaths. The age structure will continue to change, especially in high HDI regions, requiring more targeted prevention strategies in the future.
文摘Background:Gallbladder and biliary tract cancer(GBTC)has greatly damaged the health of patients and is accompanied by a dismal prognosis.The worldwide distribution of GBTC shows extensive variance and the updated data in China is lacking.This study was to determine the current status,trends,and predictions in the burden of GBTC over the past 30 years in China.Methods:This was a descriptive,epidemiological,secondary analysis of the Global Burden of Disease,Injuries,and Risk Factor Study 2019 data.Data including incidence,prevalence,mortality,and disability-adjusted life years(DALYs)of GBTC in China by year,age,and sex were assessed.Joinpoint regression analysis was conducted to evaluate trends of disease burden due to GBTC from 1990 to 2019.Nordpred age-period-cohort analysis was applied for the projection of mortality and incidence due to GBTC from 2019 to 2044.Results:Nationally,there were 38,634(95%uncertainty interval[UI]:27,350-46,512)new cases and 47,278(95%UI:32,889-57,229)patients due to GBTC,causing 34,462(95%UI:25,220-41,231)deaths,and 763,584(95%UI:566,755-920,493)DALYs in 2019.Both cases and rates of burden owing to GBTC were heavier among males and at old age.From 1990 to 2019,the age-standardized rates of incidence,prevalence,mortality,and DALYs of GBTC generally increased from 1990 to 2019,with average annual percentage change at 0.8%(95%confidential interval[CI]:0.6-1.0%),1.3%(95%CI:1.1-1.5%),0.4%(95%CI:0.2-0.6%),and 0.2%(95%CI:0.1-0.4%),respectively.Even though the age-standardized incidence rate and agestandardized mortality rate in both sexes were predicted to decline gradually from 2019 to 2044,the number of new cases and deaths were expected to grow steadily.Conclusions:GBTC is becoming a major health burden in China,particularly among males and older individuals.Given the aging population and increasing burden,effective strategies and measurements are urged to prevent or reduce the number of new cases and deaths of GBTC.
基金This study was supported by a grant from the UK Department of International Development and GlaxoSmithKline.We are grateful to Dr Tarun Dua,WHO,Department of Mental Health and Substance Abuse Geneva,and Dr Lorenzo Savioli,Department of Neglected Tropical Diseases,WHO,Geneva and Dr Mark Bradley,GlaxoSmithKline,London for their encouragement and advice.
文摘Background:Neglected Tropical Diseases(NTDs)afflict around one billion individuals in the poorest parts of the world with many more at risk.Lymphatic filariasis is one of the most prevalent of the infections and causes significant morbidity in those who suffer the clinical conditions,particularly lymphedema and hydrocele.Depressive illness has been recognised as a prevalent disability in those with the disease because of the stigmatising nature of the condition.No estimates of the burden of depressive illness of any neglected tropical disease have been undertaken to date despite the recognition that such diseases have major consequences for mental health not only for patients but also their caregivers.Methods:We developed a mathematical model to calculate the burden of Disability-Adjusted Life Years(DALY)attributable to depressive illness in lymphatic filariasis and that of their caregivers using standard methods for calculating DALYs.Estimates of numbers with clinical disease was based on published estimates in 2012 and the numbers with depressive illness from the available literature.Results:We calculated that the burden of depressive illness in filariasis patients was 5.09 million disability-adjusted life years(DALYs)and 229,537 DALYs attributable to their caregivers.These figures are around twice that of 2.78 million DALYs attributed to filariasis by the Global Burden of Disease study of 2010.Conclusions:Lymphatic filariasis and other neglected tropical diseases,notably Buruli Ulcer,cutaneous leishmaniasis,leprosy,yaws,onchocerciasis and trachoma cause significant co morbidity associated with mental illness in patients.Studies to assess the prevalence of the burden of this co-morbidity should be incorporated into any future assessment of the Global Burden of neglected tropical diseases.The prevalence of depressive illness in caregivers who support those who suffer from these conditions is required.Such assessments are critical for neglected tropical diseases which have such a huge global prevalence and thus will contribute a significant burden of co-morbidity attributable to mental illness.
基金the Natural Science Foundation of Beijing Municipality(No.7202169)the Beijing Nova Program of Science and Technology(No.Z191100001119065)the CAMS Innovation Fund for Medical Sciences(No.2017-I2M-1-006).
文摘Background:Globally,colorectal cancer(CRC)imposes a substantial burden on healthcare systems and confers considerable medical expenditures.We aimed to evaluate the global and regional burden in epidemiological trends and factors associated with the incidence and mortality of CRC.Methods:We used data from the GLOBOCAN database to estimate CRC incidence and mortality worldwide in 2020 and their association with the human development index(HDI).Trends of age-standardized rates of incidence and mortality in 60 countries(2000–2019)were evaluated by Joinpoint regression analysis using data of Global Burden of Disease 2019.The association between exposure to country-level lifestyle,metabolic and socioeconomic factors obtained from the World Health Organization Global Health Observatory and World Bank DataBank data and CRC incidence and mortality was determined by multivariable linear regression.Results:CRC incidence and mortality varied greatly in the 60 selected countries,and much higher incidence and mortality were observed in countries with higher HDIs,and vice versa.From 2000 to 2019,significant increases of incidence and mortality were observed for 33 countries(average annual percent changes[AAPCs],0.24–3.82)and 18 countries(AAPCs,0.41–2.22),respectively.A stronger increase in incidence was observed among males(AAPCs,0.36–4.54)and individuals<50 years(AAPCs,0.56–3.86).Notably,15 countries showed significant decreases in both incidence(AAPCs,0.24 to2.19)and mortality(AAPCs,0.84 to2.74).A significant increase of incidence among individuals<50 years was observed in 30 countries(AAPCs,0.28–3.62).Countries with higher incidence were more likely to have a higher prevalence of alcohol drinking,higher level of cholesterol level,higher level of unemployment,and a poorer healthcare system.Conclusions:Some high-HDI countries showed decreasing trends in CRC incidence and mortality,whereas developing countries that previously had low disease burden showed significantly increased incidence and mortality trends,especially in males and populations≥50 years,which require targeted preventive health programs.
