Global Burden of Cardiovascular Disease Attributable to High Temperature in 204 Countries and Territories from 1990 to 2019

Objective This study aimed to estimate spatiotemporal variations of global heat-related cardiovascular disease(CVD)burden from 1990 to 2019.Methods Data on the burden of heat-related CVD were derived from the Global Burden of Disease Study 2019.Deaths and disability-adjusted life years(DALYs)were used to quantify heat-induced CVD burden.We calculated the age-standardized mortality rate(ASMR)and DALY rate(ASDR)per 100,000population to compare this burden across regions.Generalized linear models were applied to evaluate estimated annual percentage changes(EAPC)for temporal trends from 1990 to 2019.The correlation between the socio-demographic index(SDI)and age-standardized rate was measured using the Spearman rank test.Results Heat-induced CVD caused approximately 90 thousand deaths worldwide in 2019.Global ASMR and ASDR of heat-related CVD in 2019 were 1.17[95%confidence interval(CI):0.13-1.98]and 25.59(95%CI:2.07-44.17)per 100,000 population,respectively.The burden was significantly increased in middle and low-SDI regions and slightly decreased in high-SDI regions from 1990 to 2019.ASMR showed an upward trend,with the most considerable increase in low-latitude countries.We observed a negative correlation between SDI and EAPC in ASMR(rs=-0.57,P<0.01)and ASDR(rs=-0.59,P<0.01)among204 countries.Conclusion Heat-attributable CVD burden substantially increased in most developing countries and tropical regions.

Global burden of inflammatory bowel disease 1990-2019:A systematic examination of the disease burden and twenty-year forecast

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.

Global burden of cirrhosis and other chronic liver diseases due to nonalcoholic fatty liver disease,1990-2019

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.

Global, regional, and national burden of gallbladder and biliary diseases from 1990 to 2019

BACKGROUND Gallbladder and biliary diseases(GABDs)are a major public health issue.AIM To analysis the cause-specific incidence,prevalence,and years lived with disability(YLDs)and its temporal trends of GABDs at the global,regional,and national level.Data on GABD were available from the Global Burden of Disease study 2019.METHODS The estimated annual percentage change(EAPC)was used to quantify temporal trend in GABD age-standardized incidence rates(ASIRs),age-standardized prevalence rate(ASPR),and age-standardized YLD rate(ASYR)by region,sex.We analyzed the relationship between the GABD burden and country development level using the human development index(HDI).RESULTS In 2019,the incident cases of GABD were 52003772,with an ASIR of 63432/100000 population.Globally,the number of incident cases and ASIR of GABD increased 97%and 58.9%between 1990 and 2019.Although,the ASPR and ASYR decreased from 1990 to 2019,the number of prevalent and YLDs cases increased.The highest ASIR was observed in Italy,and the highest ASPR and ASYR was observed in United Kingdom.The highest burden of GABD was found in low-SDI region,and the burden in female was significantly higher than males.A generally negative correlation(ρ=-0.24,P<0.05)of GABD with the EAPC and human development index(HDI)(in 2021)were observed for ASIR.What’s more,no correlation in ASPR(ρ=-0.06,P=0.39)and ASYR(ρ=-0.07,P=0.36)of GABD with the EAPC and HDI(in 2021)were observed,respectively.CONCLUSION GABD remain a major global public health challenge;however,the burden of GABD varies geographically.Globally,the number of incident cases and ASIR of GABD increased between 1990 and 2019.The results of our study provide insight into the global disease burden of GABD and may assist policymakers in formulating effective policies to mitigate modifiable risk factors.

Global Burden of Disease, Injury and Risk Factor Study 2010: Its Policy Implications for China

Results of the Global Burden of Disease, Injury and Risk Factor Study 2010 （GBD 2010） were released on December 13, 2012 in London, a series of papers concerning the project have been published in the Lancet[1]. Research findings of the project have been reported in the United States, the United Kingdom, Indonesia, China[2] and Australia, and widely applied across the world. In addition, the GBD 2010 will see more countries report their project research findings and implement these findings in the near future. The GBD 2010 provides researchers, administrators and policymakers with new and critical sources for their research, teaching and policymaking.

Global trends in hepatitis C-related hepatocellular carcinoma mortality:A public database analysis(1999-2019)

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].

Global and regional trends in the incidence and mortality burden of endometrial cancer,1990–2019:Updated results from the Global Burden of Disease Study,2019

Background:The disease burdens for endometrial cancer(EC)vary across different countries and geographical regions and change every year.Herein,we reported the updated results of the Global Burden of Disease Study 2019 on EC with respect to age-standardized incidence and mortality from 1990 to 2019.Methods:The annual percentage change(APC)of incidence and mortality was evaluated using joinpoint regression analysis to examine the temporal trends during the same timeframe in terms of the global landscape,different sociodemographic indices(SDI),and geographic regions.The relationship between Human Development Index(HDI)and incidence and mortality was additionally explored.Results:The age-standardized incidence rates(ASIRs)revealed a significant average global elevation by 0.5%per year(95%confidence interval[CI],0.3–0.7;P<0.001).The age-standardized mortality rates(ASMRs),in contrast,fell by an average of 0.8%per year(95%CI,−1.0 to−0.7;P<0.001)worldwide.The ASIRs and ASMRs for EC varied across different SDIs and geographical regions.We noted four temporal trends and a significant reduction by 0.5%per year since 2010 in the ASIR,whereas we detected six consecutively decreasing temporal trends in ASMR during the entire period.Notably,the estimated APCs were significantly positively correlated with HDIs(ρ=0.22;95%CI,0.07–0.35;P=0.003)with regard to incident cases in 2019.Conclusions:Incidence rates for EC reflected a significant increase overall(although we observed a decline since 2010),and the death rates declined consecutively from 1990 to 2019.We posit that more precise strategies can be tailored and then implemented based on the distinct age-standardized incidence and mortality burden in different geographical areas.

Incidence,prevalence,and causes of spinal injuries in China,1990-2019:Findings from the Global Burden of Disease Study 2019

Background:Spinal injuries are an urgent public health priority;nevertheless,no China-wide studies of these injuries exist.This study measured the incidence,prevalence,causes,regional distribution,and annual trends of spinal injuries in China from 1990 to 2019.Methods:We used data from the Global Burden of Diseases,Injuries,and Risk Factors Study 2019 to estimate the incidence and prevalence of spinal injuries in China.The data of 33 provincial-level administrative regions(excluding Taiwan,China)provided by the National Center for Chronic and Noncommunicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention(CDC)were use to systematically analyze the provincial etiology,geographical distribution,and annual trends of spinal injuries.The Bayesian meta-regression tool DisMod-MR 2.1 was used to ensure the consistency among incidence,prevalence,and mortality rates in each case.Results:From 1990 to 2019,the number of living patients with spinal injuries in China increased by 138.32%,from 2.14 million to 5.10 million,while the corresponding age-standardized prevalence increased from 0.20%(95%uncertainty interval[UI]:0.18-0.21%)to 0.27%(95%UI:0.26-0.29%).The incidence of spinal injuries in China increased by 89.91%(95%UI:72.39-107.66%),and the prevalence increased by 98.20%(95%UI:89.56-106.82%),both the most significant increases among the G20 countries;71.00%of the increase could be explained by age-specific prevalence.In 2019,the incidence was 16.47(95%UI:12.08-22.00,per 100,000 population),and the prevalence was 358.30(95%UI:333.96-386.62,per 100,000 population).Based on the data of 33 provincial-level administrative regions provided by CDC,age-standardized incidence and prevalence were both highest in developed provinces in Eastern China.The primary causes were falls and road injuries;however,the prevalence and specific causes differed across provinces.Conclusions:In China,the overall disease burden of spinal injuries increased significantly during the past three decades but varied considerably according to geographical location.The primary causes were falls and road injuries;however,the prevalence and specific causes differed across provinces.

Global,regional,and national burden of kidney,bladder,and prostate cancers and their attributable risk factors,1990–2019

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.

Global and national burden of atherosclerosis from 1990 to 2019:trend analysis based on the Global Burden of Disease Study 2019

Background:Atherosclerosis-related diseases represent significant health issues among adults globally.Despite their widespread impact,comprehensive data concerning the global and national burden and trends of these diseases remain sparse.Our objective is to examine the trends in the burden of atherosclerosis among adults from 1990 to 2019 at both global and national levels.Methods:We reported the average annual percentage changes(AAPCs)in prevalence,incidence,mortality,and disabilityadjusted life years(DALYs)of atherosclerosis-related diseases(ischemic heart disease[IHD],ischemic stroke,and peripheral arterial disease[PAD])at the global and national levels among individuals based on a trend analysis of the Global Burden of Diseases Study(GBD)2019.We further analyzed these global trends as a function of age,gender,and the social development index.We also used joinpoint regression analysis to identify the year with the most substantial changes in global trends.Results:Globally,the AAPC of IHD incidence rose from 1990 to 2019(0.20;95%confidence interval[CI],0.12-0.28),with substantial surges in 1995,2001,2005,2010,and 2017.Conversely,AAPC of IHD mortality rates exhibited a different trend until a rise in 2014.The AAPC of incidence rates of ischemic stroke and PAD also escalated during the same period,with respective 0.43(95%CI,0.39-0.48)and 0.13(95%CI,0.06-0.21).For ischemic stroke,both incidence and mortality soared in 2014,while PAD incidence declined in 1994 and 1998,then sharply climbed in 2016.Nationally,the Northern Mariana Islands experienced the steepest increase in IHD and PAD incidence and mortality between 1990 and 2019.China saw a significant rise in ischemic stroke incidence,whereas the highest mortality rate increase occurred in Timor-Leste.By sociodemographic index(SDI)quintile,low-middle-,middle-,and high-middle-SDI countries all showed upward trends in IHD,ischemic stroke,and PAD incidence.Simultaneously,IHD and ischemic stroke mortality rates,as well as DALYs,dropped in the low-,high-middle-,and high-SDI nations.However,PAD mortality rates and DALYs saw an uptick across all SDI quintiles.Regarding age demographics,a global decrease in the AAPC IHD incidence as noted in individuals above 55 years old,in contrast to an increase in the 20-55 age group during this period.AAPC of mortality rates for IHD,ischemic stroke,and PAD decreased across all ages.The AAPC showed an increase in IHD incidence in both genders.Conversely,IHD’s DALYs saw a reduction in both males and females.Ischemic stroke patterns mirrored these trends,whereas all measures for PAD exhibited growth for both sexes.Conclusions:From 1990 to 2019,there was an overall increasing trend in the global incidence of all three clinical manifestations of atherosclerosis.Between 1990 and 2019,both the mortality rate and DALYs for IHD and ischemic stroke declined across all age groups.Overall,the burden of atherosclerosis-related diseases has not significantly decreased and even shows signs of trending upward.These findings strongly suggest that despite some progress made,efforts to control atherosclerosis diseases globally need to be intensified.

Burden of epilepsy in China and its provinces,1990 to 2019:findings from the Global Burden of Disease Study 2019

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.

Unveiling the silent crisis:global burden of suicide‑related deaths among children aged 10–14 years

Background The rise in suicides among children aged 10–14 years demands urgent attention globally.This study aims to assess the global burden of suicide-related deaths in this age group from 1990 to 2019,considering factors such as sex,geography,and sociodemographics,to inform prevention strategies and interventions.Methods The data from Global Burden of Disease 2019,encompassing 204 countries and territories,were analyzed to investigate deaths and years of life lost(YLLs)due to suicide among children aged 10–14 years.Statistical analyses,including mortality rates,YLLs,and the sociodemographic index(SDI),were conducted using standardized tools.Results In 2019,a total of 8327[95%uncertainty interval(UI)=7073–9685]children aged 10–14 years died globally due to suicide,with a mortality rate of 1.30(95%UI=1.10–1.51)per 100,000.The rates varied across countries/territories ranging between 0.05(95%UI=0.02–0.10)in South Africa and 7.49(95%UI=5.13–10.57)in Greenland.The contribution of suicide-related deaths to all-cause mortality ranged from 0.07%(95%UI=0.04%–0.15%)in South Africa to 33.02%(95%UI=24.36%–41.53%)in Greenland.Worldwide,there were approximately 636,196(95%UI=540,383–740,009)YLLs due to suicide,with a rate of 99.07(95%UI=84.15–115.23)per 100,000.The association between SDI and suicide-related deaths was evident,with higher contributions observed in countries with higher SDI.Conclusions This study reveals a concerning global burden of suicide-related deaths among children aged 10–14 years.Despite progress in reducing mortality rates,suicide remains a significant issue.While overall rates have declined,the percentage of deaths caused by suicide in this age group is increasing.

Changing profiles of cardiovascular disease and risk factors in China:a secondary analysis for the Global Burden of Disease Study 2019

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.

Physical activity and cancer risk:a dose-response analysis for the Global Burden of Disease Study 2019

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.

Asian,regional,and national burdens of respiratory tract cancers and associated risk factors from 1990 to 2019:A systematic analysis for the global burden of disease study 2019

Background:Respiratory cancer is the leading cause of cancer-related deaths worldwide,but its statistics vary between the East and West.This study aimed to estimate the burdens of tracheal,bronchus,and lung(TBL)cancer and larynx cancer and their attributable risks from 1990 to 2019 in Asia,and at regional and national levels.Methods:This research evaluated the incidence,mortality,years lived with disability,years of life lost,and disability-adjusted life years(DALYs)for respiratory tract cancers using the Global Burden of Diseases,Injuries,and Risk Factors Study(GBD)2019 database.Age-standardized rates were calculated for TBL cancer from 1990 to 2019,adjusted for smoking and socio-demographic index(SDI).Deaths from TBL cancer and larynx cancer attributable to each risk factor were estimated for 33 Asian countries.Results:The age-standardized incidence and death rates for TBL cancer in Asia declined from 2010 to 2019,while the incidence rate of larynx cancer increased.Smoking was the leading specific risk factor for deaths from both TBL and larynx cancers.The burden of TBL cancer in Asian countries was influenced by SDI and smoking,particularly among males in Central Asia.Deaths,DALYs,and incidences of larynx cancer in East Asia had not changed significantly over the past 30 years,but showed slight downward trends in males and both sexes combined,and an upward trend in females in recent years.Conclusions:The past decade saw increases in numbers of incident cases and deaths from TBL cancer and larynx cancer in Asia.SDI and smoking were the main factors influencing the disease burden of TBL cancer in Asian countries.This study highlights the need for tailored cancer control programs to address the burden of respiratory tract cancers in different Asian countries.

Burden of multiple myeloma in China:an analysis of the Global Burden of Disease,Injuries,and Risk Factors Study 2019

Background:There is limited data to comprehensively evaluate the epidemiological characteristics of multiple myeloma(MM)in China;therefore,this study determined the characteristics of the disease burden of MM at national and provincial levels in China.Methods:The burden of MM,including incidence,mortality,prevalence,and disability-adjusted life years(DALYs),with a 95%uncertainty interval(UI),was determined in China following the general analytical strategy used in the Global Burden of Disease,Injuries,and Risk Factors Study 2019.The trends in the burden of MM from 1990 to 2019 were also evaluated.Results:There were an estimated 347.45 thousand DALYs with an age-standardized DALY rate of 17.05(95%UI,12.31-20.77)per 100,000 in 2019.The estimated number of incident case and deaths of MM were 18,793 and 13,421,with age-standardized incidence and mortality rates of 0.93(95%UI,0.67-1.15)and 0.67(95%UI,0.50-0.82)per 100,000,respectively.The age-specific DALY rates per 100,000 increased to more than 10.00 in the 40 to 44 years age group reaching a peak(93.82)in the 70 to 74 years age group.Males had a higher burden than females,with approximately 1.5-to 2.0-fold sex difference in age-specific DALY rates in all age groups.From 1990 to 2019,the DALYs of MM increased 134%,from 148,479 in 1990 to 347,453 in 2019.Conclusion:The burden of MM has doubled over the last three decades,which highlights the need to establish effective disease prevention and control strategies at both the national and provincial levels.

The Association of Socioeconomic Status with the Burden of Cataract-related Blindness and the Effect of Ultraviolet Radiation Exposure: An Ecological Study

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.

Burden of pancreatitis and associated risk factors in China,1990 to 2019:a systematic analysis for the Global Burden of Disease Study 2019

Background: Pancreatitis is a common disease of the digestive system. Acute pancreatitis is one of the most common reasons for gastrointestinal hospital admission, and chronic pancreatitis significantly reduces quality of life. However, national epidemiological data on pancreatitis in China are lacking. This study aimed to quantify the disease burden of pancreatitis in China from 1990 to 2019.Methods: This study was based on the Global Burden of Disease Study 2019 dataset. Age-standardized rates of incidence (ASIR), prevalence (ASPR), mortality (ASMR), and disability-adjusted life years (DALYs) were used to describe the disease burden of pancreatitis, and estimated annual percentage change (EAPC) was used to indicate the average change in age-standardized rates. We also described the trend of pancreatitis-related mortality and DALYs, which are attributable to alcohol use by age and sex.Results: From 1990 to 2019, the ASIR, ASPR, ASMR, and age-standardized DALYs of pancreatitis in China decreased by 10.90, 1.50, 0.49, and 15.54 per 100,000, respectively, with EAPCs of -1.35 (95% uncertainty interval [UI]: -1.67, -1.02) and -0.37 (95% UI: -0.43, -0.31), -2.01 (95% UI: -2.07, -1.94) and -2.32 (95% UI: -2.37, -2.28), respectively. Recently, the numbers of incident and prevalent cases have risen, with estimates of 380,018 (95% UI: 308,669-462,767) and 493,765 (95% UI: 416,705-578,675), respectively, in 2019. Among men, the disease burden of pancreatitis was more severe than among women, and with variances in the distribution among different age groups. Age-standardized DALYs caused by alcohol-related pancreatitis have gradually worsened in the past decade, accounting for 34.09% of the total in 2019.Conclusions: The disease burden of pancreatitis in China has declined in the past 30 years, but the exacerbation of population aging poses a challenge to prevention and control of pancreatitis. Alcohol use has gradually become an important factor in the disease burden of pancreatitis in recent years.

Global burden prediction of gastric cancer during demographic transition from 2020 to 2040

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.

Trends in mortality of liver disease due to hepatitis B in China from 1990 to 2019: findings from the Global Burden of Disease Study

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.