Background
The global burden of gallbladder and biliary tract cancer (GBTC) is increasing. A comprehensive evaluation of the burden is crucial to improve strategies for GBTC prevention and treatment.
...Methods
The incidence rates, mortality, and disability‐adjusted life years (DALYs) of GBTC from 1990 to 2017 were extracted from the Global Burden of Diseases Study (GBD) 2017. Estimated annual percent changes (EAPCs) were calculated to quantify GBTC trends during the study period.
Results
Globally, there were 210,878 new cases, 173,974 deaths, and 3,483,046 DALYs because of GBTC in 2017. GBTC incidence increased by 76%, mortality increased by 65%, and DALYs increased by 52% from 1990 to 2017. In addition, relatively higher Socio‐Demographic Index regions had greater incidence and death rates but greatly decreased age‐standardized incidence rate (ASIR) and age‐standardized death rate (ASDR). At the national level, Chile had the highest ASIR (10.38 per 100,000 population) and the highest ASDR (10.43 per 100,000 population) in 2017. The largest increases in ASIR (EAPC, 3.38) and ASDR (EAPC, 3.39) were observed in Georgia. Nonlinear associations were observed between the ASDR, the Socio‐Demographic Index, and DALYs at the 21 GBD regional levels and at the national level. The proportions of GBTC age‐standardized deaths and DALYs attributable to high body mass index were 15.4% and 16%, respectively.
Conclusions
GBTC remains a major health burden worldwide. These findings are expected to prompt policymakers to establish a cost‐effective method for the early diagnosis, prevention, and treatment of GBTC, reducing its modifiable risk factors and reversing its increasing trends.
Lay Summary
Although the rates of age‐standardized incidence, death, and disability‐adjusted life‐years for gallbladder and biliary tract cancer decreased from 1990 to 2017, the numbers of these measures increased.
Nonlinear associations existed between the age‐standardized death rate, the Socio‐Demographic Index, and disability‐adjusted life‐years at the 21 regional and national levels in the Global Burden of Disease Study.
Gallbladder and biliary tract cancer (GBTC) remains a major health burden worldwide; however, the burden of GBTC varies geographically. Establishing a cost‐effective method for the early diagnosis, prevention, and treatment of GBTC, reducing its modifiable risk factors, and reversing the increasing trend are warranted to reduce the GBTC burden.
Background
Information about global and local epidemiology and trends of skin cancers is limited, which increases the difficulty of cutaneous cancer control.
Methods
To estimate the global spatial ...patterns and temporal trends of skin cancer burden. Based on the GBD 2019, we collected and analyzed numbers and age‐standardized rates (ASR) of skin cancer incidence, disability‐adjusted life years (DALYs) and mortality (ASIR, ASDR, and ASMR) in 204 countries from 1990 through 2019 were estimated by age, sex, subtype (malignant skin melanoma MSM, squamous‐cell carcinoma SCC, and basal‐cell carcinoma BCC), Socio‐demographic Index (SDI), region, and country. Temporal trends in ASR were also analyzed using estimated annual percentage change.
Results
Globally, in 2019, there were 4.0 million BCC, 2.4 million SCC, and 0.3 million MSM. There were approximately 62.8 thousand deaths and 1.7 million DALYs due to MSM, and 56.1 thousand deaths and 1.2 million DALYs were attributed to SCC, respectively. The men had higher ASR of skin cancer burden than women. The age‐specific rates of global skin cancer burden were higher in the older adults, increasing trends observed from 55 years old. Geographically, the numbers and ASR of skin cancers varied greatly across countries, with the largest burden of ASIR in high SDI regions. However, an unexpected increase was observed in some regions from 1990 to 2019, such as East Asia, and Sub‐Saharan Africa. Although there was a slight decrease of the ASMR and ASDR, the global ASIR of MSM dramatically increased, 1990–2019. Also, there was a remarkable increase in ASR of BCC and SCC burden.
Conclusions
Skin cancer remains a major global public health threat. Reducing morbidity and mortality strategies such as primary and secondary prevention should be reconsidered, especially in the most prevalent and unexpected increased regions, especially for those areas with the greatest proportions of their population over age 55.
Main results of this systematic analysis showed that globally, in addition to a slight fall in mortality of melanoma, there was a dramatic increase in skin cancers burden from 1990 to 2019. Geographically, an unexpected increase was observed in some territories, 1990–2019, such as East Asia and Sub‐Saharan Africa, which were usually considered as low incidence areas in the past. Globally, increased efforts are needed in skin cancer prevention, especially, in regions with a high and/or increased burden of cutaneous cancer.
To provide comprehensive estimates of the global, regional, and national burden of infertility from 1990 to 2017, using findings from a 2017 study on the global burden of disease (GBD), we assessed ...the burden of infertility in 195 countries and territories from 1990 to 2017. DisMod-MR 2.1 is a Bayesian meta-regression method that estimates non-fatal outcomes using sparse and heterogeneous epidemiological data. Globally, the age-standardized prevalence rate of infertility increased by 0.370% per year for females and 0.291% per year for males from 1990 to 2017. Additionally, age-standardized disability-adjusted life-years (DALYs) of infertility increased by 0.396% per year for females and 0.293% per year for males during the observational period. An increasing trend to these burden estimates was observed throughout the all socio-demographic index (SDI) countries. Interestingly, we found that high SDI countries had the lowest level of prevalence and DALYs in both genders. However, the largest increasing trend was observed in high-SDI countries for females. By contrast, low-SDI countries had the largest increasing trend in males. Negative associations were observed between these burden estimates and the SDI level. The global disease burden of infertility has been increasing throughout the period from 1990 to 2017.
Melanoma is an aggressive form of skin cancer, and a worldwide problem with increasing incidence. Little is known about the burden of melanoma in the Chinese population. We evaluated temporal trends ...and geographic variation in melanoma‐associated burden, to narrow an important knowledge gap concerning the consequences of this disorder across time, provinces in China. After the general analytic strategy used in the 2017 Global Burden of Disease study, we analyzed the incidence, mortality, prevalence and disability‐adjusted life‐years (DALYs) of melanoma, by age, sex and geography from 1990 to 2017. Levels in melanoma burden were assessed for 33 province‐level administrative units between 1990 and 2017. We used joinpoint regression analysis to estimate the slope of incidence and mortality trends. The age‐standardized incidence rate of melanoma was 0.9 per 100,000 in 2017, with a 110.3% rise compared to 1990. Although the age‐standardized DALYs rate (per 100,000) decreased from 9.1 in 1990 to 7.6 in 2017, it showed an upward trend from 2007 to 2017. The DALYs rate increased steadily with age for females while increased and peaked at 55–59 years for males. The incidence of melanoma was higher in the clustered eastern provinces than western provinces, while the DALYs showed a pattern in opposite direction. In China, there has been a substantial increase in the burden of melanoma over the last decade, representing an ongoing challenge in Chinese population. More targeted strategies should be developed for elderly population, especially for females, to reduce the melanoma burden throughout China, particularly the western provinces.
What's new?
Little has been known about the burden of melanoma in China. In this study, the authors found that incidence and mortality rates have significantly increased over the past decade, especially in the eastern provinces. In addition, patterns of distribution by both age and sex in the Chinese population differed from previous reports involving western populations. Because the risk of this aggressive skin cancer appears to be frequently overlooked or underestimated in China, public health strategies are needed both to increase early diagnosis and to improve prevention.
Background
Alcohol use disorders (AUD) have long been considered to be some of the most disabling mental disorders; however, empirical data on the burden of disease associated with AUD have been ...sparse. The objective of this article is to quantify the burden of disease (in disability‐adjusted life years DALYs lost), deaths, years of life lost due to premature mortality (YLL), and years of life lost due to disability (YLD) associated with AUD for the United States in 2005.
Methods
Statistical modeling was based on epidemiological indicators derived from the National Epidemiologic Survey on Alcohol and Related Conditions. Formal consistency analyses were applied. Risk relations were taken from recent meta‐analyses and the disability weights from the burden of disease study of the National Institutes of Health. Monte Carlo simulations were used to derive confidence intervals. All analyses were performed by sex and age. Sensitivity analyses were undertaken on key indicators.
Results
In the United States in 2005, 65,000 deaths, 1,152,000 YLL, 2,443,000 YLD, and 3,595,000 DALYs were associated with AUD. For individuals 18 years of age and older, AUD were associated with 3% of all deaths (5% for men and 1% for women), and 5% of all YLL (7% for men and 2% for women). The majority of the burden of disease associated with AUD stemmed from YLD, which accounted for 68% of DALYs associated with AUD (66% for men and 74% for women). The youngest age group had the largest proportion of DALYs associated with AUD stemming from YLD.
Conclusions
Using data from a large representative survey (checked for consistency) and by combining these data with the best available evidence, we found that AUD were associated with a larger burden of disease than previously estimated. To reduce this disease burden, implementation of prevention interventions and expansion of treatment are necessary.
The quantification of how healthy the indoor air is, is a complex issue comprising of a large number of contaminants of various sources. The health implication of exposure to each of the contaminant ...deemed of importance can be expressed using Disability Adjusted Life Years (DALYs). The sum of all DALYs indicates how harmful the indoor air was during the investigated time‐frame. This metric was originally developed by the World Bank and the WHO. In 2012, Logue et. al described two methods to estimate the DALYs related to exposure to contaminants in the indoor air based on the yearly mean exposure concentration of a population. The downside of these methods is that, when detailed exposure concentration profiles are available the method results in a loss of information. A novel method was developed to estimate DALYs originating from exposure to indoor pollutants that can be used for time‐resolved exposure concentration data without this loss of information: Dynamic DALYs. The advantage of this method is that it can be calculated in real‐time and for short or long periods of data. As such it can be used for pin‐pointing problematic events in the exposure profile of a person and, as it can be calculated in real‐time, makes it a candidate for use in automated optimization problems. The use of Dynamic DALYs is demonstrated for a simulation case‐study of an occupied apartment. One continuously ventilated system (Dcont) and one smart ventilation system (Dsmart) are compared. Sources of typically indoor generated Volatile Organic Compounds (VOCs) were added and the related exposure profile and Dynamic DALY results of the working adult were analyzed. The results showcase detailed and more summative results with regards to health and energy use using the novel indicator. For Dcont and Dsmart the total Dynamic DALYs are 2.2 years and 8.6 years, respectively (population of 100 000, duration of 1 year), for the VOCs and sources considered in the analysis.
Aims
High fasting plasma glucose (HFPG) is an independent risk factor for several adverse health outcomes and has become a serious public health problem. We aimed to evaluate the spatial pattern and ...temporal trend of disease burden attributed to HFPG from 1990 to 2019 using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019.
Materials and Methods
Using data from GBD 2019, we estimated the numbers and age‐standardized rates of deaths and disability‐adjusted life years (DALYs) attributed to HFPG by calendar year, age, gender, country, region, Socio‐demographic Index (SDI), and specific causes. The joinpoint regression analysis was used to assess the temporal trends of deaths and DALYs from 1990 to 2019.
Results
In 2019, globally, the numbers of deaths and DALYs attributable to HFPG were approximately 6.50 million and 172.07 million, respectively, with age‐standardized rates of 83.00 per 100,000 people and 2104.26 per 100,000 people, respectively. From 1990 to 2019, the global numbers of deaths and DALYs attributed to HFPG have over doubled. The age‐standardized rate of DALYs showed an increasing trend, particularly in males and in regions with middle SDI or below. The leading causes of the global disease burden attributable to HFPG in 2019 were diabetes mellitus, ischaemic heart disease, stroke, and chronic kidney disease.
Conclusions
HFPG is an important contributor to increasing the global and regional disease burden. Necessary measures should be taken to curb the growing burden attributed to HFPG, particularly in males and in regions with middle SDI or below.
Background
China's lung cancer (LC) burden plays a pivotal role in the global cancer epidemic. Comparing LC burden and population attributable fractions (PAFs) of risk factors between China and other ...countries/regions is essential to inform effective intervention. The Global Burden of Disease (GBD) study provides a unique opportunity for such comparisons.
Methods
We extracted the number of LC deaths, age‐standardized death rates (ASDRs), age‐standardized disability‐adjusted life‐year (DALY) rates, and PAFs of risk factors for LC deaths between 1990 and 2017 from GBD 2017. The annual percentage change (APC) was used to quantify the trends of LC ASDRs and age‐standardized DALY rates. The relationship between the APC of LC ASDR and Socio‐demographic Index was assessed among China and other countries.
Results
Globally, the ASDR for LC decreased in men (APC, −0.66% 95% CI, −0.69 to −0.62) but increased in women (APC, 0.31% 95% CI, 0.26 to 0.36) from 1990 to 2017. The ASDRs in China increased both for men (APC, 1.12% 95% CI, 1.03 to 1.20) and women (APC, 0.80% 95% CI, 0.70 to 0.89). The increased LC death numbers among men (312,798) and women (139,115) in China accounted for 59.39% and 43.01% of global increases. LC years of life lost accounted for the majority of LC DALYs globally and in China. The risk factors with the highest PAFs of LC death in China were smoking and ambient particulate matter. The ASDRs for LC associated with ambient particulate matter in China ranked second globally.
Conclusions
The trends of LC ASDRs and age‐standardized DALY rates and the PAFs of risk factors vary markedly by region, indicating a need for tailored measures to reduce LC burden and improve health equality. China's LC ASDRs are among the highest in the world, and the primary intervention priorities in China should be control of ambient particulate matter and tobacco usage.
The trends of age‐standardized lung cancer death rates and the population attributable fractions of risk factors vary markedly by region, which indicates a need for tailored measures to reduce lung cancer burden and improve health equality. China's age‐standardized lung cancer death rate increased significantly and faster than expected according to the Socio‐demographic Index; this increase is attributed primarily to smoking and ambient particulate matter pollution, highlighting the importance of controlling these risk factors in China.
Background Population growth, aging, and major alterations in epidemiologic trends inadvertently modulate the status of rheumatic heart disease (RHD) epidemiology. This investigation predicted RHD ...burden pattern and temporal trends to provide epidemiologic evidence. Methods and Results Prevalence, mortality, and disability-adjusted life-years data for RHD were obtained from the GBD (Global Burden of Disease) study. We performed decomposition analysis and frontier analysis to assess variations and burden in RHD from 1990 to 2019. In 2019, there were >40.50 million RHD cases worldwide, along with nearly 0.31 million RHD-related deaths and 10.67 million years of healthy life lost to RHD. The RHD burden was commonly concentrated within lower sociodemographic index regions and countries. RHD primarily affects women (22.52 million cases in 2019), and the largest age-specific prevalence rate was at 25 to 29 years in women and 20 to 24 years in men. Multiple reports demonstrated prominent downregulation of RHD-related mortality and disability-adjusted life-years at the global, regional, and national levels. Decomposition analysis revealed that the observed improvements in RHD burden were primarily due to epidemiological alteration; however, it was negatively affected by population growth and aging. Frontier analysis revealed that the age-standardized prevalence rates were negatively linked to sociodemographic index, whereas Somalia and Burkina Faso, with lower sociodemographic index, showed the lowest overall difference from the frontier boundaries of mortality and disability-adjusted life-years. Conclusions RHD remains a major global public health issue. Countries such as Somalia and Burkina Faso are particularly successful in managing adverse outcomes from RHD and may serve as a template for other countries.
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