Statistical data on the incidence, mortality, and burden of breast cancer and the relevant risk factors are valuable for policy-making. We aimed to estimate breast cancer incidence, deaths, and ...disability-adjusted life years (DALYs) by country, gender, age group, and social-demographic status between 1990 and 2017.
We extracted breast cancer data from the 2017 Global Burden of Disease (GBD) study from 1990 through 2017 in 195 countries and territories. Data about the number of breast cancer incident cases, deaths, DALYs, and the age-standardized rates were collected. We also estimated the risk factors attributable to breast cancer deaths and DALYs using the comparative risk assessment framework of the GBD study.
In 2017, the global incidence of breast cancer increased to 1,960,681 cases. The high social-development index (SDI) quintile included the highest number of breast cancer death cases. Between 2007 and 2017, the ASDR of breast cancer declined globally, especially in high SDI and high middle SDI countries. The related DALYs were 17,708,600 in 2017 with high middle SDI quintile as the highest contributor. Of the deaths and DALYs, alcohol use was the greatest contributor in most GBD regions and other contributors included high body mass index (BMI) and high fasting plasma glucose.
The increasing global breast cancer burden is mainly observed in lower SDI countries; in higher SDI countries, the breast cancer burden tends to be relieving. Therefore, steps against attributable risk factors should be taken to reduce breast cancer burden in lower SDI countries.
Chronic kidney disease (CKD) is a public health problem largely caused by diabetes. The epidemiology of diabetes mellitus-related CKD (CKD-DM) could provide specific support to lessen global, ...regional, and national CKD burden.
Data were derived from the GBD 2019 study, including four measures and age-standardized rates (ASRs). Estimated annual percentage changes and 95% CIs were calculated to evaluate the variation trend of ASRs.
Diabetes caused the majority of new cases and patients with CKD in all regions. All ASRs for type 2 diabetes-related CKD increased over 30 years. Asia and Middle socio-demographic index (SDI) quintile always carried the heaviest burden of CKD-DM. Diabetes type 2 became the second leading cause of CKD and CKD-related death and the third leading cause of CKD-related DALYs in 2019. Type 2 diabetes-related CKD accounted for most of the CKD-DM disease burden. There were 2.62 million incident cases, 134.58 million patients, 405.99 thousand deaths, and 13.09 million disability-adjusted life-years (DALYs) of CKD-DM worldwide in 2019. Age-standardized incidence (ASIR) and prevalence rate (ASPR) of type 1 diabetes-related CKD increased, whereas age-standardized death rate (ASDR) and DALY rate decreased for females and increased for males. In high SDI quintile, ASIR and ASPR of type 1 diabetes-related CKD remained the highest, with the slowest increase, whereas the ASDR and age-standardized DALY rate remained the lowest there. In high SDI quintile, ASIR of type 2 diabetes-related CKD was the highest, with the lowest increasing rate. In addition, type 2 diabetes-related CKD occurred most in people aged 80-plus years worldwide. The main age of type 2 diabetes-related CKD patients was 55-64 years in Asia and Africa. The prevalence, mortality, and DALY rate of type 2 diabetes-related CKD increased with age. As for incidence, there was a peak at 80 years, and after age of 80, the incidence declined. CKD-DM-related anemia was mainly in mild to moderate grade.
Increasing burden of CKD-DM varied among regions and countries. Prevention and treatment measures should be strengthened according to CKD-DM epidemiology, especially in middle SDI quintile and Asia.
Accurate spatial information about irrigation is crucial to a variety of applications, such as water resources management, water exchange between the land surface and atmosphere, climate change, ...hydrological cycle, food security, and agricultural planning. Our study proposes a new method for extracting cropland irrigation information using statistical data, mean annual precipitation and Moderate Resolution Imaging Spectroradiometer (MODIS) land cover type data and surface reflectance data. The approach is based on comparing the land surface water index (LSWI) of cropland pixels to that of adjacent forest pixels with similar normalized difference vegetation index (NDVI). In our study, we validated the approach over mainland China with 612 reference samples (231 irrigated and 381 non-irrigated) and found the accuracy of 62.09%. Validation with statistical data also showed that our method explained 86.67 and 58.87% of the spatial variation in irrigated area at the provincial and prefecture levels, respectively. We further compared our new map to existing datasets of FAO/UF, IWMI, Zhu and statistical data, and found a good agreement with the irrigated area distribution from Zhu’s dataset. Results show that our method is an effective method apply to mapping irrigated regions and monitoring their yearly changes. Because the method does not depend on training samples, it can be easily repeated to other regions.
IMPORTANCE: Thyroid cancer is the most pervasive endocrine cancer worldwide. Studies examining the association between thyroid cancer and country, sex, age, sociodemographic index (SDI), and other ...factors are lacking. OBJECTIVE: To examine the thyroid cancer burden and variation trends at the global, regional, and national levels using data on sex, age, and SDI. DESIGN, SETTING, AND PARTICIPANTS: In this cross-sectional study, epidemiologic data were gathered using the Global Health Data Exchange query tool, covering persons of all ages with thyroid cancer in 195 countries and 21 regions from January 1, 1990, to December 31, 2017; data analysis was completed on October 1, 2019. All participants met the Global Burden of Disease Study inclusion criteria. MAIN OUTCOMES AND MEASURES: Outcomes included incidence, deaths, and disability-adjusted life-years (DALYs) of thyroid cancer. Measures were stratified by sex, region, country, age, and SDI. The estimated annual percentage changes (EAPCs) and age-standardized rates were calculated to evaluate the temporal trends. RESULTS: Increases of thyroid cancer were noted in incident cases (169%), deaths (87%), and DALYs (75%). Age-standardized incidence rate (ASIR) showed an upward trend over time, with an EAPC of 1.59 (95% CI, 1.51-1.67); decreases were noted in EAPCs of age-standardized death rate (−0.15; 95% CI, −0.19 to −0.12) and age-standardized DALY rate (−0.11; 95% CI, −0.15 to −0.08). Almost half (41.73% for incidence, 50.92% for deaths, and 54.39% for DALYs) of the thyroid cancer burden was noted in Southern and Eastern Asia. In addition, females accounted for most of the thyroid cancer burden (70.22% for incidence, 58.39% for deaths, and 58.68% for DALYs) and increased by years in this population, although the ASIR of males with thyroid cancer (EAPC, 2.18; 95% CI, 2.07-2.28) increased faster than that of females (EAPC, 1.38; 95% CI, 1.30-1.46). A third (34%) of patients with thyroid cancer resided in countries with a high SDI, and most patients were aged 50 to 69 years, which was older than the age in other quintiles (high SDI quintile compared with all other quintiles, P<.05). The most common age at onset of thyroid cancer worldwide was 15 to 49 years in female individuals compared with 50 to 69 years in male individuals (P<.05). Death from thyroid cancer was concentrated in participants aged 70 years or older and increased by years (average annual percentage change, 0.10; 95% CI, 0.01-0.21; P<.05). Furthermore, people in lower SDI quintiles developed thyroid cancer and died from it earlier than those in other quintiles (high and high-middle SDI vs low and low-middle SDI, P<.05). CONCLUSIONS AND RELEVANCE: Data from this study suggest considerable heterogeneity in the epidemiologic patterns of thyroid cancer across sex, age, SDI, region, and country, providing information for governments that may help improve national and local cancer control policies.
Cervical cancer (CC) is a leading cause of cancer-related death in women. Limited studies have investigated whether immune-related genes (IRGs) or tumor immune microenvironment (TIME) could be ...indicators for CC prognoses. The aim of this study was to develop an improved prognostic signature for CC based on IRGs or TIME to predict survival and response to immune checkpoint inhibitors (ICIs). A prognostic signature was constructed using bioinformatics method and its predictive capability was validated. The mechanisms underlying the signature's predictive capability were explored with CIBERSORT algorithm and mutation analysis. Immunophenoscore (IPS) is validated for ICIs response, and was therefore explored in relation to the signature. A prognostic signature based on 11 IRGs was developed. A multivariate analysis revealed that the 11-IRG signature was an independent prognostic factor for overall survival (OS) and progression-free interval in CC patients. In the 11-IRG signature high-risk group, CD8 T cells and resting mast cells, which are found to associate with better OS in our study, were lower; activated mast cells, associated with poorer OS, were higher, compared with the low-risk group. An IPS analysis suggested that the 11-IRG signature low-risk group, which possessed a higher IPS, represented a more immunogenic phenotype that was more inclined to respond to ICIs. In short, an 11-IRG prognostic signature for predicting CC patients' survival and response to ICIs was firmly established. The predictive capability of this model in CC requires further testing with the goal of better prognostic stratification and treatment management.
The content of soil water affects the physiological activities of vegetation, and the type of vegetation also affects the soil water balance. It is of great significance to study the response of ...vegetation to soil moisture change, which is helpful for understanding the vulnerability of vegetation for regional and environmental protections. The response of vegetation to soil moisture in Guangdong Province from mid-October 2015 to the end of March 2017 was studied by using cloudy region drought index (CRDI) as the drought index and volumetric soil water content (VSWC) as the soil moisture index to measure the level of water stress on vegetation. Taking the peak and valley positions of CRDI and VSWC as characteristic points, the lag time of vegetation to volumetric soil water content was obtained by judging the difference between the peak and valley positions of the two indexes. The results indicate that the response of vegetation to volumetric soil water content in Guangdong lagged 3.33 periods (9–35 days) on average. When VSWC is sufficient, there is no obvious difference in time-lag between different types of vegetation. However, when VSWC is relatively insufficient, grass shows the fastest response to the change of volumetric soil water content. Both longitude and soil moisture affect the lag time of vegetation. Under the same conditions, the higher the soil humidity is, the longer the lag time is, and the longer the delay time is with the greater longitude. CRDI can reflect the time-lag effect between vegetation and VSWC in Guangdong, indicating it is a sensitive and applicable index for characterizing the time-lag phenomena of vegetation to soil moisture.
Objectives
Motoric cognitive risk syndrome (MCR) is a newly described pre-dementia syndrome characterized by cognitive complaints and slow gait and is associated with numerous adverse outcomes. ...Previous studies have indicated an association between C-reactive protein (CRP) and cognitive decline, but no clear relationship between CRP and MCR has been reported. The purpose of the study is to examine the associations between CRP with MCR and MCR subtypes.
Methods
Participants were 5,642 adults aged ≥60 years from the China Health and Retirement Longitudinal Study (CHARLS). MCR was defined as cognitive complaints and slow gait speed without dementia or impaired mobility. Two subtypes of MCR were defined by whether memory impairment (MI) was also present, such as MCR-MI and MCR-non-MI. MI was evaluated through the immediate recall and delayed recall in a word recall test during the CHARLS and was defined as 1.0 standard deviation or more below the mean values of the test scores in this cohort.
Results
Of the participants, 421 (7.46%) met the criteria for MCR. After multivariate adjustment, participants with higher CRP levels had an increased likelihood of MCR (fourth quartile: adjusted odds ratio OR=1.44; 95% confidence interval CI: 1.06–1.95) compared with those in the first quartile group. The OR for MCR-MI was 2.04 (95% CI: 1.35–3.09) for the highest quartile of CRP compared to the lowest quartile. No significant associations between CRP levels and odds of MCR-non-MI were observed.
Conclusions
Higher CRP levels were associated with increased odds of prevalent MCR-MI but not MCR-non-MI among community-dwelling older adults.
Hexavalent chromium Cr(VI) is an occupational carcinogen that can cause lung and nasal cancers, but its association with mortality and incidence in many other cancers is unclear.
In this ...meta-analysis, we aimed to evaluate the relationship between exposure to Cr(VI) and the mortality and incidence of human cancers.
We performed a search of the literature and extracted the standardized mortality ratios (SMRs), standardized incidence ratios (SIRs), and their corresponding 95% confidence intervals (CIs), to estimate risk values. Subgroup analyses were conducted by sex, occupation, and types of cancer to identify groups that were at high-risk or predisposed to certain cancers.
A total of 47 cohort studies covering the period 1985-2016 were included (37 studies reporting SMRs and 16 studies reporting SIRs). The summary SMR for all studies combined was 1.07 (95% CI: 1.01-1.15). Summary SMRs were higher among chromate production workers, chrome platers, and masons, and especially male workers. In the subgroup analysis, Cr(VI) exposure was related to a higher risk of death owing to lung, larynx, bladder, kidney, testicular, bone, and thyroid cancer. The meta-SIR of all studies combined was 1.06 (95% CI: 1.04-1.09). Summary SIRs were elevated among cement industry workers and tanners. Cr(VI) exposure was related to an elevated risk of respiratory system, buccal cavity, pharynx, prostate, and stomach cancers.
Cr(VI) might cause cancers of the respiratory system, buccal cavity and pharynx, prostate, and stomach in humans, and it is related to increased risk of overall mortality owing to lung, larynx, bladder, kidney, testicular, bone, and thyroid cancer. In addition, there was a strong association between incidence and mortality risk of cancers and concentration of Cr(VI) in the air and the exposure time.
The epidemiology of esophageal cancer (EC) can elucidate its causes and risk factors and help develop prevention strategies. We aimed to provide an overview of the burden, trends, and risk factors of ...EC in China from 1990 to 2017. We also investigated the differences between China, Japan, and South Korea and discussed the possible causes of the disparities.
We used the Global Burden of Disease Study 2017 to obtain data on incident cases, deaths, disability-adjusted life-year (DALY) cases, age-standardized incidence rate (ASIR), age-standardized death rate (ASDR), and age-standardized DALY rate of EC in China, Japan, and South Korea from 1990 to 2017. Trend analysis was performed using joinpoint analysis. We measured the associations between ASIR, ASDR, and age-standardized DALY rate and the socio-demographic index (SDI) for 1990-2017. We also analyzed the risk factors associated with EC deaths and DALYs.
China recorded 234,624 (95% uncertainty intervals: 223,240-246,036) incident cases of and 212,586 (202,673-222,654) deaths from EC in 2017. The ASIR and ASDR declined from 1990 to 2017. Until 2017, the ASIR was 12.23, and ASDR was 11.25 per 100,000 persons. The DALYs were 4,464,980 (4,247,816-4,690,846) with an age-standardized rate of 222.58 per 100,000 persons in 2017. The ASIR, ASDR, and age-standardized DALY rate in China were twice those of Japan and South Korea. These three indicators showed a decreasing trend, whereas SDI increased, in all three countries from 1990 to 2017. Tobacco and alcohol use remained the major risk factors for EC death and DALYs, especially for men in China and women in Japan and South Korea. High body mass index (BMI) and low-fruit diet were the main risk factors for women in China.
The incident cases and deaths of EC in China, Japan, and South Korea increased from 1990 to 2017, whereas the ASIR, ASDR, and age-standardized DALY rate declined. China had the greatest burden of EC among three countries. SDI and aging along with tobacco use, alcohol use, high BMI, and low-fruit diet were the main risk factors of death and DALYs and should be paid more attention.
Hodgkin lymphoma (HL) is an uncommon B cell lymphoma. We assessed the global, regional, and national burden of HL from 1990 to 2017, by gender, age, and social-demographic index (SDI).
Data on HL, ...including incidence, mortality, and disability adjusted life-years (DALY), from 1990 to 2017 were obtained from the 2017 Global Burden of Disease study. Estimated annual percentage changes (EAPCs) were calculated to assess incidence rate, mortality, and DALY trends.
HL incidences increased by 38.66%, from 72,937 in 1990 to 101,133 in 2017, while the age-standardized incidence rate (ASIR) was relatively stable. ASIR decreased in the low SDI regions (EAPC = - 2.58; 95% CI, from - 2.66 to - 2.49) and was stable in the other four SDI regions. Incidence showed a bimodal distribution with peak values in patients aged 20-39 years and patients aged 60 years or higher. The number of death cases and DALYs were stable. The age-standardized death rate decreased by 2.36% (95% CI, from - 2.43% to - 2.30%) per year. The annual age-standardized DALY rate decreased by 2.29% (95% CI, from - 2.36% to - 2.21%). The incidence and mortality in male subjects was higher than that in female subjects. The incidence in male and female subjects aged 15-30 years old was close, whereas the biggest difference existed in patients aged < 10 years old and 45-75 years old between genders.
Globally, incidence of HL was stable, while mortality and DALY rate of HL had been decreasing from 1990 to 2017. Compared with lower and decreasing ASIR in the low SDI region, ASIR in the high SDI region was always high, indicating the need for HL treatment improvement and the establishment of more targeted and specific strategies in high SDI countries to reduce the incidence of HL.
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