ObjectiveTo provide reference for the formulation of public health policies through exploring the disease burden of aortic aneurysm (AA) in Chinese young adults. MethodsWe analyzed sex-specific mortality rates and years of life lost (YLLs) among Chinese young adults with AA in Global Burden of Disease (GBD) from 1990 to 2019, and compared with global and young adult AA data stratified by sociodemographic index (SDI). Joinpoint was used to analyze the time trend of AA burden among young males and females in China. The attributable risk factors for AA burden in young adults and its characteristics were analyzed. ResultsAmong young adults (15-39 years old) in China, the total of AA deaths in 2019 was 657 (95%UI 549-791), with an increase of 16.90% compared with 1990. The mortality rate in 2019 was 0.13 per 100 000 (95%UI 0.11-0.16), with an increase of 30.00% compared with 1990. In 2019, a total of 36921 YLLs (95%UI 30 865-44 445) were produced by young adults in China, with an increase of 13.21% compared with 1990. The YLLs rate in 2019 was 7.42 per 100 000 (95%UI 6.20-8.93), with an increase of 24.92% compared with 1990. The male YLLs rate was 11.49 per 100 000 (95%UI 9.22-14.28), with an increase of 35.18%. The female YLLs rate was 3.11 per 100 000 (95%UI 2.36-3.98), with a decrease of 3.12%. Both the AA mortality rate and YLLs rate in male young adults were higher than those in female young adults, and the growth rate from 1990 to 2019 was significantly higher than that in females. ConclusionThe disease burden of AA among young adults in China increases significantly from 1990 to 2019, mainly among males. The time trend of male and female AA YLLs in Chinese young adults is obviously inconsistent. The AA YLLs of Chinese male young adults are positively correlated with economic development and the progress of medical technology, and are in the process of gradual increase. The AA YLLs of Chinese female young adults are much lower than the average level, which is closely related to the low smoking rate.
Objective To analyze the disease burden and trends of tracheal, bronchus, and lung cancer (TBL) attributable to occupational carcinogens in China from 1990 to 2021, in order to provide reference for the prevention and control of TBL in China. Methods Based on the Global Burden of Disease database 2021, with occupational carcinogens as relevant risk factors and tracheal, bronchus, and lung cancer as the study diseases, data on mortality and disability-adjusted life years (DALYs) attributable to occupational carcinogens in China from 1990 to 2021 were extracted and age-standardized. Joinpoint regression models were used to calculate the annual percent change (APC) and average annual percent change (AAPC). Hiplot was used to visualize the distribution of disease burden by gender and age. The grey model GM (1, 1) was used to predict the disease burden and trends of TBL attributable to occupational carcinogens in China from 2022 to 2031. Results From 1990 to 2021, the overall mortality rate, DALYs rate, age-standardized mortality rate, and age-standardized DALYs rate of TBL attributable to occupational carcinogens in China increased from 1.85/100 000,53.93/100 000, 2.64/100 000, and 69.50/100 000 in 1990 to 5.22/100 000, 129.29/100 000, 3.49/100 000, and 83.80/100 000in 2021, respectively. The growth rates were 182.16%, 139.74%, 32.20%, and 20.58%, respectively. Joinpoint regression analysis showed that the AAPC values of overall mortality rate, DALYs rate, age-standardized mortality rate, and age-standardized DALYs rate of TBL attributable to occupational carcinogens in China from 1990 to 2021 were 3.41%, 2.87%, 0.92%, and 0.62%, respectively (all P<0.001), showing an overall upward trend, with higher values in females than in males. In 2021, the overall mortality rate of TBL attributable to occupational carcinogens in China gradually increased with age, with high mortality rates mainly concentrated in those aged ≥65 years, and higher rates in males than in females. The overall DALYs rate showed a trend of increasing first and then slowly decreasing with age, peaking at 65-69 years old, with higher rates in males than in females. The grey prediction model GM (1, 1) showed that the predicted values of mortality rate, DALYs rate, age-standardized mortality rate, and age-standardized DALYs rate of TBL attributable to occupational carcinogens in China from 2022 to 2031 all showed an upward trend. By 2031, the predicted values of mortality rate, DALYs rate, age-standardized mortality rate, and age-standardized DALYs rate will reach 7.19/100 000, 175.63/100 000, 4.16/100 000, and 93.64/100 000, respectively. Conclusion From 1990 to 2021, the mortality rate, DALYs rate, age-standardized mortality rate, and age-standardized DALYs rate of TBL attributable to occupational carcinogens in China all showed an upward trend. Males and the elderly are the main populations affected by the disease burden of TBL attributable to occupational carcinogens in China. It is necessary to strengthen the prevention and control of occupational carcinogens and promote health education.
ObjectiveTo analyze the gender-specific distribution patterns of the disease burden of tracheal, bronchial, and lung cancer (hereinafter referred to as lung cancer) attributed to tobacco from 1990 to 2021 globally and in China and the United States (US), and to predict the trend of disease burden changes from 2022 to 2031, aiming to provide multi-dimensional evidence-based support for optimizing tobacco control strategies and precise lung cancer prevention and control systems. MethodsData on the disease burden of lung cancer attributed to tobacco from 1990 to 2021 globally and in China and the US were extracted and integrated from the Global Burden of Disease (GBD) 2021 database. The Joinpoint 4.9.1.0 software was used to analyze the corresponding trends in disease burden. The Bayesian age-period-cohort (BAPC) prediction model was employed to forecast the disease burden of lung cancer from 2022 to 2031. ResultsIn 2021, China had the highest number of deaths and disability-adjusted life years (DALYs) due to lung cancer attributed to tobacco, followed by the US. The top three risk factors for lung cancer globally and in China and the US from 1990 to 2021 were tobacco, air pollution, and occupational risks. The disease burden of lung cancer patients attributed to tobacco has been decreasing year by year in the global and US populations [the average annual percentage change (AAPC) values of age-standardized mortality rate and DALYs rate were: globally: ?0.96%, ?1.28%; US: ?2.33%, ?2.72%], while it has been increasing in China (the AAPC values of age-standardized mortality rate and DALYs rate were 0.28% and ?0.02%, respectively). From a gender perspective, the disease burden of male patients with lung cancer attributed to tobacco was much higher than that of female patients from 1990 to 2021. Compared to the global average, the disease burden of lung cancer attributed to tobacco in China and the US from 1990 to 2021 was still heavy, with China’s burden being higher than that of the US. The elderly population aged ≥65 years in the global context and in China and the US was the primary group affected by the disease burden of lung cancer attributed to tobacco. The BAPC prediction model indicated that from 2022 to 2031, the age-standardized rates of lung cancer attributed to tobacco in the global context and in China and the US would show a declining trend. ConclusionFrom 1990 to 2021, the disease burden of lung cancer attributed to tobacco in China and the US was still heavy compared to the global average, with China’s burden being significantly higher than that of the US. The focus on prevention and control for both countries remains among the middle-aged and elderly population (especially males), which is a key challenge for tobacco-related lung cancer prevention and treatment work in the next 10 years.
Objective To analyze the trends in the disease burden of tracheal, bronchus, and lung cancer (TBL) in China and in low-, middle-, and high-socio-demographic index (SDI) countries and regions from 1990 to 2021, with the aim of providing evidence for the formulation of targeted prevention and control strategies. Methods Utilizing data from the Global Burden of Disease (GBD) Study 2021, we extracted TBL-related data from 1990 to 2021, stratified by sex, age group, and year. We assessed the disease burden and trends of TBL across different groups, conducted a decomposition analysis to identify the leading contributors to the change in disease burden, and examined the relationship between disability-adjusted life years (DALYs) and SDI. Results In 2021, the overall burden of TBL in China was substantially higher than that in other groups. The fold-increase in the number of prevalent cases, deaths, and DALYs was significantly greater in China. Moreover, the growth rates of the age-standardized prevalence rate (ASPR), age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR) in China were higher than the overall levels in other SDI countries. In all groups, the ASPR of TBL generally followed a pattern of increasing and then decreasing with age; however, for males in China and middle-SDI countries, the ASPR exhibited a decline in the 80-84 age group. Decomposition analysis revealed that the primary drivers of the increasing TBL burden varied among groups: the rise in DALYs in China and middle-SDI countries was mainly driven by population aging, in low-SDI countries by population growth, and in high-SDI countries by epidemiological transition. While global health inequality in TBL showed some improvement, low-SDI countries continued to bear a disproportionately heavy health burden. Conclusion The disease burden of TBL in China has progressively increased from 1990 to 2021, now ranking among the highest globally. Multiple factors, predominantly driven by population aging, are exacerbating this burden. The burden of TBL is influenced by advancing age, sex differences, and SDI levels. China, along with low- and middle-SDI countries, should implement targeted intervention strategies based on epidemiological findings, including expanding investment in public health services and strengthening healthcare systems, to mitigate the growing burden of TBL.
ObjectiveTo analyze the disease burden and evolving trends for gastric cancer in China and worldwide from 1990 to 2021. MethodsBased on the 2021 Global Burden of Disease (GBD) database, we analyzed the burden of gastric cancer using indicators such as incidence, mortality, disability-adjusted life years (DALYs), years of life lost (YLLs), and years lost due to disability (YLDs). Joinpoint regression analysis was used to calculate the average annual percentage change (AAPC) of these indicators to show trends over time. ResultsIn 2021, the standardized incidence rate of gastric cancer was 14.33 (per 100 000) worldwide and 29.05 (per 100 000) in China, with corresponding standardized mortality rates of 11.20 (per 100 000) and 21.51 (per 100 000). The standardized incidence rate of gastric cancer in China trended downward during 1990–2021 (AAPC=–1.61%, P<0.05), but was lower than the global decline (AAPC=–1.77%, P<0.05). During 1990-2021 in China, the rates of standardized DALYs (AAPC=–2.76%, P<0.05), standardized YLLs (AAPC=–2.78%, P<0.05) and standardized YLDs (AAPC= –1.25%, P<0.05) all showed a significant decrease. The global rates of standardized DALYs (AAPC=–2.42%, P<0.05), standardized YLLs (AAPC=–2.44%, P<0.05) and standardized YLDs (AAPC=–1.56%, P<0.05) all showed a significant decrease. These AAPC values above indicated a general attenuation in the gastric cancer burden across all age groups, both in China and worldwide. ConclusionsDespite these signs of a decline in disease burden indicators for gastric cancer in China and worldwide, the number of cases and deaths in gastric cancer remains substantial coupled with the heavy burden on the healthcare system. Therefore, increased efforts in early detection and prevention strategies are of utmost importance to further reduce the impact of this malignant disease.
Objective To assess the evolving disease burden of esophageal and gastric cancers in China from 1990 to 2021, with a focus on gender disparities, and construct a predictive model to forecast disease trends from 2022 to 2031, aiming to optimize targeted prevention strategies. MethodsEpidemiological data for esophageal and gastric cancers in China (1990-2021) were extracted from the Global Burden of Disease (GBD) 2021 database. Temporal trends were analyzed using Joinpoint regression (version 4.9.1.0), and future trends were predicted via the GM (1, 1) model under grey system theory. ResultsFrom 1990 to 2021, tobacco- and alcohol-attributable burdens of esophageal cancer increased, while tobacco- and diet-related burdens of gastric cancer showed no significant change. Deaths and disability-adjusted life years (DALY) for esophageal cancer rose by 40.61% and 17.89%, respectively; gastric cancer deaths increased by 18.95%, though DALY decreased by 1.22%. Both cancers exhibited significant declines in age-standardized mortality rates (?45.78% for esophageal cancer, ?53.29% for gastric cancer) and age-standardized DALY rates (?51.45% for esophageal cancer, ?57.58% for gastric cancer). China’s age-standardized mortality and DALY rates for both cancers remained consistently higher than global averages. Males exhibited disproportionately higher burdens than females. Predictive modeling projected continued but decelerating declines in disease burdens for both cancers by 2031. ConclusionOver three decades, China achieves measurable reductions in esophageal and gastric cancer burdens, though gastric cancer burdens remain higher than esophageal cancer. Persistent disparities relative to global levels, elevated male burdens, and aging demographics highlight the urgency for prioritized interventions targeting high-risk populations.
ObjectiveTo systematically analyze the spatiotemporal distribution characteristics and epidemiological trends of tracheal, bronchus, and lung cancer (TBL) disease burden attributed to air pollution globally and in China and the United States from 1990 to 2021, and to assess the patterns of disease burden changes from 2022 to 2031 based on predictive models, providing a scientific basis for formulating targeted TBL prevention and control strategies. MethodsBased on the Global Burden of Disease (GBD) 2021 database, we analyzed the disease burden data of TBL attributed to air pollution globally and in China and the United States from 1990 to 2021. R Studio 4.3.2 software was used to analyze the corresponding trends and the Bayesian age-period-cohort (BAPC) prediction model was used to predict the status of the disease burden of TBL attributed to air pollution in the world and in China and the United States from 2022 to 2031. ResultsIn 2021, China had the highest number of deaths and disability-adjusted life years attributed to air pollution (211 400 patients and 4.8947 million person-years), followed by the United States (6 000 patients and 124 300 person-years). The age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life years rate (ASDR) of TBL due to air pollution in the world and in China and the United States showed a decreasing trend. From 1990 to 2021, the ASMR and ASDR of TBL in China due to air pollution were much higher than those in the United States and the global average. In terms of gender, from 1990 to 2021, the disease burden of male patients with TBL attributed to air pollution was much higher than that of female patients. The BAPC prediction model showed that from 2022 to 2031, the ASMR and ASDR of TBL attributed to air pollution showed an upward trend globally, while they showed a downward trend in China and the United States. ConclusionOver the past 30 years, the air pollution-related TBL disease burden in the world and in China and the United States has continued to decline, but China's disease burden is still significantly higher than the global average. The disease burden in men far exceeds that in women, with men and the population aged ≥50 years being high-risk groups. In the future, the global disease trend may reverse and rise, while China and the United States are expected to continuously decline. However, precise prevention and control for high-risk groups remains a key challenge.
Objective To explore the long-term trends and epidemiological characteristics of the disease burden of tetanus in China over the past 30 years and to predict its disease burden in 2050, in order to comprehensively assess the overall disease burden of tetanus in China. Methods Leveraging the methods and findings of the Global Burden of Disease Study 2021, we provided a detailed description of the disease burden of tetanus in China based on key indicators such as prevalence, incidence, mortality, disability-adjusted life years, years lived with disability, and years of life lost due to premature mortality. Joinpoint regression analysis, age-period-cohort analysis, decomposition analysis, and Bayesian age-period-cohort models were employed to further elucidate the epidemiological characteristics of tetanus and predict its disease burden in China by 2050. Results From 1990 to 2021, the overall disease burden of tetanus in China exhibited a significant year-by-year decline. The primary demographic group bearing the burden of tetanus in China had gradually shifted from newborns to middle-aged and elderly individuals, with males being more affected than females. Decomposition analysis indicated that epidemiological change was a significant factor contributing to tetanus in China, while the impacts of population and aging were relatively minor. According to predictions from the Bayesian age-period-cohort model, by 2050, only the prevalence rate was expected to slightly increase, while all other indicators were projected to decline and remain at low levels. Conclusion The disease burden of tetanus in China decreased from 1990 to 2021. In subsequent prevention efforts, newborns and middle-aged and elderly individuals should be prioritized as targets for prevention and control to maintain the disease burden of tetanus at a low level.
ObjectiveTo analyze the current status and trends of the disease burden of knee osteoarthritis (KOA) in China from 1990 to 2023, and to examine the epidemiological characteristics of age, gender differences, and attribution to high body mass index (BMI), in order to provide a basis for formulating prevention and treatment strategies to reduce the disease burden of KOA in China. Methods Based on the 2023 Global Burden of Disease Study (GBD) database, data on the number, rate, and age-standardized rate of incidence, prevalence, disability-adjusted life years (DALYs) for KOA, and DALYs for KOA attributable to high BMI in the Chinese population from 1990 to 2023 were integrated. The Joinpoint 5.4.0.0 software was used to analyze the age and gender differences in KOA and the epidemiological characteristics attributable to high BMI. Results The standardized incidence, prevalence, and DALYs rates of KOA in China in 2023 increased by 6.46%, 6.43%, and 6.93%, respectively, compared with 1990. In terms of age, the disease burden of KOA in China was lowest in the age group of 30-34 years, with the highest incidence rate in the age group of 50-54 years, whereas the prevalence rate and DALYs rate continued to increase with age, and both were highest in the age group of ≥70 years. In terms of gender, all disease burden standardized rate indicators were higher in females than in males, and the difference widened with age. The rate of BMI-attributable DALYs increased at an annual average rate of 1.57% (95%CI: 1.55, 1.59) from 1990 to 2023, again with significant age and gender differences. ConclusionThe continued growth of the KOA disease burden and significant population differences characterizing China call for focused attention on the female middle-aged and elderly population, enhanced weight management, and implementation of targeted preventive and control measures.
Objective?To estimate the population attributable disease burden (PAD) of low bone mineral density (LBMD) related fractures (fragility fractures) among Chinese people over 50 years old from 1990 to 2023, using data from the Global Burden of Disease Study 2023 (GBD 2023), and to provide evidence for prevention strategies and health resource allocation. Methods? Based on the GBD 2023, the LBMD summary exposure values (SEV), fracture incidence, years lived with disability (YLDs), and LBMD-related falls YLDs of Chinese people over 50 years old from 1990 to 2023 were extracted. PAD was calculated with population attributable fraction (PAF), and an entropy-weight method was applied to evaluate the contribution of individual fracture sites. Temporal trends and sex differences were examined with Joinpoint regression. Results?From 1990 to 2023, the age-standardized SEV of LBMD in people over 50 years old showed an overall decline [average annual percent change (AAPC)=?0.564%]. Age-standardized fracture incidence, fracture YLDs rate, and LBMD-related falls YLDs rate all exhibited W-shaped upward trends (AAPC=1.045%, 0.296%, and 0.724%, respectively). PAF-based estimates indicated that LBMD-attributable fracture incidence likewise increased in a “W-shaped” manner (AAPC=0.558%), whereas the corresponding YLDs rate showed an overall W-shaped decline (AAPC=?0.193%). In international comparison, China and the global average displayed broadly concordant directions of change, with greater volatility in China and a progressive narrowing of the gap after 2015. Regarding sex differences, fracture YLDs rates were consistently higher in the males, whereas the other burden indicators were higher in the females; the temporal patterns were similar in both sexes. Entropy weight method identified hip fractures as contributing most to incidence (weight 0.133), and pelvic fractures as the largest contributor to YLDs rate (weight 0.115). ConclusionSince 1990, the LBMD attributable fracture burden in China’s older population has risen, with female and hip or pelvic fractures bearing the heaviest load. Strengthened osteoporosis screening, improved insurance coverage, and targeted health education are urgently needed to curb further increases in disease burden.