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.
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.
Recently, sponsored by the Science Popularization Department of the China Anti Cancer Association, jointly organized by the Rehabilitation Branch of the China Anti Cancer Association and the Mijian Digital Cancer Patient Course Management Platform, and co-organized by the Science Popularization Special Committee of the China Anti Cancer Association, The "2022 White Paper on the Quality of Life of Chinese Lung Cancer Patients" has been officially released (herein after referred to as the "White Paper"), which mainly elaborates on the basic situation of Chinese lung cancer patients and the medical, social, and economic impacts caused by the disease. This article interprets the White Paper in order to help the public understand the real situation of lung cancer patients and provide important empirical evidence and valuable insights for the diagnosis, treatment, and rehabilitation of lung cancer in China.
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.
ObjectiveTo systematically analyze the temporal trends of pancreatic cancer burden in globally and China from 1990 to 2021 using the Global Burden of Disease Study 2021 (GBD 2021) database and predict disease burden changes over the next 15 years. MethodsThe data of the incidence, death, disability-adjusted life years (DALYs) and age-standardized rate data of pancreatic cancer in GBD 2021 were extracted to analyze the epidemic status. Joinpoint regression models were employed to calculate average annual percentage changes (AAPC) and identify trend transitions. An auto-regressive integrated moving average (ARIMA) model was utilized to predict disease burden from 2022 to 2036. ResultsIn 2021, the global age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR) for pancreatic cancer were 5.96 (per 100 000), 5.95 (per 100 000), and 130.33 (per 100 000). Corresponding rates in China were 5.64 (per 100 000), 5.72 (per 100 000), and 137.23 (per 100 000). From 1990 to 2021, the average annual growth rate of ASIR (AAPC=0.72%), ASMR (AAPC=0.56%) and ASDR (AAPC=0.36%) were significantly higher than the global rate (ASIR: AAPC=0.27%; ASMR: AAPC=0.16%; ASDR: AAPC=0.02%). Age-specific analysis showed that the crude incidence, mortality, and DALYs rates for the population aged ≥60 years old in China (AAPC: 0.37%–1.55%) were all increasing at a higher rate than the same age group globally (AAPC: –0.02%–0.77%). Sex differences were significant, with greater disease burden in men than in women. ARIMA model predicted that Chinese and global ASIR and ASMR will continue to rise by 2036, with persistently steeper increases in males than females. ConclusionThe disease burden of pancreatic cancer in China is growing faster than that of the world, so early screening and prevention of pancreatic cancer should be strengthened.
Objective To analyze the trends in the burden of osteoporosis-related disease in China and worldwide from 1990 to 2023, and to further estimate the attributable burden of key determinants, so as to inform the formulation of prevention and control strategies for osteoporosis. Methods Based on the 2023 Global Burden of Disease (GBD) study database, the data on mortality, disability adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) attributable to low bone mineral density (LBMD) among individuals aged 40 years and older in China and globally from 1990 to 2023 were collected. Metrics focused primarily on age-standardized rates, and data were stratified by age group and gender. Joinpoint regression models were employed to estimate the annual percentage change (APC) and average annual percentage change (AAPC) to assess trends in the burden. An age-period-cohort analysis was conducted to characterize age, period, and birth cohort effects. Additionally, the Das Gupta decomposition method was applied to decompose the changes in the number of LBMD-attributable deaths in China from 1990 to 2023, quantifying the contributions of population growth, population aging, and changes in age-specific mortality rates. Results From 1990 to 2023, DALYs rates and YLLs rates attributable to LBMD showed an overall decreasing trend in both China and the world. DALYs rates declined from 311.54/100 000 to 268.55/100 000 in China and from 288.85/100 000 to 265.11/100 000 globally. In China, the YLDs rate increased from 170.42/100 000 to 197.91/100 000, whereas the global YLDs rate remained relatively stable. The burden of LBMD-related disease was consistently higher in women than in men. Falls were the leading cause of LBMD-attributable deaths and DALYs, followed by road injuries, while other types of injuries accounted for a relatively small proportion. Gupta decomposition showed that the number of LBMD-attributable deaths increased by 62.88% in men and 138.25% in women, primarily driven by population growth (contributing 108.33% in men and 138.98% in women) and population aging (contributing 42.26% in men and 70.59% in women), while changes in age-specific mortality rates offset the increase by 87.72% in men and 71.32% in women. Conclusion From 1990 to 2023, the mortality burden attributable to LBMD in China has decreased overall, but the disability burden has continued to rise, suggesting a shift in osteoporosis-related disease burden from lethality toward disability. Falls are the main attributable cause, and the burden is particularly high among older adults and women. Strengthening bone mineral density screening, fall prevention, and secondary fracture prevention and management is essential to reduce the long-term health losses associated with osteoporosis.
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.
Objective To analyze the changing trends and attributable risk factors of low back pain disease burden in Chinese population from 1990 to 2023, and to predict the related disease burden of low back pain in 2030. MethodsBased on the 2023 Global Burden of Disease (GBD) study database, the incidence, prevalence, years lived with disability (YLDs), and characteristics and trends of risk factors among Chinese individuals with low back pain from 1990 to 2023 were analyzed, the age and gender differences in disease burden were assessed, and the disease burden in 2030 was jointly predicted by autoregressive integrated moving average model and age-period-cohort model. Results From 1990 to 2023, the number of incident cases, the number of prevalent cases, and YLDs in Chinese low back pain population showed an upward trend, from 29.989 1 million cases, 68.636 3 million cases, and 7.732 4 million person-years to 41.383 6 million cases, 95.324 0 million cases, and 10.635 9 million person-years, respectively. The incidence rate, prevalence rate, and YLDs rate increased from 2 543.31 per 100 000, 5 820.89 per 100 000, and 655.77 per 100 000 to 2 892.65 per 100 000, 6 663.01 per 100 000, and 743.43 per 100 000 respectively. However, the age-standardized incidence rate, age-standardized prevalence rate, and age-standardized YLDs rate showed a downward trend, from 2 859.73 per 100 000, 6 636.60 per 100 000, and 740.83 per 100 000 to 2 164.80 per 100 000, 4 929.78 per 100 000, and 551.92 per 100 000, respectively. The burden of low back pain in women was significantly higher than that in men and increased with age (peak at 50 to 59 years old). Attribution analysis showed that smoking, occupational factors, and high body mass index (BMI) were the main factors leading to the increase of YLDs, and there was a gender difference. The tow model showed that the age-standardized incidence rate, the age-standardized prevalence rate, and the age-standardized YLDs rate for low back pain would decrease year by year from 2023 to 2030. ConclusionThe disease burden of low back pain in China shows that from 1990 to 2023, the burden of low back pain in the Chinese population has been increasing year by year. Smoking, occupational factors, and high BMI are the main risk factors. Interventions targeting these controllable risk factors are crucial for reducing the disease burden. It is expected that by 2030, the disease burden of low back pain is expected to decrease, although the absolute burden will remain high. Greater attention should be paid to the middle-aged and elderly population, especially the female population, who bear a heavier disease burden. Targeted interventions, such as weight control and smoking cessation management, should be actively implemented against these controllable risk factors.
Objective To analyze the current status and temporal trends of the disease burden of osteoarthritis (OA) in China from 1990 to 2023, stratified by anatomical sites (knee, hip, hand, and other), utilizing data from the 2023 Global Burden of Disease (GBD) study, and to explore the site-specific heterogeneity of disease burden attributed to high body mass index (BMI), providing a scientific basis for formulating precision prevention and control strategies.Methods Based on the GBD 2023 database, data on the incidence, prevalence, and years lived with disability (YLDs), as well as their corresponding age-standardized rates of OA in China from 1990 to 2023, were collected and stratified by gender, age, and anatomical site (knee, hip, hand, and other). A log-linear regression model was employed to calculate the estimated annual percentage change (EAPC) to analyze temporal trends. Additionally, the population attributable fraction (PAF) was used to quantify the contribution of high BMI to OA across different sites and to analyze the heterogeneity of this attribution. Results In 2023, the disease burden of OA in China increased. In terms of anatomical distribution, knee OA constituted the heaviest burden, with 115.0032 million prevalent cases, accounting for approximately 65.78% of the total. Attribution analysis showed that knee OA was slightly more affected by high BMI than hip OA, and the PAF increased significantly over time. In 2023, the PAFs for knee and hip OA in females (29.49% and 28.57%, respectively) were substantially higher than those in 1990 (19.10% and 18.38%). A similar upward trend was observed in males (26.65% and 25.92% in 2023). Regarding attribution differences, female PAF levels were consistently higher than those of males across all years and sites. Hand OA exhibited the fastest growth rate, with the EAPC of its age-standardized YLDs rate reaching 1.64%, far exceeding that of knee OA (0.43%). Demographically, all burden indicators were higher in females than in males. Hand OA demonstrated an intergenerational cumulative effect. The difference in YLDs rates between 2023 and 1990 widened with age, reaching 123.29 per 100 000 in the >95 years old group, highlighting the severe challenges posed by population aging. Conclusion From 1990 to 2023, the disease burden of OA in China continued to rise. Knee OA remains the heaviest burden category and is significantly driven by high BMI, whereas hand OA shows the fastest growth trend. Prevention and control strategies should focus on weight management for knee and hip OA, while prioritizing the prevention and care of hand OA in the elderly population.
ObjectiveTo analyze and compare the disease burden, trends, and influencing factors of lung cancer in adolescents and young adults (AYAs) in China and globally from 1990 to 2021, providing a reference for the prevention and treatment of lung cancer in China. MethodsIndicators of lung cancer disease burden in different genders and age groups in 204 countries or regions from 1990 to 2021 were retrieved and standardized from GBD 2021 database. The Joinpoint regression model was used to calculate the average annual percentage change (AAPC) of the standardized rates of lung cancer in AYAs in China and globally from 1990 to 2021; changes in incidence, mortality, and disability-adjusted life years (DALYs) rates due to population growth, aging, and epidemiological changes were analyzed; differences in lung cancer disease burden in AYAs in different socio-demographic index (SDI) regions were analyzed; and the influencing factors of lung cancer in AYAs in China and globally were explored. ResultsFrom 1990 to 2021, the age-standardized incidence rate (ASIR) (AAPC=?0.18%, P<0.001), age-standardized mortality rate (ASMR) (AAPC=?0.62%, P<0.001), and age-standardized DALYs rate (AAPC=?0.62%, P<0.001) of lung cancer in AYAs in China showed a downward trend, consistent with the global trend, but the decline in China was relatively small. During this period, the age-standardized rates of various indicators of lung cancer in males in China and globally were higher than those in females, and the burden of lung cancer in Chinese males was heavier. However, due to the significant downward trend in males, the gap in lung cancer burden between males and females was narrowing. At the same time, from 2013 to 2021, the ASIR [annual percent change (APC)=2.01%, P<0.001], ASMR (APC=1.46%, P<0.001), and standardized DALYs rate (APC=1.46%, P<0.001) in China showed an upward trend. From 1990 to 2021, among the main influencing factors for the incidence, mortality, and DALYs rates of lung cancer in Chinese AYAs, the contribution of aging was upward-pushing, while the increase in global indicators was mainly attributed to population growth. The global burden of lung cancer in AYAs was overly concentrated in high SDI regions. Although the gap in lung cancer burden between high SDI and low SDI regions was narrowing, it remained widespread. Globally, smoking, environmental PM2.5, insufficient fruit intake, second-hand smoke, and indoor air pollution were prominent risk factors. ConclusionFrom 1990 to 2021, the global and Chinese AYAs lung cancer incidence and mortality rates generally show a downward trend, but the female lung cancer burden relatively increases, especially in young women without a history of smoking. Continued efforts are needed to reduce the burden of lung cancer in AYAs, especially the specific risk for young women.