TL;DR
From 1990 to 2021, Iran saw nearly a twofold increase in new GC instances; however, the age-standardized incidence rate (ASIR) significantly fell, and the most significant decreases were observed in the northwestern provinces and among females.
Objectives To comprehensively assess the gastric cancer burden in China over the past three decades and analyze its epidemiological trends to inform control strategies. Study design This was a population-based observational study that systematically evaluated the burden of gastric cancer in China from 1990 to 2023, utilizing data from the Global Burden of Disease (GBD) 2023 study. Methods We evaluated gastric cancer burden metrics from GBD 2023, including incidence, mortality, YLLs, YLDs, and DALYs. Joinpoint regression and age-period-cohort modeling were employed to analyze trends and epidemiological characteristics. Results Between 1990 and 2023, the age-standardized incidence rate decreased from 54.23 to 25.04 per 100,000 , and mortality decreased from 50.93 to 16.62 per 100,000. Joinpoint analysis showed an average annual percentage change of -2.8% in incidence, with a significant trend reversal in females during 2020-2023. Age-period-cohort analysis revealed peak risk at 65-69 years and lower risk in recent birth cohorts. Conclusions While China has achieved substantial reductions in gastric cancer burden over 34 years, emerging challenges include trend reversals in females and persistent sex disparities, necessitating targeted prevention strategies.
Background Pancreatic cancer (PC) poses a significant public health challenge in China because of high mortality and increasing incidence, necessitating an analysis of its burden from 1990 to 2023 to inform future prevention. Methods Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023, we estimated absolute numbers, age-standardized rates (ASRs), and age-stratified crude rates. Joinpoint regression was employed to calculate average annual percentage changes (AAPCs). We quantified the burden attributable to specific risk factors and conducted a segmented analysis to compare trends between the pre-pandemic and pandemic periods. All estimates are presented with 95% uncertainty interval (UI). Results In 2023, China was estimated to have 118,381 incident PC cases (95% UI 103,773-135,339), 114,949 deaths (95% UI 101,214-131,619), 102,845 prevalent cases (95% UI 89,758-117,757), and 2,765,626 DALYs (95% UI 2,455,494-3,137,032). The age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized disability-adjusted life year rate (ASDR) remained stable. The age-standardized prevalence rate (ASPR) increased slightly (AAPC 0.38%, 95% CI 0.06 to 0.70). The burden was consistently higher in males than in females. Age-specific analysis highlighted rising incidence rates in both 15–49 years and ≥75 years age groups. In 2023, high fasting plasma glucose (HFPG) accounted for a higher attributable burden than smoking. Pandemic-era sensitivity analysis suggested a possible change in the direction of ASIR and ASMR trends after 2019, but the observed post-2019 increases were not statistically significant and require further validation. Conclusion The increasing absolute burden was mainly associated with population aging, while risk-attributable analysis suggested a growing contribution of metabolic factors. Prevention strategies should integrate metabolic management to tackle the dual challenges of an aging society and emerging risks in younger people.
The trends revealed a significant increase in incidence across all macro-regions, particularly in the North and South regions, whereas mortality rates remained stable, whereas mortality rates remained stable in the North and South regions.
Background Childhood kidney cancer (KC), the third most prevalent pediatric solid malignancy, remains incompletely characterized in terms of epidemiological patterns and health inequities. This study aimed to analyze global trends, inequalities, and future burden of childhood KC from 1990 to 2021. Methods Data on incidence, mortality, and disability-adjusted life years (DALYs) of KC among children aged 0–14 years were obtained from the Global Burden of Disease study 2021. Data from 1990 to 2021 were comprehensively analyzed by sex, location, age, and socio-demographic index (SDI), incorporating estimated annual percentage change, joinpoint regression, slope index of inequality and concentration index for inequality assessment, and Bayesian age-period-cohort forecasting. Results In 2021, there were 9,576 incident cases, 3,063 deaths, and 268,049 DALYs globally due to childhood KC, with corresponding age-standardized incidence rate (ASIR), mortality rate (ASMR), and disability-adjusted life years rate (ASDR) of 0.48, 0.15, and 13.32, respectively. From 1990 to 2021, the global burden of childhood KC declined overall. Joinpoint regression identified a steeper decline in the most recent period, with the ASIR decreasing by 4.87% per year from 2018 to 2021 and the ASMR and ASDR decreasing by 5.12% and 5.23% per year, respectively, from 2019 to 2021. The decline in disease burden has been more pronounced in females than in males. The burden of childhood KC was mainly concentrated among children aged 0–4 years, whose age-specific incidence, mortality, and DALY rates were generally higher than those among children aged 5–9 years and 10–14 years. While no significant association was observed between SDI and ASIR, SDI exhibited a negative correlation with ASMR and ASDR. Inequality metrics showed that childhood KC mortality and DALYs were disproportionately concentrated in lower-SDI countries, and these disparities widened over time. Projections indicate continued declines in incidence and mortality for both sexes over the next 15 years. Conclusions Over the past three decades, the burden of childhood KC significantly reduced, yet the rising incidence in lower-income regions warrants attention. Health inequities, characterized by a disproportionate concentration of the disease burden in low-SDI countries, have intensified. Enhanced understanding of pediatric KC epidemiology may aid in its prevention and management.
Divergent trends between incidence and mortality likely reflect reduced detection during the pandemic rather than true changes in disease burden, and highlight the importance of maintaining continuity of cancer screening and diagnostic services during health-system disruptions.