ObjectiveTo analyze the latest epidemiological status of breast cancer in China, trends in morbidity and mortality from 1990 to 2019, and related prognostic risk factors.MethodsData on incidence and mortality of Chinese female breast cancer, their related age-standardized rates (ASRs) from 1990 to 2019, and attributable risk factors were obtained from the Global Burden of Disease (GBD) database, and data on disability-adjusted life years (DALYs) of 34 provinces in China were obtained from literature. Joinpoint regression analysis was used to analyze the trends of ASRs. The exposure levels of each attributable risk factor and the increased cancer burden were analyzed.ResultsThe incidence of breast cancer in Chinese females increased annually, from 17.07/100 000 in 1990 to 35.61/100 000 in 2019, while the mortality rate initially increased and decreased, and then exhibited an upward trend after 2016 and there was no obvious variation from 1990 (9.16/100 000) to 2019 (9.02/100 000). Among the 34 provinces of China, Shandong Province had the most serious breast cancer burden, while Macao Special Administrative Region had the lowest. Among the seven prognostic risk factors, high body mass index (BMI) contributed the most to the breast cancer burden and the exposure risk of a diet high in red meat had shown a significant increasing trend in the past 30 years. Therefore, the disease burden caused by a high red meat diet would be increasing.ConclusionsThe incidence rate of breast cancer in Chinese females is increasing. With the development of social economy and the change of people’s dietary habits, the breast cancer burden in China trends to become heavier and heavier. Therefore, it is necessary to conduct the "three early" prevention and treatment and advocate healthy and reasonable diet and living habits to reduce the burden of breast cancer to improve prognosis and quality of life.
Objective To analyze the spatiotemporal trends in hepatitis B-related mortality and disability-adjusted life years (DALYs) attributable to high BMI at the global, regional, and national levels. Methods We extracted data on hepatitis B-related mortality numbers, DALYs, age-standardised mortality rates (ASMR), and age-standardised DALY rates (ASDR) attributed to high BMI from the GBD 2021 database for the period 1990-2021, stratified by gender, age, country, and social demographic index (SDI). Time trends were assessed using estimated annual percentage change (EAPC), and decomposition analysis and frontier analysis were employed to identify the drivers of burden changes and leading countries. Inequality indicators (inequality slope index SII and concentration index CI) were used to measure health disparities across SDI levels, and the Bayesian Age Period Cohort Model (BAPC) was applied to predict disease trends up to 2050. Results The global burden of hepatitis B disease attributable to high BMI continues to rise. In 2021, the number of DALYs reached 499 900 (four times that of 1990), and the number of deaths was five times that of 1990. The burden and rate of increase were most pronounced in Asia: in 2021, East Asia recorded 7 919.70 deaths (95%UI 2 984.05 to 14 386.39) and 257 954.31 DALYs (95%UI 97 807.17 to 482 232.54), ranked highest among the 21 GBD regions; From 1990 to 2021, South Asia recorded the fastest increase in ASMR (EAPC=4.99, 95%CI 4.83 to 5.16) and the highest growth rate in ASDR (EAPC=4.92, 95%CI 4.74 to 5.10); at the national level, China and the United States had the heaviest burden. Countries with medium SDI had the highest burden, peaking at an SDI of 0.65. Global and regional decomposition analyses indicate that epidemiological changes are the primary drivers of the increased burden. The CI and SII values derived from inequality analyses of ASDR and ASMR have both increased, indicating worsening health inequalities. Frontier analysis further confirmed that certain countries, such as Tonga and Mongolia, bear a significantly higher burden than expected for their developmental level, demonstrating marked disparities in disease burden across nations. The BAPC model predicts that the burden attributable to high BMI will continue to rise in the absence of interventions. Conclusion High BMI has become an important risk factor for hepatitis B-related diseases globally, with the burden particularly pronounced in Asian regions and middle-income countries. Health inequalities must not be overlooked. Precise interventions should be implemented based on regional, gender, and age differences.
Objective The aim of this study was to describe the trends in the burden of breast cancer in women of all ages in China from 1990 to 2021, compare it with the global burden of breast cancer in women, and predict the burden of disease in the next 15 years. Methods Based on the open data of the Global Burden of Disease (GBD) in 2021, the incidence, prevalence, mortality and disability-adjusted life years (DALYs) of breast cancer among women in China and the world were analyzed. Joinpoint was used to calculate annual percentage change (APC) and average annual percentage change (AAPC) to reflect the changing trend of disease burden. An autoregressive composite moving average (ARIMA) model was used to predict the disease burden of breast cancer in women from 2022 to 2036. Results From 1990 to 2021, the age-standardized incidence rate (ASIR) and age-standardized prevalence rate (ASPR) of female breast cancer in China showed an increasing trend, with an average annual increase of 2.400 7% and 2.334 8%, respectively, and the age-standardized mortality rate (ASMR) and age-standardized DALYs rate (ASDR) showed a decreasing trend. The average annual decline was 0.290 0% and 0.198 3%, respectively. Meanwhile, ASIR and ASPR of global female breast cancer also showed an increasing trend, with an average annual increase of 0.474 9% and 0.3445 2% respectively, while ASMR and ASDR showed a decreasing trend, with an average annual decrease of 0.425 2% and 0.321 8% respectively. Among them, there were differences in the impact of age on the burden of female breast cancer. The peak of ASIR and ASPR appeared in the age group of 50 to 69 years old, and generally increased with the increase of age, and then decreased when reaching the peak. ASMR and ASDR increased with age. In the following 15 years, the prevalence of breast cancer in women in China and globally showed an increasing trend, while the mortality rate showed a decreasing trend. Conclusion From the analysis of the disease burden from 1990 to 2021, breast cancer has a huge harm to women, and the incidence of young and middle-aged women is high, the death rate of middle-aged and elderly women is high, and the disease time is long, which brings a heavy psychological and economic burden to patients and society. From the trend forecast for the next 15 years, the prevalence of breast cancer in women in China and the world will increase, while the mortality rate will decrease slightly, but the decrease is not large, which will bring huge public health challenges and put higher requirements on the prevention and control of the disease. To reduce the disease burden of breast cancer, comprehensive strategies for disease control are needed, including prevention of risk factors at the primary care level, screening of at-risk populations, and quality medical services.
Objective Based on the Global Burden of Disease (GBD) 2021 database, to analyze the dynamic trends and regional differences in the burden of disease of premenstrual syndrome (PMS) among women of childbearing age globally from 1990 to 2021, and to provide an evidence-based basis for optimizing the allocation of reproductive health resources. Methods Data on the prevalence, incidence and disability-adjusted life years (DALYs) of PMS in 204 countries and regions in the GBD 2021 database were extracted and combined with sociodemographic indices (SDI) to assess the temporal trends and spatial distribution characteristics of the burden of disease using the annual average percentage change (AAPC). Results The global prevalence, incidence and DALYs of PMS in women of reproductive age in 2021 were 45 666.32/100 000, 11 935.05/100 000 and 381.11/100 000, respectively. From 1990 to 2021, the prevalence (AAPC=0.05%) and DALYs (AAPC=0.05%) showed a slight upward trend and a slight decrease in prevalence (AAPC=?0.06%). Prevalence and DALYs increased at a higher rate in low SDI regions, and the fastest rate of increase was seen in high-income North America in high-SDI regions. Conclusion The PMS disease burden is unevenly distributed globally and is influenced by a variety of factors, including the level of social development. In the future, it is necessary to combine multidisciplinary intervention strategies and incorporate prospective data to improve prediction models to support the development of global female reproductive health policies.
