Browsing by Author "Catherine Bisignano"

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Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life Years for 29 Cancer Groups From 2010 to 2019 A Systematic Analysis for the Global Burden of Disease Study 2019
(American Medical Association, 2022) Jonathan M. Kocarnik; Kelly Compton; Frances E. Dean; Weijia Fu; Brian L. Gaw; James D. Harvey; Hannah Jacqueline Henrikson; Dan Lu; Alyssa Pennini; Rixing Xu; Emad Ababneh; Mohsen Abbasi-Kangevari; Hedayat Abbastabar; Sherief M. Abd-Elsalam; Amir Abdoli; Aidin Abedi; Hassan Abidi; Hassan Abolhassani; Isaac Akinkunmi Adedeji; Qorinah Estiningtyas Sakilah Adnani; Shailesh M. Advani; Muhammad Sohail Afzal; Mohammad Aghaali; Bright Opoku Ahinkorah; Sajjad Ahmad; Tauseef Ahmad; Ali Ahmadi; Sepideh Ahmadi; Tarik Ahmed Rashid; Yusra Ahmed Salih; Gizachew Taddesse Akalu; Addis Aklilu; Tayyaba Akram; Chisom Joyqueenet Akunna; Hanadi Al Hamad; Fares Alahdab; Ziyad Al-Aly; Saqib Ali; Yousef Alimohamadi; Vahid Alipour; Syed Mohamed Aljunid; Motasem Alkhayyat; Amir Almasi-Hashiani; Nihad A. Almasri; Sadeq Ali Ali Al-Maweri; Sami Almustanyir; Nivaldo Alonso; Nelson Alvis-Guzman; Hubert Amu; Etsay Woldu Anbesu; Robert Ancuceanu; Fereshteh Ansari; Alireza Ansari-Moghaddam; Maxwell Hubert Antwi; Davood Anvari; Anayochukwu Edward Anyasodor; Muhammad Aqeel; Jalal Arabloo; Morteza Arab-Zozani; Olatunde Aremu; Hany Ariffin; Timur Aripov; Muhammad Arshad; Al Artaman; Judie Arulappan; Zatollah Asemi; Mohammad Asghari Jafarabadi; Tahira Ashraf; Prince Atorkey; Avinash Aujayeb; Marcel Ausloos; Atalel Fentahun Awedew; Beatriz Paulina Ayala Quintanilla; Temesgen Ayenew; Mohammed A. Azab; Sina Azadnajafabad; Amirhossein Azari Jafari; Ghasem Azarian; Ahmed Y. Azzam; Ashish D. Badiye; Saeed Bahadory; Atif Amin Baig; Jennifer L. Baker; Senthilkumar Balakrishnan; Maciej Banach; Till Winfried Bärnighausen; Francesco Barone-Adesi; Fabio Barra; Amadou Barrow; Masoud Behzadifar; Uzma Iqbal Belgaumi; Woldesellassie M. Mequanint Bezabhe; Yihienew Mequanint Bezabih; Devidas S. Bhagat; Akshaya Srikanth Bhagavathula; Nikha Bhardwaj; Pankaj Bhardwaj; Sonu Bhaskar; Krittika Bhattacharyya; Vijayalakshmi S. Bhojaraja; Sadia Bibi; Ali Bijani; Antonio Biondi; Catherine Bisignano; Tone Bjorge; Archie Bleyer; Oleg Blyuss; Obasanjo Afolabi Bolarinwa; Srinivasa Rao Bolla; Dejana Braithwaite; Amanpreet Brar; Hermann Brenner; Maria Teresa Bustamante-Teixeira; Nadeem Shafique Butt; Zahid A. Butt; Florentino Luciano Caetano dos Santos; Yin Cao; Giulia Carreras; Ferrán Catalá-López; Francieli Cembranel; Ester Cerin; Achille Cernigliaro; Raja Chandra Chakinala; Soosanna Kumary Chattu; Vijay Kumar Chattu; Pankaj Chaturvedi; Odgerel Chimed-Ochir; Daniel Youngwhan Cho; Devasahayam J. Christopher; Dinh-Toi Chu; Michael T. Chung; Joao Conde; Sanda Cortés; Paolo Angelo Cortesi; Vera Marisa Costa; Amanda Ramos Cunha; Omid Dadras; Amare Belachew Dagnew; Saad M.A. Dahlawi; Xiaochen Dai; Lalit Dandona; Rakhi Dandona; Aso Mohammad Darwesh; José das Neves; Fernando Pio De la Hoz; Asmamaw Bizuneh Demis; Edgar Denova-Gutiérrez; Deepak Dhamnetiya; Mandira Lamichhane Dhimal; Meghnath Dhimal; Mostafa Dianatinasab; Daniel Diaz; Shirin Djalalinia; Huyen Phuc Do; Saeid Doaei; Fariba Dorostkar; Francisco Winter dos Santos Figueiredo; Tim Robert Driscoll; Hedyeh Ebrahimi; Sahar Eftekharzadeh; Maha El Tantawi; Hassan El-Abid; Iffat Elbarazi; Hala Rashad Elhabashy; Muhammed Elhadi; Shaimaa I. El-Jaafary; Babak Eshrati; Sharareh Eskandarieh; Firooz Esmaeilzadeh; Arash Etemadi; Sayeh Ezzikouri; Mohammed Faisaluddin; Emerito Jose A. Faraon; Jawad Fares; Farshad Farzadfar; Abdullah Hamid Feroze; Simone Ferrero; Lorenzo Ferro Desideri; Irina Filip; Florian Fischer; James L. Fisher; Masoud Foroutan; Takeshi Fukumoto; Peter Andras Gaal; Mohamed M. Gad; Muktar A. Gadanya; Silvano Gallus; Mariana Gaspar Fonseca; Abera Getachew Obsa; Mansour Ghafourifard; Ahmad Ghashghaee; Nermin Ghith; Maryam Gholamalizadeh; Syed Amir Gilani; Themba G. Ginindza; Abraham Tamirat T. Gizaw; James C. Glasbey; Mahaveer Golechha; Pouya Goleij; Ricardo Santiago Gomez; Sameer Vali Gopalani; Giuseppe Gorini; Houman Goudarzi; Giuseppe Grosso; Mohammed Ibrahim Mohialdeen Gubari; Maximiliano Ribeiro Guerra; Avirup Guha; D. Sanjeeva Gunasekera; Bhawna Gupta; Veer Bala Gupta; Vivek Kumar Gupta; Reyna Alma Gutiérrez; Nima Hafezi-Nejad; Mohammad Rifat Haider; Arvin Haj-Mirzaian; Rabih Halwani; Randah R. Hamadeh; Sajid Hameed; Samer Hamidi; Asif Hanif; Shafiul Haque; Netanja I. Harlianto; Josep Maria Haro; Ahmed I. Hasaballah; Soheil Hassanipour; Roderick J. Hay; Simon I. Hay; Khezar Hayat; Golnaz Heidari; Mohammad Heidari; Brenda Yuliana Herrera-Serna; Claudiu Herteliu; Kamal Hezam; Ramesh Holla; Md Mahbub Hossain; Mohammad Bellal Hossain Hossain; Mohammad-Salar Hosseini; Mostafa Hosseini; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Mowafa Househ; Mohamed Hsairi; Junjie Huang; Fernando N. Hugo; Rabia Hussain; Nawfal R. Hussein; Bing-Fang Hwang; Ivo Iavicoli; Segun Emmanuel Ibitoye; Fidelia Ida; Kevin S. Ikuta; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Lalu Muhammad Irham; Jessica Y. Islam; Rakibul M. Islam; Sheikh Mohammed Shariful Islam; Nahlah Elkudssiah Ismail; Gaetano Isola; Masao Iwagami; Louis Jacob; Vardhmaan Jain; Mihajlo B. Jakovljevic; Tahereh Javaheri; Shubha Jayaram; Seyed Behzad Jazayeri; Ravi Prakash Jha; Jost B. Jonas; Tamas Joo; Nitin Joseph; Farahnaz Joukar; Mikk Jürisson; Ali Kabir; Danial Kahrizi; Leila R. Kalankesh; Rohollah Kalhor; Feroze Kaliyadan; Yogeshwar Kalkonde; Ashwin Kamath; Nawzad Kameran Al-Salihi; Himal Kandel; Neeti Kapoor; André Karch; Ayele Semachew Kasa; Srinivasa Vittal Katikireddi; Joonas H. Kauppila; Taras Kavetskyy; Sewnet Adem Kebede; Pedram Keshavarz; Mohammad Keykhaei; Yousef Saleh Khader; Rovshan Khalilov; Gulfaraz Khan; Maseer Khan; Md Nuruzzaman Khan; Moien A.B. Khan; Young-Ho Khang; Amir M. Khater; Maryam Khayamzadeh; Gyu Ri Kim; Yun Jin Kim; Adnan Kisa; Sezer Kisa; Katarzyna Kissimova-Skarbek; Jacek A. Kopec; Rajasekaran Koteeswaran; Parvaiz A. Koul; Sindhura Lakshmi Koulmane Laxminarayana; Ai Koyanagi; Burcu Kucuk Bicer; Nuworza Kugbey; G. Anil Kumar; Narinder Kumar; Nithin Kumar; Om P. Kurmi; Tezer Kutluk; Carlo La Vecchia; Faris Hasan Lami; Iván Landires; Paolo Lauriola; Sang-Woong Lee; Shaun Wen Huey Lee; Wei-Chen Lee; Yo Han Lee; James Leigh; Elvynna Leong; Jiarui Li; Ming-Chieh Li; Xuefeng Liu; Joana A. Loureiro; Raimundas Lunevicius; Muhammed Magdy Abd El Razek; Azeem Majeed; Alaa Makki; Shilpa Male; Ahmad Azam Malik; Mohammad Ali Mansournia; Santi Martini; Seyedeh Zahra Masoumi; Prashant Mathur; Martin McKee; Ravi Mehrotra; Walter Mendoza; Ritesh G. Menezes; Endalkachew Worku Mengesha; Mohamed Kamal Mesregah; Tomislav Mestrovic; Junmei Miao Jonasson; Bartosz Miazgowski; Tomasz Miazgowski; Irmina Maria Michalek; Ted R. Miller; Hamed Mirzaei; Hamid Reza Mirzaei; Sanjeev Misra; Prasanna Mithra; Masoud Moghadaszadeh; Karzan Abdulmuhsin Mohammad; Yousef Mohammad; Mokhtar Mohammadi; Seyyede Momeneh Mohammadi; Abdollah Mohammadian-Hafshejani; Shafiu Mohammed; Nagabhishek Moka; Ali H. Mokdad; Mariam Molokhia; Lorenzo Monasta; Mohammad Ali Moni; Mohammad Amin Moosavi; Yousef Moradi; Paula Moraga; Joana Morgado-Da-Costa; Shane Douglas Morrison; Abbas Mosapour; Sumaira Mubarik; Lillian Mwanri; Ahamarshan Jayaraman Nagarajan; Shankar Prasad Nagaraju; Chie Nagata; Mukhammad David Naimzada; Vinay Nangia; Atta Abbas Naqvi; Sreenivas Narasimha Swamy; Rawlance Ndejjo; Sabina O. Nduaguba; Ionut Negoi; Serban Mircea Negru; Sandhya Neupane Kandel; Cuong Tat Nguyen; Huong Lan Thi Nguyen; Robina Khan Niazi; Chukwudi A. Nnaji; Nurulamin M. Noor; Virginia Nunez-Samudio; Chimezie Igwegbe Nzoputam; Bogdan Oancea; Chimedsuren Ochir; Oluwakemi Ololade Odukoya; Felix Akpojene Ogbo; Andrew T. Olagunju; Babayemi Oluwaseun Olakunde; Emad Omar; Ahmed Omar Bali; Abidemi E. Emmanuel Omonisi; Sokking Ong; Obinna E. Onwujekwe; Hans Orru; Doris V. Ortega-Altamirano; Nikita Otstavnov; Stanislav S. Otstavnov; Mayowa O. Owolabi; Mahesh P A; Jagadish Rao Padubidri; Keyvan Pakshir; Adrian Pana; Demosthenes Panagiotakos; Songhomitra Panda-Jonas; Shahina Pardhan; Eun-Cheol Park; Eun-Kee Park; Fatemeh Pashazadeh Kan; Harsh K. Patel; Jenil R. Patel; Siddhartha Pati; Sanjay M. Pattanshetty; Uttam Paudel; David M. Pereira; Renato B. Pereira; Arokiasamy Perianayagam; Julian David Pillay; Saeed Pirouzpanah; Farhad Pishgar; Indrashis Podder; Maarten J. Postma; Hadi Pourjafar; Akila Prashant; Liliana Preotescu; Mohammad Rabiee; Navid Rabiee; Amir Radfar; Raghu Anekal Radhakrishnan; Venkatraman Radhakrishnan; Ata Rafiee; Fakher Rahim; Shadi Rahimzadeh; Mosiur Rahman; Muhammad Aziz Rahman; Amir Masoud Rahmani; Nazanin Rajai; Aashish Rajesh; Ivo Rakovac; Pradhum Ram; Kiana Ramezanzadeh; Kamal Ranabhat; Priyanga Ranasinghe; Chythra R. Rao; Sowmya J. Rao; Reza Rawassizadeh; Mohammad Sadegh Razeghinia; Andre M.N. Renzaho; Negar Rezaei; Nima Rezaei; Aziz Rezapour; Thomas J. Roberts; Jefferson Antonio Buendia Rodriguez; Peter Rohloff; Michele Romoli; Luca Ronfani; Gholamreza Roshandel; Godfrey M. Rwegerera; S. Manjula; Siamak Sabour; Basema Saddik; Umar Saeed; Amirhossein Sahebkar; Harihar Sahoo; Sana Salehi; Marwa Rashad Salem; Hamideh Salimzadeh; Mehrnoosh Samaei; Abdallah M. Samy; Juan Sanabria; Senthilkumar Sankararaman; Milena M. Santric-Milicevic; Yaeesh Sardiwalla; Arash Sarveazad; Brijesh Sathian; Monika Sawhney; Mete Saylan; Ione Jayce Ceola Schneider; Mario Sekerija; Allen Seylani; Omid Shafaat; Zahra Shaghaghi; Masood Ali Shaikh; Erfan Shamsoddin; Mohammed Shannawaz; Rajesh Sharma; Aziz Sheikh; Sara Sheikhbahaei; Adithi Shetty; Jeevan K. Shetty; Pavanchand H. Shetty; Kenji Shibuya; Reza Shirkoohi; K.M. Shivakumar; Velizar Shivarov; Soraya Siabani; Sudeep K. Siddappa Malleshappa; Diego Augusto Santos Silva; Jasvinder A. Singh; Yitagesu Sintayehu; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Matthew J. Soeberg; Ahmad Sofi-Mahmudi; Houman Sotoudeh; Paschalis Steiropoulos; Kurt Straif; Ranjeeta Subedi; Mu'awiyyah Babale Sufiyan; Iyad Sultan; Saima Sultana; Daniel Sur; Viktória Szerencsés; Miklós Szócska; Rafael Tabarés-Seisdedos; Takahiro Tabuchi; Hooman Tadbiri; Amir Taherkhani; Ken Takahashi; Iman M. Talaat; Ker-Kan Tan; Vivian Y. Tat; Bemnet Amare A. Tedla; Yonas Getaye Tefera; Arash Tehrani-Banihashemi; Mohamad-Hani Temsah; Fisaha Haile Tesfay; Gizachew Assefa Tessema; Rekha Thapar; Aravind Thavamani; Viveksandeep Thoguluva Chandrasekar; Nihal Thomas; Hamid Reza Tohidinik; Mathilde Touvier; Marcos Roberto Tovani-Palone; Eugenio Traini; Bach Xuan Tran; Khanh Bao Tran; Mai Thi Ngoc Tran; Jaya Prasad Tripathy; Biruk Shalmeno Tusa; Irfan Ullah; Saif Ullah; Krishna Kishore Umapathi; Bhaskaran Unnikrishnan; Era Upadhyay; Marco Vacante; Maryam Vaezi; Sahel Valadan Tahbaz; Diana Zuleika Velazquez; Massimiliano Veroux; Francesco S. Violante; Vasily Vlassov; Bay Vo; Victor Volovici; Giang Thu Vu; Yasir Waheed; Richard G. Wamai; Paul Ward; Yi Feng Wen; Ronny Westerman; Andrea Sylvia Winkler; Lalit Yadav; Seyed Hossein Yahyazadeh Jabbari; Lin Yang; Sanni Yaya; Taklo Simeneh Yazie Yazie; Yigizie Yeshaw; Naohiro Yonemoto; Mustafa Z. Younis; Zabihollah Yousefi; Chuanhua Yu; Deniz Yuce; Ismaeel Yunusa; Vesna Zadnik; Fariba Zare; Mikhail Sergeevich Zastrozhin; Anasthasia Zastrozhina; Jianrong Zhang; Chenwen Zhong; Linghui Zhou; Cong Zhu; Arash Ziapour; Ivan R. Zimmermann; Christina Fitzmaurice; Christopher J.L. Murray; Lisa M. Force
IMPORTANCE The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) provided systematic estimates of incidence, morbidity, and mortality to inform local and international efforts toward reducing cancer burden. OBJECTIVE To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic Index (SDI) quintiles from 2010 to 2019. EVIDENCE REVIEW The GBD 2019 estimation methods were used to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs) in 2019 and over the past decade. Estimates are also provided by quintiles of the SDI, a composite measure of educational attainment, income per capita, and total fertility rate for those younger than 25 years. Estimates include 95% uncertainty intervals (UIs). FINDINGS In 2019, there were an estimated 23.6 million (95% UI, 22.2-24.9 million) new cancer cases (17.2 million when excluding nonmelanoma skin cancer) and 10.0 million (95% UI, 9.36-10.6 million) cancer deaths globally, with an estimated 250 million (235-264 million) DALYs due to cancer. Since 2010, these represented a 26.3% (95% UI, 20.3%-32.3%) increase in new cases, a 20.9% (95% UI, 14.2%-27.6%) increase in deaths, and a 16.0% (95% UI, 9.3%-22.8%) increase in DALYs. Among 22 groups of diseases and injuries in the GBD 2019 study, cancer was second only to cardiovascular diseases for the number of deaths, years of life lost, and DALYs globally in 2019. Cancer burden differed across SDI quintiles. The proportion of years lived with disability that contributed to DALYs increased with SDI, ranging from 1.4% (1.1%-1.8%) in the low SDI quintile to 5.7% (4.2%-7.1%) in the high SDI quintile. While the high SDI quintile had the highest number of new cases in 2019, the middle SDI quintile had the highest number of cancer deaths and DALYs. From 2010 to 2019, the largest percentage increase in the numbers of cases and deaths occurred in the low and low-middle SDI quintiles. CONCLUSIONS AND RELEVANCE The results of this systematic analysis suggest that the global burden of cancer is substantial and growing, with burden differing by SDI. These results provide comprehensive and comparable estimates that can potentially inform efforts toward equitable cancer control around the world. © 2022 American Medical Association. All rights reserved.
Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021
(Elsevier B.V., 2024) Austin E. Schumacher; Hmwe Hmwe Kyu; Amirali Aali; Cristiana Abbafati; Jaffar Abbas; Rouzbeh Abbasgholizadeh; Madineh Akram Abbasi; Mohammadreza Abbasian; Samar Abd ElHafeez; Michael Abdelmasseh; Sherief Abd-Elsalam; Ahmed Abdelwahab; Mohammad Abdollahi; Meriem Abdoun; Auwal Abdullahi; Ame Mehadi Abdurehman; Mesfin Abebe; Aidin Abedi; Armita Abedi; Tadesse M. Abegaz; Roberto Ariel Abeldaño Zuñiga; E.S. Abhilash; Olugbenga Olusola Abiodun; Richard Gyan Aboagye; Hassan Abolhassani; Mohamed Abouzid; Lucas Guimarães Abreu; Woldu Aberhe Abrha; Michael R.M. Abrigo; Dariush Abtahi; Samir Abu Rumeileh; Niveen M.E. Abu-Rmeileh; Salahdein Aburuz; Ahmed Abu-Zaid; Juan Manuel Acuna; Tim Adair; Isaac Yeboah Addo; Oladimeji M. Adebayo; Oyelola A. Adegboye; Victor Adekanmbi; Bashir Aden; Abiola Victor Adepoju; Charles Oluwaseun Adetunji; Temitayo Esther Adeyeoluwa; Olorunsola Israel Adeyomoye; Rishan Adha; Amin Adibi; Wirawan Adikusuma; Qorinah Estiningtyas Sakilah Adnani; Saryia Adra; Abel Afework; Aanuoluwapo Adeyimika Afolabi; Ali Afraz; Shadi Afyouni; Saira Afzal; Pradyumna Agasthi; Shahin Aghamiri; Antonella Agodi; Williams Agyemang-Duah; Bright Opoku Ahinkorah; Aqeel Ahmad; Danish Ahmad; Firdos Ahmad; Muayyad M. Ahmad; Tauseef Ahmad; Keivan Ahmadi; Amir Mahmoud Ahmadzade; Mohadese Ahmadzade; Ayman Ahmed; Haroon Ahmed; Luai A. Ahmed; Muktar Beshir Ahmed; Syed Anees Ahmed; Marjan Ajami; Budi Aji; Olufemi Ajumobi; Gizachew Taddesse Akalu; Essona Matatom Akara; Karolina Akinosoglou; Sreelatha Akkala; Samuel Akyirem; Hanadi Al Hamad; Syed Mahfuz Al Hasan; Ammar Al Homsi; Mohammad Al Qadire; Moein Ala; Timothy Olukunle Aladelusi; Tareq Mohammed Ali Al-Ahdal; Samer O. Alalalmeh; Ziyad Al-Aly; Khurshid Alam; Manjurul Alam; Zufishan Alam; Rasmieh Mustafa Al-Amer; Fahad Mashhour Alanezi; Turki M. Alanzi; Mohammed Albashtawy; Mohammad T. AlBataineh; Robert W. Aldridge; Sharifullah Alemi; Ayman Al-Eyadhy; Adel Ali Saeed Al-Gheethi; Khalid F. Alhabib; Fadwa Alhalaiqa Naji Alhalaiqa; Mohammed Khaled Al-Hanawi; Abid Ali; Akhtar Ali; Beriwan Abdulqadir Ali; Hassam Ali; Mohammed Usman Ali; Rafat Ali; Syed Shujait Shujait Ali; Zahid Ali; Shohreh Alian Samakkhah; Gianfranco Alicandro; Sheikh Mohammad Alif; Mohammad Aligol; Rasoul Alimi; Ahmednur Adem Aliyi; Adel Al-Jumaily; Syed Mohamed Aljunid; Wael Almahmeed; Sabah Al-Marwani; Sadeq Ali Ali Al-Maweri; Joseph Uy Almazan; Hesham M. Al-Mekhlafi; Omar Almidani; Mahmoud A. Alomari; Nivaldo Alonso; Jaber S. Alqahtani; Ahmed Yaseen Alqutaibi; Salman Khalifah Al-Sabah; Awais Altaf; Jaffar A. Al-Tawfiq; Khalid A. Altirkawi; Farrukh Jawad Alvi; Hassan Alwafi; Yaser Mohammed Al-Worafi; Hany Aly; Karem H. Alzoubi; Azmeraw T. Amare; Edward Kwabena Ameyaw; Abebe Feyissa Amhare; Tarek Tawfik Amin; Alireza Amindarolzarbi; Javad Aminian Dehkordi; Sohrab Amiri; Hubert Amu; Dickson A. Amugsi; Jimoh Amzat; Robert Ancuceanu; Deanna Anderlini; Pedro Prata Andrade; Catalina Liliana Andrei; Tudorel Andrei; Dhanalakshmi Angappan; Abhishek Anil; Afifa Anjum; Catherine M. Antony; Ernoiz Antriyandarti; Iyadunni Adesola Anuoluwa; Sumadi Lukman Anwar; Anayochukwu Edward Anyasodor; Seth Christopher Yaw Appiah; Muhammad Aqeel; Jalal Arabloo; Razman Arabzadeh Bahri; Morteza Arab-Zozani; Mosab Arafat; Ana Margarida Araújo; Aleksandr Y. Aravkin; Abdulfatai Aremu; Hany Ariffin; Timur Aripov; Benedetta Armocida; Mahwish Arooj; Anton A. Artamonov; Kurnia Dwi Artanti; Judie Arulappan; Idowu Thomas Aruleba; Raphael Taiwo Aruleba; Ashokan Arumugam; Malke Asaad; Saeed Asgary; Mubarek Yesse Ashemo; Muhammad Ashraf; Marvellous O. Asika; Seyyed Shamsadin Athari; Maha Moh'd Wahbi Atout; Alok Atreya; Sameh Attia; Avinash Aujayeb; Abolfazl Avan; Adedapo Wasiu Awotidebe; Beatriz Paulina Ayala Quintanilla; Martin Amogre Ayanore; Getnet Melaku Ayele; Jose L. Ayuso-Mateos; Seyed Mohammad Ayyoubzadeh; Sina Azadnajafabad; Gulrez Shah Azhar; Shahkaar Aziz; Ahmed Y. Azzam; Mina Babashahi; Abraham Samuel Babu; Muhammad Badar; Alaa Badawi; Ashish D. Badiye; Soroush Baghdadi; Nasser Bagheri; Sara Bagherieh; Sulaiman Bah; Saeed Bahadorikhalili; Jianjun Bai; Ruhai Bai; Jennifer L. Baker; Shankar M. Bakkannavar; Abdulaziz T. Bako; Senthilkumar Balakrishnan; Saliu A. Balogun; Ovidiu Constantin Baltatu; Kiran Bam; Maciej Banach; Soham Bandyopadhyay; Biswajit Banik; Palash Chandra Banik; Hansi Bansal; Shirin Barati; Martina Barchitta; Mainak Bardhan; Suzanne Lyn Barker-Collo; Francesco Barone-Adesi; Hiba Jawdat Barqawi; Ronald D. Barr; Lope H. Barrero; Zarrin Basharat; Asma'u I.J. Bashir; Hameed Akande Bashiru; Pritish Baskaran; Buddha Basnyat; Quique Bassat; João Diogo Basso; Saurav Basu; Kavita Batra; Ravi Batra; Bernhard T. Baune; Mohsen Bayati; Nebiyou Simegnew Bayileyegn; Thomas Beaney; Neeraj Bedi; Tahmina Begum; Emad Behboudi; Amir Hossein Behnoush; Maryam Beiranvand; Diana Fernanda Bejarano Ramirez; Uzma Iqbal Belgaumi; Michelle L. Bell; Aminu K. Bello; Muhammad Bashir Bello; Olorunjuwon Omolaja Bello; Luis Belo; Apostolos Beloukas; Salaheddine Bendak; Derrick A. Bennett; Isabela M. Bensenor; Habib Benzian; Zombor Berezvai; Adam E. Berman; Amiel Nazer C. Bermudez; Paulo J.G. Bettencourt; Habtamu B. Beyene; Kebede A. Beyene; Devidas S. Bhagat; Akshaya Srikanth Bhagavathula; Neeraj Bhala; Ashish Bhalla; Dinesh Bhandari; Nikha Bhardwaj; Pankaj Bhardwaj; Prarthna V. Bhardwaj; Ashish Bhargava; Sonu Bhaskar; Vivek Bhat; Gurjit Kaur Bhatti; Jasvinder Singh Bhatti; Manpreet S. Bhatti; Rajbir Bhatti; Zulfiqar A. Bhutta; Boris Bikbov; Nada Binmadi; Bagas Suryo Bintoro; Antonio Biondi; Catherine Bisignano; Francesca Bisulli; Atanu Biswas; Raaj Kishore Biswas; Saeid Bitaraf; Tone Bjørge; Archie Bleyer; Mary Sefa Boampong; Virginia Bodolica; Aadam Olalekan Bodunrin; Obasanjo Afolabi Bolarinwa; Milad Bonakdar Hashemi; Aime Bonny; Kaustubh Bora; Berrak Bora Basara; Safiya Bala Borodo; Rohan Borschmann; Alejandro Botero Carvajal; Souad Bouaoud; Sofiane Boudalia; Edward J. Boyko; Nicola Luigi Bragazzi; Dejana Braithwaite; Hermann Brenner; Gabrielle Britton; Annie J. Browne; Andre R. Brunoni; Norma B. Bulamu; Lemma N. Bulto; Danilo Buonsenso; Katrin Burkart; Richard A. Burns; Sharath Burugina Nagaraja; Reinhard Busse; Yasser Bustanji; Zahid A. Butt; Florentino Luciano Caetano Dos Santos; Tianji Cai; Daniela Calina; Luis Alberto Cámera; Luciana Aparecida Campos; Ismael R. Campos-Nonato; Chao Cao; Carlos Alberto Cardenas; Rosario Cárdenas; Sinclair Carr; Giulia Carreras; Juan J. Carrero; Andrea Carugno; Felix Carvalho; Márcia Carvalho; Joao Mauricio Castaldelli-Maia; Carlos A. Castañeda-Orjuela; Giulio Castelpietra; Ferrán Catalá-López; Alberico L. Catapano; Maria Sofia Cattaruzza; Arthur Caye; Christopher R. Cederroth; Francieli Cembranel; Muthia Cenderadewi; Kelly M. Cercy; Ester Cerin; Muge Cevik; Pamela R. Chacón-Uscamaita; Yaacoub Chahine; Chiranjib Chakraborty; Jeffrey Shi Kai Chan; Chin-Kuo Chang; Periklis Charalampous; Jaykaran Charan; Vijay Kumar Chattu; Victoria Chatzimavridou-Grigoriadou; Malizgani Paul Chavula; Huzaifa Ahmad Cheema; An-Tian Chen; Haowei Chen; Lingxiao Chen; Meng Xuan Chen; Simiao Chen; Nicolas Cherbuin; Derek S. Chew; Gerald Chi; Jesus Lorenzo Chirinos-Caceres; Abdulaal Chitheer; So Mi Jemma Cho; William C.S. Cho; Bryan Chong; Hitesh Chopra; Rahul Choudhary; Rajiv Chowdhury; Dinh-Toi Chu; Isaac Sunday Chukwu; Eric Chung; Eunice Chung; Sheng-Chia Chung; Karly I. Cini; Cain C.T. Clark; Kaleb Coberly; Alyssa Columbus; Haley Comfort; Joao Conde; Sara Conti; Paolo Angelo Cortesi; Vera Marisa Costa; Ewerton Cousin; Richard G. Cowden; Michael H. Criqui; Natália Cruz-Martins; Garland T. Culbreth; Patricia Cullen; Matthew Cunningham; Daniel da Silva E Silva; Sriharsha Dadana; Omid Dadras; Zhaoli Dai; Koustuv Dalal; Lachlan L. Dalli; Giovanni Damiani; Emanuele D'Amico; Sara Daneshvar; Aso Mohammad Darwesh; Jai K. Das; Saswati Das; Nihar Ranjan Dash; Mohsen Dashti; Claudio Alberto Dávila-Cervantes; Nicole Davis Weaver; Kairat Davletov; Diego De Leo; Aklilu Tamire Debele; Louisa Degenhardt; Reza Dehbandi; Lee Deitesfeld; Ivan Delgado-Enciso; Laura Delgado-Ortiz; Daniel Demant; Berecha Hundessa Demessa; Andreas K. Demetriades; Xinlei Deng; Edgar Denova-Gutiérrez; Kebede Deribe; Nikolaos Dervenis; Don C. Des Jarlais; Hardik Dineshbhai Desai; Rupak Desai; Keshab Deuba; Vinoth Gnana Chellaiyan Devanbu; Sourav Dey; Arkadeep Dhali; Kuldeep Dhama; Mandira Lamichhane Dhimal; Meghnath Dhimal; Sameer Dhingra; Diana Dias Da Silva; Daniel Diaz; Adriana Dima; Delaney D. Ding; M. Ashworth Dirac; Abhinav Dixit; Shilpi Gupta Dixit; Thanh Chi Do; Thao Huynh Phuong Do; Camila Bruneli Do Prado; Masoud Dodangeh; Klara Georgieva Dokova; Christiane Dolecek; E Ray Dorsey; Wendel Mombaque dos Santos; Rajkumar Doshi; Leila Doshmangir; Abdel Douiri; Robert Kokou Dowou; Tim Robert Driscoll; Haneil Larson Dsouza; John Dube; Samuel C. Dumith; Susanna J. Dunachie; Bruce B. Duncan; Andre Rodrigues Duraes; Senbagam Duraisamy; Oyewole Christopher Durojaiye; Sulagna Dutta; Paulina Agnieszka Dzianach; Arkadiusz Marian Dziedzic; Oluwakemi Ebenezer; Ejemai Eboreime; Alireza Ebrahimi; Chidiebere Peter Echieh; Abdelaziz Ed-Dra; Hisham Atan Edinur; David Edvardsson; Kristina Edvardsson; Defi Efendi; Ferry Efendi; Shayan Eghdami; Terje Andreas Eikemo; Ebrahim Eini; Michael Ekholuenetale; Emmanuel Ekpor; Temitope Cyrus Ekundayo; Rabie Adel El Arab; Doaa Abdel Wahab El Morsi; Maysaa El Sayed Zaki; Maha El Tantawi; Iffat Elbarazi; Noha Mousaad Elemam; Frank J. Elgar; Islam Y. Elgendy; Ghada Metwally Tawfik ElGohary; Hala Rashad Elhabashy; Muhammed Elhadi; Omar Abdelsadek Abdou Elmeligy; Mohammed Elshaer; Ibrahim Elsohaby; Amir Emami Zeydi; Mehdi Emamverdi; Theophilus I. Emeto; Luchuo Engelbert Bain; Ryenchindorj Erkhembayar; Tesfahun C. Eshetie; Sharareh Eskandarieh; Juan Espinosa-Montero; Kara Estep; Farshid Etaee; Ugochukwu Anthony Eze; Natalia Fabin; Adewale Oluwaseun Fadaka; Adeniyi Francis Fagbamigbe; Saman Fahimi; Luca Falzone; Carla Sofia E Sá Farinha; MoezAlIslam Ezzat Mahmoud Faris; Mohsen Farjoud Kouhanjani; Andre Faro; Hossein Farrokhpour; Ali Fatehizadeh; Hamed Fattahi; Nelsensius Klau Fauk; Pooria Fazeli; Valery L. Feigin; Ginenus Fekadu; Seyed-Mohammad Fereshtehnejad; Abdullah Hamid Feroze; Daniela Ferrante; Pietro Ferrara; Nuno Ferreira; Getahun Fetensa; Irina Filip; Florian Fischer; Joanne Flavel; Abraham D. Flaxman; Luisa S. Flor; Bobirca Teodor Florin; Morenike Oluwatoyin Folayan; Kristen Marie Foley; Artem Alekseevich Fomenkov; Lisa M. Force; Carla Fornari; Behzad Foroutan; Matteo Foschi; Kate Louise Francis; Richard Charles Franklin; Alberto Freitas; Joseph Friedman; Sara D. Friedman; Takeshi Fukumoto; John E. Fuller; Peter Andras Gaal; Muktar A. Gadanya; Santosh Gaihre; Abduzhappar Gaipov; Emmanuela Gakidou; Yaseen Galali; Nasrin Galehdar; Silvano Gallus; Quan Gan; Aravind P. Gandhi; Balasankar Ganesan; Jalaj Garg; Shuo-Yan Gau; Prem Gautam; Rupesh K. Gautam; Federica Gazzelloni; Miglas W. Gebregergis; Mesfin Gebrehiwot; Tesfay Brhane Gebremariam; Urge Gerema; Motuma Erena Getachew; Tamirat Getachew; Peter W. Gething; Mansour Ghafourifard; Sulmaz Ghahramani; Khalid Yaser Ghailan; Alireza Ghajar; Mohammad Javad Ghanbarnia; MohammadReza Ghasemi; Afsaneh Ghasemzadeh; Fariba Ghassemi; Ramy Mohamed Ghazy; Sailaja Ghimire; Asadollah Gholamian; Ali Gholamrezanezhad; Pooyan Ghorbani Vajargah; Ghozali Ghozali; Sherief Ghozy; Arun Digambarrao Ghuge; Alessandro Gialluisi; Ruth Margaret Gibson; Artyom Urievich Gil; Paramjit Singh Gill; Tiffany K. Gill; Richard F. Gillum; Themba G. Ginindza; Alem Girmay; James C. Glasbey; Elena V. Gnedovskaya; Laszlo Göbölös; Amit Goel; Mohamad Goldust; Mahaveer Golechha; Pouya Goleij; Arefeh Golestanfar; Davide Golinelli; Philimon N. Gona; Houman Goudarzi; Amir Hossein Goudarzian; Anmol Goyal; Scott Greenhalgh; Michal Grivna; Giovanni Guarducci; Mohammed Ibrahim Mohialdeen Gubari; Mesay Dechasa Gudeta; Avirup Guha; Stefano Guicciardi; Damitha Asanga Gunawardane; Sasidhar Gunturu; Cui Guo; Anish Kumar Gupta; Bhawna Gupta; Indarchand Ratanlal Gupta; Rajat Das Gupta; Sapna Gupta; Veer Bala Gupta; Vijai Kumar Gupta; Vivek Kumar Gupta; Reyna Alma Gutiérrez; Farrokh Habibzadeh; Parham Habibzadeh; Vladimir Hachinski; Mohammad Haddadi; Rasool Haddadi; Nils Haep; Adel Hajj Ali; Esam S. Halboub; Sobia Ahsan Halim; Brian J. Hall; Sebastian Haller; Rabih Halwani; Randah R. Hamadeh; Kanaan Hamagharib Abdullah; Samer Hamidi; Mohammad Hamiduzzaman; Ahmad Hammoud; Nasrin Hanifi; Graeme J. Hankey; Md Abdul Hannan; Md Nuruzzaman Haque; Harapan Harapan; Josep Maria Haro; Ahmed I. Hasaballah; Faizul Hasan; Ikramul Hasan; M Tasdik Hasan; Hamidreza Hasani; Mohammad Hasanian; Ali Hasanpour-Dehkordi; Abbas M. Hassan; Amr Hassan; Hossein Hassanian-Moghaddam; Soheil Hassanipour; Johannes Haubold; Rasmus J. Havmoeller; Simon I. Hay; Youssef Hbid; Jeffrey J. Hebert; Omar E. Hegazi; Golnaz Heidari; Mohammad Heidari; Mahsa Heidari-Foroozan; Reza Heidari-Soureshjani; Bartosz Helfer; Claudiu Herteliu; Hamed Hesami; Dineshani Hettiarachchi; Demisu Zenbaba Heyi; Kamal Hezam; Yuta Hiraike; Howard J. Hoffman; Ramesh Holla; Nobuyuki Horita; Md Belal Hossain; Md Mahbub Hossain; Sahadat Hossain; Mohammad-Salar Hosseini; Hassan Hosseinzadeh; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Mohamed Hsairi; Vivian Chia-Rong Hsieh; Chengxi Hu; Junjie Huang; Md Nazmul Huda; Fernando N. Hugo; Michael Hultström; Javid Hussain; Salman Hussain; Nawfal R. Hussein; Le Duc Huy; Hong-Han Huynh; Bing-Fang Hwang; Segun Emmanuel Ibitoye; Oluwatope Olaniyi Idowu; Desta Ijo; Kevin S. Ikuta; Mehran Ilaghi; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Mustapha Immurana; Leeberk Raja Inbaraj; Arnaud Iradukunda; Farideh Iravanpour; Kenneth Chukwuemeka Iregbu; Md Rabiul Islam; Mohammad Mainul Islam; Sheikh Mohammed Shariful Islam; Farhad Islami; Nahlah Elkudssiah Ismail; Gaetano Isola; Masao Iwagami; Chidozie C.D. Iwu; Chinwe Juliana Iwu-Jaja; Mahalaxmi Iyer; Linda Merin; Jalil Jaafari; Louis Jacob; Kathryn H. Jacobsen; Farhad Jadidi-Niaragh; Morteza Jafarinia; Khushleen Jaggi; Kasra Jahankhani; Nader Jahanmehr; Haitham Jahrami; Akhil Jain; Nityanand Jain; Ammar Abdulrahman Jairoun; Mihajlo Jakovljevic; Reza Jalilzadeh Yengejeh; Elham Jamshidi; Chinmay T. Jani; Mark M. Janko; Abubakar Ibrahim Jatau; Sathish Kumar Jayapal; Shubha Jayaram; Jayakumar Jeganathan; Alelign Tasew Jema; Digisie Mequanint Jemere; Wonjeong Jeong; Anil K. Jha; Ravi Prakash Jha; John S. 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Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic. Funding: Bill & Melinda Gates Foundation. © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
(Elsevier B.V., 2024) Mohsen Naghavi; Kanyin Liane Ong; Amirali Aali; Hazim S. Ababneh; Yohannes Habtegiorgis Abate; Cristiana Abbafati; Rouzbeh Abbasgholizadeh; Mohammadreza Abbasian; Mohsen Abbasi-Kangevari; Hedayat Abbastabar; Samar Abd ElHafeez; Michael Abdelmasseh; Sherief Abd-Elsalam; Ahmed Abdelwahab; Mohammad Abdollahi; Mohammad-Amin Abdollahifar; Meriem Abdoun; Deldar Morad Abdulah; Auwal Abdullahi; Mesfin Abebe; Samrawit Shawel Abebe; Aidin Abedi; Kedir Hussein Abegaz; E.S. Abhilash; Hassan Abidi; Olumide Abiodun; Richard Gyan Aboagye; Hassan Abolhassani; Meysam Abolmaali; Mohamed Abouzid; Girma Beressa Aboye; Lucas Guimaraes Abreu; Woldu Aberhe Abrha; Dariush Abtahi; Samir Abu Rumeileh; Hasan Abualruz; Bilyaminu Abubakar; Eman Abu-Gharbieh; Niveen Me Abu-Rmeileh; Salahdein Aburuz; Ahmed Abu-Zaid; Manfred Mario Kokou Accrombessi; Tadele Girum Adal; Abdu A. Adamu; Isaac Yeboah Addo; Giovanni Addolorato; Akindele Olupelumi Adebiyi; Victor Adekanmbi; Abiola Victor Adepoju; Charles Oluwaseun Adetunji; Juliana Bunmi Adetunji; Temitayo Esther Adeyeoluwa; Daniel Adedayo Adeyinka; Olorunsola Israel Adeyomoye; Biruk Adie Admass; Qorinah Estiningtyas Sakilah Adnani; Saryia Adra; Aanuoluwapo Adeyimika Afolabi; Muhammad Sohail Afzal; Saira Afzal; Suneth Buddhika Agampodi; Pradyumna Agasthi; Manik Aggarwal; Shahin Aghamiri; Feleke Doyore Agide; Antonella Agodi; Anurag Agrawal; Williams Agyemang-Duah; Bright Opoku Ahinkorah; Aqeel Ahmad; Danish Ahmad; Firdos Ahmad; Muayyad M Ahmad; Sajjad Ahmad; Shahzaib Ahmad; Tauseef Ahmad; Keivan Ahmadi; Amir Mahmoud Ahmadzade; Ali Ahmed; Ayman Ahmed; Haroon Ahmed; Luai A. Ahmed; Mehrunnisha Sharif Ahmed; Meqdad Saleh Ahmed; Muktar Beshir Ahmed; Syed Anees Ahmed; Marjan Ajami; Budi Aji; Essona Matatom Akara; Hossein Akbarialiabad; Karolina Akinosoglou; Tomi Akinyemiju; Mohammed Ahmed Akkaif; Samuel Akyirem; Hanadi Al Hamad; Syed Mahfuz Al Hasan; Fares Alahdab; Samer O. Alalalmeh; Tariq A. Alalwan; Ziyad Al-Aly; Khurshid Alam; Manjurul Alam; Noore Alam; Rasmieh Mustafa Al-Amer; Fahad Mashhour Alanezi; Turki M. Alanzi; Sayer Al-Azzam; Almaza Albakri; Mohammed Albashtawy; Mohammad T. AlBataineh; Jacqueline Elizabeth Alcalde-Rabanal; Khalifah A. Aldawsari; Wafa A. Aldhaleei; Robert W. Aldridge; Haileselasie Berhane Alema; Mulubirhan Assefa Alemayohu; Sharifullah Alemi; Yihun Mulugeta Alemu; Adel Ali Saeed Al-Gheethi; Khalid F. Alhabib; Fadwa Alhalaiqa Naji Alhalaiqa; Mohammed Khaled Al-Hanawi; Abid Ali; Amjad Ali; Liaqat Ali; Mohammed Usman Ali; Rafat Ali; Shahid Ali; Syed Shujait Shujait Ali; Gianfranco Alicandro; Sheikh Mohammad Alif; Reyhaneh Alikhani; Yousef Alimohamadi; Ahmednur Adem Aliyi; Mohammad A. M. Aljasir; Syed Mohamed Aljunid; Francois Alla; Peter Allebeck; Sabah Al-Marwani; Sadeq Ali Ali Al-Maweri; Joseph Uy Almazan; Hesham M. Al-Mekhlafi; Louay Almidani; Omar Almidani; Mahmoud A. Alomari; Basem Al-Omari; Jordi Alonso; Jaber S. Alqahtani; Shehabaldin Alqalyoobi; Ahmed Yaseen Alqutaibi; Salman Khalifah Al-Sabah; Zaid Altaany; Awais Altaf; Jaffar A. Al-Tawfiq; Khalid A. Altirkawi; Deborah Oyine Aluh; Nelson Alvis-Guzman; Hassan Alwafi; Yaser Mohammed Al-Worafi; Hany Aly; Safwat Aly; Karem H. Alzoubi; Reza Amani; Azmeraw T. Amare; Prince M. Amegbor; Edward Kwabena Ameyaw; Tarek Tawfik Amin; Alireza Amindarolzarbi; Sohrab Amiri; Mohammad Hosein Amirzade-Iranaq; Hubert Amu; Dickson A. Amugsi; Ganiyu Adeniyi Amusa; Robert Ancuceanu; Deanna Anderlini; David B. Anderson; Pedro Prata Andrade; Catalina Liliana Andrei; Tudorel Andrei; Colin Angus; Abhishek Anil; Sneha Anil; Amir Anoushiravani; Hossein Ansari; Ansariadi Ansariadi; Alireza Ansari-Moghaddam; Catherine M. Antony; Ernoiz Antriyandarti; Davood Anvari; Saeid Anvari; Saleha Anwar; Sumadi Lukman Anwar; Razique Anwer; Anayochukwu Edward Anyasodor; Muhammad Aqeel; Juan Pablo Arab; Jalal Arabloo; Mosab Arafat; Aleksandr Y. Aravkin; Demelash Areda; Abdulfatai Aremu; Olatunde Aremu; Hany Ariffin; Mesay Arkew; Benedetta Armocida; Michael Benjamin Arndt; Johan Arnlov; Mahwish Arooj; Anton A. Artamonov; Judie Arulappan; Raphael Taiwo Aruleba; Ashokan Arumugam; Malke Asaad; Mohsen Asadi-Lari; Akeza Awealom Asgedom; Mona Asghariahmadabad; Mohammad Asghari-Jafarabadi; Muhammad Ashraf; Armin Aslani; Thomas Astell-Burt; Mohammad Athar; Seyyed Shamsadin Athari; Bantalem Tilaye Tilaye Atinafu; Habtamu Wondmagegn Atlaw; Prince Atorkey; Maha Moh'D Wahbi Atout; Alok Atreya; Avinash Aujayeb; Marcel Ausloos; Abolfazl Avan; Atalel Fentahun Awedew; Amlaku Mulat Aweke; Beatriz Paulina Ayala Quintanilla; Haleh Ayatollahi; Jose L. Ayuso-Mateos; Seyed Mohammad Ayyoubzadeh; Sina Azadnajafabad; Rui M. S. Azevedo; Ahmed Y. Azzam; B.B. Darshan; Abraham Samuel Babu; Muhammad Badar; Ashish D. Badiye; Soroush Baghdadi; Nasser Bagheri; Sara Bagherieh; Sulaiman Bah; Saeed Bahadorikhalili; Najmeh Bahmanziari; Ruhai Bai; Atif Amin Baig; Jennifer L. Baker; Abdulaziz T. Bako; Ravleen Kaur Bakshi; Senthilkumar Balakrishnan; Madhan Balasubramanian; Ovidiu Constantin Baltatu; Kiran Bam; MacIej Banach; Soham Bandyopadhyay; Palash Chandra Banik; Hansi Bansal; Kannu Bansal; Franca Barbic; Martina Barchitta; Mainak Bardhan; Erfan Bardideh; Suzanne Lyn Barker-Collo; Till Winfried Barnighausen; Francesco Barone-Adesi; Hiba Jawdat Barqawi; Lope H. Barrero; Amadou Barrow; Sandra Barteit; Lingkan Barua; Zarrin Basharat; Azadeh Bashiri; Afisu Basiru; Pritish Baskaran; Buddha Basnyat; Quique Bassat; João Diogo Basso; Ann V. L. Basting; Sanjay Basu; Kavita Batra; Bernhard T. Baune; Mohsen Bayati; Nebiyou Simegnew Bayileyegn; Thomas Beaney; Neeraj Bedi; Massimiliano Beghi; Emad Behboudi; Priyamadhaba Behera; Amir Hossein Behnoush; Masoud Behzadifar; Maryam Beiranvand; Diana Fernanda Bejarano Ramirez; Yannick Béjot; Sefealem Assefa Belay; Chalie Mulu Belete; Michelle L. Bell; Muhammad Bashir Bello; Olorunjuwon Omolaja Bello; Luis Belo; Apostolos Beloukas; Rose Grace Bender; Isabela M. Bensenor; Azizullah Beran; Zombor Berezvai; Alemshet Yirga Berhie; Betyna N. Berice; Robert S. Bernstein; Gregory J. Bertolacci; Paulo J. G. Bettencourt; Kebede A. Beyene; Devidas S. Bhagat; Akshaya Srikanth Bhagavathula; Neeraj Bhala; Ashish Bhalla; Dinesh Bhandari; Kayleigh Bhangdia; Nikha Bhardwaj; Pankaj Bhardwaj; Prarthna V. Bhardwaj; Ashish Bhargava; Sonu Bhaskar; Vivek Bhat; Gurjit Kaur Bhatti; Jasvinder Singh Bhatti; Manpreet S. Bhatti; Rajbir Bhatti; Zulfiqar A. Bhutta; Boris Bikbov; Jessica Devin Bishai; Catherine Bisignano; Francesca Bisulli; Atanu Biswas; Bijit Biswas; Saeid Bitaraf; Bikes Destaw Bitew; Veera R. Bitra; Tone Bjørge; Micheal Kofi Boachie; Mary Sefa Boampong; Anca Vasilica Bobirca; Virginia Bodolica; Aadam Olalekan Bodunrin; Eyob Ketema Bogale; Kassawmar Angaw Bogale; Somayeh Bohlouli; Obasanjo Afolabi Bolarinwa; Archith Boloor; Milad Bonakdar Hashemi; Aime Bonny; Kaustubh Bora; Berrak Bora Basara; Hamed Borhany; Arturo Borzutzky; Souad Bouaoud; Antoine Boustany; Christopher Boxe; Edward J. Boyko; Oliver J. Brady; Dejana Braithwaite; Luisa C. Brant; Michael Brauer; Alexandra Brazinova; Javier Brazo-Sayavera; Nicholas J. K. Breitborde; Susanne Breitner; Hermann Brenner; Andrey Nikolaevich Briko; Nikolay Ivanovich Briko; Gabrielle Britton; Julie Brown; Traolach Brugha; Norma B. Bulamu; Lemma N. Bulto; Danilo Buonsenso; Richard A. Burns; Reinhard Busse; Yasser Bustanji; Nadeem Shafique Butt; Zahid A. Butt; Florentino Luciano Caetano Dos Santos; Daniela Calina; Luis Alberto Camera; Luciana Aparecida Campos; Ismael R. Campos-Nonato; Chao Cao; Yin Cao; Angelo Capodici; Rosario Cárdenas; Sinclair Carr; Giulia Carreras; Juan J. Carrero; Andrea Carugno; Cristina G. Carvalheiro; Felix Carvalho; Márcia Carvalho; Joao Mauricio Castaldelli-Maia; Carlos A. Castañeda-Orjuela; Giulio Castelpietra; Ferrán Catalá-López; Alberico L. Catapano; Maria Sofia Cattaruzza; Christopher R. Cederroth; Luca Cegolon; Francieli Cembranel; Muthia Cenderadewi; Kelly M. Cercy; Ester Cerin; Muge Cevik; Joshua Chadwick; Yaacoub Chahine; Chiranjib Chakraborty; Promit Ananyo Chakraborty; Jeffrey Shi Kai Chan; Raymond N. C. Chan; Rama Mohan Chandika; Eeshwar K. Chandrasekar; Chin-Kuo Chang; Jung-Chen Chang; Gashaw Sisay Chanie; Periklis Charalampous; Vijay Kumar Chattu; Pankaj Chaturvedi; Victoria Chatzimavridou-Grigoriadou; Akhilanand Chaurasia; Angela W. Chen; An-Tian Chen; Catherine S. Chen; Haowei Chen; Meng Xuan Chen; Simiao Chen; Ching-Yu Cheng; Esther T. W. Cheng; Nicolas Cherbuin; Wondimye Ashenafi Cheru; Ju-Huei Chien; Odgerel Chimed-Ochir; Ritesh Chimoriya; Patrick R. Ching; Jesus Lorenzo Chirinos-Caceres; Abdulaal Chitheer; William C. S. Cho; Bryan Chong; Hitesh Chopra; Sonali Gajanan Choudhari; Rajiv Chowdhury; Devasahayam J. Christopher; Isaac Sunday Chukwu; Eric Chung; Erin Chung; Eunice Chung; Sheng-Chia Chung; Muhammad Chutiyami; Zinhle Cindi; Iolanda Cioffi; Mareli M. Claassens; Rafael M. Claro; Kaleb Coberly; Rebecca M. Cogen; Alyssa Columbus; Haley Comfort; Joao Conde; Samuele Cortese; Paolo Angelo Cortesi; Vera Marisa Costa; Simona Costanzo; Ewerton Cousin; Rosa A. S. Couto; Richard G. Cowden; Kenneth Michael Cramer; Michael H. Criqui; Natalia Cruz-Martins; Silvia Magali Cuadra-Hernandez; Garland T. Culbreth; Patricia Cullen; Matthew Cunningham; Maria Paula Curado; Sriharsha Dadana; Omid Dadras; Siyu Dai; Xiaochen Dai; Zhaoli Dai; Lachlan L. Dalli; Giovanni Damiani; Jiregna Darega Gela; Jai K. Das; Saswati Das; Subasish Das; Ana Maria Dascalu; Nihar Ranjan Dash; Mohsen Dashti; Anna Dastiridou; Gail Davey; Claudio Alberto Davila-Cervantes; Nicole Davis Weaver; Kairat Davletov; Diego De Leo; Katie De Luca; Aklilu Tamire Debele; Shayom Debopadhaya; Louisa Degenhardt; Azizallah Dehghan; Lee Deitesfeld; Cristian Del Bo; Ivan Delgado-Enciso; Berecha Hundessa Demessa; Andreas K. Demetriades; Ke Deng; Xinlei Deng; Edgar Denova-Gutierrez; Niloofar Deravi; Nebiyu Dereje; Nikolaos Dervenis; Emina Dervišević; Don C. Des Jarlais; Hardik Dineshbhai Desai; Rupak Desai; Vinoth Gnana Chellaiyan Devanbu; Syed Masudur Rahman Dewan; Arkadeep Dhali; Kuldeep Dhama; Meghnath Dhimal; Sameer Dhingra; Vishal R. Dhulipala; Diana Dias Da Silva; Daniel Diaz; Michael J. Diaz; Adriana Dima; Delaney D. Ding; Huanghe Ding; Ricardo Jorge Dinis-Oliveira; M. Ashworth Dirac; Shirin Djalalinia; Thao Huynh Phuong Do; Camila Bruneli Do Prado; Saeid Doaei; Masoud Dodangeh; Milad Dodangeh; Sushil Dohare; Klara Georgieva Dokova; Christiane Dolecek; Regina-Mae Villanueva Dominguez; Wanyue Dong; Deepa Dongarwar; Mario D'Oria; Fariba Dorostkar; E. Ray Dorsey; Wendel Mombaque Dos Santos; Rajkumar Doshi; Leila Doshmangir; Robert Kokou Dowou; Tim Robert Driscoll; Haneil Larson Dsouza; Viola Dsouza; Mi Du; John Dube; Bruce B. Duncan; Andre Rodrigues Duraes; Senbagam Duraisamy; Oyewole Christopher Durojaiye; Laura Dwyer-Lindgren; Paulina Agnieszka Dzianach; Arkadiusz Marian Dziedzic; Abdel Rahman E'Mar; Ejemai Eboreime; Alireza Ebrahimi; Chidiebere Peter Echieh; Hisham Atan Edinur; David Edvardsson; Kristina Edvardsson; Defi Efendi; Ferry Efendi; Diyan Ermawan Effendi; Terje Andreas Eikemo; Ebrahim Eini; Michael Ekholuenetale; Temitope Cyrus Ekundayo; Iman El Sayed; Iffat Elbarazi; Teshome Bekele Elema; Noha Mousaad Elemam; Frank J. Elgar; Islam Y. Elgendy; Ghada Metwally Tawfik ElGohary; Hala Rashad Elhabashy; Muhammed Elhadi; Waseem El-Huneidi; Legesse Tesfaye Elilo; Omar Abdelsadek Abdou Elmeligy; Mohamed A. Elmonem; Mohammed Elshaer; Ibrahim Elsohaby; Theophilus I. Emeto; Luchuo Engelbert Bain; Ryenchindorj Erkhembayar; Christopher Imokhuede Esezobor; Babak Eshrati; Sharareh Eskandarieh; Juan Espinosa-Montero; Habtamu Esubalew; Farshid Etaee; Natalia Fabin; Adewale Oluwaseun Fadaka; Adeniyi Francis Fagbamigbe; Ayesha Fahim; Saman Fahimi; Aliasghar Fakhri-Demeshghieh; Luca Falzone; Mohammad Fareed; Carla Sofia E Sa Farinha; Moezalislam Ezzat Mahmoud Faris; Pawan Sirwan Faris; Andre Faro; Abidemi Omolara Fasanmi; Ali Fatehizadeh; Hamed Fattahi; Nelsensius Klau Fauk; Pooria Fazeli; Valery L. Feigin; Alireza Feizkhah; Ginenus Fekadu; Xiaoru Feng; Seyed-Mohammad Fereshtehnejad; Abdullah Hamid Feroze; Daniela Ferrante; Alize J. Ferrari; Nuno Ferreira; Getahun Fetensa; Bikila Regassa Feyisa; Irina Filip; Florian Fischer; Joanne Flavel; David Flood; Bobirca Teodor Florin; Nataliya A. Foigt; Morenike Oluwatoyin Folayan; Artem Alekseevich Fomenkov; Behzad Foroutan; Masoud Foroutan; Ingeborg Forthun; Daniela Fortuna; Matteo Foschi; Kayode Raphael Fowobaje; Kate Louise Francis; Richard Charles Franklin; Alberto Freitas; Joseph Friedman; Sara D. Friedman; Takeshi Fukumoto; John E. Fuller; Blima Fux; Peter Andras Gaal; Muktar A. Gadanya; Abhay Motiramji Gaidhane; Santosh Gaihre; Emmanuela Gakidou; Yaseen Galali; Natalie C. Galles; Silvano Gallus; Mandukhai Ganbat; Aravind P. Gandhi; Balasankar Ganesan; Mohammad Arfat Ganiyani; Ma Garcia-Gordillo; William M. Gardner; Jalaj Garg; Naval Garg; Rupesh K. Gautam; Semiu Olatunde Gbadamosi; Tilaye Gebru Gebi; Miglas W. Gebregergis; Mesfin Gebrehiwot; Teferi Gebru Gebremeskel; Simona Roxana Georgescu; Tamirat Getachew; Peter W. 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Background: Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. Methods: The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model—a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates—with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality—which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. Findings: The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2–100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1–290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1–211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4–48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3–37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7–9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. Interpretation: Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. Funding: Bill & Melinda Gates Foundation. © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
(Elsevier B.V., 2020) Cristiana Abbafati; Kaja M. Abbas; Mohammad Abbasi; Mitra Abbasifard; Mohsen Abbasi-Kangevari; Hedayat Abbastabar; Foad Abd-Allah; Ahmed Abdelalim; Mohammad Abdollahi; Ibrahim Abdollahpour; Aidin Abedi; Parisa Abedi; Kedir Hussein Abegaz; Hassan Abolhassani; Akine Eshete Abosetugn; Victor Aboyans; Elissa M. Abrams; Lucas Guimarães Abreu; Michael R.M. Abrigo; Abdulaziz Khalid Abu Haimed; Ahmed Abualhasan; Eman Abu-Gharbieh; Laith Jamal Abu-Raddad; Abdelrahman I. Abushouk; Alyssa Acebedo; Ilana N. Ackerman; Maryam Adabi; Tim Adair; Abdu A. Adamu; Oladimeji M. Adebayo; Isaac Akinkunmi Adedeji; Victor Adekanmbi; Jaimie D. Adelson; Abiodun Moshood Adeoye; Olatunji O. Adetokunboh; Davoud Adham; Shailesh M. Advani; Mohsen Afarideh; Mahdi Afshari; Ashkan Afshin; Emilie E. Agardh; Gina Agarwal; Pradyumna Agasthi; Kareha M. Agesa; Mohammad Aghaali; Seyed Mohammad Kazem Aghamir; Anurag Agrawal; Tauseef Ahmad; Alireza Ahmadi; Keivan Ahmadi; Mehdi Ahmadi; Hamid Ahmadieh; Ehsan Ahmadpour; Muktar Beshir Ahmed; Budi Aji; Temesgen Yihunie Akalu; Rufus Olusola Akinyemi; Tomi Akinyemiju; Blessing Akombi; Chisom Joyqueenet Akunna; Fares Alahdab; Ziyad Al-Aly; Khurshid Alam; Noore Alam; Samiah Alam; Tahiya Alam; Fahad Mashhour Alanezi; Turki M. Alanzi; Samuel B. Albertson; Jacqueline Elizabeth Alcalde-Rabanal; Niguse Meles Alema; Biresaw Wassihun Alemu; Yihun Mulugeta Alemu; Khalid F. Alhabib; Robert Kaba Alhassan; Muhammad Ali; Saqib Ali; Gianfranco Alicandro; Mehran Alijanzadeh; Cyrus Alinia; Vahid Alipour; Hesam Alizade; Syed Mohamed Aljunid; François Alla; Peter Allebeck; Majid Abdulrahman Hamad Almadi; Ali Almasi; Amir Almasi-Hashiani; Nihad A. Almasri; Hesham M. Al-Mekhlafi; Abdulaziz M. Almulhim; Jordi Alonso; Rajaa M. Al-Raddadi; Khalid A. Altirkawi; Arwa Khalid Alumran; Nelson Alvis-Guzman; Nelson J. Alvis-Zakzuk; Azmeraw T. Amare; Bekalu Amare; Saeed Amini; Mostafa Amini-Rarani; Arya Aminorroaya; Fatemeh Amiri; Arianna Maever L. Amit; Dickson A. Amugsi; Gianna Gayle Herrera Amul; Etsay Woldu Anbesu; Robert Ancuceanu; Deanna Anderlini; Jason A. Anderson; Catalina Liliana Andrei; Tudorel Andrei; Sofia Androudi; Colin Angus; Mina Anjomshoa; Fereshteh Ansari; Iman Ansari; Alireza Ansari-Moghaddam; Ippazio Cosimo Antonazzo; Carl Abelardo T. Antonio; Catherine M. Antony; Ernoiz Antriyandarti; Davood Anvari; Razique Anwer; Seth Christopher Yaw Appiah; Jalal Arabloo; Morteza Arab-Zozani; Aleksandr Y. Aravkin; Aseb Arba Kinfe Arba; Olatunde Aremu; Filippo Ariani; Timur Aripov; Bahram Armoon; Johan Ärnlöv; Oluwaseyi Olalekan Arowosegbe; Krishna K. Aryal; Afsaneh Arzani; Malke Asaad; Mehran Asadi-Aliabadi; Ali A. Asadi-Pooya; Samaneh Asgari; Babak Asghari; Mohammad Asghari Jafarabadi; Charlie Ashbaugh; Michael Assmus; Zahra Atafar; Seyyed Shamsadin Athari; Desta Debalkie Atnafu; Maha Moh'd Wahbi Atout; Sachin R. Atre; Madhu Sudhan Atteraya; Floriane Ausloos; Marcel Ausloos; Leticia Avila-Burgos; Euripide Frinel Gbenato Arthur Avokpaho; Beatriz Paulina Ayala Quintanilla; Getinet Ayano; Martin Amogre Ayanore; Getie Lake Aynalem; Yared Asmare Aynalem; Muluken Altaye Ayza; Samad Azari; Ghasem Azarian; Zelalem Nigussie Azene; Gulrez Azhar; Peter S. Azzopardi; B.B. Darshan; Ebrahim Babaee; Alaa Badawi; Ashish D. Badiye; Mojtaba Bagherzadeh; Eleni Bagli; Mohammad Amin Bahrami; Atif Amin Baig; Mohan Bairwa; Mohammad Hossein Bakhshaei; Ahad Bakhtiari; Shankar M. Bakkannavar; Arun Balachandran; Senthilkumar Balakrishnan; Shivanthi Balalla; Shelly Balassyano; Alberto Baldasseroni; Kylie Ball; Shoshana H. Ballew; Daniela Balzi; Maciej Banach; Srikanta K. Banerjee; Palash Chandra Banik; Marlena S. Bannick; Agegnehu Bante Bante; Simachew Animen Bante; Adhanom Gebreegziabher Baraki; Miguel A. Barboza; Suzanne Lyn Barker-Collo; Till Winfried Bärnighausen; Lope H. Barrero; Celine M. Barthelemy; Lingkan Barua; Akbar Barzegar; Huda Basaleem; Quique Bassat; Sanjay Basu; Bernhard T. Baune; Mohsen Bayati; Bayisa Abdissa Baye; Gholamreza Bazmandegan; Jacob S. Becker; Neeraj Bedi; Ettore Beghi; Masoud Behzadifar; Yannick Béjot; Tariku Tesfaye Tesfaye Bekuma; Michelle L. Bell; Aminu K. Bello; Rose G. Bender; Derrick A. Bennett; Fiona B. Bennitt; Isabela M. Bensenor; Catherine P. Benziger; Kidanemaryam Berhe; Adam E. Berman; Eduardo Bernabe; Robert S. Bernstein; Gregory J. Bertolacci; Akshaya Srikanth Bhagavathula; Reshmi Bhageerathy; Neeraj Bhala; Dinesh Bhandari; Pankaj Bhardwaj; Anusha Ganapati Bhat; Krittika Bhattacharyya; Suraj Bhattarai; Zulfiqar A. Bhutta; Sadia Bibi; Molly H. Biehl; Ali Bijani; Boris Bikbov; Ver Bilano; Muhammad Shahdaat Bin Sayeed; Antonio Biondi; Binyam Minuye Birihane; Donal Bisanzio; Catherine Bisignano; Raaj Kishore Biswas; Helen Bitew; Tone Bjørge; Moses John Bockarie; Somayeh Bohlouli; Mehdi Bohluli; Hunduma Amensisa Bojia; Srinivasa Rao Bolla; Archith Boloor; Alexandra S. Boon-Dooley; Guilherme Borges; Antonio Maria Borzì; Shiva Borzouei; Dipan Bose; Cristina Bosetti; Soufiane Boufous; Rupert Bourne; Oliver J. Brady; Dejana Braithwaite; Michael Brauer; Carol Brayne; Nicholas J.K. Breitborde; Susanne Breitner; Hermann Brenner; Alexey V. Breusov; Paul Svitil Briant; Andrew M. Briggs; Andrey Nikolaevich Briko; Nikolay Ivanovich Briko; Gabrielle B. Britton; Traolach Brugha; Dana Bryazka; Rachelle Buchbinder; Blair R. Bumgarner; Katrin Burkart; Richard Thomas Burnett; Sharath Burugina Nagaraja; Reinhard Busse; Zahid A. Butt; Florentino Luciano Caetano dos Santos; Leah E. Cahill; Lucero Cahuana-Hurtado; Tianji Cai; Charlton S.K.H. Callender; Luis Alberto Cámera; Ismael R. Campos-Nonato; Julio Cesar Campuzano Rincon; Jackie Cao; Josip Car; Rosario Cárdenas; Giulia Carreras; Juan J. Carrero; Felix Carvalho; Joao Mauricio Castaldelli-Maia; Carlos A. Castañeda-Orjuela; Giulio Castelpietra; Chris D. Castle; Emma Castro; Franz Castro; Ferrán Catalá-López; Kate Causey; Christopher R. Cederroth; Kelly M. Cercy; Ester Cerin; Julian Chalek; Joht Singh Chandan; Alex R. Chang; Angela Y. Chang; Jung-Chen Chang; Kai-Lan Chang; Jaykaran Charan; Fiona J. Charlson; Vijay Kumar Chattu; Sarika Chaturvedi; Nicolas Cherbuin; Odgerel Chimed-Ochir; Ken Lee Chin; Jesus Lorenzo Chirinos-Caceres; Daniel Youngwhan Cho; Jee-Young Jasmine Choi; Hanne Christensen; Dinh-Toi Chu; Michael T. Chung; Sheng-Chia Chung; Flavia M. Cicuttini; Liliana G. Ciobanu; Massimo Cirillo; Beniamino Cislaghi; Thomas Khaled Dwayne Classen; Aaron J. Cohen; Emma L. Collins; Haley Comfort; Kelly Compton; Sara Conti; Owen R. Cooper; Barbara Corso; Paolo Angelo Cortesi; Vera Marisa Costa; Ewerton Cousin; Richard G. Cowden; Benjamin C. Cowie; Elizabeth A. Cromwell; Andrew J. Croneberger; Di H. Cross; Marita Cross; Christopher Stephen Crowe; Jessica A. Cruz; Steven Cummins; Matthew Cunningham; Saad M.A. Dahlawi; Haijiang Dai; Hancheng Dai; Albertino Antonio Moura Damasceno; Giovanni Damiani; Emanuele D'Amico; Lalit Dandona; Rakhi Dandona; Parnaz Daneshpajouhnejad; William James Dangel; Anna-Karin Danielsson; Jiregna Darega Gela; Paul I. Dargan; Aso Mohammad Darwesh; Ahmad Daryani; Jai K. Das; Rajat Das Gupta; José das Neves; Aditya Prasad Dash; Gail Davey; Claudio Alberto Dávila-Cervantes; Adrian C. Davis; Dragos Virgil Davitoiu; Kairat Davletov; Diego De Leo; Jan-Walter De Neve; Frances E. Dean; Nicole K. DeCleene; Amanda Deen; Louisa Degenhardt; Marissa DeLang; Robert Paul Dellavalle; Feleke Mekonnen Demeke; Gebre Teklemariam Demoz; Desalegn Getnet Demsie; Edgar Denova-Gutiérrez; Nebiyu Dereje Dereje; Kebede Deribe; Nikolaos Dervenis; Rupak Desai; Assefa Desalew; Getenet Ayalew Dessie; Keshab Deuba; Samath Dhamminda Dharmaratne; Govinda Prasad Dhungana; Mostafa Dianatinasab; Diana Dias da Silva; Daniel Diaz; Zahra Sadat Dibaji Forooshani; Martin Dichgans; Alireza Didarloo; Zachary V. Dingels; Ilse N. Dippenaar; M. Ashworth Dirac; Shirin Djalalinia; Hoa Thi Do; Klara Dokova; David Teye Doku; Christiane Dolecek; Andrew J. Dolgert; Fariba Dorostkar; Chirag P. Doshi; Pratik P. Doshi; Leila Doshmangir; Abdel Douiri; Matthew C. Doxey; Kerrie E. Doyle; Tim Robert Driscoll; Eleonora Dubljanin; Susanna J. Dunachie; Bruce B. Duncan; Andre Rodrigues Duraes; Arielle Wilder Eagan; Hedyeh Ebrahimi; Mohammad Ebrahimi Kalan; David Edvardsson; Andem Effiong; Joshua R. Ehrlich; Nevine El Nahas; Iman El Sayed; Maysaa El Sayed Zaki; Maha El Tantawi; Iffat Elbarazi; Islam Y. Elgendy; Hala Rashad Elhabashy; Shaimaa I. El-Jaafary; Aisha Elsharkawy; Iqbal R.F. Elyazar; Mohammad Hassan Emamian; Sophia Emmons-Bell; Holly E. Erskine; Babak Eshrati; Khalil Eskandari; Sharareh Eskandarieh; Saman Esmaeilnejad; Firooz Esmaeilzadeh; Alireza Esteghamati; Sadaf Esteghamati; Kara Estep; Arash Etemadi; Atkilt Esaiyas Etisso; Oluchi Ezekannagha; Jessica Fanzo; Tamer Farag; Mohammad Farahmand; Anwar Faraj; Emerito Jose A. Faraon; Mohammad Fareed; Roghiyeh Faridnia; Carla Sofia e Sá Farinha; Andrea Farioli; Pawan Sirwan Faris; Andre Faro; Mithila Faruque; Farshad Farzadfar; Nazir Fattahi; Ali Akbar Fazaeli; Mehdi Fazlzadeh; Valery L. Feigin; Rachel Feldman; Seyed-Mohammad Fereshtehnejad; Eduarda Fernandes; Giannina Ferrara; Pietro Ferrara; Alize J. Ferrari; Manuela L. Ferreira; Garumma Tolu Feyissa; Irina Filip; Florian Fischer; James L. Fisher; Ryan Fitzgerald; Carsten Flohr; Luisa Sorio Flor; Nataliya A. Foigt; Morenike Oluwatoyin Folayan; Artem Alekseevich Fomenkov; Lisa M. Force; Carla Fornari; Masoud Foroutan; Jack T. Fox; Joel Msafiri Francis; Tahvi D. Frank; Richard Charles Franklin; Marisa Freitas; Weijia Fu; Takeshi Fukumoto; Kai Fukutaki; John E. Fuller; Nancy Fullman; João M. Furtado; Mohamed M. Gad; Abhay Motiramji Gaidhane; Emmanuela Gakidou; Natalie C. Galles; Silvano Gallus; Amiran Gamkrelidze; Alberto L. Garcia-Basteiro; William M. Gardner; Biniyam Sahiledengle Geberemariyam; Abiyu Mekonnen Gebrehiwot; Ketema Bizuwork Gebremedhin; Gebreamlak Gebremedhn Gebremeskel; Leake G. Gebremeskel; Begashaw Melaku Gebresillassie; Assefa Ayalew Ayalew Ayalew Gebreslassie; Yilma Chisha Dea Geramo; Abraham Geremew; Anna Gershberg Hayoon; Hailay Abrha Gesesew; Peter W. 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Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and development investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
(Elsevier B.V., 2020) Cristiana Abbafati; Kaja M. Abbas; Mohsen Abbasi-Kangevari; Foad Abd-Allah; Ahmed Abdelalim; Mohammad Abdollahi; Ibrahim Abdollahpour; Kedir Hussein Abegaz; Hassan Abolhassani; Victor Aboyans; Lucas Guimarães Abreu; Michael R.M. Abrigo; Ahmed Abualhasan; Laith Jamal Abu-Raddad; Abdelrahman I. Abushouk; Maryam Adabi; Victor Adekanmbi; Abiodun Moshood Adeoye; Olatunji O. Adetokunboh; Davoud Adham; Shailesh M. Advani; Ashkan Afshin; Gina Agarwal; Seyed Mohammad Kazem Aghamir; Anurag Agrawal; Tauseef Ahmad; Keivan Ahmadi; Mehdi Ahmadi; Hamid Ahmadieh; Muktar Beshir Ahmed; Temesgen Yihunie Akalu; Rufus Olusola Akinyemi; Tomi Akinyemiju; Blessing Akombi; Chisom Joyqueenet Akunna; Fares Alahdab; Ziyad Al-Aly; Khurshid Alam; Samiah Alam; Tahiya Alam; Fahad Mashhour Alanezi; Turki M. Alanzi; Biresaw Wassihun Alemu; Khalid F. Alhabib; Muhammad Ali; Saqib Ali; Gianfranco Alicandro; Cyrus Alinia; Vahid Alipour; Hesam Alizade; Syed Mohamed Aljunid; François Alla; Peter Allebeck; Amir Almasi-Hashiani; Hesham M. Al-Mekhlafi; Jordi Alonso; Khalid A. Altirkawi; Mostafa Amini-Rarani; Fatemeh Amiri; Dickson A. Amugsi; Robert Ancuceanu; Deanna Anderlini; Jason A. Anderson; Catalina Liliana Andrei; Tudorel Andrei; Colin Angus; Mina Anjomshoa; Fereshteh Ansari; Alireza Ansari-Moghaddam; Ippazio Cosimo Antonazzo; Carl Abelardo T. Antonio; Catherine M. Antony; Ernoiz Antriyandarti; Davood Anvari; Razique Anwer; Seth Christopher Yaw Appiah; Jalal Arabloo; Morteza Arab-Zozani; Aleksandr Y. Aravkin; Filippo Ariani; Bahram Armoon; Johan Ärnlöv; Afsaneh Arzani; Mehran Asadi-Aliabadi; Ali A. Asadi-Pooya; Charlie Ashbaugh; Michael Assmus; Zahra Atafar; Desta Debalkie Atnafu; Maha Moh'd Wahbi Atout; Floriane Ausloos; Marcel Ausloos; Beatriz Paulina Ayala Quintanilla; Getinet Ayano; Martin Amogre Ayanore; Samad Azari; Ghasem Azarian; Zelalem Nigussie Azene; Alaa Badawi; Ashish D. Badiye; Mohammad Amin Bahrami; Mohammad Hossein Bakhshaei; Ahad Bakhtiari; Shankar M. Bakkannavar; Alberto Baldasseroni; Kylie Ball; Shoshana H. Ballew; Daniela Balzi; Maciej Banach; Srikanta K. Banerjee; Agegnehu Bante Bante; Adhanom Gebreegziabher Baraki; Suzanne Lyn Barker-Collo; Till Winfried Bärnighausen; Lope H. Barrero; Celine M. Barthelemy; Lingkan Barua; Sanjay Basu; Bernhard T. Baune; Mohsen Bayati; Jacob S. Becker; Neeraj Bedi; Ettore Beghi; Yannick Béjot; Michelle L. Bell; Fiona B. Bennitt; Isabela M. Bensenor; Kidanemaryam Berhe; Adam E. Berman; Akshaya Srikanth Bhagavathula; Reshmi Bhageerathy; Neeraj Bhala; Dinesh Bhandari; Krittika Bhattacharyya; Zulfiqar A. Bhutta; Ali Bijani; Boris Bikbov; Muhammad Shahdaat Bin Sayeed; Antonio Biondi; Binyam Minuye Birihane; Catherine Bisignano; Raaj Kishore Biswas; Helen Bitew; Somayeh Bohlouli; Mehdi Bohluli; Alexandra S. Boon-Dooley; Guilherme Borges; Antonio Maria Borzì; Shiva Borzouei; Cristina Bosetti; Soufiane Boufous; Dejana Braithwaite; Michael Brauer; Nicholas J.K. Breitborde; Susanne Breitner; Hermann Brenner; Paul Svitil Briant; Andrey Nikolaevich Briko; Nikolay Ivanovich Briko; Gabrielle B. Britton; Dana Bryazka; Blair R. Bumgarner; Katrin Burkart; Richard Thomas Burnett; Sharath Burugina Nagaraja; Zahid A. Butt; Florentino Luciano Caetano Dos Santos; Leah E. Cahill; Luis Alberto Cámera; Ismael R. Campos-Nonato; Rosario Cárdenas; Giulia Carreras; Juan J. Carrero; Felix Carvalho; Joao Mauricio Castaldelli-Maia; Carlos A. Castañeda-Orjuela; Giulio Castelpietra; Franz Castro; Kate Causey; Christopher R. Cederroth; Kelly M. Cercy; Ester Cerin; Joht Singh Chandan; Kai-Lan Chang; Fiona J. Charlson; Vijay Kumar Chattu; Sarika Chaturvedi; Nicolas Cherbuin; Odgerel Chimed-Ochir; Daniel Youngwhan Cho; Jee-Young Jasmine Choi; Hanne Christensen; Dinh-Toi Chu; Michael T. Chung; Sheng-Chia Chung; Flavia M. Cicuttini; Liliana G. Ciobanu; Massimo Cirillo; Thomas Khaled Dwayne Classen; Aaron J. Cohen; Kelly Compton; Owen R. Cooper; Vera Marisa Costa; Ewerton Cousin; Richard G. Cowden; Di H. Cross; Jessica A. Cruz; Saad M.A. Dahlawi; Albertino Antonio Moura Damasceno; Giovanni Damiani; Lalit Dandona; Rakhi Dandona; William James Dangel; Anna-Karin Danielsson; Paul I. Dargan; Aso Mohammad Darwesh; Ahmad Daryani; Jai K. Das; Rajat Das Gupta; José das Neves; Claudio Alberto Dávila-Cervantes; Dragos Virgil Davitoiu; Diego De Leo; Louisa Degenhardt; Marissa DeLang; Robert Paul Dellavalle; Feleke Mekonnen Demeke; Gebre Teklemariam Demoz; Desalegn Getnet Demsie; Edgar Denova-Gutiérrez; Nikolaos Dervenis; Govinda Prasad Dhungana; Mostafa Dianatinasab; Diana Dias da Silva; Daniel Diaz; Zahra Sadat Dibaji Forooshani; Shirin Djalalinia; Hoa Thi Do; Klara Dokova; Fariba Dorostkar; Leila Doshmangir; Tim Robert Driscoll; Bruce B. Duncan; Andre Rodrigues Duraes; Arielle Wilder Eagan; David Edvardsson; Nevine El Nahas; Iman El Sayed; Maha El Tantawi; Iffat Elbarazi; Islam Y. Elgendy; Shaimaa I. El-Jaafary; Iqbal R.F. Elyazar; Sophia Emmons-Bell; Holly E. Erskine; Sharareh Eskandarieh; Saman Esmaeilnejad; Alireza Esteghamati; Kara Estep; Arash Etemadi; Atkilt Esaiyas Etisso; Jessica Fanzo; Mohammad Farahmand; Mohammad Fareed; Roghiyeh Faridnia; Andrea Farioli; Andre Faro; Mithila Faruque; Farshad Farzadfar; Nazir Fattahi; Mehdi Fazlzadeh; Valery L. Feigin; Rachel Feldman; Seyed-Mohammad Fereshtehnejad; Eduarda Fernandes; Giannina Ferrara; Alize J. Ferrari; Manuela L. Ferreira; Irina Filip; Florian Fischer; James L. Fisher; Luisa Sorio Flor; Nataliya A. Foigt; Morenike Oluwatoyin Folayan; Artem Alekseevich Fomenkov; Lisa M. Force; Masoud Foroutan; Richard Charles Franklin; Marisa Freitas; Weijia Fu; Takeshi Fukumoto; João M. Furtado; Mohamed M. Gad; Emmanuela Gakidou; Silvano Gallus; Alberto L. Garcia-Basteiro; William M. Gardner; Biniyam Sahiledengle Geberemariyam; Assefa Ayalew Ayalew Ayalew Gebreslassie; Abraham Geremew; Anna Gershberg Hayoon; Peter W. Gething; Maryam Ghadimi; Keyghobad Ghadiri; Fatemeh Ghaffarifar; Mansour Ghafourifard; Farhad Ghamari; Ahmad Ghashghaee; Hesam Ghiasvand; Nermin Ghith; Asadollah Gholamian; Rakesh Ghosh; Paramjit Singh Gill; Themba G. Ginindza; Giorgia Giussani; Elena V. Gnedovskaya; Salime Goharinezhad; Sameer Vali Gopalani; Giuseppe Gorini; Houman Goudarzi; Alessandra C. Goulart; Felix Greaves; Michal Grivna; Giuseppe Grosso; Mohammed Ibrahim Mohialdeen Gubari; Harish Chander Gugnani; Rafael Alves Guimarães; Rashid Abdi Guled; Gaorui Guo; Yuming Guo; Rajeev Gupta; Tarun Gupta; Beatrix Haddock; Nima Hafezi-Nejad; Abdul Hafiz; Arvin Haj-Mirzaian; Arya Haj-Mirzaian; Brian J. Hall; Iman Halvaei; Randah R. Hamadeh; Samer Hamidi; Melanie S. Hammer; Graeme J. Hankey; Hamidreza Haririan; Josep Maria Haro; Ahmed I. Hasaballah; Md Mehedi Hasan; Edris Hasanpoor; Abdiwahab Hashi; Soheil Hassanipour; Hadi Hassankhani; Rasmus J. Havmoeller; Simon I. Hay; Khezar Hayat; Golnaz Heidari; Reza Heidari-Soureshjani; Hannah J. Henrikson; Molly E. Herbert; Claudiu Herteliu; Fatemeh Heydarpour; Thomas R. Hird; Hans W. Hoek; Ramesh Holla; Praveen Hoogar; H. Dean Hosgood; Naznin Hossain; Mostafa Hosseini; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Mowafa Househ; Mohamed Hsairi; Vivian Chia-Rong Hsieh; Guoqing Hu; Kejia Hu; Tanvir M. Huda; Ayesha Humayun; Chantal K. Huynh; Bing-Fang Hwang; Vincent C. Iannucci; Segun Emmanuel Ibitoye; Nayu Ikeda; Kevin S. Ikuta; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Leeberk Raja Inbaraj; Helen Ippolito; Usman Iqbal; Seyed Sina Naghibi Irvani; Caleb Mackay Salpeter Irvine; M. Mofizul Islam; Sheikh Mohammed Shariful Islam; Hiroyasu Iso; Rebecca Q. Ivers; Chidozie C.D. Iwu; Chinwe Juliana Iwu; Ihoghosa Osamuyi Iyamu; Jalil Jaafari; Kathryn H. Jacobsen; Hussain Jafari; Morteza Jafarinia; Mohammad Ali Jahani; Mihajlo Jakovljevic; Farzad Jalilian; Spencer L. James; Hosna Janjani; Tahereh Javaheri; Javad Javidnia; Panniyammakal Jeemon; Ensiyeh Jenabi; Ravi Prakash Jha; Vivekanand Jha; John S. Ji; Lars Johansson; Oommen John; Yetunde O. John-Akinola; Catherine Owens Johnson; Jost B. Jonas; Farahnaz Joukar; Jacek Jerzy Jozwiak; Mikk Jürisson; Ali Kabir; Zubair Kabir; Hamed Kalani; Rizwan Kalani; Leila R. Kalankesh; Rohollah Kalhor; Tanuj Kanchan; Neeti Kapoor; Behzad Karami Matin; André Karch; Mohd Anisul Karim; Getachew Mullu Kassa; Srinivasa Vittal Katikireddi; Gbenga A. Kayode; Ali Kazemi Karyani; Peter Njenga Keiyoro; Cathleen Keller; Laura Kemmer; Parkes J. Kendrick; Nauman Khalid; Mohammad Khammarnia; Ejaz Ahmad Khan; Maseer Khan; Khaled Khatab; Mona M. Khater; Mahalaqua Nazli Khatib; Maryam Khayamzadeh; Salman Khazaei; Christian Kieling; Yun Jin Kim; Ruth W. Kimokoti; Adnan Kisa; Sezer Kisa; Mika Kivimäki; Luke D. Knibbs; Ann Kristin Skrindo Knudsen; Jonathan M. Kocarnik; Sonali Kochhar; Jacek A. Kopec; Vladimir Andreevich Korshunov; Parvaiz A. Koul; Ai Koyanagi; Moritz U.G. Kraemer; Kewal Krishan; Kris J. Krohn; Hans Kromhout; Barthelemy Kuate Defo; G. Anil Kumar; Vivek Kumar; Om P. Kurmi; Dian Kusuma; Carlo La Vecchia; Ben Lacey; Dharmesh Kumar Lal; Ratilal Lalloo; Tea Lallukka; Faris Hasan Lami; Iván Landires; Justin J. Lang; Sinéad M. Langan; Anders O. Larsson; Savita Lasrado; Paolo Lauriola; Jeffrey V. Lazarus; Paul H. Lee; Shaun Wen Huey Lee; Kate E. Legrand; James Leigh; Matilde Leonardi; Haley Lescinsky; Janni Leung; Miriam Levi; Shanshan Li; Lee-Ling Lim; Shai Linn; Shiwei Liu; Simin Liu; Yang Liu; Justin Lo; Alan D. Lopez; Jaifred Christian F. Lopez; Platon D. Lopukhov; Stefan Lorkowski; Paulo A. Lotufo; Alton Lu; Alessandra Lugo; Emilie R. Maddison; Phetole Walter Mahasha; Mokhtar Mahdavi Mahdavi; Morteza Mahmoudi; Azeem Majeed; Afshin Maleki; Shokofeh Maleki; Reza Malekzadeh; Deborah Carvalho Malta; Abdullah A. Mamun; Ana Laura Manda; Helena Manguerra; Fariborz Mansour-Ghanaei; Borhan Mansouri; Mohammad Ali Mansournia; Ana M. Mantilla Herrera; Joemer C. Maravilla; Ashley Marks; Randall V. Martin; Santi Martini; Francisco Rogerlândio Martins-Melo; Anthony Masaka; Seyedeh Zahra Masoumi; Manu Raj Mathur; Kunihiro Matsushita; Pallab K. Maulik; Colm McAlinden; John J. McGrath; Martin McKee; Man Mohan Mehndiratta; Fereshteh Mehri; Kala M. Mehta; Ziad A. Memish; Walter Mendoza; Ritesh G. Menezes; Endalkachew Worku Mengesha; Alibek Mereke; Seid Tiku Mereta; Atte Meretoja; Tuomo J. Meretoja; Tomislav Mestrovic; Bartosz Miazgowski; Tomasz Miazgowski; Irmina Maria Michalek; Ted R. Miller; Edward J. Mills; G.K. Mini; Mohammad Miri; Andreea Mirica; Erkin M. Mirrakhimov; Hamed Mirzaei; Maryam Mirzaei; Roya Mirzaei; Mehdi Mirzaei-Alavijeh; Awoke Temesgen Misganaw; Prasanna Mithra; Babak Moazen; Dara K. Mohammad; Yousef Mohammad; Naser Mohammad Gholi Mezerji; Abdollah Mohammadian-Hafshejani; Noushin Mohammadifard; Reza Mohammadpourhodki; Ammas Siraj Mohammed; Hussen Mohammed; Jemal Abdu Mohammed; Shafiu Mohammed; Ali H. Mokdad; Mariam Molokhia; Lorenzo Monasta; Meghan D. Mooney; Ghobad Moradi; Masoud Moradi; Maziar Moradi-Lakeh; Rahmatollah Moradzadeh; Paula Moraga; Lidia Morawska; Joana Morgado-Da-Costa; Shane Douglas Morrison; Abbas Mosapour; Jonathan F. Mosser; Simin Mouodi; Seyyed Meysam Mousavi; Amin Mousavi Khaneghah; Ulrich Otto Mueller; Satinath Mukhopadhyay; Erin C. Mullany; Kamarul Imran Musa; Saravanan Muthupandian; Ashraf F. Nabhan; Mehdi Naderi; Ahamarshan Jayaraman Nagarajan; Gabriele Nagel; Mohsen Naghavi; Behshad Naghshtabrizi; Mukhammad David Naimzada; Farid Najafi; Vinay Nangia; Jobert Richie Nansseu; Morteza Naserbakht; Vinod C. Nayak; Ionut Negoi; Josephine W. Ngunjiri; Cuong Tat Nguyen; Huong Lan Thi Nguyen; Ming Nguyen; Yeshambel T. Nigatu; Rajan Nikbakhsh; Molly R. Nixon; Chukwudi A. Nnaji; Shuhei Nomura; Bo Norrving; Jean Jacques Noubiap; Christoph Nowak; Virginia Nunez-Samudio; Bogdan Oancea; Christopher M. Odell; Felix Akpojene Ogbo; In-Hwan Oh; Emmanuel Wandera Okunga; Morteza Oladnabi; Andrew T. Olagunju; Bolajoko Olubukunola Olusanya; Jacob Olusegun Olusanya; Muktar Omer Omer; Kanyin L. Ong; Obinna E. Onwujekwe; Heather M. Orpana; Alberto Ortiz; Osayomwanbo Osarenotor; Frank B. Osei; Samuel M. Ostroff; Adrian Otoiu; Nikita Otstavnov; Stanislav S. Otstavnov; Simon Øverland; Mayowa O. Owolabi; P.A. Mahesh; Jagadish Rao Padubidri; Raffaele Palladino; Songhomitra Panda-Jonas; Anamika Pandey; Charles D. H. Parry; Maja Pasovic; Deepak Kumar Pasupula; Sangram Kishor Patel; Mona Pathak; Scott B. Patten; George C. Patton; Hamidreza Pazoki Toroudi; Amy E. Peden; Alyssa Pennini; Veincent Christian Filipino Pepito; Emmanuel K. Peprah; David M. Pereira; Konrad Pesudovs; Hai Quang Pham; Michael R. Phillips; Cristiano Piccinelli; Tessa M. Pilz; Michael A. Piradov; Meghdad Pirsaheb; Dietrich Plass; Suzanne Polinder; Kevan R. Polkinghorne; Constance Dimity Pond; Maarten J. Postma; Hadi Pourjafar; Farshad Pourmalek; Anna Poznañska; Sergio I. Prada; V. Prakash; Dimas Ria Angga Pribadi; Elisabetta Pupillo; Zahiruddin Quazi Syed; Mohammad Rabiee; Navid Rabiee; Amir Radfar; Ata Rafiee; Alberto Raggi; Muhammad Aziz Rahman; Ali Rajabpour-Sanati; Fatemeh Rajati; Ivo Rakovac; Pradhum Ram; Kiana Ramezanzadeh; Chhabi Lal Ranabhat; Puja C. Rao; Sowmya J. Rao; Vahid Rashedi; Priya Rathi; David Laith Rawaf; Salman Rawaf; Lal Rawal; Reza Rawassizadeh; Ramu Rawat; Christian Razo; Sofia Boston Redford; Robert C. Reiner; Marissa Bettay Reitsma; Giuseppe Remuzzi; Vishnu Renjith; Andre M.N. Renzaho; Serge Resnikoff; Negar Rezaei; Nima Rezaei; Aziz Rezapour; Phoebe-Anne Rhinehart; Seyed Mohammad Riahi; Daniel Cury Ribeiro; Daniela Ribeiro; Jennifer Rickard; Juan A. Rivera; Nicholas L.S. Roberts; Sonia Rodríguez-Ramírez; Leonardo Roever; Luca Ronfani; Robin Room; Gholamreza Roshandel; Gregory A. Roth; Dietrich Rothenbacher; Enrico Rubagotti; Godfrey M. Rwegerera; Siamak Sabour; Perminder S. Sachdev; Basema Saddik; Ehsan Sadeghi; Masoumeh Sadeghi; Reza Saeedi; Sahar Saeedi Moghaddam; Yahya Safari; Sare Safi; Saeid Safiri; Rajesh Sagar; Amirhossein Sahebkar; S. Mohammad Sajadi; Nasir Salam; Payman Salamati; Hosni Salem; Marwa R. Salem; Hamideh Salimzadeh; Omar Mukhtar Salman; Joshua A. Salomon; Zainab Samad; Hossein Samadi Kafil; Evanson Zondani Sambala; Abdallah M. Samy; Juan Sanabria; Tania G. Sánchez-Pimienta; Damian Francesco Santomauro; Itamar S. Santos; João Vasco Santos; Milena M. Santric-Milicevic; Sivan Yegnanarayana Iyer Saraswathy; Rodrigo Sarmiento-Suárez; Nizal Sarrafzadegan; Benn Sartorius; Arash Sarveazad; Brijesh Sathian; Thirunavukkarasu Sathish; Davide Sattin; Sonia Saxena; Lauren E. Schaeffer; Silvia Schiavolin; Markus P. 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Stanaway; Caroline Stein; Dan J. Stein; Caitlyn Steiner; Leo Stockfelt; Mark A. Stokes; Kurt Straif; Jacob L. Stubbs; Mu'awiyyah Babale Sufiyan; Hafiz Ansar Rasul Suleria; Rizwan Suliankatchi Abdulkader; Gerhard Sulo; Iyad Sultan; Rafael Tabarés-Seisdedos; Karen M. Tabb; Takahiro Tabuchi; Amir Taherkhani; Masih Tajdini; Ken Takahashi; Jukka S. Takala; Animut Tagele Tamiru; Nuno Taveira; Arash Tehrani-Banihashemi; Mohamad-Hani Temsah; Getayeneh Antehunegn Tesema; Zemenu Tadesse Tessema; George D. Thurston; Mariya Vladimirovna Titova; Hamid Reza Tohidinik; Marcello Tonelli; Roman Topor-Madry; Fotis Topouzis; Anna E. Torre; Mathilde Touvier; Marcos Roberto Tovani-Palone; Bach Xuan Tran; Ravensara Travillian; Aristidis Tsatsakis; Lorainne Tudor Car; Stefanos Tyrovolas; Riaz Uddin; Chukwuma David Umeokonkwo; Bhaskaran Unnikrishnan; Era Upadhyay; Marco Vacante; Pascual R. 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Background: Rigorous analysis of levels and trends in exposure to leading risk factors and quantification of their effect on human health are important to identify where public health is making progress and in which cases current efforts are inadequate. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a standardised and comprehensive assessment of the magnitude of risk factor exposure, relative risk, and attributable burden of disease. Methods: GBD 2019 estimated attributable mortality, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs) for 87 risk factors and combinations of risk factors, at the global level, regionally, and for 204 countries and territories. GBD uses a hierarchical list of risk factors so that specific risk factors (eg, sodium intake), and related aggregates (eg, diet quality), are both evaluated. This method has six analytical steps. (1) We included 560 risk–outcome pairs that met criteria for convincing or probable evidence on the basis of research studies. 12 risk–outcome pairs included in GBD 2017 no longer met inclusion criteria and 47 risk–outcome pairs for risks already included in GBD 2017 were added based on new evidence. (2) Relative risks were estimated as a function of exposure based on published systematic reviews, 81 systematic reviews done for GBD 2019, and meta-regression. (3) Levels of exposure in each age-sex-location-year included in the study were estimated based on all available data sources using spatiotemporal Gaussian process regression, DisMod-MR 2.1, a Bayesian meta-regression method, or alternative methods. (4) We determined, from published trials or cohort studies, the level of exposure associated with minimum risk, called the theoretical minimum risk exposure level. (5) Attributable deaths, YLLs, YLDs, and DALYs were computed by multiplying population attributable fractions (PAFs) by the relevant outcome quantity for each age-sex-location-year. (6) PAFs and attributable burden for combinations of risk factors were estimated taking into account mediation of different risk factors through other risk factors. Across all six analytical steps, 30 652 distinct data sources were used in the analysis. Uncertainty in each step of the analysis was propagated into the final estimates of attributable burden. Exposure levels for dichotomous, polytomous, and continuous risk factors were summarised with use of the summary exposure value to facilitate comparisons over time, across location, and across risks. Because the entire time series from 1990 to 2019 has been re-estimated with use of consistent data and methods, these results supersede previously published GBD estimates of attributable burden. Findings: The largest declines in risk exposure from 2010 to 2019 were among a set of risks that are strongly linked to social and economic development, including household air pollution; unsafe water, sanitation, and handwashing; and child growth failure. Global declines also occurred for tobacco smoking and lead exposure. The largest increases in risk exposure were for ambient particulate matter pollution, drug use, high fasting plasma glucose, and high body-mass index. In 2019, the leading Level 2 risk factor globally for attributable deaths was high systolic blood pressure, which accounted for 10·8 million (95% uncertainty interval [UI] 9·51–12·1) deaths (19·2% [16·9–21·3] of all deaths in 2019), followed by tobacco (smoked, second-hand, and chewing), which accounted for 8·71 million (8·12–9·31) deaths (15·4% [14·6–16·2] of all deaths in 2019). The leading Level 2 risk factor for attributable DALYs globally in 2019 was child and maternal malnutrition, which largely affects health in the youngest age groups and accounted for 295 million (253–350) DALYs (11·6% [10·3–13·1] of all global DALYs that year). The risk factor burden varied considerably in 2019 between age groups and locations. Among children aged 0–9 years, the three leading detailed risk factors for attributable DALYs were all related to malnutrition. Iron deficiency was the leading risk factor for those aged 10–24 years, alcohol use for those aged 25–49 years, and high systolic blood pressure for those aged 50–74 years and 75 years and older. Interpretation: Overall, the record for reducing exposure to harmful risks over the past three decades is poor. Success with reducing smoking and lead exposure through regulatory policy might point the way for a stronger role for public policy on other risks in addition to continued efforts to provide information on risk factor harm to the general public. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Global fertility in 204 countries and territories, 1950–2021, with forecasts to 2100: a comprehensive demographic analysis for the Global Burden of Disease Study 2021
(Elsevier B.V., 2024) Natalia V. Bhattacharjee; Austin E. Schumacher; Amirali Aali; Yohannes Habtegiorgis Abate; Rouzbeh Abbasgholizadeh; Mohammadreza Abbasian; Mohsen Abbasi-Kangevari; Hedayat Abbastabar; Samar Abd ElHafeez; Sherief Abd-Elsalam; Mohammad Abdollahi; Mohammad-Amin Abdollahifar; Meriem Abdoun; Auwal Abdullahi; Mesfin Abebe; Samrawit Shawel Abebe; Olumide Abiodun; Hassan Abolhassani; Meysam Abolmaali; Mohamed Abouzid; Girma Beressa Aboye; Lucas Guimarães Abreu; Woldu Aberhe Abrha; Michael R.M. Abrigo; Dariush Abtahi; Hasan Abualruz; Bilyaminu Abubakar; Eman Abu-Gharbieh; Niveen M.E. Abu-Rmeileh; Tadele Girum Girum Adal; Mesafint Molla Adane; Oluwafemi Atanda Adeagbo Adeagbo; Rufus Adesoji Adedoyin; Victor Adekanmbi; Bashir Aden; Abiola Victor Adepoju; Olatunji O. Adetokunboh; Juliana Bunmi Adetunji; Daniel Adedayo Adeyinka; Olorunsola Israel Adeyomoye; Qorinah Estiningtyas Sakilah Adnani; Saryia Adra; Rotimi Felix Afolabi; Shadi Afyouni; Muhammad Sohail Afzal; Saira Afzal; Shahin Aghamiri; Antonella Agodi; Williams Agyemang-Duah; Bright Opoku Ahinkorah; Austin J. Ahlstrom; Aqeel Ahmad; Danish Ahmad; Firdos Ahmad; Muayyad M. Ahmad; Sajjad Ahmad; Tauseef Ahmad; Ali Ahmed; Ayman Ahmed; Haroon Ahmed; Luai A. Ahmed; Meqdad Saleh Ahmed; Syed Anees Ahmed; Marjan Ajami; Budi Aji; Gizachew Taddesse Akalu; Hossein Akbarialiabad; Rufus Olusola Akinyemi; Mohammed Ahmed Akkaif; Sreelatha Akkala; Hanadi Al Hamad; Syed Mahfuz Al Hasan; Mohammad Al Qadire; Tareq Mohammed Ali AL-Ahdal; Samer O. Alalalmeh; Tariq A. Alalwan; Ziyad Al-Aly; Khurshid Alam; Rasmieh Mustafa Al-Amer; Fahad Mashhour Alanezi; Turki M. Alanzi; Almaza Albakri; Mohammed Albashtawy; Mohammad T. AlBataineh; Hediyeh Alemi; Sharifullah Alemi; Yihun Mulugeta Alemu; Ayman Al-Eyadhy; Adel Ali Saeed Al-Gheethi; Khalid F. Alhabib; Noora Alhajri; Fadwa Alhalaiqa Naji Alhalaiqa; Robert Kaba Alhassan; Abid Ali; Beriwan Abdulqadir Ali; Liaqat Ali; Mohammed Usman Ali; Rafat Ali; Syed Shujait Shujait Ali; Sheikh Mohammad Alif; Mohammad Aligol; Mehran Alijanzadeh; Mohammad A.M. Aljasir; Syed Mohamed Aljunid; Sabah Al-Marwani; Joseph Uy Almazan; Hesham M. Al-Mekhlafi; Omar Almidani; Mahmoud A. Alomari; Basem Al-Omari; Jaber S. Alqahtani; Ahmed Yaseen Alqutaibi; Rajaa M. Al-Raddadi; Salman Khalifah Al-Sabah; Awais Altaf; Jaffar A. Al-Tawfiq; Khalid A. Altirkawi; Deborah Oyine Aluh; Farrukh Jawad Alvi; Nelson Alvis-Guzman; Hassan Alwafi; Yaser Mohammed Al-Worafi; Hany Aly; Safwat Aly; Karem H. Alzoubi; Edward Kwabena Ameyaw; Tarek Tawfik Amin; Alireza Amindarolzarbi; Mostafa Amini-Rarani; Sohrab Amiri; Irene Gyamfuah Ampomah; Dickson A. Amugsi; Ganiyu Adeniyi Amusa; Robert Ancuceanu; Deanna Anderlini; Pedro Prata Andrade; Catalina Liliana Andrei; Tudorel Andrei; Abhishek Anil; Sneha Anil; Adnan Ansar; Alireza Ansari-Moghaddam; Catherine M. Antony; Ernoiz Antriyandarti; Saeid Anvari; Saleha Anwar; Razique Anwer; Anayochukwu Edward Anyasodor; Jalal Arabloo; Razman Arabzadeh Bahri; Elshaimaa A. Arafa; Mosab Arafat; Ana Margarida Araujo; Aleksandr Y. Aravkin; Abdulfatai Aremu; Timur Aripov; Mesay Arkew; Benedetta Armocida; Johan Ärnlöv; Mahwish Arooj; Anton A. Artamonov; Judie Arulappan; Raphael Taiwo Aruleba; Ashokan Arumugam; Mohsen Asadi-Lari; Zatollah Asemi; Saeed Asgary; Mona Asghariahmadabad; Mohammad Asghari-Jafarabadi; Mubarek Yesse Ashemo; Muhammad Ashraf; Tahira Ashraf; Marvellous O. Asika; Seyyed Shamsadin Athari; Maha Moh'd Wahbi Atout; Alok Atreya; Avinash Aujayeb; Marcel Ausloos; Abolfazl Avan; Amlaku Mulat Aweke; Getnet Melaku Ayele; Seyed Mohammad Ayyoubzadeh; Sina Azadnajafabad; Rui M.S. Azevedo; Ahmed Y. Azzam; Muhammad Badar; Ashish D. Badiye; Soroush Baghdadi; Nasser Bagheri; Sara Bagherieh; Najmeh Bahmanziari; Ruhai Bai; Atif Amin Baig; Jennifer L. Baker; Abdulaziz T. Bako; Ravleen Kaur Bakshi; Madhan Balasubramanian; Ovidiu Constantin Baltatu; Kiran Bam; MacIej Banach; Soham Bandyopadhyay; Biswajit Banik; Palash Chandra Banik; Hansi Bansal; Mehmet Firat Baran; Martina Barchitta; Mainak Bardhan; Erfan Bardideh; Suzanne Lyn Barker-Collo; Till Winfried Bärnighausen; Francesco Barone-Adesi; Hiba Jawdat Barqawi; Amadou Barrow; Sandra Barteit; Zarrin Basharat; Asma'u I.J. Bashir; Hameed Akande Bashiru; Afisu Basiru; Joao Diogo Basso; Sanjay Basu; Abdul-Monim Mohammad Batiha; Kavita Batra; Bernhard T. Baune; Mohsen Bayati; Tahmina Begum; Emad Behboudi; Amir Hossein Behnoush; Maryam Beiranvand; Diana Fernanda Bejarano Ramirez; Alehegn Bekele; Sefealem Assefa Belay; Uzma Iqbal Belgaumi; Michelle L. Bell; Olorunjuwon Omolaja Bello; Apostolos Beloukas; Isabela M. Bensenor; Zombor Berezvai; Alemshet Yirga Berhie; Amiel Nazer C. Bermudez; Paulo J.G. Bettencourt; Akshaya Srikanth Bhagavathula; Nikha Bhardwaj; Pankaj Bhardwaj; Prarthna V. Bhardwaj; Sonu Bhaskar; Vivek Bhat; Gurjit Kaur Bhatti; Jasvinder Singh Bhatti; Manpreet S. Bhatti; Rajbir Bhatti; Antonio Biondi; Catherine Bisignano; Atanu Biswas; Raaj Kishore Biswas; Veera R. Bitra; Tone Bjørge; Elye Bliss; Micheal Kofi Boachie; Anca Vasilica Bobirca; Virginia Bodolica; Aadam Olalekan Bodunrin; Eyob Ketema Bogale; Kassawmar Angaw Bogale; Milad Bonakdar Hashemi; Berrak Bora Basara; Souad Bouaoud; Dejana Braithwaite; Michael Brauer; Nicholas J.K. Breitborde; Dana Bryazka; Norma B. Bulamu; Danilo Buonsenso; Katrin Burkart; Richard A. Burns; Yasser Bustanji; Nadeem Shafique Butt; Zahid A. Butt; Florentino Luciano Caetano Dos Santos; Daniela Calina; Ismael R. Campos-Nonato; Fan Cao; Shujin Cao; Angelo Capodici; Giulia Carreras; Andrea Carugno; Carlos A. Castañeda-Orjuela; Giulio Castelpietra; Maria Sofia Cattaruzza; Arthur Caye; Luca Cegolon; Francieli Cembranel; Ester Cerin; Joshua Chadwick; Yaacoub Chahine; Chiranjib Chakraborty; Julian Chalek; Jeffrey Shi Kai Chan; Periklis Charalampous; Vijay Kumar Chattu; Sarika Chaturvedi; Malizgani Paul Chavula; An-Tian Chen; Haowei Chen; Simiao Chen; Gerald Chi; Fatemeh Chichagi; Ju-Huei Chien; Patrick R. Ching; William C.S. Cho; Sungchul Choi; Bryan Chong; Hitesh Chopra; Sonali Gajanan Choudhari; Devasahayam J. Christopher; Dinh-Toi Chu; Isaac Sunday Chukwu; Eric Chung; Sheng-Chia Chung; Zinhle Cindi; Iolanda Cioffi; Raffaela Ciuffreda; Rafael M. Claro; Kaleb Coberly; Alyssa Columbus; Haley Comfort; Joao Conde; Michael H. Criqui; Natalia Cruz-Martins; Silvia Magali Cuadra-Hernández; Sriharsha Dadana; Omid Dadras; Tukur Dahiru; Zhaoli Dai; Bronte Dalton; Giovanni Damiani; Aso Mohammad Darwesh; Jai K. Das; Saswati Das; Mohsen Dashti; Anna Dastiridou; Claudio Alberto Dávila-Cervantes; Kairat Davletov; Aklilu Tamire Debele; Shayom Debopadhaya; Somayeh Delavari; Ivan Delgado-Enciso; Dessalegn Demeke; Berecha Hundessa Demessa; Xinlei Deng; Edgar Denova-Gutiérrez; Kebede Deribe; Nikolaos Dervenis; Hardik Dineshbhai Desai; Rupak Desai; Vinoth Gnana Chellaiyan Devanbu; Arkadeep Dhali; Kuldeep Dhama; Meghnath Dhimal; Vishal R. Dhulipala; Diana Dias Da Silva; Daniel Diaz; Michael J. Diaz; Adriana Dima; Delaney D. Ding; M. Ashworth Dirac; Thanh Chi Do; Thao Huynh Phuong Do; Camila Bruneli Do Prado; Sushil Dohare; Wanyue Dong; Mario D'Oria; Wendel Mombaque Dos Santos; Leila Doshmangir; Robert Kokou Dowou; Ashel Chelsea Dsouza; Haneil Larson Dsouza; Viola Dsouza; John Dube; Joe Duprey; Andre Rodrigues Duraes; Senbagam Duraisamy; Oyewole Christopher Durojaiye; Sulagna Dutta; Laura Dwyer-Lindgren; Paulina Agnieszka Dzianach; Arkadiusz Marian Dziedzic; Alireza Ebrahimi; Hisham Atan Edinur; Kristina Edvardsson; Ferry Efendi; Terje Andreas Eikemo; Michael Ekholuenetale; Maha El Tantawi; Noha Mousaad Elemam; Ghada Metwally Tawfik ElGohary; Muhammed Elhadi; Legesse Tesfaye Elilo; Omar Abdelsadek Abdou Elmeligy; Mohamed A. Elmonem; Mohammed Elshaer; Ibrahim Elsohaby; Amir Emami Zeydi; Luchuo Engelbert Bain; Sharareh Eskandarieh; Francesco Esposito; Kara Estep; Farshid Etaee; Natalia Fabin; Adeniyi Francis Fagbamigbe; Saman Fahimi; Aliasghar Fakhri-Demeshghieh; Luca Falzone; Ali Faramarzi; MoezAlIslam Ezzat Mahmoud Faris; Sam Farmer; Andre Faro; Abidemi Omolara Fasanmi; Ali Fatehizadeh; Nelsensius Klau Fauk; Pooria Fazeli; Valery L. Feigin; Seyed-Mohammad Fereshtehnejad; Abdullah Hamid Feroze; Pietro Ferrara; Nuno Ferreira; Getahun Fetensa; Irina Filip; Florian Fischer; Joanne Flavel; Nataliya A. Foigt; Morenike Oluwatoyin Folayan; Artem Alekseevich Fomenkov; Behzad Foroutan; Matteo Foschi; Kayode Raphael Fowobaje; Kate Louise Francis; Alberto Freitas; Takeshi Fukumoto; John E. Fuller; Blima Fux; Peter Andras Gaal; Muktar A. Gadanya; Abhay Motiramji Gaidhane; Yaseen Galali; Silvano Gallus; Aravind P. Gandhi; Balasankar Ganesan; Mohammad Arfat Ganiyani; M.A. Garcia-Gordillo; Naval Garg; Rupesh K. Gautam; Federica Gazzelloni; Semiu Olatunde Gbadamosi; Miglas W. Gebregergis; Mesfin Gebrehiwot; Tesfay Brhane Gebremariam; Teferi Gebru Gebremeskel; Yohannes Fikadu Geda; Simona Roxana Georgescu; Urge Gerema; Habtamu Geremew; Motuma Erena Getachew; Peter W. Gething; MohammadReza Ghasemi; Ghazal Ghasempour Dabaghi; Afsaneh Ghasemzadeh; Fariba Ghassemi; Ramy Mohamed Ghazy; Sailaja Ghimire; Asadollah Gholamian; Ali Gholamrezanezhad; Mahsa Ghorbani; Aloke Gopal Ghoshal; Arun Digambarrao Ghuge; Artyom Urievich Gil; Tiffany K. Gill; Matteo Giorgi; Alem Girmay; James C. Glasbey; Laszlo Göbölös; Amit Goel; Ali Golchin; Mahaveer Golechha; Pouya Goleij; Sameer Vali Gopalani; Houman Goudarzi; Alessandra C. Goulart; Anmol Goyal; Simon Matthew Graham; Michal Grivna; Shi-Yang Guan; Giovanni Guarducci; Mohammed Ibrahim Mohialdeen Gubari; Mesay Dechasa Gudeta; Stefano Guicciardi; Snigdha Gulati; David Gulisashvili; Damitha Asanga Gunawardane; Cui Guo; Anish Kumar Gupta; Bhawna Gupta; Manoj Kumar Gupta; Mohak Gupta; Sapna Gupta; Veer Bala Gupta; Vijai Kumar Gupta; Vivek Kumar Gupta; Annie Haakenstad; Farrokh Habibzadeh; Najah R. Hadi; Nils Haep; Ramtin Hajibeygi; Sebastian Haller; Rabih Halwani; Randah R. Hamadeh; Nadia M. Hamdy; Sajid Hameed; Samer Hamidi; Qiuxia Han; Alexis J. Handal; Graeme J. Hankey; Md Nuruzzaman Haque; Josep Maria Haro; Ahmed I. Hasaballah; Ikramul Hasan; Mohammad Jahid Hasan; S.M. Mahmudul Hasan; Hamidreza Hasani; Md Saquib Hasnain; Amr Hassan; Ikrama Hassan; Soheil Hassanipour; Hadi Hassankhani; Simon I. Hay; Jeffrey J. Hebert; Omar E. Hegazi; Mohammad Heidari; Bartosz Helfer; Mehdi Hemmati; Brenda Yuliana Herrera-Serna; Claudiu Herteliu; Kamran Hessami; Kamal Hezam; Yuta Hiraike; Nguyen Quoc Hoan; Ramesh Holla; Nobuyuki Horita; Md Mahbub Hossain; Mohammad Bellal Hossain Hossain; Hassan Hosseinzadeh; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Mohamed Hsairi; Vivian Chia-Rong Hsieh; Chengxi Hu; Junjie Huang; M. Mamun Huda; Ayesha Humayun; Javid Hussain; Nawfal R. Hussein; Hong-Han Huynh; Bing-Fang Hwang; Segun Emmanuel Ibitoye; Pulwasha Maria Iftikhar; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Mustapha Immurana; Leeberk Raja Inbaraj; Afrin Iqbal; Md. Rabiul Islam; Nahlah Elkudssiah Ismail; Hiroyasu Iso; Gaetano Isola; Masao Iwagami; Mahalaxmi Iyer; J. 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Background: Accurate assessments of current and future fertility—including overall trends and changing population age structures across countries and regions—are essential to help plan for the profound social, economic, environmental, and geopolitical challenges that these changes will bring. Estimates and projections of fertility are necessary to inform policies involving resource and health-care needs, labour supply, education, gender equality, and family planning and support. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 produced up-to-date and comprehensive demographic assessments of key fertility indicators at global, regional, and national levels from 1950 to 2021 and forecast fertility metrics to 2100 based on a reference scenario and key policy-dependent alternative scenarios. Methods: To estimate fertility indicators from 1950 to 2021, mixed-effects regression models and spatiotemporal Gaussian process regression were used to synthesise data from 8709 country-years of vital and sample registrations, 1455 surveys and censuses, and 150 other sources, and to generate age-specific fertility rates (ASFRs) for 5-year age groups from age 10 years to 54 years. ASFRs were summed across age groups to produce estimates of total fertility rate (TFR). Livebirths were calculated by multiplying ASFR and age-specific female population, then summing across ages 10–54 years. To forecast future fertility up to 2100, our Institute for Health Metrics and Evaluation (IHME) forecasting model was based on projections of completed cohort fertility at age 50 years (CCF50; the average number of children born over time to females from a specified birth cohort), which yields more stable and accurate measures of fertility than directly modelling TFR. CCF50 was modelled using an ensemble approach in which three sub-models (with two, three, and four covariates variously consisting of female educational attainment, contraceptive met need, population density in habitable areas, and under-5 mortality) were given equal weights, and analyses were conducted utilising the MR-BRT (meta-regression—Bayesian, regularised, trimmed) tool. To capture time-series trends in CCF50 not explained by these covariates, we used a first-order autoregressive model on the residual term. CCF50 as a proportion of each 5-year ASFR was predicted using a linear mixed-effects model with fixed-effects covariates (female educational attainment and contraceptive met need) and random intercepts for geographical regions. Projected TFRs were then computed for each calendar year as the sum of single-year ASFRs across age groups. The reference forecast is our estimate of the most likely fertility future given the model, past fertility, forecasts of covariates, and historical relationships between covariates and fertility. We additionally produced forecasts for multiple alternative scenarios in each location: the UN Sustainable Development Goal (SDG) for education is achieved by 2030; the contraceptive met need SDG is achieved by 2030; pro-natal policies are enacted to create supportive environments for those who give birth; and the previous three scenarios combined. Uncertainty from past data inputs and model estimation was propagated throughout analyses by taking 1000 draws for past and present fertility estimates and 500 draws for future forecasts from the estimated distribution for each metric, with 95% uncertainty intervals (UIs) given as the 2·5 and 97·5 percentiles of the draws. To evaluate the forecasting performance of our model and others, we computed skill values—a metric assessing gain in forecasting accuracy—by comparing predicted versus observed ASFRs from the past 15 years (2007–21). A positive skill metric indicates that the model being evaluated performs better than the baseline model (here, a simplified model holding 2007 values constant in the future), and a negative metric indicates that the evaluated model performs worse than baseline. Findings: During the period from 1950 to 2021, global TFR more than halved, from 4·84 (95% UI 4·63–5·06) to 2·23 (2·09–2·38). Global annual livebirths peaked in 2016 at 142 million (95% UI 137–147), declining to 129 million (121–138) in 2021. Fertility rates declined in all countries and territories since 1950, with TFR remaining above 2·1—canonically considered replacement-level fertility—in 94 (46·1%) countries and territories in 2021. This included 44 of 46 countries in sub-Saharan Africa, which was the super-region with the largest share of livebirths in 2021 (29·2% [28·7–29·6]). 47 countries and territories in which lowest estimated fertility between 1950 and 2021 was below replacement experienced one or more subsequent years with higher fertility; only three of these locations rebounded above replacement levels. Future fertility rates were projected to continue to decline worldwide, reaching a global TFR of 1·83 (1·59–2·08) in 2050 and 1·59 (1·25–1·96) in 2100 under the reference scenario. The number of countries and territories with fertility rates remaining above replacement was forecast to be 49 (24·0%) in 2050 and only six (2·9%) in 2100, with three of these six countries included in the 2021 World Bank-defined low-income group, all located in the GBD super-region of sub-Saharan Africa. The proportion of livebirths occurring in sub-Saharan Africa was forecast to increase to more than half of the world's livebirths in 2100, to 41·3% (39·6–43·1) in 2050 and 54·3% (47·1–59·5) in 2100. The share of livebirths was projected to decline between 2021 and 2100 in most of the six other super-regions—decreasing, for example, in south Asia from 24·8% (23·7–25·8) in 2021 to 16·7% (14·3–19·1) in 2050 and 7·1% (4·4–10·1) in 2100—but was forecast to increase modestly in the north Africa and Middle East and high-income super-regions. Forecast estimates for the alternative combined scenario suggest that meeting SDG targets for education and contraceptive met need, as well as implementing pro-natal policies, would result in global TFRs of 1·65 (1·40–1·92) in 2050 and 1·62 (1·35–1·95) in 2100. The forecasting skill metric values for the IHME model were positive across all age groups, indicating that the model is better than the constant prediction. Interpretation: Fertility is declining globally, with rates in more than half of all countries and territories in 2021 below replacement level. Trends since 2000 show considerable heterogeneity in the steepness of declines, and only a small number of countries experienced even a slight fertility rebound after their lowest observed rate, with none reaching replacement level. Additionally, the distribution of livebirths across the globe is shifting, with a greater proportion occurring in the lowest-income countries. Future fertility rates will continue to decline worldwide and will remain low even under successful implementation of pro-natal policies. These changes will have far-reaching economic and societal consequences due to ageing populations and declining workforces in higher-income countries, combined with an increasing share of livebirths among the already poorest regions of the world. Funding: Bill & Melinda Gates Foundation. © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Global, regional, and national burden of stroke and its risk factors, 1990-2019: A systematic analysis for the Global Burden of Disease Study 2019
(Elsevier Ltd, 2021) Valery L. Feigin; Benjamin A. Stark; Catherine Owens Johnson; Gregory A. Roth; Catherine Bisignano; Gdiom Gebreheat Abady; Mitra Abbasifard; Mohsen Abbasi-Kangevari; Foad Abd-Allah; Vida Abedi; Ahmed Abualhasan; Niveen M.E. Abu-Rmeileh; Abdelrahman I. Abushouk; Oladimeji M. Adebayo; Gina Agarwal; Pradyumna Agasthi; Bright Opoku Ahinkorah; Sohail Ahmad; Sepideh Ahmadi; Yusra Ahmed Salih; Budi Aji; Samaneh Akbarpour; Rufus Olusola Akinyemi; Hanadi Al Hamad; Fares Alahdab; Sheikh Mohammad Alif; Vahid Alipour; Syed Mohamed Aljunid; Sami Almustanyir; Rajaa M Al-Raddadi; Rustam Al-Shahi Salman; Nelson Alvis-Guzman; Robert Ancuceanu; Deanna Anderlini; Jason A. Anderson; Adnan Ansar; Ippazio Cosimo Antonazzo; Jalal Arabloo; Johan Ärnlöv; Kurnia Dwi Artanti; Zahra Aryan; Samaneh Asgari; Tahira Ashraf; Mohammad Athar; Alok Atreya; Marcel Ausloos; Atif Amin Baig; Ovidiu Constantin Baltatu; MacIej Banach; Miguel A. Barboza; Suzanne Lyn Barker-Collo; Till Winfried Bärnighausen; Mark Thomaz Ugliara Barone; Sanjay Basu; Gholamreza Bazmandegan; Ettore Beghi; Mahya Beheshti; Yannick Béjot; Arielle Wilder Bell; Derrick A. Bennett; Isabela M. Bensenor; Woldesellassie Mequanint Bezabhe; Yihienew Mequanint Bezabih; Akshaya Srikanth Bhagavathula; Pankaj Bhardwaj; Krittika Bhattacharyya; Ali Bijani; Boris Bikbov; Mulugeta M. Birhanu; Archith Boloor; Aime Bonny; Michael Brauer; Hermann Brenner; Dana Bryazka; Zahid A. Butt; Florentino Luciano Caetano Dos Santos; Ismael R. Campos-Nonato; Carlos Cantu-Brito; Juan J. Carrero; Carlos A. Castañeda-Orjuela; Alberico L. Catapano; Promit Ananyo Chakraborty; Jaykaran Charan; Sonali Gajanan Choudhari; Enayet Karim Chowdhury; Dinh-Toi Chu; Sheng-Chia Chung; David Colozza; Vera Marisa Costa; Simona Costanzo; Michael H. Criqui; Omid Dadras; Baye Dagnew; Xiaochen Dai; Koustuv Dalal; Albertino Antonio Moura Damasceno; Emanuele D'Amico; Lalit Dandona; Rakhi Dandona; Jiregna Darega Gela; Kairat Davletov; Vanessa De La Cruz-Góngora; Rupak Desai; Deepak Dhamnetiya; Samath Dhamminda Dharmaratne; Mandira Lamichhane Dhimal; Meghnath Dhimal; Daniel Diaz; Martin Dichgans; Klara Dokova; Rajkumar Doshi; Abdel Douiri; Bruce B. Duncan; Sahar Eftekharzadeh; Michael Ekholuenetale; Nevine El Nahas; Islam Y. Elgendy; Muhammed Elhadi; Shaimaa I El-Jaafary; Matthias Endres; Aman Yesuf Endries; Daniel Asfaw Erku; Emerito Jose A. Faraon; Umar Farooque; Farshad Farzadfar; Abdullah Hamid Feroze; Irina Filip; Florian Fischer; David Flood; Mohamed M. Gad; Shilpa Gaidhane; Reza Ghanei Gheshlagh; Ahmad Ghashghaee; Nermin Ghith; Ghozali Ghozali; Sherief Ghozy; Alessandro Gialluisi; Simona Giampaoli; Syed Amir Gilani; Paramjit Singh Gill; Elena V. Gnedovskaya; Mahaveer Golechha; Alessandra C. Goulart; Yuming Guo; Rajeev Gupta; Veer Bala Gupta; Vivek Kumar Gupta; Pradip Gyanwali; Nima Hafezi-Nejad; Samer Hamidi; Asif Hanif; Graeme J. Hankey; Arief Hargono; Abdiwahab Hashi; Treska S. Hassan; Hamid Yimam Hassen; Rasmus J. Havmoeller; Simon I. Hay; Khezar Hayat; Mohamed I. Hegazy; Claudiu Herteliu; Ramesh Holla; Sorin Hostiuc; Mowafa Househ; Junjie Huang; Ayesha Humayun; Bing-Fang Hwang; Licia Iacoviello; Ivo Iavicoli; Segun Emmanuel Ibitoye; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Usman Iqbal; Seyed Sina Naghibi Irvani; Sheikh Mohammed Shariful Islam; Nahlah Elkudssiah Ismail; Hiroyasu Iso; Gaetano Isola; Masao Iwagami; Louis Jacob; Vardhmaan Jain; Sung-In Jang; Sathish Kumar Jayapal; Shubha Jayaram; Ranil Jayawardena; Panniyammakal Jeemon; Ravi Prakash Jha; Walter D. Johnson; Jost B. Jonas; Nitin Joseph; Jacek Jerzy Jozwiak; Mikk Jürisson; Rizwan Kalani; Rohollah Kalhor; Yogeshwar Kalkonde; Ashwin Kamath; Zahra Kamiab; Tanuj Kanchan; Himal Kandel; André Karch; Patrick D.M.C. Katoto; Gbenga A. Kayode; Pedram Keshavarz; Yousef Saleh Khader; Ejaz Ahmad Khan; Imteyaz A. Khan; Maseer Khan; Moien A.B. Khan; Mahalaqua Nazli Khatib; Jagdish Khubchandani; Gyu Ri Kim; Min Seo Kim; Yun Jin Kim; Adnan Kisa; Sezer Kisa; Mika Kivimäki; Dhaval Kolte; Ali Koolivand; Sindhura Lakshmi Koulmane Laxminarayana; Ai Koyanagi; Kewal Krishan; Vijay Krishnamoorthy; Rita V. Krishnamurthi; G. Anil Kumar; Dian Kusuma; Carlo La Vecchia; Ben Lacey; Hassan Mehmood Lak; Tea Lallukka; Savita Lasrado; Pablo M. Lavados; Matilde Leonardi; Bingyu Li; Shanshan Li; Hualiang Lin; Ro-Ting Lin; Xuefeng Liu; Warren David Lo; Stefan Lorkowski; Giancarlo Lucchetti; Ricardo Lutzky Saute; Hassan Magdy Abd El Razek; Francesca Giulia Magnani; Preetam Bhalchandra Mahajan; Azeem Majeed; Alaa Makki; Reza Malekzadeh; Ahmad Azam Malik; Navid Manafi; Mohammad Ali Mansournia; Lorenzo Giovanni Mantovani; Santi Martini; Giampiero Mazzaglia; Man Mohan Mehndiratta; Ritesh G. Menezes; Atte Meretoja; Amanual Getnet Mersha; Junmei Miao Jonasson; Bartosz Miazgowski; Tomasz Miazgowski; Irmina Maria Michalek; Erkin M. Mirrakhimov; Yousef Mohammad; Abdollah Mohammadian-Hafshejani; Shafiu Mohammed; Ali H. Mokdad; Yaser Mokhayeri; Mariam Molokhia; Mohammad Ali Moni; Ahmed Al Montasir; Rahmatollah Moradzadeh; Lidia Morawska; Jakub Morze; Walter Muruet; Kamarul Imran Musa; Ahamarshan Jayaraman Nagarajan; Mohsen Naghavi; Sreenivas Narasimha Swamy; Bruno Ramos Nascimento; Ruxandra Irina Negoi; Sandhya Neupane Kandel; Trang Huyen Nguyen; Bo Norrving; Jean Jacques Noubiap; Vincent Ebuka Nwatah; Bogdan Oancea; Oluwakemi Ololade Odukoya; Andrew T. Olagunju; Hans Orru; Mayowa O. Owolabi; Jagadish Rao Padubidri; Adrian Pana; Tarang Parekh; Eun-Cheol Park; Fatemeh Pashazadeh Kan; Mona Pathak; Mario F.P. Peres; Arokiasamy Perianayagam; Truong-Minh Pham; Michael A. Piradov; Vivek Podder; Suzanne Polinder; Maarten J. Postma; Akram Pourshams; Amir Radfar; Alireza Rafiei; Alberto Raggi; Fakher Rahim; Vafa Rahimi-Movaghar; Mosiur Rahman; Muhammad Aziz Rahman; Amir Masoud Rahmani; Nazanin Rajai; Priyanga Ranasinghe; Chythra R. Rao; Sowmya J. Rao; Priya Rathi; David Laith Rawaf; Salman Rawaf; Marissa B. Reitsma; Vishnu Renjith; Andre M.N. Renzaho; Aziz Rezapour; Jefferson Antonio Buendia Rodriguez; Leonardo Roever; Michele Romoli; Andrzej Rynkiewicz; Simona Sacco; Masoumeh Sadeghi; Sahar Saeedi Moghaddam; Amirhossein Sahebkar; K.M. Saif-Ur-Rahman; Rehab Salah; Mehrnoosh Samaei; Abdallah M. Samy; Itamar S. Santos; Milena M. Santric-Milicevic; Nizal Sarrafzadegan; Brijesh Sathian; Davide Sattin; Silvia Schiavolin; Markus P. Schlaich; Maria Inês Schmidt; Aletta Elisabeth Schutte; Sadaf G. Sepanlou; Allen Seylani; Feng Sha; Saeed Shahabi; Masood Ali Shaikh; Mohammed Shannawaz; Md. Shajedur Rahman Shawon; Aziz Sheikh; Sara Sheikhbahaei; Kenji Shibuya; Soraya Siabani; Diego Augusto Santos Silva; Jasvinder A. Singh; Jitendra Kumar Singh; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Badr Hasan Sobaih; Stefan Stortecky; Saverio Stranges; Eyayou Girma Tadesse; Ingan Ukur Tarigan; Mohamad-Hani Temsah; Yvonne Teuschl; Amanda G. Thrift; Marcello Tonelli; Marcos Roberto Tovani-Palone; Bach Xuan Tran; Manjari Tripathi; Gebiyaw Wudie Tsegaye; Anayat Ullah; Brigid Unim; Bhaskaran Unnikrishnan; Alireza Vakilian; Sahel Valadan Tahbaz; Tommi Juhani Vasankari; Narayanaswamy Venketasubramanian; Dominique Vervoort; Bay Vo; Victor Volovici; Kia Vosoughi; Giang Thu Vu; Linh Gia Vu; Hatem A. Wafa; Yasir Waheed; Yanzhong Wang; Tissa Wijeratne; Andrea Sylvia Winkler; Charles D.A. Wolfe; Mark Woodward; Jason H. Wu; Sarah Wulf Hanson; Xiaoyue Xu; Lalit Yadav; Ali Yadollahpour; Seyed Hossein Yahyazadeh Jabbari; Kazumasa Yamagishi; Hiroshi Yatsuya; Naohiro Yonemoto; Chuanhua Yu; Ismaeel Yunusa; Muhammed Shahriar Zaman; Sojib Bin Zaman; Maryam Zamanian; Ramin Zand; Alireza Zandifar; Mikhail Sergeevich Zastrozhin; Anasthasia Zastrozhina; Yunquan Zhang; Zhi-Jiang Zhang; Chenwen Zhong; Yves Miel H. Zuniga; Christopher J.L. Murray
Background Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. Methods We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. Findings In 2019, there were 12·2 million (95% UI 11·0–13·6) incident cases of stroke, 101 million (93·2–111) prevalent cases of stroke, 143 million (133–153) DALYs due to stroke, and 6·55 million (6·00–7·02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11·6% [10·8–12·2] of total deaths) and the third-leading cause of death and disability combined (5·7% [5·1–6·2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70·0% (67·0–73·0), prevalent strokes increased by 85·0% (83·0–88·0), deaths from stroke increased by 43·0% (31·0–55·0), and DALYs due to stroke increased by 32·0% (22·0–42·0). During the same period, age-standardised rates of stroke incidence decreased by 17·0% (15·0–18·0), mortality decreased by 36·0% (31·0–42·0), prevalence decreased by 6·0% (5·0–7·0), and DALYs decreased by 36·0% (31·0–42·0). However, among people younger than 70 years, prevalence rates increased by 22·0% (21·0–24·0) and incidence rates increased by 15·0% (12·0–18·0). In 2019, the age-standardised stroke-related mortality rate was 3·6 (3·5–3·8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3·7 (3·5–3·9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62·4% of all incident strokes in 2019 (7·63 million [6·57–8·96]), while intracerebral haemorrhage constituted 27·9% (3·41 million [2·97–3·91]) and subarachnoid haemorrhage constituted 9·7% (1·18 million [1·01–1·39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79·6 million [67·7–90·8] DALYs or 55·5% [48·2–62·0] of total stroke DALYs), high body-mass index (34·9 million [22·3–48·6] DALYs or 24·3% [15·7–33·2]), high fasting plasma glucose (28·9 million [19·8–41·5] DALYs or 20·2% [13·8–29·1]), ambient particulate matter pollution (28·7 million [23·4–33·4] DALYs or 20·1% [16·6–23·0]), and smoking (25·3 million [22·6–28·2] DALYs or 17·6% [16·4–19·0]). Interpretation The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries. © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-Adjusted life-years for 29 cancer groups, 1990 to 2017: A systematic analysis for the global burden of disease study
(American Medical Association, 2019) Christina Fitzmaurice; Degu Abate; Naghmeh Abbasi; Hedayat Abbastabar; Foad Abd-Allah; Omar Abdel-Rahman; Ahmed Abdelalim; Amir Abdoli; Ibrahim Abdollahpour; Abdishakur S. M. Abdulle; Nebiyu Dereje Abebe; Haftom Niguse Abraha; Laith Jamal Abu-Raddad; Ahmed Abualhasan; Isaac Akinkunmi Adedeji; Shailesh M. Advani; Mohsen Afarideh; Mahdi Afshari; Mohammad Aghaali; Dominic Agius; Sutapa Agrawal; Ayat Ahmadi; Elham Ahmadian; Ehsan Ahmadpour; Muktar Beshir Ahmed; Mohammad Esmaeil Akbari; Tomi Akinyemiju; Ziyad Al-Aly; Assim M. Alabdulkader; Fares Alahdab; Tahiya Alam; Genet Melak Alamene; Birhan Tamene T. Alemnew; Kefyalew Addis Alene; Cyrus Alinia; Vahid Alipour; Syed Mohamed Aljunid; Fatemeh Allah Bakeshei; Majid Abdulrahman Hamad Almadi; Amir Almasi-Hashiani; Ubai Alsharif; Shirina Alsowaidi; Nelson Alvis-Guzman; Erfan Amini; Saeed Amini; Yaw Ampem Amoako; Zohreh Anbari; Nahla Hamed Anber; Catalina Liliana Andrei; Mina Anjomshoa; Fereshteh Ansari; Ansariadi Ansariadi; Seth Christopher Yaw Appiah; Morteza Arab-Zozani; Jalal Arabloo; Zohreh Arefi; Olatunde Aremu; Habtamu Abera Areri; Al Artaman; Hamid Asayesh; Ephrem Tsegay Asfaw; Alebachew Fasil Ashagre; Reza Assadi; Bahar Ataeinia; Hagos Tasew Atalay; Zerihun Ataro; Suleman Atique; Marcel Ausloos; Leticia Avila-Burgos; Euripide F. G. A. Avokpaho; Ashish Awasthi; Nefsu Awoke; Beatriz Paulina Ayala Quintanilla; Martin Amogre Ayanore; Henok Tadesse Ayele; Ebrahim Babaee; Umar Bacha; Alaa Badawi; Mojtaba Bagherzadeh; Eleni Bagli; Senthilkuimar Balakrishnan; Abbas Balouchi; Till Winfried Barnighausen; Robert J. Battista; Masoud Behzadifar; Meysam Behzadifar; Bayu Begashaw Bekele; Yared Belete Belay; Yaschilal Muche Belayneh; Kathleen Kim Sachiko Berfield; Adugnaw Berhane; Eduardo Bernabe; Mircea Beuran; Nickhill Bhakta; Krittika Bhattacharyya; Belete Biadgo; Ali Bijani; Muhammad Shahdaat Bin Sayeed; Charles Birungi; Catherine Bisignano; Helen Bitew; Tone Bjorge; Archie Bleyer; Kassawmar Angaw Bogale; Hunduma Amensisa Bojia; Antonio M. Borzi; Cristina Bosetti; Ibrahim R. Bou-Orm; Hermann Brenner; Jerry D. Brewer; Andrey Nikolaevich Briko; Nikolay Ivanovich Briko; Maria Teresa Bustamante-Teixeira; Zahid A. Butt; Giulia Carreras; Juan J. Carrero; Felix Carvalho; Clara Castro; Franz Castro; Ferran Catala-Lopez; Ester Cerin; Yazan Chaiah; Wagaye Fentahun Chanie; Vijay Kumar Chattu; Pankaj Chaturvedi; Neelima Singh Chauhan; Mohammad Chehrazi; Peggy Pei-Chia Chiang; Tesfaye Yitna Chichiabellu; Onyema Greg Chido-Amajuoyi; Odgerel Chimed-Ochir; Jee-Young J. Choi; Devasahayam J. Christopher; Dinh-Toi Chu; Maria-Magdalena Constantin; Vera M. Costa; Emanuele Crocetti; Christopher Stephen Crowe; Maria Paula Curado; Saad M. A. Dahlawi; Giovanni Damiani; Amira Hamed Darwish; Ahmad Daryani; Jose Das Neves; Feleke Mekonnen Demeke; Asmamaw Bizuneh Demis; Birhanu Wondimeneh Demissie; Gebre Teklemariam Demoz; Edgar Denova-Gutierrez; Afshin Derakhshani; Kalkidan Solomon Deribe; Rupak Desai; Beruk Berhanu Desalegn; Melaku Desta; Subhojit Dey; Samath Dhamminda Dharmaratne; Meghnath Dhimal; Daniel Diaz; Mesfin Tadese Tadese Dinberu; Shirin Djalalinia; David Teye Doku; Thomas M. Drake; Manisha Dubey; Eleonora Dubljanin; Eyasu Ejeta Duken; Hedyeh Ebrahimi; Andem Effiong; Aziz Eftekhari; Iman El Sayed; Maysaa El Sayed Zaki; Shaimaa I. El-Jaafary; Ziad El-Khatib; Demelash Abewa Elemineh; Hajer Elkout; Richard G. Ellenbogen; Aisha Elsharkawy; Mohammad Hassan Emamian; Daniel Adane Endalew; Aman Yesuf Endries; Babak Eshrati; Ibtihal Fadhil; Vahid Fallah; Mahbobeh Faramarzi; Mahdieh Abbasalizad Farhangi; Andrea Farioli; Farshad Farzadfar; Netsanet Fentahun; Eduarda Fernandes; Garumma Tolu Feyissa; Irina Filip; Florian Fischer; James L. Fisher; Lisa M. Force; Masoud Foroutan; Marisa Freitas; Takeshi Fukumoto; Neal D. Futran; Silvano Gallus; Fortune Gbetoho Gankpe; Reta Tsegaye Gayesa; Tsegaye Tewelde Gebrehiwot; Gebreamlak Gebremedhn Gebremeskel; Getnet Azeze Gedefaw; Belayneh K. Gelaw; Birhanu Geta; Sefonias Getachew; Kebede Embaye Gezae; Mansour Ghafourifard; Alireza Ghajar; Ahmad Ghashghaee; Asadollah Gholamian; Paramjit Singh Gill; Themba T. G. Ginindza; Alem Girmay; Muluken Gizaw; Ricardo Santiago Gomez; Sameer Vali Gopalani; Giuseppe Gorini; Barbara Niegia Garcia Goulart; Ayman Grada; Maximiliano Ribeiro Guerra; Andre Luiz Sena Guimaraes; Prakash C. Gupta; Rahul Gupta; Kishor Hadkhale; Arvin Haj-Mirzaian; Arya Haj-Mirzaian; Randah R. Hamadeh; Samer Hamidi; Lolemo Kelbiso Hanfore; Josep Maria Haro; Milad Hasankhani; Amir Hasanzadeh; Hamid Yimam Hassen; Roderick J. Hay; Simon I. Hay; Andualem Henok; Nathaniel J. Henry; Claudiu Herteliu; Hagos D. Hidru; Chi Linh Hoang; Michael K. Hole; Praveen Hoogar; Nobuyuki Horita; H. Dean Hosgood; Mostafa Hosseini; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Mowafa Househ; Mohammedaman Mama Hussen; Bogdan Ileanu; Milena D. Ilic; Kaire Innos; Seyed Sina Naghibi Irvani; Kufre Robert Iseh; Sheikh Mohammed Shariful Islam; Farhad Islami; Nader Jafari Balalami; Morteza Jafarinia; Leila Jahangiry; Mohammad Ali Jahani; Nader Jahanmehr; Mihajlo Jakovljevic; Spencer L. James; Mehdi Javanbakht; Sudha Jayaraman; Sun Ha Jee; Ensiyeh Jenabi; Ravi Prakash Jha; Jost B. Jonas; Jitendra Jonnagaddala; Tamas Joo; Suresh Banayya Jungari; Mikk Jurisson; Ali Kabir; Farin Kamangar; Andre Karch; Narges Karimi; Ansar Karimian; Amir Kasaeian; Gebremicheal Gebreslassie Kasahun; Belete Kassa; Tesfaye Dessale Kassa; Mesfin Wudu Kassaw; Anil Kaul; Peter Njenga Keiyoro; Abraham Getachew Kelbore; Amene Abebe Kerbo; Yousef Saleh Khader; Maryam Khalilarjmandi; Ejaz Ahmad Khan; Gulfaraz Khan; Young-Ho Khang; Khaled Khatab; Amir Khater; Maryam Khayamzadeh; Maryam Khazaee-Pool; Salman Khazaei; Abdullah T. Khoja; Mohammad Hossein Khosravi; Jagdish Khubchandani; Neda Kianipour; Daniel Kim; Yun Jin Kim; Adnan Kisa; Sezer Kisa; Katarzyna Kissimova-Skarbek; Hamidreza Komaki; Ai Koyanagi; Kristopher J. Krohn; Burcu Kucuk Bicer; Nuworza Kugbey; Vivek Kumar; Desmond Kuupiel; Carlo La Vecchia; Deepesh P. Lad; Eyasu Alem Lake; Ayenew Molla Lakew; Dharmesh Kumar Lal; Faris Hasan Lami; Qing Lan; Savita Lasrado; Paolo Lauriola; Jeffrey V. Lazarus; James Leigh; Cheru Tesema Leshargie; Yu Liao; Miteku Andualem Limenih; Stefan Listl; Alan D. Lopez; Platon D. Lopukhov; Raimundas Lunevicius; Mohammed Madadin; Sameh Magdeldin; Hassan Magdy Abd El Razek; Azeem Majeed; Afshin Maleki; Reza Malekzadeh; Ali Manafi; Navid Manafi; Wondimu Ayele Manamo; Morteza Mansourian; Mohammad Ali Mansournia; Lorenzo Giovanni Mantovani; Saman Maroufizadeh; Santi Martini S. Martini; Tivani Phosa Mashamba-Thompson; Benjamin Ballard Massenburg; Motswadi Titus Maswabi; Manu Raj Mathur; Colm McAlinden; Martin McKee; Hailemariam Abiy Alemu Meheretu; Ravi Mehrotra; Varshil Mehta; Toni Meier; Yohannes A. Melaku; Gebrekiros Gebremichael Meles; Hagazi Gebre Meles; Addisu Melese; Mulugeta Melku; Peter T. N. Memiah; Walter Mendoza; Ritesh G. Menezes; Shahin Merat; Tuomo J. Meretoja; Tomislav Mestrovic; Bartosz Miazgowski; Tomasz Miazgowski; Kebadnew Mulatu M. Mihretie; Ted R. Miller; Edward J. Mills; Seyed Mostafa Mir; Hamed Mirzaei; Hamid Reza Mirzaei; Rashmi Mishra; Babak Moazen; Dara K. Mohammad; Karzan Abdulmuhsin Mohammad; Yousef Mohammad; Aso Mohammad Darwesh; Abolfazl Mohammadbeigi; Hiwa Mohammadi; Moslem Mohammadi; Mahdi Mohammadian; Abdollah Mohammadian-Hafshejani; Milad Mohammadoo-Khorasani; Reza Mohammadpourhodki; Ammas Siraj Mohammed; Jemal Abdu Mohammed; Shafiu Mohammed; Farnam Mohebi; Ali H. Mokdad; Lorenzo Monasta; Yoshan Moodley; Mahmood Moosazadeh; Maryam Moossavi; Ghobad Moradi; Mohammad Moradi-Joo; Maziar Moradi-Lakeh; Farhad Moradpour; Lidia Morawska; Joana Morgado-Da-costa; Naho Morisaki; Shane Douglas Morrison; Abbas Mosapour; Seyyed Meysam Mousavi; Achenef Asmamaw Muche; Oumer Sada S. Muhammed; Jonah Musa; Ashraf R. Nabhan; Mehdi Naderi; Ahamarshan Jayaraman Nagarajan; Gabriele Nagel; Azin Nahvijou; Gurudatta Naik; Farid Najafi; Luigi Naldi; Hae Sung Nam; Naser Nasiri; Javad Nazari; Ionut Negoi; Subas Neupane; Polly A. Newcomb; Haruna Asura Nggada; Josephine W. Ngunjiri; Cuong Tat Nguyen; Leila Nikniaz; Dina Nur Anggraini Ningrum; Yirga Legesse Nirayo; Molly R. Nixon; Chukwudi A. Nnaji; Marzieh Nojomi; Shirin Nosratnejad; Malihe Nourollahpour Shiadeh; Mohammed Suleiman Obsa; Richard Ofori-Asenso; Felix Akpojene Ogbo; In-Hwan Oh; Andrew T. Olagunju; Tinuke O. Olagunju; Mojisola Morenike Oluwasanu; Abidemi E. Omonisi; Obinna E. Onwujekwe; Anu Mary Oommen; Eyal Oren; Doris D. V. Ortega-Altamirano; Erika Ota; Stanislav S. Otstavnov; Mayowa Ojo Owolabi; Mahesh P A; Jagadish Rao Padubidri; Smita Pakhale; Amir H. Pakpour; Adrian Pana; Eun-Kee Park; Hadi Parsian; Tahereh Pashaei; Shanti Patel; Snehal T. Patil; Alyssa Pennini; David M. Pereira; Cristiano Piccinelli; Julian David Pillay; Majid Pirestani; Farhad Pishgar; Maarten J. Postma; Hadi Pourjafar; Farshad Pourmalek; Akram Pourshams; Swayam Prakash; Narayan Prasad; Mostafa Qorbani; Mohammad Rabiee; Navid Rabiee; Amir Radfar; Alireza Rafiei; Fakher Rahim; Mahdi Rahimi; Muhammad Aziz Rahman; Fatemeh Rajati; Saleem M. Rana; Samira Raoofi; Goura Kishor Rath; David Laith Rawaf; Salman Rawaf; Robert C. Reiner; Andre M. N. Renzaho; Nima Rezaei; Aziz Rezapour; Ana Isabel Ribeiro; Daniela Ribeiro; Luca Ronfani; Elias Merdassa Roro; Gholamreza Roshandel; Ali Rostami; Ragy Safwat Saad; Parisa Sabbagh; Siamak Sabour; Basema Saddik; Saeid Safiri; Amirhossein Sahebkar; Mohammad Reza Salahshoor; Farkhonde Salehi; Hosni Salem; Marwa Rashad Salem; Hamideh Salimzadeh; Joshua A. Salomon; Abdallah M. Samy; Juan Sanabria; Milena M. Santric Milicevic; Benn Sartorius; Arash Sarveazad; Brijesh Sathian; Maheswar Satpathy; Miloje Savic; Monika Sawhney; Mehdi Sayyah; Ione J. C. Schneider; Ben Schottker; Mario Sekerija; Sadaf G. Sepanlou; Masood Sepehrimanesh; Seyedmojtaba Seyedmousavi; Faramarz Shaahmadi; Hosein Shabaninejad; Mohammad Shahbaz; Masood Ali Shaikh; Amir Shamshirian; Morteza Shamsizadeh; Heidar Sharafi; Zeinab Sharafi; Mehdi Sharif; Ali Sharifi; Hamid Sharifi; Rajesh Sharma; Aziz Sheikh; Reza Shirkoohi; Sharvari Rahul Shukla; Si Si; Soraya Siabani; Diego Augusto Santos Silva; Dayane Gabriele Alves Silveira; Ambrish Singh; Jasvinder A. Singh; Solomon Sisay; Freddy Sitas; Eugene Sobngwi; Moslem Soofi; Joan B. Soriano; Vasiliki Stathopoulou; Mu'awiyyah Babale Sufiyan; Rafael Tabares-Seisdedos; Takahiro Tabuchi; Ken Takahashi; Omid Reza Tamtaji; Mohammed Rasoul Tarawneh; Segen Gebremeskel Tassew; Parvaneh Taymoori; Arash Tehrani-Banihashemi; Mohamad-Hani Temsah; Omar Temsah; Berhe Etsay Tesfay; Fisaha Haile Tesfay; Manaye Yihune Teshale; Gizachew Assefa Tessema; Subash Thapa; Kenean Getaneh Tlaye; Roman Topor-Madry; Marcos Roberto Tovani-Palone; Eugenio Traini; Bach Xuan Tran; Khanh Bao Tran; Afewerki Gebremeskel Tsadik; Irfan Ullah; Olalekan A. Uthman; Marco Vacante; Maryam Vaezi; Patricia Varona Perez; Yousef Veisani; Simone Vidale; Francesco S. Violante; Vasily Vlassov; Stein Emil Vollset; Theo Vos; Kia Vosoughi; Giang Thu Vu; Isidora S. Vujcic; Henry Wabinga; Tesfahun Mulatu Wachamo; Fasil Shiferaw Wagnew; Yasir Waheed; Fitsum Weldegebreal; Girmay Teklay Weldesamuel; Tissa Wijeratne; Dawit Zewdu Wondafrash; Tewodros Eshete Wonde; Adam Belay Wondmieneh; Hailemariam Mekonnen Workie; Rajaram Yadav; Abbas Yadegar; Ali Yadollahpour; Mehdi Yaseri; Vahid Yazdi-Feyzabadi; Alex Yeshaneh; Mohammed Ahmed Yimam; Ebrahim M. Yimer; Engida Yisma; Naohiro Yonemoto; Mustafa Z. Younis; Bahman Yousefi; Mahmoud Yousefifard; Chuanhua Yu; Erfan Zabeh; Vesna Zadnik; Telma Zahirian Moghadam; Zoubida Zaidi; Mohammad Zamani; Hamed Zandian; Alireza Zangeneh; Leila Zaki; Kazem Zendehdel; Zerihun Menlkalew Zenebe; Taye Abuhay Zewale; Arash Ziapour; Sanjay Zodpey; Christopher J. L. Murray
Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-Adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572000 deaths and 15.2 million DALYs), and stomach cancer (542000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601000 deaths and 17.4 million DALYs), TBL cancer (596000 deaths and 12.6 million DALYs), and colorectal cancer (414000 deaths and 8.3 million DALYs). Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care. © 2019 American Medical Association. All rights reserved.
Global, regional, and national sex-specific burden and control of the HIV epidemic, 1990–2019, for 204 countries and territories: the Global Burden of Diseases Study 2019
(Elsevier Ltd, 2021) Deepa Jahagirdar; Magdalene K. Walters; Amanda Novotney; Edmond D. Brewer; Tahvi D. Frank; Austin Carter; Molly H. Biehl; Hedayat Abbastabar; E.S. Abhilash; Eman Abu-Gharbieh; Laith Jamal Abu-Raddad; Victor Adekanmbi; Daniel Adedayo Adeyinka; Qorinah Estiningtyas Sakilah Adnani; Saira Afzal; Soodabeh Aghababaei; Bright Opoku Ahinkorah; Sajjad Ahmad; Keivan Ahmadi; Sepideh Ahmadi; Ehsan Ahmadpour; Muktar Beshir Ahmed; Tarik Ahmed Rashid; Yusra Ahmed Salih; Addis Aklilu; Tayyaba Akram; Chisom Joyqueenet Akunna; Hanadi Al Hamad; Fares Alahdab; Fahad Mashhour Alanezi; Ekaterina A. Aleksandrova; Kefyalew Addis Alene; Liaqat Ali; Vahid Alipour; Sami Almustanyir; Nelson Alvis-Guzman; Edward Kwabena Ameyaw; Hubert Amu; Catalina Liliana Andrei; Tudorel Andrei; Davood Anvari; Jalal Arabloo; Olatunde Aremu; Judie Arulappan; Desta Debalkie Atnafu; Beatriz Paulina Ayala Quintanilla; Muluken Altaye Ayza; Samad Azari; B.B. Darshan; Maciej Banach; Till Winfried Bärnighausen; Fabio Barra; Amadou Barrow; Sanjay Basu; Shahrzad Bazargan-Hejazi; Habtamu Gebrehana Belay; Tezera Moshago Berheto; Woldesellassie Mequanint Bezabhe; Yihienew Mequanint Bezabih; Akshaya Srikanth Bhagavathula; Nikha Bhardwaj; Pankaj Bhardwaj; Krittika Bhattacharyya; Sadia Bibi; Ali Bijani; Catherine Bisignano; Obasanjo Afolabi Bolarinwa; Archith Boloor; Azizbek A. Boltaev; Nikolay Ivanovich Briko; Danilo Buonsenso; Katrin Burkart; Zahid A. Butt; Chao Cao; Jaykaran Charan; Souranshu Chatterjee; Soosanna Kumary Chattu; Vijay Kumar Chattu; Sonali Gajanan Choudhari; Dinh-Toi Chu; Rosa A.S. Couto; Richard G. Cowden; Berihun Assefa Dachew; Omid Dadras; Amare Belachew Dagnew; Saad M.A. Dahlawi; Xiaochen Dai; Lalit Dandona; Rakhi Dandona; José das Neves; Louisa Degenhardt; Feleke Mekonnen Demeke; Abebaw Alemayehu Desta; Keshab Deuba; Deepak Dhamnetiya; Govinda Prasad Dhungana; Mostafa Dianatinasab; Daniel Diaz; Shirin Djalalinia; Linh Phuong Doan; Fariba Dorostkar; Hisham Atan Edinur; Andem Effiong; Sahar Eftekharzadeh; Maysaa El Sayed Zaki; Rajesh Elayedath; Muhammed Elhadi; Shaimaa I. El-Jaafary; Ziad El-Khatib; Aisha Elsharkawy; Aklilu Endalamaw; Aman Yesuf Endries; Sharareh Eskandarieh; Ifeanyi Jude Ezeonwumelu; Sayeh Ezzikouri; Mohammad Farahmand; Emerito Jose A. Faraon; Abidemi Omolara Fasanmi; Simone Ferrero; Lorenzo Ferro Desideri; Irina Filip; Florian Fischer; Morenike Oluwatoyin Folayan; Masoud Foroutan; Takeshi Fukumoto; Mohamed M. Gad; Muktar A. Gadanya; Abhay Motiramji Gaidhane; Tushar Garg; Reta Tsegaye Gayesa; Eyob Alemayehu Gebreyohannes; Hailay Abrha Gesesew; Abera Getachew Obsa; Keyghobad Ghadiri; Ahmad Ghashghaee; Syed Amir Gilani; Themba G. Ginindza; Ionela-Roxana Glăvan; Ekaterina Vladimirovna Glushkova; Mahaveer Golechha; Harish Chander Gugnani; Bhawna Gupta; Sapna Gupta; Veer Bala Gupta; Vivek Kumar Gupta; Samer Hamidi; Senad Handanagic; Shafiul Haque; Harapan Harapan; Arief Hargono; Ahmed I. Hasaballah; Abdiwahab Hashi; Shoaib Hassan; Soheil Hassanipour; Khezar Hayat; Ileana Heredia-Pi; Kamal Hezam; Ramesh Holla; Praveen Hoogar; Mohammad Enamul Hoque; Mostafa Hosseini; Mehdi Hosseinzadeh; Mohamed Hsairi; Rabia Hussain; Segun Emmanuel Ibitoye; Bulat Idrisov; Kevin S. Ikuta; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Seyed Sina Naghibi Irvani; M. Mofizul Islam; Nahlah Elkudssiah Ismail; Ramaiah Itumalla; Ihoghosa Osamuyi Iyamu; Roxana Jabbarinejad; Vardhmaan Jain; Ranil Jayawardena; Ravi Prakash Jha; Nitin Joseph; Ali Kabir; Zubair Kabir; Rohollah Kalhor; Feroze Kaliyadan; Ashwin Kamath; Tanuj Kanchan; Himal Kandel; Getinet Kassahun; Patrick D.M.C. Katoto; Gbenga A. Kayode; Ermiyas Mulu Kebede; Hafte Kahsay Kebede; Himanshu Khajuria; Nauman Khalid; Ejaz Ahmad Khan; Gulfaraz Khan; Khaled Khatab; Min Seo Kim; Yun Jin Kim; Adnan Kisa; Sezer Kisa; Sonali Kochhar; Vladimir Andreevich Korshunov; Parvaiz A. Koul; Sindhura Lakshmi Koulmane Laxminarayana; Ai Koyanagi; Kewal Krishan; Barthelemy Kuate Defo; G. Anil Kumar; Manasi Kumar; Nithin Kumar; Alexander Kwarteng; Dharmesh Kumar Lal; Iván Landires; Savita Lasrado; Zohra S. Lassi; Jeffrey V. Lazarus; Jane Jean-Hee Lee; Yeong Yeh Lee; Kate E. LeGrand; Christine Lin; Xuefeng Liu; Emilie R. Maddison; Hassan Magdy Abd El Razek; Phetole Walter Mahasha; Azeem Majeed; Alaa Makki; Ahmad Azam Malik; Wondimu Ayele Manamo; Mohammad Ali Mansournia; Francisco Rogerlândio Martins-Melo; Seyedeh Zahra Masoumi; Ziad A. Memish; Ritesh G. Menezes; Endalkachew Worku Mengesha; Hayimro Edemealem Merie; Amanual Getnet Mersha; Tomislav Mestrovic; Peter Meylakhs; Nour Mheidly; Ted R. Miller; Andreea Mirica; Babak Moazen; Yousef Mohammad; Mokhtar Mohammadi; Arif Mohammed; Salahuddin Mohammed; Shafiu Mohammed; Modhurima Moitra; Ali H. Mokdad; Mariam Molokhia; Mohammad Ali Moni; Ghobad Moradi; Yousef Moradi; Christine Mpundu-Kaambwa; Sumaira Mubarik; Sandra B. Munro; Lillian Mwanri; Jean B. Nachega; Ahamarshan Jayaraman Nagarajan; Aparna Ichalangod Narayana; Muhammad Naveed; Biswa Prakash Nayak; Sabina O. Nduaguba; Sandhya Neupane Kandel; Georges Nguefack-Tsague; Trang Huyen Nguyen; Molly R. Nixon; Chukwudi A. Nnaji; Jean Jacques Noubiap; Virginia Nuñez-Samudio; Thomas Elliot Nyirenda; Onome Bright Oghenetega; Andrew T. Olagunju; Babayemi Oluwaseun Olakunde; Oluwatomi Funbi Owopetu; P.A. Mahesh; Jagadish Rao Padubidri; Smita Pakhale; Tarang Parekh; Fatemeh Pashazadeh Kan; Shrikant Pawar; Veincent Christian Filipino Pepito; Emmanuel K. Peprah; Marina Pinheiro; Khem Narayan Pokhrel; Roman V. Polibin; Richard Charles G. Pollok; Maarten J. Postma; Zahiruddin Quazi Syed; Amir Radfar; Raghu Anekal Radhakrishnan; Fakher Rahim; Vafa Rahimi-Movaghar; Shadi Rahimzadeh; Mosiur Rahman; Amir Masoud Rahmani; Pradhum Ram; Chhabi Lal Ranabhat; Priyanga Ranasinghe; Chythra R. Rao; Sowmya J. Rao; Priya Rathi; David Laith Rawaf; Salman Rawaf; Lemma Demissie Regassa; Inayat ur Rehman; Andre M.N. Renzaho; Nima Rezaei; Omid Rezahosseini; Mohammad Sadegh Rezai; Aziz Rezapour; Rezaul Karim Ripon; Voilet Rodrigues; Denis O. Roshchin; Godfrey M. Rwegerera; Umar Saeed; Sahar Saeedi Moghaddam; Rajesh Sagar; K.M. Saif-Ur-Rahman; Marwa Rashad Salem; Mehrnoosh Samaei; Abdallah M. Samy; Milena M. Santric-Milicevic; Satish Saroshe; Brijesh Sathian; Maheswar Satpathy; Monika Sawhney; Aletta Elisabeth Schutte; Allen Seylani; Masood Ali Shaikh; Mohammed Feyisso Shaka; Hina Shamshad; Morteza Shamsizadeh; Mohammed Shannawaz; Adithi Shetty; Jae Il Shin; K.M. Shivakumar; Jasvinder A. Singh; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Ranjani Somayaji; Sergey Soshnikov; Emma Elizabeth Spurlock; Dan J. Stein; Mu'awiyyah Babale Sufiyan; Hooman Tadbiri; Birkneh Tilahun Tadesse; Eyayou Girma Tadesse; Animut Tagele Tamiru; Elvis Enowbeyang Tarkang; Nuno Taveira; Yohannes Tekalegn; Fisaha Haile Tesfay; Gizachew Assefa Tessema; Rekha Thapar; Marcos Roberto Tovani-Palone; Eugenio Traini; Bach Xuan Tran; Alexander C. Tsai; Biruk Shalmeno Tusa; Saif Ullah; Chukwuma David Umeokonkwo; Bhaskaran Unnikrishnan; Sahel Valadan Tahbaz; Jorge Hugo Villafañe; Sergey Konstantinovitch Vladimirov; Bay Vo; Avina Vongpradith; Giang Thu Vu; Yasir Waheed; Richard G. Wamai; Guan Wang; Yanzhong Wang; Paul Ward; Ronny Westerman; Andrea Sylvia Winkler; Lalit Yadav; Seyed Hossein Yahyazadeh Jabbari; Taklo Simeneh Yazie; Siyan Yi; Vahit Yiğit; Birhanu Wubale Yirdaw; Naohiro Yonemoto; Chuanhua Yu; Ismaeel Yunusa; Mikhail Sergeevich Zastrozhin; Anasthasia Zastrozhina; Zhi-Jiang Zhang; Alimuddin Zumla; Joshua A. Salomon; Jeffrey W. Eaton; Mohsen Naghavi; Laura Dwyer-Lindgren; Haidong Wang; Stephen S. Lim; Simon I. Hay; Christopher J.L. Murray; Hmwe H. Kyu
Background: The sustainable development goals (SDGs) aim to end HIV/AIDS as a public health threat by 2030. Understanding the current state of the HIV epidemic and its change over time is essential to this effort. This study assesses the current sex-specific HIV burden in 204 countries and territories and measures progress in the control of the epidemic. Methods: To estimate age-specific and sex-specific trends in 48 of 204 countries, we extended the Estimation and Projection Package Age-Sex Model to also implement the spectrum paediatric model. We used this model in cases where age and sex specific HIV-seroprevalence surveys and antenatal care-clinic sentinel surveillance data were available. For the remaining 156 of 204 locations, we developed a cohort-incidence bias adjustment to derive incidence as a function of cause-of-death data from vital registration systems. The incidence was input to a custom Spectrum model. To assess progress, we measured the percentage change in incident cases and deaths between 2010 and 2019 (threshold >75% decline), the ratio of incident cases to number of people living with HIV (incidence-to-prevalence ratio threshold <0·03), and the ratio of incident cases to deaths (incidence-to-mortality ratio threshold <1·0). Findings: In 2019, there were 36·8 million (95% uncertainty interval [UI] 35·1–38·9) people living with HIV worldwide. There were 0·84 males (95% UI 0·78–0·91) per female living with HIV in 2019, 0·99 male infections (0·91–1·10) for every female infection, and 1·02 male deaths (0·95–1·10) per female death. Global progress in incident cases and deaths between 2010 and 2019 was driven by sub-Saharan Africa (with a 28·52% decrease in incident cases, 95% UI 19·58–35·43, and a 39·66% decrease in deaths, 36·49–42·36). Elsewhere, the incidence remained stable or increased, whereas deaths generally decreased. In 2019, the global incidence-to-prevalence ratio was 0·05 (95% UI 0·05–0·06) and the global incidence-to-mortality ratio was 1·94 (1·76–2·12). No regions met suggested thresholds for progress. Interpretation: Sub-Saharan Africa had both the highest HIV burden and the greatest progress between 1990 and 2019. The number of incident cases and deaths in males and females approached parity in 2019, although there remained more females with HIV than males with HIV. Globally, the HIV epidemic is far from the UNAIDS benchmarks on progress metrics. Funding: The Bill & Melinda Gates Foundation, the National Institute of Mental Health of the US National Institutes of Health (NIH), and the National Institute on Aging of the NIH. © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017
(Elsevier Ltd, 2020) Sadaf G. Sepanlou; Saeid Safiri; Catherine Bisignano; Kevin S. Ikuta; Shahin Merat; Mehdi Saberifiroozi; Hossein Poustchi; Derrick Tsoi; Danny V. Colombara; Amir Abdoli; Rufus Adesoji Adedoyin; Mohsen Afarideh; Sutapa Agrawal; Sohail Ahmad; Elham Ahmadian; Ehsan Ahmadpour; Tomi Akinyemiju; Chisom Joyqueenet Akunna; Vahid Alipour; Amir Almasi-Hashiani; Abdulaziz M. Almulhim; Rajaa M. Al-Raddadi; Nelson Alvis-Guzman; Nahla Hamed Anber; Colin Angus; Amir Anoushiravani; Jalal Arabloo; Ephrem Mebrahtu Araya; Daniel Asmelash; Bahar Ataeinia; Zerihun Ataro; Maha Moh'd Wahbi Atout; Floriane Ausloos; Ashish Awasthi; Alaa Badawi; Maciej Banach; Diana Fernanda Bejarano Ramirez; Akshaya Srikanth Bhagavathula; Neeraj Bhala; Krittika Bhattacharyya; Antonio Biondi; Srinivasa Rao Bolla; Archith Boloor; Antonio M. Borzì; Zahid A. Butt; Luis L. A. Alberto Cámera; Ismael R. Campos-Nonato; Félix Carvalho; Dinh-Toi Chu; Sheng-Chia Chung; Paolo Angelo Cortesi; Vera M. Costa; Benjamin C. Cowie; Ahmad Daryani; Barbora de Courten; Gebre Teklemariam Demoz; Rupak Desai; Samath Dhamminda Dharmaratne; Shirin Djalalinia; Hoa Thi Do; Fariba Dorostkar; Thomas M. Drake; Manisha Dubey; Bruce B. Duncan; Andem Effiong; Aziz Eftekhari; Aisha Elsharkawy; Arash Etemadi; Mohammad Farahmand; Farshad Farzadfar; Eduarda Fernandes; Irina Filip; Florian Fischer; Ketema Bizuwork Bizuwork Gebremedhin; Birhanu Geta; Syed Amir Gilani; Paramjit Singh Gill; Reyna Alma Gutiérrez; Michael Tamene Haile; Arvin Haj-Mirzaian; Saeed S. Hamid; Milad Hasankhani; Amir Hasanzadeh; Maryam Hashemian; Hamid Yimam Hassen; Simon I. Hay; Khezar Hayat; Behnam Heidari; Andualem Henok; Chi Linh Hoang; Mihaela Hostiuc; Sorin Hostiuc; Vivian Chia-Rong Hsieh; Ehimario U. Igumbor; Olayinka Stephen Ilesanmi; Seyed Sina Naghibi Irvani; Nader Jafari Balalami; Spencer L. James; Panniyammakal Jeemon; Ravi Prakash Jha; Jost B. Jonas; Jacek Jerzy Jozwiak; Ali Kabir; Amir Kasaeian; Hagazi Gebremedhin Kassaye; Adane Teshome Kefale; Rovshan Khalilov; Muhammad Ali Khan; Ejaz Ahmad Khan; Amir Khater; Yun Jin Kim; Ai Koyanagi; Carlo La Vecchia; Lee-Ling Lim; Alan D. Lopez; Stefan Lorkowski; Paulo A. Lotufo; Rafael Lozano; Muhammed Magdy Abd El Razek; Hue Thi Mai; Navid Manafi; Amir Manafi; Mohammad Ali Mansournia; Lorenzo Giovanni Mantovani; Giampiero Mazzaglia; Dhruv Mehta; Walter Mendoza; Ritesh G. Menezes; Melkamu Merid Mengesha; Tuomo J. Meretoja; Tomislav Mestrovic; Bartosz Miazgowski; Ted R. Miller; Erkin M. Mirrakhimov; Prasanna Mithra; Babak Moazen; Masoud Moghadaszadeh; Abdollah Mohammadian-Hafshejani; Shafiu Mohammed; Ali H. Mokdad; Pablo A. Montero-Zamora; Ghobad Moradi; Mukhammad David Naimzada; Vinod Nayak; Ionut Negoi; Trang Huyen Nguyen; Richard Ofori-Asenso; In-Hwan Oh; Tinuke O. Olagunju; Jagadish Rao Padubidri; Keyvan Pakshir; Adrian Pana; Mona Pathak; Akram Pourshams; Navid Rabiee; Amir Radfar; Alireza Rafiei; Kiana Ramezanzadeh; Saleem Muhammad M. Rana; Salman Rawaf; David Laith Rawaf; Robert C. Reiner; Leonardo Roever; Robin Room; Gholamreza Roshandel; Saeed Safari; Abdallah M. Samy; Juan Sanabria; Benn Sartorius; Maria Inês Schmidt; Subramanian Senthilkumaran; Masood Ali Shaikh; Mehdi Sharif; Amrollah Sharifi; Mika Shigematsu; Jasvinder A. Singh; Amin Soheili; Hafiz Ansar Rasul Suleria; Berhane Fseha Teklehaimanot; Berhe Etsay Tesfay; Marco Vacante; Amir Vahedian-Azimi; Pascual R. Valdez; Tommi Juhani Vasankari; Giang Thu Vu; Yasir Waheed; Kidu Gidey Weldegwergs; Andrea Werdecker; Ronny Westerman; Dawit Zewdu Wondafrash; Adam Belay Wondmieneh; Yordanos Gizachew Yeshitila; Naohiro Yonemoto; Chuanhua Yu; Zoubida Zaidi; Afshin Zarghi; Shira Zelber-Sagi; Kaleab Alemayehu Zewdie; Zhi-Jiang Zhang; Xiu-Ju Zhao; Mohsen Naghavi; Reza Malekzadeh
Background: Cirrhosis and other chronic liver diseases (collectively referred to as cirrhosis in this paper) are a major cause of morbidity and mortality globally, although the burden and underlying causes differ across locations and demographic groups. We report on results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 on the burden of cirrhosis and its trends since 1990, by cause, sex, and age, for 195 countries and territories. Methods: We used data from vital registrations, vital registration samples, and verbal autopsies to estimate mortality. We modelled prevalence of total, compensated, and decompensated cirrhosis on the basis of hospital and claims data. Disability-adjusted life-years (DALYs) were calculated as the sum of years of life lost due to premature death and years lived with disability. Estimates are presented as numbers and age-standardised or age-specific rates per 100 000 population, with 95% uncertainty intervals (UIs). All estimates are presented for five causes of cirrhosis: hepatitis B, hepatitis C, alcohol-related liver disease, non-alcoholic steatohepatitis (NASH), and other causes. We compared mortality, prevalence, and DALY estimates with those expected according to the Socio-demographic Index (SDI) as a proxy for the development status of regions and countries. Findings: In 2017, cirrhosis caused more than 1·32 million (95% UI 1·27–1·45) deaths (440 000 [416 000–518 000; 33·3%] in females and 883 000 [838 000–967 000; 66·7%] in males) globally, compared with less than 899 000 (829 000–948 000) deaths in 1990. Deaths due to cirrhosis constituted 2·4% (2·3–2·6) of total deaths globally in 2017 compared with 1·9% (1·8–2·0) in 1990. Despite an increase in the number of deaths, the age-standardised death rate decreased from 21·0 (19·2–22·3) per 100 000 population in 1990 to 16·5 (15·8–18·1) per 100 000 population in 2017. Sub-Saharan Africa had the highest age-standardised death rate among GBD super-regions for all years of the study period (32·2 [25·8–38·6] deaths per 100 000 population in 2017), and the high-income super-region had the lowest (10·1 [9·8–10·5] deaths per 100 000 population in 2017). The age-standardised death rate decreased or remained constant from 1990 to 2017 in all GBD regions except eastern Europe and central Asia, where the age-standardised death rate increased, primarily due to increases in alcohol-related liver disease prevalence. At the national level, the age-standardised death rate of cirrhosis was lowest in Singapore in 2017 (3·7 [3·3–4·0] per 100 000 in 2017) and highest in Egypt in all years since 1990 (103·3 [64·4–133·4] per 100 000 in 2017). There were 10·6 million (10·3–10·9) prevalent cases of decompensated cirrhosis and 112 million (107–119) prevalent cases of compensated cirrhosis globally in 2017. There was a significant increase in age-standardised prevalence rate of decompensated cirrhosis between 1990 and 2017. Cirrhosis caused by NASH had a steady age-standardised death rate throughout the study period, whereas the other four causes showed declines in age-standardised death rate. The age-standardised prevalence of compensated and decompensated cirrhosis due to NASH increased more than for any other cause of cirrhosis (by 33·2% for compensated cirrhosis and 54·8% for decompensated cirrhosis) over the study period. From 1990 to 2017, the number of prevalent cases more than doubled for compensated cirrhosis due to NASH and more than tripled for decompensated cirrhosis due to NASH. In 2017, age-standardised death and DALY rates were lower among countries and territories with higher SDI. Interpretation: Cirrhosis imposes a substantial health burden on many countries and this burden has increased at the global level since 1990, partly due to population growth and ageing. Although the age-standardised death and DALY rates of cirrhosis decreased from 1990 to 2017, numbers of deaths and DALYs and the proportion of all global deaths due to cirrhosis increased. Despite the availability of effective interventions for the prevention and treatment of hepatitis B and C, they were still the main causes of cirrhosis burden worldwide, particularly in low-income countries. The impact of hepatitis B and C is expected to be attenuated and overtaken by that of NASH in the near future. Cost-effective interventions are required to continue the prevention and treatment of viral hepatitis, and to achieve early diagnosis and prevention of cirrhosis due to alcohol-related liver disease and NASH. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
The global, regional, and national burden of colorectal cancer and its attributable risk factors in 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017
(Elsevier Ltd, 2019) Saeid Safiri; Sadaf G. Sepanlou; Kevin S. Ikuta; Catherine Bisignano; Hamideh Salimzadeh; Alireza Delavari; Reza Ansari; Gholamreza Roshandel; Shahin Merat; Christina Fitzmaurice; Lisa M. Force; Molly R. Nixon; Hedayat Abbastabar; Kedir Hussein Abegaz; Mohsen Afarideh; Ayat Ahmadi; Muktar Beshir Ahmed; Tomi Akinyemiju; Fares Alahdab; Raghib Ali; Mahtab Alikhani; Vahid Alipour; Syed Mohamed Aljunid; Majid Abdulrahman Hamad Almadi; Amir Almasi-Hashiani; Rajaa M. Al-Raddadi; Nelson Alvis-Guzman; Saeed Amini; Nahla Hamed Anber; Alireza Ansari-Moghaddam; Jalal Arabloo; Zohreh Arefi; Mohammad Asghari Jafarabadi; Abbas Azadmehr; Alaa Badawi; Nafiseh Baheiraei; Till Winfried Bärnighausen; Huda Basaleem; Masoud Behzadifar; Meysam Behzadifar; Yaschilal Muche Belayneh; Kidanemaryam Berhe; Krittika Bhattacharyya; Belete Biadgo; Ali Bijani; Antonio Biondi; Tone Bjørge; Antonio M. Borzì; Cristina Bosetti; Ibrahim R. Bou-Orm; Hermann Brenner; Andrey Nikolaevich Briko; Nikolay Ivanovich Briko; Giulia Carreras; Félix Carvalho; Carlos A. Castañeda-Orjuela; Ester Cerin; Peggy Pei-Chia Chiang; Onyema Greg Chido-Amajuoyi; Ahmad Daryani; Dragos Virgil Davitoiu; Gebre Teklemariam Demoz; Rupak Desai; Mostafa Dianati Nasab; Aziz Eftekhari; Iman El Sayed; Iffat Elbarazi; Mohammad Hassan Emamian; Aman Yesuf Endries; Firooz Esmaeilzadeh; Alireza Esteghamati; Arash Etemadi; Farshad Farzadfar; Eduarda Fernandes; João C. Fernandes; Irina Filip; Florian Fischer; Masoud Foroutan; Mohamed M. Gad; Silvano Gallus; Fatemeh Ghaseni-Kebria; Ahmad Ghashghaee; Giuseppe Gorini; Nima Hafezi-Nejad; Arvin Haj-Mirzaian; Arya Haj-Mirzaian; Susan Hasanpour-Heidari; Amir Hasanzadeh; Soheil Hassanipour; Simon I. Hay; Chi Linh Hoang; Mihaela Hostiuc; Mowafa Househ; Olayinka Stephen Ilesanmi; Milena D. Ilic; Kaire Innos; Seyed Sina Naghibi Irvani; Farhad Islami; Anelisa Jaca; Nader Jafari Balalami; Nastaran Jafari Delouei; Morteza Jafarinia; Mohammad Ali Jahani; Mihajlo Jakovljevic; Spencer L. James; Mehdi Javanbakht; Ensiyeh Jenabi; Ravi Prakash Jha; Farahnaz Joukar; Amir Kasaeian; Tesfaye Dessale Kassa; Mesfin Wudu Kassaw; Andre Pascal Kengne; Yousef Saleh Khader; Mojtaba Khaksarian; Rovshan Khalilov; Ejaz Ahmad Khan; Maryam Khayamzadeh; Maryam Khazaee-Pool; Salman Khazaei; Fatemeh Khosravi Shadmani; Jagdish Khubchandani; Daniel Kim; Adnan Kisa; Sezer Kisa; Jonathan M. Kocarnik; Hamidreza Komaki; Jacek A. Kopec; Ai Koyanagi; Ernst J. Kuipers; Vivek Kumar; Carlo La Vecchia; Faris Hasan Lami; Alan D. Lopez; Platon D. Lopukhov; Raimundas Lunevicius; Azeem Majeed; Maryam Majidinia; Amir Manafi; Navid Manafi; Ana-Laura Manda; Fariborz Mansour-Ghanaei; Lorenzo Giovanni Mantovani; Dhruv Mehta; Toni Meier; Hagazi Gebre Meles; Walter Mendoza; Tomislav Mestrovic; Bartosz Miazgowski; Tomasz Miazgowski; Seyed Mostafa Mir; Hamed Mirzaei; Karzan Abdulmuhsin Mohammad; Naser Mohammad Gholi Mezerji; Abdollah Mohammadian-Hafshejani; Milad Mohammadoo-Khorasani; Shafiu Mohammed; Farnam Mohebi; Ali H. Mokdad; Lorenzo Monasta; Maryam Moossavi; Ghobad Moradi; Farhad Moradpour; Rahmatollah Moradzadeh; Azin Nahvijou; Gurudatta Naik; Farid Najafi; Javad Nazari; Ionut Negoi; Serban Negru; Cuong Tat Nguyen; Trang Huyen Nguyen; Dina Nur Anggraini Ningrum; Felix Akpojene Ogbo; Andrew T. Olagunju; Tinuke O. Olagunju; Adrian Pana; David M. Pereira; Majid Pirestani; Akram Pourshams; Hossein Poustchi; Mostafa Qorbani; Mohammad Rabiee; Navid Rabiee; Amir Radfar; Marveh Rahmati; Fatemeh Rajati; Samira Raoofi; David Laith Rawaf; Salman Rawaf; Robert C. Reiner; Andre M N. Renzaho; Nima Rezaei; Aziz Rezapour; Anas M. Saad; Seyedmohammad Saadatagah; Basema Saddik; Farkhonde Salehi; Saleh Salehi Zahabi; Inbal Salz; Abdallah M. Samy; Juan Sanabria; Milena M. Santric Milicevic; Arash Sarveazad; Maheswar Satpathy; Ione J C. Schneider; Mario Sekerija; Faramarz Shaahmadi; Hosein Shabaninejad; Morteza Shamsizadeh; Zeinab Sharafi; Mehdi Sharif; Amrollah Sharifi; Sara Sheikhbahaei; Reza Shirkoohi; Sudeep K. Siddappa Malleshappa; Diego Augusto Santos Silva; Mekonnen Sisay; Catalin-Gabriel Smarandache; Moslem Soofi; Kjetil Soreide; Sergey Soshnikov; Vladimir I. Starodubov; Rafael Tabarés-Seisdedos; Mark Sullman; Amir Taherkhani; Berhe Etsay Tesfay; Roman Topor-Madry; Eugenio Traini; Bach Xuan Tran; Khanh Bao Tran; Irfan Ullah; Olalekan A. Uthman; Marco Vacante; Amir Vahedian-Azimi; Alessandro Valli; Elena Varavikova; Isidora S. Vujcic; Ronny Westerman; Vahid Yazdi-Feyzabadi; Engida Yisma; Chuanhua Yu; Vesna Zadnik; Telma Zahirian Moghadam; Leila Zaki; Hamed Zandian; Zhi-Jiang Zhang; Christopher J L. Murray; Mohsen Naghavi; Reza Malekzadeh
Background: Data about the global, regional, and country-specific variations in the levels and trends of colorectal cancer are required to understand the impact of this disease and the trends in its burden to help policy makers allocate resources. Here we provide a status report on the incidence, mortality, and disability caused by colorectal cancer in 195 countries and territories between 1990 and 2017. Methods: Vital registration, sample vital registration, verbal autopsy, and cancer registry data were used to generate incidence, death, and disability-adjusted life-year (DALY) estimates of colorectal cancer at the global, regional, and national levels. We also determined the association between development levels and colorectal cancer age-standardised DALY rates, and calculated DALYs attributable to risk factors that had evidence of causation with colorectal cancer. All of the estimates are reported as counts and age-standardised rates per 100 000 person-years, with some estimates also presented by sex and 5-year age groups. Findings: In 2017, there were 1·8 million (95% UI 1·8–1·9) incident cases of colorectal cancer globally, with an age-standardised incidence rate of 23·2 (22·7–23·7) per 100 000 person-years that increased by 9·5% (4·5–13·5) between 1990 and 2017. Globally, colorectal cancer accounted for 896 000 (876 300–915 700) deaths in 2017, with an age-standardised death rate of 11·5 (11·3–11·8) per 100 000 person-years, which decreased between 1990 and 2017 (−13·5% [–18·4 to −10·0]). Colorectal cancer was also responsible for 19·0 million (18·5–19·5) DALYs globally in 2017, with an age-standardised rate of 235·7 (229·7–242·0) DALYs per 100 000 person-years, which decreased between 1990 and 2017 (−14·5% [–20·4 to −10·3]). Slovakia, the Netherlands, and New Zealand had the highest age-standardised incidence rates in 2017. Greenland, Hungary, and Slovakia had the highest age-standardised death rates in 2017. Numbers of incident cases and deaths were higher among males than females up to the ages of 80–84 years, with the highest rates observed in the oldest age group (≥95 years) for both sexes in 2017. There was a non-linear association between the Socio-demographic Index and the Healthcare Access and Quality Index and age-standardised DALY rates. In 2017, the three largest contributors to DALYs at the global level, for both sexes, were diet low in calcium (20·5% [12·9–28·9]), alcohol use (15·2% [12·1–18·3]), and diet low in milk (14·3% [5·1–24·8]). Interpretation: There is substantial global variation in the burden of colorectal cancer. Although the overall colorectal cancer age-standardised death rate has been decreasing at the global level, the increasing age-standardised incidence rate in most countries poses a major public health challenge across the world. The results of this study could be useful for policy makers to carry out cost-effective interventions and to reduce exposure to modifiable risk factors, particularly in countries with high incidence or increasing burden. Funding: Bill & Melinda Gates Foundation. © 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
The global, regional, and national burden of oesophageal cancer and its attributable risk factors in 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017
(Elsevier Ltd, 2020) Farin Kamangar; Dariush Nasrollahzadeh; Saeid Safiri; Sadaf G Sepanlou; Christina Fitzmaurice; Kevin S Ikuta; Catherine Bisignano; Farhad Islami; Gholamreza Roshandel; Stephen S Lim; Hassan Abolhassani; Eman Abu-Gharbieh; Rufus Adesoji Adedoyin; Shailesh M Advani; Muktar Beshir Ahmed; Miloud Taki Eddine Aichour; Tomi Akinyemiju; Chisom Joyqueenet Akunna; Fares Alahdab; Vahid Alipour; Amir Almasi-Hashiani; Abdulaziz M Almulhim; Nahla Hamed Anber; Alireza Ansari-Moghaddam; Jalal Arabloo; Morteza Arab-Zozani; Atalel Fentahun Awedew; Alaa Badawi; Kathleen S Sachiko Berfield; Kidanemaryam Berhe; Krittika Bhattacharyya; Antonio Biondi; Tone Bjørge; Antonio Maria Borzì; Cristina Bosetti; Giulia Carreras; Felix Carvalho; Clara Castro; Dinh-Toi Chu; Vera Marisa Costa; Baye Dagnew; Jiregna Darega Gela; Ahmad Daryani; Feleke Mekonnen Demeke; Gebre Teklemariam Demoz; Mostafa Dianatinasab; Iffat Elbarazi; Mohammad Hassan Emamian; Arash Etemadi; Pawan Sirwan Faris; Eduarda Fernandes; Irina Filip; Florian Fischer; Mohamed M Gad; Silvano Gallus; Abadi Kahsu Gebre; Tsegaye Tewelde Gebrehiwot; Gebreamlak Gebremedhn Gebremeskel; Begashaw Melaku Gebresillassie; Fatemeh Ghasemi-Kebria; Ahmad Ghashghaee; Nermin Ghith; Mahaveer Golechha; Giuseppe Gorini; Rahul Gupta; Nima Hafezi-Nejad; Arvin Haj-Mirzaian; James D Harvey; Maryam Hashemian; Hamid Yimam Hassen; Simon I Hay; Andualem Henok; Chi Linh Hoang; H Dean Hosgood; Mowafa Househ; Olayinka Stephen Ilesanmi; Milena D Ilic; Seyed Sina Naghibi Irvani; Charvi Jain; Spencer L James; Sun Ha Jee; Ravi Prakash Jha; Farahnaz Joukar; Ali Kabir; Amir Kasaeian; Mesfin Wudu Kassaw; Supreet Kaur; Andre Pascal Kengne; Esma Kerboua; Yousef Saleh Khader; Rovshan Khalilov; Ejaz Ahmad Khan; Abdullah T Khoja; Jonathan M Kocarnik; Hamidreza Komaki; Vivek Kumar; Carlo La Vecchia; Savita Lasrado; Bingyu Li; Alan D Lopez; Azeem Majeed; Navid Manafi; Ana Laura Manda; Fariborz Mansour-Ghanaei; Manu Raj Mathur; Varshil Mehta; Dhruv Mehta; Walter Mendoza; Prasanna Mithra; Karzan Abdulmuhsin Mohammad; Abdollah Mohammadian-Hafshejani; Reza Mohammadpourhodki; Jemal Abdu Mohammed; Farnam Mohebi; Ali H Mokdad; Lorenzo Monasta; Delaram Moosavi; Mahmood Moosazadeh; Ghobad Moradi; Farhad Moradpour; Rahmatollah Moradzadeh; Gurudatta Naik; Ionut Negoi; Haruna Asura Nggada; Huong Lan Thi Nguyen; Rajan Nikbakhsh; Molly R Nixon; Andrew T Olagunju; Tinuke O Olagunju; Jagadish Rao Padubidri; Keyvan Pakshir; Shanti Patel; Mona Pathak; Hai Quang Pham; Akram Pourshams; Navid Rabiee; Mohammad Rabiee; Amir Radfar; Alireza Rafiei; Kiana Ramezanzadeh; Goura Kishor Rath; Priya Rathi; Salman Rawaf; David Laith Rawaf; Nima Rezaei; Elias Merdassa Roro; Anas M Saad; Hamideh Salimzadeh; Abdallah M Samy; Benn Sartorius; Arash Sarveazad; Mario Sekerija; Feng Sha; Morteza Shamsizadeh; Sara Sheikhbahaei; Reza Shirkoohi; Sudeep K Siddappa Malleshappa; Jasvinder A Singh; Dhirendra Narain Sinha; Catalin-Gabriel Smarandache; Sergey Soshnikov; Hafiz Ansar Rasul Suleria; Degena Bahrey Tadesse; Berhe Etsay Tesfay; Bhaskar Thakur; Eugenio Traini; Khanh Bao Tran; Bach Xuan Tran; Irfan Ullah; Marco Vacante; Yousef Veisani; Isidora S Vujcic; Girmay Teklay Weldesamuel; Rixing Xu; Vahid Yazdi-Feyzabadi; Deniz Yuce; Vesna Zadnik; Zoubida Zaidi; Zhi-Jiang Zhang; Reza Malekzadeh; Mohsen Naghavi
Background Oesophageal cancer is a common and often fatal cancer that has two main histological subtypes: oesophageal squamous cell carcinoma and oesophageal adenocarcinoma. Updated statistics on the incidence and mortality of oesophageal cancer, and on the disability-adjusted life-years (DALYs) caused by the disease, can assist policy makers in allocating resources for prevention, treatment, and care of oesophageal cancer. We report the latest estimates of these statistics for 195 countries and territories between 1990 and 2017, by age, sex, and Socio-demographic Index (SDI), using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD). Methods We used data from vital registration systems, vital registration-samples, verbal autopsy records, and cancer registries, combined with relevant modelling, to estimate the mortality, incidence, and burden of oesophageal cancer from 1990 to 2017. Mortality-to-incidence ratios (MIRs) were estimated and fed into a Cause of Death Ensemble model (CODEm) including risk factors. MIRs were used for mortality and non-fatal modelling. Estimates of DALYs attributable to the main risk factors of oesophageal cancer available in GBD were also calculated. The proportion of oesophageal squamous cell carcinoma to all oesophageal cancers was extracted by use of publicly available data, and its variation was examined against SDI, the Healthcare Access and Quality (HAQ) Index, and available risk factors in GBD that are specific for oesophageal squamous cell carcinoma (eg, unimproved water source and indoor air pollution) and for oesophageal adenocarcinoma (gastro-oesophageal reflux disease). Findings There were 473 000 (95% uncertainty interval [95% UI] 459 000-485 000) new cases of oesophageal cancer and 436 000 (425 000-448 000) deaths due to oesophageal cancer in 2017. Age-standardised incidence was 5.9 (5.7-6.1) per 100 000 population and age-standardised mortality was 5.5 (5.3-5.6) per 100 000. Oesophageal cancer caused 9.78 million (9.53-10.03) DALYs, with an age-standardised rate of 120 (117-123) per 100 000 population. Between 1990 and 2017, age-standardised incidence decreased by 22.0% (18.6-25.2), mortality decreased by 29.0% (25.8-32.0), and DALYs decreased by 33.4% (30.4-36.1) globally. However, as a result of population growth and ageing, the total number of new cases increased by 52.3% (45.9-58.9), from 310 000 (300 000-322 000) to 473 000 (459 000-485 000); the number of deaths increased by 40.0% (34.1-46.3), from 311 000 (301 000-323 000) to 436 000 (425 000-448 000); and total DALYs increased by 27.4% (22.1-33.1), from 7.68 million (7.42-7.97) to 9.78 million (9.53-10.03). At the national level, China had the highest number of incident cases (235 000 [223 000-246 000]), deaths (213 000 [203 000-223 000]), and DALYs (4.46 million [4.25-4.69]) in 2017. The highest national-level agestandardised incidence rates in 2017 were observed in Malawi (23.0 [19.4-26.5] per 100 000 population) and Mongolia (18.5 [16.4-20.8] per 100 000). In 2017, age-standardised incidence was 2.7 times higher, mortality 2.9 times higher, and DALYs 3.0 times higher in males than in females. In 2017, a substantial proportion of oesophageal cancer DALYs were attributable to known risk factors: tobacco smoking (39.0% [35.5-42.2]), alcohol consumption (33.8% [27.3-39.9]), high BMI (19.5% [6.3-36.0]), a diet low in fruits (19.1% [4.2-34.6]), and use of chewing tobacco (7.5% [5.2-9.6]). Countries with a low SDI and HAQ Index and high levels of indoor air pollution had a higher proportion of oesophageal squamous cell carcinoma to all oesophageal cancer cases than did countries with a high SDI and HAQ Index and with low levels of indoor air pollution. Interpretation Despite reductions in age-standardised incidence and mortality rates, oesophageal cancer remains a major cause of cancer mortality and burden across the world. Oesophageal cancer is a highly fatal disease, requiring increased primary prevention efforts and, possibly, screening in some high-risk areas. Substantial variation exists in age-standardised incidence rates across regions and countries, for reasons that are unclear. © 2020 The Author(s).