Browsing by Author "Muhammad Sohail Afzal"

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Adolescent transport and unintentional injuries: a systematic analysis using the Global Burden of Disease Study 2019
(Elsevier Ltd, 2022) Amy E. Peden; Patricia Cullen; Kate Louise Francis; Holger Moeller; Margaret M. Peden; Pengpeng Ye; Maoyi Tian; Zhiyong Zou; Susan M. Sawyer; Amirali Aali; Zeinab Abbasi-Kangevari; Mohsen Abbasi-Kangevari; Michael Abdelmasseh; Meriem Abdoun; Rami Abd-Rabu; Deldar Morad Abdulah; Ame Mehadi Abdurehman; Getachew Abebe; Ayele Mamo Abebe; Aidin Abedi; Hassan Abidi; Richard Gyan Aboagye; Hiwa Abubaker Ali; Eman Abu Gharbieh; Denberu Eshetie Adane; Tigist Demssew Adane; Isaac Yeboah Addo; Ololade Grace Adewole; Sangeet Adhikari; Mohammad Adnan; Qorinah Estiningtyas Sakilah Adnani; Aanuoluwapo Adeyimika Bachelor Afolabi; Saira Afzal; Muhammad Sohail Afzal; Zahra Babaei Aghdam; Bright Opoku Ahinkorah; Araz Ramazan Ahmad; Tauseef Ahmad; Sajjad Ahmad; Ali Ahmadi; Haroon Ahmed; Muktar Beshir Ahmed; Ali Ahmed; Ayman Ahmed; Jivan Qasim Ahmed; Tarik Ahmed Rashid; Janardhana P. Aithala; Budi Aji; Meisam Akhlaghdoust; Fares Alahdab; Fahad Mashhour Alanezi; Astawus Alemayehu; Hanadi Al Hamad; Syed Shujait Ali; Liaqat Ali; Yousef Alimohamadi; Vahid Alipour; Syed Mohamed Aljunid; Louay Almidani; Sami Almustanyir; Khalid A. Altirkawi; Nelson J. Alvis-Zakzuk; Edward Kwabena Ameyaw; Tarek Tawfik Amin; Mehrdad Amir-Behghadami; Sohrab Amiri; Hoda Amiri; Tadele Fentabil Anagaw; Tudorel Andrei; Catalina Liliana Andrei; Davood Anvari; Sumadi Lukman Anwar; Anayochukwu Edward Anyasodor; Jalal Arabloo; Morteza Arab-Zozani; Asrat Arja; Judie Arulappan; Ashokan Arumugam; Armin Aryannejad; Saeed Asgary; Tahira Ashraf; Seyyed Shamsadin Athari; Alok Atreya; Sameh Attia; Avinash Aujayeb; Atalel Fentahun Awedew; Sina Azadnajafabad; Mohammadreza Azangou-Khyavy; Samad Azari; Amirhossein Azari Jafari; Hosein Azizi; Ahmed Y. Azzam; Ashish D. Badiye; Nayereh Baghcheghi; Sara Bagherieh; Atif Amin Baig; Shankar M. Bakkannavar; Asaminew Birhanu Balta; MacIej Banach; Palash Chandra Banik; Hansi Bansal; Mainak Bardhan; Francesco BaroneAdesi; Amadou Barrow; Azadeh Bashiri; Pritish Baskaran; Saurav Basu; Nebiyou Simegnew Bayileyegn; Abebe Ayalew Bekel; Alehegn Bekele Bekele; Salaheddine Bendak; Isabela M. Bensenor; Alemshet Yirga Berhie; Devidas S. Bhagat; Akshaya Srikanth Bhagavathula; Pankaj Bhardwaj; Nikha Bhardwaj; Sonu Bhaskar; Ajay Nagesh Bhat; Krittika Bhattacharyya; Zulfiqar A. Bhutta; Sadia Bibi; Bagas Suryo Bintoro; Saeid Bitaraf; Belay Boda Abule Bodicha; Archith Boloor; Souad Bouaoud; Julie Brown; Katrin Burkart; Nadeem Shafique Butt; Muhammad Hammad Butt; Luis Alberto CÃ¡mera; Julio Cesar Campuzano Rincon; Chao Cao; Andre F. Carvalho; MÃ¡rcia Carvalho; Promit Ananyo Chakraborty; Eeshwar K. Chandrasekar; Jung-Chen Chang; Periklis Charalampous; Jaykaran Charan; Vijay Kumar Chattu; Bitew Mekonnen Chekole; Abdulaal Chitheer; Daniel Youngwhan Cho; Hitesh Chopra; Devasahayam J. Christopher; Isaac Sunday Chukwu; NatÃ¡lia Cruz-Martins; Omid Dadras; Saad M.A. Dahlawi; Xiaochen Dai; Giovanni Damiani; Gary L. Darmstadt; Reza Darvishi Cheshmeh Soltani; Aso Mohammad Darwesh; Saswati Das; Anna Dastiridou; Sisay Abebe Debela; Amin Dehghan; Getnet Makasha Demeke; Andreas K. Demetriades; Solomon Demissie; Fikadu Nugusu Dessalegn; Abebaw Alemayehu Desta; Mostafa Dianatinasab; Nancy Diao; Diana Dias Da Silva; Daniel Diaz; Lankamo Ena Digesa; Mengistie Diress; Shirin Djalalinia; Linh Phuong Doan; Milad Dodangeh; Paul Narh Doku; Deepa Dongarwar; Haneil Larson Dsouza; Ebrahim Eini; Michael Ekholuenetale; Temitope Cyrus Ekundayo; Ahmed Elabbas Mustafa Elagali; Mostafa Ahmed Elbahnasawy; Hala Rashad Elhabashy; Muhammed Elhadi; Maysaa El Sayed Zaki; Daniel Berhanie Enyew; Ryenchindorj Erkhembayar; Sharareh Eskandarieh; Farshid Etaee; Adeniyi Francis Fagbamigbe; Pawan Sirwan Faris; Abbas Farmany; Andre Faro; Farshad Farzadfar; Ali Fatehizadeh; Seyed Mohammad Fereshtehnejad; Abdullah Hamid Feroze; Getahun Fetensa; Bikila Regassa Feyisa; Irina Filip; Florian Fischer; Behzad Foroutan; Masoud Foroutan; Kayode Raphael Fowobaje; Richard Charles Franklin; Takeshi Fukumoto; Peter Andras Gaal; Muktar A. Gadanya; Yaseen Galali; Nasrin Galehdar; Balasankar Ganesan; Tushar Garg; Mesfin Gebrehiwot Damtew Gebrehiwot; Yosef Haile Gebremariam; Yibeltal Yismaw Gela; Urge Gerema; Mansour Ghafourifard; Seyyed-Hadi Ghamari; Reza Ghanbari; Mohammad Ghasemi Nour; Maryam Gholamalizadeh; Ali Gholami; Ali Gholamrezanezhad; Sherief Ghozy; Syed Amir Gilani; Tiffany K. Gill; Iago GinÃ©-VÃ¡zquez; Zeleke Abate Girma; James C. Glasbey; Franklin N. Glozah; Mahaveer Golechha; Pouya Goleij; Michal Grivna; Habtamu Alganeh Guadie; Damitha Asanga Gunawardane; Yuming Guo; Veer Bala Gupta; Sapna Gupta; Bhawna Gupta; Vivek Kumar Gupta; Arvin Haj-Mirzaian; Rabih Halwani; Randah R. Hamadeh; Sajid Hameed; Lolemo Kelbiso Hanfore; Asif Hanif; Arief Hargono; Netanja I. Harlianto; Mehdi Harorani; Ahmed I. Hasaballah; S.M. Mahmudul Hasan; Amr Hassan; Soheil Hassanipour; Hadi Hassankhani; Rasmus J. Havmoeller; Simon I. Hay; Mohammad Heidari; Delia Hendrie; Demisu Zenbaba Heyi; Yuta Hiraike; Ramesh Holla; Nobuyuki Horita; Sheikh Jamal Hossain; Mohammad Bellal Hossain Hossain; Sedighe Hosseini Shabanan; Mehdi Hosseinzadeh; Sorin Hostiuc; Amir Human Hoveidaei; Alexander Kevin Hsiao; Salman Hussain; Amal Hussein; Segun Emmanuel Ibitoye; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Behzad Imani; Mustapha Immurana; Leeberk Raja Inbaraj; Sheikh Mohammed Shariful Islam; Rakibul M. Islam; Mohammad Mainul Islam; Nahlah Elkudssiah Ismail; J. Linda Merin; Haitham Jahrami; Mihajlo Jakovljevic; Manthan Dilipkumar Janodia; Tahereh Javaheri; Sathish Kumar Jayapal; Umesh Umesh Jayarajah; Sudha Jayaraman; Jayakumar Jeganathan; Bedru Jemal; Ravi Prakash Jha; Jost B. Jonas; Tamas Joo; Nitin Joseph; Jacek Jerzy Jozwiak; Mikk JÃ¼risson; Ali Kabir; Vidya Kadashetti; Dler Hussein Kadir; Laleh R. Kalankesh; Leila R. Kalankesh; Rohollah Kalhor; Vineet Kumar Kamal; Rajesh Kamath; Himal Kandel; Rami S. Kantar; Neeti Kapoor; Hassan Karami; Ibraheem M. Karaye; Samad Karkhah; Patrick D.M.C. Katoto; Joonas H. Kauppila; Gbenga A. Kayode; Leila Keikavoosi-Arani; Cumali Keskin; Yousef Saleh Khader; Himanshu Khajuria; Mohammad Khammarnia; Ejaz Ahmad Khan; Md Nuruzzaman Khan; Maseer Khan; Yusra H. Khan; Imteyaz A. Khan; Abbas Khan; Moien A.B. Khan; Javad Khanali; Moawiah Mohammad Khatatbeh; Hamid Reza Khayat Kashani; Habibolah Khazaie; Jagdish Khubchandani; Zemene Demelash Kifle; Jihee Kim; Yun Jin Kim; Sezer Kisa; Adnan Kisa; Cameron J. Kneib; Farzad Kompani; Hamid Reza Koohestani; Parvaiz A. Koul; Sindhura Lakshmi Koulmane Laxminarayana; Ai Koyanagi; Kewal Krishan; Vijay Krishnamoorthy; Burcu Kucuk Bicer; Nithin Kumar; Naveen Kumar; Narinder Kumar; Manasi Kumar; Om P. Kurmi; Lucie Laflamme; Judit LÃ¡m; IvÃ¡n Landires; Bagher Larijani; Savita Lasrado; Paolo Lauriola; Carlo La Vecchia; Shaun Wen Huey Lee; Yo Han Lee; Sang-Woong Lee; Wei Chen Lee; Samson Mideksa Legesse; Shanshan Li; Stephen S. Lim; LÃ¡szlÃ³ Lorenzovici; Amana Ogeto Luke; Farzan Madadizadeh; Áurea M. Madureira-Carvalho; Muhammed Magdy Abd El Razek; Soleiman Mahjoub; Ata Mahmoodpoor; Razzagh Mahmoudi; Marzieh Mahmoudimanesh; Azeem Majeed; Alaa Makki; Elaheh Malakan Rad; Mohammad-Reza Malekpour; Ahmad Azam Malik; Tauqeer Hussain Mallhi; Deborah Carvalho Malta; Borhan Mansouri; Mohammad Ali Mansournia; Elezebeth Mathews; Sazan Qadir Maulud; Dennis Mazingi; Entezar Mehrabi Nasab; Oliver Mendoza-Cano; Ritesh G. Menezes; Dechasa Adare Mengistu; Alexios-Fotios A. Mentis; Atte Meretoja; Mohamed Kamal Mesregah; Tomislav Mestrovic; Ana Carolina Micheletti Gomide Nogueira de Sá; Ted R. Miller; Seyed Peyman Mirghaderi; Andreea Mirica; Seyyedmohammadsadeq Mirmoeeni; Erkin M. Mirrakhimov; Moonis Mirza; Sanjeev Misra; Prasanna Mithra; Chaitanya Mittal; Madeline E. Moberg; Mokhtar Mohammadi; Soheil Mohammadi; Esmaeil Mohammadi; Reza Mohammadpourhodki; Shafiu Mohammed; Teroj Abdulrahman Mohammed; Mohammad Mohseni; Ali H. Mokdad; Sara Momtazmanesh; Lorenzo Monasta; Mohammad Ali Moni; Rafael Silveira Moreira; Shane Douglas Morrison; Ebrahim Mostafavi; Haleh Mousavi Isfahani; Sumaira Mubarik; Lorenzo Muccioli; Soumyadeep Mukherjee; Francesk Mulita; Ghulam Mustafa; Ahamarshan Jayaraman Nagarajan; Mukhammad David Naimzada; Vinay Nangia; Hasan Nassereldine; Zuhair S. Natto; Biswa Prakash Nayak; Ionut Negoi; Seyed Aria Nejadghaderi; Samata Nepal; Sandhya Neupane Kandel; Nafise Noroozi; Virginia NuÃ±ez-Samudio; Ogochukwu Janet Nzoputam; Chimezie Igwegbe Nzoputam; Chimedsuren Ochir; Julius Nyerere Odhiambo; Oluwakemi Ololade Odukoya; Hassan Okati-Aliabad; Osaretin Christabel Okonji; Andrew T. Olagunju; Ahmed Omar Bali; Emad Omer; Adrian Otoiu; Stanislav S. Otstavnov; Nikita Otstavnov; Bilcha Oumer; Mayowa O. Owolabi; P.A. Mahesh; Alicia Padron-Monedero; Jagadish Rao Padubidri; Mohammad Taha Pahlevan Fallahy; Songhomitra Panda-Jonas; Seithikurippu R. Pandi-Perumal; Shahina Pardhan; Eun-Kee Park; Sangram Kishor Patel; Aslam Ramjan Pathan; Siddhartha Pati; Uttam Paudel; Shrikant Pawar; Paolo Pedersini; Mario F.P. Peres; Ionela-Roxana Petcu; Michael R. Phillips; Julian David Pillay; Zahra Zahid Piracha; Mohsen Poursadeqiyan; Naeimeh Pourtaheri; Ibrahim Qattea; Amir Radfar; Ata Rafiee; Pankaja Raghav Raghav; Fakher Rahim; Muhammad Aziz Rahman; Firman Suryadi Rahman; Mosiur Rahman; Amir Masoud Rahmani; Shayan Rahmani; Sheetal Raj Moolambally; Sheena Ramazanu; Kiana Ramezanzadeh; Juwel Rana; Saleem Muhammad Rana; Chythra R. Rao; Sowmya J. Rao; Vahid Rashedi; Mohammad Mahdi Rashidi; Prateek Rastogi; Azad Rasul; Salman Rawaf; David Laith Rawaf; Lal Rawal; Reza Rawassizadeh; Negar Rezaei; Nazila Rezaei; Mohsen Rezaeian; Aziz Rezapour; Abanoub Riad; Muhammad Riaz; Jennifer Rickard; Jefferson Antonio Buendia Rodriguez; Leonardo Roever; Luca Ronfani; Bedanta Roy; S. Manjula; Aly M.A. Saad; Siamak Sabour; Leila Sabzmakan; Basema Saddik; Malihe Sadeghi; Mohammad Reza Saeb; Umar Saeed; Sahar Saeedi Moghaddam; Sher Zaman Safi; Biniyam Sahiledengle; Harihar Sahoo; Mohammad Ali Sahraian; Morteza Saki; Payman Salamati; Sana Salehi; Marwa Rashad Salem; Abdallah M. Samy; Juan Sanabria; Milena M. Santric-Milicevic; Muhammad Arif Nadeem Saqib; Yaser Sarikhani; Arash Sarveazad; Brijesh Sathian; Maheswar Satpathy; Ganesh Kumar Saya; Ione Jayce Ceola Schneider; David C. Schwebel; Hamed Seddighi; Subramanian Senthilkumaran; Allen Seylani; Hosein Shabaninejad; Melika Shafeghat; Pritik A. Shah; Saeed Shahabi; Ataollah Shahbandi; Fariba Shahraki-Sanavi; Masood Ali Shaikh; Elaheh Shaker; Mehran Shams-Beyranvand; Mohd Shanawaz; Mohammed Shannawaz; Mequannent Melaku Sharew Sharew; Neeraj Sharma; Bereket Beyene Shashamo; Maryam Shayan; Rahim Ali Sheikhi; Jiabin Shen; B. Suresh Kumar Shetty; Pavanchand H. Shetty; Jae Il Shin; Nebiyu Aniley Shitaye; K.M. Shivakumar; Parnian Shobeiri; Seyed Afshin Shorofi; Sunil Shrestha; Soraya Siabani; Negussie Boti Sidemo; Wudneh Simegn; Ehsan Sinaei; Paramdeep Singh; Robert Sinto; Md Shahjahan Siraj; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; David A. Sleet; S.N. Chandan; Bogdan Socea; Marco Solmi; Yonatan Solomon; Yi Song; Raúl A.R.C. Sousa; Ireneous N. Soyiri; Mark A. Stokes; Muhammad Suleman; Rizwan Suliankatchi Abdulkader; Jing Sun; Rafael TabarÃ©s-Seisdedos; Seyyed Mohammad Tabatabaei; Mohammad Tabish; Ensiyeh Taheri; Moslem Taheri Soodejani; Mircea Tampa; KerKan Tan; Ingan Ukur Tarigan; Md Tariqujjaman; Nathan Y. Tat; Vivian Y. Tat; Arash Tavakoli; Belay Negash Tefera; Yibekal Manaye Tefera; Gebremaryam Temesgen; Mohamad-Hani Temsah; Pugazhenthan Thangaraju; Rekha Thapar; Nikhil Kenny Thomas; Jansje Henny Vera Ticoalu; Marius Belmondo Tincho; Amir Tiyuri; Munkhsaikhan Togtmol; Marcos Roberto Tovani-Palone; Mai Thi Ngoc Tran; Sana Ullah; Saif Ullah; Irfan Ullah; Srikanth Umakanthan; Bhaskaran Unnikrishnan; Era Upadhyay; Sahel Valadan Tahbaz; Pascual R. Valdez; Tommi Juhani Vasankari; Siavash Vaziri; Massimiliano Veroux; Dominique Vervoort; Francesco S. Violante; Vasily Vlassov; Linh Gia Vu; Yasir Waheed; Yanzhong Wang; Yuan-Pang Wang; Cong Wang; Taweewat Wiangkham; Nuwan Darshana Wickramasinghe; Abay Tadesse Woday; Ai-Min Wu; Gahin Abdulraheem Tayib Yahya; Seyed Hossein Yahyazadeh Jabbari; Lin Yang; Sanni Yaya; Arzu Yigit; Vahit Yigit; Eshetu Yisihak; Naohiro Yonemoto; Yuyi You; Mustafa Z. Younis; Chuanhua Yu; Ismaeel Yunusa; Hossein Yusefi; Mazyar Zahir; Sojib Bin Zaman; Iman Zare; Kourosh Zarea; Mikhail Sergeevich Zastrozhin; Zhi-Jiang Zhang; Yunquan Zhang; Arash Ziapour; Sanjay Zodpey; Mohammad Zoladl; George C. Patton; Rebecca Q. Ivers
Background: Globally, transport and unintentional injuries persist as leading preventable causes of mortality and morbidity for adolescents. We sought to report comprehensive trends in injury-related mortality and morbidity for adolescents aged 10–24 years during the past three decades. Methods: Using the Global Burden of Disease, Injuries, and Risk Factors 2019 Study, we analysed mortality and disability-adjusted life-years (DALYs) attributed to transport and unintentional injuries for adolescents in 204 countries. Burden is reported in absolute numbers and age-standardised rates per 100 000 population by sex, age group (10–14, 15–19, and 20–24 years), and sociodemographic index (SDI) with 95% uncertainty intervals (UIs). We report percentage changes in deaths and DALYs between 1990 and 2019. Findings: In 2019, 369 061 deaths (of which 214 337 [58%] were transport related) and 31·1 million DALYs (of which 16·2 million [52%] were transport related) among adolescents aged 10–24 years were caused by transport and unintentional injuries combined. If compared with other causes, transport and unintentional injuries combined accounted for 25% of deaths and 14% of DALYs in 2019, and showed little improvement from 1990 when such injuries accounted for 26% of adolescent deaths and 17% of adolescent DALYs. Throughout adolescence, transport and unintentional injury fatality rates increased by age group. The unintentional injury burden was higher among males than females for all injury types, except for injuries related to fire, heat, and hot substances, or to adverse effects of medical treatment. From 1990 to 2019, global mortality rates declined by 34·4% (from 17·5 to 11·5 per 100 000) for transport injuries, and by 47·7% (from 15·9 to 8·3 per 100 000) for unintentional injuries. However, in low-SDI nations the absolute number of deaths increased (by 80·5% to 42 774 for transport injuries and by 39·4% to 31 961 for unintentional injuries). In the high-SDI quintile in 2010–19, the rate per 100 000 of transport injury DALYs was reduced by 16·7%, from 838 in 2010 to 699 in 2019. This was a substantially slower pace of reduction compared with the 48·5% reduction between 1990 and 2010, from 1626 per 100 000 in 1990 to 838 per 100 000 in 2010. Between 2010 and 2019, the rate of unintentional injury DALYs per 100 000 also remained largely unchanged in high-SDI countries (555 in 2010 vs 554 in 2019; 0·2% reduction). The number and rate of adolescent deaths and DALYs owing to environmental heat and cold exposure increased for the high-SDI quintile during 2010–19. Interpretation: As other causes of mortality are addressed, inadequate progress in reducing transport and unintentional injury mortality as a proportion of adolescent deaths becomes apparent. The relative shift in the burden of injury from high-SDI countries to low and low–middle-SDI countries necessitates focused action, including global donor, government, and industry investment in injury prevention. The persisting burden of DALYs related to transport and unintentional injuries indicates a need to prioritise innovative measures for the primary prevention of adolescent injury. Funding: Bill & Melinda Gates Foundation. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Age–sex differences in the global burden of lower respiratory infections and risk factors, 1990–2019: results from the Global Burden of Disease Study 2019
(Elsevier Ltd, 2022) Hmwe Hmwe Kyu; Avina Vongpradith; Sarah Brooke Sirota; Amanda Novotney; Christopher E Troeger; Matthew C Doxey; Rose G Bender; Jorge R Ledesma; Molly H Biehl; Samuel B Albertson; Joseph Jon Frostad; Katrin Burkart; Fiona B Bennitt; Jeff T Zhao; William M Gardner; Hailey Hagins; Dana Bryazka; Regina-Mae Villanueva Dominguez; Semagn Mekonnen Abate; Michael Abdelmasseh; Amir Abdoli; Gholamreza Abdoli; Aidin Abedi; Vida Abedi; Tadesse M Abegaz; Hassan Abidi; Richard Gyan Aboagye; Hassan Abolhassani; Yonas Derso Abtew; Hiwa Abubaker Ali; Eman Abu-Gharbieh; Ahmed Abu-Zaid; Kidist Adamu; Isaac Yeboah Addo; Oyelola A Adegboye; Mohammad Adnan; Qorinah Estiningtyas Sakilah Adnani; Muhammad Sohail Afzal; Saira Afzal; Bright Opoku Ahinkorah; Aqeel Ahmad; Araz Ramazan Ahmad; Sajjad Ahmad; Ali Ahmadi; Sepideh Ahmadi; Haroon Ahmed; Jivan Qasim Ahmed; Tarik Ahmed Rashid; Mostafa Akbarzadeh-Khiavi; Hanadi Al Hamad; Luciana Albano; Mamoon A Aldeyab; Bezatu Mengistie Alemu; Kefyalew Addis Alene; Abdelazeem M Algammal; Fadwa Alhalaiqa Naji Alhalaiqa; Robert Kaba Alhassan; Beriwan Abdulqadir Ali; Liaqat Ali; Musa Mohammed Ali; Syed Shujait Ali; Yousef Alimohamadi; Vahid Alipour; Adel Al-Jumaily; Syed Mohamed Aljunid; Sami Almustanyir; Rajaa M Al-Raddadi; Rami H Hani Al-Rifai; Saif Aldeen S AlRyalat; Nelson Alvis-Guzman; Nelson J Alvis-Zakzuk; Edward Kwabena Ameyaw; Javad Javad Aminian Dehkordi; John H Amuasi; Dickson A Amugsi; Etsay Woldu Anbesu; Adnan Ansar; Anayochukwu Edward Anyasodor; Jalal Arabloo; Demelash Areda; Ayele Mamo Argaw; Zeleke Gebru Argaw; Judie Arulappan; Raphael Taiwo Aruleba; Mulusew A Asemahagn; Seyyed Shamsadin Athari; Daniel Atlaw; Engi F Attia; Sameh Attia; Avinash Aujayeb; Tewachew Awoke; Tegegn Mulatu Ayana; Martin Amogre Ayanore; Sina Azadnajafabad; Mohammadreza Azangou-Khyavy; Samad Azari; Amirhossein Azari Jafari; Muhammad Badar; Ashish D Badiye; Nayereh Baghcheghi; Sara Bagherieh; Atif Amin Baig; MacIej Banach; Indrajit Banerjee; Mainak Bardhan; Francesco Barone-Adesi; Hiba Jawdat Barqawi; Amadou Barrow; Azadeh Bashiri; Quique Bassat; Abdul-Monim Mohammad Batiha; Abate Bekele Belachew; Melaku Ashagrie Belete; Uzma Iqbal Belgaumi; Akshaya Srikanth Bhagavathula; Nikha Bhardwaj; Pankaj Bhardwaj; Parth Bhatt; Vijayalakshmi S Bhojaraja; Zulfiqar A Bhutta; Soumitra S Bhuyan; Ali Bijani; Saeid Bitaraf; Belay Boda Abule Bodicha; Nikolay Ivanovich Briko; Danilo Buonsenso; Muhammad Hammad Butt; Jiao Cai; Paulo Camargos; Luis Alberto Cámera; Promit Ananyo Chakraborty; Muluken Genetu Chanie; Jaykaran Charan; Vijay Kumar Chattu; Patrick R Ching; Sungchul Choi; Yuen Yu Chong; Sonali Gajanan Choudhari; Enayet Karim Chowdhury; Devasahayam J Christopher; Dinh-Toi Chu; Natalie L Cobb; Aaron J Cohen; Natália Cruz-Martins; Omid Dadras; Fentaw Teshome Dagnaw; Xiaochen Dai; Lalit Dandona; Rakhi Dandona; An Thi Minh Dao; Sisay Abebe Debela; Biniyam Demisse; Fitsum Wolde Demisse; Solomon Demissie; Diriba Dereje; Hardik Dineshbhai Desai; Abebaw Alemayehu Desta; Belay Desye; Sameer Dhingra; Nancy Diao; Daniel Diaz; Lankamo Ena Digesa; Linh Phuong Doan; Milad Dodangeh; Deepa Dongarwar; Fariba Dorostkar; Wendel Mombaque Dos Santos; Haneil Larson Dsouza; Eleonora Dubljanin; Oyewole Christopher Durojaiye; Hisham Atan Edinur; Elham Ehsani-Chimeh; Ebrahim Eini; Michael Ekholuenetale; Temitope Cyrus Ekundayo; Eman D El Desouky; Iman El Sayed; Maysaa El Sayed Zaki; Muhammed Elhadi; Ahmed Mahmoud Rabie Elkhapery; Amir Emami; Luchuo Engelbert Bain; Ryenchindorj Erkhembayar; Farshid Etaee; Mohamad Ezati Asar; Adeniyi Francis Fagbamigbe; Shahab Falahi; Aida Fallahzadeh; Anwar Faraj; Emerito Jose A Faraon; Ali Fatehizadeh; Pietro Ferrara; Allegra Allegra Ferrari; Getahun Fetensa; Florian Fischer; Joanne Flavel; Masoud Foroutan; Peter Andras Gaal; Abhay Motiramji Gaidhane; Santosh Gaihre; Nasrin Galehdar; Alberto L Garcia-Basteiro; Tushar Garg; Mesfin Damtew Gebrehiwot; Mathewos Alemu Gebremichael; Yibeltal Yismaw Gela; Belete Negese Belete Gemeda; Bradford D Gessner; Melaku Getachew; Asmare Getie; Seyyed-Hadi Ghamari; Mohammad Ghasemi Nour; Ahmad Ghashghaee; Ali Gholamrezanezhad; Abdolmajid Gholizadeh; Rakesh Ghosh; Sherief Ghozy; Pouya Goleij; Mohamad Golitaleb; Giuseppe Gorini; Alessandra C Goulart; Girma Garedew Goyomsa; Habtamu Alganeh Guadie; Zewdie Gudisa; Rashid Abdi Guled; Sapna Gupta; Veer Bala Gupta; Vivek Kumar Gupta; Alemu Guta; Parham Habibzadeh; Arvin Haj-Mirzaian; Rabih Halwani; Samer Hamidi; Md Abdul Hannan; Mehdi Harorani; Ahmed I Hasaballah; Hamidreza Hasani; Abbas M Hassan; Shokoufeh Hassani; Hossein Hassanian-Moghaddam; Hadi Hassankhani; Khezar Hayat; Behzad Heibati; Mohammad Heidari; Demisu Zenbaba Heyi; Kamal Hezam; Ramesh Holla; Sung Hwi Hong; Nobuyuki Horita; Mohammad-Salar Hosseini; Mehdi Hosseinzadeh; Mihaela Hostiuc; Mowafa Househ; Soodabeh Hoveidamanesh; Junjie Huang; Nawfal R Hussein; Ivo Iavicoli; Segun Emmanuel Ibitoye; Kevin S Ikuta; Olayinka Stephen Ilesanmi; Irena M Ilic; Milena D Ilic; Mustapha Immurana; Nahlah Elkudssiah Ismail; Masao Iwagami; Jalil Jaafari; Elham Jamshidi; Sung-In Jang; Amirreza Javadi Mamaghani; Tahereh Javaheri; Fatemeh Javanmardi; Javad Javidnia; Sathish Kumar Jayapal; Umesh Jayarajah; Shubha Jayaram; Alelign Tasew Jema; Wonjeong Jeong; Jost B Jonas; Nitin Joseph; Farahnaz Joukar; Jacek Jerzy Jozwiak; V. K; Zubair Kabir; Salah Eddine Oussama Kacimi; Vidya Kadashetti; Laleh R Kalankesh; Rohollah Kalhor; Ashwin Kamath; Bhushan Dattatray Kamble; Himal Kandel; Tesfaye K Kanko; Ibraheem M Karaye; André Karch; Samad Karkhah; Bekalu Getnet Kassa; Patrick D M C Katoto; Harkiran Kaur; Rimple Jeet Kaur; Leila Keikavoosi-Arani; Mohammad Keykhaei; Yousef Saleh Khader; Himanshu Khajuria; Ejaz Ahmad Khan; Gulfaraz Khan; Imteyaz A Khan; Maseer Khan; Md Nuruzzaman Khan; Moien A B Khan; Yusra H Khan; Moawiah Mohammad Khatatbeh; Mina Khosravifar; Jagdish Khubchandani; Min Seo Kim; Ruth W Kimokoti; Adnan Kisa; Sezer Kisa; Niranjan Kissoon; Luke D Knibbs; Sonali Kochhar; Farzad Kompani; Hamid Reza Koohestani; Vladimir Andreevich Korshunov; Soewarta Kosen; Parvaiz A Koul; Ai Koyanagi; Kewal Krishan; Barthelemy Kuate Defo; G Anil Kumar; Om P Kurmi; Ambily Kuttikkattu; Dharmesh Kumar Lal; Judit Lám; Iván Landires; Caterina Ledda; Sang-Woong Lee; Miriam Levi; Sonia Lewycka; Gang Liu; Wei Liu; Rakesh Lodha; László Lorenzovici; Mojgan Lotfi; Joana A Loureiro; Farzan Madadizadeh; Ata Mahmoodpoor; Razzagh Mahmoudi; Marzieh Mahmoudimanesh; Jamal Majidpoor; Alaa Makki; Elaheh Malakan Rad; Ahmad Azam Malik; Tauqeer Hussain Mallhi; Yosef Manla; Clara N Matei; Alexander G Mathioudakis; Richard James Maude; Entezar Mehrabi Nasab; Addisu Melese; Ziad A Memish; Oliver Mendoza-Cano; Alexios-Fotios A Mentis; Tuomo J Meretoja; Mehari Woldemariam Merid; Tomislav Mestrovic; Ana Carolina Micheletti Gomide Nogueira De Sá; Gelana Fekadu Worku Mijena; Le Huu Nhat Minh; Shabir Ahmad Mir; Reza Mirfakhraie; Seyyedmohammadsadeq Mirmoeeni; Agha Zeeshan Mirza; Moonis Mirza; Mohammad Mirza-Aghazadeh-Attari; Abay Sisay Misganaw; Awoke Temesgen Misganaw; Esmaeil Mohammadi; Mokhtar Mohammadi; Arif Mohammed; Shafiu Mohammed; Syam Mohan; Mohammad Mohseni; Nagabhishek Moka; Ali H Mokdad; Sara Momtazmanesh; Lorenzo Monasta; Md Moniruzzaman; Fateme Montazeri; Catrin E Moore; Abdolvahab Moradi; Lidia Morawska; Jonathan F Mosser; Ebrahim Mostafavi; Majid Motaghinejad; Haleh Mousavi Isfahani; Seyed Ali Mousavi-Aghdas; Sumaira Mubarik; Efrén Murillo-Zamora; Ghulam Mustafa; Sanjeev Nair; Tapas Sadasivan Nair; Houshang Najafi; Atta Abbas Naqvi; Sreenivas Narasimha Swamy; Zuhair S Natto; Biswa Prakash Nayak; Seyed Aria Nejadghaderi; Huy Van Nguyen Nguyen; Robina Khan Niazi; Antonio Tolentino Nogueira De Sá; Hasti Nouraei; Ali Nowroozi; Virginia Nuñez-Samudio; Chimezie Igwegbe Nzoputam; Ogochukwu Janet Nzoputam; Bogdan Oancea; Chimedsuren Ochir; Oluwakemi Ololade Odukoya; Hassan Okati-Aliabad; Akinkunmi Paul Okekunle; Osaretin Christabel Okonji; Andrew T Olagunju; Isaac Iyinoluwa Olufadewa; Ahmed Omar Bali; Emad Omer; Eyal Oren; Erika Ota; Nikita Otstavnov; Abderrahim Oulhaj; P.A. Mahesh; Jagadish Rao Padubidri; Keyvan Pakshir; Reza Pakzad; Tamás Palicz; Anamika Pandey; Suman Pant; Shahina Pardhan; Eun-Cheol Park; Eun-Kee Park; Fatemeh Pashazadeh Kan; Rajan Paudel; Shrikant Pawar; Minjin Peng; Gavin Pereira; Simone Perna; Navaraj Perumalsamy; Ionela-Roxana Petcu; David M Pigott; Zahra Zahid Piracha; Vivek Podder; Roman V Polibin; Maarten J Postma; Hamid Pourasghari; Naeimeh Pourtaheri; Mirza Muhammad Fahd Qadir; Mathieu Raad; Mohammad Rabiee; Navid Rabiee; Saber Raeghi; Alireza Rafiei; Fakher Rahim; Mehran Rahimi; Vafa Rahimi-Movaghar; Azizur Rahman; Md Obaidur Rahman; Mosiur Rahman; Muhammad Aziz Rahman; Amir Masoud Rahmani; Vahid Rahmanian; Pradhum Ram; Kiana Ramezanzadeh; Juwel Rana; Priyanga Ranasinghe; Usha Rani; Sowmya J Rao; Sina Rashedi; Mohammad-Mahdi Rashidi; Azad Rasul; Zubair Ahmed Ratan; David Laith Rawaf; Salman Rawaf; Reza Rawassizadeh; Mohammad Sadegh Razeghinia; Elrashdy Moustafa Mohamed Redwan; Marissa B Reitsma; Andre M N Renzaho; Mohsen Rezaeian; Abanoub Riad; Reza Rikhtegar; Jefferson Antonio Buendia Rodriguez; Emma L B Rogowski; Luca Ronfani; Kristina E Rudd; Basema Saddik; Erfan Sadeghi; Umar Saeed; Azam Safary; Sher Zaman Safi; Maryam Sahebazzamani; Amirhossein Sahebkar; Sateesh Sakhamuri; Sana Salehi; Muhammad Salman; Hossein Samadi Kafil; Abdallah M Samy; Milena M Santric-Milicevic; Bruno Piassi Sao Jose; Maryam Sarkhosh; Brijesh Sathian; Monika Sawhney; Ganesh Kumar Saya; Abdul-Aziz Seidu; Allen Seylani; Amira A Shaheen; Masood Ali Shaikh; Elaheh Shaker; Hina Shamshad; Mequannent Melaku Sharew; Asaad Sharhani; Azam Sharifi; Purva Sharma; Ali Sheidaei; Suchitra M Shenoy; Jeevan K Shetty; Damtew Solomon Shiferaw; Mika Shigematsu; Jae Il Shin; Hesamaddin Shirzad-Aski; K.M. Shivakumar; Siddharudha Shivalli; Parnian Shobeiri; Wudneh Simegn; Colin R Simpson; Harpreet Singh; Jasvinder A Singh; Paramdeep Singh; Samarjeet Singh Siwal; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Mohammad Sadegh Soltani-Zangbar; Suhang Song; Yimeng Song; Prashant Sood; Chandrashekhar T Sreeramareddy; Paschalis Steiropoulos; Muhammad Suleman; Seyed-Amir Tabatabaeizadeh; Alireza Tahamtan; Majid Taheri; Moslem Taheri Soodejani; Elahe Taki; Iman M Talaat; Mircea Tampa; Sarmila Tandukar; Nathan Y Tat; Vivian Y Tat; Yibekal Manaye Tefera; Gebremaryam Temesgen; Mohamad-Hani Temsah; Azene Tesfaye; Degefa Gomora Tesfaye; Belay Tessema; Rekha Thapar; Jansje Henny Vera Ticoalu; Amir Tiyuri; Imad I Tleyjeh; Munkhsaikhan Togtmol; Marcos Roberto Tovani-Palone; Derara Girma Tufa; Irfan Ullah; Era Upadhyay; Sahel Valadan Tahbaz; Pascual R Valdez; Rohollah Valizadeh; Constantine Vardavas; Tommi Juhani Vasankari; Bay Vo; Linh Gia Vu; Birhanu Wagaye; Yasir Waheed; Yu Wang; Abdul Waris; T Eoin West; Nuwan Darshana Wickramasinghe; Xiaoyue Xu; Sajad Yaghoubi; Gahin Abdulraheem Tayib Yahya; Seyed Hossein Yahyazadeh Jabbari; Dong Keon Yon; Naohiro Yonemoto; Burhan Abdullah Zaman; Alireza Zandifar; Moein Zangiabadian; Heather J Zar; Iman Zare; Zahra Zareshahrabadi; Armin Zarrintan; Mikhail Sergeevich Zastrozhin; Wu Zeng; Mengxi Zhang; Zhi-Jiang Zhang; Chenwen Zhong; Mohammad Zoladl; Alimuddin Zumla; Stephen S Lim; Theo Vos; Mohsen Naghavi; Michael Brauer; Simon I Hay; Christopher J L Murray
Background: The global burden of lower respiratory infections (LRIs) and corresponding risk factors in children older than 5 years and adults has not been studied as comprehensively as it has been in children younger than 5 years. We assessed the burden and trends of LRIs and risk factors across all age groups by sex, for 204 countries and territories. Methods: In this analysis of data for the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we used clinician-diagnosed pneumonia or bronchiolitis as our case definition for LRIs. We included International Classification of Diseases 9th edition codes 079.6, 466–469, 470.0, 480–482.8, 483.0–483.9, 484.1–484.2, 484.6–484.7, and 487–489 and International Classification of Diseases 10th edition codes A48.1, A70, B97.4–B97.6, J09–J15.8, J16–J16.9, J20–J21.9, J91.0, P23.0–P23.4, and U04–U04.9. We used the Cause of Death Ensemble modelling strategy to analyse 23 109 site-years of vital registration data, 825 site-years of sample vital registration data, 1766 site-years of verbal autopsy data, and 681 site-years of mortality surveillance data. We used DisMod-MR 2.1, a Bayesian meta-regression tool, to analyse age–sex-specific incidence and prevalence data identified via systematic reviews of the literature, population-based survey data, and claims and inpatient data. Additionally, we estimated age–sex-specific LRI mortality that is attributable to the independent effects of 14 risk factors. Findings: Globally, in 2019, we estimated that there were 257 million (95% uncertainty interval [UI] 240–275) LRI incident episodes in males and 232 million (217–248) in females. In the same year, LRIs accounted for 1·30 million (95% UI 1·18–1·42) male deaths and 1·20 million (1·07–1·33) female deaths. Age-standardised incidence and mortality rates were 1·17 times (95% UI 1·16–1·18) and 1·31 times (95% UI 1·23–1·41) greater in males than in females in 2019. Between 1990 and 2019, LRI incidence and mortality rates declined at different rates across age groups and an increase in LRI episodes and deaths was estimated among all adult age groups, with males aged 70 years and older having the highest increase in LRI episodes (126·0% [95% UI 121·4–131·1]) and deaths (100·0% [83·4–115·9]). During the same period, LRI episodes and deaths in children younger than 15 years were estimated to have decreased, and the greatest decline was observed for LRI deaths in males younger than 5 years (–70·7% [–77·2 to –61·8]). The leading risk factors for LRI mortality varied across age groups and sex. More than half of global LRI deaths in children younger than 5 years were attributable to child wasting (population attributable fraction [PAF] 53·0% [95% UI 37·7–61·8] in males and 56·4% [40·7–65·1] in females), and more than a quarter of LRI deaths among those aged 5–14 years were attributable to household air pollution (PAF 26·0% [95% UI 16·6–35·5] for males and PAF 25·8% [16·3–35·4] for females). PAFs of male LRI deaths attributed to smoking were 20·4% (95% UI 15·4–25·2) in those aged 15–49 years, 30·5% (24·1–36·9) in those aged 50–69 years, and 21·9% (16·8–27·3) in those aged 70 years and older. PAFs of female LRI deaths attributed to household air pollution were 21·1% (95% UI 14·5–27·9) in those aged 15–49 years and 18·2% (12·5–24·5) in those aged 50–69 years. For females aged 70 years and older, the leading risk factor, ambient particulate matter, was responsible for 11·7% (95% UI 8·2–15·8) of LRI deaths. Interpretation: The patterns and progress in reducing the burden of LRIs and key risk factors for mortality varied across age groups and sexes. The progress seen in children younger than 5 years was clearly a result of targeted interventions, such as vaccination and reduction of exposure to risk factors. Similar interventions for other age groups could contribute to the achievement of multiple Sustainable Development Goals targets, including promoting wellbeing at all ages and reducing health inequalities. Interventions, including addressing risk factors such as child wasting, smoking, ambient particulate matter pollution, and household air pollution, would prevent deaths and reduce health disparities. Funding: Bill & Melinda Gates Foundation. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Assessing performance of the Healthcare Access and Quality Index, overall and by select age groups, for 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019
(Elsevier Ltd, 2022) Annie Haakenstad; Jamal Akeem Yearwood; Nancy Fullman; Corinne Bintz; Kelly Bienhoff; Marcia R Weaver; Vishnu Nandakumar; Jonah N Joffe; Kate E LeGrand; Megan Knight; Cristiana Abbafati; Mohsen Abbasi-Kangevari; Amir Abdoli; Roberto Ariel Abeldaño Zuñiga; Isaac Akinkunmi Adedeji; Victor Adekanmbi; Olatunji O Adetokunboh; Muhammad Sohail Afzal; Saira Afzal; Marcela Agudelo-Botero; Bright Opoku Ahinkorah; Sajjad Ahmad; Ali Ahmadi; Sepideh Ahmadi; Ali Ahmed; Tarik Ahmed Rashid; Budi Aji; Wuraola Akande-Sholabi; Khurshid Alam; Hanadi Al Hamad; Robert Kaba Alhassan; Liaqat Ali; Vahid Alipour; Syed Mohamed Aljunid; Edward Kwabena Ameyaw; Tarek Tawfik Amin; Hubert Amu; Dickson A Amugsi; Robert Ancuceanu; Pedro Prata Andrade; Afifa Anjum; Jalal Arabloo; Morteza Arab-Zozani; Hany Ariffin; Judie Arulappan; Zahra Aryan; Tahira Ashraf; Desta Debalkie Atnafu; Alok Atreya; Marcel Ausloos; Leticia Avila-Burgos; Getinet Ayano; Martin Amogre Ayanore; Samad Azari; Ashish D Badiye; Atif Amin Baig; Mohan Bairwa; Shankar M Bakkannavar; Shrikala Baliga; Palash Chandra Banik; Till Winfried Bärnighausen; Fabio Barra; Amadou Barrow; Sanjay Basu; Mohsen Bayati; Rebuma Belete; Arielle Wilder Bell; Devidas S Bhagat; Akshaya Srikanth Bhagavathula; Pankaj Bhardwaj; Nikha Bhardwaj; Sonu Bhaskar; Krittika Bhattacharyya; Zulfiqar A Bhutta; Sadia Bibi; Ali Bijani; Boris Bikbov; Antonio Biondi; Obasanjo Afolabi Bolarinwa; Aime Bonny; Hermann Brenner; Danilo Buonsenso; Katrin Burkart; Reinhard Busse; Zahid A Butt; Nadeem Shafique Butt; Florentino Luciano Caetano Dos Santos; Lucero Cahuana-Hurtado; Luis Alberto Cámera; Rosario Cárdenas; Vera L A Carneiro; Ferrán Catalá-López; Joht Singh Chandan; Jaykaran Charan; Prachi P Chavan; Simiao Chen; Shu Chen; Sonali Gajanan Choudhari; Enayet Karim Chowdhury; Mohiuddin Ahsanul Kabir Chowdhury; Massimo Cirillo; Barbara Corso; Omid Dadras; Saad M A Dahlawi; Xiaochen Dai; Lalit Dandona; Rakhi Dandona; William James Dangel; Claudio Alberto Dávila-Cervantes; Kairat Davletov; Keshab Deuba; Meghnath Dhimal; Mandira Lamichhane Dhimal; Shirin Djalalinia; Huyen Phuc Do; Leila Doshmangir; Bruce B Duncan; Andem Effiong; Elham Ehsani-Chimeh; Islam Y Elgendy; Muhammed Elhadi; Iman El Sayed; Maha El Tantawi; Daniel Asfaw Erku; Sharareh Eskandarieh; Jawad Fares; Farshad Farzadfar; Simone Ferrero; Lorenzo Ferro Desideri; Florian Fischer; Nataliya A Foigt; Masoud Foroutan; Takeshi Fukumoto; Peter Andras Gaal; Santosh Gaihre; William M Gardner; Tushar Garg; Abera Getachew Obsa; Mansour Ghafourifard; Ahmad Ghashghaee; Nermin Ghith; Syed Amir Gilani; Paramjit Singh Gill; Salime Goharinezhad; Mahaveer Golechha; Jenny S Guadamuz; Yuming Guo; Rajat Das Gupta; Rajeev Gupta; Vivek Kumar Gupta; Veer Bala Gupta; Mohammad Hamiduzzaman; Asif Hanif; Josep Maria Haro; Ahmed I Hasaballah; Md Mehedi Hasan; M Tasdik Hasan; Abdiwahab Hashi; Simon I Hay; Khezar Hayat; Mohammad Heidari; Golnaz Heidari; Nathaniel J Henry; Claudiu Herteliu; Ramesh Holla; Sahadat Hossain; Sheikh Jamal Hossain; Mohammad Bellal Hossain Hossain; Mehdi Hosseinzadeh; Sorin Hostiuc; Soodabeh Hoveidamanesh; Vivian Chia-Rong Hsieh; Guoqing Hu; Junjie Huang; M Mamun Huda; Susan C Ifeagwu; Kevin S Ikuta; Olayinka Stephen Ilesanmi; Seyed Sina Naghibi Irvani; Rakibul M Islam; Sheikh Mohammed Shariful Islam; Nahlah Elkudssiah Ismail; Hiroyasu Iso; Gaetano Isola; Ramaiah Itumalla; Masao Iwagami; Mohammad Ali Jahani; Nader Jahanmehr; Rajesh Jain; Mihajlo Jakovljevic; Manthan Dilipkumar Janodia; Sathish Kumar Jayapal; Shubha Jayaram; Ravi Prakash Jha; Jost B Jonas; Tamas Joo; Nitin Joseph; Mikk Jürisson; Ali Kabir; Leila R Kalankesh; Rohollah Kalhor; Aruna M Kamath; Kaloyan Kamenov; Himal Kandel; Rami S Kantar; Neeti Kapoor; Marina Karanikolos; Srinivasa Vittal Katikireddi; Taras Kavetskyy; Norito Kawakami; Gbenga A Kayode; Leila Keikavoosi-Arani; Mohammad Keykhaei; Yousef Saleh Khader; Himanshu Khajuria; Rovshan Khalilov; Mohammad Khammarnia; Md Nuruzzaman Khan; Moien A B Khan; Maseer Khan; Mehdi Khezeli; Min Seo Kim; Yun Jin Kim; Sezer Kisa; Adnan Kisa; Vitalii Klymchuk; Kamrun Nahar Koly; Oleksii Korzh; Soewarta Kosen; Parvaiz A Koul; Barthelemy Kuate Defo; G Anil Kumar; Dian Kusuma; Hmwe Hmwe Kyu; Anders O Larsson; Savita Lasrado; Wei-Chen Lee; Yo Han Lee; Chiachi Bonnie Lee; Shanshan Li; Giancarlo Lucchetti; Preetam Bhalchandra Mahajan; Azeem Majeed; Alaa Makki; Reza Malekzadeh; Ahmad Azam Malik; Deborah Carvalho Malta; Mohammad Ali Mansournia; Lorenzo Giovanni Mantovani; Adolfo Martinez-Valle; Francisco Rogerlândio Martins-Melo; Seyedeh Zahra Masoumi; Manu Raj Mathur; Richard James Maude; Pallab K Maulik; Martin McKee; Walter Mendoza; Ritesh G Menezes; George A Mensah; Atte Meretoja; Tuomo J Meretoja; Tomislav Mestrovic; Irmina Maria Michalek; Erkin M Mirrakhimov; Awoke Misganaw; Sanjeev Misra; Babak Moazen; Mokhtar Mohammadi; Shafiu Mohammed; Modhurima Moitra; Ali H Mokdad; Mariam Molokhia; Lorenzo Monasta; Mohammad Ali Moni; Ghobad Moradi; Rafael Silveira Moreira; Jonathan F Mosser; Ebrahim Mostafavi; Simin Mouodi; Ahamarshan Jayaraman Nagarajan; Chie Nagata; Mohsen Naghavi; Vinay Nangia; Sreenivas Narasimha Swamy; Aparna Ichalangod Narayana; Bruno Ramos Nascimento; Hasan Nassereldine; Biswa Prakash Nayak; Javad Nazari; Ionut Negoi; Samata Nepal; Sandhya Neupane Kandel; Josephine W Ngunjiri; Huong Lan Thi Nguyen; Cuong Tat Nguyen; Dina Nur Anggraini Ningrum; Jean Jacques Noubiap; Bogdan Oancea; Onome Bright Oghenetega; In-Hwan Oh; Andrew T Olagunju; Babayemi Oluwaseun Olakunde; Ahmed Omar Bali; Emad Omer; Obinna E Onwujekwe; Adrian Otoiu; Jagadish Rao Padubidri; Raffaele Palladino; Adrian Pana; Songhomitra Panda-Jonas; Seithikurippu R Pandi-Perumal; Shahina Pardhan; Deepak Kumar Pasupula; Praveen Kumar Pathak; George C Patton; Shrikant Pawar; Jeevan Pereira; Manju Pilania; Bakhtiar Piroozi; Vivek Podder; Khem Narayan Pokhrel; Maarten J Postma; Sergio I Prada; Zahiruddin Quazi Syed; Navid Rabiee; Raghu Anekal Radhakrishnan; Md. Mosfequr Rahman; Mosiur Rahman; Mahfuzar Rahman; Mohammad Hifz Ur Rahman; Amir Masoud Rahmani; Chhabi Lal Ranabhat; Chythra R Rao; Sowmya J Rao; Davide Rasella; Salman Rawaf; David Laith Rawaf; Lal Rawal; Andre M N Renzaho; Bhageerathy Reshmi; Serge Resnikoff; Aziz Rezapour; Seyed Mohammad Riahi; Rezaul Karim Ripon; Simona Sacco; Masoumeh Sadeghi; Umar Saeed; Amirhossein Sahebkar; Biniyam Sahiledengle; Harihar Sahoo; Maitreyi Sahu; Joseph S Salama; Payman Salamati; Abdallah M Samy; Juan Sanabria; Milena M Santric-Milicevic; Brijesh Sathian; Monika Sawhney; Maria Inês Schmidt; Abdul-Aziz Seidu; Sadaf G Sepanlou; Allen Seylani; Masood Ali Shaikh; Aziz Sheikh; Adithi Shetty; Mika Shigematsu; Rahman Shiri; K.M. Shivakumar; Azad Shokri; Jasvinder A Singh; Dhirendra Narain Sinha; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Ahmad Sofi-Mahmudi; Raúl A R C Sousa; Jacqueline H Stephens; Jing Sun; Miklós Szócska; Rafael Tabarés-Seisdedos; Hooman Tadbiri; Animut Tagele Tamiru; Kavumpurathu Raman Thankappan; Roman Topor-Madry; Marcos Roberto Tovani-Palone; Mai Thi Ngoc Tran; Bach Xuan Tran; Niharika Tripathi; Jaya Prasad Tripathy; Christopher E Troeger; Deinzel Robles Uezono; Saif Ullah; Anayat Ullah; Bhaskaran Unnikrishnan; Marco Vacante; Sahel Valadan Tahbaz; Pascual R Valdez; Milena Vasic; Massimiliano Veroux; Dominique Vervoort; Francesco S Violante; Sergey Konstantinovitch Vladimirov; Vasily Vlassov; Bay Vo; Yasir Waheed; Richard G Wamai; Yuan-Pang Wang; Yanzhong Wang; Paul Ward; Taweewat Wiangkham; Lalit Yadav; Seyed Hossein Yahyazadeh Jabbari; Kazumasa Yamagishi; Sanni Yaya; Vahid Yazdi-Feyzabadi; Siyan Yi; Vahit Yiǧit; Naohiro Yonemoto; Mustafa Z Younis; Chuanhua Yu; Ismaeel Yunusa; Sojib Bin Zaman; Mikhail Sergeevich Zastrozhin; Zhi-Jiang Zhang; Chenwen Zhong; Yves Miel H Zuniga; Stephen S Lim; Christopher J L Murray; Rafael Lozano
Background: Health-care needs change throughout the life course. It is thus crucial to assess whether health systems provide access to quality health care for all ages. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019), we measured the Healthcare Access and Quality (HAQ) Index overall and for select age groups in 204 locations from 1990 to 2019. Methods: We distinguished the overall HAQ Index (ages 0–74 years) from scores for select age groups: the young (ages 0–14 years), working (ages 15–64 years), and post-working (ages 65–74 years) groups. For GBD 2019, HAQ Index construction methods were updated to use the arithmetic mean of scaled mortality-to-incidence ratios (MIRs) and risk-standardised death rates (RSDRs) for 32 causes of death that should not occur in the presence of timely, quality health care. Across locations and years, MIRs and RSDRs were scaled from 0 (worst) to 100 (best) separately, putting the HAQ Index on a different relative scale for each age group. We estimated absolute convergence for each group on the basis of whether the HAQ Index grew faster in absolute terms between 1990 and 2019 in countries with lower 1990 HAQ Index scores than countries with higher 1990 HAQ Index scores and by Socio-demographic Index (SDI) quintile. SDI is a summary metric of overall development. Findings: Between 1990 and 2019, the HAQ Index increased overall (by 19·6 points, 95% uncertainty interval 17·9–21·3), as well as among the young (22·5, 19·9–24·7), working (17·2, 15·2–19·1), and post-working (15·1, 13·2–17·0) age groups. Large differences in HAQ Index scores were present across SDI levels in 2019, with the overall index ranging from 30·7 (28·6–33·0) on average in low-SDI countries to 83·4 (82·4–84·3) on average in high-SDI countries. Similarly large ranges between low-SDI and high-SDI countries, respectively, were estimated in the HAQ Index for the young (40·4–89·0), working (33·8–82·8), and post-working (30·4–79·1) groups. Absolute convergence in HAQ Index was estimated in the young group only. In contrast, divergence was estimated among the working and post-working groups, driven by slow progress in low-SDI countries. Interpretation: Although major gaps remain across levels of social and economic development, convergence in the young group is an encouraging sign of reduced disparities in health-care access and quality. However, divergence in the working and post-working groups indicates that health-care access and quality is lagging at lower levels of social and economic development. To meet the needs of ageing populations, health systems need to improve health-care access and quality for working-age adults and older populations while continuing to realise gains among the young. Funding: Bill & Melinda Gates Foundation. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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.
Diabetes mortality and trends before 25 years of age: an analysis of the Global Burden of Disease Study 2019
(Elsevier Ltd, 2022) Ewerton Cousin; Bruce B. Duncan; Caroline Stein; Kanyin Liane Ong; Theo Vos; Cristiana Abbafati; Mohsen Abbasi-Kangevari; Michael Abdelmasseh; Amir Abdoli; Rami Abd-Rabu; Hassan Abolhassani; Eman Abu-Gharbieh; Manfred Mario Kokou Accrombessi; Qorinah Estiningtyas Sakilah Adnani; Muhammad Sohail Afzal; Gina Agarwal; Krishna K. Agrawaal; Marcela Agudelo-Botero; Bright Opoku Ahinkorah; Sajjad Ahmad; Tauseef Ahmad; Keivan Ahmadi; Sepideh Ahmadi; Ali Ahmadi; Ali Ahmed; Yusra Ahmed Salih; Wuraola Akande-Sholabi; Tayyaba Akram; Hanadi Al Hamad; Ziyad Al-Aly; Jacqueline Elizabeth Alcalde-Rabanal; Vahid Alipour; Syed Mohamed Aljunid; Rajaa M. Al-Raddadi; Nelson Alvis-Guzman; Saeed Amini; Robert Ancuceanu; Tudorel Andrei; Catalina Liliana Andrei; Ranjit Mohan Anjana; Adnan Ansar; Ippazio Cosimo Antonazzo; Benny Antony; Anayochukwu Edward Anyasodor; Jalal Arabloo; Damian Arizmendi; Benedetta Armocida; Anton A. Artamonov; Judie Arulappan; Zahra Aryan; Samaneh Asgari; Tahira Ashraf; Thomas Astell-Burt; Prince Atorkey; Maha Moh'd Wahbi Atout; Martin Amogre Ayanore; Ashish D. Badiye; Atif Amin Baig; Mohan Bairwa; Jennifer L. Baker; Ovidiu Constantin Baltatu; Palash Chandra Banik; Anthony Barnett; Mark Thomaz Ugliara Barone; Francesco Barone-Adesi; Amadou Barrow; Neeraj Bedi; Rebuma Belete; Uzma Iqbal Belgaumi; Arielle Wilder Bell; Derrick A. Bennett; Isabela M. Bensenor; David Beran; Akshaya Srikanth Bhagavathula; Sonu Bhaskar; Krittika Bhattacharyya; Vijayalakshmi S. Bhojaraja; Ali Bijani; Boris Bikbov; Setognal Birara; Virginia Bodolica; Aime Bonny; Hermann Brenner; Nikolay Ivanovich Briko; Zahid A. Butt; Florentino Luciano Caetano dos Santos; Luis Alberto Cámera; Ismael R. Campos-Nonato; Yin Cao; Chao Cao; Ester Cerin; Promit Ananyo Chakraborty; Joht Singh Chandan; Vijay Kumar Chattu; Simiao Chen; Jee-Young Jasmine Choi; Sonali Gajanan Choudhari; Enayet Karim Chowdhury; Dinh-Toi Chu; Barbara Corso; Omid Dadras; Xiaochen Dai; Albertino Antonio Moura Damasceno; Lalit Dandona; Rakhi Dandona; Claudio Alberto Dávila-Cervantes; Jan-Walter De Neve; Edgar Denova-Gutiérrez; Deepak Dhamnetiya; Daniel Diaz; Sanam Ebtehaj; Hisham Atan Edinur; Sahar Eftekharzadeh; Iman El Sayed; Islam Y. Elgendy; Muhammed Elhadi; Mohamed A. Elmonem; Mohammed Faisaluddin; Umar Farooque; Xiaoqi Feng; Eduarda Fernandes; Florian Fischer; David Flood; Marisa Freitas; Peter Andras Gaal; Mohamed M. Gad; Piyada Gaewkhiew; Lemma Getacher; Mansour Ghafourifard; Reza Ghanei Gheshlagh; Ahmad Ghashghaee; Nermin Ghith; Ghozali Ghozali; Paramjit Singh Gill; Ibrahim Abdelmageed Ginawi; Ekaterina Vladimirovna Glushkova; Mahaveer Golechha; Sameer Vali Gopalani; Rafael Alves Guimarães; Rajat Das Gupta; Rajeev Gupta; Vivek Kumar Gupta; Veer Bala Gupta; Sapna Gupta; Tesfa Dejenie Habtewold; Nima Hafezi-Nejad; Rabih Halwani; Asif Hanif; Graeme J. Hankey; Shafiul Haque; Ahmed I. Hasaballah; Syed Shahzad Hasan; Abdiwahab Hashi; Soheil Hassanipour; Simon I. Hay; Khezar Hayat; Mohammad Heidari; Mohammad Bellal Hossain Hossain; Sahadat Hossain; Mostafa Hosseini; Soodabeh Hoveidamanesh; Junjie Huang; Ayesha Humayun; Rabia Hussain; Bing-Fang Hwang; Segun Emmanuel Ibitoye; Kevin S. Ikuta; Leeberk Raja Inbaraj; Usman Iqbal; Md Shariful Islam; Sheikh Mohammed Shariful Islam; Rakibul M. Islam; Nahlah Elkudssiah Ismail; Gaetano Isola; Ramaiah Itumalla; Masao Iwagami; Ihoghosa Osamuyi Iyamu; Mohammad Ali Jahani; Mihajlo Jakovljevic; Ranil Jayawardena; Ravi Prakash Jha; Oommen John; Jost B. Jonas; Tamas Joo; Ali Kabir; Rohollah Kalhor; Ashwin Kamath; Tanuj Kanchan; Himal Kandel; Neeti Kapoor; Gbenga A. Kayode; Sewnet Adem Kebede; Pedram Keshavarz; Mohammad Keykhaei; Yousef Saleh Khader; Himanshu Khajuria; Moien A. B. Khan; Md Nuruzzaman Khan; Maseer Khan; Amir M. Khater; Tawfik Ahmed Muthafer Khoja; Jagdish Khubchandani; Min Seo Kim; Yun Jin Kim; Ruth W. Kimokoti; Sezer Kisa; Adnan Kisa; Mika Kivimäki; Vladimir Andreevich Korshunov; Oleksii Korzh; Ai Koyanagi; Kewal Krishan; Barthelemy Kuate Defo; G. Anil Kumar; Nithin Kumar; Dian Kusuma; Carlo La Vecchia; Ben Lacey; Anders O. Larsson; Savita Lasrado; Wei-Chen Lee; Chiachi Bonnie Lee; Paul H. Lee; Shaun Wen Huey Lee; Ming-Chieh Li; Stephen S. Lim; Lee-Ling Lim; Giancarlo Lucchetti; Azeem Majeed; Ahmad Azam Malik; Borhan Mansouri; Lorenzo Giovanni Mantovani; Santi Martini; Prashant Mathur; Colm McAlinden; Nafiul Mehedi; Teferi Mekonnen; Ritesh G. Menezes; Amanual Getnet Mersha; Junmei Miao Jonasson; Tomasz Miazgowski; Irmina Maria Michalek; Andreea Mirica; Erkin M. Mirrakhimov; Agha Zeeshan Mirza; Prasanna Mithra; Abdollah Mohammadian-Hafshejani; Reza Mohammadpourhodki; Arif Mohammed; Ali H. Mokdad; Mariam Molokhia; Lorenzo Monasta; Mohammad Ali Moni; Farhad Moradpour; Rahmatollah Moradzadeh; Ebrahim Mostafavi; Ulrich Otto Mueller; Christopher J. L. Murray; Ahmad Mustafa; Gabriele Nagel; Vinay Nangia; Atta Abbas Naqvi; Biswa Prakash Nayak; Javad Nazari; Rawlance Ndejjo; Ruxandra Irina Negoi; Sandhya Neupane Kandel; Cuong Tat Nguyen; Huong Lan Thi Nguyen; Jean Jacques Noubiap; Christoph Nowak; Bogdan Oancea; Oluwakemi Ololade Odukoya; Ayodipupo Sikiru Oguntade; Temitope T. Ojo; Andrew T. Olagunju; Obinna E. Onwujekwe; Alberto Ortiz; Mayowa O. Owolabi; Raffaele Palladino; Songhomitra Panda-Jonas; Seithikurippu R. Pandi-Perumal; Shahina Pardhan; Tarang Parekh; Mojtaba Parvizi; Veincent Christian Filipino Pepito; Arokiasamy Perianayagam; Ionela-Roxana Petcu; Manju Pilania; Vivek Podder; Roman V. Polibin; Maarten J. Postma; Akila Prashant; Navid Rabiee; Mohammad Rabiee; Vafa Rahimi-Movaghar; Muhammad Aziz Rahman; Md. Mosfequr Rahman; Mosiur Rahman; Setyaningrum Rahmawaty; Nazanin Rajai; Pradhum Ram; Juwel Rana; Kamal Ranabhat; Priyanga Ranasinghe; Chythra R. Rao; Satish Rao; Salman Rawaf; David Laith Rawaf; Lal Rawal; Andre M. N. Renzaho; Nima Rezaei; Aziz Rezapour; Seyed Mohammad Riahi; Daniela Ribeiro; Jefferson Antonio Buendia Rodriguez; Leonardo Roever; Peter Rohloff; Godfrey M. Rwegerera; Paul MacDaragh Ryan; Maha Mohamed Saber-Ayad; Siamak Sabour; Basema Saddik; Sahar Saeedi Moghaddam; Amirhossein Sahebkar; Harihar Sahoo; K.M. Saif-Ur-Rahman; Hamideh Salimzadeh; Mehrnoosh Samaei; Juan Sanabria; Milena M. Santric-Milicevic; Brijesh Sathian; Thirunavukkarasu Sathish; Markus P. Schlaich; Abdul-Aziz Seidu; Mario Šekerija; Nachimuthu Senthil Kumar; Allen Seylani; Masood Ali Shaikh; Hina Shamshad; Md Shajedur Rahman Shawon; Sara Sheikhbahaei; Jeevan K. Shetty; Rahman Shiri; K.M. Shivakumar; Kerem Shuval; Jasvinder A. Singh; Ambrish Singh; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Ahmad Sofi-Mahmudi; Amin Soheili; Jing Sun; Viktória Szerencsés; Miklós Szócska; Rafael Tabarés-Seisdedos; Hooman Tadbiri; Eyayou Girma Tadesse; Md. Tariqujjaman; Kavumpurathu Raman Thankappan; Rekha Thapar; Nihal Thomas; Binod Timalsina; Ruoyan Tobe-Gai; Marcello Tonelli; Marcos Roberto Tovani-Palone; Bach Xuan Tran; Jaya Prasad Tripathy; Lorainne Tudor Car; Biruk Shalmeno Tusa; Riaz Uddin; Era Upadhyay; Sahel Valadan Tahbaz; Pascual R. Valdez; Tommi Juhani Vasankari; Madhur Verma; Victor E. Villalobos-Daniel; Sergey Konstantinovitch Vladimirov; Bay Vo; Giang Thu Vu; Rade Vukovic; Yasir Waheed; Richard G. Wamai; Andrea Werdecker; Nuwan Darshana Wickramasinghe; Andrea Sylvia Winkler; Befikadu Legesse Wubishet; Xiaoyue Xu; Suowen Xu; Seyed Hossein Yahyazadeh Jabbari; Hiroshi Yatsuya; Sanni Yaya; Taklo Simeneh Yazie Yazie; Siyan Yi; Naohiro Yonemoto; Ismaeel Yunusa; Siddhesh Zadey; Sojib Bin Zaman; Maryam Zamanian; Nelson Zamora; Mikhail Sergeevich Zastrozhin; Anasthasia Zastrozhina; Zhi-Jiang Zhang; Chenwen Zhong; Mohammad Zmaili; Alimuddin Zumla; Mohsen Naghavi; Maria Inês Schmidt
Background: Diabetes, particularly type 1 diabetes, at younger ages can be a largely preventable cause of death with the correct health care and services. We aimed to evaluate diabetes mortality and trends at ages younger than 25 years globally using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Methods: We used estimates of GBD 2019 to calculate international diabetes mortality at ages younger than 25 years in 1990 and 2019. Data sources for causes of death were obtained from vital registration systems, verbal autopsies, and other surveillance systems for 1990–2019. We estimated death rates for each location using the GBD Cause of Death Ensemble model. We analysed the association of age-standardised death rates per 100 000 population with the Socio-demographic Index (SDI) and a measure of universal health coverage (UHC) and described the variability within SDI quintiles. We present estimates with their 95% uncertainty intervals. Findings: In 2019, 16 300 (95% uncertainty interval 14 200 to 18 900) global deaths due to diabetes (type 1 and 2 combined) occurred in people younger than 25 years and 73·7% (68·3 to 77·4) were classified as due to type 1 diabetes. The age-standardised death rate was 0·50 (0·44 to 0·58) per 100 000 population, and 15 900 (97·5%) of these deaths occurred in low to high-middle SDI countries. The rate was 0·13 (0·12 to 0·14) per 100 000 population in the high SDI quintile, 0·60 (0·51 to 0·70) per 100 000 population in the low-middle SDI quintile, and 0·71 (0·60 to 0·86) per 100 000 population in the low SDI quintile. Within SDI quintiles, we observed large variability in rates across countries, in part explained by the extent of UHC (r2=0·62). From 1990 to 2019, age-standardised death rates decreased globally by 17·0% (−28·4 to −2·9) for all diabetes, and by 21·0% (–33·0 to −5·9) when considering only type 1 diabetes. However, the low SDI quintile had the lowest decline for both all diabetes (−13·6% [–28·4 to 3·4]) and for type 1 diabetes (−13·6% [–29·3 to 8·9]). Interpretation: Decreasing diabetes mortality at ages younger than 25 years remains an important challenge, especially in low and low-middle SDI countries. Inadequate diagnosis and treatment of diabetes is likely to be major contributor to these early deaths, highlighting the urgent need to provide better access to insulin and basic diabetes education and care. This mortality metric, derived from readily available and frequently updated GBD data, can help to monitor preventable diabetes-related deaths over time globally, aligned with the UN's Sustainable Development Targets, and serve as an indicator of the adequacy of basic diabetes care for type 1 and type 2 diabetes across nations. Funding: Bill & Melinda Gates Foundation. © 2022 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. Gething; Molla Getie; Keyghobad Ghadiri; Sulmaz Ghahramani; Khalid Yaser Ghailan; Mohammad-Reza Ghasemi; Ghazal Ghasempour Dabaghi; Afsaneh Ghasemzadeh; Ahmad Ghashghaee; Fariba Ghassemi; Ramy Mohamed Ghazy; Ajnish Ghimire; Sama Ghoba; Maryam Gholamalizadeh; Asadollah Gholamian; Ali Gholamrezanezhad; Nasim Gholizadeh; Mahsa Ghorbani; Pooyan Ghorbani Vajargah; Aloke Gopal Ghoshal; Paramjit Singh Gill; Tiffany K. Gill; Richard F. Gillum; Themba G. Ginindza; Alem Girmay; James C. Glasbey; Elena V. Gnedovskaya; Laszlo Gobolos; Myron Anthony Godinho; Amit Goel; Ali Golchin; Mohamad Goldust; Mahaveer Golechha; Pouya Goleij; Nelson G. M. Gomes; Philimon N. Gona; Sameer Vali Gopalani; Giuseppe Gorini; Houman Goudarzi; Alessandra C. Goulart; Barbara Niegia Garcia Goulart; Anmol Goyal; Ayman Grada; Simon Matthew Graham; Michal Grivna; Giuseppe Grosso; Shi-Yang Guan; Giovanni Guarducci; Mohammed Ibrahim Mohialdeen Gubari; Mesay Dechasa Gudeta; Avirup Guha; Stefano Guicciardi; Rafael Alves Guimaraes; Snigdha Gulati; Damitha Asanga Gunawardane; Sasidhar Gunturu; Cui Guo; Anish Kumar Gupta; Bhawna Gupta; Manoj Kumar Gupta; Mohak Gupta; Rajat Das Gupta; Rajeev Gupta; Sapna Gupta; Veer Bala Gupta; Vijai Kumar Gupta; Vivek Kumar Gupta; Lami Gurmessa; Reyna Alma Gutierrez; Farrokh Habibzadeh; Parham Habibzadeh; Rasool Haddadi; Mostafa Hadei; Najah R. Hadi; Nils Haep; Nima Hafezi-Nejad; Demewoz Haile; Alemayehu Hailu; Arvin Haj-Mirzaian; Esam S. Halboub; Brian J. Hall; Sebastian Haller; Rabih Halwani; Randah R. Hamadeh; Sajid Hameed; Samer Hamidi; Erin B. Hamilton; Chieh Han; Qiuxia Han; Asif Hanif; Nasrin Hanifi; Graeme J. 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Hussein; Foziya Mohammed Hussien; Hong-Han Huynh; Bing-Fang Hwang; Segun Emmanuel Ibitoye; Khalid S. Ibrahim; Pulwasha Maria Iftikhar; Desta Ijo; Adalia I. Ikiroma; Kevin S. Ikuta; Paul Chukwudi Ikwegbue; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Mohammad Tarique Imam; Mustapha Immurana; Sumant Inamdar; Endang Indriasih; Muhammad Iqhrammullah; Arnaud Iradukunda; Kenneth Chukwuemeka Iregbu; Md Rabiul Islam; Sheikh Mohammed Shariful Islam; Farhad Islami; Faisal Ismail; Nahlah Elkudssiah Ismail; Hiroyasu Iso; Gaetano Isola; Masao Iwagami; Chidozie C. D. Iwu; Ihoghosa Osamuyi Iyamu; Mahalaxmi Iyer; J. Linda Merin; Jalil Jaafari; Louis Jacob; Kathryn H. Jacobsen; Farhad Jadidi-Niaragh; Morteza Jafarinia; Abdollah Jafarzadeh; Khushleen Jaggi; Kasra Jahankhani; Nader Jahanmehr; Haitham Jahrami; Nityanand Jain; Ammar Abdulrahman Jairoun; Abhishek Jaiswal; Elham Jamshidi; Mark M. Janko; Abubakar Ibrahim Jatau; Sabzali Javadov; Tahereh Javaheri; Sathish Kumar Jayapal; Shubha Jayaram; Rime Jebai; Sun Ha Jee; Jayakumar Jeganathan; Anil K. Jha; Ravi Prakash Jha; Heng Jiang; Yingzhao Jin; Olatunji Johnson; Mohammad Jokar; Jost B. Jonas; Tamas Joo; Abel Joseph; Nitin Joseph; Charity Ehimwenma Joshua; Grace Joshy; Jacek Jerzy Jozwiak; Mikk Jurisson; K. Vaishali; Billingsley Kaambwa; Ali Kabir; Zubair Kabir; Vidya Kadashetti; Dler Hussein Kadir; Rizwan Kalani; Laleh R. Kalankesh; Leila R. Kalankesh; Feroze Kaliyadan; Sanjay Kalra; Vineet Kumar Kamal; Sivesh Kathir Kamarajah; Rajesh Kamath; Zahra Kamiab; Naser Kamyari; Thanigaivelan Kanagasabai; Tanuj Kanchan; Himal Kandel; Arun R. Kanmanthareddy; Edmund Wedam Kanmiki; Kehinde Kazeem Kanmodi; S. Suthanthira Kannan; Sushil Kumar Kansal; Rami S. Kantar; Neeti Kapoor; Mehrdad Karajizadeh; Shama D. Karanth; Reema A. Karasneh; Ibraheem M. Karaye; Andre Karch; Asima Karim; Salah Eddin Karimi; Arman Karimi Behnagh; Faizan Zaffar Kashoo; Qalandar Hussein Abdulkarim Kasnazani; Hengameh Kasraei; Nicholas J. Kassebaum; Molly B. Kassel; Joonas H. Kauppila; Navjot Kaur; Norito Kawakami; Gbenga A. Kayode; Foad Kazemi; Sina Kazemian; Tahseen Haider Kazmi; Getu Mosisa Kebebew; Adera Debella Kebede; Fassikaw Kebede; Tibebeselassie S. Keflie; Peter Njenga Keiyoro; Cathleen Keller; Jaimon Terence Kelly; John H. Kempen; Jessica A. Kerr; Emmanuelle Kesse-Guyot; Himanshu Khajuria; Amirmohammad Khalaji; Nauman Khalid; Anees Ahmed Khalil; Alireza Khalilian; Faham Khamesipour; Ajmal Khan; Asaduzzaman Khan; Gulfaraz Khan; Ikramullah Khan; Imteyaz A. Khan; M. Nuruzzaman Khan; Mohammad Jobair Khan; Moien Ab Khan; Zeeshan Ali Khan; Mahammed Ziauddin Khan Suheb; Shaghayegh Khanmohammadi
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 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. Linda Merin; Jalil Jaafari; Louis Jacob; Farhad Jadidi-Niaragh; Khushleen Jaggi; Kasra Jahankhani; Nader Jahanmehr; Haitham Jahrami; Akhil Jain; Nityanand Jain; Ammar Abdulrahman Jairoun; Mihajlo Jakovljevic; Elham Jamshidi; Sabzali Javadov; Tahereh Javaheri; Sathish Kumar Jayapal; Shubha Jayaram; Sun Ha Jee; Jayakumar Jeganathan; Anil K. Jha; Ravi Prakash Jha; Heng Jiang; Mohammad Jokar; Jost B. Jonas; Tamas Joo; Nitin Joseph; Charity Ehimwenma Joshua; Farahnaz Joukar; Jacek Jerzy Jozwiak; Mikk Jürisson; K. Vaishali; Billingsley Kaambwa; Abdulkareem Kabir; Ali Kabir; Hannaneh Kabir; Zubair Kabir; Rizwan Kalani; Leila R. Kalankesh; Feroze Kaliyadan; Sanjay Kalra; Rajesh Kamath; Sagarika Kamath; Tanuj Kanchan; Edmund Wedam Kanmiki; Kehinde Kazeem Kanmodi; S. Suthanthira Kannan; Sushil Kumar Kansal; Rami S. Kantar; Neeti Kapoor; Mehrdad Karajizadeh; Manoochehr Karami; Ibraheem M. Karaye; Faizan Zaffar Kashoo; Hengameh Kasraei; Nicholas J. Kassebaum; Molly B. Kassel; Joonas H. Kauppila; Foad Kazemi; Sara Kazeminia; John H. Kempen; Evie Shoshannah Kendal; Kamyab Keshtkar; Mohammad Keykhaei; Himanshu Khajuria; Amirmohammad Khalaji; Nauman Khalid; Anees Ahmed Khalil; Alireza Khalilian; Faham Khamesipour; Ajmal Khan; Asaduzzaman Khan; Ikramullah Khan; M. Nuruzzaman Khan; Maseer Khan; Mohammad Jobair Khan; Moien A.B. Khan; Young-Ho Khang; Shaghayegh Khanmohammadi; Khaled Khatab; Armin Khavandegar; Hamid Reza Khayat Kashani; Feriha Fatima Khidri; Moein Khormali; Mohammad Ali Khosravi; Mahmood Khosrowjerdi; Wondwosen Teklesilasie Kidane; Zemene Demelash Kifle; Julie Sojin Kim; Min Seo Kim; Ruth W. Kimokoti; Kasey E. Kinzel; Girmay Tsegay Kiross; Adnan Kisa; Sezer Kisa; Ali-Asghar Kolahi; Farzad Kompani; Gerbrand Koren; Oleksii Korzh; Soewarta Kosen; Sindhura Lakshmi Koulmane Laxminarayana; Kewal Krishan; Varun Krishna; Vijay Krishnamoorthy; Barthelemy Kuate Defo; Connor M. Kubeisy; Burcu Kucuk Bicer; Md Abdul Kuddus; Mohammed Kuddus; Ilari Kuitunen; Mukhtar Kulimbet; Harish Kumar; Satyajit Kundu; Kunle Rotimi Kunle; Om P. Kurmi; Asep Kusnali; Dian Kusuma; Evans F. Kyei; Ilias Kyriopoulos; Carlo La Vecchia; Ben Lacey; Muhammad Awwal Ladan; Lucie Laflamme; Chandrakant Lahariya; Daphne Teck Ching Lai; Dharmesh Kumar Lal; Ratilal Lalloo; Judit Lám; Demetris Lamnisos; Ivan Landires; Francesco Lanfranchi; Berthold Langguth; Ariane Laplante-Lévesque; Heidi Jane Larson; Anders O. Larsson; Savita Lasrado; Kamaluddin Latief; Kaveh Latifinaibin; Long Khanh Dao Le; Nhi Huu Hanh Le; Trang Diep Thanh Le; Caterina Ledda; Munjae Lee; Paul H. Lee; Seung Won Lee; Yo Han Lee; Gebretsadik Kiros Lema; Elvynna Leong; Temesgen L. Lerango; An Li; Ming-Chieh Li; Shanshan Li; Wei Li; Xiaopan Li; Virendra S. Ligade; Stephen S. Lim; Ro-Ting Lin; Paulina A. Lindstedt; Stefan Listl; Gang Liu; Jue Liu; Xiaofeng Liu; Xuefeng Liu; Yuewei Liu; Erand Llanaj; Ruben López-Bueno; Platon D. 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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 mortality associated with 33 bacterial pathogens in 2019: a systematic analysis for the Global Burden of Disease Study 2019
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Khan; Moawiah Mohammad Khatatbeh; Mona M Khater; Hamid Reza Khayat Kashani; Jagdish Khubchandani; Hanna Kim; Min Seo Kim; Ruth W Kimokoti; Niranjan Kissoon; Sonali Kochhar; Farzad Kompani; Soewarta Kosen; Parvaiz A Koul; Sindhura Lakshmi Koulmane Laxminarayana; Fiorella Krapp Lopez; Kewal Krishan; Vijay Krishnamoorthy; Vishnutheertha Kulkarni; Naveen Kumar; Om P Kurmi; Ambily Kuttikkattu; Hmwe Hmwe Kyu; Dharmesh Kumar Lal; Judit Lám; Iván Landires; Savita Lasrado; Sang-Woong Lee; Jacopo Lenzi; Sonia Lewycka; Shanshan Li; Stephen S Lim; Wei Liu; Rakesh Lodha; Michael J Loftus; Ayush Lohiya; Lászl Lorenzovici; Mojgan Lotfi; Ata Mahmoodpoor; Mansour Adam Mahmoud; Razzagh Mahmoudi; Azeem Majeed; Jamal Majidpoor; Alaa Makki; Galana Ayana Mamo; Yosef Manla; Miquel Martorell; Clara N Matei; Barney Mcmanigal; Entezar Mehrabi Nasab; Ravi Mehrotra; Addisu Melese; Oliver Mendoza-Cano; Ritesh G Menezes; Alexios-Fotios A Mentis; Georgia Micha; Irmina Maria Michalek; Ana Carolina Micheletti Gomide Nogueira Des; Neda Milevska Kostova; Shabir Ahmad Mir; Mojgan Mirghafourvand; Seyyedmohammadsadeq Mirmoeeni; Erkin M Mirrakhimov; Mohammad Mirza-Aghazadeh-attari; Abay Sisay Misganaw; Awoke Misganaw; Sanjeev Misra; Esmaeil Mohammadi; Mokhtar Mohammadi; Abdollah Mohammadian-Hafshejani; Shafiu Mohammed; Syam Mohan; Mohammad Mohseni; Ali H Mokdad; Sara Momtazmanesh; Lorenzo Monasta; Catrin E Moore; Maryam Moradi; Mostafa Moradi Sarabi; Shane Douglas Morrison; Majid Motaghinejad; Haleh Mousavi Isfahani; Amin Mousavi Khaneghah; Seyed Ali Mousavi-Aghdas; Sumaira Mubarik; Francesk Mulita; Getaneh Baye B Mulu; Sandra B Munro; Saravanan Muthupandian; Tapas Sadasivan Nair; Atta Abbas Naqvi; Himanshi Narang; Zuhair S Natto; Muhammad Naveed; Biswa Prakash Nayak; Shumaila Naz; Ionut Negoi; Seyed Aria Nejadghaderi; Sandhya Neupane Kandel; Che Henry Ngwa; Robina Khan Niazi; Antonio Tolentino Nogueira Des; Nafise Noroozi; Hasti Nouraei; Ali Nowroozi; Virginia Nuñez-Samudio; Jerry John Nutor; Chimezie Igwegbe Nzoputam; Ogochukwu Janet Nzoputam; Bogdan Oancea; Rahman Md Obaidur; Vivek Anand Ojha; Akinkunmi Paul Okekunle; Osaretin Christabel Okonji; Andrew T Olagunju; Bolajoko Olubukunola Olusanya; Ahmed Omar Bali; Emad Omer; Nikita Otstavnov; Bilcha Oumer; Jagadish Rao Padubidri; Keyvan Pakshir; Tamás Palicz; Adrian Pana; Shahina Pardhan; Jose L Paredes; Utsav Parekh; Eun-Cheol Park; Seoyeon Park; Ashish Pathak; Rajan Paudel; Uttam Paudel; Shrikant Pawar; Hamidreza Pazoki Toroudi; Minjin Peng; Umberto Pensato; Veincent Christian Filipino Pepito; Marcos Pereira; Mario F P Peres; Norberto Perico; Ionela-Roxana Petcu; Zahra Zahid Piracha; Indrashis Podder; Nayanum Pokhrel; Ramesh Poluru; Maarten J Postma; Naeimeh Pourtaheri; Akila Prashant; Ibrahim Qattea; Mohammad Rabiee; Navid Rabiee; Amir Radfar; Saber Raeghi; Sima Rafiei; Pankaja Raghav Raghav; Leila Rahbarnia; Vafa Rahimi-Movaghar; Mosiur Rahman; Muhammad Aziz Rahman; Amir Masoud Rahmani; Vahid Rahmanian; Pradhum Ram; Muhammad Modassar Ali Nawaz Ranjha; Sowmya J Rao; Mohammad-Mahdi Rashidi; Azad Rasul; Zubair Ahmed Ratan; Salman Rawaf; Reza Rawassizadeh; Mohammad Sadegh Razeghinia; Elrashdy Moustafa Mohamed Redwan; Misganu Teshoma Regasa; Giuseppe Remuzzi; Melese Abate Reta; Nazila Rezaei; Aziz Rezapour; Abanoub Riad; Rezaul Karim Ripon; Kristina E Rudd; Basema Saddik; Saeid Sadeghian; Umar Saeed; Mohsen Safaei; Azam Safary; Sher Zaman Safi; Maryam Sahebazzamani; Amirhossein Sahebkar; Harihar Sahoo; Saina Salahi; Sarvenaz Salahi; Hedayat Salari; Sana Salehi; Hossein Samadi Kafil; Abdallah M Samy; Nima Sanadgol; Senthilkumar Sankararaman; Francesco Sanmarchi; Brijesh Sathian; Monika Sawhney; Ganesh Kumar Saya; Subramanian Senthilkumaran; Allen Seylani; Pritik A Shah; Masood Ali Shaikh; Elaheh Shaker; Murad Ziyaudinovich Shakhmardanov; Mequannent Melaku Sharew; Athena Sharifi-Razavi; Purva Sharma; Rahim Ali Sheikhi; Ali Sheikhy; Pavanchand H Shetty; Mika Shigematsu; Jae Il Shin; Hesamaddin Shirzad-Aski; K.M. Shivakumar; Parnian Shobeiri; Seyed Afshin Shorofi; Sunil Shrestha; Migbar Mekonnen Sibhat; Negussie Boti Sidemo; Mustafa Kamal Sikder; Luís Manuel Lopes Rodrigues Silva; Jasvinder A Singh; Paramdeep Singh; Surjit Singh; Md Shahjahan Siraj; Samarjeet Singh Siwal; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Bogdan Socea; Damtew Damtew Solomon; Yimeng Song; Chandrashekhar T Sreeramareddy; Muhammad Suleman; Rizwan Suliankatchi Abdulkader; Saima Sultana; Miklós Szócska; Seyed-Amir Tabatabaeizadeh; Mohammad Tabish; Majid Taheri; Elahe Taki; Ker-Kan Tan; Sarmila Tandukar; Nathan Y Tat; Vivian Y Tat; Belay Negash Tefera; Yibekal Manaye Tefera; Gebremaryam Temesgen; Mohamad-Hani Temsah; Samar Tharwat; Arulmani Thiyagarajan; Imad I Tleyjeh; Christopher E Troeger; Krishna Kishore Umapathi; Era Upadhyay; Sahel Valadan Tahbaz; Pascual R Valdez; Jef Van Den Eynde; H Rogier Van Doorn; Siavash Vaziri; Georgios-Ioannis Verras; Harimadhav Viswanathan; Bay Vo; Abdul Waris; Gizachew Tadesse Wassie; Nuwan Darshana Wickramasinghe; Sajad Yaghoubi; Gahin Abdulraheem Tayib Yahya Yahya; Seyed Hossein Yahyazadeh Jabbari; Arzu Yigit; Vahit Yigit; Dong Keon Yon; Naohiro Yonemoto; Mazyar Zahir; Burhan Abdullah Zaman; Sojib Bin Zaman; Moein Zangiabadian; Iman Zare; Mikhail Sergeevich Zastrozhin; Zhi-Jiang Zhang; Peng Zheng; Chenwen Zhong; Mohammad Zoladl; Alimuddin Zumla; Simon I Hay; Christiane Dolecek; Benn Sartorius; Christopher J L Murray; Mohsen Naghavi
Background: Reducing the burden of death due to infection is an urgent global public health priority. Previous studies have estimated the number of deaths associated with drug-resistant infections and sepsis and found that infections remain a leading cause of death globally. Understanding the global burden of common bacterial pathogens (both susceptible and resistant to antimicrobials) is essential to identify the greatest threats to public health. To our knowledge, this is the first study to present global comprehensive estimates of deaths associated with 33 bacterial pathogens across 11 major infectious syndromes. Methods: We estimated deaths associated with 33 bacterial genera or species across 11 infectious syndromes in 2019 using methods from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, in addition to a subset of the input data described in the Global Burden of Antimicrobial Resistance 2019 study. This study included 343 million individual records or isolates covering 11 361 study-location-years. We used three modelling steps to estimate the number of deaths associated with each pathogen: deaths in which infection had a role, the fraction of deaths due to infection that are attributable to a given infectious syndrome, and the fraction of deaths due to an infectious syndrome that are attributable to a given pathogen. Estimates were produced for all ages and for males and females across 204 countries and territories in 2019. 95% uncertainty intervals (UIs) were calculated for final estimates of deaths and infections associated with the 33 bacterial pathogens following standard GBD methods by taking the 2·5th and 97·5th percentiles across 1000 posterior draws for each quantity of interest. Findings: From an estimated 13·7 million (95% UI 10·9–17·1) infection-related deaths in 2019, there were 7·7 million deaths (5·7–10·2) associated with the 33 bacterial pathogens (both resistant and susceptible to antimicrobials) across the 11 infectious syndromes estimated in this study. We estimated deaths associated with the 33 bacterial pathogens to comprise 13·6% (10·2–18·1) of all global deaths and 56·2% (52·1–60·1) of all sepsis-related deaths in 2019. Five leading pathogens—Staphylococcus aureus, Escherichia coli, Streptococcus pneumoniae, Klebsiella pneumoniae, and Pseudomonas aeruginosa—were responsible for 54·9% (52·9–56·9) of deaths among the investigated bacteria. The deadliest infectious syndromes and pathogens varied by location and age. The age-standardised mortality rate associated with these bacterial pathogens was highest in the sub-Saharan Africa super-region, with 230 deaths (185–285) per 100 000 population, and lowest in the high-income super-region, with 52·2 deaths (37·4–71·5) per 100 000 population. S aureus was the leading bacterial cause of death in 135 countries and was also associated with the most deaths in individuals older than 15 years, globally. Among children younger than 5 years, S pneumoniae was the pathogen associated with the most deaths. In 2019, more than 6 million deaths occurred as a result of three bacterial infectious syndromes, with lower respiratory infections and bloodstream infections each causing more than 2 million deaths and peritoneal and intra-abdominal infections causing more than 1 million deaths. Interpretation: The 33 bacterial pathogens that we investigated in this study are a substantial source of health loss globally, with considerable variation in their distribution across infectious syndromes and locations. Compared with GBD Level 3 underlying causes of death, deaths associated with these bacteria would rank as the second leading cause of death globally in 2019; hence, they should be considered an urgent priority for intervention within the global health community. Strategies to address the burden of bacterial infections include infection prevention, optimised use of antibiotics, improved capacity for microbiological analysis, vaccine development, and improved and more pervasive use of available vaccines. These estimates can be used to help set priorities for vaccine need, demand, and development. Funding: Bill & Melinda Gates Foundation, Wellcome Trust, and Department of Health and Social Care, using UK aid funding managed by the Fleming Fund. © 2022 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 colorectal cancer and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
(Elsevier Ltd, 2022) Rajesh Sharma; Mohsen Abbasi-Kangevari; Rami Abd-Rabu; Hassan Abidi; Eman Abu-Gharbieh; Juan Manuel Acuna; Sangeet Adhikari; Shailesh M. Advani; Muhammad Sohail Afzal; Mohamad Aghaie Meybodi; Bright Opoku Ahinkorah; Sajjad Ahmad; Ali Ahmadi; Sepideh Ahmadi; Haroon Ahmed; Luai A. Ahmed; Muktar Beshir Ahmed; Hanadi Al Hamad; Fares Alahdab; Fahad Mashhour Alanezi; Turki M. Alanzi; Fadwa Alhalaiqa Naji Alhalaiqa; Yousef Alimohamadi; Vahid Alipour; Syed Mohamed Aljunid; Motasem Alkhayyat; Sami Almustanyir; Rajaa M. Al-Raddadi; Saba Alvand; Nelson Alvis-Guzman; Saeed Amini; Robert Ancuceanu; Amir Anoushiravani; Ali Arash Anoushirvani; Alireza Ansari-Moghaddam; Jalal Arabloo; Armin Aryannejad; Mohammad Asghari Jafarabadi; Seyyed Shamsadin Athari; Floriane Ausloos; Marcel Ausloos; Atalel Fentahun Awedew; Mamaru Ayenew Awoke; Tegegn Mulatu Ayana; Sina Azadnajafabad; Hiva Azami; Mohammadreza Azangou-Khyavy; Amirhossein Azari Jafari; Ashish D. Badiye; Sara Bagherieh; Saeed Bahadory; Atif Amin Baig; Jennifer L. Baker; Maciej Banach; Amadou Barrow; Alemshet Yirga Berhie; Sima Besharat; Devidas S. Bhagat; Akshaya Srikanth Bhagavathula; Neeraj Bhala; Krittika Bhattacharyya; Vijayalakshmi S. Bhojaraja; Sadia Bibi; Ali Bijani; Antonio Biondi; Tone Bjørge; Belay Boda Abule Bodicha; Dejana Braithwaite; Hermann Brenner; Daniela Calina; Chao Cao; Yin Cao; Giulia Carreras; Felix Carvalho; Ester Cerin; Raja Chandra Chakinala; William C.S. Cho; Dinh-Toi Chu; Joao Conde; Vera Marisa Costa; Natália Cruz-Martins; Omid Dadras; Xiaochen Dai; Lalit Dandona; Rakhi Dandona; Anna Danielewicz; Feleke Mekonnen Demeke; Getu Debalkie Demissie; Rupak Desai; Deepak Dhamnetiya; Mostafa Dianatinasab; Daniel Diaz; Mojtaba Didehdar; Saeid Doaei; Linh Phuong Doan; Milad Dodangeh; Fatemeh Eghbalian; Debela Debela Ejeta; Michael Ekholuenetale; Temitope Cyrus Ekundayo; Iman El Sayed; Muhammed Elhadi; Daniel Berhanie Enyew; Tahir Eyayu; Rana Ezzeddini; Ildar Ravisovich Fakhradiyev; Umar Farooque; Hossein Farrokhpour; Farshad Farzadfar; Ali Fatehizadeh; Hamed Fattahi; Nima Fattahi; Masood Fereidoonnezhad; Eduarda Fernandes; Getahun Fetensa; Irina Filip; Florian Fischer; Masoud Foroutan; Peter Andras Gaal; Mohamed M. Gad; Silvano Gallus; Tushar Garg; Tamiru Getachew; Seyyed-Hadi Ghamari; Ahmad Ghashghaee; Nermin Ghith; Maryam Gholamalizadeh; Jamshid Gholizadeh Navashenaq; Abraham Tamirat Gizaw; James C. Glasbey; Mahaveer Golechha; Pouya Goleij; Kebebe Bekele Gonfa; Giuseppe Gorini; Avirup Guha; Sapna Gupta; Veer Bala Gupta; Vivek Kumar Gupta; Rasool Haddadi; Nima Hafezi-Nejad; Arvin Haj-Mirzaian; Rabih Halwani; Shafiul Haque; Sanam Hariri; Ahmed I. Hasaballah; Soheil Hassanipour; Simon I. Hay; Claudiu Herteliu; Ramesh Holla; Mohammad-Salar Hosseini; Mehdi Hosseinzadeh; Mihaela Hostiuc; Mowafa Househ; Junjie Huang; Ayesha Humayun; Ivo Iavicoli; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Farhad Islami; Masao Iwagami; Mohammad Ali Jahani; Mihajlo Jakovljevic; Tahereh Javaheri; Ranil Jayawardena; Rime Jebai; Ravi Prakash Jha; Tamas Joo; Nitin Joseph; Farahnaz Joukar; Jacek Jerzy Jozwiak; Ali Kabir; Rohollah Kalhor; Ashwin Kamath; Neeti Kapoor; Ibraheem M. Karaye; Amirali Karimi; Joonas H. Kauppila; Asma Kazemi; Mohammad Keykhaei; Yousef Saleh Khader; Himanshu Khajuria; Rovshan Khalilov; Javad Khanali; Maryam Khayamzadeh; Mahmoud Khodadost; Hanna Kim; Min Seo Kim; Adnan Kisa; Sezer Kisa; Ali-Asghar Kolahi; Hamid Reza Koohestani; Jacek A. Kopec; Rajasekaran Koteeswaran; Ai Koyanagi; Yuvaraj Krishnamoorthy; G. Anil Kumar; Manoj Kumar; Vivek Kumar; Carlo La Vecchia; Faris Hasan Lami; Iván Landires; Caterina Ledda; Sang-Woong Lee; Wei-Chen Lee; Yeong Yeh Lee; Elvynna Leong; Bingyu Li; Stephen S. Lim; Stany W. Lobo; Joana A. Loureiro; Raimundas Lunevicius; Farzan Madadizadeh; Ata Mahmoodpoor; Azeem Majeed; Mohammad-Reza Malekpour; Reza Malekzadeh; Ahmad Azam Malik; Fariborz Mansour-Ghanaei; Lorenzo Giovanni Mantovani; Miquel Martorell; Sahar Masoudi; Prashant Mathur; Jitendra Kumar Meena; Entezar Mehrabi Nasab; Walter Mendoza; Alexios-Fotios A. Mentis; Tomislav Mestrovic; Junmei Miao Jonasson; Bartosz Miazgowski; Tomasz Miazgowski; Gelana Fekadu Worku Mijena; Seyyedmohammadsadeq Mirmoeeni; Mohammad Mirza-Aghazadeh-Attari; Hamed Mirzaei; Sanjeev Misra; Karzan Abdulmuhsin Mohammad; Esmaeil Mohammadi; Saeed Mohammadi; Seyyede Momeneh Mohammadi; Abdollah Mohammadian-Hafshejani; Shafiu Mohammed; Teroj Abdulrahman Mohammed; Nagabhishek Moka; Ali H. Mokdad; Zeinab Mokhtari; Mariam Molokhia; Sara Momtazmanesh; Lorenzo Monasta; Ghobad Moradi; Rahmatollah Moradzadeh; Paula Moraga; Joana Morgado-Da-Costa; Sumaira Mubarik; Francesk Mulita; Mohsen Naghavi; Mukhammad David Naimzada; Hae Sung Nam; Zuhair S. Natto; Biswa Prakash Nayak; Javad Nazari; Ehsan Nazemalhosseini-Mojarad; Ionut Negoi; Cuong Tat Nguyen; Son Hoang Nguyen; Nurulamin M. Noor; Maryam Noori; Seyyed Mohammad Ali Noori; Virginia Nuñez-Samudio; Chimezie Igwegbe Nzoputam; Bogdan Oancea; Oluwakemi Ololade Odukoya; Ayodipupo Sikiru Oguntade; Hassan Okati-Aliabad; Andrew T. Olagunju; Tinuke O. Olagunju; Sokking Ong; Samuel M. Ostroff; Alicia Padron-Monedero; Reza Pakzad; Adrian Pana; Anamika Pandey; Fatemeh Pashazadeh Kan; Urvish K. Patel; Uttam Paudel; Renato B. Pereira; Navaraj Perumalsamy; Richard G. Pestell; Zahra Zahid Piracha; Richard Charles G. Pollok; Akram Pourshams; Naeimeh Pourtaheri; Akila Prashant; Mohammad Rabiee; Navid Rabiee; Amir Radfar; Sima Rafiei; Mosiur Rahman; Amir Masoud Rahmani; Vahid Rahmanian; Nazanin Rajai; Aashish Rajesh; Vajiheh Ramezani-Doroh; Kiana Ramezanzadeh; Kamal Ranabhat; Sina Rashedi; Amirfarzan Rashidi; Mahsa Rashidi; Mohammad-Mahdi Rashidi; Mandana Rastegar; David Laith Rawaf; Salman Rawaf; Reza Rawassizadeh; Mohammad Sadegh Razeghinia; Andre M.N. Renzaho; Negar Rezaei; Nima Rezaei; Saeid Rezaei; Mohsen Rezaeian; Sahba Rezazadeh-Khadem; Gholamreza Roshandel; Maha Mohamed Saber-Ayad; Bahar Saberzadeh-Ardestani; Basema Saddik; Hossein Sadeghi; Umar Saeed; Maryam Sahebazzamani; Amirhossein Sahebkar; Amir Salek Farrokhi; Amir Salimi; Hamideh Salimzadeh; Pouria Samadi; Mehrnoosh Samaei; Abdallah M. Samy; Juan Sanabria; Milena M. Santric-Milicevic; Muhammad Arif Nadeem Saqib; Arash Sarveazad; Brijesh Sathian; Maheswar Satpathy; Ione Jayce Ceola Schneider; Mario Šekerija; Sadaf G. Sepanlou; Allen Seylani; Feng Sha; Sayed Mohammad Shafiee; Zahra Shaghaghi; Saeed Shahabi; Elaheh Shaker; Maedeh Sharifian; Javad Sharifi-Rad; Sara Sheikhbahaei; Jeevan K. Shetty; Reza Shirkoohi; Parnian Shobeiri; Sudeep K. Siddappa Malleshappa; Diego Augusto Santos Silva; Guilherme Silva Julian; Achintya Dinesh Singh; Jasvinder A. Singh; Md Shahjahan Siraj; Gholam Reza Sivandzadeh; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Bogdan Socea; Marco Solmi; Mohammad Sadegh Soltani-Zangbar; Suhang Song; Viktória Szerencsés; Miklós Szócska; Rafael Tabarés-Seisdedos; Elnaz Tabibian; Majid Taheri; Yasaman Taheri Abkenar; Amir Taherkhani; Iman M. Talaat; Ker-Kan Tan; Abdelghani Tbakhi; Bekele Tesfaye; Amir Tiyuri; Daniel Nigusse Tollosa; Mathilde Touvier; Bach Xuan Tran; Biruk Shalmeno Tusa; Irfan Ullah; Saif Ullah; Marco Vacante; Sahel Valadan Tahbaz; Massimiliano Veroux; Bay Vo; Theo Vos; Cong Wang; Ronny Westerman; Melat Woldemariam; Seyed Hossein Yahyazadeh Jabbari; Lin Yang; Fereshteh Yazdanpanah; Chuanhua Yu; Deniz Yuce; Ismaeel Yunusa; Vesna Zadnik; Mazyar Zahir; Iman Zare; Zhi-Jiang Zhang; Mohammad Zoladi
Background: Colorectal cancer is the third leading cause of cancer deaths worldwide. Given the recent increasing trends in colorectal cancer incidence globally, up-to-date information on the colorectal cancer burden could guide screening, early detection, and treatment strategies, and help effectively allocate resources. We examined the temporal patterns of the global, regional, and national burden of colorectal cancer and its risk factors in 204 countries and territories across the past three decades. Methods: Estimates of incidence, mortality, and disability-adjusted life years (DALYs) for colorectal cancer were generated as a part of the Global Burden of Diseases, Injuries and Risk Factors Study (GBD) 2019 by age, sex, and geographical location for the period 1990–2019. Mortality estimates were produced using the cause of death ensemble model. We also calculated DALYs attributable to risk factors that had evidence of causation with colorectal cancer. Findings: Globally, between 1990 and 2019, colorectal cancer incident cases more than doubled, from 842 098 (95% uncertainty interval [UI] 810 408–868 574) to 2·17 million (2·00–2·34), and deaths increased from 518 126 (493 682–537 877) to 1·09 million (1·02–1·15). The global age-standardised incidence rate increased from 22·2 (95% UI 21·3–23·0) per 100 000 to 26·7 (24·6–28·9) per 100 000, whereas the age-standardised mortality rate decreased from 14·3 (13·5–14·9) per 100 000 to 13·7 (12·6–14·5) per 100 000 and the age-standardised DALY rate decreased from 308·5 (294·7–320·7) per 100 000 to 295·5 (275·2–313·0) per 100 000 from 1990 through 2019. Taiwan (province of China; 62·0 [48·9–80·0] per 100 000), Monaco (60·7 [48·5–73·6] per 100 000), and Andorra (56·6 [42·8–71·9] per 100 000) had the highest age-standardised incidence rates, while Greenland (31·4 [26·0–37·1] per 100 000), Brunei (30·3 [26·6–34·1] per 100 000), and Hungary (28·6 [23·6–34·0] per 100 000) had the highest age-standardised mortality rates. From 1990 through 2019, a substantial rise in incidence rates was observed in younger adults (age <50 years), particularly in high Socio-demographic Index (SDI) countries. Globally, a diet low in milk (15·6%), smoking (13·3%), a diet low in calcium (12·9%), and alcohol use (9·9%) were the main contributors to colorectal cancer DALYs in 2019. Interpretation: The increase in incidence rates in people younger than 50 years requires vigilance from researchers, clinicians, and policy makers and a possible reconsideration of screening guidelines. The fast-rising burden in low SDI and middle SDI countries in Asia and Africa calls for colorectal cancer prevention approaches, greater awareness, and cost-effective screening and therapeutic options in these regions. Funding: Bill & Melinda Gates Foundation. © 2022 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 hepatitis B, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
(Elsevier Ltd, 2022) Brittney S. Sheena; Lindsey Hiebert; Hannah Han; Helen Ippolito; Mohsen Abbasi-Kangevari; Zeinab Abbasi-Kangevari; Hedayat Abbastabar; Amir Abdoli; Hiwa Abubaker Ali; Mesafint Molla Adane; Oyelola A. Adegboye; Qorinah Estiningtyas Sakilah Adnani; Shailesh M. Advani; Muhammad Sohail Afzal; Saira Afzal; Mohamad Aghaie Meybodi; Bahman Ahadinezhad; Bright Opoku Ahinkorah; Sajjad Ahmad; Tauseef Ahmad; Sepideh Ahmadi; Haroon Ahmed; Muktar Beshir Ahmed; Tarik Ahmed Rashid; Gizachew Taddesse Akalu; Addis Aklilu; Tayyaba Akram; Hanadi Al Hamad; Fares Alahdab; Adugnaw Zeleke Alem; Dejene Tsegaye Alem; Fadwa Alhalaiqa Naji Alhalaiqa; Robert Kaba Alhassan; Liaqat Ali; Muhammad Ashar Ali; Yousef Alimohamadi; Vahid Alipour; Motasem Alkhayyat; Sami Almustanyir; Rajaa M. Al-Raddadi; Haya Altawalah; Saeed Amini; Hubert Amu; Robert Ancuceanu; Catalina Liliana Andrei; Tudorel Andrei; Amir Anoushiravani; Adnan Ansar; Anayochukwu Edward Anyasodor; Jalal Arabloo; Morteza Arab-Zozani; Ayele Mamo Argaw; Zeleke Gebru Argaw; Muhammad Arshad; Anton A. Artamonov; Tahira Ashraf; Daniel Atlaw; Floriane Ausloos; Marcel Ausloos; Sina Azadnajafabad; Mohammadreza Azangou-Khyavy; Amirhossein Azari Jafari; Ghasem Azarian; Sayna Bagheri; Saeed Bahadory; Atif Amin Baig; Maciej Banach; Nastaran Barati; Amadou Barrow; Abdul-Monim Mohammad Batiha; Diana Fernanda Bejarano Ramirez; Uzma Iqbal Belgaumi; Alemshet Yirga Berhie; Devidas S. Bhagat; Nikha Bhardwaj; Pankaj Bhardwaj; Krittika Bhattacharyya; Vijayalakshmi S. Bhojaraja; Ali Bijani; Antonio Biondi; Belay Boda Abule Bodicha; Hunduma Amensisa Bojia; Archith Boloor; Cristina Bosetti; Dejana Braithwaite; Nikolay Ivanovich Briko; Zahid A. Butt; Luis Alberto Cámera; Raja Chandra Chakinala; Promit Ananyo Chakraborty; Jaykaran Charan; Shu Chen; Jee-Young Jasmine Choi; Sonali Gajanan Choudhari; Fazle Rabbi Chowdhury; Dinh-Toi Chu; Sheng-Chia Chung; Paolo Angelo Cortesi; Benjamin C. Cowie; Garland T. Culbreth; Omid Dadras; Xiaochen Dai; Lalit Dandona; Rakhi Dandona; Fernando Pio De La Hoz; Sisay Abebe Debela; Mohammed Gebre Dedefo; Feleke Mekonnen Demeke; Takele Gezahegn G. Demie; Getu Debalkie Demissie; Meseret Derbew Molla; Abebaw Alemayehu Desta; Deepak Dhamnetiya; Mandira Lamichhane Dhimal; Meghnath Dhimal; Mojtaba Didehdar; Linh Phuong Doan; Fariba Dorostkar; Thomas M. Drake; Fatemeh Eghbalian; Michael Ekholuenetale; Iman El Sayed; Maysaa El Sayed Zaki; Muhammed Elhadi; Mohamed A. Elmonem; Aisha Elsharkawy; Shymaa Enany; Daniel Berhanie Enyew; Ryenchindorj Erkhembayar; Sharareh Eskandarieh; Firooz Esmaeilzadeh; Sayeh Ezzikouri; Hossein Farrokhpour; Getahun Fetensa; Florian Fischer; Masoud Foroutan; Mohamed M. Gad; Abhay Motiramji Gaidhane; Shilpa Gaidhane; Natalie C. Galles; Silvano Gallus; Teferi Gebru Gebremeskel; Eyob Alemayehu Gebreyohannes; Keyghobad Ghadiri; Kazem Ghaffari; Mansour Ghafourifard; Seyyed-Hadi Ghamari; Ahmad Ghashghaee; Ali Gholami; Abdolmajid Gholizadeh; Aima Gilani; Amit Goel; Mahaveer Golechha; Pouya Goleij; Davide Golinelli; Giuseppe Gorini; Yitayal Ayalew Goshu; Max G. Griswold; Mohammed Ibrahim Mohialdeen Gubari; Bhawna Gupta; Sapna Gupta; Veer Bala Gupta; Vivek Kumar Gupta; Rasool Haddadi; Rabih Halwani; Saeed S. Hamid; Samer Hamidi; Asif Hanif; Shafiul Haque; Harapan Harapan; Arief Hargono; Sanam Hariri; Ahmed I. Hasaballah; S.M. Mahmudul Hasan; Soheil Hassanipour; Hadi Hassankhani; Simon I. Hay; Khezar Hayat; Golnaz Heidari; Claudiu Herteliu; Demisu Zenbaba Heyi; Kamal Hezam; Ramesh Holla; Mohammad-Salar Hosseini; Mostafa Hosseini; Mehdi Hosseinzadeh; Mihaela Hostiuc; Mowafa Househ; Junjie Huang; Nawfal R. Hussein; Ivo Iavicoli; Segun Emmanuel Ibitoye; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Lalu Muhammad Irham; Jessica Y. Islam; Nahlah Elkudssiah Ismail; Kathryn H. Jacobsen; Farhad Jadidi-Niaragh; Amirreza Javadi Mamaghani; Shubha Jayaram; Ranil Jayawardena; Rime Jebai; Ravi Prakash Jha; Nitin Joseph; Farahnaz Joukar; Billingsley Kaambwa; Ali Kabir; Zubair Kabir; Rohollah Kalhor; Himal Kandel; Tesfaye K. Tesfaye Kanko; Rami S. Kantar; Ibraheem M. Karaye; Bekalu Getnet Kassa; Phillip M. Kemp Bohan; Mohammad Keykhaei; Yousef Saleh Khader; Himanshu Khajuria; Gulfaraz Khan; Imteyaz A. Khan; Junaid Khan; Moien A.B. Khan; Javad Khanali; Amir M. Khater; Mahalaqua Nazli Khatib; Mahmoud Khodadost; Abdullah T. Khoja; Omid Khosravizadeh; Jagdish Khubchandani; Gyu Ri Kim; Hanna Kim; Min Seo Kim; Yun Jin Kim; Jonathan M. Kocarnik; Ali-Asghar Kolahi; Rajasekaran Koteeswaran; G. Anil Kumar; Carlo La Vecchia; Dharmesh Kumar Lal; Iván Landires; Savita Lasrado; Jeffrey V. Lazarus; Caterina Ledda; Doo Woong Lee; Sang-Woong Lee; Yeong Yeh Lee; Miriam Levi; Jiarui Li; Stephen S. Lim; Stany W. Lobo; Platon D. Lopukhov; Joana A. Loureiro; Jennifer H. MacLachlan; Hassan Magdy Abd El Razek; Muhammed Magdy Abd El Razek; Azeem Majeed; Alaa Makki; Mohammad-Reza Malekpour; Reza Malekzadeh; Ahmad Azam Malik; Fariborz Mansour-Ghanaei; Mohammad Ali Mansournia; Francisco Rogerlândio Martins-Melo; Philippa C. Matthews; Walter Mendoza; Ritesh G. Menezes; Tuomo J. Meretoja; Amanual Getnet Mersha; Tomislav Mestrovic; Ted R. Miller; Le Huu Nhat Minh; Andreea Mirica; Seyyedmohammadsadeq Mirmoeeni; Erkin M. Mirrakhimov; Sanjeev Misra; Prasanna Mithra; Babak Moazen; Ashraf Mohamadkhani; Mokhtar Mohammadi; Shafiu Mohammed; Nagabhishek Moka; Ali H. Mokdad; Jalal Moludi; Sara Momtazmanesh; Lorenzo Monasta; Ghobad Moradi; Maliheh Moradzadeh; Rahmatollah Moradzadeh; Paula Moraga; Ebrahim Mostafavi; Sumaira Mubarik; Malaisamy Muniyandi; Christopher J.L. Murray; Mohsen Naghavi; Mukhammad David Naimzada; Sreenivas Narasimha Swamy; Zuhair S. Natto; Biswa Prakash Nayak; Javad Nazari; Ionut Negoi; Serban Mircea Negru; Seyed Aria Nejadghaderi; Sandhya Neupane Kandel; Huong Lan Thi Nguyen; Che Henry Ngwa; Robina Khan Niazi; Chukwudi A. Nnaji; Jean Jacques Noubiap; Ali Nowroozi; Virginia Nuñez-Samudio; Bogdan Oancea; Chimedsuren Ochir; Oluwakemi Ololade Odukoya; In-Hwan Oh; Andrew T. Olagunju; Babayemi Oluwaseun Olakunde; Ahmed Omar Bali; Emad Omer; Stanislav S. Otstavnov; Bilcha Oumer; Jagadish Rao Padubidri; Adrian Pana; Anamika Pandey; Eun-Cheol Park; Fatemeh Pashazadeh Kan; Urvish K. Patel; Uttam Paudel; Ionela-Roxana Petcu; Zahra Zahid Piracha; Richard Charles G. Pollok; Maarten J. Postma; Akram Pourshams; Hossein Poustchi; Mohammad Rabiee; Navid Rabiee; Alireza Rafiei; Sima Rafiei; Pavan Manibettu Raghuram; Mosiur Rahman; Amir Masoud Rahmani; Setyaningrum Rahmawaty; Aashish Rajesh; Priyanga Ranasinghe; Chythra R. Rao; Sowmya J. Rao; Mahsa Rashidi; Mohammad-Mahdi Rashidi; David Laith Rawaf; Salman Rawaf; Reza Rawassizadeh; Negar Rezaei; Aziz Rezapour; Sahba Rezazadeh-Khadem; Jefferson Antonio Buendia Rodriguez; Godfrey M. Rwegerera; Siamak Sabour; Basema Saddik; Mohammad Reza Saeb; Umar Saeed; Amirhossein Sahebkar; K.M. Saif-Ur-Rahman; Sarvenaz Salahi; Hamideh Salimzadeh; Chethan Sampath; Abdallah M. Samy; Juan Sanabria; Francesco Sanmarchi; Milena M. Santric-Milicevic; Arash Sarveazad; Brijesh Sathian; Monika Sawhney; Abdul-Aziz Seidu; Sadaf G. Sepanlou; Allen Seylani; Saeed Shahabi; Masood Ali Shaikh; Elaheh Shaker; Murad Ziyaudinovich Shakhmardanov; Mohammed Shannawaz; Suchitra M. Shenoy; Jeevan K. Shetty; Pavanchand H. Shetty; Kenji Shibuya; Jae Il Shin; Parnian Shobeiri; Migbar Mekonnen Sibhat; Achintya Dinesh Singh; Jasvinder A. Singh; Surjit Singh; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Amir Ali Sohrabpour; Suhang Song; Seidamir Pasha Tabaeian; Eyayou Girma Tadesse; Majid Taheri; Mircea Tampa; Ker-Kan Tan; Ahmad Tavakoli; Abdelghani Tbakhi; Belay Negash Tefera; Arash Tehrani-Banihashemi; Habtamu Molla Tesfaw; Rekha Thapar; Aravind Thavamani; Seyed Abolfazl Tohidast; Daniel Nigusse Tollosa; Maria Elena Tosti; Marcos Roberto Tovani-Palone; Eugenio Traini; Mai Thi Ngoc Tran; Indang Trihandini; Biruk Shalmeno Tusa; Irfan Ullah; Marco Vacante; Sahel Valadan Tahbaz; Pascual R. Valdez; Shoban Babu Varthya; Bay Vo; Yasir Waheed; Adisu Birhanu Weldesenbet; Melat Woldemariam; Suowen Xu; Seyed Hossein Yahyazadeh Jabbari; Mehdi Yaseri; Yigizie Yeshaw; Vahit Yiǧit; Birhanu Wubale Yirdaw; Naohiro Yonemoto; Chuanhua Yu; Ismaeel Yunusa; Mazyar Zahir; Leila Zaki; Mohammad Zamani; Maryam Zamanian; Mikhail Sergeevich Zastrozhin; Theo Vos; John W. Ward; M. Ashworth Dirac
Background: Combating viral hepatitis is part of the UN Sustainable Development Goals (SDGs), and WHO has put forth hepatitis B elimination targets in its Global Health Sector Strategy on Viral Hepatitis (WHO-GHSS) and Interim Guidance for Country Validation of Viral Hepatitis Elimination (WHO Interim Guidance). We estimated the global, regional, and national prevalence of hepatitis B virus (HBV), as well as mortality and disability-adjusted life-years (DALYs) due to HBV, as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. This included estimates for 194 WHO member states, for which we compared our estimates to WHO elimination targets. Methods: The primary data sources were population-based serosurveys, claims and hospital discharges, cancer registries, vital registration systems, and published case series. We estimated chronic HBV infection and the burden of HBV-related diseases, defined as an aggregate of cirrhosis due to hepatitis B, liver cancer due to hepatitis B, and acute hepatitis B. We used DisMod-MR 2.1, a Bayesian mixed-effects meta-regression tool, to estimate the prevalence of chronic HBV infection, cirrhosis, and aetiological proportions of cirrhosis. We used mortality-to-incidence ratios modelled with spatiotemporal Gaussian process regression to estimate the incidence of liver cancer. We used the Cause of Death Ensemble modelling (CODEm) model, a tool that selects models and covariates on the basis of out-of-sample performance, to estimate mortality due to cirrhosis, liver cancer, and acute hepatitis B. Findings: In 2019, the estimated global, all-age prevalence of chronic HBV infection was 4·1% (95% uncertainty interval [UI] 3·7 to 4·5), corresponding to 316 million (284 to 351) infected people. There was a 31·3% (29·0 to 33·9) decline in all-age prevalence between 1990 and 2019, with a more marked decline of 76·8% (76·2 to 77·5) in prevalence in children younger than 5 years. HBV-related diseases resulted in 555 000 global deaths (487 000 to 630 000) in 2019. The number of HBV-related deaths increased between 1990 and 2019 (by 5·9% [–5·6 to 19·2]) and between 2015 and 2019 (by 2·9% [–5·9 to 11·3]). By contrast, all-age and age-standardised death rates due to HBV-related diseases decreased during these periods. We compared estimates for 2019 in 194 WHO locations to WHO-GHSS 2020 targets, and found that four countries achieved a 10% reduction in deaths, 15 countries achieved a 30% reduction in new cases, and 147 countries achieved a 1% prevalence in children younger than 5 years. As of 2019, 68 of 194 countries had already achieved the 2030 target proposed in WHO Interim Guidance of an all-age HBV-related death rate of four per 100 000. Interpretation: The prevalence of chronic HBV infection declined over time, particularly in children younger than 5 years, since the introduction of hepatitis B vaccination. HBV-related death rates also decreased, but HBV-related death counts increased as a result of population growth, ageing, and cohort effects. By 2019, many countries had met the interim seroprevalence target for children younger than 5 years, but few countries had met the WHO-GHSS interim targets for deaths and new cases. Progress according to all indicators must be accelerated to meet 2030 targets, and there are marked disparities in burden and progress across the world. HBV interventions, such as vaccination, testing, and treatment, must be strategically supported and scaled up to achieve elimination. Funding: Bill & Melinda Gates Foundation. © 2022 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 household air pollution, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
(Elsevier B.V., 2025) Fiona B. Bennitt; Sarah S. Wozniak; Kate Causey; Sandra Spearman; Chukwuma O. Okereke; Vanessa Garcia; Nadim Hashmeh; Charlie Ashbaugh; Atef Abdelkader; Meriem Abdoun; Muhammed Jemal Abdurebi; Armita Abedi; Roberto Ariel Abeldaño Zuñiga; Richard Gyan Aboagye; Bilyaminu Abubakar; Ahmed Abu-Zaid; Mesafint Molla Adane; Oyelola Abdulwasiu Adegboye; Victor Tunde Adekanmbi; Abiola Victor Adepoju; Temitayo Esther Adeyeoluwa; Olorunsola I. Adeyomoye; Rishan Adha; Muhammad Sohail Afzal; Saira Afzal; Feleke Doyore Agide; Aqeel Ahmad; Danish Ahmad; Muayyad M. Ahmad; Sajjad U. Ahmad; A. A. Ahmadi; Sepideh Ahmadi; Anisuddin Ahmed; Ayman Ahmed; Haroon Ahmed; Marjan Ajami; Rufus Olusola Akinyemi; Salah T. Al Awaidy; Hanadi Al Hamad; Muaaz Mutaz Alajlani; Mulubirhan Assefa Alemayohu; Adel Ali Saeed Al-Gheethi; Abid Ali; Waad K. Ali; Sheikh Mohammad Alif; Sami Almustanyir; Nelson Rafael Alvis-Guzman; Nelson J. Alvis-Zakzuk; Hany Z. Aly; Hubert Amu; Ganiyu Adeniyi Amusa; Tadele Fentabil Anagaw; Boluwatife Stephen Anuoluwa; Iyadunni A. Anuoluwa; Saeid Anvari; Ekenedilichukwu Emmanuel Anyabolo; Geminn Louis Carace Apostol; Aleksandr Y. Aravkin; Demelash Areda; Brhane Berhe Aregawi; Olatunde Aremu; Akeza Awealom Asgedom; Mubarek Yesse Ashemo; Tahira Ashraf; Seyyed Shamsadin Athari; Sina Azadnajafabad; Ahmed Y. Azzam; Giridhara Rathnaiah Rathnaiah Babu; Saeed Bahramian; Kiran Bam; Maciej P. Banach; Biswajit Banik; Mehmet Firat Baran; Francesco Barone-Adesi; Sandra Barteit; Hameed Akande Bashiru; Pritish Baskaran; Mohammad Mahdi Bastan; Sanjay Basu; Saurav Basu; Sefealem Assefa Belay; Melesse B.Y. Belayneh; Apostolos I. Beloukas; Derrick A. Bennett; Devidas S. Bhagat; Dinesh Mani Bhandari; Pankaj Bhardwaj; Sonu M.M. Bhaskar; Ajay Nagesh Bhat; Priyadarshini Bhattacharjee; Gurjit Kaur Bhatti; Manpreet Singh Bhatti; Cem Bilgin; Mary Sefa Boampong; Sri Harsha Boppana; Samuel Adolf Bosoka; Boudalia Sofiane; Fan Cao; Rama Mohan Chandika; Gashaw Sisay Chanie
Background: Despite a substantial reduction in the use of solid fuels for cooking worldwide, exposure to household air pollution (HAP) remains a leading global risk factor, contributing considerably to the burden of disease. We present a comprehensive analysis of spatial patterns and temporal trends in exposure and attributable disease from 1990 to 2021, featuring substantial methodological updates compared with previous iterations of the Global Burden of Diseases, Injuries, and Risk Factors Study, including improved exposure estimations accounting for specific fuel types. Methods: We estimated HAP exposure and trends and attributable burden for cataract, chronic obstructive pulmonary disease, ischaemic heart disease, lower respiratory infections, tracheal cancer, bronchus cancer, lung cancer, stroke, type 2 diabetes, and causes mediated via adverse reproductive outcomes for 204 countries and territories from 1990 to 2021. We first estimated the mean fuel type-specific concentrations (in μg/m3) of fine particulate matter (PM2·5) pollution to which individuals using solid fuels for cooking were exposed, categorised by fuel type, location, year, age, and sex. Using a systematic review of the epidemiological literature and a newly developed meta-regression tool (meta-regression: Bayesian, regularised, trimmed), we derived disease-specific, non-parametric exposure–response curves to estimate relative risk as a function of PM2·5 concentration. We combined our exposure estimates and relative risks to estimate population attributable fractions and attributable burden for each cause by sex, age, location, and year. Findings: In 2021, 2·67 billion (95% uncertainty interval [UI] 2·63–2·71) people, 33·8% (95% UI 33·2–34·3) of the global population, were exposed to HAP from all sources at a mean concentration of 84·2 μg/m3. Although these figures show a notable reduction in the percentage of the global population exposed in 1990 (56·7%, 56·4–57·1), in absolute terms, there has been only a decline of 0·35 billion (10%) from the 3·02 billion people exposed to HAP in 1990. In 2021, 111 million (95% UI 75·1–164) global disability-adjusted life-years (DALYs) were attributable to HAP, accounting for 3·9% (95% UI 2·6–5·7) of all DALYs. The rate of global, HAP-attributable DALYs in 2021 was 1500·3 (95% UI 1028·4–2195·6) age-standardised DALYs per 100 000 population, a decline of 63·8% since 1990, when HAP-attributable DALYs comprised 4147·7 (3101·4–5104·6) age-standardised DALYs per 100 000 population. HAP-attributable burden remained highest in sub-Saharan Africa and south Asia, with 4044·1 (3103·4–5219·7) and 3213·5 (2165·4–4409·4) age-standardised DALYs per 100 000 population, respectively. The rate of HAP-attributable DALYs was higher for males (1530·5, 1023·4–2263·6) than for females (1318·5, 866·1–1977·2). Approximately one-third of the HAP-attributable burden (518·1, 410·1–641·7) was mediated via short gestation and low birthweight. Decomposition of trends and drivers behind changes in the HAP-attributable burden highlighted that declines in exposures were counteracted by population growth in most regions of the world, especially sub-Saharan Africa. Interpretation: Although the burden attributable to HAP has decreased considerably, HAP remains a substantial risk factor, especially in sub-Saharan Africa and south Asia. Our comprehensive estimates of HAP exposure and attributable burden offer a robust and reliable resource for health policy makers and practitioners to precisely target and tailor health interventions. Given the persistent and substantial impact of HAP in many regions and countries, it is imperative to accelerate efforts to transition under-resourced communities to cleaner household energy sources. Such initiatives are crucial for mitigating health risks and promoting sustainable development, ultimately improving the quality of life and health outcomes for millions of people. Funding: Bill & Melinda Gates Foundation. © 2025 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license
Global, regional, and national burden of injuries, and burden attributable to injuries risk factors, 1990 to 2019: results from the Global Burden of Disease study 2019
(Elsevier B.V., 2024) Mohammad-Reza Malekpour; Negar Rezaei; Sina Azadnajafabad; Javad Khanali; Mohammadreza Azangou-Khyavy; Sahar Saeedi Moghaddam; Mahsa Heidari-Foroozan; Sahba Rezazadeh-Khadem; Seyyed-Hadi Ghamari; Mohsen Abbasi-Kangevari; Gdiom Gebreheat Abady; Rizwan Suliankatchi Abdulkader; Ayele Mamo Abebe; Eman Abu-Gharbieh; Dilaram Acharya; Isaac Yeboah Addo; Oluwafemi Atanda Adeagbo; Oyelola A. Adegboye; Daniel Adedayo Adeyinka; Qorinah Estiningtyas Sakilah Adnani; Aanuoluwapo Adeyimika Afolabi; Saira Afzal; Muhammad Sohail Afzal; Sajjad Ahmad; Aqeel Ahmad; Ali Ahmadi; Hamid Ahmadieh; Haroon Ahmed; Mehrunnisha Sharif Ahmed; Marjan Ajami; Hossein Akbarialiabad; Chisom Joyqueenet Akunna; Fares Alahdab; Fahad Mashhour Alanezi; Turki M. Alanzi; Robert Kaba Alhassan; Liaqat Ali; Shohreh Alian Samakkhah; Yousef Alimohamadi; Syed Mohamed Aljunid; Sami Almustanyir; Salman Khalifah Al-Sabah; Khalid A. Altirkawi; Hiwot Amare; Edward Kwabena Ameyaw; Tarek Tawfik Amin; Sohrab Amiri; Tudorel Andrei; Catalina Liliana Andrei; Davood Anvari; Sumadi Lukman Anwar; Muhammad Aqeel; Morteza Arab-Zozani; Ashokan Arumugam; Umesh Raj Aryal; Malke Asaad; Saeed Asgary; Tahira Ashraf; Thomas Astell-Burt; Seyyed Shamsadin Athari; Alok Atreya; Avinash Aujayeb; Atalel Fentahun F. Awedew; Beatriz Paulina Ayala Quintanilla; Setognal Birara Aychiluhm; Alemu Degu Ayele; Hosein Azizi; Ahmed Y. Azzam; Shankar M. Bakkannavar; Mainak Bardhan; Suzanne Lyn Barker-Collo; Hiba Jawdat Barqawi; Amadou Barrow; Azadeh Bashiri; Pritish Baskaran; Saurav Basu; Neeraj Bedi; Alehegn Bekele; Luis Belo; Derrick A. Bennett; Isabela M. Bensenor; Alemshet Yirga Berhie; Akshaya Srikanth Bhagavathula; Soumyadeep Bhaumik; Zulfiqar A. Bhutta; Saeid Bitaraf; Archith Boloor; Guilherme Borges; Rohan Borschmann; Soufiane Boufous; Michael Brauer; Andrew M. Briggs; Julie Brown; Dana Bryazka; Luis Alberto Cámera; Rosario Cárdenas; Márcia Carvalho; Ferrán Catalá-López; Ester Cerin; Jaykaran Charan; Vijay Kumar Chattu; Wai Tong Chien; Abdulaal Chitheer; Daniel Youngwhan Cho; Steffan Wittrup McPhee Christensen; Devasahayam J. Christopher; Dinh-Toi Chu; Isaac Sunday Chukwu; Beniamino Cislaghi; Scott Richard Clark; Natalia Cruz-Martins; Patricia Cullen; Omid Dadras; Xiaochen Dai; Giovanni Damiani; Rakhi Dandona; Gary L. Darmstadt; Reza Darvishi Cheshmeh Soltani; Aso Mohammad Darwesh; Claudio Alberto Dávila-Cervantes; Diego De Leo; Katie de Luca; Andreas K. Demetriades; Biniyam Demisse; Fitsum Wolde Demisse; Solomon Demissie; Belay Desye; Samath Dhamminda Dharmaratne; Mengistie Diress; Shirin Djalalinia; Milad Dodangeh; Deepa Dongarwar; Hisham Atan Edinur; Ebrahim Eini; Michael Ekholuenetale; Frank J. Elgar; Islam Y. Elgendy; Hala Rashad Elhabashy; Muhammed Elhadi; Waseem El-Huneidi; Mohammad Hassan Emamian; Luchuo Engelbert Bain; Daniel Berhanie Enyew; Habitu Birhan Eshetu; Sharareh Eskandarieh; Farshid Etaee; Adeniyi Francis Fagbamigbe; Andre Faro; Abidemi Omolara Fasanmi; Ali Fatehizadeh; Xiaoqi Feng; Seyed-Mohammad Fereshtehnejad; Pietro Ferrara; Getahun Fetensa; Florian Fischer; Richard Charles Franklin; Takeshi Fukumoto; Yaseen Galali; Nasrin Galehdar; Fortune Gbetoho Gankpe; Mesfin Gebrehiwot; Teferi Gebru Gebremeskel; Leta Adugna Geleta; Motuma Erena Getachew; Mansour Ghafourifard; Mohammad Ghasemi Nour; Ahmad Ghashghaee; Ali Gholamrezanezhad; Tiffany K. Gill; Themba G. Ginindza; James C. Glasbey; Laszlo Göbölös; Kimiya Gohari; Mahaveer Golechha; Pouya Goleij; Michal Grivna; Damitha Asanga Gunawardane; Bhawna Gupta; Brian J. Hall; Randah R. Hamadeh; Pawan Kumar Hamal; Sajid Hameed; Samer Hamidi; Mohammad Hamiduzzaman; Asif Hanif; Syed Emdadul Haque; Arief Hargono; Netanja I. Harlianto; Risky Kusuma Hartono; Ahmed I. Hasaballah; Hamidreza Hasani; Hossein Hassanian-Moghaddam; Soheil Hassanipour; Hadi Hassankhani; Khezar Hayat; Mohammad Heidari; Delia Hendrie; Demisu Zenbaba Heyi; Yuta Hiraike; Nobuyuki Horita; Mohammad Bellal Hossain; Mehdi Hosseinzadeh; Amir Human Hoveidaei; Guoqing Hu; Olayinka Stephen Ilesanmi; Mustapha Immurana; Leeberk Raja Inbaraj; Sheikh Mohammed Shariful Islam; Rakibul M. Islam; Nahlah Elkudssiah Ismail; Jagnoor Jagnoor; Haitham Jahrami; Mihajlo Jakovljevic; Elham Jamshidi; Manthan Dilipkumar Janodia; Tahereh Javaheri; Sathish Kumar Jayapal; Jayakumar Jeganathan; Jost B. Jonas; Nitin Joseph; Farahnaz Joukar; Mikk Jürisson; Ali Kabir; Vidya Kadashetti; Rajesh Kamath; Ashwin Kamath; Bhushan Dattatray Kamble; Himal Kandel; Rami S. Kantar; Ibraheem M. Karaye; Samad Karkhah; Faizan Zaffar Kashoo; Bekalu Getnet Kassa; Joonas H. Kauppila; Leila Keikavoosi-Arani; Phillip M. Kemp Bohan; Mohammad Keykhaei; Nauman Khalid; Mohammad Khammarnia; Moien A.B. Khan; M. Nuruzzaman Khan; Ejaz Ahmad Khan; Maseer Khan; Moawiah Mohammad Khatatbeh; Jagdish Khubchandani; Yun Jin Kim; Gyu Ri Kim; Adnan Kisa; Sezer Kisa; Farzad Kompani; K.M. Marulasiddaiah Kondlahalli Shivakumar; Parvaiz A. Koul; Ai Koyanagi; Kewal Krishan; Vijay Krishnamoorthy; Estie Kruger; Burcu Kucuk Bicer; Nithin Kumar; Narinder Kumar; Carlo La Vecchia; Hilton Lam; Faris Hasan Lami; Iván Landires; Van Charles Lansingh; Paolo Lauriola; Long Khanh Dao Le; Janet L. Leasher; Caterina Ledda; Doo Woong Lee; Yo Han Lee; Wei-Chen Lee; Andrew Tiyamike Makhiringa Likaka; Stephen S. Lim; Shai Linn; Giancarlo Lucchetti; Raimundas Lunevicius; Ronan A. Lyons; Mohammed Magdy Abd El Razek; Mahadeshwara Prasad; Razzagh Mahmoudi; Azeem Majeed; Jeadran N. Malagón-Rojas; Elaheh Malakan Rad; Deborah Carvalho Malta; Yosef Manla; Borhan Mansouri; Mohammad Ali Mansournia; Joemer C. Maravilla; Elezebeth Mathews; Pallab K. Maulik; Enkeleint A. Mechili; Entezar Mehrabi Nasab; Walter Mendoza; Dechasa Adare Mengistu; Alexios-Fotios A. Mentis; Mohamed Kamal Mesregah; Tomislav Mestrovic; Tomasz Miazgowski; Shabir Ahmad Mir; Andreea Mirica; Erkin M. Mirrakhimov; Moonis Mirza; Soheil Mohammadi; Shafiu Mohammed; Modhurima Moitra; Ali H. Mokdad; Mariam Molokhia; Lorenzo Monasta; Maryam Moradi; Shane Douglas Morrison; Sumaira Mubarik; Efren Murillo-Zamora; Ghulam Mustafa; Ashraf Fawzy Nabhan; Vinay Nangia; Bruno Ramos Nascimento; Zuhair S. Natto; Ionut Negoi; Seyed Aria Nejadghaderi; Evangelia Nena; Samata Nepal; Haruna Asura Nggada; Josephine W. Ngunjiri; Chukwudi A. Nnaji; Ogochukwu Janet Nzoputam; Chimezie Igwegbe Nzoputam; Bogdan Oancea; Kehinde O. Obamiro; Oluwakemi Ololade Odukoya; Onome Bright Oghenetega; Oh In-Hwan; Hassan Okati-Aliabad; Osaretin Christabel Okonji; Adeolu Olufunso Oladunjoye; Andrew T. Olagunju; Diriba Dereje Olana; Ahmed Omar Bali; Adrian Otoiu; Mayowa O. Owolabi; Mahesh Padukudru P A; Alicia Padron-Monedero; Songhomitra Panda-Jonas; Seithikurippu R. Pandi-Perumal; Shahina Pardhan; Park Eun-Kee; Jay Patel; Uttam Paudel; Shrikant Pawar; Hamidreza Pazoki Toroudi; Amy E. Peden; Paolo Pedersini; Marcos Pereira; Konrad Pesudovs; Ionela-Roxana Petcu; Tom Pham; Michael R. Phillips; Zahra Zahid Piracha; Suzanne Polinder; Ibrahim Qattea; Ata Rafiee; Pankaja Raghav; Muhammad Aziz Rahman; Mosiur Rahman; Amir Masoud Rahmani; Vahid Rahmanian; Sheena Ramazanu; Usha Rani; Temam Beshir Raru; Mohammad-Mahdi Rashidi; Prateek Rastogi; Azad Rasul; Zubair Ahmed Ratan; Reza Rawassizadeh; Maryam Rezaei; Nazila Rezaei; Mohsen Rezaeian; Muhammad Riaz; Jennifer Rickard; Nicholas L.S. Roberts; Jefferson Antonio Buendia Rodriguez; Leonardo Roever; Luca Ronfani; Bedanta Roy; S. Manjula; S.N. Chandan; Siamak Sabour; Mohammad Reza Saeb; Umar Saeed; Sare Safi; Amirhossein Sahebkar; Biniyam Sahiledengle; Mohammad Ali Sahraian; Payman Salamati; Juan Sanabria; Muhammad Arif Nadeem Saqib; Yaser Sarikhani; Arash Sarveazad; Davide Sattin; Ganesh Kumar Saya; David C. Schwebel; Binyam Tariku Seboka; Abdul-Aziz Seidu; Allen Seylani; Pritik A. Shah; Ataollah Shahbandi; Amira A. Shaheen; Masood Ali Shaikh; Mohd Shanawaz; Nigussie Tadesse Sharew; Azam Sharifi; Neeraj Sharma; Vishal Sharma; Bereket Beyene Shashamo; Ali Sheidaei; Rahim Ali Sheikhi; Jiabin Shen; Adithi Shetty; B. Suresh Kumar Shetty; Rahman Shiri; Seyed Afshin Shorofi; Roman Shrestha; Negussie Boti Sidamo; Luís Manuel Lopes Rodrigues Silva; Wudneh Simegn; Jasvinder A. Singh; Surjit Singh; Ambrish Singh; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; David A. Sleet; Bogdan Socea; Yonatan Solomon; Yi Song; Houman Sotoudeh; Raul A.R. C. Sousa; Jeffrey D. Stanaway; Dan J. Stein; Paschalis Steiropoulos; Mark A. Stokes; Narayan Subedi; Jing Sun; Rafael Tabarés-Seisdedos; Moslem Taheri Soodejani; Mircea Tampa; Ker-Kan Tan; M.D. Tariqujjaman; Elvis Enowbeyang Tarkang; Nathan Y. Tat; Yibekal Manaye Tefera; Rekha Thapar; Jansje Henny Vera Ticoalu; Jaya Prasad Tripathy; Lorainne Tudor Car; Derara Girma Tufa; Sana Ullah; Irfan Ullah; Krishna Kishore Umapathi; Era Upadhyay; Sahel Valadan Tahbaz; Pascual R. Valdez; Shoban Babu Varthya; Massimiliano Veroux; Dominique Vervoort; Francesco S. Violante; Vasily Vlassov; Bay Vo; Yasir Waheed; Yanzhong Wang; Gizachew Tadesse Wassie; Taweewat Wiangkham; Caroline Wilkerson; Asrat Arja Wolde; Hong Xiao; Yuichiro Yano; Sanni Yaya; Pengpeng Ye; Paul Yip; Naohiro Yonemoto; Mustafa Z. Younis; Chuanhua Yu; Leila Zaki; Michael Zastrozhin; Yunquan Zhang; Zhi-Jiang Zhang; Sanjay Zodpey; Mohsen Naghavi; Bagher Larijani; Farshad Farzadfar
Objectives: In this study, the trends and current situation of the injury burden as well as attributable burden to injury risk factors at global, regional, and national levels based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 are presented. Study design: To assess the attributable burden of injury risk factors, the data of interest on data sources were retrieved from the Global Health Data Exchange (GHDx) and analyzed. Methods: Cause-specific death from injuries was estimated using the Cause of Death Ensemble model in the GBD 2019. The burden attributable to each injury risk factor was incorporated in the population attributable fraction to estimate the total attributable deaths and disability-adjusted life years. The Socio-demographic Index (SDI) was used to evaluate countries’ developmental status. Results: Globally, there were 713.9 million (95% uncertainty interval [UI]: 663.8 to 766.9) injuries incidence and 4.3 million (UI: 3.9 to 4.6) deaths caused by injuries in 2019. There was an inverse relationship between age-standardized disability-adjusted life year rate and SDI quintiles in 2019. Overall, low bone mineral density was the leading risk factor of injury deaths in 2019, with a contribution of 10.5% (UI: 9.0 to 11.6) of total injuries and age-standardized deaths, followed by occupational risks (7.0% [UI: 6.3–7.9]) and alcohol use (6.8% [UI: 5.2 to 8.5]). Conclusion: Various risks were responsible for the imposed burden of injuries. This study highlighted the small but persistent share of injuries in the global burden of diseases and injuries to provide beneficial data to produce proper policies to reach an effective global injury prevention plan. © 2024
Global, regional, and national burden of stroke and its risk factors, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
(Elsevier Ltd, 2024) Valery L Feigin; Melsew Dagne Abate; Yohannes Habtegiorgis Abate; Samar Abd ElHafeez; Foad Abd-Allah; Ahmed Abdelalim; Atef Abdelkader; Michael Abdelmasseh; Sherief Abd-Elsalam; Parsa Abdi; Arash Abdollahi; Meriem Abdoun; Rami Abd-Rabu; Deldar Morad Abdulah; Auwal Abdullahi; Mesfin Abebe; Roberto Ariel Abeldaño Zuñiga; E.S. Abhilash; Olugbenga Olusola Abiodun; Olumide Abiodun; Rahim Abo Kasem; Richard Gyan Aboagye; Mohamed Abouzid; Lucas Guimarães Abreu; Woldu Aberhe Abrha; Dariush Abtahi; Samir Abu Rumeileh; Ahmed Abualhasan; Hasan Abualruz; Eman Abu-Gharbieh; Hana J Abukhadijah; Niveen ME Abu-Rmeileh; Salahdein Aburuz; Ahmed Abu-Zaid; Juan Manuel Acuna; Denberu Eshetie Adane; Mesafint Molla Adane; Isaac Yeboah Addo; Rufus Adesoji Adedoyin; Oyelola A Adegboye; Victor Adekanmbi; Kishor Adhikari; Qorinah Estiningtyas Sakilah Adnani; Saryia Adra; Leticia Akua Adzigbli; Abdelrahman Yousry Afify; Aanuoluwapo Adeyimika Afolabi; Fatemeh Afrashteh; Muhammad Sohail Afzal; Saira Afzal; Shahin Aghamiri; Williams Agyemang-Duah; Bright Opoku Ahinkorah; Aqeel Ahmad; Muayyad M Ahmad; Sajjad Ahmad; Shahzaib Ahmad; Tauseef Ahmad; Amir Mahmoud Ahmadzade; Ali Ahmed; Ayman Ahmed; Haroon Ahmed; Syed Anees Ahmed; Marjan Ajami; Budi Aji; Essona Matatom Akara; Rufus Olusola Akinyemi; Mohammed Ahmed Akkaif; Ashley E Akrami; Salah Al Awaidy; 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Zewdu Bishaw Aynalem; Sina Azadnajafabad; Hiva Azami; Shahkaar Aziz; Ahmed Y Azzam; Abraham Samuel Babu; Giridhara Rathnaiah Babu; Muhammad Badar; Ashish D Badiye; Pegah Bahrami Taghanaki; Saeed Bahramian; Ruhai Bai; Atif Amin Baig; Shankar M Bakkannavar; Abdulaziz T Bako; Ovidiu Constantin Baltatu; Kiran Bam; Maciej Banach; Morteza Banakar; Soham Bandyopadhyay; Palash Chandra Banik; Kannu Bansal; Yanping Bao; Miguel A Barboza; Mainak Bardhan; Noel C Barengo; Suzanne Lyn Barker-Collo; Till Winfried Bärnighausen; Hiba Jawdat Barqawi; Amadou Barrow; Lingkan Barua; Azadeh Bashiri; Hameed Akande Bashiru; Afisu Basiru; Mohammad-Mahdi Bastan; Sanjay Basu; Saurav Basu; Kavita Batra; Ahmet Begde; Babak Behnam; Amir Hossein Behnoush; Melesse B Y Belayneh; Michael Belingheri; Umar Muhammad Bello; Derrick A Bennett; Isabela M Bensenor; Fentaw Tadese Berhe; Amiel Nazer C Bermudez; Habtamu B B Beyene; Kebede A Beyene; Devidas S Bhagat; Akshaya Srikanth Bhagavathula; Neeraj Bhala; Ashish Bhalla; Nikha Bhardwaj; 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Theophilus I Emeto; Christopher Imokhuede Esezobor; Negin Esfandiari; Zahra Esmaeili; Francesco Esposito; Mohammad Etoom; Natalia Fabin; Ibtihal Fadhil; Adeniyi Francis Fagbamigbe; Omotayo Francis Fagbule; Shahriar Faghani; Ayesha Fahim; Ildar Ravisovich Fakhradiyev; Luca Falzone; Mohammad Fareed; Jawad Fares; Carla Sofia e Sá Farinha; MoezAlIslam Ezzat Mahmoud Faris; Pawan Sirwan Faris; Mohsen Farjoud Kouhanjani; Andre Faro; Hossein Farrokhpour; Abidemi Omolara Fasanmi; Nelsensius Klau Fauk; Patrick Fazeli; Timur Fazylov; Alireza Feizkhah; Ginenus Fekadu; Xiaoqi Feng; Seyed-Mohammad Fereshtehnejad; Pietro Ferrara; Nuno Ferreira; Getahun Fetensa; Bikila Regassa Feyisa; Florian Fischer; Luisa S Flor; Kristen Marie Foley; Ana Catarina Fonseca; Roham Foroumadi; Behzad Foroutan; Daniela Fortuna; Matteo Foschi; Richard Charles Franklin; Ni Kadek Yuni Fridayani; Sridevi G; Peter Andras Gaal; Abhay Motiramji Gaidhane; Abduzhappar Gaipov; Yaseen Galali; Silvano Gallus; Aravind P Gandhi; Balasankar Ganesan; Danijela Gasevic; Prem Gautam; Rupesh K Gautam; Miglas Welay Gebregergis; Mesfin Gebrehiwot; Kebre Gebrekirstos Gebrekidan; Lemma Getacher; Genanew K Getahun; Molla Getie; Delaram J Ghadimi; Fataneh Ghadirian; Amir Ghaffari Jolfayi; Mansour Ghafourifard; Mohammad-Reza Ghasemi; Afsaneh Ghasemzadeh; Ramy Mohamed Ghazy; Ehsan Gholami; Zainab Gholami; Sherief Ghozy; Stefano Giannoni Luza; Jaleed Ahmed Gilani; Tiffany K Gill; Richard F Gillum; Ebisa Zerihun Gindaba; Elena V Gnedovskaya; Amit Goel; Mohamad Goldust; Mahaveer Golechha; Pouya Goleij; Davide Golinelli; Philimon N Gona; Giuseppe Gorini; Alessandra C Goulart; Barbara Niegia Garcia Goulart; Mahdi Gouravani; Michal Grivna; Giuseppe Grosso; Ashna Grover; Shi-Yang Guan; Giovanni Guarducci; Avirup Guha; Stefano Guicciardi; Snigdha Gulati; Damitha Asanga Gunawardane; Cui Guo; Zhifeng Guo; Anish Kumar Gupta; Bhawna Gupta; Mohak Gupta; Rahul Gupta; Rajat Das Gupta; Rajeev Gupta; Sapna Gupta; Farrokh Habibzadeh; Najah R Hadi; Mohammad Haghani Dogahe; Hamed Haghi-Aminjan; Dariush Haghmorad; Arvin Haj-Mirzaian; Aram Halimi; Nadia M Hamdy; Samer Hamidi; Erin B Hamilton; Asif Hanif; Nasrin Hanifi; Graeme J Hankey; Md Abdul Hannan; Zaim Anan Haq; Arief Hargono; Netanja I Harlianto; Josep Maria Haro; Eka Mishbahatul Marah Has; Ahmed I Hasaballah; Ikramul Hasan; Md Saquib Hasnain; Ikrama Hassan; Mahgol Sadat Hassan Zadeh Tabatabaei; Johannes Haubold; Rasmus J Havmoeller; Simon I Hay; Youssef Hbid; Jeffrey J Hebert; Omar E Hegazi; Mohammad Heidari; Mehdi Hemmati; Demisu Zenbaba Heyi; Kamal Hezam; Yuta Hiraike; Nguyen Quoc Hoan; Ramesh Holla; Nobuyuki Horita; Md Mahbub Hossain; Hassan Hosseinzadeh; Mehdi Hosseinzadeh; Ahmad Hosseinzadeh Adli; Mihaela Hostiuc; Sorin Hostiuc; Ben Hu; Chengxi Hu; Junjie Huang; Ayesha Humayun; Salman Hussain; Le Duc Huy; Hong-Han Huynh; Bing-Fang Hwang; Segun Emmanuel Ibitoye; Nayu Ikeda; Adalia Ikiroma; Olayinka Stephen Ilesanmi; Irena M Ilic; Milena D Ilic; Mohammad Tarique Imam; Mustapha Immurana; Leeberk Raja Inbaraj; Muhammad Iqhrammullah; Arnaud Iradukunda; Lalu Muhammad Irham; Md Rabiul Islam; Faisal Ismail; Nahlah Elkudssiah Ismail; Hiroyasu Iso; Gaetano Isola; Ramaiah Itumalla; Masao Iwagami; Chidozie Declan CD Iwu; Vinothini J; Jalil Jaafari; Louis Jacob; Abdollah Jafarzadeh; Haitham Jahrami; Akhil Jain; Nityanand Jain; Ammar Abdulrahman Jairoun; Abhishek Jaiswal; Mihajlo Jakovljevic; Reza Jalilzadeh Yengejeh; Balamurugan Janakiraman; Abubakar Ibrahim Jatau; Sathish Kumar Jayapal; Shubha Jayaram; Sun Ha Jee; Jayakumar Jeganathan; Mihretu Jegnie; Alelign Tasew Jema; Bijay Mukesh Jeswani; Angeline Jeyakumar; Anil K Jha; Ravi Prakash Jha; Zixiang Ji; Heng Jiang; Shuai Jin; Yingzhao Jin; Mohammad Jokar; Jost B Jonas; Tamas Joo; Jobinse Jose; Nitin Joseph; Charity Ehimwenma Joshua; Farahnaz Joukar; Jacek Jerzy Jozwiak; Mikk Jürisson; Ali Kabir; Md Awal Kabir; Zubair Kabir; Vidya Kadashetti; Rizwan Kalani; Sanjay Kalra; Vineet Kumar Kamal; Arun Kamireddy; Haidong Kan; Mona Kanaan; Himal Kandel; Kehinde Kazeem Kanmodi; 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Miikka Korja; Vladimir Andreevich Korshunov; Oleksii Korzh; Soewarta Kosen; Karel Kostev; Nikhil Kothari; Ashwin Laxmikant Kotnis; Sindhura Lakshmi Koulmane Laxminarayana; Kewal Krishan; Varun Krishna; Vijay Krishnamoorthy; Bindu Krishnan; Jera Kruja; Barthelemy Kuate Defo; Burcu Kucuk Bicer; Md Abdul Kuddus; Mohammed Kuddus; Nuworza Kugbey; Mukhtar Kulimbet; Vishnutheertha Kulkarni; Akshay Kumar; Ashish Kumar; Dewesh Kumar; G Anil Kumar; Nithin Kumar; Rakesh Kumar; Senthil Kumaran D; Amartya Kundu; Satyajit Kundu; Setor K Kunutsor; Om P Kurmi; Dian Kusuma; L V Simhachalam Kutikuppala; Ambily Kuttikkattu; Ville Kytö; Carlo La Vecchia; Ben Lacey; Chandrakant Lahariya; Dharmesh Kumar Lal; Tea Lallukka; Judit Lám; Iván Landires; Anders O Larsson; Savita Lasrado; Kaveh Latifinaibin; Paolo Lauriola; Pablo M Lavados; Basira Kankia Lawal; Long Khanh Dao Le; Nhi Huu Hanh Le; Thao Thi Thu Le; Trang Diep Thanh Le; Paul H Lee; Seung Won Lee; Wei-Chen Lee; Yo Han Lee; Ming-Chieh Li; Wei Li; Xiaopan Li; Yichong Li; Lee-Ling Lim; Stephen S Lim; John C Lin; Daniel Lindholm; Shai Linn; Gang Liu; Runben Liu; Shuke Liu; Xiaofeng Liu; Xuefeng Liu; Erand Llanaj; Chun-Han Lo; Warren David Lo; Valerie Lohner; José Francisco López-Gil; László Lorenzovici; Stefan Lorkowski; Paulo A Lotufo; Giancarlo Lucchetti; Lisha Luo; Jay B Lusk; Zheng Feei Ma; Monika Machoy; Farzan Madadizadeh; Ralph Maddison; Elham Mahmoudi; Golnaz Mahmoudvand; Omar M Makram; Elaheh Malakan Rad; Kashish Malhotra; Ahmad Azam Malik; Iram Malik; Tauqeer Hussain Mallhi; Deborah Carvalho Malta; Abdullah A Mamun; Yosef Manla; Mohammad Hadi Mansouri; Pejman Mansouri; Vahid Mansouri; Mohammad Ali Mansournia; Lorenzo Giovanni Mantovani; Emmanuel Manu; Hamid Reza Marateb; Abdoljalal Marjani; Daniela Martini; Santi Martini; Miquel Martorell; Sharmeen Maryam; Roy Rillera Marzo; Awoke Masrie; Yasith Mathangasinghe; Pallab K Maulik; Mahsa Mayeli; Mohsen Mazidi; Martin McKee; Steven M McPhail; Enkeleint A Mechili; Asim Mehmood; Kamran Mehrabani-Zeinabad; Tesfahun Mekene Meto; Hadush Negash Meles; Walter Mendoza; Ritesh G Menezes; George A Mensah; Sultan Ayoub Meo; Atte Meretoja; Tuomo J Meretoja; Tomislav Mestrovic; Chamila Dinushi Kukulege Mettananda; Tomasz Miazgowski; Irmina Maria Michalek; Ana Carolina Micheletti Gomide Nogueira de Sá; Giuseppe Minervini; Le Huu Nhat Minh; G.K. Mini; Mojgan Mirghafourvand; Andreea Mirica; Erkin M Mirrakhimov; Mohammad Mirza-Aghazadeh-Attari; Manish Mishra; Sanjeev Misra; Prasanna Mithra; Ahmed Ismail Mohamed; Jama Mohamed; Nouh Saad Mohamed; Ameen Mosa Mohammad; Esmaeil Mohammadi; Saeed Mohammadi; Soheil Mohammadi; Abdollah Mohammadian-Hafshejani; Ibrahim Mohammadzadeh; Hussen Mohammed; Mustapha Mohammed; Salahuddin Mohammed; Shafiu Mohammed; Ali H Mokdad; Hossein Molavi Vardanjani; Mariam Molokhia; Shaher Momani; Lorenzo Monasta; Mohammad Ali Moni; Fateme Montazeri; AmirAli Moodi Ghalibaf; Mahmood Moosazadeh; Maryam Moradi; Yousef Moradi; Paula Moraga; Lidia Morawska; Rafael Silveira Moreira; Shane Douglas Morrison; Reza Mosaddeghi Heris; Elias Mossialos; Parsa Mousavi; Ahmed Msherghi; Sumaira Mubarik; Lorenzo Muccioli; Admir Mulita; Malaisamy Muniyandi; Kavita Munjal; Efren Murillo-Zamora; Sathish Muthu; Woojae Myung; Amin Nabavi; Ashraf Fawzy Nabhan; Ayoub Nafei; Ahamarshan Jayaraman Nagarajan; Pirouz Naghavi; Ganesh R Naik; Gurudatta Naik; Mukhammad David Naimzada; Sanjeev Nair; Tapas Sadasivan Nair; Soroush Najdaghi; Hastyar Hama Rashid Najmuldeen; Noureddin Nakhostin Ansari; Vinay Nangia; Sreenivas Narasimha Swamy; Shumaila Nargus; Delaram Narimani Davani; Bruno Ramos Nascimento; Gustavo G Nascimento; Ali Nasrollahizadeh; Amir Nasrollahizadeh; Zuhair S Natto; Javaid Nauman; Samidi Nirasha Kumari Navaratna; Biswa Prakash Nayak; Vinod C Nayak; Athare Nazri-Panjaki; Rawlance Ndejjo; Ionut Negoi; Ruxandra Irina Negoi; Seyed Aria Nejadghaderi; Chakib Nejjari; Mohammad Hadi Nematollahi; Samata Nepal; Charles Richard James Newton; Dang H Nguyen; Duc Hoang Nguyen; Hau Thi Hien Nguyen; Hien Quang Nguyen; Nhien Ngoc Y Nguyen; Phat Tuan Nguyen; Van Thanh Nguyen; Robina Khan Niazi; Yeshambel T Nigatu; Nasrin Nikravangolsefid; Dina Nur Anggraini Ningrum; Chukwudi A Nnaji; Lawrence Achilles Nnyanzi; Shuhei Nomura; Syed Toukir Ahmed Noor; Bo Norrving; Nawsherwan Nawsherwan; Jean Jacques Noubiap; Chisom Adaobi Nri-Ezedi; George Ntaios; Mpiko Ntsekhe; Fred Nugen; Mario Cesare Nurchis; Dieta Nurrika; Chimezie Igwegbe Nzoputam; Ogochukwu Janet Nzoputam; Bogdan Oancea; Kehinde O Obamiro; Ismail A Odetokun; Martin James O'Donnell; James Odhiambo Oguta; In-Hwan Oh; Tolulope R Ojo-Akosile; Hassan Okati-Aliabad; Sylvester Reuben Okeke; Akinkunmi Paul Okekunle; Lawrence Okidi; Osaretin Christabel Okonji; Morteza Oladnabi; Andrew T Olagunju; Muideen Tunbosun Olaiya; Oladotun Victor Olalusi; Tosin Abiola Olasehinde; Omotola O Olasupo; Matthew Idowu Olatubi; Arão Belitardo Oliveira; Gláucia Maria Moraes Oliveira; Abdulhakeem Abayomi Olorukooba; Isaac Iyinoluwa Olufadewa; Yinka Doris Doris Oluwafemi; Gideon Olamilekan Oluwatunase; Hany A Omar; Ahmed Omar Bali; Adrienne E O'Neil; Sok King Ong; Obinna E Onwujekwe; Abdulahi Opejin Opejin; Michal Ordak; Raffaele Ornello; Doris V Ortega-Altamirano; Alberto Ortiz; Esteban Ortiz-Prado; Wael M S Osman; Uchechukwu Levi Osuagwu; Stanislav S Otstavnov; Mayowa O Owolabi; Ifeoluwa Temitayo Oyeyemi; Ahmad Ozair; Mahesh Padukudru P A; Kevin Pacheco-Barrios; Alicia Padron-Monedero; Jagadish Rao Padubidri; Tamás Palicz; Raul Felipe Palma-Alvarez; Feng Pan; Songhomitra Panda-Jonas; Deepshikha Pande Katare; Anamika Pandey; Ashok Pandey; Seithikurippu R Pandi-Perumal; Leonidas D Panos; Ioannis Pantazopoulos; Paraskevi Papadopoulou; Shahina Pardhan; Pragyan Paramita Parija
Background: Up-to-date estimates of stroke burden and attributable risks and their trends at global, regional, and national levels are essential for evidence-based health care, prevention, and resource allocation planning. We aimed to provide such estimates for the period 1990–2021. Methods: We estimated incidence, prevalence, death, and disability-adjusted life-year (DALY) counts and age-standardised rates per 100 000 people per year for overall stroke, ischaemic stroke, intracerebral haemorrhage, and subarachnoid haemorrhage, for 204 countries and territories from 1990 to 2021. We also calculated burden of stroke attributable to 23 risk factors and six risk clusters (air pollution, tobacco smoking, behavioural, dietary, environmental, and metabolic risks) at the global and regional levels (21 GBD regions and Socio-demographic Index [SDI] quintiles), using the standard GBD methodology. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In 2021, stroke was the third most common GBD level 3 cause of death (7·3 million [95% UI 6·6–7·8] deaths; 10·7% [9·8–11·3] of all deaths) after ischaemic heart disease and COVID-19, and the fourth most common cause of DALYs (160·5 million [147·8–171·6] DALYs; 5·6% [5·0–6·1] of all DALYs). In 2021, there were 93·8 million (89·0–99·3) prevalent and 11·9 million (10·7–13·2) incident strokes. We found disparities in stroke burden and risk factors by GBD region, country or territory, and SDI, as well as a stagnation in the reduction of incidence from 2015 onwards, and even some increases in the stroke incidence, death, prevalence, and DALY rates in southeast Asia, east Asia, and Oceania, countries with lower SDI, and people younger than 70 years. Globally, ischaemic stroke constituted 65·3% (62·4–67·7), intracerebral haemorrhage constituted 28·8% (28·3–28·8), and subarachnoid haemorrhage constituted 5·8% (5·7–6·0) of incident strokes. There were substantial increases in DALYs attributable to high BMI (88·2% [53·4–117·7]), high ambient temperature (72·4% [51·1 to 179·5]), high fasting plasma glucose (32·1% [26·7–38·1]), diet high in sugar-sweetened beverages (23·4% [12·7–35·7]), low physical activity (11·3% [1·8–34·9]), high systolic blood pressure (6·7% [2·5–11·6]), lead exposure (6·5% [4·5–11·2]), and diet low in omega-6 polyunsaturated fatty acids (5·3% [0·5–10·5]). Interpretation: Stroke burden has increased from 1990 to 2021, and the contribution of several risk factors has also increased. Effective, accessible, and affordable measures to improve stroke surveillance, prevention (with the emphasis on blood pressure, lifestyle, and environmental factors), acute care, and rehabilitation need to be urgently implemented across all countries to reduce stroke burden. 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 upper respiratory infections and otitis media, 1990-2021: a systematic analysis from the Global Burden of Disease Study 2021
(Elsevier Ltd, 2025) Sarah Brooke Sirota; Regina Mae Villanueva Dominguez; Rose Grace Bender; Avina Vongpradith; Samuel B. Albertson; Amanda Novotney; Katrin G. Burkart; Austin R. Carter; Erin Chung; Xiaochen Dai; Luisa Sório Flor; Stephen S. Lim; Tomislav Meštrović; Ali H.I. Mokdad; Vincent Mougin; Maja Pasovic; David M. Pigott; Quinn Rafferty; Austin E. Schumacher; Aleksandr Y. Aravkin; Nicholas J. Kassebaum; Mohsen Naghavi; Theo Vos; Simon I. Hay; Christopher J.L. Murray; Hmwe Hmwe Kyu; Benn K.D. Sartorius; Sonali Kochhar; Vijay Krishnamoorthy; Hafsa Zia; Matthew C. Doxey; Mohamad Goldust; Xiaofeng Liu; Shrikant Pawar; Parsa Abdi; Meriem Abdoun; Ayele Mamo Abebe; Birhan Tsegaw Taye; Kedir Hussein Abegaz; Mesud Mohammed; Richard Gyan Aboagye; Leticia Akua Adzigbli; Robert Kaba Alhassan; Hubert Amu; V. N. Orish; Hassan Abolhassani; Nazila Rezaei; Mohammad Mahdi Bastan; Parsa Mousavi; Mohammad Mahdi Rashidi; Nima A. Rezaei; Amir Hossein Behnoush; Amirmohammad Khalaji; Mohsen Merati; Fatemeh Chichagi; Omid Dadras; Mohadese Dashtkoohi; Mostafa Hadei; Elaheh Malakan Rad; Mohammad Sadeq Najafi; Vafa Rahimi-Movaghar; Seyedahmad Ahmad Seyedalinaghi; Mahan Shafie; Amin Sharifan; Seyed Mohammad Vahabi; Lucas Guimarães Abreu; Elton Junio Sady Prates; Hasan Abualruz; Eman F. Abu-Gharbieh; Yasser Khalil Bustanji; Malik Sallam; Hiba Jawdat Barqawi; Nihar Ranjan Dash; Rabih Halwani; Mahmoud M. Ramadan; Narjes Saheb Sharif-Askari; Iman M. Talaat; Karem Hasan Alzoubi; Basema Ahmad Saddik; Mohamed A. Saleh; Fatemeh Saheb Sharif-Askari; Sameh S.M. Soliman; Salahdein Mohammed Aburuz; Rami H. Al-Rifai; Gulfaraz Khan; Mesafint Molla Adane; Eyob Ketema Bogale; Isaac Yeboah Addo; Victor Tunde Adekanmbi; Weichen Lee; Qorinah Estiningtyas Sakilah Adnani; Maarten Jacobus Postma; Muhammad Sohail Afzal; Saira Afzal; Bright Opoku Ahinkorah; Gang Liu; Nghia Minh Tran; Sajjad U. Ahmad; Ayman Ahmed; Emmanuel Edwar Siddig
Background: Upper respiratory infections (URIs) are the leading cause of acute disease incidence worldwide and contribute to a substantial health-care burden. Although acute otitis media is a common complication of URIs, the combined global burden of URIs and otitis media has not been studied comprehensively. We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 to explore the fatal and non-fatal burden of the two diseases across all age groups, including a granular analysis of children younger than 5 years, in 204 countries and territories from 1990 to 2021. Methods: Mortality due to URIs and otitis media was estimated with use of vital registration and sample-based vital registration data, which are used as inputs to the Cause of Death Ensemble model to separately model URIs and otitis media mortality by age and sex. Morbidity was modelled with a Bayesian meta-regression tool using data from published studies identified via systematic reviews, population-based survey data, and cause-specific URI and otitis media mortality estimates. Additionally, we assessed and compared the burden of otitis media as it relates to URIs and examined the collective burden and contributing risk factors of both diseases. Findings: The global number of new episodes of URIs was 12·8 billion (95% uncertainty interval 11·4 to 14·5) for all ages across males and females in 2021. The global all-age incidence rate of URIs decreased by 10·1% (-12·0 to -8·1) from 1990 to 2019. From 2019 to 2021, the global all-age incidence rate fell by 0·5% (-0·8 to -0·1). Globally, the incidence rate of URIs was 162 484·8 per 100 000 population (144 834·0 to 183 289·4) in 2021, a decrease of 10·5% (-12·4 to -8·4) from 1990, when the incidence rate was 181 552·5 per 100 000 population (160 827·4 to 206 214·7). The highest incidence rates of URIs were seen in children younger than 2 years in 2021, and the largest number of episodes was in children aged 5-9 years. The number of new episodes of otitis media globally for all ages was 391 million (292 to 525) in 2021. The global incidence rate of otitis media was 4958·9 per 100 000 (3705·4 to 6658·6) in 2021, a decrease of 16·3% (-18·1 to -14·0) from 1990, when the incidence rate was 5925·5 per 100 000 (4371·8 to 8097·9). The incidence rate of otitis media in 2021 was highest in children younger than 2 years, and the largest number of episodes was in children aged 2-4 years. The mortality rate of URIs in 2021 was 0·2 per 100 000 (0·1 to 0·5), a decrease of 64·2% (-84·6 to -43·4) from 1990, when the mortality rate was 0·7 per 100 000 (0·2 to 1·1). In both 1990 and 2021, the mortality rate of otitis media was less than 0·1 per 100 000. Together, the combined burden accounted for by URIs and otitis media in 2021 was 6·86 million (4·24 to 10·4) years lived with disability and 8·16 million (4·99 to 12·0) disability-adjusted life-years (DALYs) for all ages across males and females. Globally, the all-age DALY rate of URIs and otitis media combined in 2021 was 103 per 100 000 (63 to 152). Infants aged 1-5 months had the highest combined DALY rate in 2021 (647 per 100 000 [189 to 1412]), followed by early neonates (aged 0-6 days; 582 per 100 000 [176 to 1297]) and late neonates (aged 7-24 days; 482 per 100 000 [161 to 1052]). Interpretation: The findings of this study highlight the widespread burden posed by URIs and otitis media across all age groups and both sexes. There is a continued need for surveillance, prevention, and management to better understand and reduce the burden associated with URIs and otitis media, and research is needed to assess their impacts on individuals, communities, economies, and health-care systems worldwide. Funding: Bill & Melinda Gates Foundation. © 2025 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
The global burden of adolescent and young adult cancer in 2019: a systematic analysis for the Global Burden of Disease Study 2019
(Elsevier Ltd, 2022) Elysia M. Alvarez; Lisa M. Force; Rixing Xu; Kelly Compton; Dan Lu; Hannah Jacqueline Henrikson; Jonathan M. Kocarnik; James D. Harvey; Alyssa Pennini; Frances E. Dean; Weijia Fu; Martina T. Vargas; Theresa H. M. Keegan; Hany Ariffin; Ronald D. Barr; Yana Arturovna Erdomaeva; D. Sanjeeva Gunasekera; Yetunde O. John-Akinola; Tyler G. Ketterl; Tezer Kutluk; Marcio Henrique Malogolowkin; Prashant Mathur; Venkatraman Radhakrishnan; Lynn Ann Gloeckler Ries; Carlos Rodriguez-Galindo; Garik Barisovich Sagoyan; Iyad Sultan; Behzad Abbasi; Mohsen Abbasi-Kangevari; Zeinab Abbasi-Kangevari; Hedayat Abbastabar; Michael Abdelmasseh; Sherief Abd-Elsalam; Amir Abdoli; Haimanot Abebe; Aidin Abedi; Hassan Abidi; Hassan Abolhassani; Hiwa Abubaker Ali; Eman Abu-Gharbieh; Basavaprabhu Achappa; Juan Manuel Acuna; Isaac Akinkunmi Adedeji; Oyelola A. Adegboye; Qorinah Estiningtyas Sakilah Adnani; Shailesh M. Advani; Muhammad Sohail Afzal; Mohamad Aghaie Meybodi; Bahman Ahadinezhad; Bright Opoku Ahinkorah; Sajjad Ahmad; Sepideh Ahmadi; Muktar Beshir Ahmed; Tarik Ahmed Rashid; Yusra Ahmed Salih; Wajeeha Aiman; Gizachew Taddesse Akalu; Hanadi Al Hamad; Fares Alahdab; Abdulhadi A. AlAmodi; Fahad Mashhour Alanezi; Turki M. Alanzi; Adugnaw Zeleke Alem; Dejene Tsegaye Alem; Yosef Alemayehu; Fadwa Naji Alhalaiqa; Robert Kaba Alhassan; Saqib Ali; Gianfranco Alicandro; Vahid Alipour; Syed Mohamed Aljunid; Motasem Alkhayyat; Sunitha Alluri; Nihad A. Almasri; Sadeq Ali Al-Maweri; Sami Almustanyir; Rajaa M. Al-Raddadi; Nelson Alvis-Guzman; Edward Kwabena Ameyaw; Saeed Amini; Hubert Amu; Robert Ancuceanu; Catalina Liliana Andrei; Tudorel Andrei; Fereshteh Ansari; Alireza Ansari-Moghaddam; Davood Anvari; Anayochukwu Edward Anyasodor; Jalal Arabloo; Morteza Arab-Zozani; Ayele Mamo Argaw; Muhammad Arshad; Judie Arulappan; Armin Aryannejad; Zatollah Asemi; Mohammad Asghari Jafarabadi; Mohammad Reza Atashzar; Prince Atorkey; Alok Atreya; Sameh Attia; Avinash Aujayeb; Marcel Ausloos; Leticia Avila-Burgos; Atalel Fentahun Awedew; Beatriz Paulina Ayala Quintanilla; Alemu Degu Ayele; Solomon Shitu Ayen; Mohammed A. Azab; Sina Azadnajafabad; Hiva Azami; Mohammadreza Azangou-Khyavy; Amirhossein Azari Jafari; Ghasem Azarian; Ahmed Y. Azzam; Saeed Bahadory; Jianjun Bai; Atif Amin Baig; Jennifer L. Baker; Maciej Banach; Till Winfried Bärnighausen; Francesco Barone-Adesi; Fabio Barra; Amadou Barrow; Huda Basaleem; Abdul-Monim Mohammad Batiha; Masoud Behzadifar; Niguss Cherie Bekele; Rebuma Belete; Uzma Iqbal Belgaumi; Arielle Wilder Bell; Alemshet Yirga Berhie; Devidas S. Bhagat; Akshaya Srikanth Bhagavathula; Nikha Bhardwaj; Pankaj Bhardwaj; Sonu Bhaskar; Krittika Bhattacharyya; Vijayalakshmi S. Bhojaraja; Sadia Bibi; Ali Bijani; Antonio Biondi; Setognal Birara; Tone Bjørge; Obasanjo Afolabi Bolarinwa; Srinivasa Rao Bolla; Archith Boloor; Dejana Braithwaite; Hermann Brenner; Norma B. Bulamu; Katrin Burkart; Maria Teresa Bustamante-Teixeira; Nadeem Shafique Butt; Zahid A. Butt; Florentino Luciano Caetano Dos Santos; Chao Cao; Yin Cao; Giulia Carreras; Ferrán Catalá-López; Francieli Cembranel; Ester Cerin; Raja Chandra Chakinala; Promit Ananyo Chakraborty; Vijay Kumar Chattu; Pankaj Chaturvedi; Akhilanand Chaurasia; Prachi P. Chavan; Odgerel Chimed-Ochir; Jee-Young Jasmine Choi; Devasahayam J. Christopher; Dinh-Toi Chu; Michael T. Chung; Joao Conde; Vera Marisa Costa; Omar B. Da; Omid Dadras; Saad M. A. Dahlawi; Xiaochen Dai; Giovanni Damiani; Emanuele D'Amico; Lalit Dandona; Rakhi Dandona; Parnaz Daneshpajouhnejad; Amira Hamed Darwish; Ahmad Daryani; Fernando Pio De La Hoz; Sisay Abebe Debela; Takele Gezahegn G. Demie; Getu Debalkie Demissie; Zeleke Geto Demissie; Edgar Denova-Gutiérrez; Meseret Derbew Molla; Rupak Desai; Abebaw Alemayehu Desta; Deepak Dhamnetiya; Samath Dhamminda Dharmaratne; Mandira Lamichhane Dhimal; Meghnath Dhimal; Mostafa Dianatinasab; Mojtaba Didehdar; Mengistie Diress; Shirin Djalalinia; Huyen Phuc Do; Saeid Doaei; Fariba Dorostkar; Wendel Mombaque Dos Santos; Thomas M. Drake; Michael Ekholuenetale; Iman El Sayed; Maysaa El Sayed Zaki; Maha El Tantawi; Hassan El-Abid; Mostafa Ahmed Elbahnasawy; Iffat Elbarazi; Hala Rashad Elhabashy; Muhammed Elhadi; Shaimaa I. El-Jaafary; Daniel Berhanie Enyew; Ryenchindorj Erkhembayar; Babak Eshrati; Sharareh Eskandarieh; Mohammed Faisaluddin; Jawad Fares; Umar Farooque; Abidemi Omolara Fasanmi; Wafa Fatima; José Miguel P. Ferreira De Oliveira; Simone Ferrero; Lorenzo Ferro Desideri; Getahun Fetensa; Irina Filip; Florian Fischer; James L. Fisher; Masoud Foroutan; Takeshi Fukumoto; Peter Andras Gaal; Mohamed M. Gad; Piyada Gaewkhiew; Silvano Gallus; Tushar Garg; Teferi Gebru Gebremeskel; Belete Negese Belete Gemeda; Tamiru Getachew; Mansour Ghafourifard; Seyyed-Hadi Ghamari; Ahmad Ghashghaee; Fariba Ghassemi; Nermin Ghith; Ali Gholami; Jamshid Gholizadeh Navashenaq; Syed Amir Gilani; Themba G. Ginindza; Abraham Tamirat Gizaw; James C. Glasbey; Amit Goel; Mahaveer Golechha; Pouya Goleij; Davide Golinelli; Sameer Vali Gopalani; Giuseppe Gorini; Houman Goudarzi; Bárbara Niegia Garcia Goulart; Ayman Grada; Mohammed Ibrahim Mohialdeen Gubari; Maximiliano Ribeiro Guerra; Avirup Guha; Bhawna Gupta; Sapna Gupta; Veer Bala Gupta; Vivek Kumar Gupta; Rasool Haddadi; Nima Hafezi-Nejad; Alemayehu Hailu; Arvin Haj-Mirzaian; Rabih Halwani; Randah R. Hamadeh; Mitiku Teshome Hambisa; Sajid Hameed; Samer Hamidi; Shafiul Haque; Sanam Hariri; Josep Maria Haro; Ahmed I. Hasaballah; S M. Mahmudul Hasan; Seyedeh Melika Hashemi; Treska S. Hassan; Soheil Hassanipour; Simon I. Hay; Khezar Hayat; Sultan H. Hebo; Golnaz Heidari; Mohammad Heidari; Brenda Yuliana Herrera-Serna; Claudiu Herteliu; Demisu Zenbaba Heyi; Kamal Hezam; Michael K. Hole; Ramesh Holla; Nobuyuki Horita; Md Mahbub Hossain; Mohammad Bellal Hossain; Mohammad-Salar Hosseini; Mostafa Hosseini; Ali Hosseinzadeh; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Mowafa Househ; Mohamed Hsairi; Junjie Huang; Nawfal R. Hussein; Bing-Fang Hwang; Segun Emmanuel Ibitoye; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Kaire Innos; Lalu Muhammad Irham; Rakibul M. Islam; Sheikh Mohammed Shariful Islam; Nahlah Elkudssiah Ismail; Gaetano Isola; Masao Iwagami; Louis Jacob; Farhad Jadidi-Niaragh; Vardhmaan Jain; Mihajlo Jakovljevic; Roksana Janghorban; Amirreza Javadi Mamaghani; Shubha Jayaram; Ranil Jayawardena; Seyed Behzad Jazayeri; Rime Jebai; Ravi Prakash Jha; Tamas Joo; Nitin Joseph; Farahnaz Joukar; Mikk Jürisson; Billingsley Kaambwa; Ali Kabir; Leila R. Kalankesh; Feroze Kaliyadan; Zul Kamal; Ashwin Kamath; Himal Kandel; Sitanshu Sekhar Kar; Ibraheem M. Karaye; Amirali Karimi; Bekalu Getnet Kassa; Joonas H. Kauppila; Phillip M. Kemp Bohan; Andre Pascal Kengne; Amene Abebe Kerbo; Mohammad Keykhaei; Yousef Saleh Khader; Himanshu Khajuria; Nastaran Khalili; Neda Khalili; Ejaz Ahmad Khan; Gulfaraz Khan; Maseer Khan; Md Nuruzzaman Khan; Moien A. B. Khan; Javad Khanali; Maryam Khayamzadeh; Omid Khosravizadeh; Jagdish Khubchandani; Roba Khundkar; Min Seo Kim; Yun Jin Kim; Adnan Kisa; Sezer Kisa; Katarzyna Kissimova-Skarbek; Ali-Asghar Kolahi; Jacek A. Kopec; Rajasekaran Koteeswaran; Sindhura Lakshmi Koulmane Laxminarayana; Ai Koyanagi; Nuworza Kugbey; G. Anil Kumar; Nithin Kumar; Alexander Kwarteng; Carlo La Vecchia; Qing Lan; Iván Landires; Savita Lasrado; Paolo Lauriola; Caterina Ledda; Sang-Woong Lee; Wei-Chen Lee; Yeong Yeh Lee; Yo Han Lee; James Leigh; Elvynna Leong; Bingyu Li; Jiarui Li; Ming-Chieh Li; Stephen S. Lim; Xuefeng Liu; Stany W. Lobo; Joana A. Loureiro; Alessandra Lugo; Raimundas Lunevicius; Hassan Magdy Abd El Razek; Muhammed Magdy Abd El Razek; Morteza Mahmoudi; Azeem Majeed; Alaa Makki; Shilpa Male; Mohammad-Reza Malekpour; Reza Malekzadeh; Ahmad Azam Malik; Mohammed A. Mamun; Navid Manafi; Fariborz Mansour-Ghanaei; Borhan Mansouri; Mohammad Ali Mansournia; Santi Martini; Seyedeh Zahra Masoumi; Clara N. Matei; Manu Raj Mathur; Colm McAlinden; Ravi Mehrotra; Walter Mendoza; Ritesh G. Menezes; Alexios-Fotios A. Mentis; Tuomo J. Meretoja; Amanual Getnet Mersha; Mohamed Kamal Mesregah; Tomislav Mestrovic; Junmei Miao Jonasson; Bartosz Miazgowski; Irmina Maria Michalek; Ted R. Miller; Alemu Basazin Mingude; Seyyedmohammadsadeq Mirmoeeni; Hamed Mirzaei; Sanjeev Misra; Prasanna Mithra; Karzan Abdulmuhsin Mohammad; Mokhtar Mohammadi; Seyyede Momeneh Mohammadi; Abdollah Mohammadian-Hafshejani; Reza Mohammadpourhodki; Arif Mohammed; Shafiu Mohammed; Teroj Abdulrahman Mohammed; Nagabhishek Moka; Ali H. Mokdad; Mariam Molokhia; Sara Momtazmanesh; Lorenzo Monasta; Mohammad Ali Moni; Ghobad Moradi; Yousef Moradi; Maliheh Moradzadeh; Rahmatollah Moradzadeh; Paula Moraga; Shane Douglas Morrison; Ebrahim Mostafavi; Amin Mousavi Khaneghah; Christine Mpundu-Kaambwa; Sumaira Mubarik; Lillian Mwanri; Ashraf F. Nabhan; Shankar Prasad Nagaraju; Chie Nagata; Mohsen Naghavi; Mukhammad David Naimzada; Luigi Naldi; Vinay Nangia; Atta Abbas Naqvi; Sreenivas Narasimha Swamy; Aparna Ichalangod Narayana; Biswa Prakash Nayak; Vinod C. Nayak; Javad Nazari; Sabina Onyinye Nduaguba; Ionut Negoi; Serban Mircea Negru; Seyed Aria Nejadghaderi; Samata Nepal; Sandhya Neupane Kandel; Haruna Asura Nggada; Cuong Tat Nguyen; Chukwudi A. Nnaji; Hamed Nosrati; Hasti Nouraei; Ali Nowroozi; Virginia Nuñez-Samudio; Vincent Ebuka Nwatah; Chimezie Igwegbe Nzoputam; Bogdan Oancea; Oluwakemi Ololade Odukoya; Ayodipupo Sikiru Oguntade; In-Hwan Oh; Andrew T. Olagunju; Tinuke O. 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Background: In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15–39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods: Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15–39 years to define adolescents and young adults. Findings: There were 1·19 million (95% UI 1·11–1·28) incident cancer cases and 396 000 (370 000–425 000) deaths due to cancer among people aged 15–39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59·6 [54·5–65·7] per 100 000 person-years) and high-middle SDI countries (53·2 [48·8–57·9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14·2 [12·9–15·6] per 100 000 person-years) and middle SDI (13·6 [12·6–14·8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23·5 million (21·9–25·2) DALYs to the global burden of disease, of which 2·7% (1·9–3·6) came from YLDs and 97·3% (96·4–98·1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation: Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. Funding: Bill & Melinda Gates Foundation, American Lebanese Syrian Associated Charities, St Baldrick's Foundation, and the National Cancer Institute. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
The global burden of cancer attributable to risk factors, 2010–19: a systematic analysis for the Global Burden of Disease Study 2019
(Elsevier B.V., 2022) Khanh Bao Tran; Justin J. Lang; Kelly Compton; Rixing Xu; Alistair R. Acheson; Hannah Jacqueline Henrikson; Jonathan M. Kocarnik; Louise Penberthy; Amirali Aali; Qamar Abbas; Behzad Abbasi; Mohsen Abbasi-Kangevari; Zeinab Abbasi-Kangevari; Hedayat Abbastabar; Michael Abdelmasseh; Sherief Abd-Elsalam; Ahmed Abdelwahab Abdelwahab; Gholamreza Abdoli; Hanan Abdulkadir Abdulkadir; Aidin Abedi; Kedir Hussein Abegaz; Hassan Abidi; Richard Gyan Aboagye; Hassan Abolhassani; Abdorrahim Absalan; Yonas Derso Abtew; Hiwa Abubaker Ali; Eman Abu-Gharbieh; Basavaprabhu Achappa; Juan Manuel Acuna; Daniel Addison; Isaac Yeboah Addo; Oyelola A. Adegboye; Miracle Ayomikun Adesina; Mohammad Adnan; Qorinah Estiningtyas Sakilah Adnani; Shailesh M. Advani; Sumia Afrin; Muhammad Sohail Afzal; Manik Aggarwal; Bright Opoku Ahinkorah; Araz Ramazan Ahmad; Rizwan Ahmad; Sajjad Ahmad; Sohail Ahmad; Sepideh Ahmadi; Haroon Ahmed; Luai A. Ahmed; Muktar Beshir Ahmed; Tarik Ahmed Rashid; Wajeeha Aiman; Marjan Ajami; Gizachew Taddesse Akalu; Mostafa Akbarzadeh-Khiavi; Addis Aklilu; Maxwell Akonde; Chisom Joyqueenet Akunna; Hanadi Al Hamad; Fares Alahdab; Fahad Mashhour Alanezi; Turki M. Alanzi; Saleh Ali Alessy; Abdelazeem M. Algammal; Mohammed Khaled Al-Hanawi; Robert Kaba Alhassan; Beriwan Abdulqadir Ali; Liaqat Ali; Syed Shujait Ali; Yousef Alimohamadi; Vahid Alipour; Syed Mohamed Aljunid; Motasem Alkhayyat; Sadeq Ali Ali Al-Maweri; Sami Almustanyir; Nivaldo Alonso; Shehabaldin Alqalyoobi; Rajaa M. Al-Raddadi; Rami H. Hani Al-Rifai; Salman Khalifah Al-Sabah; Ala’a B. Al-Tammemi; Haya Altawalah; Nelson Alvis-Guzman; Firehiwot Amare; Edward Kwabena Ameyaw; Javad Javad Aminian Dehkordi; Mohammad Hosein Amirzade-Iranaq; Hubert Amu; Ganiyu Adeniyi Amusa; Robert Ancuceanu; Jason A. Anderson; Yaregal Animut Animut; Amir Anoushiravani; Ali Arash Anoushirvani; Alireza Ansari-Moghaddam; Mustafa Geleto Ansha; Benny Antony; Maxwell Hubert Antwi; Sumadi Lukman Anwar; Razique Anwer; Anayochukwu Edward Anyasodor; Jalal Arabloo; Morteza Arab-Zozani; Olatunde Aremu; Ayele Mamo Argaw; Hany Ariffin; Timur Aripov; Muhammad Arshad; Al Artaman; Judie Arulappan; Raphael Taiwo Aruleba; Armin Aryannejad; Malke Asaad; Mulusew A. Asemahagn; Zatollah Asemi; Mohammad Asghari-Jafarabadi; Tahira Ashraf; Reza Assadi; Mohammad Athar; Seyyed Shamsadin Athari; Maha Moh’d Wahbi Atout; Sameh Attia; Avinash Aujayeb; Marcel Ausloos; Leticia Avila-Burgos; Atalel Fentahun Awedew; Mamaru Ayenew Awoke; Tewachew Awoke; Beatriz Paulina Ayala Quintanilla; Tegegn Mulatu Ayana; Solomon Shitu Ayen; Davood Azadi; Sina Azadnajafabad; Saber Azami-Aghdash; Melkalem Mamuye Azanaw; Mohammadreza Azangou-Khyavy; Amirhossein Azari Jafari; Hosein Azizi; Ahmed Y.Y. 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Bhuyan; Sadia Bibi; Awraris Hailu Bilchut; Bagas Suryo Bintoro; Antonio Biondi; Mesfin Geremaw Birega Birega; Habitu Eshetu Birhan; Tone Bjørge; Oleg Blyuss; Belay Boda Abule Bodicha; Srinivasa Rao Bolla; Archith Boloor; Cristina Bosetti; Dejana Braithwaite; Michael Brauer; Hermann Brenner; Andrey Nikolaevich Briko; Nikolay Ivanovich Briko; Christina Maree Buchanan; Norma B. Bulamu; Maria Teresa Bustamante-Teixeira; Muhammad Hammad Butt; Nadeem Shafique Butt; Zahid A. Butt; Florentino Luciano Caetano Dos Santos; Luis Alberto Cámera; Chao Cao; Yin Cao; Giulia Carreras; Márcia Carvalho; Francieli Cembranel; Ester Cerin; Promit Ananyo Chakraborty; Periklis Charalampous; Vijay Kumar Chattu; Odgerel Chimed-Ochir; Jesus Lorenzo Chirinos-Caceres; Daniel Youngwhan Cho; William C.S. Cho; Devasahayam J. Christopher; Dinh-Toi Chu; Isaac Sunday Chukwu; Aaron J. Cohen; Joao Conde; Sandra Cortés; Vera Marisa Costa; Natália Cruz-Martins; Garland T. Culbreth; Omid Dadras; Fentaw Teshome Dagnaw; Saad M.A. Dahlawi; Xiaochen Dai; Lalit Dandona; Rakhi Dandona; Parnaz Daneshpajouhnejad; Anna Danielewicz; An Thi Minh Dao; Reza Darvishi Cheshmeh Soltani; Aso Mohammad Darwesh; Saswati Das; Dragos Virgil Davitoiu; Elham Davtalab Esmaeili; Fernando Pio De La Hoz; Sisay Abebe Debela; Azizallah Dehghan; Biniyam Demisse; Fitsum Wolde Demisse; Edgar Denova-Gutiérrez; Afshin Derakhshani; Meseret Derbew Molla; Diriba Dereje; Kalkidan Solomon Deribe; Rupak Desai; Markos Desalegn Desalegn; Fikadu Nugusu Dessalegn; Samuel Abebe A. Dessalegni; Gashaw Dessie; Abebaw Alemayehu Desta; Syed Masudur Rahman Dewan; Samath Dhamminda Dharmaratne; Meghnath Dhimal; Mostafa Dianatinasab; Nancy Diao; Daniel Diaz; Lankamo Ena Digesa; Shilpi Gupta Dixit; Saeid Doaei; Linh Phuong Doan; Paul Narh Doku; Deepa Dongarwar; Wendel Mombaque dos Santos; Tim Robert Driscoll; Haneil Larson Dsouza; Oyewole Christopher Durojaiye; Sareh Edalati; Fatemeh Eghbalian; Elham Ehsani-Chimeh; Ebrahim Eini; Michael Ekholuenetale; Temitope Cyrus Ekundayo; Donatus U. Ekwueme; Maha El Tantawi; Mostafa Ahmed Elbahnasawy; Iffat Elbarazi; Hesham Elghazaly; Muhammed Elhadi; Waseem El-Huneidi; Mohammad Hassan Emamian; Luchuo Engelbert Bain; Daniel Berhanie Enyew; Ryenchindorj Erkhembayar; Tegegne Eshetu; Babak Eshrati; Sharareh Eskandarieh; Juan Espinosa-Montero; Farshid Etaee; Azin Etemadimanesh; Tahir Eyayu; Ifeanyi Jude Ezeonwumelu; Sayeh Ezzikouri; Adeniyi Francis Fagbamigbe; Saman Fahimi; Ildar Ravisovich Fakhradiyev; Emerito Jose A. Faraon; Jawad Fares; Abbas Farmany; Umar Farooque; Hossein Farrokhpour; Abidemi Omolara Fasanmi; Ali Fatehizadeh; Wafa Fatima; Hamed Fattahi; Ginenus Fekadu; Berhanu Elfu Feleke; Allegra Allegra Ferrari; Simone Ferrero; Lorenzo Ferro Desideri; Irina Filip; Florian Fischer; Roham Foroumadi; Masoud Foroutan; Takeshi Fukumoto; Peter Andras Gaal; Mohamed M. Gad; Muktar A. Gadanya; Abduzhappar Gaipov; Nasrin Galehdar; Silvano Gallus; Tushar Garg; Mariana Gaspar Fonseca; Yosef Haile Gebremariam; Teferi Gebru Gebremeskel; Mathewos Alemu Gebremichael; Yohannes Fikadu Geda; Yibeltal Yismaw Gela; Belete Negese Belete Gemeda; Melaku Getachew; Motuma Erena Getachew; Kazem Ghaffari; Mansour Ghafourifard; Seyyed-Hadi Ghamari; Mohammad Ghasemi Nour; Fariba Ghassemi; Ajnish Ghimire; Nermin Ghith; Maryam Gholamalizadeh; Jamshid Gholizadeh Navashenaq; Sherief Ghozy; Syed Amir Gilani; Paramjit Singh Gill; Themba G. Ginindza; Abraham Tamirat T. Gizaw; James C. 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Hassan; Soheil Hassanipour; Khezar Hayat; Golnaz Heidari; Mohammad Heidari; Zahra Heidarymeybodi; Brenda Yuliana Herrera-Serna; Claudiu Herteliu; Kamal Hezam; Yuta Hiraike; Mbuzeleni Mbuzeleni Hlongwa; Ramesh Holla; Marianne Holm; Nobuyuki Horita; Mohammad Hoseini; Md. Mahbub Hossain; Mohammad Bellal Hossain Hossain; Mohammad-Salar Hosseini; Ali Hosseinzadeh; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Mowafa Househ; Junjie Huang; Fernando N. Hugo; Ayesha Humayun; Salman Hussain; Nawfal R. Hussein; Bing-Fang Hwang; Segun Emmanuel Ibitoye; Pulwasha Maria Iftikhar; Kevin S. Ikuta; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Mustapha Immurana; Kaire Innos; Pooya Iranpour; Lalu Muhammad Irham; Md Shariful Islam; Rakibul M. Islam; Farhad Islami; Nahlah Elkudssiah Ismail; Gaetano Isola; Masao Iwagami; Linda Merin J; Abhishek Jaiswal; Mihajlo Jakovljevic; Mahsa Jalili; Shahram Jalilian; Elham Jamshidi; Sung-In Jang; Chinmay T. Jani; Tahereh Javaheri; Umesh Umesh Jayarajah; Shubha Jayaram; Seyed Behzad Jazayeri; Rime Jebai; Bedru Jemal; Wonjeong Jeong; Ravi Prakash Jha; Har Ashish Jindal; Yetunde O. John-Akinola; Jost B. Jonas; Tamas Joo; Nitin Joseph; Farahnaz Joukar; Jacek Jerzy Jozwiak; Mikk Jürisson; Ali Kabir; Salah Eddine Oussama Kacimi; Vidya Kadashetti; Farima Kahe; Pradnya Vishal Kakodkar; Laleh R. Kalankesh; Leila R. Kalankesh; Rohollah Kalhor; Vineet Kumar Kamal; Farin Kamangar; Ashwin Kamath; Tanuj Kanchan; Eswar Kandaswamy; Himal Kandel; HyeJung Kang; Girum Gebremeskel Kanno; Neeti Kapoor; Sitanshu Sekhar Kar; Shama D. Karanth; Ibraheem M. Karaye; André Karch; Amirali Karimi; Bekalu Getnet Kassa; Patrick D.M.C. Katoto; Joonas H. Kauppila; Harkiran Kaur; Abinet Gebremickael Kebede; Leila Keikavoosi-Arani; Gemechu Gemechu Kejela; Phillip M. Kemp Bohan; Maryam Keramati; Mohammad Keykhaei; Himanshu Khajuria; Abbas Khan; Abdul Aziz Khan Khan; Ejaz Ahmad Khan; Gulfaraz Khan; Md. Nuruzzaman Khan; Moien A.B. Khan; Javad Khanali; Khaled Khatab; Moawiah Mohammad Khatatbeh; Mahalaqua Nazli Khatib; Maryam Khayamzadeh; Hamid Reza Khayat Kashani; Mohammad Amin Khazeei Tabari; Mehdi Khezeli; Mahmoud Khodadost; Min Seo Kim; Yun Jin Kim; Adnan Kisa; Sezer Kisa; Miloslav Klugar; Jitka Klugarová; Ali-Asghar Kolahi; Pavel Kolkhir; Farzad Kompani; Parvaiz A. Koul; Sindhura Lakshmi Koulmane Laxminarayana; Ai Koyanagi; Kewal Krishan; Yuvaraj Krishnamoorthy; Burcu Kucuk Bicer; Nuworza Kugbey; Mukhtar Kulimbet; Akshay Kumar; G. Anil Kumar; Narinder Kumar; Om P. Kurmi; Ambily Kuttikkattu; Carlo La Vecchia; Arista Lahiri; Dharmesh Kumar Lal; Judit Lám; Qing Lan; Iván Landires; Bagher Larijani; Savita Lasrado; Jerrald Lau; Paolo Lauriola; Caterina Ledda; Sang-Woong Lee; Shaun Wen Huey Lee; Wei-Chen Lee; Yeong Yeh Lee; Yo Han Lee; Samson Mideksa Legesse; James Leigh; Elvynna Leong; Ming-Chieh Li; Stephen S. Lim; Gang Liu; Jue Liu; Chun-Han Lo; Ayush Lohiya; Platon D. Lopukhov; László Lorenzovici; Mojgan Lotfi; Joana A. Loureiro; Raimundas Lunevicius; Farzan Madadizadeh; Ahmad R. Mafi; Sameh Magdeldin; Soleiman Mahjoub; Ata Mahmoodpoor; Morteza Mahmoudi; Marzieh Mahmoudimanesh; Rashidul Alam Mahumud; Azeem Majeed; Jamal Majidpoor; Alaa Makki; Konstantinos Christos Makris; Elaheh Malakan Rad; Mohammad-Reza Malekpour; Reza Malekzadeh; Ahmad Azam Malik; Tauqeer Hussain Mallhi; Sneha Deepak Mallya; Mohammed A. Mamun; Ana Laura Manda; Fariborz Mansour-Ghanaei; Borhan Mansouri; Mohammad Ali Mansournia; Lorenzo Giovanni Mantovani; Santi Martini; Miquel Martorell; Sahar Masoudi; Seyedeh Zahra Masoumi; Clara N. Matei; Elezebeth Mathews; Manu Raj Mathur; Vasundhara Mathur; Martin McKee; Jitendra Kumar Meena; Khalid Mehmood; Entezar Mehrabi Nasab; Ravi Mehrotra; Addisu Melese; Walter Mendoza; Ritesh G. Menezes; SIsay Derso Mengesha; Laverne G. Mensah; Alexios-Fotios A. Mentis; Andry Yasmid Mera Mera-Mamián; Tuomo J. Meretoja; Mehari Woldemariam Merid; Amanual Getnet Mersha; Belsity Temesgen Meselu; Mahboobeh Meshkat; Tomislav Mestrovic; Junmei Miao Jonasson; Tomasz Miazgowski; Irmina Maria Michalek; Gelana Fekadu Worku Mijena; Ted R. Miller; Shabir Ahmad Mir; Seyed Kazem Mirinezhad; Seyyedmohammadsadeq Mirmoeeni; Mohammad Mirza-Aghazadeh-Attari; Hamed Mirzaei; Hamid Reza Mirzaei; Abay Sisay Misganaw; Sanjeev Misra; Karzan Abdulmuhsin Mohammad; Esmaeil Mohammadi; Mokhtar Mohammadi; Abdollah Mohammadian-Hafshejani; Reza Mohammadpourhodki; Arif Mohammed; Shafiu Mohammed; Syam Mohan; Mohammad Mohseni; Nagabhishek Moka; Ali H. 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Background: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods: The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk–outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings: Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01–4·94) deaths and 105 million (95·0–116) DALYs for both sexes combined, representing 44·4% (41·3–48·4) of all cancer deaths and 42·0% (39·1–45·6) of all DALYs. There were 2·88 million (2·60–3·18) risk-attributable cancer deaths in males (50·6% [47·8–54·1] of all male cancer deaths) and 1·58 million (1·36–1·84) risk-attributable cancer deaths in females (36·3% [32·5–41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6–28·4) and DALYs by 16·8% (8·8–25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9–42·8] and 33·3% [25·8–42·0]). Interpretation: The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Funding: Bill & Melinda Gates Foundation. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license