Objective To analyze the current status and temporal trends of the disease burden of spinal fractures in China from 1990 to 2021 based on data from the Global Burden of Disease Study 2021 (GBD 2021), aiming to provide evidence for developing prevention and treatment strategies. Methods Epidemiological data on spinal fractures in China, the United States of America (USA), and globally were extracted from the GBD 2021 database. Joinpoint regression models were applied to analyze temporal trends. Age-standardized incidence, prevalence, and disability-adjusted life years (DALYs) rates were calculated, with comparisons of gender- and age-group disparities. Results In 2021, the number of incident cases, prevalent cases, and DALYs of spinal fractures in China increased by 52.28%, 113.68%, and 106.98%, respectively, compared to 1990. The age-standardized incidence, prevalence, and DALYs rates rose by 11.80%, 16.11%, and 14.79%, respectively. The disease burden escalated significantly with age, peaking in individuals aged ≥75 years. Males exhibited higher age-standardized incidence and DALYs rates than females. Comparative analysis revealed that the age-standardized DALYs rate in China (4.19/100 000) was lower than that in globally (6.62/100 000) and USA (15.92/100 000). However, China showed an upward trend [annual average percentage change (AAPC)=0.19%], contrasting with a declining trend in the USA (AAPC=–0.08%). ConclusionThe escalating disease burden of spinal fractures in China is closely linked to population aging, gender disparities, and insufficient targeted prevention policies. Future strategies should integrate age- and gender-specific interventions, including strengthened osteoporosis prevention, trauma risk control, and big data-driven precision measures, to mitigate this burden.
Objective The aim of this study was to describe the trends in the burden of breast cancer in women of all ages in China from 1990 to 2021, compare it with the global burden of breast cancer in women, and predict the burden of disease in the next 15 years. Methods Based on the open data of the Global Burden of Disease (GBD) in 2021, the incidence, prevalence, mortality and disability-adjusted life years (DALYs) of breast cancer among women in China and the world were analyzed. Joinpoint was used to calculate annual percentage change (APC) and average annual percentage change (AAPC) to reflect the changing trend of disease burden. An autoregressive composite moving average (ARIMA) model was used to predict the disease burden of breast cancer in women from 2022 to 2036. Results From 1990 to 2021, the age-standardized incidence rate (ASIR) and age-standardized prevalence rate (ASPR) of female breast cancer in China showed an increasing trend, with an average annual increase of 2.400 7% and 2.334 8%, respectively, and the age-standardized mortality rate (ASMR) and age-standardized DALYs rate (ASDR) showed a decreasing trend. The average annual decline was 0.290 0% and 0.198 3%, respectively. Meanwhile, ASIR and ASPR of global female breast cancer also showed an increasing trend, with an average annual increase of 0.474 9% and 0.3445 2% respectively, while ASMR and ASDR showed a decreasing trend, with an average annual decrease of 0.425 2% and 0.321 8% respectively. Among them, there were differences in the impact of age on the burden of female breast cancer. The peak of ASIR and ASPR appeared in the age group of 50 to 69 years old, and generally increased with the increase of age, and then decreased when reaching the peak. ASMR and ASDR increased with age. In the following 15 years, the prevalence of breast cancer in women in China and globally showed an increasing trend, while the mortality rate showed a decreasing trend. Conclusion From the analysis of the disease burden from 1990 to 2021, breast cancer has a huge harm to women, and the incidence of young and middle-aged women is high, the death rate of middle-aged and elderly women is high, and the disease time is long, which brings a heavy psychological and economic burden to patients and society. From the trend forecast for the next 15 years, the prevalence of breast cancer in women in China and the world will increase, while the mortality rate will decrease slightly, but the decrease is not large, which will bring huge public health challenges and put higher requirements on the prevention and control of the disease. To reduce the disease burden of breast cancer, comprehensive strategies for disease control are needed, including prevention of risk factors at the primary care level, screening of at-risk populations, and quality medical services.
Objective To investigate financial burden of in-patients with hypothalamus-pituitary-adrenal gland/gonad diseases in the West China Hospital of Sichuan University, 2011, so as to provide baseline data for further research. Methods The data of in-patients (who had been discharged from the department of endocrinology and metabolism or discharged after being transferred to other departments for diagnosis and treatment in the West China Hospital in 2011) were collected from the Hospital Information System (HIS) of the West China Hospital, including basic information, initial diagnosis when the patients were discharged, hospital costs, the information about whether the patients had been registered the insurance in hospital, etc. We classified diseases according to ICD-10 based on the initial diagnosis when the patients were discharged on the first page of case reports. The data were input using Excel 2010 software, and statistical analysis was performed using SPSS 13.0 software. Results The results showed that: in 2011, 352 person-times of in-patients with hypothalamus-pituitary-adrenal gland/gonad disease as first diagnosis were hospitalized in the department of endocrinology and metabolism, of which, 139 were male and 213 were female, with mean age of 42.9±15.0 years; and b) median hospital stay was 11 days, the average cost of hospital stay for each patient was RMB 4 361.09 yuan, most of which was for lab tests, examination, and biomedicine cost. Conclusion Hypothalamus-pituitary-adrenal gland/gonad diseases are an important health problem in the department of endocrinology and metabolism in a Triple-A Hospital. Most of hospitalization costs are for lab tests, examination, and biomedicine cost.
ObjectiveTo analyze the epidemiological burden and trend of skin malignant melanoma in China based on the data from the global burden of disease 2019 (GBD 2019). MethodsThe data about quantity of incidences/illnesses/deaths, age-standardized incidence/prevalence rates/mortality, disability-adjusted life years (DALYs), and DALY rate of skin malignant melanoma in China from 1990 to 2019 were obtained from the GBD 2019 databases. The epidemiological trends, age-period-cohort trends, and the relationship between the incidence and sociodemographic index (SDI) were analyzed.ResultsIn 2019, both prevalence and incidence of skin malignant melanoma in China were at low levels in the world, the age-standardized mortality ranked the 35th in the 204 countries GBD researched, the number of prevalent cases and incident cases increased compared with 1990 (12.65% and 3.57%, respectively), the prevalence and incidence rates showed growth trends, while the DALY rate and mortality decreased slowly. The prevalence of skin malignant melanoma peaked age at 50 to 54 years old. The incidence peak age of males was older than that of females (55-59 years old for males vs. 50-54 years old for females), while the mortality peak age of males was younger than that of females (55-59 years old for males vs. 75-79 years old for females). With the increasing of SDI value, the incidence of skin malignant melanoma showed a linear growth trend. DALY rate was negatively correlated with SDI (P<0.05). ConclusionFrom 1990 to 2019, age-standardized incidence and prevalence of skin malignant melanoma in China are increasing, while DALY rate and mortality are decreasing, and these are correlated with social and medical development.
ObjectiveTo systematically analyze the spatiotemporal distribution characteristics and epidemiological trends of tracheal, bronchus, and lung cancer (TBL) disease burden attributed to air pollution globally and in China and the United States from 1990 to 2021. Furthermore, based on predictive models, assess the patterns of disease burden changes from 2022 to 2031, providing a scientific basis for formulating targeted TBL prevention and control strategies. MethodsBased on the Global Burden of Disease (GBD) 2021 database, we analyzed the disease burden data of TBL attributed to air pollution globally and in China and the United States from 1990 to 2021. R Studio 4.3.2 software was used to analyze the corresponding trends and the Bayesian age-period-cohort (BAPC) prediction model was used to predict the status of the disease burden of TBL attributed to air pollution in the world and in China and the United States from 2022 to 2031. ResultsIn 2021, the highest number of deaths and disability-adjusted life years attributed to air pollution were in China (211 400 patients and 4.8947 million person-years), followed by the United States (6 000 patients and 124 300 person-years). The age standardized mortality rate (ASMR) and age standardized disability-adjusted life years rate (ASDR) of TBL due to air pollution in the world and in China and the United States showed a decreasing trend (with an average annual percentage change of<0). From 1990 to 2021, the ASMR and ASDR of TBL in China due to air pollution were much higher than those in the United States and the global average. In terms of gender, from 1990 to 2021, the disease burden of male patients with TBL attributed to air pollution in the world and in China and the United States was much higher than that of female patients. The BAPC prediction model showed that from 2022 to 2031, the ASMR and ASDR of TBL attributed to air pollution will showed an upward trend globally, while they showed a downward trend in China and the United States. ConclusionOver the past 30 years, the air pollution-related TBL disease burden in the world and in China and the United States has continued to decline, but China's level is still significantly higher than the global average. The disease burden in men far exceeds that in women, with men and the elderly population aged ≥50 years being high-risk groups. In the future, the global disease trend may reverse and rise, while China and the United States are expected to continuously decline. However, precise prevention and control for high-risk groups remains a key challenge.
Clarifying the burden of disease is of great significance for determining the focus of healthcare and optimizing the allocation of medical resources. However, differences in research methods and assumptions often affect the comparability of different research results, thus leading to difficulties in healthcare decision-making. Disability-adjusted life year (DALY) is the most commonly used indicator to measure the burden of disease, but the reporting quality of disease burden studies using the DALY metric is uneven. To standardize the reporting of such studies, international scholars developed and recently published the STROBOD statement in Population Health Metrics. Its checklist includes seven parts: title, abstract, introduction, methods, results, discussion, and open science, involving a total of 28 items. To assist domestic scholars in better understanding and applying this reporting standard, this article interprets each item with published examples, aiming to improve the overall quality of disease burden research and provide high-quality evidence for public health decision-making.
目的 评估中医药临床研究是否与我国主要疾病负担相关。 方法 首先从1999年－2004年出版的13种中医、中西医结合杂志中手工检索出随机对照试验（RCT），并提取出杂志名称、出版年限、治疗的疾病类别及样本含量等数据。然后采用死亡率和伤残调整寿命年（DALY）作为衡量标准，统计2002年我国疾病负担前30位病因的RCT数量，采用秩相关分析这些疾病负担与发表的中医药RCT及其受试者数量的关系。 结果 最终确认7 422个RCT，约38%的RCT来自于3种国家级杂志。这些RCT覆盖了我国疾病负担中的主要病种，其中4 280个RCT（57.7%）研究前30位病因合并产生的42个病种，只有3个病种（7%）没有任何RCT研究。采用DALY得到的相关系数分别是0.108（P=0.569）、0.092（P=0.628），通过死亡率产生的相关系数分别是0.453（P=0.012）、0.536（P=0.002）。 结论 中医药RCT与采用死亡率衡量的疾病负担明显相关，但采用DALY分析却未发现二者存在相关性。中医药临床研究可能更注重死亡率高的病种，一定程度上忽略了DALY衡量的疾病负担。
Objective To systematically review the incidence, mortality and disease burden of colorectal cancer (CRC) in China. Methods The CNKI, WanFang Data, VIP, CBM, PubMed, Embase and Web of Science databases were searched to collect cohort studies about the incidence, mortality and disease burden of CRC in China from the establishment of the database to July 2024. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by using Stata 18.0 software. Results A total of fifty-six studies were included. The result of meta-analysis showed that the overall incidence of CRC in China was 31‰ (95%CI 29‰ to 33‰), and the incidence of male was 35‰ (95%CI 32‰ to 37‰). The female incidence was 27‰ (95%CI 25‰ to 29‰). The overall mortality of CRC in China was 20‰ (95%CI 17‰ to 22‰), of which the male mortality was 22‰ (95%CI 19‰ to 25‰), and the female mortality was 18‰ (95%CI 15‰ to 20‰). Conclusion The incidence and mortality rates of CRC in China are high, resulting in a significant disease burden that varies regionally. The incidence and mortality of males are significantly higher than those of females. Intervention measures should be taken to reduce the disease burden of CRC in China according to the related risk factors of CRC.
ObjectiveTo analyze and compare the disease burden, trends, and influencing factors of lung cancer in adolescents and young adults (AYAs) in China and globally from 1990 to 2021, providing a reference for the prevention and treatment of lung cancer in China. MethodsIndicators of lung cancer disease burden in different genders and age groups in 204 countries or regions from 1990 to 2021 were retrieved and standardized from GBD 2021 database. The Joinpoint regression model was used to calculate the average annual percentage change (AAPC) of the standardized rates of lung cancer in AYAs in China and globally from 1990 to 2021; changes in incidence, mortality, and disability-adjusted life years (DALYs) rates due to population growth, aging, and epidemiological changes were analyzed; differences in lung cancer disease burden in AYAs in different socio-demographic index (SDI) regions were analyzed; and the influencing factors of lung cancer in AYAs in China and globally were explored. ResultsFrom 1990 to 2021, the age-standardized incidence rate (ASIR) (AAPC=−0.18%, P<0.001), age-standardized mortality rate (ASMR) (AAPC=−0.62%, P<0.001), and age-standardized DALYs rate (AAPC=−0.62%, P<0.001) of lung cancer in AYAs in China showed a downward trend, consistent with the global trend, but the decline in China was relatively small. During this period, the age-standardized rates of various indicators of lung cancer in males in China and globally were higher than those in females, and the burden of lung cancer in Chinese males was heavier. However, due to the significant downward trend in males, the gap in lung cancer burden between males and females was narrowing. At the same time, from 2013 to 2021, the ASIR [annual percent change (APC)=2.01%, P<0.001], ASMR (APC=1.46%, P<0.001), and standardized DALYs rate (APC=1.46%, P<0.001) in China showed an upward trend. From 1990 to 2021, among the main influencing factors for the incidence, mortality, and DALYs rates of lung cancer in Chinese AYAs, the contribution of aging was upward-pushing, while the increase in global indicators was mainly attributed to population growth. The global burden of lung cancer in AYAs was overly concentrated in high SDI regions. Although the gap in lung cancer burden between high SDI and low SDI regions was narrowing, it remained widespread. Globally, smoking, environmental PM2.5, insufficient fruit intake, second-hand smoke, and indoor air pollution were prominent risk factors. ConclusionFrom 1990 to 2021, the global and Chinese AYAs lung cancer incidence and mortality rates generally show a downward trend, but the female lung cancer burden relatively increases, especially in young women without a history of smoking. Continued efforts are needed to reduce the burden of lung cancer in AYAs, especially the specific risk for young women.
ObjectivesTo estimate the latest burden of disability adjusted life years (DALYs) for liver cancer in China and the long-term trend, and to make future prediction.MethodsBased on the visualization platform of Global Burden of Disease 2016, data on the DALYs for liver cancer in China was extracted. The very recent status in 2016 and the previous trend from 1990 to 2016 were described, using annualized rate of change (ARC). The burden from 2017 to 2050 was further predicted by combining the ARC and the Chinese population data projected by the United Nation.ResultsIn 2016, the total DALYs for liver cancer in China was estimated as 11 539 000 person years (accounting for 54.6% of the global burden), and years of life lost (YLLs) and years lived with disability (YLDs) contributed 98.9% and 1.1%, respectively. The age-standardized DALY rate was 844.1 per 100 000 (3.0 times of the global average) and the male-to-female ratio was 3.4. The DALY rate continuously increased from 1990–2016 (ARC=0.57%), particularly in recent 5 years (ARC=1.75%). Among the DALYs for all cancers, liver cancer contributed approximately 20% and constantly remained as the top 2 (ranking as the number one before year 2005). There were inverse trends in gender, with increasing in males and decreasing in females (ARC was 0.77% and –0.11%, respectively). Hepatitis B infection continually kept the leading cause of DALYs for liver cancer (accounting for nearly 57%), and the DALY rate was gradually increasing (ARC=0.43%). Although the peak age of DALY rate was stable at 65to 69 years, the peak age of the DALYs changed from 55 to 59 years in 1990 to 60 ~ 64 years in 2016. In 2050, the estimated DALYs for liver cancer in China will reach 14.37 million person years, 20.0% more than that in 2017.ConclusionsThe DALYs caused by liver cancer in China exceeds the overall burden of all other countries in the world, and accounts for 1/5 of DALYs for all cancers in local population. The burden in males has been continuously rising, and the leading cause remained unchanged as hepatitis B infection. With population aging, the DALYs for liver cancer in China will be incessant to increase, suggesting the necessity to implement continuous effort in risk factors prevention (e.g. hepatitis B infection), and efficient management in high risk population of liver cancer.