The increasing absolute burden was mainly associated with population aging, while risk-attributable analysis suggested a growing contribution of metabolic factors.
Abstract
Background Pancreatic cancer (PC) poses a significant public health challenge in China because of high mortality and increasing incidence, necessitating an analysis of its burden from 1990 to 2023 to inform future prevention. Methods Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023, we estimated absolute numbers, age-standardized rates (ASRs), and age-stratified crude rates. Joinpoint regression was employed to calculate average annual percentage changes (AAPCs). We quantified the burden attributable to specific risk factors and conducted a segmented analysis to compare trends between the pre-pandemic and pandemic periods. All estimates are presented with 95% uncertainty interval (UI). Results In 2023, China was estimated to have 118,381 incident PC cases (95% UI 103,773-135,339), 114,949 deaths (95% UI 101,214-131,619), 102,845 prevalent cases (95% UI 89,758-117,757), and 2,765,626 DALYs (95% UI 2,455,494-3,137,032). The age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized disability-adjusted life year rate (ASDR) remained stable. The age-standardized prevalence rate (ASPR) increased slightly (AAPC 0.38%, 95% CI 0.06 to 0.70). The burden was consistently higher in males than in females. Age-specific analysis highlighted rising incidence rates in both 15–49 years and ≥75 years age groups. In 2023, high fasting plasma glucose (HFPG) accounted for a higher attributable burden than smoking. Pandemic-era sensitivity analysis suggested a possible change in the direction of ASIR and ASMR trends after 2019, but the observed post-2019 increases were not statistically significant and require further validation. Conclusion The increasing absolute burden was mainly associated with population aging, while risk-attributable analysis suggested a growing contribution of metabolic factors. Prevention strategies should integrate metabolic management to tackle the dual challenges of an aging society and emerging risks in younger people.
Pancreatic cancer (PC) remains a major global health burden characterized by high mortality and substantial socioeconomic inequality. This study compared long-term trends, inequality patterns, and risk-factor transitions of PC burden in China and the United States from 1990 to 2023.
Using Global Burden of Disease Study (GBD) 1990–2023 data, we analyzed incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of PC. Temporal trends were assessed using Joinpoint regression analysis, calculating annual percent changes (APCs) and average annual percent changes (AAPCs). Socioeconomic inequalities were evaluated using the slope index of inequality (SII) and concentration index (CIX). Population attributable fractions (PAFs) were used to quantify major risk factors.
In 2023, China had more cases than the United States (103,000
vs.
66,000) but lower age-standardized prevalence (4.51
vs.
11.19), incidence (5.13
vs.
10.53), mortality (4.97
vs.
9.56) and DALYs per 100,000. From 1990 to 2023, burden increased in both countries, although age-standardized DALYs declined slightly in China (AAPC −0.15%) and increased in the United States (0.12%). Burden peaked at 60–74 years in China and shifted to older ages in the United States. Sex differences diminished with age and became non-significant in the oldest age groups. Globally, the burden remained concentrated in high socio-demographic index (SDI) with widening inequality. High fasting plasma glucose surpassed tobacco use as the leading attributable risk factor in the United States and became a major contributor in China.
China had a higher absolute burden but lower age-standardized rates (ASR) than the United States. The United States burden was more concentrated in older age groups, while the global burden remained concentrated in high-SDI regions with widening inequality. Rising high fasting plasma glucose underscores the need for metabolic risk management in PC prevention.
Miao Li, Bing-Qing Wu, Bo Ma et al.· Journal of Pancreatology· 0 citations
Background: Iraq carries a disproportionately high burden of bladder cancer compared with global averages, with limited contemporary epidemiological characterization. This study provides a comprehensive analysis of BC burden in Iraq using GBD-2023 data from 1990 to 2023, with projections to 2035.
Subjects and Methods: Data were extracted from the GBD-2023 database. Incidence, deaths, DALYs, YLLs, and YLDs were analyzed. Average annual percentage change was computed using log-linear regression. Risk factors were assessed through GBD-2023 comparative risk assessment data. Projections to 2035 used join point-derived trend parameters applied to UN World Population Prospects 2024.
Results: In 2023, Iraq recorded 4,866 new BC cases, 1,848 deaths, and 48,433 DALYs, increases of 482.9%, 329.6%, and 349.6%, respectively, from 1990. The age-standardized incidence rate (ASIR) rose from 10.52 to 19.15 per 100,000 compared to a global fall from 7.25 to 6.30 per 100,000. Iraq's ASIR in 2023 was 3.0 times the global average; its age-standardized mortality rate was 3.4 times the global figure; and its age-standardized DALY rate was 3.7 times the global figure. Female rates rose proportionally faster (AAPC: +2.35% vs +1.94%). Smoking contributed 33.6% of DALYs in 2023, down from 36.9% in 1990, while the contribution of hyperglycemia rose from 8.3% to 12.6%. Approximately 8,400 BC cases are projected by 2035.
Conclusions: Iraq carries an increasingly disproportionate bladder cancer burden compared to global rates, with significantly rising age-standardized rates in contrast to the declining global trend. Two modifiable risk factors should be prioritized in future targeted intervention: smoking and hyperglycemia.
Samir Muter, Matthew Harper· AL-Kindy College Medical Jou...· 0 citations
The prevalence of gastric cancer (GC) in China, India, and the USA has different epidemiology, but comparative analyses with regard to their time trends and causes are underdeveloped. Using the 2023 Global Burden of Disease (GBD) database (1990–2023), we evaluated GC trends via Joinpoint regression. Das Gupta decomposition and comparative risk assessment quantified demographic/epidemiological drivers and behavioral risks. ARIMA models projected the burden through 2040. Globally, gastric cancer age-standardized incidence rates (ASIR) declined from 26.31 to 14.00 per 100,000 between 1990 and 2023, whereas absolute incident cases increased from 1.05 to 1.28 million. China maintained the highest disease burden in 2023 (ASIR: 25.04/100,000) despite achieving the steepest reductions in age-standardized incidence, mortality, and DALY rates. India demonstrated the slowest decline in age-standardized rates, while incident cases nearly doubled from 42,800 to 85,400 during the study period. Joinpoint analysis identified significant upward ASIR trends after 2020 in China (APC = 3.62) and globally (APC = 1.61). Smoking remained the leading attributable risk factor, particularly in China. Decomposition analysis showed that population aging and growth were the principal drivers of increasing absolute burden. ARIMA projections suggested that China will continue to carry the highest gastric cancer burden through 2040. Despite declining standardized rates, population aging and growth continue to drive absolute case numbers upward. To mitigate this evolving burden, China requires optimized early screening and stringent behavioral risk control; India needs expanded cancer registry coverage and equitable rural healthcare access; while the USA should prioritize targeted strategies to mitigate internal disparities among subpopulations.
Feng Lin, Xue-Ying Wei, Li-Huan Song et al.· Discover Oncology· 0 citations
OBJECTIVE
Cervical cancer remains a major public health challenge among women in China. This study aimed to comprehensively assess long-term trends and future projections of cervical cancer burden in China.
METHODS
Data on cervical cancer in China from 1990 to 2023 were extracted from Global Burden of Disease Study2023. Prevalence, incidence, deaths, years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life years (DALYs), and age-standardized rates (ASRs) were analyzed. Temporal trends were evaluated using estimated annual percentage change (EAPC) and Joinpoint regression. Das Gupta decomposition quantified the contributions of population growth, aging, and epidemiological change. Nordpred was used to project deaths and DALYs from 2024 to 2045.
RESULTS
From 1990 to 2023, prevalent cervical cancer cases increased from 445,795 (95% uncertainty interval [UI]=301,749-642,609) to 752,306 (95% UI=481,273 to 1,011,544). YLDs increased by 62%, whereas YLLs decreased by 4%. Overall DALYs decreased slightly from 1,457,115 (95% UI=1,070,025 to 2,064,940) to 1,430,054 (95% UI=896,628 to 1,874,757), while deaths increased by 16%. Age-standardized DALYs rate (ASDR) declined from 294.14 to 132.72 per 100,000 population, with an EAPC of -2.43 (95% confidence interval=-2.54 to -2.33). Decomposition showed that population aging and growth offset favorable epidemiological changes, and projections suggested continued declines in ASDR with relatively stable deaths through 2045.
CONCLUSION
Despite sustained declines in ASRs, the absolute burden of cervical cancer in China remains considerable due to demographic shifts. These findings underscore the urgent need to strengthen human papillomavirus vaccination coverage and expand equitable cervical cancer screening programs.
Chao Ma, P. Yin, Nan Hong· Journal of Gynecologic Oncol...· 0 citations
Cervical cancer burden attributable to unsafe sex showed the highest DALY rate among females aged 50-69 years and the highest mortality rate among those aged 70 years or older, and overall, cervical cancer burden exhibited an inverse association with SDI.
Seohyun Shin, Dongjin Yeo, Hyunjee Kim et al.· European Journal of Obstetri...· 0 citations
Objectives To comprehensively assess the gastric cancer burden in China over the past three decades and analyze its epidemiological trends to inform control strategies. Study design This was a population-based observational study that systematically evaluated the burden of gastric cancer in China from 1990 to 2023, utilizing data from the Global Burden of Disease (GBD) 2023 study. Methods We evaluated gastric cancer burden metrics from GBD 2023, including incidence, mortality, YLLs, YLDs, and DALYs. Joinpoint regression and age-period-cohort modeling were employed to analyze trends and epidemiological characteristics. Results Between 1990 and 2023, the age-standardized incidence rate decreased from 54.23 to 25.04 per 100,000 , and mortality decreased from 50.93 to 16.62 per 100,000. Joinpoint analysis showed an average annual percentage change of -2.8% in incidence, with a significant trend reversal in females during 2020-2023. Age-period-cohort analysis revealed peak risk at 65-69 years and lower risk in recent birth cohorts. Conclusions While China has achieved substantial reductions in gastric cancer burden over 34 years, emerging challenges include trend reversals in females and persistent sex disparities, necessitating targeted prevention strategies.
Xin Liu, Shuqiang Cheng, Hanlin Yang et al.· Public Health in Practice· 0 citations
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