Age-standardized YLL, YLD, and DALY rates (95% UI) and country ranks (from best to worst) for Poland and other Central European countries, for both sexes combined, males, and females, in 1990 and 2017.

Age-standardized YLL, YLD, and DALY rates (95% UI) and country ranks (from best to worst) for Poland and other Central European countries, for both sexes combined, males, and females, in 1990 and 2017.</p

Changes in disease burden in Poland between 1990–2017 in comparison with other Central European countries: A systematic analysis for the Global Burden of Disease Study 2017 - Fig 3

Leading Level 4 causes of YLLs (a), YLDs (b), and DALYs (c) in Central European countries, with the ratio of observed to expected (OER) age-standardized rates by location: (a) YLLs, (b) YLDs, (c) DALYs. Colors represent OER ranges: 0–0.54 = blue, 0.55–0.69 = green, 0.70–0.84 = light green, 0.85–0.99 = yellow green, 1.0 = white, 1.01–1.24 = dark yellow, 1.25–1.66 = orange, 1.67–2.91 = dark orange, 2.92+ = red.</p

Observed-to-expected ratios for age-standardized YLL, YLD, and DALY rates for both sexes from all causes in Central European countries in 2017.

Observed-to-expected ratios for age-standardized YLL, YLD, and DALY rates for both sexes from all causes in Central European countries in 2017.</p

Ranking of Central European countries according to all-cause DALY rates for both sexes combined in 1990 and 2017, by age categories.

Ranking of Central European countries according to all-cause DALY rates for both sexes combined in 1990 and 2017, by age categories.</p

Changes in disease burden in Poland between 1990–2017 in comparison with other Central European countries: A systematic analysis for the Global Burden of Disease Study 2017 - Fig 1

Age-standardized rates in 2017 (left) and relative (%) change from 1990 to 2017 (right) for YLLs, YLDs, and DALYs for males, females, and both sexes combined for Poland, Eastern Europe, Central Europe, and Western Europe.</p

Top 25 Level 3 causes of YLLs, YLDs, and DALYs in Poland in 2017 for both sexes combined, males, and females, and changes in ranks, counts, all-age rates, and age-standardized rates between 1990 and 2017.

Top 25 Level 3 causes of YLLs, YLDs, and DALYs in Poland in 2017 for both sexes combined, males, and females, and changes in ranks, counts, all-age rates, and age-standardized rates between 1990 and 2017.</p

Ranking of CE countries according to age-standardized DALY rates, for both sexes combined, in 1990 and 2017.

Ranking of CE countries according to age-standardized DALY rates, for both sexes combined, in 1990 and 2017.</p

All-age rates, percentage contribution, and relative (%) change for Level 1 causes of YLLs, YLDs, and DALYs for Poland and Central Europe, both sexes combined, in 1990 and 2017.

All-age rates, percentage contribution, and relative (%) change for Level 1 causes of YLLs, YLDs, and DALYs for Poland and Central Europe, both sexes combined, in 1990 and 2017.</p

Global, regional, and national burden of respiratory tract cancers and associated risk factors from 1990 to 2019 a systematic analysis for the Global Burden of Disease Study 2019

BackgroundPrevention, control, and treatment of respiratory tract cancers are important steps towards achieving target 3.4 of the UN Sustainable Development Goals (SDGs)-a one-third reduction in premature mortality due to non-communicable diseases by 2030. We aimed to provide global, regional, and national estimates of the burden of tracheal, bronchus, and lung cancer and larynx cancer and their attributable risks from 1990 to 2019.MethodsBased on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 methodology, we evaluated the incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs) of respiratory tract cancers (ie, tracheal, bronchus, and lung cancer and larynx cancer). Deaths from tracheal, bronchus, and lung cancer and larynx cancer attributable to each risk factor were estimated on the basis of risk exposure, relative risks, and the theoretical minimum risk exposure level input from 204 countries and territories, stratified by sex and Socio-demographic Index (SDI). Trends were estimated from 1990 to 2019, with an emphasis on the 2010-19 period.FindingsGlobally, there were 2·26 million (95% uncertainty interval 2·07 to 2·45) new cases of tracheal, bronchus, and lung cancer, and 2·04 million (1·88 to 2·19) deaths and 45·9 million (42·3 to 49·3) DALYs due to tracheal, bronchus, and lung cancer in 2019. There were 209 000 (194 000 to 225 000) new cases of larynx cancer, and 123 000 (115 000 to 133 000) deaths and 3·26 million (3·03 to 3·51) DALYs due to larynx cancer globally in 2019. From 2010 to 2019, the number of new tracheal, bronchus, and lung cancer cases increased by 23·3% (12·9 to 33·6) globally and the number of larynx cancer cases increased by 24·7% (16·0 to 34·1) globally. Global age-standardised incidence rates of tracheal, bronchus, and lung cancer decreased by 7·4% (-16·8 to 1·6) and age-standardised incidence rates of larynx cancer decreased by 3·0% (-10·5 to 5·0) in males over the past decade; however, during the same period, age-standardised incidence rates in females increased by 0·9% (-8·2 to 10·2) for tracheal, bronchus, and lung cancer and decreased by 0·5% (-8·4 to 8·1) for larynx cancer. Furthermore, although age-standardised incidence and death rates declined in both sexes combined from 2010 to 2019 at the global level for tracheal, bronchus, lung and larynx cancers, some locations had rising rates, particularly those on the lower end of the SDI range. Smoking contributed to an estimated 64·2% (61·9-66·4) of all deaths from tracheal, bronchus, and lung cancer and 63·4% (56·3-69·3) of all deaths from larynx cancer in 2019. For males and for both sexes combined, smoking was the leading specific risk factor for age-standardised deaths from tracheal, bronchus, and lung cancer per 100 000 in all SDI quintiles and GBD regions in 2019. However, among females, household air pollution from solid fuels was the leading specific risk factor in the low SDI quintile and in three GBD regions (central, eastern, and western sub-Saharan Africa) in 2019.InterpretationThe numbers of incident cases and deaths from tracheal, bronchus, and lung cancer and larynx cancer increased globally during the past decade. Even more concerning, age-standardised incidence and death rates due to tracheal, bronchus, lung cancer and larynx cancer increased in some populations-namely, in the lower SDI quintiles and among females. Preventive measures such as smoking control interventions, air quality management programmes focused on major air pollution sources, and widespread access to clean energy should be prioritised in these settings

The global epidemiology and health burden of the autism spectrum: findings from the Global Burden of Disease Study 2021

Background: High-quality estimates of the epidemiology of the autism spectrum and the health needs of autistic people are necessary for service planners and resource allocators. Here we present the global prevalence and health burden of autism spectrum disorder from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 following improvements to the epidemiological data and burden estimation methods. Methods: For GBD 2021, a systematic literature review involving searches in PubMed, Embase, PsycINFO, the Global Health Data Exchange, and consultation with experts identified data on the epidemiology of autism spectrum disorder. Eligible data were used to estimate prevalence via a Bayesian meta-regression tool (DisMod-MR 2.1). Modelled prevalence and disability weights were used to estimate health burden in years lived with disability (YLDs) as the measure of non-fatal health burden and disability-adjusted life-years (DALYs) as the measure of overall health burden. Data by ethnicity were not available. People with lived experience of autism were involved in the design, preparation, interpretation, and writing of this Article. Findings: An estimated 61·8 million (95% uncertainty interval 52·1–72·7) individuals (one in every 127 people) were on the autism spectrum globally in 2021. The global age-standardised prevalence was 788·3 (663·8–927·2) per 100 000 people, equivalent to 1064·7 (898·5–1245·7) autistic males per 100 000 males and 508·1 (424·6–604·3) autistic females per 100 000 females. Autism spectrum disorder accounted for 11·5 million (7·8–16·3) DALYs, equivalent to 147·6 (100·2–208·2) DALYs per 100 000 people (age-standardised) globally. At the super-region level, age-standardised DALY rates ranged from 126·5 (86·0–178·0) per 100 000 people in southeast Asia, east Asia, and Oceania to 204·1 (140·7–284·7) per 100 000 people in the high-income super-region. DALYs were evident across the lifespan, emerging for children younger than age 5 years (169·2 [115·0–237·4] DALYs per 100 000 people) and decreasing with age (163·4 [110·6–229·8] DALYs per 100 000 people younger than 20 years and 137·7 [93·9–194·5] DALYs per 100 000 people aged 20 years and older). Autism spectrum disorder was ranked within the top-ten causes of non-fatal health burden for people younger than 20 years. Interpretation: The high prevalence and high rank for non-fatal health burden of autism spectrum disorder in people younger than 20 years underscore the importance of early detection and support to autistic young people and their caregivers globally. Work to improve the precision and global representation of our findings is required, starting with better global coverage of epidemiological data so that geographical variations can be better ascertained. The work presented here can guide future research efforts, and importantly, decisions concerning allocation of health services that better address the needs of all autistic individuals. Funding: Queensland Health and the Bill & Melinda Gates Foundation.</p