The global burden of cancer attributable to risk factors, 2010–19: a systematic analysis for the Global Burden of Disease Study 2019

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

Virtual in-service training from the librarians' point of view in libraries of medical sciences universities in Tehran

Background: In-service training courses are one of the most available programs that are used to improve the quantity and quality level of the staff services in various organizations, including libraries and information centers. With the advent of new technologies in the field of education, the problems and shortcomings of traditional in-service training courses were replaced with virtual ones. This study aimed to evaluate the virtual in-service training courses from the librarians' point of view in libraries of state universities of medical sciences in Tehran. Methods: This was a descriptive- analytical study. The statistical population consisted of all librarians at libraries of universities of medical sciences in Tehran. Out of 103 librarians working in the libraries under the study, 93 (90) participated in this study. Data were collected, using a questionnaire. Results: The results revealed that 94/6 of librarians were satisfied to participate in virtual in-service training courses. In this study, only 45 out of 93 participants said that the virtual in-service courses were held in their libraries. Of the participants, 75.6 were satisfied with the length of training courses, and one month seemed to be adequate time duration for the librarians to be more satisfied. The satisfaction level of the individuals who participated in in-service courses of the National Library was moderate to high. A total of 84.4 participants announced that the productivity level of the training courses was moderate to high. The most important problem with which the librarians were confronted in virtual in-service training was the "low speed of the internet and inadequate computer substructures". Conclusion: Effectiveness of in-service training courses from librarians' point of view was at an optimal level in the studied libraries