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

INTRAOPERATIVE FINDINGS OF SEVERITY OF CORONARY ARTERY DISEASE: THE IMPORTANCE OF LOW - DENSITY LIPOPROTEIN CHOLESTEROL CONTROL

The correlation between severity and extent of coronary artery disease (CAD) and lipid measurement was assessed in 152 patients undergoing coronary artery bypass graft surgery (CABG). Tfie severity and extent of CAD was determined under direct vision of a cardiac surgeon during the CABG. Patients were divided Into two groups: 1. those with very severe and diffuse CAD that all their coronaries were severely diseased. 2) those with less severe CAD that their involvement limitted to certain coronary branches. Patient with all coronary involvement revealded significantly higher mean level of low density lipoprotein cholesterol (LDL-C). Tliese paitents had also higher mean levels of total cholestrol (TC) and lower mean high density lipoprotein (HDL-C); but these differences were not statistically significant. Only 18% of our patients had desirable lipid levels-after CABG. We concluded that higher (LDL-C) levels may related with more severe CAD. However, this is a cross-sectional study; so a carefali controlled prospective study is recommended. Because new studies revealed that lower (LDL-C) levels (LDL <100) mgldl help to maintenance of graft's patency, more attention to LDL-C control after CABG is necessary

Lithium as a Differential Neuroprotector During Brain Irradiation

info:eu-repo/semantics/publishe