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. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

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

Age and Sex Standardized Prevalence of Corneal Opacity and Its Determinants: Tehran Geriatric Eye Study (TGES)

Background: We aimed to determine the age and sex standardized prevalence of corneal opacity and its determinants Methods: The Tehran Geriatric Eye Study (TGES) is a population-based cross-sectional study conducted on 3791 subjects aged above 60 yr in Tehran, Iran (2019) selected using stratified random cluster sampling. After sampling, all subjects underwent complete ophthalmic, optometric, and eye examinations. Results: The 3310 participated in the study, of whom the data of 3284 were analyzed. The age and sex standardized prevalence with 95 confidence interval (CI) of corneal opacity in at least one eye, both eyes, and one eye was 9.58 (95 CI: 8.50 to 10.79), 5.52 (95 CI: 4.71 to 6.45), and 4.07 (95 CI: 3.35 to 4.94), respectively. The mean uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA) according to LogMar were worse in subjects with corneal opacity (both P80 yr (OR: 2.05; P: 0.004), and lack of insurance coverage (OR: 1.87; P: 0.004) increased the odds and high school education (OR: 0.68; P: 0.003) reduced the odds of corneal opacity. Among the study variables, sex was the most important determinant of corneal opacity (standardized beta: 0.126). Conclusion: This study found a high prevalence of corneal opacity in the geriatric population. Considering the increasing trend of population aging in Iran, attention should be paid to prioritizing public health policies to estimate resources required for providing comprehensive corneal services and improving geriatric eye health

Age- and Sex-Standardized Prevalence of Age-Related Cataract and Its Determinants; Tehran Geriatric Eye Study (TGES)

Purpose To determine the prevalence of cataract and its relationship with some determinants in individuals above 60 years. Methods Of 3792 subjects that were invited, 3310 participated in the study (response rate = 87.31). All subjects underwent full optometric, slit lamp, and fundoscopic examinations. Then, their lenses were evaluated according to the World Health Organization cataract grading system after pupil dilation. Results Age- and sex-standardized prevalence with 95 confidence interval (CI) of nuclear, cortical, posterior subcapsular cataracts (PSC), any type cataract, and all lens change was 53.09 (49.80 to 56.35), 23.02 (20.87 to 25.32), 5.57 (4.62 to 6.70), 58.78 (55.65 to 61.83), and 72.49 (70.14 to 74.71), respectively. Any type, nuclear, cortical, and PSC cataracts, had a positive association with age and an inverse association with education. Moreover, the prevalence of cortical and PSC cataract had an inverse association with economic status. Among all variables, age was the strongest determinant for cataract and its subtype. Conclusion This study found a higher prevalence of cataract compared to some previous studies such that about two-thirds of the geriatric population had cataract in the past or at the time of the study. Considering the association of cataract with variables such as economic status and education level, it seems that training and increased awareness and knowledge of the elderly population regarding the importance of eye care by physicians plays an important role in reducing the burden of cataract

Age- and Sex-Standardized Prevalence of Age-Related Cataract and Its Determinants; Tehran Geriatric Eye Study (TGES)

Purpose To determine the prevalence of cataract and its relationship with some determinants in individuals above 60 years. Methods Of 3792 subjects that were invited, 3310 participated in the study (response rate = 87.31). All subjects underwent full optometric, slit lamp, and fundoscopic examinations. Then, their lenses were evaluated according to the World Health Organization cataract grading system after pupil dilation. Results Age- and sex-standardized prevalence with 95 confidence interval (CI) of nuclear, cortical, posterior subcapsular cataracts (PSC), any type cataract, and all lens change was 53.09 (49.80 to 56.35), 23.02 (20.87 to 25.32), 5.57 (4.62 to 6.70), 58.78 (55.65 to 61.83), and 72.49 (70.14 to 74.71), respectively. Any type, nuclear, cortical, and PSC cataracts, had a positive association with age and an inverse association with education. Moreover, the prevalence of cortical and PSC cataract had an inverse association with economic status. Among all variables, age was the strongest determinant for cataract and its subtype. Conclusion This study found a higher prevalence of cataract compared to some previous studies such that about two-thirds of the geriatric population had cataract in the past or at the time of the study. Considering the association of cataract with variables such as economic status and education level, it seems that training and increased awareness and knowledge of the elderly population regarding the importance of eye care by physicians plays an important role in reducing the burden of cataract

Marin Mersenne, Brustbild

Signatur des Originals: S 36/G0163

Global and regional estimates of prevalence of amblyopia: A systematic review and meta-analysis

BACKGROUND: Amblyopia is one of the most important causes of vision impairment in the world, especially in children. Although its prevalence varies in different parts of the world, no study has evaluated its prevalence in different geographical regions comprehensively. The aim of the present study was to provide global and regional estimates of the prevalence of amblyopia in different age groups via a systematic search. METHODS: In this study, international databases, including Embase, Scopus, PubMed, Web of Science, and other relevant databases, were searched systematically to find articles on the prevalence of amblyopia in different age groups published in English. The prevalence and 95 CI were calculated using binomial distribution. The Cochran's Q-test and I(2) statistic were applied to assess heterogeneity, a random-effects model was used to estimate the pooled prevalence, and a meta-regression method was utilized to investigate the factors affecting heterogeneity between studies. RESULTS: Of 1252 studies, 73 studies were included in the analysis (sample volume: 530,252). Most of these studies (n = 25) were conducted in the WHO-Western Pacific Regional Office. The pooled prevalence estimate of amblyopia was 1.75 (95 CI: 1.62-1.88), with the highest estimate in European Regional Office (3.67, 95 CI: 2.89-4.45) and the lowest in African Regional Office (0.51, 95 CI: 0.24-0.78). The most common cause of amblyopia was anisometropia (61.64). The I(2) heterogeneity was 98 (p < 0.001). According to the results of univariate meta-regression, the variables of WHO region (b: 0.566, p < 0.001), sample size (b: -0.284 x 10(-4), p: 0.025), and criteria for definition of amblyopia (b: -0.292, p: 0.010) had a significant effect on heterogeneity between studies, while age group, publication date, and cause of amblyopia had no significant effect on heterogeneity. CONCLUSION: The prevalence of amblyopia varies in different parts of the world, with the highest prevalence in European countries. Geographical location and criteria for definition of amblyopia are among factors contributing to the difference across the world. The results of this study can help stakeholders to design health programs, especially health interventions and amblyopia screening programs