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

Global, regional, and national age-sex-specific mortality and life expectancy, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017

BACKGROUND: Assessments of age-specific mortality and life expectancy have been done by the UN Population Division, Department of Economics and Social Affairs (UNPOP), the United States Census Bureau, WHO, and as part of previous iterations of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). Previous iterations of the GBD used population estimates from UNPOP, which were not derived in a way that was internally consistent with the estimates of the numbers of deaths in the GBD. The present iteration of the GBD, GBD 2017, improves on previous assessments and provides timely estimates of the mortality experience of populations globally. METHODS: The GBD uses all available data to produce estimates of mortality rates between 1950 and 2017 for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries. Data used include vital registration systems, sample registration systems, household surveys (complete birth histories, summary birth histories, sibling histories), censuses (summary birth histories, household deaths), and Demographic Surveillance Sites. In total, this analysis used 8259 data sources. Estimates of the probability of death between birth and the age of 5 years and between ages 15 and 60 years are generated and then input into a model life table system to produce complete life tables for all locations and years. Fatal discontinuities and mortality due to HIV/AIDS are analysed separately and then incorporated into the estimation. We analyse the relationship between age-specific mortality and development status using the Socio-demographic Index, a composite measure based on fertility under the age of 25 years, education, and income. There are four main methodological improvements in GBD 2017 compared with GBD 2016: 622 additional data sources have been incorporated; new estimates of population, generated by the GBD study, are used; statistical methods used in different components of the analysis have been further standardised and improved; and the analysis has been extended backwards in time by two decades to start in 1950. FINDINGS: Globally, 18·7% (95% uncertainty interval 18·4–19·0) of deaths were registered in 1950 and that proportion has been steadily increasing since, with 58·8% (58·2–59·3) of all deaths being registered in 2015. At the global level, between 1950 and 2017, life expectancy increased from 48·1 years (46·5–49·6) to 70·5 years (70·1–70·8) for men and from 52·9 years (51·7–54·0) to 75·6 years (75·3–75·9) for women. Despite this overall progress, there remains substantial variation in life expectancy at birth in 2017, which ranges from 49·1 years (46·5–51·7) for men in the Central African Republic to 87·6 years (86·9–88·1) among women in Singapore. The greatest progress across age groups was for children younger than 5 years; under-5 mortality dropped from 216·0 deaths (196·3–238·1) per 1000 livebirths in 1950 to 38·9 deaths (35·6–42·83) per 1000 livebirths in 2017, with huge reductions across countries. Nevertheless, there were still 5·4 million (5·2–5·6) deaths among children younger than 5 years in the world in 2017. Progress has been less pronounced and more variable for adults, especially for adult males, who had stagnant or increasing mortality rates in several countries. The gap between male and female life expectancy between 1950 and 2017, while relatively stable at the global level, shows distinctive patterns across super-regions and has consistently been the largest in central Europe, eastern Europe, and central Asia, and smallest in south Asia. Performance was also variable across countries and time in observed mortality rates compared with those expected on the basis of development. INTERPRETATION: This analysis of age-sex-specific mortality shows that there are remarkably complex patterns in population mortality across countries. The findings of this study highlight global successes, such as the large decline in under-5 mortality, which reflects significant local, national, and global commitment and investment over several decades. However, they also bring attention to mortality patterns that are a cause for concern, particularly among adult men and, to a lesser extent, women, whose mortality rates have stagnated in many countries over the time period of this study, and in some cases are increasing

Lipids and fatty acids in wild and pond-reared mud crab Scylla serrata (Forsskål) during ovarian maturation and spawning

Wild-caught and pond-reared female mud crab Scylla serrata at different stages of ovarian maturation were collected from Samar and Capiz, Philippines. Crabs were categorized into five stages according to the external morphological and microscopic appearance of the most advanced oocytes. The ovaries, hepatopancreas, muscle and newly spawned eggs (NSE) were analysed for lipid class components and fatty acids. Total lipid was higher in pond-reared than in wild-caught crabs but increased with ovarian maturation in both groups. Ovarian lipid peaked at the fully mature stage, coinciding with a decline in hepatopancreatic and muscle lipids. Lipid levels declined significantly in spent females. The tissues contained elevated highly unsaturated fatty acids such as arachidonic (20:4n-6), eicosapentaenoic (20:5n-3) and docosahexaenoic (22:6n-3) acids, but at higher levels in late maturing and fully mature ovaries and in NSE. The type of lipid class and fatty acid components in mature ovaries as well as in NSE are generally considered to be indicative of their importance in reproductive physiology and embryonic and larval development.This study was funded by the European Union’s INCO-DEV project on Culture and Management of the crab Scylla (CAMS, contract ECA4-CT-2001-10022). The authors would like to thank Mr Quirico J. Ganon, who transported the crabs from Samar and Capiz to SEAFDEC AQD Philippines, and the staff of Laboratory of Aquaculture & Artemia Reference Center, Ghent University, Belgium, for the lipid class and fatty acid analyses

Reproductive cycle of the swimming crab Portunus spinimanus Latreille (Crustacea, Decapoda, Brachyura) from Ubatuba, S\ue3o Paulo, Brazil

This study analyses some reproductive aspects of Portunus spinimanus Latreille, 1819, a crab usually commercialized in Ubatuba region. Monthly otter-trawl collections were taken for two years along the northern coast of São Paulo State, Brazil. The reproductive period was studied based on the frequency of ovigerous females in the population along the year; the frequency of physiologically mature swimming crabs and the type of spawn. The condition of development of ovigerous females ovary was associated with the stage of eggs development. This species presents continuous reproduction in Ubatuba region and total spawn, but with successive broods, which suggests a multiple spawn during the reproduction period

Dynamics of gonadal development of Aegla platensis Schmitt (Decapoda, Anomura, Aeglidae)

One way to estimate gonadal development through the reproductive cycle is to observe the growth of the gonads related to the organs used to store energy. The aim of this study was to follow the gonadosomatic and hepatosomatic indexes during annual cycle of Aegla platensis Schmitt, 1942. Adult animals were collected in Taquara, Rio Grande do Sul, Brazil (29&deg;46'S, 50&deg;53'W). Males and females were initially weighed and dissected and had their gonads and hepatopancreas (HP) removed and weighed in order to estimate the Gonadosomatic (GI) and hepatosomatic (HI) indexes. In females, the indexes were also compared to the degree of development of the ovaries. In males the GI showed a peak of gonadal development in the autumn (p < 0.05), just when the HI showed a decrease (p < 0.05). Females showed a rise in the GI at the end of summer and beginning of autumn (p < 0.05). In females, GI values increased as the ovary matured. In A. platensis, for both males and females, the HI never showed values lower than the GI, which may indicate that these aeglids show a different pattern of energy utilization from other decapods, where as gonadal development peaks the HI decreases markedly.<br>Uma maneira de estimar o desenvolvimento gonadal ao longo do ciclo reprodutivo é observar o crescimento das gônadas em relação aos órgãos utilizados para o estoque de energia. O objetivo desse estudo foi acompanhar os índices gonadossomático e hepatossomático durante o ciclo reprodutivo de Aegla platensis Schmitt, 1942. Animais adultos foram coletados em Taquara, Rio Grande do Sul, Brasil (29&deg;46'S, 50&deg;53'W). Machos e fêmeas foram pesados e dissecados, gônadas e hepatopâncreas (HP) foram retirados e pesados para obtenção dos índices gonadossomático (IG) e hepatossomático (IH). Nas fêmeas, os índices também foram comparados com o grau de desenvolvimento dos ovários. Nos machos o IG mostrou um pico de desenvolvimento gonadal no outono (p < 0,05), quando os valores do IH diminuíram (p < 0,05). Fêmeas mostraram um aumento do IG no final do verão e início do outono (p < 0,05) e os valores do IG aumentaram à medida que o ovário tornava-se maduro. Em A. platensis, tanto nos machos como nas fêmeas, os valores do IH nunca mostraram valores mais baixos que o IG, o que pode indicar que esses aeglídeos apresentam um padrão de utilização de energia diferente dos outros decápodos, onde à medida que o desenvolvimento gonadal aumenta os valores do IH diminuem marcadamente