The global burden of adolescent and young adult cancer in 2019 : a systematic analysis for the Global Burden of Disease Study 2019

Background In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15-39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15-39 years to define adolescents and young adults. Findings There were 1.19 million (95% UI 1.11-1.28) incident cancer cases and 396 000 (370 000-425 000) deaths due to cancer among people aged 15-39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59.6 [54.5-65.7] per 100 000 person-years) and high-middle SDI countries (53.2 [48.8-57.9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14.2 [12.9-15.6] per 100 000 person-years) and middle SDI (13.6 [12.6-14.8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23.5 million (21.9-25.2) DALYs to the global burden of disease, of which 2.7% (1.9-3.6) came from YLDs and 97.3% (96.4-98.1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

Vitamin D deficiency and associated factors among antenatal care attending pregnant women in Sodo town, South Ethiopia: A facility-based cross-sectional study.

BackgroundVitamin D deficiency is an emerging public health problem globally, with devastating health consequences. Pregnant women are most susceptible for Vitamin D deficiency, and black women particularly are under double burden of the problem. Therefore, this study aimed to determine the prevalence of Vitamin D deficiency and identify associated factors among antenatal care attending pregnant women.MethodsA facility-based cross-sectional study involving 331 pregnant women was conducted from March to April in 2021. Systematic random sampling technique was used to select the study participants from antenatal care service providing facilities. Data were collected by using interviewer-administered questionnaire and 5ml of blood sample was collected using aseptic techniques. Data were entered into Epi Data software version 3.1 and exported to SPSS version 20 for analysis. Binary logistic regression analysis was used to identify the associated factors.ResultsIn this study, about 39% of the women were Vitamin D deficient; of which 8.8% were severely deficient. The mean serum Vitamin D level was 24.43ng/ml. Women with Body Mass Index (BMI) ≥30 (AOR = 47.31; 95% CI: 3.94, 567.70) and who never ate egg had a higher chance of being Vitamin D deficient (AOR = 7.48; 95% CI: 1.02, 55.05). On the other hand, women who were exposed to mid-day time sunlight (AOR = 0.30; 95% CI: 0.11, 0.77) were less likely to become Vitamin D deficient.ConclusionsVitamin D deficiency is higher among obese women and women who did not consume egg. Being exposed to mid-day sunlight is protective against Vitamin D deficiency. Having optimal body weight, mid-day sun light exposure and consumption of Vitamin D rich diet might contribute to reduce the risk of Vitamin D deficiency