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. Funding: Bill & Melinda Gates Foundation, American Lebanese Syrian Associated Charities, St Baldrick's Foundation, and the National Cancer Institute

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

Yield and quality of cereals in response to inputs and spatial variability

SIGLEAvailable from British Library Document Supply Centre- DSC:DXN063721 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

A Contrastive Study of Violence against Women in “Daughter of Dust” and “Koli Kenar-e Atash” (Gypsy by the Fire)

''Contrastive Literature'' is an efficient way to study similarities of literary works from different cultures of the world. ''Violence against Women'' is one of the main keywords of ''feminism'' which shows ''gender'' is the reason of all cruelties against women in different societies. Violence against women, which is being controlled directly or indirectly by men, occurs in two aspects: general and private. In this study the theme of violence against women is studied and analyzed in two novels, i.e. “Daughter of Dust” and “Koli Kenar-e Atash”: ''physical-psychological violence'', ''sexual-psychological violence'', ''psychological violence'', and ''economic violence''. The main reason for the persistence of this violence is keeping silence, assent, and absence of protest against violence

A multidimensional and dynamic analysis of urban spatial structure: a case-study of the Sydney metropolitan area, 1981 - 2006

This thesis investigates the spatial structural change of the Sydney metropolitan area over the period of ‎‎1981 - 2006. In considering the multidimensional view of urban spatial structure from a conceptual ‎standpoint this thesis postulates that urban spatial structure can be captured by a focus on four key ‎dimensions: density, diversity, accessibility and centers. ‎‎ The central aim of this thesis is to propose and test a methodology for the diagnosis of urban spatial ‎structure across its multidimensional characteristics, to capture the space-time dynamics of changes in the ‎urban area and the changing parameters associated with these changes in Sydney and elsewhere. The aim ‎provides two main challenges; one empirical and one methodological. On the empirical side, the challenge is ‎to structure a longitudinal data set where the same indices are measured at various point in time for the ‎same spatial unit. The second challenge is to process all the computed information and analyse it in a ‎meaningful way that allows for exploring complex relations among the multidimensional characteristics on ‎the other hand. To achieve this aim the thesis takes four structural dimensions – density, diversity, ‎accessibility and centres – and defining specific indices that make it possible to quantify each concept. ‎‎ The key outcomes of this thesis are: a high resolution and temporally and spatially consistent data set ‎for the analysis urban spatial structure; identification and measurement of defined spatial metrics; a spatial ‎representation of the changing nature of urban spatial structure in the Sydney metropolitan area over the ‎period 1981 to 2006; evaluations of the changing geography of the multidimensional characteristics of the ‎Sydney metropolitan area.‎The first conclusion about Sydney is that urban spatial structure in this city can be clearly characterised a ‎multi-dimensional as opposed to being treated as uni-dimensional. The thesis results also highlighted that ‎Sydney, generally, cannot be totally characterised as having ‘American’ style urban sprawl. Analysis of the ‎multi-dimensional structure showed that Sydney has both strong mono-centric and weak polycentric ‎characteristics for population and employment density distributions and the modelling analyses highlight ‎the reasonably strong effects of the metrics on population and employment density distribution.