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The UAE healthy future study: a pilot for a prospective cohort study of 20,000 United Arab Emirates nationals
Abdulle, Abdishakur; Alnaeemi, Abdullah; Aljunaibi, Abdullah; Al Ali, Abdulrahman; Al Saedi, Khaled; Al Zaabi, Eiman; Oumeziane, Naima; Al Bastaki, Marina; Al-Houqani, Mohammed; Al Maskari, Fatma; Al Dhaheri, Ayesha; Shah, Syed M; Loney, Tom; El-Sadig, Mohamed; Oulhaj, Abderrahim; Wareth, Leila Abdel; Al Mahmeed, Wael; Alsafar, Habiba; Hirsch, Benjamin; Al Anouti, Fatme; Yaaqoub, Jamila; Inman, Claire K; Al Hamiz, Aisha; Al Hosani, Ayesha; Haji, Muna; Alsharid, Teeb; Al Zaabi, Thekra; Al Maisary, Fatima; Galani, Divya; Sprosen, Tim; El Shahawy, Omar; Ahn, Jiyoung; Kirchhoff, Tomas; Ramasamy, Ravichandran; Schmidt, Ann Marie; Hayes, Richard; Sherman, Scott; Ali, Raghib
BACKGROUND:The United Arab Emirates (UAE) is faced with a rapidly increasing burden of non-communicable diseases including obesity, diabetes, and cardiovascular disease. The UAE Healthy Future study is a prospective cohort designed to identify associations between risk factors and these diseases amongst Emiratis. The study will enroll 20,000 UAE nationals aged ≥18 years. Environmental and genetic risk factors will be characterized and participants will be followed for future disease events. As this was the first time a prospective cohort study was being planned in the UAE, a pilot study was conducted in 2015 with the primary aim of establishing the feasibility of conducting the study. Other objectives were to evaluate the implementation of the main study protocols, and to build adequate capacity to conduct advanced clinical laboratory analyses. METHODS:Seven hundred sixty nine UAE nationals aged ≥18 years were invited to participate voluntarily in the pilot study. Participants signed an informed consent, completed a detailed questionnaire, provided random blood, urine, and mouthwash samples and were assessed for a series of clinical measures. All specimens were transported to the New York University Abu Dhabi laboratories where samples were processed and analyzed for routine chemistry and hematology. Plasma, serum, and a small whole blood sample for DNA extraction were aliquoted and stored at -80 °C for future analyses. RESULTS:Overall, 517 Emirati men and women agreed to participate (68% response rate). Of the total participants, 495 (95.0%), 430 (82.2%), and 492 (94.4%), completed the questionnaire, physical measurements, and provided biological samples, respectively. CONCLUSIONS:The pilot study demonstrated the feasibility of recruitment and completion of the study protocols for the first large-scale cohort study designed to identify emerging risk factors for the major non-communicable diseases in the region.
PMCID:5755402
PMID: 29304844
ISSN: 1471-2458
CID: 2899502
Patterns of tobacco use in the United Arab Emirates Healthy Future (UAEHFS) pilot study
Al-Houqani, Mohammed; Leinberger-Jabari, Andrea; Al Naeemi, Abdullah; Al Junaibi, Abdullah; Al Zaabi, Eiman; Oumeziane, Naima; Kazim, Marina; Al Maskari, Fatima; Al Dhaheri, Ayesha; Abdel Wareth, Leila; Al Mahmeed, Wael; Alsafar, Habiba; Al Anouti, Fatme; Abdulle, Abdishakur; Inman, Claire K; Al Hamiz, Aisha; Haji, Muna; Ahn, Jiyoung; Kirchhoff, Tomas; Hayes, Richard B; Ramasamy, Ravichandran; Schmidt, Ann Marie; El Shahawy, Omar; Weitzman, Michael; Ali, Raghib; Sherman, Scott
INTRODUCTION/BACKGROUND:Self-reported tobacco use in the United Arab Emirates is among the highest in the region. Use of tobacco products other than cigarettes is widespread, but little is known about specific behavior use patterns. There have been no studies that have biochemically verified smoking status. METHODS:The UAE Healthy Future Study (UAEHFS) seeks to understand the causes of non-communicable diseases through a 20,000-person cohort study. During the study pilot, 517 Emirati nationals were recruited to complete a questionnaire, provide clinical measurements and biological samples. Complete smoking data were available for 428 participants. Validation of smoking status via cotinine testing was conducted based on complete questionnaire data and matching urine samples for 399 participants, using a cut-off of 200ng/ml to indicate active smoking status. RESULTS:Self-reported tobacco use was 36% among men and 3% among women in the sample. However, biochemical verification of smoking status revealed that 42% men and 9% of women were positive for cotinine indicating possible recent tobacco use. Dual and poly-use of tobacco products was fairly common with 32% and 6% of the sample reporting respectively. CONCLUSIONS:This is the first study in the region to biochemically verify tobacco use self-report data. Tobacco use in this study population was found to be higher than previously thought, especially among women. Misclassification of smoking status was more common than expected. Poly-tobacco use was also very common. Additional studies are needed to understand tobacco use behaviors and the extent to which people may be exposed to passive tobacco smoke. IMPLICATIONS/CONCLUSIONS:This study is the first in the region to biochemically verify self-reported smoking status.
PMCID:5976156
PMID: 29847569
ISSN: 1932-6203
CID: 3136292
The AGE-RAGE axis in an Arab population: The United Arab Emirates Healthy Futures (UAEHFS) pilot study
Inman, Claire K; Aljunaibi, Abdullah; Koh, Hyunwook; Abdulle, Abdishakur; Ali, Raghib; Alnaeemi, Abdullah; Al Zaabi, Eiman; Oumeziane, Naima; Al Bastaki, Marina; Al-Houqani, Mohammed; Al-Maskari, Fatma; Al Dhaheri, Ayesha; Shah, Syed M; Abdel Wareth, Laila; Al Mahmeed, Wael; Alsafar, Habiba; Al Anouti, Fatme; Al Hosani, Ayesha; Haji, Muna; Galani, Divya; O'Connor, Matthew J; Ahn, Jiyoung; Kirchhoff, Tomas; Sherman, Scott; Hayes, Richard B; Li, Huilin; Ramasamy, Ravichandran; Schmidt, Ann Marie
Aims/UNASSIGNED:The transformation of the United Arab Emirates (UAE) from a semi-nomadic to a high income society has been accompanied by increasing rates of obesity and Type 2 diabetes mellitus. We examined if the AGE-RAGE (receptor for advanced glycation endproducts) axis is associated with obesity and diabetes mellitus in the pilot phase of the UAE Healthy Futures Study (UAEHFS). Methods/UNASSIGNED:517 Emirati subjects were enrolled and plasma/serum levels of AGE, carboxy methyl lysine (CML)-AGE, soluble (s)RAGE and endogenous secretory (es)RAGE were measured along with weight, height, waist and hip circumference (WC/HC), blood pressure, HbA1c, Vitamin D levels and routine chemistries. The relationship between the AGE-RAGE axis and obesity and diabetes mellitus was tested using proportional odds models and linear regression. Results/UNASSIGNED:After covariate adjustment, AGE levels were significantly associated with diabetes status. Levels of sRAGE and esRAGE were associated with BMI and levels of sRAGE were associated with WC/HC. Conclusions/UNASSIGNED:The AGE-RAGE axis is associated with diabetes status and obesity in this Arab population. Prospective serial analysis of this axis may identify predictive biomarkers of obesity and cardiometabolic dysfunction in the UAEHFS.
PMCID:5691216
PMID: 29204365
ISSN: 2214-6237
CID: 2892882
Levels of soluble rage but not endogenous secretory (ES) rage differ between type 2 diabetic versus control subjects in the United Arab Emirates [Meeting Abstract]
Abdulle, A; Inman, C K; Saleh, A; Noshi, M; Galani, D; Abdelwareth, L; Alsafar, H; Elfatih, A; Al, shamsi H; Ali, R; Li, H; Ramasamy, R; Marie, Schmidt A; Benbarka, M M; Hassan, M H
Background: The United Arab Emirates (UAE) is experiencing increasing rates of obesity, type 2 diabetes (T2D) and its complications. We tested if soluble levels of cell surface-cleaved RAGE (sRAGE) or endogenous secretory RAGE (esRAGE), the product of alternative mRNA splicing of AGER, are associated with T2D and obesity in the UAE.
Method(s): A case-control study was performed in the Diabetes, Endocrinology and General Medical Clinics of the Sheikh Khalifa Medical City in Abu Dhabi. 216 T2D subjects and 215 controls (mean age 57.4+/-12.1 vs. 50.7+/-15.4 years, respectively) were enrolled. Plasma sRAGE and esRAGE levels, anthropomorphic characteristics and routine chemistries were measured. The relationship between sRAGE and esRAGE with obesity and T2D status was tested using a linear regression model.
Result(s): Univariate analyses comparing T2D case and control subjects revealed differences in sRAGE (1,033+/-545.3 vs. 1,169+/-664.1 pg/ml, respectively; p=0.02) but not esRAGE. Covariate adjustment revealed that differences in sRAGE were significant after correction for age and sex and additionally for waist-hip ratio (WHR); total cholesterol (TC), HDL; hsCRP; Vit D; or triglyceride (TG) levels separately. In cases or controls, we tested associations of body mass index (BMI) or WHR with sRAGE and esRAGE. In controls but not T2D cases, sRAGE and esRAGE were significantly associated with BMI, after correction for age and sex and additionally for eGFR; blood pressure; TC, HDL; hsCRP; Vit D; creatinine; TG and HbA1c in a combined model. In the case of WHR, in controls and T2D cases, there were no associations with sRAGE, but only in T2D cases, WHR was associated with esRAGE after correction for age and sex and blood pressure; TC, HDL; hsCRP, HbA1c, creatinine; TG, eGFR, Vit D and TG in a combined model.
Conclusion(s): Levels of sRAGE but not esRAGE distinguish T2D case vs. controls in the UAE population. Genetic and unique obesity-dependent factors may underlie lack of association between esRAGE in cases vs. controls, which may affect vulnerability to T2D and its complications in the UAE
EMBASE:633701273
ISSN: 1533-3450
CID: 4750412
Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016
Hay, Simon I; Abajobir, Amanuel Alemu; Abate, Kalkidan Hassen; Abbafati, Cristiana; Abbas, Kaja M; Abd-Allah, Foad; Abdulle, Abdishakur M; Abebo, Teshome Abuka; Abera, Semaw Ferede; Aboyans, Victor; Abu-Raddad, Laith J; Ackerman, Ilana N; Adedeji, Isaac A; Adetokunboh, Olatunji; Afshin, Ashkan; Aggarwal, Rakesh; Agrawal, Sutapa; Agrawal, Anurag; Kiadaliri, Aliasghar Ahmad; Ahmed, Muktar Beshir; Aichour, Amani Nidhal; Aichour, Ibtihel; Aichour, Miloud Taki Eddine; Aiyar, Sneha; Akinyemiju, Tomi F; Akseer, Nadia; Al Lami, Faris Hasan; Alahdab, Fares; Al-Aly, Ziyad; Alam, Khurshid; Alam, Noore; Alam, Tahiya; Alasfoor, Deena; Alene, Kefyalew Addis; Ali, Raghib; Alizadeh-Navaei, Reza; Alkaabi, Juma M; Alkerwi, Ala'a; Alla, Francois; Allebeck, Peter; Allen, Christine; Al-Maskari, Fatma; AlMazroa, Mohammad AbdulAziz; Al-Raddadi, Rajaa; Alsharif, Ubai; Alsowaidi, Shirina; Althouse, Benjamin M; Altirkawi, Khalid A; Alvis-Guzman, Nelson; Amare, Azmeraw T; Amini, Erfan; Ammar, Walid; Ampem, Yaw Amoako; Ansha, Mustafa Geleto; Antonio, Carl Abelardo T; Anwari, Palwasha; Arnlov, Johan; Arora, Megha; Al Artaman; Aryal, Krishna Kumar; Asgedom, Solomon W; Atey, Tesfay Mehari; Atnafu, Niguse Tadele; Avila-Burgos, Leticia; Avokpaho, Euripide Frinel GArthur; Awasthi, Ashish; Awasthi, Shally; Quintanilla, Beatriz Paulina Ayala; Azarpazhooh, Mahmoud Reza; Azzopardi, Peter; Babalola, Tesleem Kayode; Bacha, Umar; Badawi, Alaa; Balakrishnan, Kalpana; Bannick, Marlena S; Barac, Aleksandra; Barker-Collo, Suzanne L; Barnighausen, Till; Barquera, Simon; Barrero, Lope H; Basu, Sanjay; Battista, Robert; Battle, Katherine E; Baune, Bernhard T; Bazargan-Hejazi, Shahrzad; Beardsley, Justin; Bedi, Neeraj; Bejot, Yannick; Bekele, Bayu Begashaw; Bell, Michelle L; Bennett, Derrick A; Bennett, James R; Bensenor, Isabela M; Benson, Jennifer; Berhane, Adugnaw; Berhe, Derbew Fikadu; Bernabe, Eduardo; Betsu, Balem Demtsu; Beuran, Mircea; Beyene, Addisu Shunu; Bhansali, Anil; Bhatt, Samir; Bhutta, Zulfiqar A; Biadgilign, Sibhatu; Bienhoff, Kelly; Bikbov, Boris; Birungi, Charles; Biryukov, Stan; Bisanzio, Donal; Bizuayehu, Habtamu Mellie; Blyth, Fiona M; Boneya, Dube Jara; Bose, Dipan; Bou-Orm, Ibrahim R; Bourne, Rupert RA; Brainin, Michael; Brayne, Carol EG; Brazinova, Alexandra; Breitborde, Nicholas JK; Briant, Paul S; Britton, Gabrielle; Brugha, Traolach S; Buchbinder, Rachelle; Bulto, Lemma Negesa Bulto; Bumgarner, Blair; Butt, Zahid A; Cahuana-Hurtado, Lucero; Cameron, Ewan; Ricardo Campos-Nonato, Ismael; Carabin, Helene; Cardenas, Rosario; Carpenter, David O; Carrero, Juan Jesus; Carter, Austin; Carvalho, Felix; Casey, Daniel; Castaneda-Orjuela, Carlos A; Rivas, Jacqueline Castillo; Castle, Chris D; Catala-Lopez, Ferran; Chang, Jung-Chen; Charlson, Fiona J; Chaturvedi, Pankaj; Chen, Honglei; Chibalabala, Mirriam; Chibueze, Chioma Ezinne; Chisumpa, Vesper Hichilombwe; Chitheer, Abdulaal A; Chowdhury, Rajiv; Christopher, Devasahayam Jesudas; Ciobanu, Liliana G; Cirillo, Massimo; Colombara, Danny; Cooper, Leslie Trumbull; Cooper, Cyrus; Cortesi, Paolo Angelo; Cortinovis, Monica; Criqui, Michael H; Cromwell, Elizabeth A; Cross, Marita; Crump, John A; Dadi, Abel Fekadu; Dalal, Koustuv; Damasceno, Albertino; Dandona, Lalit; Dandona, Rakhi; das Neves, Jose; Davitoiu, Dragos V; Davletov, Kairat; de Courten, Barbora; de Leo, Diego; De Steur, Hans; Degenhardt, Louisa; Deiparine, Selina; Dellavalle, Robert P; Deribe, Kebede; Deribew, Amare; Des Jarlais, Don C; Dey, Subhojit; Dharmaratne, Samath D; Dhillon, Preet K; Dicker, Daniel; Djalalinia, Shirin; Huyen Phuc Do; Dokova, Klara; Doku, David Teye; Dorsey, ERay; Bender dos Santos, Kadine Priscila; Driscoll, Tim R; Dubey, Manisha; Duncan, Bruce Bartholow; Ebel, Beth E; Echko, Michelle; El-Khatib, Ziad Ziad; Enayati, Ahmadali; Endries, Aman Yesuf; Ermakov, Sergey Petrovich; Erskine, Holly E; Eshetie, Setegn; Eshrati, Babak; Esteghamati, Alireza; Estep, Kara; Fanuel, Fanuel Belayneh Bekele; Farag, Tamer; Sofia, Carla; Farinha, Sa; Faro, Andre; Farzadfar, Farshad; Fazeli, Mir Sohail; Feigin, Valery L; Feigl, Andrea B; Fereshtehnejad, Seyed-Mohammad; Fernandes, Joao C; Ferrari, Alize J; Feyissa, Tesfaye Regassa; Filip, Irina; Fischer, Florian; Fitzmaurice, Christina; Flaxman, Abraham D; Foigt, Nataliya; Foreman, Kyle J; Franklin, Richard C; Frostad, Joseph J; Fullman, Nancy; Furst, Thomas; Furtado, Joao M; Futran, Neal D; Gakidou, Emmanuela; Garcia-Basteiro, Alberto L; Gebre, Teshome; Gebregergs, Gebremedhin Berhe; Gebrehiwot, Tsegaye Tewelde; Geleijnse, Johanna M; Geleto, Ayele; Gemechu, Bikila Lencha; Gesesew, Hailay Abrha; Gething, Peter W; Ghajar, Alireza; Gibney, Katherine B; Gillum, Richard F; Ginawi, Ibrahim Abdelmageem Mohamed; Gishu, Melkamu Dedefo; Giussani, Giorgia; Godwin, William W; Goel, Kashish; Goenka, Shifalika; Goldberg, Ellen M; Gona, Philimon N; Goodridge, Amador; Gopalani, Sameer Vali; Gosselin, Richard A; Gotay, Carolyn C; Goto, Atsushi; Goulart, Alessandra Carvalho; Graetz, Nicholas; Gugnani, Harish Chander; Gupta, Rajeev; Gupta, Prakash C; Gupta, Tanush; Gupta, Vipin; Gupta, Rahul; Gutierrez, Reyna A; Hachinski, Vladimir; Hafezi-Nejad, Nima; Hailu, Alemayehu Desalegne; Hailu, Gessessew Bugssa; Hamadeh, Randah Ribhi; Hamidi, Samer; Hammami, Mouhanad; Handal, Alexis J; Hankey, Graeme J; Hao, Yuantao; Harb, Hilda L; Hareri, Habtamu Abera; Haro, Josep Maria; Harun, Kimani M; Harvey, James; Hassanvand, Mohammad Sadegh; Havmoeller, Rasmus; Hay, Roderick J; Hedayati, Mohammad T; Hendrie, Delia; Henry, Nathaniel J; Heredia-Pi, Ileana Beatriz; Heydarpour, Pouria; Hoek, Hans W; Hoffman, Howard J; Horino, Masako; Horita, Nobuyuki; Hosgood, HDean; Hostiuc, Sorin; Hotez, Peter J; Hoy, Damian G; Htet, Aung Soe; Hu, Guoqing; Huang, John J; Huynh, Chantal; Iburg, Kim Moesgaard; Igumbor, Ehimario Uche; Ikeda, Chad; Irvine, Caleb Mackay Salpeter; Jacobsen, Kathryn H; Jahanmehr, Nader; Jakovljevic, Mihajlo B; James, Peter; Jassal, Simerjot K; Javanbakht, Mehdi; Jayaraman, Sudha P; Jeemon, Panniyammakal; Jensen, Paul N; Jha, Vivekanand; Jiang, Guohong; John, Denny; Johnson, Catherine O; Johnson, Sarah Charlotte; Jonas, Jost B; Jurisson, Mikk; Kabir, Zubair; Kadel, Rajendra; Kahsay, Amaha; Kamal, Ritul; Kar, Chittaranjan; Karam, Nadim E; Karch, Andre; Karema, Corine Kakizi; Karimi, Seyed M; Karimkhani, Chante; Kasaeian, Amir; Kassa, Getachew Mullu; Kassebaum, Nicholas J; Kassaw, Nigussie Assefa; Kastor, Anshul; Katikireddi, Srinivasa Vittal; Kaul, Anil; Kawakami, Norito; Keiyoro, Peter Njenga; Kemmer, Laura; Kengne, Andre Pascal; Keren, Andre; Kesavachandran, Chandrasekharan Nair; Khader, Yousef Saleh; Khalil, Ibrahim A; Khan, Ejaz Ahmad; Khang, Young-Ho; Khoja, Abdullah T; Khosravi, Ardeshir; Khubchandani, Jagdish; Kieling, Christian; Kim, Yun Jin; Kim, Daniel; Kimokoti, Ruth W; Kinfu, Yohannes; Kisa, Adnan; Kissimova-Skarbek, Katarzyna A; Kissoon, Niranjan; Kivimaki, Mika; Knudsen, Ann Kristin; Kokubo, Yoshihiro; Kolte, Dhaval; Kopec, Jacek A; Kosen, Soewarta; Kotsakis, Georgios A; Koul, Parvaiz A; Koyanagi, Ai; Kravchenko, Michael; Krohn, Kristopher J; Defo, Barthelemy Kuate; Bicer, Burcu Kucuk; Kumar, GAnil; Kumar, Pushpendra; Kyu, Hmwe H; Lager, Anton Carl Jonas; Lal, Dharmesh Kumar; Lalloo, Ratilal; Lallukka, Tea; Lambert, Nkurunziza; Lan, Qing; Lansingh, Van C; Larsson, Anders; Leasher, Janet L; Lee, Paul H; Leigh, James; Leshargie, Cheru Tesema; Leung, Janni; Leung, Ricky; Levi, Miriam; Li, Yichong; Li, Yongmei; Liang, Xiaofeng; Liben, Misgan Legesse; Lim, Stephen S; Linn, Shai; Liu, Angela; Liu, Patrick Y; Liu, Shiwei; Liu, Yang; Lodha, Rakesh; Logroscino, Giancarlo; Looker, Katharine J; Lopez, Alan D; Lorkowski, Stefan; Lotufo, Paulo A; Lozano, Rafael; Lucas, Timothy CD; Lunevicius, Raimundas; Lyons, Ronan A; Macarayan, Erlyn Rachelle King; Maddison, Emilie R; Abd el Razek, Hassan Magdy; Magis-Rodriguez, Carlos; Mahdavi, Mahdi; Majdan, Marek; Majdzadeh, Reza; Majeed, Azeem; Malekzadeh, Reza; Malhotra, Rajesh; Malta, Deborah Carvalho; Mamun, Abdullah A; Manguerra, Helena; Manhertz, Treh; Mantovani, Lorenzo G; Mapoma, Chabila C; March, Lyn M; Marczak, Laurie B; Martinez-Raga, Jose; Henrique, Paulo; Martins, Viegas; Martins-Melo, Francisco Rogerlndio; Martopullo, Ira; Marz, Winfried; Mathur, Manu Raj; Mazidi, Mohsen; McAlinden, Colm; McGaughey, Madeline; McGrath, John J; Mckee, Martin; Mehata, Suresh; Meier, Toni; Meles, Kidanu Gebremariam; Memiah, Peter; Memish, Ziad A; Mendoza, Walter; Mengesha, Melkamu Merid; Mengistie, Mubarek Abera; Mengistu, Desalegn Tadese; Mensah, George A; Meretoja, Atte; Meretoja, Tuomo J; Mezgebe, Haftay Berhane; Micha, Renata; Millear, Anoushka; Miller, Ted R; Minnig, Shawn; Mirarefin, Mojde; Mirrakhimov, Erkin M; Misganaw, Awoke; Mishra, Shiva Raj; Mitchell, Philip B; Mohammad, Karzan Abdulmuhsin; Mohammadi, Alireza; Mohammed, Shafiu; Mohammed, Kedir Endris; Mohammed, Muktar Sano Kedir; Mohan, Murali BV; Mokdad, Ali H; Mollenkopf, Sarah K; Monasta, Lorenzo; Montanez Hernandez, Julio Cesar; Montico, Marcella; Moradi-Lakeh, Maziar; Moraga, Paula; Morawska, Lidia; Mori, Rintaro; Morrison, Shane D; Moses, Mark; Mountjoy-Venning, Cliff; Mruts, Kalayu Birhane; Mueller, Ulrich O; Muller, Kate; Mudoch, Michele E; Murthy, Srinivas; Murthy, Gudlavalleti Venkata Satyanarayana; Musa, Kamarul Imran; Nachega, Jean B; Nagel, Gabriele; Naghavi, Mohsen; Naheed, Aliya; Naidoo, Kovin S; Nangia, Vinay; Nasher, Jamal T; Natarajan, Gopalakrishnan; Negasa, Dumessa Edessa; Negoi, Ionut; Negoi, Ruxandra Irina; Newton, Charles R; Ngunjiri, Josephine Wanjiku; Cuong Tat Nguyen; Quyen Le Nguyen; Grant Nguyen; Trang Huyen Nguyen; Minh Nguyen; Nichols, Emma; Ningrum, Dina Nur Anggraini; Vuong Minh Nong; Norheim, Ole F; Norrving, Bo; Noubiap, Jean Jacques N; Nyandwi, Alypio; Obermeyer, Carla Makhlouf; O'Donnell, Martin J; Ogbo, Felix Akpojene; Oh, In-Hwan; Okoro, Anselm; Oladimeji, Olanrewaju; Olagunju, Andrew Toyin; Olagunju, Tinuke Oluwasefunmi; Olsen, Helen E; Olusanya, Bolajoko Olubukunola; Olusanya, Jacob Olusegun; Ong, Kanyin; Opio, John Nelson; Oren, Eyal; Ortiz, Alberto; Osborne, Richard H; Osgood-Zimmerman, Aaron; Osman, Majdi; Ota, Erika; Owolabi, Mayowa O; Pa, Mahesh; Pacella, Rosana E; Panda, Basant Kumar; Pandian, Jeyaraj D; Papachristou, Christina; Park, Eun-Kee; Parry, Charles D; Parsaeian, Mahboubeh; Patil, Snehal T; Patten, Scott B; Patton, George C; Paudel, Deepak; Paulson, Katherine; Pearce, Neil; Pereira, David M; Perez, Krystle Marie; Perico, Norberto; Pesudovs, Konrad; Peterson, Carrie Beth; Petri, William Arthur; Petzold, Max; Phillips, Michael Robert; Phipps, Geoffrey; Pigott, David M; Pillay, Julian David; Pinho, Christine; Piradov, Michael A; Plass, Dietrich; Pletcher, Martin A; Popova, Svetlana; Poulton, Richie G; Pourmalek, Farshad; Prabhakaran, Dorairaj; Prasad, Narayan; Purcell, Carrie; Purwar, Manorama; Qorbani, Mostafa; Rabiee, Rynaz HS; Radfar, Amir; Rafay, Anwar; Rahimi, Kazem; Rahimi-Movaghar, Afarin; Rahimi-Movaghar, Vafa; Rahman, Mahfuzar; Rahman, Muhammad Aziz; Rahman, Mohammad Hifz Ur; Rai, Rajesh Kumar; Rajsic, Sasa; Ram, Usha; Ranabhat, Chhabi Lal; Rangaswamy, Thara; Rankin, Zane; Rao, Paturi Vishnupriya; Rao, Puja C; Rawaf, Salman; Ray, Sarah E; Reiner, Robert C; Reinig, Nikolas; Reitsma, Marissa; Remuzzi, Giuseppe; Renzaho, Andre MN; Resnikoff, Serge; Rezaei, Satar; Ribeiro, Antonio L; Roba, Hirbo Shore; Robinson, Stephen R; Rojas-Rueda, David; Rokni, Mohammad Bagher; Ronfani, Luca; Roshandel, Gholamreza; Roth, Gregory A; Rothenbacher, Dietrich; Roy, Ambuj; Rubagotti, Enrico; Ruhago, George Mugambage; Saadat, Soheil; Safdarian, Mahdi; Safiri, Saeid; Sagar, Rajesh; Sahathevan, Ramesh; Sahraian, Mohammad Ali; Salama, Joseph; Saleh, Muhammad Muhammad; Salomon, Joshua A; Salvi, Sundeep Santosh; Samy, Abdallah M; Sanabria, Juan Ramon; Dolores Sanchez-Nino, Maria; Santomauro, Damian; Santos, Joao Vasco; Santos, Itamar S; Milicevic, Milena MSantric; Sartorius, Benn; Satpathy, Maheswar; Sawhney, Monika; Saxena, Sonia; Schelonka, Kathryn; Schmidt, Maria Ines; Schneider, Ione JC; Ben Schottker; Schutte, Aletta E; Schwebel, David C; Schwendicke, Falk; Seedat, Soraya; Sepanlou, Sadaf G; Servan-Mori, Edson E; Shaheen, Amira; Shaikh, Masood Ali; Shamsipour, Mansour; Islam, Sheikh Mohammed Shariful; Sharma, Rajesh; Sharma, Jayendra; She, Jun; Shi, Peilin; Shibuya, Kenji; Shields, Chloe; Shiferaw, Mekonnen Sisay; Shigematsu, Mika; Shiri, Rahman; Shirkoohi, Reza; Shirude, Shreya; Shishani, Kawkab; Shoman, Haitham; Siabani, Soraya; Sibai, Abla Mehio; Sigfusdottir, Inga Dora; Silberberg, Donald H; Silva, Joao Pedro; Santos Silva, Diego Augusto; Alves Silveira, Dayane Gabriele; Singh, Jasvinder A; Singh, Virendra; Singh, Om Prakash; Singh, Narinder Pal; Sinha, Dhirendra Narain; Skiadaresi, Eirini; Skirbekk, Vegard; Slepak, Erica Leigh; Smith, David L; Smith, Mari; Sobaih, Badr HA; Sobngwi, Eugene; Soljak, Michael; Sorensen, Reed JD; Moraes Sousa, Tatiane Cristina; Sposato, Luciano A; Sufiyan, Muawiyyah Babale; Abdulkader, Rizwan Suliankatchi; Sunguya, Bruno F; Sur, Patrick J; Swaminathan, Soumya; Sykes, Bryan L; Sylte, Dillon; Szoeke, Cassandra EI; Tabares-Seisdedos, Rafael; Tadakamadla, Santosh Kumar; Taffere, Getachew Redae; Takala, Jukka S; Tandon, Nikhil; Tanne, David; Tarekegn, Yihunie L; Tavakkoli, Mohammad; Taveira, Nuno; Taylor, Hugh R; Tegegne, Teketo Kassaw; Tehrani-Banihashemi, Arash; Tekelab, Tesfalidet; Shifa, Girma Temam; Terkawi, Abdullah Sulieman; Tesfaye, Dawit Jember; Tesssema, Belay; Thakur, JS; Thamsuwan, Ornwipa; Theadom, Alice M; Theis, Andrew M; Thomas, Katie E; Thomas, Nihal; Thompson, Robert; Thrift, Amanda G; Tobe-Gai, Ruoyan; Tobollik, Myriam; Tonelli, Marcello; Topor-Madry, Roman; Tortajada, Miguel; Touvier, Mathilde; Traebert, Jefferson; Tran, Bach Xuan; Troeger, Christopher; Truelsen, Thomas; Tsoi, Derrick; Tuzcu, Emin Murat; Tymeson, Hayley; Tyrovolas, Stefanos; Ukwaja, Kingsley Nnanna; Undurraga, Eduardo A; Uneke, Chigozie Jesse; Updike, Rachel; Uthman, Olalekan A; Uzochukwu, Benjamin SChudi; van Boven, Job FM; Varughese, Santosh; Vasankari, Tommi; Veerman, Lennert J; Venkatesh, S; Venketasubramanian, Narayanaswamy; Vidavalur, Ramesh; Vijayakumar, Lakshmi; Violante, Francesco S; Vishnu, Abhishek; Vladimirov, Sergey K; Vlassov, Vasiliy Victorovich; Vollset, Stein Emil; Vos, Theo; Wadilo, Fiseha; Wakayo, Tolassa; Wallin, Mitchell T; Wang, Yuan-Pang; Weichenthal, Scott; Weiderpass, Elisabete; Weintraub, Robert G; Weiss, Daniel J; Werdecker, Andrea; Westerman, Ronny; Whiteford, Harvey A; Wijeratne, Tissa; Williams, Hywel C; Wiysonge, Charles Shey; Woldeyes, Belete Getahun; Wolfe, Charles DA; Woodbrook, Rachel; Woolf, Anthony D; Workicho, Abdulhalik; Xavier, Denis; Xu, Gelin; Yadgir, Simon; Yaghoubi, Mohsen; Yakob, Bereket; Yan, Lijing L; Yano, Yuichiro; Ye, Pengpeng; Yihdego, Mahari Gidey; Yimam, Hassen Hamid; Yip, Paul; Yonemoto, Naohiro; Yoon, Seok-Jun; Yotebieng, Marcel; Younis, Mustafa Z; Yu, Chuanhua; Zaidi, Zoubida; Zaki, Maysaa El Sayed; Zegeye, Elias Asfaw; Zenebe, Zerihun Menlkalew; Zhang, Xueying; Zheng, Yingfeng; Zhou, Maigeng; Zipkin, Ben; Zodpey, Sanjay; Zoeckler, Leo; Zuhlke, Liesl Joanna; Murray, Christopher JL; GBD 2016 DALYs HALE Collaborators
Background Measurement of changes in health across locations is useful to compare and contrast changing epidemiological patterns against health system performance and identify specific needs for resource allocation in research, policy development, and programme decision making. Using the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we drew from two widely used summary measures to monitor such changes in population health: disability-adjusted life-years (DALYs) and healthy life expectancy (HALE). We used these measures to track trends and benchmark progress compared with expected trends on the basis of the Socio-demographic Index (SDI). Methods We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2016. We calculated DALYs by summing years of life lost and years of life lived with disability for each location, age group, sex, and year. We estimated HALE using age-specific death rates and years of life lived with disability per capita. We explored how DALYs and HALE differed from expected trends when compared with the SDI: the geometric mean of income per person, educational attainment in the population older than age 15 years, and total fertility rate. Findings The highest globally observed HALE at birth for both women and men was in Singapore, at 75.2 years (95% uncertainty interval 71.9-78.6) for females and 72.0 years (68.8-75.1) for males. The lowest for females was in the Central African Republic (45.6 years [42.0-49.5]) and for males was in Lesotho (41.5 years [39.0-44.0]). From 1990 to 2016, global HALE increased by an average of 6.24 years (5.97-6.48) for both sexes combined. Global HALE increased by 6.04 years (5.74-6.27) for males and 6.49 years (6.08-6.77) for females, whereas HALE at age 65 years increased by 1.78 years (1.61-1.93) for males and 1.96 years (1.69-2.13) for females. Total global DALYs remained largely unchanged from 1990 to 2016 (-2.3% [-5.9 to 0.9]), with decreases in communicable, maternal, neonatal, and nutritional (CMNN) disease DALYs offset by increased DALYs due to non-communicable diseases (NCDs). The exemplars, calculated as the five lowest ratios of observed to expected age-standardised DALY rates in 2016, were Nicaragua, Costa Rica, the Maldives, Peru, and Israel. The leading three causes of DALYs globally were ischaemic heart disease, cerebrovascular disease, and lower respiratory infections, comprising 16.1% of all DALYs. Total DALYs and age-standardised DALY rates due to most CMNN causes decreased from 1990 to 2016. Conversely, the total DALY burden rose for most NCDs; however, age-standardised DALY rates due to NCDs declined globally. Interpretation At a global level, DALYs and HALE continue to show improvements. At the same time, we observe that many populations are facing growing functional health loss. Rising SDI was associated with increases in cumulative years of life lived with disability and decreases in CMNN DALYs offset by increased NCD DALYs. Relative compression of morbidity highlights the importance of continued health interventions, which has changed in most locations in pace with the gross domestic product per person, education, and family planning. The analysis of DALYs and HALE and their relationship to SDI represents a robust framework with which to benchmark location-specific health performance. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform health policies, health system improvement initiatives, targeted prevention efforts, and development assistance for health, including financial and research investments for all countries, regardless of their level of sociodemographic development. The presence of countries that substantially outperform others suggests the need for increased scrutiny for proven examples of best practices, which can help to extend gains, whereas the presence of underperforming countries suggests the need for devotion of extra attention to health systems that need more robust support. This is an Open Access article under the CC BY 4.0 license.
ISI:000410630000005
ISSN: 1474-547x
CID: 2719102
Childhood cancer incidence by ethnic group in England, 2001-2007: a descriptive epidemiological study
Sayeed, Shameq; Barnes, Isobel; Ali, Raghib
BACKGROUND: After the first year of life, cancers are the commonest cause of death in children. Incidence rates vary between ethnic groups, and recent advances in data linkage allow for a more accurate estimation of these variations. Identifying such differences may help identify potential risk or protective factors for certain childhood cancers. This study thus aims to ascertain whether such differences do indeed exist using nationwide data across seven years, as have previously been described in adult cancers. METHODS: We obtained data for all cancer registrations for children (aged 0-14) in England from January 2001 to December 2007. Ethnicity (self-assigned) was established through record linkage to the Hospital Episodes Statistics database or cancer registry data. Cancers were classified morphologically according to the International Classification of Childhood Cancer into four groups - leukaemias; lymphomas; central nervous system; and other solid tumours. Age standardised incidence rates were estimated for each ethnic group, as well as incidence rate ratios comparing each individual ethnic group (Indian, Pakistani, Bangladeshi, Black African, Black Carribean, Chinese) to Whites, adjusting for sex, age and deprivation. RESULTS: The majority of children in the study are UK born. Black children (RR = 1.18, 99% CI: 1.01-1.39), and amongst South Asians, Pakistani children (RR = 1.19, 99% CI: 1.02-1.39) appear to have an increased risk of all cancers. There is an increased risk of leukaemia in South Asians (RR = 1.31, 99% CI: 1.08-1.58), and of lymphoma in Black (RR = 1.72, 99% CI: 1.13-2.63) and South Asian children (RR = 1.51, 99% CI: 1.10-2.06). South Asians appear to have a decreased risk of CNS cancers (RR = 0.71, 99% CI: 0.54-0.95). CONCLUSIONS: In the tradition of past migrant studies, such descriptive studies within ethnic minority groups permit a better understanding of disease incidence within the population, but also allow for the generation of hypotheses to begin to understand why such differences might exist. Though a major cause of mortality in this age group, childhood cancer remains a relatively rare disease; however, the methods used here have permitted the first nationwide estimation of childhood cancer by individual ethnic group.
PMCID:5574126
PMID: 28841853
ISSN: 1471-2407
CID: 2705742
Burden of musculoskeletal disorders in the Eastern Mediterranean Region, 1990-2013: findings from the Global Burden of Disease Study 2013
Moradi-Lakeh, Maziar; Forouzanfar, Mohammad H; Vollset, Stein Emil; El Bcheraoui, Charbel; Daoud, Farah; Afshin, Ashkan; Charara, Raghid; Khalil, Ibrahim; Higashi, Hideki; Abd El Razek, Mohamed Magdy; Kiadaliri, Aliasghar Ahmad; Alam, Khurshid; Akseer, Nadia; Al-Hamad, Nawal; Ali, Raghib; AlMazroa, Mohammad AbdulAziz; Alomari, Mahmoud A; Al-Rabeeah, Abdullah A; Alsharif, Ubai; Altirkawi, Khalid A; Atique, Suleman; Badawi, Alaa; Barrero, Lope H; Basulaiman, Mohammed; Bazargan-Hejazi, Shahrzad; Bedi, Neeraj; Bensenor, Isabela M; Buchbinder, Rachelle; Danawi, Hadi; Dharmaratne, Samath D; Zannad, Faiez; Farvid, Maryam S; Fereshtehnejad, Seyed-Mohammad; Farzadfar, Farshad; Fischer, Florian; Gupta, Rahul; Hamadeh, Randah Ribhi; Hamidi, Samer; Horino, Masako; Hoy, Damian G; Hsairi, Mohamed; Husseini, Abdullatif; Javanbakht, Mehdi; Jonas, Jost B; Kasaeian, Amir; Khan, Ejaz Ahmad; Khubchandani, Jagdish; Knudsen, Ann Kristin; Kopec, Jacek A; Lunevicius, Raimundas; Abd El Razek, Hassan Magdy; Majeed, Azeem; Malekzadeh, Reza; Mate, Kedar; Mehari, Alem; Meltzer, Michele; Memish, Ziad A; Mirarefin, Mojde; Mohammed, Shafiu; Naheed, Aliya; Obermeyer, Carla Makhlouf; Oh, In-Hwan; Park, Eun-Kee; Peprah, Emmanuel Kwame; Pourmalek, Farshad; Qorbani, Mostafa; Rafay, Anwar; Rahimi-Movaghar, Vafa; Shiri, Rahman; Rahman, Sajjad Ur; Rai, Rajesh Kumar; Rana, Saleem M; Sepanlou, Sadaf G; Shaikh, Masood Ali; Shiue, Ivy; Sibai, Abla Mehio; Silva, Diego Augusto Santos; Singh, Jasvinder A; Skogen, Jens Christoffer; Terkawi, Abdullah Sulieman; Ukwaja, Kingsley N; Westerman, Ronny; Yonemoto, Naohiro; Yoon, Seok-Jun; Younis, Mustafa Z; Zaidi, Zoubida; Zaki, Maysaa El Sayed; Lim, Stephen S; Wang, Haidong; Vos, Theo; Naghavi, Mohsen; Lopez, Alan D; Murray, Christopher J L; Mokdad, Ali H
OBJECTIVES/OBJECTIVE:We used findings from the Global Burden of Disease Study 2013 to report the burden of musculoskeletal disorders in the Eastern Mediterranean Region (EMR). METHODS:The burden of musculoskeletal disorders was calculated for the EMR's 22 countries between 1990 and 2013. A systematic analysis was performed on mortality and morbidity data to estimate prevalence, death, years of live lost, years lived with disability and disability-adjusted life years (DALYs). RESULTS:For musculoskeletal disorders, the crude DALYs rate per 100 000 increased from 1297.1 (95% uncertainty interval (UI) 924.3-1703.4) in 1990 to 1606.0 (95% UI 1141.2-2130.4) in 2013. During 1990-2013, the total DALYs of musculoskeletal disorders increased by 105.2% in the EMR compared with a 58.0% increase in the rest of the world. The burden of musculoskeletal disorders as a proportion of total DALYs increased from 2.4% (95% UI 1.7-3.0) in 1990 to 4.7% (95% UI 3.6-5.8) in 2013. The range of point prevalence (per 1000) among the EMR countries was 28.2-136.0 for low back pain, 27.3-49.7 for neck pain, 9.7-37.3 for osteoarthritis (OA), 0.6-2.2 for rheumatoid arthritis and 0.1-0.8 for gout. Low back pain and neck pain had the highest burden in EMR countries. CONCLUSIONS:This study shows a high burden of musculoskeletal disorders, with a faster increase in EMR compared with the rest of the world. The reasons for this faster increase need to be explored. Our findings call for incorporating prevention and control programmes that should include improving health data, addressing risk factors, providing evidence-based care and community programmes to increase awareness.
PMCID:5738600
PMID: 28209629
ISSN: 1468-2060
CID: 3619422
Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990-2015: a novel analysis from the Global Burden of Disease Study 2015
Barber, Ryan M; Fullman, Nancy; Sorensen, Reed JD; Bollyky, Thomas; McKee, Martin; Nolte, Ellen; Abajobir, Amanuel Alemu; Abate, Kalkidan Hassen; Abbafati, Cristiana; Abbas, Kaja M; Abd-Allah, Foad; Abdulle, Abdishakur M; Abdurahman, Ahmed Abdulahi; Abera, Semaw Ferede; Abraham, Biju; Abreha, Girmatsion Fisseha; Adane, Kelemework; Adelekan, Ademola Lukman; Adetifa, Ifedayo Morayo O; Afshin, Ashkan; Agarwal, Arnav; Agarwal, Sanjay Kumar; Agarwal, Sunilkumar; Agrawal, Anurag; Kiadaliri, Aliasghar Ahmad; Ahmadi, Alireza; Ahmed, Kedir Yimam; Ahmed, Muktar Beshir; Akinyemi, Rufus Olusola; Akinyemiju, Tomi F; Akseer, Nadia; Al-Aly, Ziyad; Alam, Khurshid; Alam, Noore; Alam, Sayed Saidul; Alemu, Zewdie Aderaw; Alene, Kefyalew Addis; Alexander, Lily; Ali, Raghib; Ali, Syed Danish; Alizadeh-Navaei, Reza; Alkerwi, Ala'a; Alla, Francois; Allebeck, Peter; Allen, Christine; Al-Raddadi, Rajaa; Alsharif, Ubai; Altirkawi, Khalid A; Martin, Elena Alvarez; Alvis-Guzman, Nelson; Amare, Azmeraw T; Amini, Erfan; Ammar, Walid; Amo-Adjei, Joshu; Amoako, Yaw Ampem; Anderson, Benjamin O; Androudi, Sofia; Ansari, Hossein; Ansha, Mustafa Geleto; Antonio, Carl Abelardo T; Aernloev, Johan; Artaman, Al; Asayesh, Hamid; Assadi, Reza; Astatkie, Ayalew; Atey, Tesfay Mehari; Atique, Suleman; Atnafu, Niguse Tadele; Atre, Sachin R; Avila-Burgos, Leticia; Avokpaho, Euripide Frinel GArthur; Quintanilla, Beatriz Paulina Ayala; Awasthi, Ashish; Ayele, Nebiyu Negussu; Azzopardi, Peter; Saleem, Huda Omer Ba; Baernighausen, Till; Bacha, Umar; Badawi, Alaa; Banerjee, Amitava; Barac, Aleksandra; Barboza, Miguel A; Barker-Collo, Suzanne L; Barrero, Lope H; Basu, Sanjay; Baune, Bernhard T; Baye, Kaleab; Bayou, Yibeltal Tebekaw; Bazargan-Hejazi, Shahrzad; Bedi, Neeraj; Beghi, Ettore; Bejot, Yannick; Bello, Aminu K; Bennett, Derrick A; Bensenor, Isabela M; Berhane, Adugnaw; Bernabe, Eduardo; Bernal, Oscar Alberto; Beyene, Addisu Shunu; Beyene, Tariku Jibat; Bhutta, Zulfiqar A; Biadgilign, Sibhatu; Bikbov, Boris; Birlik, Sait Mentes; Birungi, Charles; Biryukov, Stan; Bisanzio, Donal; Bizuayehu, Habtamu Mellie; Bose, Dipan; Brainin, Michael; Brauer, Michael; Brazinova, Alexandra; Breitborde, Nicholas JK; Brenner, Hermann; Butt, Zahid A; Cardenas, Rosario; Cahuana-Hurtado, Lucero; Campos-Nonato, Ismael Ricardo; Car, Josip; Carrero, Juan Jesus; Casey, Daniel; Caso, Valeria; Castaneda-Orjuela, Carlos A; Rivas, Jacqueline Castillo; Catala-Lopez, Ferran; Cecilio, Pedro; Cercy, Kelly; Charlson, Fiona J; Chen, Alan Z; Chew, Adrienne; Chibalabala, Mirriam; Chibueze, Chioma Ezinne; Chisumpa, Vesper Hichilombwe; Chitheer, Abdulaal A; Chowdhury, Rajiv; Christensen, Hanne; Christopher, Devasahayam Jesudas; Ciobanu, Liliana G; Cirillo, Massimo; Coggeshall, Megan S; Cooper, Leslie Trumbull; Cortinovis, Monica; Crump, John A; Dalal, Koustuv; Dandona, Lalit; Dandona, Rakhi; Dargan, Paul I; das Neves, Jose; Davey, Gail; Davitoiu, Dragos V; Davletov, Kairat; De Leo, Diego; Del Gobbo, Liana C; del Pozo-Cruz, Borja; Dellavalle, Robert P; Deribe, Kebede; Deribew, Amare; Jarlais, Don CDes; Dey, Subhojit; Dharmaratne, Samath D; Dicker, Daniel; Ding, Eric L; Dokova, Klara; Dorsey, ERay; Doyle, Kerrie E; Dubey, Manisha; Ehrenkranz, Rebecca; Ehrenkranz, Rebecca; Ellingsen, Christian Lycke; Elyazar, Iqbal; Enayati, Ahmadali; Ermakov, Sergey Petrovich; Eshrati, Babak; Esteghamati, Alireza; Estep, Kara; Fuerst, Thomas; Faghmous, Imad DA; Fanuel, Fanuel Belayneh Bekele; Faraon, Emerito Jose Aquino; Farid, Talha A; Farinha, Carla Sofia e Sa; Faro, Andre; Farvid, Maryam S; Farzadfar, Farshad; Feigin, Valery L; Feigl, Andrea B; Fereshtehnejad, Seyed-Mohammad; Fernandes, Jefferson G; Fernandes, Joao C; Feyissa, Tesfaye Regassa; Fischer, Florian; Fitzmaurice, Christina; Fleming, Thomas D; Foigt, Nataliya; Foreman, Kyle J; Forouzanfar, Mohammad H; Franklin, Richard C; Frostad, Joseph; hiwot, Tsegaye Tewelde G; Gakidou, Emmanuela; Gambashidze, Ketevan; Gamkrelidze, Amiran; Gao, Wayne; Garcia-Basteiro, Alberto L; Gebre, Teshome; Gebremedhin, Amanuel Tesfay; Gebremichael, Mengistu Welday; Gebru, Alemseged Aregay; Gelaye, Amha Admasie; Geleijnse, Johanna M; Genova-Maleras, Ricard; Gibney, Katherine B; Giref, Ababi Zergaw; Gishu, Melkamu Dedefo; Giussani, Giorgia; Godwin, William W; Gold, Audra; Goldberg, Ellen M; Gona, Philimon N; Goodridge, Amador; Gopalani, Sameer Vali; Goto, Atsushi; Graetz, Nicholas; Greaves, Felix; Griswold, Max; Guban, Peter Imre; Gugnani, Harish Chander; Gupta, Prakash C; Gupta, Rahul; Gupta, Rajeev; Gupta, Tanush; Gupta, Vipin; Habtewold, Tesfa Dejenie; Hafezi-Nejad, Nima; Haile, Demewoz; Hailu, Alemayehu Desalegne; Hailu, Gessessew Bugssa; Hakuzimana, Alex; Hamadeh, Randah Ribhi; Hambisa, Mitiku Teshome; Hamidi, Samer; Hammami, Mouhanad; Hankey, Graeme J; Hao, Yuantao; Harb, Hilda L; Hareri, Habtamu Abera; Haro, Josep Maria; Hassanvand, Mohammad Sadegh; Havmoeller, Rasmus; Hay, Roderick J; Hay, Simon I; Hendrie, Delia; Heredia-Pi, Ileana Beatriz; Hoek, Hans W; Horino, Masako; Horita, Nobuyuki; Hosgood, HDean; Htet, Aung Soe; Hu, Guoqing; Huang, Hsiang; Huang, John J; Huntley, Bethany M; Huynh, Chantal; Iburg, Kim Moesgaard; Ileanu, Bogdan Vasile; Innos, Kaire; Irenso, Asnake Ararsa; Jahanmehr, Nader; Jakovljevic, Mihajlo B; James, Peter; James, Spencer Lewis; Javanbakht, Mehdi; Jayaraman, Sudha P; Jayatilleke, Achala Upendra; Jeemon, Panniyammakal; Jha, Vivekanand; John, Denny; Johnson, Catherine; Johnson, Sarah C; Jonas, Jost B; Juel, Knud; Kabir, Zubair; Kalkonde, Yogeshwar; Kamal, Ritul; Kan, Haidong; Karch, Andre; Karema, Corine Kakizi; Karimi, Seyed M; Kasaeian, Amir; Kassebaum, Nicholas J; Kastor, Anshul; Katikireddi, Srinivasa Vittal; Kazanjan, Konstantin; Keiyoro, Peter Njenga; Kemmer, Laura; Kemp, Andrew Haddon; Kengne, Andre Pascal; Kerbo, Amene Abebe; Kereselidze, Maia; Kesavachandran, Chandrasekharan Nair; Khader, Yousef Saleh; Khalil, Ibrahim; Khan, Abdur Rahman; Khan, Ejaz Ahmad; Khan, Gulfaraz; Khang, Young-Ho; Khoja, Abdullah Tawfih Abdullah; Khonelidze, Irma; Khubchandani, Jagdish; Kibret, Getiye Dejenu; Kim, Daniel; Kim, Pauline; Kim, Yun Jin; Kimokoti, Ruth W; Kinfu, Yohannes; Kissoon, Niranjan; Kivipelto, Miia; Kokubo, Yoshihiro; Kolk, Anneli; Kolte, Dhaval; Kopec, Jacek A; Kosen, Soewarta; Koul, Parvaiz A; Koyanagi, Ai; Kravchenko, Michael; Krishnaswami, Sanjay; Krohn, Kristopher J; Defo, Barthelemy Kuate; Bicer, Burcu Kucuk; Kuipers, Ernst J; Kulkarni, Veena S; Kumar, GAnil; Kumsa, Fekede Asefa; Kutz, Michael; Kyu, Hmwe H; Lager, Anton Carl Jonas; Lal, Aparna; Lal, Dharmesh Kumar; Lalloo, Ratilal; Lallukka, Tea; Lan, Qing; Langan, Sinead M; Lansingh, Van C; Larson, Heidi J; Larsson, Anders; Laryea, Dennis Odai; Latif, Asma Abdul; Lawrynowicz, Alicia Elena Beatriz; Leasher, Janet L; Leigh, James; Leinsalu, Mall; Leshargie, Cheru Tesema; Leung, Janni; Leung, Ricky; Levi, Miriam; Liang, Xiaofeng; Lim, Stephen S; Lind, Margaret; Linn, Shai; Lipshultz, Steven E; Liu, Patrick; Liu, Yang; Lo, Loon-Tzian; Logroscino, Giancarlo; Lopez, Alan D; Lorch, Scott A; Lotufo, Paulo A; Lozano, Rafael; Lunevicius, Raimundas; Lyons, Ronan A; Macarayan, Erlyn Rachelle King; Mackay, Mark T; El Razek, Hassan Magdy Abd; El Razek, Mohammed Magdy Abd; Mahdavi, Mahdi; Majeed, Azeem; Malekzadeh, Reza; Malta, Deborah Carvalho; Mantovani, Lorenzo G; Manyazewal, Tsegahun; Mapoma, Chabila C; Marcenes, Wagner; Marks, Guy B; Marquez, Neal; Martinez-Raga, Jose; Marzan, Melvin Barrientos; Massano, Joao; Mathur, Manu Raj; Maulik, Pallab K; Mazidi, Mohsen; McAlinden, Colm; McGrath, John J; McNellan, Claire; Meaney, Peter A; Mehari, Alem; Mehndiratta, Man Mohan; Meier, Toni; Mekonnen, Alemayehu B; Meles, Kidanu Gebremariam; Memish, Ziad A; Mengesha, Melkamu Merid; Mengiste, Desalegn Tadese; Mengistie, Mubarek Abera; Menota, Bereket Gebremichael; Mensah, George A; Mereta, Seid Tiku; Meretoja, Atte; Meretoja, Tuomo J; Mezgebe, Haftay Berhane; Micha, Renata; Millear, Anoushka; Mills, Edward J; Minnig, Shawn; Mirarefin, Mojde; Mirrakhimov, Erkin M; Mock, Charles N; Mohammad, Karzan Abdulmuhsin; Mohammed, Shafiu; Mohanty, Sanjay K; Mokdad, Ali H; Mola, Glen Liddell D; Molokhia, Mariam; Monasta, Lorenzo; Montico, Marcella; Moradi-Lakeh, Maziar; Moraga, Paula; Morawska, Lidia; Mori, Rintaro; Moses, Mark; Mueller, Ulrich O; Murthy, Srinivas; Musa, Kamarul Imran; Nachega, Jean B; Nagata, Chie; Nagel, Gabriele; Naghavi, Mohsen; Naheed, Aliya; Naldi, Luigi; Nangia, Vinay; Nascimento, Bruno Ramos; Negoi, Ionut; Neupane, Sudan Prasad; Newton, Charles R; Ng, Marie; Ngalesoni, Frida Namnyak; Ngunjiri, Josephine Wanjiku; Nguyen, Grant; Ningrum, Dina Nur Anggraini; Nolte, Sandra; Nomura, Marika; Norheim, Ole F; Norrving, Bo; Noubiap, Jean Jacques N; Obermeyer, Carla Makhlouf; Ogbo, Felix Akpojene; Oh, In-Hwan; Okoro, Anselm; Oladimeji, Olanrewaju; Olagunju, Andrew Toyin; Olivares, Pedro R; Olsen, Helen E; Olusanya, Bolajoko Olubukunola; Olusanya, Jacob Olusegun; Opio, John Nelson; Oren, Eyal; Ortiz, Alberto; Osborne, Richard H; Osman, Majdi; Owolabi, Mayowa O; Mahesh, PA; Pain, Amanda W; Pakhale, Smita; Castillo, Elizabeth Palomares; Pana, Adrian; Papachristou, Christina; Parsaeian, Mahboubeh; Patel, Tejas; Patton, George C; Paudel, Deepak; Paul, Vinod K; Pearce, Neil; Pereira, David M; Perez-Padilla, Rogelio; Perez-Ruiz, Fernando; Perico, Norberto; Pesudovs, Konrad; Petzold, Max; Phillips, Michael Robert; Pigott, David M; Pillay, Julian David; Pinho, Christine; Polinder, Suzanne; Pond, Constance D; Prakash, V; Purwar, Manorama; Qorbani, Mostafa; Quistberg, DAlex; Radfar, Amir; Rafay, Anwar; Rahimi, Kazem; Rahimi-Movaghar, Vafa; Rahman, Mahfuzar; Rahman, Mohammad Hifz Ur; Rai, Rajesh Kumar; Ram, Usha; Rana, Saleem M; Rankin, Zane; Rao, Paturi Vishnupriya; Rao, Puja C; Rawaf, Salman; Rego, Maria Albertina Santiago; Reitsma, Marissa; Remuzzi, Giuseppe; Renzaho, Andre MNN; Resnikoff, Serge; Rezaei, Satar; Rezai, Mohammad Sadegh; Ribeiro, Antonio L; Roba, Hirbo Shore; Rokni, Mohammad Bagher; Ronfani, Luca; Roshandel, Gholamreza; Roth, Gregory A; Rothenbacher, Dietrich; Roy, Nawal K; Sachdev, Perminder S; Sackey, Ben Benasco; Saeedi, Mohammad Yahya; Safiri, Saeid; Sagar, Rajesh; Sahraian, Mohammad Ali; Saleh, Muhammad Muhammad; Salomon, Joshua A; Samy, Abdallah M; Sanabria, Juan Ramon; Sanchez-Nino, Maria Dolores; Sandar, Logan; Santos, Itamar S; Santos, Joao Vasco; Milicevic, Milena MSantric; Sarmiento-Suarez, Rodrigo; Sartorius, Benn; Satpathy, Maheswar; Savic, Miloje; Sawhney, Monika; Saylan, Mete I; Schoettker, Ben; Schutte, Aletta E; Schwebel, David C; Seedat, Soraya; Seid, Abdulbasit Musa; Seifu, Canaan Negash; Sepanlou, Sadaf G; Serdar, Berrin; Servan-Mori, Edson E; Setegn, Tesfaye; Shackelford, Katya Anne; Shaheen, Amira; Shahraz, Saeid; Shaikh, Masood Ali; Shakh-Nazarova, Marina; Shamsipour, Mansour; Islam, Sheikh Mohammed Shariful; Sharma, Jayendra; Sharma, Rajesh; She, Jun; Sheikhbahaei, Sara; Shen, Jiabin; Shi, Peilin; Shigematsu, Mika; Shin, Min-Jeong; Shiri, Rahman; Shoman, Haitham; Shrime, Mark G; Sibamo, Ephrem Lejore Sibamo; Sigfusdottir, Inga Dora; Silva, Diego Augusto Santos; Silveira, Dayane Gabriele Alves; Sindi, Shireen; Singh, Abhishek; Singh, Jasvinder A; Singh, Om Prakash; Singh, Prashant Kumar; Singh, Virendra; Sinke, Abiy Hiruye; Sinshaw, Aklilu Endalamaw; Skirbekk, Vegard; Sliwa, Karen; Smith, Alison; Sobngwi, Eugene; Soneji, Samir; Soriano, Joan B; Sousa, Tatiane Cristina Moraes; Sposato, Luciano A; Sreeramareddy, Chandrashekhar T; Stathopoulou, Vasiliki; Steel, Nicholas; Steiner, Caitlyn; Steinke, Sabine; Stokes, Mark Andrew; Stranges, Saverio; Strong, Mark; Stroumpoulis, Konstantinos; Sturua, Lela; Sufiyan, Muawiyyah Babale; Suliankatchi, Rizwan Abdulkader; Sun, Jiandong; Sur, Patrick; Swaminathan, Soumya; Sykes, Bryan L; Tabares-Seisdedos, Rafael; Tabb, Karen M; Taffere, Getachew Redae; Talongwa, Roberto Tchio; Tarajia, Musharaf; Tavakkoli, Mohammad; Taveira, Nuno; Teeple, Stephanie; Tegegne, Teketo Kassaw; Tehrani-Banihashemi, Arash; Tekelab, Tesfalidet; Tekle, Dejen Yemane; Shifa, Girma Temam; Terkawi, Abdullah Sulieman; Tesema, Azeb Gebresilassie; Thakur, JS; Thomson, Alan J; Tillmann, Taavi; Tiruye, Tenaw Yimer; Tobe-Gai, Ruoyan; Tonelli, Marcello; Topor-Madry, Roman; Tortajada, Miguel; Troeger, Christopher; Truelsen, Thomas; Tura, Abera Kenay; Uchendu, Uche S; Ukwaja, Kingsley N; Undurraga, Eduardo A; Uneke, Chigozie Jesse; Uthman, Olalekan A; van Boven, Job FM; Van Dingenen, Rita; Varughese, Santosh; Vasankari, Tommi; Venketasubramanian, Narayanaswamy; Violante, Francesco S; Vladimirov, Sergey K; Vlassov, Vasiliy Victorovich; Vollset, Stein Emil; Vos, Theo; Wagner, Joseph A; Wakayo, Tolassa; Waller, Stephen G; Walson, Judd L; Wang, Haidong; Wang, Yuan-Pang; Watkins, David A; Weiderpass, Elisabete; Weintraub, Robert G; Wen, Chi-Pang; Werdecker, Andrea; Wesana, Joshua; Westerman, Ronny; Whiteford, Harvey A; Wilkinson, James D; Wiysonge, Charles Shey; Woldeyes, Belete Getahun; Wolfe, Charles DA; Won, Sungho; Workicho, Abdulhalik; Workie, Shimelash Bitew; Wubshet, Mamo; Xavier, Denis; Xu, Gelin; Yadav, Ajit Kumar; Yaghoubi, Mohsen; Yakob, Bereket; Yan, Lijing L; Yano, Yuichiro; Yaseri, Mehdi; Yimam, Hassen Hamid; Yip, Paul; Yonemoto, Naohiro; Yoon, Seok-Jun; Younis, Mustafa Z; Yu, Chuanhua; Zaidi, Zoubida; Zaki, Maysaa El Sayed; Zambrana-Torrelio, Carlos; Zapata, Tomas; Zenebe, Zerihun Menlkalew; Zodpey, Sanjay; Zoeckler, Leo; Zuhlke, Liesl Joanna; Murray, Christopher JL; GBD 2015 Healthcare Access Quality
Background National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. Methods We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure-the Healthcare Quality and Access (HAQ) Index-on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r= 0.88), an index of 11 universal health coverage interventions (r= 0.83), and human resources for health per 1000 (r= 0.77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time. Findings Between 1990 and 2015, nearly all countries and territories saw their HAQ Index values improve; nonetheless, the difference between the highest and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28.6 to 94.6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle-SDI countries; and measles and tetanus among lowest-SDI countries. While the global HAQ Index average rose from 40.7 (95% uncertainty interval, 39.0-42.8) in 1990 to 53.7 (52.2-55.4) in 2015, far less progress occurred in narrowing the gap between observed HAQ Index values and maximum levels achieved; at the global level, the difference between the observed and frontier HAQ Index only decreased from 21.2 in 1990 to 20.1 in 2015. If every country and territory had achieved the highest observed HAQ Index by their corresponding level of SDI, the global average would have been 73.8 in 2015. Several countries, particularly in eastern and western sub-Saharan Africa, reached HAQ Index values similar to or beyond their development levels, whereas others, namely in southern sub-Saharan Africa, the Middle East, and south Asia, lagged behind what geographies of similar development attained between 1990 and 2015. Interpretation This novel extension of the GBD Study shows the untapped potential for personal health-care access and quality improvement across the development spectrum. Amid substantive advances in personal health care at the national level, heterogeneous patterns for individual causes in given countries or territories suggest that few places have consistently achieved optimal health-care access and quality across health-system functions and therapeutic areas. This is especially evident in middle-SDI countries, many of which have recently undergone or are currently experiencing epidemiological transitions. The HAQ Index, if paired with other measures of health-systemcharacteristics such as intervention coverage, could provide a robust avenue for tracking progress on universal health coverage and identifying local priorities for strengthening personal health-care quality and access throughout the world.
ISI:000405477900026
ISSN: 1474-547x
CID: 2650242
Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-years for 32 Cancer Groups, 1990 to 2015: A Systematic Analysis for the Global Burden of Disease Study
Fitzmaurice, Christina; Allen, Christine; Barber, Ryan M; Barregard, Lars; Bhutta, Zulfiqar A; Brenner, Hermann; Dicker, Daniel J; Chimed-Orchir, Odgerel; Dandona, Rakhi; Dandona, Lalit; Fleming, Tom; Forouzanfar, Mohammad H; Hancock, Jamie; Hay, Roderick J; Hunter-Merrill, Rachel; Huynh, Chantal; Hosgood, H Dean; Johnson, Catherine O; Jonas, Jost B; Khubchandani, Jagdish; Kumar, G Anil; Kutz, Michael; Lan, Qing; Larson, Heidi J; Liang, Xiaofeng; Lim, Stephen S; Lopez, Alan D; MacIntyre, Michael F; Marczak, Laurie; Marquez, Neal; Mokdad, Ali H; Pinho, Christine; Pourmalek, Farshad; Salomon, Joshua A; Sanabria, Juan Ramon; Sandar, Logan; Sartorius, Benn; Schwartz, Stephen M; Shackelford, Katya A; Shibuya, Kenji; Stanaway, Jeff; Steiner, Caitlyn; Sun, Jiandong; Takahashi, Ken; Vollset, Stein Emil; Vos, Theo; Wagner, Joseph A; Wang, Haidong; Westerman, Ronny; Zeeb, Hajo; Zoeckler, Leo; Abd-Allah, Foad; Ahmed, Muktar Beshir; Alabed, Samer; Alam, Noore K; Aldhahri, Saleh Fahed; Alem, Girma; Alemayohu, Mulubirhan Assefa; Ali, Raghib; Al-Raddadi, Rajaa; Amare, Azmeraw; Amoako, Yaw; Artaman, Al; Asayesh, Hamid; Atnafu, Niguse; Awasthi, Ashish; Saleem, Huda Ba; Barac, Aleksandra; Bedi, Neeraj; Bensenor, Isabela; Berhane, Adugnaw; Bernabé, Eduardo; Betsu, Balem; Binagwaho, Agnes; Boneya, Dube; Campos-Nonato, Ismael; Castañeda-Orjuela, Carlos; Catalá-López, Ferrán; Chiang, Peggy; Chibueze, Chioma; Chitheer, Abdulaal; Choi, Jee-Young; Cowie, Benjamin; Damtew, Solomon; das Neves, José; Dey, Suhojit; Dharmaratne, Samath; Dhillon, Preet; Ding, Eric; Driscoll, Tim; Ekwueme, Donatus; Endries, Aman Yesuf; Farvid, Maryam; Farzadfar, Farshad; Fernandes, Joao; Fischer, Florian; G/Hiwot, Tsegaye Tewelde; Gebru, Alemseged; Gopalani, Sameer; Hailu, Alemayehu; Horino, Masako; Horita, Nobuyuki; Husseini, Abdullatif; Huybrechts, Inge; Inoue, Manami; Islami, Farhad; Jakovljevic, Mihajlo; James, Spencer; Javanbakht, Mehdi; Jee, Sun Ha; Kasaeian, Amir; Kedir, Muktar Sano; Khader, Yousef S; Khang, Young-Ho; Kim, Daniel; Leigh, James; Linn, Shai; Lunevicius, Raimundas; El Razek, Hassan Magdy Abd; Malekzadeh, Reza; Malta, Deborah Carvalho; Marcenes, Wagner; Markos, Desalegn; Melaku, Yohannes A; Meles, Kidanu G; Mendoza, Walter; Mengiste, Desalegn Tadese; Meretoja, Tuomo J; Miller, Ted R; Mohammad, Karzan Abdulmuhsin; Mohammadi, Alireza; Mohammed, Shafiu; Moradi-Lakeh, Maziar; Nagel, Gabriele; Nand, Devina; Le Nguyen, Quyen; Nolte, Sandra; Ogbo, Felix A; Oladimeji, Kelechi E; Oren, Eyal; Pa, Mahesh; Park, Eun-Kee; Pereira, David M; Plass, Dietrich; Qorbani, Mostafa; Radfar, Amir; Rafay, Anwar; Rahman, Mahfuzar; Rana, Saleem M; Søreide, Kjetil; Satpathy, Maheswar; Sawhney, Monika; Sepanlou, Sadaf G; Shaikh, Masood Ali; She, Jun; Shiue, Ivy; Shore, Hirbo Roba; Shrime, Mark G; So, Samuel; Soneji, Samir; Stathopoulou, Vasiliki; Stroumpoulis, Konstantinos; Sufiyan, Muawiyyah Babale; Sykes, Bryan L; Tabarés-Seisdedos, Rafael; Tadese, Fentaw; Tedla, Bemnet Amare; Tessema, Gizachew Assefa; Thakur, J S; Tran, Bach Xuan; Ukwaja, Kingsley Nnanna; Uzochukwu, Benjamin S Chudi; Vlassov, Vasiliy Victorovich; Weiderpass, Elisabete; Wubshet Terefe, Mamo; Yebyo, Henock Gebremedhin; Yimam, Hassen Hamid; Yonemoto, Naohiro; Younis, Mustafa Z; Yu, Chuanhua; Zaidi, Zoubida; Zaki, Maysaa El Sayed; Zenebe, Zerihun Menlkalew; Murray, Christopher J L; Naghavi, Mohsen
IMPORTANCE/OBJECTIVE:Cancer is the second leading cause of death worldwide. Current estimates on the burden of cancer are needed for cancer control planning. OBJECTIVE:To estimate mortality, incidence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 32 cancers in 195 countries and territories from 1990 to 2015. EVIDENCE REVIEW/METHODS:Cancer mortality was estimated using vital registration system data, cancer registry incidence data (transformed to mortality estimates using separately estimated mortality to incidence [MI] ratios), and verbal autopsy data. Cancer incidence was calculated by dividing mortality estimates through the modeled MI ratios. To calculate cancer prevalence, MI ratios were used to model survival. To calculate YLDs, prevalence estimates were multiplied by disability weights. The YLLs were estimated by multiplying age-specific cancer deaths by the reference life expectancy. DALYs were estimated as the sum of YLDs and YLLs. A sociodemographic index (SDI) was created for each location based on income per capita, educational attainment, and fertility. Countries were categorized by SDI quintiles to summarize results. FINDINGS/RESULTS:In 2015, there were 17.5 million cancer cases worldwide and 8.7 million deaths. Between 2005 and 2015, cancer cases increased by 33%, with population aging contributing 16%, population growth 13%, and changes in age-specific rates contributing 4%. For men, the most common cancer globally was prostate cancer (1.6 million cases). Tracheal, bronchus, and lung cancer was the leading cause of cancer deaths and DALYs in men (1.2 million deaths and 25.9 million DALYs). For women, the most common cancer was breast cancer (2.4 million cases). Breast cancer was also the leading cause of cancer deaths and DALYs for women (523 000 deaths and 15.1 million DALYs). Overall, cancer caused 208.3 million DALYs worldwide in 2015 for both sexes combined. Between 2005 and 2015, age-standardized incidence rates for all cancers combined increased in 174 of 195 countries or territories. Age-standardized death rates (ASDRs) for all cancers combined decreased within that timeframe in 140 of 195 countries or territories. Countries with an increase in the ASDR due to all cancers were largely located on the African continent. Of all cancers, deaths between 2005 and 2015 decreased significantly for Hodgkin lymphoma (-6.1% [95% uncertainty interval (UI), -10.6% to -1.3%]). The number of deaths also decreased for esophageal cancer, stomach cancer, and chronic myeloid leukemia, although these results were not statistically significant. CONCLUSION AND RELEVANCE/CONCLUSIONS:As part of the epidemiological transition, cancer incidence is expected to increase in the future, further straining limited health care resources. Appropriate allocation of resources for cancer prevention, early diagnosis, and curative and palliative care requires detailed knowledge of the local burden of cancer. The GBD 2015 study results demonstrate that progress is possible in the war against cancer. However, the major findings also highlight an unmet need for cancer prevention efforts, including tobacco control, vaccination, and the promotion of physical activity and a healthy diet.
PMID: 27918777
ISSN: 2374-2445
CID: 5265392
Global Burden of Hypertension and Systolic Blood Pressure of at Least 110 to 115 mm Hg, 1990-2015
Forouzanfar, Mohammad H; Liu, Patrick; Roth, Gregory A; Ng, Marie; Biryukov, Stan; Marczak, Laurie; Alexander, Lily; Estep, Kara; Hassen Abate, Kalkidan; Akinyemiju, Tomi F; Ali, Raghib; Alvis-Guzman, Nelson; Azzopardi, Peter; Banerjee, Amitava; Barnighausen, Till; Basu, Arindam; Bekele, Tolesa; Bennett, Derrick A; Biadgilign, Sibhatu; Catala-Lopez, Ferran; Feigin, Valery L; Fernandes, Joao C; Fischer, Florian; Gebru, Alemseged Aregay; Gona, Philimon; Gupta, Rajeev; Hankey, Graeme J; Jonas, Jost B; Judd, Suzanne E; Khang, Young-Ho; Khosravi, Ardeshir; Kim, Yun Jin; Kimokoti, Ruth W; Kokubo, Yoshihiro; Kolte, Dhaval; Lopez, Alan; Lotufo, Paulo A; Malekzadeh, Reza; Melaku, Yohannes Adama; Mensah, George A; Misganaw, Awoke; Mokdad, Ali H; Moran, Andrew E; Nawaz, Haseeb; Neal, Bruce; Ngalesoni, Frida Namnyak; Ohkubo, Takayoshi; Pourmalek, Farshad; Rafay, Anwar; Rai, Rajesh Kumar; Rojas-Rueda, David; Sampson, Uchechukwu K; Santos, Itamar S; Sawhney, Monika; Schutte, Aletta E; Sepanlou, Sadaf G; Shifa, Girma Temam; Shiue, Ivy; Tedla, Bemnet Amare; Thrift, Amanda G; Tonelli, Marcello; Truelsen, Thomas; Tsilimparis, Nikolaos; Ukwaja, Kingsley Nnanna; Uthman, Olalekan A; Vasankari, Tommi; Venketasubramanian, Narayanaswamy; Vlassov, Vasiliy Victorovich; Vos, Theo; Westerman, Ronny; Yan, Lijing L; Yano, Yuichiro; Yonemoto, Naohiro; Zaki, Maysaa El Sayed; Murray, Christopher J L
Importance: Elevated systolic blood (SBP) pressure is a leading global health risk. Quantifying the levels of SBP is important to guide prevention policies and interventions. Objective: To estimate the association between SBP of at least 110 to 115 mm Hg and SBP of 140 mm Hg or higher and the burden of different causes of death and disability by age and sex for 195 countries and territories, 1990-2015. Design: A comparative risk assessment of health loss related to SBP. Estimated distribution of SBP was based on 844 studies from 154 countries (published 1980-2015) of 8.69 million participants. Spatiotemporal Gaussian process regression was used to generate estimates of mean SBP and adjusted variance for each age, sex, country, and year. Diseases with sufficient evidence for a causal relationship with high SBP (eg, ischemic heart disease, ischemic stroke, and hemorrhagic stroke) were included in the primary analysis. Main Outcomes and Measures: Mean SBP level, cause-specific deaths, and health burden related to SBP (>/=110-115 mm Hg and also >/=140 mm Hg) by age, sex, country, and year. Results: Between 1990-2015, the rate of SBP of at least 110 to 115 mm Hg increased from 73119 (95% uncertainty interval [UI], 67949-78241) to 81373 (95% UI, 76814-85770) per 100000, and SBP of 140 mm Hg or higher increased from 17307 (95% UI, 17117-17492) to 20526 (95% UI, 20283-20746) per 100000. The estimated annual death rate per 100000 associated with SBP of at least 110 to 115 mm Hg increased from 135.6 (95% UI, 122.4-148.1) to 145.2 (95% UI 130.3-159.9) and the rate for SBP of 140 mm Hg or higher increased from 97.9 (95% UI, 87.5-108.1) to 106.3 (95% UI, 94.6-118.1). For loss of DALYs associated with systolic blood pressure of 140 mm Hg or higher, the loss increased from 95.9 million (95% uncertainty interval [UI], 87.0-104.9 million) to 143.0 million (95% UI, 130.2-157.0 million) [corrected], and for SBP of 140 mm Hg or higher, the loss increased from 5.2 million (95% UI, 4.6-5.7 million) to 7.8 million (95% UI, 7.0-8.7 million). The largest numbers of SBP-related deaths were caused by ischemic heart disease (4.9 million [95% UI, 4.0-5.7 million]; 54.5%), hemorrhagic stroke (2.0 million [95% UI, 1.6-2.3 million]; 58.3%), and ischemic stroke (1.5 million [95% UI, 1.2-1.8 million]; 50.0%). In 2015, China, India, Russia, Indonesia, and the United States accounted for more than half of the global DALYs related to SBP of at least 110 to 115 mm Hg. Conclusions and Relevance: In international surveys, although there is uncertainty in some estimates, the rate of elevated SBP (>/=110-115 and >/=140 mm Hg) increased substantially between 1990 and 2015, and DALYs and deaths associated with elevated SBP also increased. Projections based on this sample suggest that in 2015, an estimated 3.5 billion adults had SBP of at least 110 to 115 mm Hg and 874 million adults had SBP of 140 mm Hg or higher.
PMID: 28097354
ISSN: 1538-3598
CID: 2642012
