With the prevalence of unhealthy lifestyles and the accelerated trend of population aging, the mortality rate of cardiovascular diseases remains high in China. A timely understanding of the current and future trends of cardiovascular disease mortality in China, as well as exploring potential influencing factors and solutions, can provide a reference for formulating cardiovascular disease prevention and control measures.
To analyze the trend of cardiovascular disease mortality in China from 2009 to 2021 and predict the future trends from 2022 to 2030.
Cardiovascular disease mortality data were selected and analyzed based on gender, urban-rural areas, regions, and age groups from the "China Death Surveillance Data Set (2009-2021) " published by the Chinese Center for Disease Control and Prevention. The Joinpoint regression model was used to calculate the annual percentage change (APC) and average annual percentage change (AAPC) to analyze the changing trends. Additionally, a GM (1, 1) model was established using R (4.3.1) software to predict the crude mortality rate of cardiovascular diseases in China from 2022 to 2030.
From 2009 to 2021, the crude mortality rate of cardiovascular diseases in China increased from 235.83/100 000 in 2009 to 353.31/100 000 in 2021, with the AAPC of 3.3% (95%CI=2.8% to 3.8%, P<0.001). The age-standardized mortality rate decreased from 281.82/100 000 in 2009 to 221.24/100 000 in 2021, with the AAPC of -1.9% (95%CI=-2.6% to -1.2%, P<0.001). During this period, the standardized mortality rate for cardiovascular diseases in China showed a decreasing trend across different genders (AAPC for males=-2.0%, AAPC for females=-2.1%; P<0.05), urban and rural areas (AAPC for urban=-1.3%, AAPC for rural=-2.4%; P<0.05), and regions (AAPC for eastern region=-2.1%, AAPC for central region=-2.2%, AAPC for western region=-1.0%; P<0.05). Notably, the mortality rate decline was greater in females than males, in rural areas than urban areas, and the central region than the eastern and western regions. The results of the GM (1, 1) model showed that the crude mortality rate of cardiovascular diseases in China will continue to rise to 461.57/100 000 from 2022 to 2030.
From 2009 to 2021, the overall crude mortality rate of cardiovascular disease in China has shown a continuous upward trend, while the overall standardized mortality rate has shown a downward trend. The burden of cardiovascular disease mortality in China still faces severe challenges. The GM (1, 1) model predicts a continuous increase in the crude mortality rate of cardiovascular diseases in China from 2022 to 2030. Therefore, it is necessary to formulate and implement scientifically effective measures for the prevention and control of cardiovascular diseases, with a focus on male, elderly and rural residents.
Gastroesophageal reflux disease (GERD) has a high incidence and a heavy disease burden in recent years, but there is a lack of data to understand the burden of GERD in China. This study describes and analyzes the disease burden of GERD in order to better understand the prevalence of GERD in China.
To analyze the disease burden and prevalence trend of GERD in China from 1990 to 2019, and to provide a reference for the prevention and treatment of GERD in China.
Crude and standardized incidence, prevalence, and DALY rates of GERD in China from 1990 to 2019 were obtained from the Global Burden of Disease Database 2019 (GBD 2019) ; the rate of change was calculated, and Joinpoint regression model was used to analyze the standardized incidence, prevalence, and DALY rates of GERD, and the annual percentage change (APC) was calculated.
In 2019, the crude rate and standardized rate of GERD incidence in China were 2 299.80 per 100 000 and 1 841.66 per 100 000, respectively. Compared with 1 761.59 per 100 000 and 1 849.31 per 100 000 in 1990, the crude rate increased by 30.55%, and the standardized rate decreased by 0.41%. In 2019, the crude rate and standardized rate of GERD prevalence in China were 5 739.55 per 100 000 and 4 509.32 per 100 000, respectively. Compared with 4 252.72 per 100 000 and 4 532.19 per 100 000 in 1990, the crude rate increased by 34.96%, and the standardized rate decreased by 0.51%. In 2019, the crude rate and standardized rate of GERD DALY rate in China were 44.37 per 100 000 and 34.94 per 100 000, respectively. Compared with 33.10 per 100 000 and 35.04 per 100 000 in 1990, the crude rate increased by 34.05%, and the standardized rate decreased by 0.29%. The standardized incidence, prevalence, and DALY rates were lower than crude rates after 1996. The standardized incidence, prevalence, and DALY rates of Chinese women were higher than those of men from 1990 to 2019. The results of Joinpoint regression analysis showed that the standardized incidence of GERD in China showed a downward trend from 1990 to 1994 (APC=-1.0%), a downward trend from 2005 to 2010 (APC=-1.4%), and an upward trend from 2014 to 2017 (APC=3.2%). The standardized prevalence of GERD in China showed a downward trend from 1990 to 1994 (APC=-1.2%), a downward trend from 2005 to 2009 (APC=-1.7%), and an upward trend from 2014 to 2017 (APC=3.7%). The standardized DALY rates of GERD in China showed a downward trend from 1990 to 1994 (APC=-1.1%), a downward trend from 2005 to 2009 (APC=-1.7%), and an upward trend from 2014 to 2017 (APC=3.6%). In 2019, the standardized incidence, prevalence, and DALY rates of GERD in China continued to increase with age, peaking at the age of 70 to 84 years. The number of new cases and cases of GERD in 2019 were respectively about 32.711 3 million and 81.636 5 million, and the populations were mainly concentrated in the age group of 45 to 59 years and 30 to 34 years.
From 1990 to 2019, the disease burden of GERD in China showed an upward trend in terms of crude rate and a slight decline in terms of standardized rate, indicating that aging had a great impact on the incidence, prevalence and DALY rate of GERD in China. In addition, it is important to pay attention to the middle-aged and young population, who account for a larger proportion of the population already suffering from GERD and may be closely related to overweight or obesity, alcohol consumption and dietary habits, etc.
Dental caries is one of the most common noncommunicable diseases worldwide, affecting more than one-third of the global population. The analysis of the current situation and trends in the disease burden of dental caries may provide a reference for the prevention and control strategies of dental caries.
To analyze the current situation and trends in the incidence, prevalence and years lived with disability (YLD) of dental caries in China and provide a reference for the development of the prevention and control of dental caries.
Data on the incidence, prevalence and YLD of caries of deciduous teeth and permanent teeth between 1990 and 2019 in China were extracted from the 2019 Global Burden of Disease (GBD) study. The percentage change in the counts of incident cases, prevalent cases and YLD of caries of deciduous teeth and permanent teeth from 1990 to 2019 was calculated, and Joinpoint regression model was used to analyze the annual percentage change (APC) and average APC (AAPC) in age-standardized rates of incidence, prevalence and YLD between 1990 and 2019 in China.
Compared with 1990, the counts of incident cases, prevalent cases and YLD of caries of deciduous teeth in China in 2019 decreased by 25.69%, 28.74% and 28.63%, respectively; the counts of incident cases, prevalent cases and YLD of caries of permanent teeth in China in 2019 increased by 17.41%, 15.84% and 15.07%, respectively. In all age groups in 2019, the highest incidence rate (118.96%) of caries of deciduous teeth was observed in children aged 5 to 9 years, as well as the highest prevalence rate (53.08%) and YLD rate (20.40/100, 000) of caries of deciduous teeth in children aged 1 to 4 years. The highest incidence rate (62.30%), prevalence rate (32.19%), and YLD rate (32.41/100 000) of caries of permanent teeth were observed in adults aged 20 to 24 years in 2019. Joinpoint regression analysis showed that the age-standardized rates of incidence (AAPC=0.21%, 95%CI=0.19% to 0.22%), prevalence (AAPC=0.03%, 95%CI=0.01% to 0.05%) and YLD (AAPC=0.03%, 95%CI=0.01% to 0.05%) of caries of deciduous teeth showed an overall upward trend in China between 1990 and 2019, and the age-standardized rates of incidence (AAPC=-0.05%, 95%CI=-0.05% to -0.04%), prevalence (AAPC=-0.23%, 95%CI=-0.32% to -0.14%) and YLD (AAPC=-0.22%, 95%CI=-0.31% to -0.13%) of caries of permanent teeth showed a downward trend in China between 1990 and 2019.
From 1990 to 2019, the burdens in caries of deciduous teeth in China showed an increasing trend, while the burdens in caries of permanent teeth caries showed a decreasing trend but remained serious in China. Caries prevention should not only be limited to children, but should include people of all age groups.
Gallbladder cancer is featured by difficult early detection, poor treatment effectiveness and high mortality. An in-depth epidemiology research of gallbladder cancer can provide valuable data for the formulation of prevention and treatment strategies for gallbladder cancer.
To analyze the trend of disease burden of gallbladder cancer in China from 1990 to 2019, and to estimate its onset age, period, cohort effects and future trends.
Data of disease burden of gallbladder cancer, including the incidence, prevalence, mortality, disability adjusted life year (DALYs) rate and corresponding standardized rates in China from 1990 to 2019 were extracted from the 2019 Global Burden of Disease Research (GBD 2019) database from March to June 2023. The annual percentage change (APC) and average annual percentage change (AAPC) were calculated using Joinpoint to analyze the trend of disease burden of gallbladder cancer in China from 1990 to 2019. A Bayesian age-period-cohort analysis (BAPC) model was created to predict the incidence of gallbladder cancer in China from 2020 to 2030.
From 1990 to 2019, the standardized incidence rate of gallbladder cancer in China significantly rose from 1.58/100 000 in 1990 to 2.01/100 000 in 2019, with the AAPC of 0.82% (95%CI=0.65%-1.00%, P<0.001). The standardized prevalence significantly rose from 1.64/100 000 in 1990 to 2.40/100 000 in 2019, with the AAPC of 1.34% (95%CI=1.14%-1.54%, P<0.001). The standardized mortality significantly rose from 1.61/100 000 in 1990 to 1.82/100 000 in 2019, with the AAPC of 0.40% (95%CI=0.24%-0.56%, P<0.001). The standardized DALYs rate significantly rose from 35.18/100 000 in 1990 to 37.71/100 000 in 2019, with the AAPC of 0.25% (95%CI=0.12%-0.38%, P<0.001). The BAPC model revealed that the net drift values for the incidence and mortality of gallbladder cancer in China from 1990 to 2019 were 0.99 (95%CI=0.81-1.18) and 0.42 (95%CI=0.21-0.63), respectively. The incidence and mortality of gallbladder cancer increased with age, and the incidence of gallbladder cancer achieved the peak in people aged 80 years and above. The risk of onset and death of gallbladder cancer showed a decreasing trend at first and then an increasing trend followed by a decreasing trend over time, both of which peaked from 2005 to 2009. In addition, the risk of onset and death of gallbladder cancer showed an increasing trend at first and then a decreasing trend over the time of birth cohort. The BAPC model predicted that the standardized incidence, morbidity, mortality and DALYs rate of gallbladder cancer in China will show a slight upward trend from 2020 to 2030.
From 1990 to 2019, the standardized incidence, prevalence, mortality and DALYs rate of gallbladder cancer in China showed an upward trend, and the disease burden was still serious. The prevention and treatment of gallbladder cancer among men and the elderly, and vigorous propaganda of medical knowledge about cancer prevention, biliary disease control and promotion of healthy lifestyles should be strengthen to reduce the disease burden of gallbladder cancer.
