ObjectiveTo analyze the disease burden and development trend of non-Hodgkin lymphoma (NHL) in China from 1990 to 2019. MethodsThe changes of incidence, mortality, disability-adjusted life years (DALY) and their corresponding age-normalization rates for NHL were analyzed by using the 2019 Global Burden of Disease Database. Regression analysis was performed by Joinpoint software to calculate annual percentage change (APC) and average annual percentage change (AAPC) of standardized morbidity, standardized mortality, standardized DALY rate to reflect the change trend of disease burden. And the results were compared with global data. ResultsFrom 1990 to 2019, the disease burden of NHL in China showed an overall increasing trend. Compared with 2019, the standard incidence rate, standard mortality rate and standard DALY rate of NHL in China increased by 144.72%, 27.17% and 15.61%, respectively. The annual rates of change were 3.12%, 0.80% and 0.51%, respectively. There were gender and age differences in disease burden. The burden of disease increased with age, and the burden of disease was higher in males than in females. ConclusionThe disease burden of NHL in China shows an increasing trend from 1990 to 2019. With the development of diagnosis and treatment options, the disease burden has decreased in recent years, but it is still higher than the global level. There is still a need to strengthen research on its pathogenesis and treatment options, and to actively intervene in high-risk groups to reduce the disease burden of NHL.
ObjectiveTo understand the current status of research methods in disease burden systematic reviews, identify limitations and shortcomings of existing research methods, and provide suggestions to address relevant issues. MethodsA computer search of the PubMed database was conducted to collect systematic reviews on disease burden, with search limits set from database inception to December 21, 2023. Two independent researchers utilized Endnote 20 for literature screening and Excel 2019 for data extraction and descriptive analysis. ResultsA total of 216 articles were included in the review, revealing a year-on-year increase in the number of systematic reviews on disease burden since 2004. The journal PharmacoEconomics published the most articles (n=22), while research on certain infectious diseases and parasitic infections was the most prevalent (n=51). Only 31 articles provided a complete account of the entire systematic review process. The reporting rates for inclusion/exclusion criteria, information retrieval, literature screening, and statistical analysis steps were all 100%. However, the rate of protocol registration was relatively low at 19%. Eighty-eight percent of the articles utilized software such as Excel and Epidata for data extraction, yet only 32% adhered to the reproducibility principles outlined in AMSTAR-2. In terms of quality assessment, 105 articles underwent evaluation, with the Joanna Briggs Institute checklist and Newcastle-Ottawa scale being the most commonly used quality assessment tools for epidemiological studies, while economic studies preferred the Drummond checklist (n=9). Regarding the details of inclusion/exclusion criteria, only 53% of studies reported their study design in detail, and less than one-sixth provided a comprehensive description of the interventions and control measures. Statistical analyses predominantly employed qualitative methods (80%), with quantitative analyses comprising a minority (20%), all of which were conducted using meta-analysis techniques, primarily utilizing R software (n=15). ConclusionThe number of systematic reviews on disease burden has shown a yearly increasing trend; however, most studies have failed to comprehensively adhere to the fundamental processes of systematic reviews, significantly limiting their quality. Currently, the primary issues include a lack of protocol registration, incomplete supplementary searches, mismatched quality assessment tools, and insufficiently comprehensive outcome measures. To address these challenges, it is essential to develop a methodological guideline for systematic reviews on disease burden that incorporates these concerns. Such a guideline would standardize researchers' practices and ensure strict adherence to systematic review methodologies, thereby enhancing the scientific rigor of the research and its support for clinical decision-making.
Objective To systematically review the epidemic trend and disease burden of ischemic stroke in the Chinese population and to provide references for formulating reasonable prevention and treatment measures and allocating health resources. Methods Based on Global Burden of Disease (GBD) data, we analyzed the morbidity, mortality, disability-adjusted life year (DALY) and normalized rates for ischemic stroke in China from 1990 to 2019 and evaluated the changes in the disease burden by sex and age group. Meanwhile, joinpoint regression model was constructed to analyze the time trend change in each stage during the study period. Results Compared with 1990, the incidence, mortality and DALY rate of ischemic stroke in China increased by 171.68%, 125.60% and 98.60% in 2019, among which the incidence, mortality and DALY rate of males increased by 184.29%, 148.96% and 115.16%, respectively; the morbidity, mortality and DALY rates of females increased by 160.9%, 101.32% and 81.44%, respectively. The age-standardized incidence increased by 34.70%, while the age-standardized mortality and age-standardized DALY rate decreased by 3.33% and 4.02%, respectively; the age-standardized incidence, mortality and DALY rates of males increased by 39.52%, 8.03% and 3.68%, respectively; the age-standardized incidence rate of females increased by 31.40%, while the age-standardized mortality rate and age-standardized DALY rate decreased by 14.02% and 11.53%, respectively. In 2019, both the mortality rate and DALY rate due to ischemic stroke increased with age, and the highest rate was found in the population over 85 years old. Males over 60 years old were significantly than females. In the 55-84 age group, the incidence of ischemic stroke in females was higher than that in males, while in the 85 and above age group, the incidence of ischemic stroke in females was lower than that in males. The AAPC of age-standardized incidence, age-standardized mortality, and age-standardized DALY rates due to ischemic stroke from 1990 to 2019 were 1.06% (95%CI 1.00% to 1.11%), 0.01% (95%CI −0.45% to 0.48%) and −0.16% (95%CI −0.53% to 0.22%), respectively. All indicators of the AAPC for males were higher than those for females. ConclusionThe curvent age-standardized mortality and DALY rate of ischemic stroke in China have decreased slightly compared with 1990. The crude mortality, morbidity and disease burden have significantly increased. All indicators of the AAPC for males were higher than those for females. To reduce the epidemic trend and disease burden of ischemic stroke, reasonable prevention and treatment measures and rational allocation of health resources should be made according to sex and age.
Objective To systematically review the incidence, mortality and disease burden of colorectal cancer (CRC) in China. Methods The CNKI, WanFang Data, VIP, CBM, PubMed, Embase and Web of Science databases were searched to collect cohort studies about the incidence, mortality and disease burden of CRC in China from the establishment of the database to July 2024. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by using Stata 18.0 software. Results A total of fifty-six studies were included. The result of meta-analysis showed that the overall incidence of CRC in China was 31‰ (95%CI 29‰ to 33‰), and the incidence of male was 35‰ (95%CI 32‰ to 37‰). The female incidence was 27‰ (95%CI 25‰ to 29‰). The overall mortality of CRC in China was 20‰ (95%CI 17‰ to 22‰), of which the male mortality was 22‰ (95%CI 19‰ to 25‰), and the female mortality was 18‰ (95%CI 15‰ to 20‰). Conclusion The incidence and mortality rates of CRC in China are high, resulting in a significant disease burden that varies regionally. The incidence and mortality of males are significantly higher than those of females. Intervention measures should be taken to reduce the disease burden of CRC in China according to the related risk factors of CRC.
ObjectiveThe aim of this study was to assess the disease burden of non-COVID-19 lower respiratory infection (LRI) in China during the period 1990−2021, particularly during the period 2019−2021. MethodsData on the burden of disease for LRI in China were obtained from the GBD 2021 database. A Joinpoint regression model was used to describe the changes in disease burden trends of LRI in China from 1990 to 2021, and the results are presented in terms of average annual percentage change (AAPC). ResultsIn 2021, the age-standardized incidence rate of LRI in China was 2 853.31/100 000, the age-standardized rate of DALY was 347.67/100 000, and the age-standardized mortality rate was 14.03/100 000. Compared with 1990, the AAPC were −2.13%, −6.89% and −4.10% respectively. In contrast, during the COVID-19 pandemic, both showed a decreasing and then increasing trend, except for the age-standardized incidence rate, which showed a decreasing trend. Children under 5 years of age have experienced the greatest reduction in the burden of disease over the past decades, while the burden of disease has increased in absolute terms for the elderly over 70 years of age. Compared with 1990, the disease burden of LRI in China due to each pathogenic microorganism has decreased. And during 2019−2021, all pathogens showed an increasing trend, except for ASMR caused by influenza (APC=−55.21%) and respiratory syncytial virus (APC=−53.35%). In 2021, the primary attributable risk factors for LRI mortality in China shifted from household air pollution due to solid fuels, childhood underweight, and childhood stunting in 1990 to ambient particulate matter pollution, smoking, and secondhand smoke. ConclusionThe disease burden of LRIs in China showed an overall decreasing trend from 1990 to 2021, but with large variations between age groups and pathogens. During the two years following the outbreak of the COVID-19 pandemic, the incidence of LRI in China, along with the disease burden caused by influenza and respiratory syncytial virus, significantly declined. Over the past few decades, the attributable risk factors for mortality and DALYs have undergone substantial changes. To address this phenomenon, targeted measures should be implemented to reduce the burden of LRI on the population caused by air pollution and smoking.
Objective To analyze the burden of cardiovascular diseases (CVDs) and its trend attributed to household air pollution (HAP) from solid fuels in China from 1990 to 2019. Methods Using the data derived from the Global Burden of Disease Study 2019 (GBD 2019), including mortality rates, disability-adjusted life years (DALY), age-standardized mortality rates, age-standardized DALY rates, annual percentage change (APC), and average annual percentage change rate (AAPC), we analyzed the CVD burden and its trend attributed to HAP in China from 1990 to 2019. Results In 2019, HAP in China resulted in 227 000 deaths and 5 182 200 DALYs of CVD; the mortality rate attributed to HAP was 15.96 per 100 000, and the DALY rate was 364.34 per 100 000. In 2019, the age-standardized mortality and DALY rates in China were 12.52 and 262.65 per 100 000, respectively, which were lower than the rates globally, and the rates for males were higher than those for females (13.90 vs. 11.32 per 100 000, 291.76 vs. 234.50 per 100 000). In 2019, both mortality and DALY rates attributed to HAP increased with age, peaking in the age groups of 95 plus and 85-89, respectively. From 1990 to 2019 in China, both age-standardized mortality and DALY rates of CVD attributed to HAP showed a downward trend over time. The average annual percentage change rate (AAPC) of the age-standardized mortality rate was −6.0% (95%CI: −6.2% to −5.8%), and the APCC of the age-standardized DALY rate was −5.8% (95%CI: −6.1% to −5.6%). The burden of the CVD subclass also showed a downward trend. Conclusion From 1990 to 2019, the burden of CVD attributed to HAP from solid fuels in China shows a significant downward trend, with sex and age differences. Females and the elderly are the key groups of disease burden, so effective interventions should be taken for these groups.
ObjectiveThis study intends to analyze the changing disease burden of mood disorders in China from 1990 to 2021 and project the epidemiological trends in the next two decades. MethodsThis study uses data from the Global Burden of Disease (GBD) 2021 database on three mood disorders in China (bipolar disorder, major depressive disorder, and dysthymia) from 1990 to 2021. The indicators such as age-standardized number of diseases and disability-adjusted life years (DALYs) were used to explore the characteristics of time, gender, and age distribution of the disease burden of mental disorders. The BAPC model was used to predict the disease burden in the next two decades. ResultsIn 2021, the number of cases of dysthymia, MDD, and BD in China was 27.84 million, 26.0 million, and 2.85 million, with an increase of 73.24%, 38.33%, and 36.79% compared with 1990, respectively. In 2021, DALYs of dysthymic disorder, MDD and BD were 2.67 million, 5.2 million and 0.61 million person-years, which increased by 71.45%, 34.29% and 34.76% compared with 1990, respectively. The burden of mood disorders is heavier among women and the middle-aged and elderly population. In addition, it is expected that ASPR and ASDR of dysthymia will continue to increase after a brief decline, MDD will show a downward trend, while BD will show a slight upward trend in the next two decades. ConclusionThe disease burden of mood disorders in China remains substantial, with dysthymia and BD showing persistent upward tendency. More resources should be invested in mental health care.
ObjectiveTo analyze the disease burden and temporal trends of chronic obstructive pulmonary disease (COPD) attributable to air pollution in China from 1990 to 2021. MethodsUtilizing data from the Global Burden of Disease Study 2021 (GBD 2021), we assessed the burden of COPD attributable to air pollution in China through metrics including death counts, disability-adjusted life years (DALYs), age-standardized mortality rate (ASMR), age-standardized DALY rate (ASDR), annual percentage change (APC), and average annual percentage change (AAPC). A Bayesian Age-Period-Cohort (BAPC) model was employed to project future trends in COPD burden attributable to air pollution. ResultsIn 2021, China’s ASMR and ASDR for COPD attributable to air pollution were 32.57 and 533.84 per 100 000 population, respectively, exceeding global averages. From 1990 to 2021, both ASMR and ASDR exhibited significant declining trends, with AAPCs of −5.24% (95% CI −5.78% to −4.70%) and −5.28% (95% CI −5.75% to −4.81%), respectively. The burden intensified with advancing age and was disproportionately higher among males compared to females. BAPC projections indicate a continued decline in COPD burden from 2022 to 2035, with ASMR expected to decrease from 56.40 to 23.02 per 100 000 and ASDR from 900.14 to 408.64 per 100 000. Conclusion Despite sustained reductions in the burden of COPD attributable to air pollution in China from 1990 to 2021, with further declines anticipated through 2035, national rates remain elevated relative to global benchmarks. Male and elderly populations bear the highest burden, underscoring the urgency for targeted interventions to mitigate air pollution exposure and address health disparities in vulnerable demographics.
ObjectiveTo assess the impact of different interventions on the disease burden of chronic obstructive pulmonary disease (COPD). MethodsThe CNKI, VIP, WanFang Data, PubMed, Web of Science, Cochrane Library were electronically searched to collect randomized controlled trials (RCTs) on the disease burden of COPD from inception to October, 2023. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies; then, network meta-analysis was performed by using Stata 16 software and R programming language. ResultsA total of 69 RCTs involving 26 interventions were included. The results of the network meta-analysis showed that compared with invasive ventilation therapy, non-invasive positive pressure ventilation treatment (SMD=−3.84, 95%CI −5.16 to −2.52) and Erchenzhikeqingfei granules (SMD=−3.04, 95%CI −5.89 to −0.20) were reducing the hospitalization cost of COPD patients (P<0.05). The effects of Jianpi Yifei granules, midazolam, targeted oxygen therapy, non-invasive positive pressure ventilation, and nutritional support protocol on reducing mortality in patients with COPD were superior to conventional treatments (RR=4.50, 95%CI 1.02 to 19.79; RR=4.81, 95%CI 1.25 to 18.52; RR=6.92, 95%CI 3.34 to 14.32; RR=3.56, 95%CI 1.14 to 11.08; RR=2.70, 95%CI 1.86 to 3.92; RR=3.60, 95%CI 2.01 to 6.45). Surface under the cumulative ranking(SUCRA) showed that oxygen therapy prescription had the highest probability of becoming the best measure (75.2%) to reduce mortality in patients with chronic obstructive pulmonary disease, the non-invasive positive pressure ventilation treatment was the most effective intervention(87.4%) to reduce the hospitalization cost of COPD patients. ConclusionOxygen therapy prescription might be the best measure to reduce mortality and the non-invasive positive pressure ventilation treatment might be the best measure to reduce the hospitalization cost of COPD patients. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo analyze the trend of chronic kidney disease (CKD) disease burden attributable to metabolic factors in China from 1990 to 2021, and to predict the death of CKD due to metabolic factors in China from 2022 to 2046. MethodsBased on the 2021 Global Burden of Disease Database, this paper collected and sorted out the CKD deaths, disability-adjusted life years (DALYs), premature death lost life years (YLLs), and disability life lost years (YLDs) attributed to metabolic factors by different ages and sexes in China from 1990 to 2021, and used the Joinpoint regression model to systematically evaluate the temporal trends of standardized mortality and standardized DALYs rate. The age-period-cohort (APC) model was used to assess age, period, and cohort effects, and the R software Nordpred package was used to predict future changes in the burden of disease. ResultsCompared with 1990, the mortality rate, DALYs rate, YLLs rate, and YLDs rate attributable to metabolic factors of Chinese residents in 2021 showed an upward trend, and the characteristics of male higher than female, higher age group than lower age group. The primary metabolic factor influencing the disease burden of CKD was hyperglycemia. The results of Joinpoint analysis showed a downward trend in the standardized mortality and standardized DALYs rate of CKD attributed to metabolic factors. The results of age-period-cohort model analysis showed that the age effect of CKD attributed to metabolic factors increased significantly, the period effect increased slowly, and the cohort effect showed a downward trend. ConclusionThe disease burden of CKD attributed to metabolic factors in China is generally on the rise, and men, the elderly, and diabetic patients are the key focus of the disease.