A Bayesian generalized age-period-cohort power model for cancer projections

Global burden of non-communicable diseases attributable to kidney dysfunction with projection into 2040

BACKGROUND

Spatiotemporal disparities exist in the disease burden of non-communicable diseases (NCDs) attributable to kidney dysfunction, which has been poorly assessed. The present study aimed to evaluate the spatiotemporal trends of the global burden of NCDs attributable to kidney dysfunction and to predict future trends.

METHODS

Data on NCDs attributable to kidney dysfunction, quantified using deaths and disability-adjusted life-years (DALYs), were extracted from the Global Burden of Diseases Injuries, and Risk Factors (GBD) Study in 2019. Estimated annual percentage change (EAPC) of age-standardized rate (ASR) was calculated with linear regression to assess the changing trend. Pearson's correlation analysis was used to determine the association between ASR and Sociodemographic Index (SDI) for 21 GBD regions. A Bayesian age-period-cohort (BAPC) model was used to predict future trends up to 2040.

RESULTS

Between 1990 and 2019, the absolute number of deaths and DALYs from NCDs attributable to kidney dysfunction increased globally. The death cases increased from 1,571,720 (95% uncertainty interval [UI]: 1,344,420-1,805,598) in 1990 to 3,161,552 (95% UI: 2,723,363-3,623,814) in 2019 for both sexes combined. Both the ASR of death and DALYs increased in Andean Latin America, the Caribbean, Central Latin America, Southeast Asia, Oceania, and Southern Sub-Saharan Africa. In contrast, the age-standardized metrics decreased in the high-income Asia Pacific region. The relationship between SDI and ASR of death and DALYs was negatively correlated. The BAPC model indicated that there would be approximately 5,806,780 death cases and 119,013,659 DALY cases in 2040 that could be attributed to kidney dysfunction. Age-standardized death of cardiovascular diseases (CVDs) and CKD attributable to kidney dysfunction were predicted to decrease and increase from 2020 to 2040, respectively.

CONCLUSION

NCDs attributable to kidney dysfunction remain a major public health concern worldwide. Efforts are required to attenuate the death and disability burden, particularly in low and low-to-middle SDI regions.

Global burden and prediction study of cutaneous squamous cell carcinoma from 1990 to 2030: A systematic analysis and comparison with China

Background

China has the highest number of new cancer cases and deaths globally. Due to particularly low scores in health care quality for cutaneous squamous cell carcinoma (cSCC), the country's cSCC burden requires greater awareness. Consequently, we aimed to evaluate and predict the trend of the cSCC burden globally and in China from 1990 to 2030.

Methods

We retrieved data from the Global Burden of Disease 2019 study, which provided estimates of the incidence, mortality, prevalence, and disability-adjusted life years (DALYs) of cSCC from 1990 to 2019. We set up joint-point analyses and Bayesian age-period-cohort (BAPC) models to predict the disease burden of cSCC up to 2030.

Results

In 2019, China reported age-standardised rates of cSCC prevalence, incidence, mortality, and DALYs of 2.54, 2.12, 0.88, and 16.76 per 100 000 population, respectively. The country's prevalence and incidence rates from 1990 to 2019 were lower than the global levels, but its mortality and DALY rates were higher. The age-standardised rates were higher for males, and the disease burden increased with each age group globally and in China. Moreover, the average annual percentage change showed all indicators were growing faster than the global levels. According to the BAPC model, there will be an upward trend in the prevalence and incidence globally and in China between 2020 and 2030, with a decrease in mortality and DALYs.

Conclusions

We observed an upward trend in the cSCC burden over the past 30 years in China. Prevalence and incidence are expected to continue at a higher rate than the global average in the next decade, while mortality and DALYs are predicted to decrease. As the Chinese population ages, efforts toward managing and preventing cSCC should be targeted towards the elderly population.

Global, regional, and national burden of inflammatory bowel disease and its associated anemia, 1990 to 2019 and predictions to 2050: An analysis of the global burden of disease study 2019

AIM

Inflammatory bowel disease (IBD) exhibited a global increase in incidence over the past decade. Understanding global burden of IBD can offer valuable insights for shaping future management strategies. We aimed to provide a comprehensive assessment of global burden of IBD from 1990 to 2019 and predictions to 2050.

METHODS

Data on prevalence, incidence, Disability-Adjusted Life Years (DALYs), Years Lived with Disability (YLDs) and IBD-attributable impairment factor (anemia) were extracted from the Global Burden of Diseases (GBD) 2019. Subgroup analyses were performed based on gender, geographical regions, and the Socio-Demographic Index (SDI). Joinpoint model, Bayesian age-period-cohort model and decomposition methodology were utilized to evaluate the temporal trends from 1990 to 2019, forecast the disease burden up to 2050 and decompose incidence, prevalence, YLDs and DALYs of IBD by population age structure, population growth and epidemiologic changes.

RESULTS

From 1990 to 2019, number of prevalence, DALYs, YLDs for IBD and number of prevalence for IBD-related-anemia increased significantly. Age-standardized rates of incidence, prevalence, DALYs, and YLDs showed declining trends, with this decline anticipated to continue until 2050 for both genders. The IBD burden remained high in countries with high and high-middle SDI. Besides, countries with low, low-middle, and middle SDI were experiencing an increasing burden. Number and ASR of prevalence and YLDs of IBD related anemia increased with SDI Decomposition analysis indicated that population growth was the primary contributing factor, followed by population aging.

CONCLUSION

Due to population growth and aging, the burden of IBD is projected to continue rising until 2050, which emphasizes the urgency of addressing the evolving public health challenge posed by IBD.

Disease Burden and Prediction Analysis of Tracheal, Bronchus, and Lung Cancer Attributable to Residential Radon, Solid Fuels, and Particulate Matter Pollution Under Different Sociodemographic Transitions From 1990 to 2030

BACKGROUND

This study investigated the impact of epidemiologic and sociodemographic changes in tracheal, bronchus, and lung cancer associated with residential radon, solid fuels, and particulate matter.

RESEARCH QUESTION

What are the influencing factors of tracheal, bronchus, and lung cancer disease burden attributable to the three pollutants?

STUDY DESIGN AND METHODS

Data were obtained from the Global Burden of Disease 2019. Age-standardized mortality rate (ASMR) and sociodemographic index (SDI) values were collected from 21 regions, and restricted cubic splines and quantile regression were used to investigate the relationship between ASMR or age-standardized disability-adjusted life years rate (ASDR), and SDI. Additionally, five countries with different SDIs were selected, and the Bayesian age-period-cohort model was used to predict the ASMR trends from 2020 to 2030.

RESULTS

High SDI quintiles were associated with increased residential radon pollution. The disease burden attributed to these three pollutants was particularly severe in the middle SDI quintiles. Older adults aged 80 to 89 years had the highest age-specific mortality, and the disease burden was greater in male patients than in female patients with these cancers attributed to the pollutants. The highest ASMR attributable to particulate matter when the SDI was 0.7. As the SDI increased, the disease burden caused by radon increased, whereas the burden caused by solid fuels decreased. Projections have indicated a rise in the death burden in patients with this cancer from particulate pollution in China, India, and Uganda over the next decade.

INTERPRETATION

The disease burden of tracheal, bronchus, and lung cancer attributed to the three pollutants was influenced by SDI, sex, and age. Older men are more susceptible to be affected. More preventive interventions may be required for men at younger ages to reduce the high death burden of older men. However, it is necessary to give due attention to women in specific countries in the future.

Trends in gastric cancer incidence and mortality in Asia and association analysis with human development index, 1990-2019

OBJECTIVES

To describe the epidemiological time trends and gender, age and regional differences of gastric cancer in Asia during 1990-2019, and to analyze the association between the human development index (HDI) and the statistical indicators of the burden of disease.

METHODS

Describing trends in age-standardized incidence rates (ASIR) and age-standardized mortality rate (ASMR) in Asia from 1990 to 2019 based on GBD-reported population-based surveillance of gastric cancer in Asia. Obtained ASIR, ASMR, and mortality to incidence ratios (MIR) for gastric cancer in different countries in 2019, with association analysis by Kruskal-Wallis nonparametric test.

RESULTS

The annual percentage change in ASIR and ASMR in Asia from 1990 to 2019 was - 1.20% and - 1.91%. Male gastric cancer patients have higher ASIR and ASMR than female gastric cancer patients. Decreasing trends in ASIR and ASMR for the total population in five Asian regions. From 1990 to 2019, the average annual change in ASMR was - 2.45%, - 1.43%, - 0.53%, - 0.62%, and - 0.27% for Central Asia, East Asia, high-income Asia-Pacific, South Asia, and Southeast Asia, respectively (p < 0.05). Both incidence and mortality were concentrated in the age groups of 85-89 and 89-94 years. Classifying Asian countries into different levels of HDI, only MIR was associated with HDI levels.

CONCLUSION

ASIR and ASMR of gastric cancer in the total population, different regions, and countries in Asia from 1990 to 2019 showed an overall decreasing trend. The MIR index is suggestive of survival rates and the role of cancer care in individual countries. Asian countries should develop different strategies for gastric cancer screening and prevention according to high-risk age, high-risk gender and HDI.

Long-term trend of future Cancer onset: A model-based prediction of Cancer incidence and onset age by region and gender

OBJECTIVES

This study provided estimates of cancer incidence rate and onset age by Socio-demographic Index (SDI) regions and gender from 2020 to 2040, aiming to clarify the long-term patterns of future cancer onset.

METHOD

Based on the incidence data from the Global Burden of Diseases (GBD) 2019 study, we constructed the Bayesian age-period-cohort model to calculate the age-standardized incidence rates (ASIR) of cancers from 2020 to 2040. Using the average annual percentage change (AAPC) to quantify the trends of ASIR and the onset age. In addition, the incidences in 2019 were fixed to distinguish the age onset changes caused by demographic and incidence from 2020 to 2040.

RESULTS

Globally, two-thirds of cancers have escalating trends of incidence rate, and the proportion of cancer weighted average onset age above 60 years old will grow from 62% to 76% between 2020 and 2040. In five SDI regions, the proportion of weighted average onset age above 60 years old will rise above 10% in the next 20 years and increase sequentially with the rise of the SDI level. Preclude sex-specific cancers, the onset age is younger in men than in women in 2040. Rule out the influence of changing demographics, half of cancer's morbidity has a youth-oriented tendency globally, which is concentrated in hormone-related and digestive tract cancer.

CONCLUSION

From 2020 to 2040, the incidence and onset age changes demonstrate marked geographic and gender variations in the cancer spectrum. Cancer incidence and onset age are predicted to continuously increase worldwide in the future.

Global burden of female breast cancer and its association with socioeconomic development status, 1990-2044

BACKGROUND

Breast cancer is a widespread disease in women worldwide.

AIM

We aimed to explore the global epidemiological trends of female breast cancer (FBC) between 1990 and 2044.

METHODS AND RESULTS

Disease burden, population, and socio-demographic index (SDI) data were obtained from the Global Health Data Exchange (GHDx) database. We analyzed temporal trends, age differences, risk factors, and geographic patterns of FBC disease burden globally and explored the association between age-standardized incidence rate (ASIR) of FBC and SDI. Bayesian age-period-cohort model was also performed to predict the changes in FBC incidence worldwide from 2020 to 2044. First, the global ASIR of FBC increased by 14.31% from 1990 to 2019 (95% Uncertainty Interval 4.75% to 23.98%). The death rate presented a falling trend. Second, alcohol use is the most-highlighted risk factor for FBC in some high-income regions such as Europe. A high fasting plasma glucose levels is the most prominent risk factor for FBC in Latin America and Africa. Third, the ASIR of the FBC increases with the SDI. Fourth, the incidence is expected to increase faster among women aged 35-60 years and fastest for those aged 50-54 years from 2020 to 2044. Countries with a high incidence of FBC that is expected to increase significantly include Barbados, Burkina Faso, Senegal, Monaco, Lebanon, Togo, and Uganda.

CONCLUSION

The disease burden of FBC varies worldwide; the findings suggest attaching importance to the control of middle and low-middle SDI regions. Public health as well as cancer prevention experts should pay more attention to regions and populations at an increased risk of developing FBC, focusing on their prevention and rehabilitation while conducting further epidemiological studies to investigate the risk factors of their increase.

Trends in incidence and mortality for ovarian cancer in China from 1990 to 2019 and its forecasted levels in 30 years

BACKGROUND

The specific long-term trend in ovarian cancer (OC) rates in China has been rarely investigated. We aimed to estimate the temporal trends in incidence and mortality rates from 1990 to 2019 in OC and predict the next 30-year levels. Data on the incidence, mortality rates, and the number of new cases and deaths cases due to OC in the China cohort from 1990 to 2019 were retrieved from the Global Burden of Disease Study 2019. Temporal trends in incidence and mortality rates were evaluated by joinpoint regression models. The incidence and mortality rates and the estimated number of cases from 2020 to 2049 were predicted using the Bayesian age-period-cohort model.

RESULTS

Consecutive increasing trends in age-standardized incidence (average annual percent change [AAPC] = 2.03; 95% confidence interval [CI], 1.90-2.16; p < 0.001) and mortality (AAPC = 1.58; 95% CI, 1.38-1.78; p < 0.001) rates in OC were observed from 1990-2019 in China. Theoretically, both the estimated age-standardized (per 100,000 women) incidence (from 4.77 in 2019 to 8.95 in 2049) and mortality (from 2.88 in 2019 to 4.03 in 2049) rates will continue to increase substantially in the coming 30 years. And the estimated number of new cases of, and deaths from OC will increase by more than 3 times between 2019 and 2049.

CONCLUSIONS

The disease burden of OC in incidence and mortality has been increasing in China over the past 30 years and will be predicted to increase continuously in the coming three decades.

Global estimates of rehabilitation needs and disease burden in tracheal, bronchus, and lung cancer from 1990 to 2019 and projections to 2045 based on the global burden of disease study 2019

Background

The global cancer burden is substantial and spiraling. Although rehabilitation specialists could offer assistance, oncologic rehabilitation is still underutilized and not a routine part of clinical oncology guidelines worldwide. Global investigations of disease prevalence and years lived with disability (YLDs) for tracheal, bronchus, and lung (TBL) cancer are valuable for facilitating clinical practice improvement and health resource management. The objective of this study is to report the global estimates of rehabilitation needs and disease burden of TBL cancers from 1990 to 2019 and provide predictions for 2045.

Methods

To estimate the need for rehabilitation, the data used from the Global Burden of Disease Study 2019 to calculate the prevalence, YLDs, and the attributable risk factors of TBL cancer. The Bayesian age-period-cohort model and Auto-Regressive Integrated Moving Average model were established to forecast the future health burden. All analyses were done at the global level and then some in the aggregation with the seven World Bank regions. All the data were analyzed by R software (x64 version 4.2.1) and Microsoft Excel (version 2019).

Results

Globally in 2019, 3,212,307 cases of TBL cancer (95% UI 2,937,037-3,488,346) could have benefitted from rehabilitation, contributing to 544,215 (95% UI 396,134-700,099) YLDs. Over the past 30 years, the age-standardized rate (ASR) of prevalence (EAPC = 0.51) and YLDs (EAPC = 0.03) increased. Throughout this period, the global prevalence and YLDs counts were greater in males than females. The ASR of prevalence and YLDs are projected to show a slight downward trend by 2045 on the global scale, the overall prevalence and YLDs due to TBL cancer are likely to increase further, but all indicators show a growing trend in females.

Conclusion

TBL cancer remains one of the major public health issues globally. According to the forecasted results, the burden of YLDs due to TBL cancer will continue to rise, and the increment is higher in females than males. A rising number of patients worldwide will benefit from rehabilitation services in the future to achieve precise control and management throughout the TBL cancer patient lifecycle.

Global, region and national trends and age-period-cohort effects in colorectal cancer burden from 1990 to 2019, with predictions to 2039

Nowadays, colorectal cancer (CRC) is the second leading cause of cancer deaths and contributes to a gradually increasing disease burden. We aimed to estimate the secular trends of global CRC burden, the effect of age, period, and birth cohort, and project the global burden over time. Based on the epidemiological CRC data from 1990 to 2019 in 204 countries and territories from GBD 2019, the estimated annual percentage change (EAPC), was calculated from a linear model and joinpoint regression model. We utilized an age-period-cohort model to reckon age, period, and birth cohort effects on CRC age-standardized rate. The burden of CRC was projected by conducting the BAPC model. Globally, there was a slight decline in the age-standardized DALY rate, which was more apparent in females, with high SDI regions and in Australia and Western Europe areas. Meanwhile, our model predicts a weaker increase in morbidity (EAPC of 0.37) and a speedier reduction in mortality (EAPC of -0.66) by the next 20 years. The relative risk of period for high SDI regions decreased from 1.08 (95%UI: 1.06-1.1) in 1990-1994 to 0.85 (95%UI:0.83-0.88) in 2015-2019, but worsens in low and middle SDI regions. The local drifts were more than 1 in the 30-34 and 35-39 age groups, indicating the rising tide of early-onset CRC. Given the gender and region-specific CRC, targeted efforts to reduce the prevalence of risk factors, improve screening coverage rates, and strengthen foundational medical facilities are necessary.

Global, regional, and national burden of disease study of atrial fibrillation/flutter, 1990-2019: results from a global burden of disease study, 2019

Background

Data from the Global Burden of Disease, Injury, and Risk Factor Study 2019 (GBD 2019) was used to assess the burden and change in prevalence, incidence, deaths, disability-adjusted life years, and risk factors for atrial fibrillation/flutter in 204 countries and territories between 1990 and 2019.

Methods

Incidence, prevalence, deaths, disability-adjusted life years (DALYs), and their age-standardized rates of AF/AFL were analyzed by age, sex, socio-demographic index (SDI), and human development index (HDI) using the Global Burden of Disease study 2019 (GBD2019) results，and risk factors for AF/AFL (mainly high systolic blood pressure, high body-mass index, alcohol use, smoking and diet high in sodium) were differentially analyzed.

Results

There are 59.70 million (95% uncertainty interval (UI) 45.73–75.29 million) AF/AFL patients worldwide in 2019, with 4.72 million (95% uncertainty interval (UI) 3.64–5.96 million) new cases and 0.315 million deaths (95% uncertainty interval (UI) 0.268–0.361 million) and 8.39 million disability-adjusted years (95% uncertainty interval (UI) 6.69–10.54 million). The highest risk factor for deaths, DALYs attributable to AF/AFL in 2019 was high systolic blood pressure, high body-mass index, alcohol use, smoking, and diet high in sodium. It is estimated that between 2030 and 2034, the total incidence of male AF/ AFL will be 16.08 million, and the total number of deaths will be 1.01 million. For females, the total number of incidence is 16.85 million, and the total number of deaths is 1.49 million.

Conclusions

AF/AFL remains a major global public health problem, although the ASR of prevalence, incidence, and DALY at the worldwide level showed a decreasing trend from 1990 to 2019(the ASR of deaths increased slightly). However, the unfavorable trend observed in this study in countries with lower SDI suggests that current prevention and treatment strategies should be reoriented. Some countries should develop more targeted and specific strategies to prevent the increase of AF/AFL.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14403-2.

Projection of Cancer Incidence and Mortality From 2020 to 2035 in the Korean Population Aged 20 Years and Older

OBJECTIVES

This study aimed to identify the current patterns of cancer incidence and estimate the projected cancer incidence and mortality between 2020 and 2035 in Korea.

METHODS

Data on cancer incidence cases were extracted from the Korean Statistical Information Service from 2000 to 2017, and data on cancer-related deaths were extracted from the National Cancer Center from 2000 to 2018. Cancer cases and deaths were classified according to the International Classification of Diseases, 10th edition. For the current patterns of cancer incidence, age-standardized incidence rates (ASIRs) and age-standardized mortality rates were investigated using the 2000 mid-year estimated population aged over 20 years and older. A joinpoint regression model was used to determine the 2020 to 2035 trends in cancer.

RESULTS

Overall, cancer cases were predicted to increase from 265 299 in 2020 to 474 085 in 2035 (growth rate: 1.8%). The greatest increase in the ASIR was projected for prostate cancer among male (7.84 vs. 189.53 per 100 000 people) and breast cancer among female (34.17 vs. 238.45 per 100 000 people) from 2000 to 2035. Overall cancer deaths were projected to increase from 81 717 in 2020 to 95 845 in 2035 (average annual growth rate: 1.2%). Although most cancer mortality rates were projected to decrease, those of breast, pancreatic, and ovarian cancer among female were projected to increase until 2035.

CONCLUSIONS

These up-to-date projections of cancer incidence and mortality in the Korean population may be a significant resource for implementing cancer-related regulations or developing cancer treatments.

Trends and predictions of lung cancer incidence in Jiangsu Province, China, 2009–2030: a bayesian age-period-cohort modelling study

Background

Lung cancer is currently the most frequent cancer in Jiangsu Province, China, and the features of cancer distribution have changed continuously in the last decade. The aim of this study was to analyse the trend of the incidence of lung cancer in Jiangsu from 2009 to 2018 and predict the incidence from 2019 to 2030.

Methods

Data on lung cancer incidence in Jiangsu from 2009 to 2018 were retrieved from the Jiangsu Cancer Registry. The average annual percentage change (AAPC) was used to quantify the trend of the lung cancer age-standardized rate (ASR) using Joinpoint software. Bayesian age-period-cohort models were used to predict lung cancer incidence up to 2030.

Results

In Jiangsu, the lung cancer crude rate increased from 45.73 per 100,000 in 2009 to 69.93 per 100,000 in 2018. The lung cancer ASR increased from 29.03 per 100,000 to 34.22 per 100,000 during the same period (AAPC = 2.17%, 95% confidence interval [CI], 1.54%, 2.80%). Between 2019 and 2030, the lung cancer ASR is predicted to decrease slightly to 32.14 per 100,000 (95% highest density interval [HDI], 24.99, 40.22). Meanwhile, the ASR showed a downward trend in males and rural regions while remaining stable in females and urban regions.

Conclusion

We predict that the incidence of lung cancer in Jiangsu will decrease in the next 12 years, mainly due to the decrease in males and rural areas. Therefore, future lung cancer prevention and control efforts should be focused on females and urban regions.

Current status, trends, and predictions in the burden of gallbladder and biliary tract cancer in China from 1990 to 2019

BACKGROUND

Gallbladder and biliary tract cancer (GBTC) has greatly damaged the health of patients and is accompanied by a dismal prognosis. The worldwide distribution of GBTC shows extensive variance and the updated data in China is lacking. This study was to determine the current status, trends, and predictions in the burden of GBTC over the past 30 years in China.

METHODS

This was a descriptive, epidemiological, secondary analysis of the Global Burden of Disease, Injuries, and Risk Factor Study 2019 data. Data including incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of GBTC in China by year, age, and sex were assessed. Joinpoint regression analysis was conducted to evaluate trends of disease burden due to GBTC from 1990 to 2019. Nordpred age-period-cohort analysis was applied for the projection of mortality and incidence due to GBTC from 2019 to 2044.

RESULTS

Nationally, there were 38,634 (95% uncertainty interval [UI]: 27,350-46,512) new cases and 47,278 (95% UI: 32,889-57,229) patients due to GBTC, causing 34,462 (95% UI: 25,220-41,231) deaths, and 763,584 (95% UI: 566,755-920,493) DALYs in 2019. Both cases and rates of burden owing to GBTC were heavier among males and at old age. From 1990 to 2019, the age-standardized rates of incidence, prevalence, mortality, and DALYs of GBTC generally increased from 1990 to 2019, with average annual percentage change at 0.8% (95% confidential interval [CI]: 0.6-1.0%), 1.3% (95% CI: 1.1-1.5%), 0.4% (95% CI: 0.2-0.6%), and 0.2% (95% CI: 0.1-0.4%), respectively. Even though the age-standardized incidence rate and age-standardized mortality rate in both sexes were predicted to decline gradually from 2019 to 2044, the number of new cases and deaths were expected to grow steadily.

CONCLUSIONS

GBTC is becoming a major health burden in China, particularly among males and older individuals. Given the aging population and increasing burden, effective strategies and measurements are urged to prevent or reduce the number of new cases and deaths of GBTC.

Global trend of aetiology-based primary liver cancer incidence from 1990 to 2030: a modelling study

BACKGROUND

Predictions of primary liver cancer (PLC) incidence rates and case numbers are critical to understand and plan for PLC disease burden.

METHODS

Data on PLC incidence rates and case numbers from 1990 to 2017 were retrieved from the Global Burden of Disease database. The estimated average percentage change (EAPC) was calculated to quantify the trends of PLC age-standardized incidence rates (ASRs). Bayesian age-period-cohort models were constructed to project PLC incidence rates and case numbers through 2030.

RESULTS

Globally, the PLC case number doubled from 472 300 in 1990 to 953 100 in 2017. The case number will further increase to 1 571 200 in 2030, and the ASR will increase from 11.80 per 100 000 in 2018 to 14.08 per 100 000 in 2030. The most pronounced increases are observed in people afflicted by non-alcoholic steatohepatitis (NASH) and in older people. The trends of PLC incidence rates between 1990 and 2030 are heterogeneous among countries and can be summarized as five scenarios: (i) 46 countries that have and will continue to experience a persistent increase (e.g. Australia); (ii) 21 countries that experienced an initial decrease (or remained stable) but are predicted to increase (e.g. China); (iii) 7 countries that experienced an initial increase but are predicted to remain stable (e.g. USA); (iv) 29 countries that experienced an initial increase but are predicted to decrease (e.g. Egypt); and (v) 82 countries that have and will continue to experience a persistent decrease (e.g. Japan).

CONCLUSION

PLC incidence rates and case numbers are anticipated to increase at the global level through 2030. The increases in people afflicted by NASH and among older people suggest a dearth of attention for these populations in current prevention strategies and highlight their priority in future schedules for global control of PLC.

Burden of Thyroid Cancer From 1990 to 2019 and Projections of Incidence and Mortality Until 2039 in China: Findings From Global Burden of Disease Study

Projecting the burden of thyroid cancer (TC) over time provides essential information to effectively plan measures for its management and prevention. This research obtained data from the Global Burden of Disease (GBD) Study from between 1990 and 2019 to model how TC will affect China until 2039 by conducting the Bayesian age-period-cohort analysis. The number of new TC cases in China was 10,030 in 1990, 39,080 in 2019, and is projected to be 47,820 in 2039. This corresponds to 3,320, 7,240, and 4,160 deaths, respectively. Disability-adjusted life years (DALYs) cases increased from 103,490 in 1990 to 187,320 in 2019. The age-standardized rate (ASR) of incidence increased from 1.01 to 2.05 during 1990-2019 and was projected to increase to 3.37 per 100,000 person-years until 2039. The ASR of mortality (ASMR) remained stable during the study period and was projected to have a mild decline from 0.39 to 0.29/100,000 during 2020-2039. Although the ASMR in male patients has maintained increasing at a rate of 2.2% per year over the past 30 years, it is expected to decline at a rate of 1.07% per year in 2019-2039. The most significant increase in crude incidence occurred in people aged 45-65 from 1990 to 2019, however, this will shift into young people aged 10-24 from 2020 to 2039. In addition, the proportion of deaths and DALYs caused by obesity increased from 1990 to 2019 and affected men more than women. In conclusion, a substantial increase in counts of incidence of TC in China is projected over the next two decades, combined with the slightly declining mortality, indicating that rational health policies are needed in the future to cope with the increasing number of TC patients, especially among males and adolescents.

Statistical projection methods for lung cancer incidence and mortality: a systematic review

OBJECTIVES

To identify and summarise all studies using statistical methods to project lung cancer incidence or mortality rates more than 5 years into the future.

STUDY TYPE

Systematic review.

METHODS

We performed a systematic literature search in multiple electronic databases to identify studies published from 1 January 1988 to 14 August 2018, which used statistical methods to project lung cancer incidence and/or mortality rates. Reference lists of relevant articles were checked for additional potentially relevant articles. We developed an organisational framework to classify methods into groups according to the type of data and the statistical models used. Included studies were critically appraised using prespecified criteria.

RESULTS

One hundred and one studies met the inclusion criteria; six studies used more than one statistical method. The number of studies reporting statistical projections for lung cancer increased substantially over time. Eighty-eight studies used projection methods, which did not incorporate data on smoking in the population, and 16 studies used a method which did incorporate data on smoking. Age-period-cohort models (44 studies) were the most commonly used methods, followed by other generalised linear models (35 studies). The majority of models were developed using observed rates for more than 10 years and used data that were considered to be good quality. A quarter of studies provided comparisons of fitted and observed rates. While validation by withholding the most recent observed data from the model and then comparing the projected and observed rates for the most recent period provides important information on the model's performance, only 12 studies reported doing this.

CONCLUSION

This systematic review provides an up-to-date summary of the statistical methods used in published lung cancer incidence or mortality projections. The assessment of the strengths of existing methods will help researchers to better apply and develop statistical methods for projecting lung cancer rates. Some of the common methods described in this review can be applied to the projection of rates for other cancer types or other non-infectious diseases.

Trends in Colon and Rectal Cancer Incidence in Australia from 1982 to 2014: Analysis of Data on Over 375,000 Cases

BACKGROUND

Colorectal cancer is the third most commonly diagnosed cancer in Australia. Emerging evidence from several countries suggests increasing incidence in people aged <50 years.

METHODS

We assessed colon and rectal cancer incidence trends in people aged 20+ in Australia from 1982 to 2014. We used data on 375,008 incident cases (248,162 colon and 126,846 rectal). We quantified the annual percentage change (APC) in rates by age group using Joinpoint regression.

RESULTS

For people aged <50 years, colon cancer rates increased from the mid-2000s, with the increase in APCs ranging from 1.7% to 9.3% per annum (depending on specific age group); rectal cancer rates increased from the early 1990s, with APCs ranging from 0.9% to 7.1% per annum. For people aged 50 to 69 years, colon and rectal cancer rates decreased from the mid-1990s, with the decrease in APCs in specific age groups ranging from 0.8% to 4.8% per annum (except for colon cancer in those ages 65 to 69 years, where similar rate decreases were observed from 2007). An overall reduction in older persons (>70 years) was estimated at 1.9% to 4.9% per annum for colon cancer from 2010 onward and 1.1% to 1.8% per annum in rectal cancer from the early 2000s onward.

CONCLUSIONS

Colon and rectal cancer incidence has increased in people aged <50 years in Australia over the last two decades. However, colon and rectal cancer rates decreased in people aged 50+, likely due to de facto and organized bowel cancer screening.

IMPACT

Further research is needed to examine the cause of the increase and to quantify the impact of future trends on the cost-effectiveness of population-based screening for those <50 years.

Estimated future incidence of malignant mesothelioma in South Korea: Projection from 2014 to 2033

Malignant mesothelioma is a malignant tumor on the pleura or the peritoneum caused mostly by asbestos. Although asbestos is not currently used in South Korea, the incidence of mesothelioma is increasing due to its long latent period. This study predicted the incidence of malignant mesothelioma in South Korea over the next 20 years using an age-period-cohort (APC) model. Data regarding mesothelioma incidence from 1994–2013 were acquired from the Korea Central Cancer Registry (KCCR). Demographic data, including prospective resident data, were acquired from the Korean Statistical Information Service (KOSIS) for 1994–2033. An APC model with Møller’s power-link function was utilized to predict the incidence of mesothelioma. It was predicted that 2,380 and 1,199 new cases of mesothelioma in men and women, respectively, would occur over the next 20 years. For both sexes, the mesothelioma incidence rate was predicted to be greater in 2029–2033 compared to that in 2009–2013 (men, 0.282 vs 0.563; women, 0.155 vs 0.217). For men, the age-standardized incidence rate was predicted to be slightly greater in 2029–2033 relative to the rate in 2009–2013 (0.228 vs 0.235), while the age-standardized incidence rate in women decreased within the same timeframe (0.113 vs 0.109). The changes in mesothelioma incidence were mostly caused by changes in the population structure due to aging and not by changes in the mesothelioma risk ratio. The results of this study project a continuous increase in mesothelioma incidence in South Korea over the next 20 years. Although the projected increase in mesothelioma incidence was not related to an increase in the mesothelioma risk ratio, continuous preventive efforts are necessary to reduce the exposure to asbestos and prevent the trend from worsening.

Forecasting Cause-Specific Mortality in Korea up to Year 2032

Forecasting cause-specific mortality can help estimate the future burden of diseases and provide a clue for preventing diseases. Our objective was to forecast the mortality for causes of death in the future (2013-2032) based on the past trends (1983-2012) in Korea. The death data consisted of 12 major causes of death from 1983 to 2012 and the population data consisted of the observed and estimated populations (1983-2032) in Korea. The modified age-period-cohort model with an R-based program, nordpred software, was used to forecast future mortality. Although the age-standardized rates for the world standard population for both sexes are expected to decrease from 2008-2012 to 2028-2032 (males: -31.4%, females: -32.3%), the crude rates are expected to increase (males: 46.3%, females: 33.4%). The total number of deaths is also estimated to increase (males: 52.7%, females: 41.9%). Additionally, the largest contribution to the overall change in deaths was the change in the age structures. Several causes of death are projected to increase in both sexes (cancer, suicide, heart diseases, pneumonia and Alzheimer's disease), while others are projected to decrease (cerebrovascular diseases, liver diseases, diabetes mellitus, traffic accidents, chronic lower respiratory diseases, and pulmonary tuberculosis). Cancer is expected to be the highest cause of death for both the 2008-2012 and 2028-2032 time periods in Korea. To reduce the disease burden, projections of the future cause-specific mortality should be used as fundamental data for developing public health policies.

The future excess fraction model for calculating burden of disease

BACKGROUND

Estimates of the burden of disease caused by a particular agent are used to assist in making policy and prioritizing actions. Most estimations have employed the attributable fraction approach, which estimates the proportion of disease cases or deaths in a specific year which are attributable to past exposure to a particular agent. While this approach has proven extremely useful in quantifying health effects, it requires historical data on exposures which are not always available.

METHODS

We present an alternative method, the future excess fraction method, which is based on the lifetime risk approach, and which requires current rather than historical exposure data. This method estimates the future number of exposure-related disease cases or deaths occurring in the subgroup of the population who were exposed to the particular agent in a specific year. We explain this method and use publically-available data on current asbestos exposure and mesothelioma incidence to demonstrate the use of the method.

CONCLUSIONS

Our approach to modelling burden of disease is useful when there are no historical measures of exposure and where future disease rates can be projected on person years at risk.