Aims Anxiety disorders are widespread across the world. A systematic understanding of the disease burden, temporal trend and risk factors of anxiety disorders provides the essential foundation for targeted public policies on mental health at the national, regional, and global levels. Methods The estimation of anxiety disorders in the Global Burden of Disease Study 2019 using systematic review was conducted to describe incidence, prevalence and disability-adjusted life years (DALYs) in 204 countries and regions from 1990 to 2019. We calculated the estimated annual percentage change (EAPC) to quantify the temporal trends in anxiety disorders burden by sex, region and age over the past 30 years and analysed the impact of epidemiological and demographic changes on anxiety disorders. Results Globally, 45.82 [95% uncertainty interval (UI): 37.14, 55.62] million incident cases of anxiety disorders, 301.39 million (95% UI: 252.63, 356.00) prevalent cases and 28.68 (95% UI: 19.86, 39.32) million DALYs were estimated in 2019. Although the overall age-standardised burden rate of anxiety disorders remained stable over the past three decades, the latest absolute number of anxiety disorders increased by 50% from 1990. We observed huge disparities in both age-standardised burden rate and changing trend of anxiety disorders in sex, country and age. In 2019, 7.07% of the global DALYs due to anxiety disorders were attributable to bullying victimisation, mainly among the population aged 5–39 years, and the proportion increased in almost all countries and territories compared with 1990. Conclusion Anxiety disorder is still the most common mental illness in the world and has a striking impact on the global burden of disease. Controlling potential risk factors, such as bullying, establishing effective mental health knowledge dissemination and diversifying intervention strategies adapted to specific characteristics will reduce the burden of anxiety disorders.

A population-based case-control was performed to explore familial aggregation of esophageal squamous cell carcinoma (ESCC). Family history of cancer was assessed by a structured questionnaire, and from which 2 cohorts of relatives of cases and controls were reconstructed. Unconditional logistic regression and Cox proportional hazards regression were applied for case-control design and reconstructed cohort design, respectively. We observed a close to doubled risk of ESCC associated with a positive family history of esophageal cancer among first degree relatives (odds ratio [OR] = 1.85, 95% confidence interval [CI]: 1.42–2.41), after adjusting age, sex, family size and other confounders. The excess risks of ESCC increased with the increasing of first-degree relatives affected by esophageal cancer (p < 0.001). In particular, those individuals whose both parents with esophageal cancer had an 8-fold excess risk of ESCC (95% CI: 1.74–36.32). The reconstructed cohort analysis showed that the cumulative risk of esophageal cancer to age 75 was 12.2% in the first-degree relatives of cases and 7.0% in those of controls (hazard ratio = 1.91, 95% CI: 1.54–2.37). Our results suggest family history of esophageal cancer significantly increases the risk for ESCC. Future studies are needed to understand how the shared genetic susceptibility and/or environmental exposures contribute to the observed excess risk.

Previous results regarding the associations between esophageal squamous-cell carcinoma (ESCC) risk and smoking/alcohol drinking in high-risk areas are inconsistent. We performed a large population-based case-control study from 2010 to 2013 in a high-incidence area of China, and enrolled 1353 ESCC cases and 1961 controls. Data regarding smoking and alcohol drinking were collected via face-to-face interviews using a structured questionnaire. Odd ratios (ORs) with 95% confidence intervals (CIs) were estimated using unconditional logistic regression models. After adjusting for alcohol drinking and other potential confounders, male heavy smokers (i.e., those who started smoked more than 20 cigarettes per day or 40 pack-years, or started smoking early), showed a moderately increased risk for ESCC; however, current smoking was not associated with an increased risk. Alcohol drinking among males significantly increased the risk for ESCC (OR = 2.20, 95%CI:1.79~2.70). We observed increasing excess ESCC risks with decreasing age at behavior initiation as well as with increasing duration and intensity of alcohol intake, which were particularly evident among current smokers. In contrast, neither smoking nor alcohol drinking was not associated with ESCC risk among females. In conclusion, alcohol drinking shows a monotonic dose-response relationship with ESCC risk among men, and this relationship is particularly evident among smokers.

Background: Dengue is the most prevalent and rapidly spreading mosquito-borne viral disease. We present the global, regional, and national burden of dengue from 1990 to 2019 based on the findings from the Global Burden of Diseases, Injures, and Risk Factors Study 2019 (GBD 2019). Methods: Based upon GBD 2019 dengue data on age-standardized incidence rate (ASIR), age-standardized death rate (ASDR) and age-standardized disability-adjusted life years (DALYs) rate, this study estimates and presents annual percentage change (EAPC) to quantify trends over time to assess potential correlates of increased dengue activity such as global travel, and warming. Results: Globally from 1990 to 2019, dengue incident cases, deaths and DALYs gradually increased. Those under 5, once accounting for the largest portion of deaths and DALYs in 1990, were eclipsed by those 15–49 years old in 2019. Age standardized incidence (ASIR: EAPC 3.16, 95%CI: 2.90–3.43), death (ASDR: EAPC 5.42, 95%CI: 2.64–8.28), and DALY rates (EAPC 2.31, 95%CI: 2.00–2.62) accelerated most among high-middle and high socio-demographic index (SDI) regions. Southeast Asia and South Asia had most of the dengue incident cases, deaths and DALYs, but East Asia had the fastest rise in ASIR (EAPC 4.57, 95%CI: 4.31, 4.82), while Tropical Latin America led in ASDR (EAPC 11.32, 95%CI: 9.11, 13.58) and age-standardized DALYs rate (EAPC 4.13, 95%CI: 2.98, 5.29). SDI showed consistent bell shape relationship with ASIR, ASDR and age-standardized DALYs rate. Global Land-Ocean Temperature Index and air passenger travel metrics were found to be remarkably positively correlated with dengue burden. Conclusions: The burden of dengue has become heavier from 1990 to 2019, amidst the three decades of urbanization, warming climates and increased human mobility in much of the world. Southeast Asia and South Asia remain regions of concern, especially in conjunction with the Americas swift rise in dengue burden.

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Projecting the burden of pancreatic cancer over time provides essential information to effectively plan measures for its management and prevention. Here, we obtained data from the Global Burden of Disease (GBD) Study between 1990 and 2019, to model how pancreatic cancer will affect the 27 countries of the European Union (EU) plus the United Kingdom (the pre-Brexit EU-28) until 2039 by conducting the Bayesian age-period-cohort analysis. The number of new pancreatic cancer cases in the EU-28 was 59 000 in 1990, 109 000 in 2019 and projected to be 147 000 in 2039. This corresponded to 60 000, 109 000 and 155 000 for deaths, and a loss of 1.3 million, 2.0 million and 2.7 million for disability-adjusted life years (DALYs), respectively. The most pronounced increase of the crude incidence rate was observed and projected to be in the population older than 80 years. The agestandardized rate (ASR) of incidence, however, increased from 8.6 to 10.1 per 100 000 person-years during 1990-2019 but was projected to remain stable during 2019-2039. At the same time, our models only predicted a mild increase in the ASR of mortality until 2039. The fraction of pancreatic cancer mortality attributable to tobacco consumption decreased during 1990-2019, but we found upward trends for the attributable fractions for high fasting plasma glucose and high body mass index.In conclusion, a substantial increase in counts of incidence, mortality and DALYs lost of pancreatic cancer in the EU-28 is projected over the next two decades, which indicates the need for future health policies and interventions.

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Background: Hundreds of studies have found that the microbiota contributes to the development of gastric cancer in the past two decades. This study aimed to access the research trends of microbiota and gastric cancer. Materials and Methods: Publications from January 1, 2000 to December 31, 2019 were retrieved from the Web of Science Core Collection database and screened according to inclusion criteria. Different kinds of software, SPSS21.0, HistCite, VOSviewer, CiteSpace, and the online bibliometric analysis platform were used to evaluate and visualize the results. Results: A total of 196 publications were finally identified, and the annual number of publications showed an increasing trend. These publications were from 44 countries and the USA showed its dominant position in publication outputs, H-index, total citations, and international collaborations. The journal of Helicobacter was the most productive journal. Correa P and Peek RM published the most papers, and the most productive institution was Vanderbilt University. The keyword of "Helicobacter pylori" ranked first in research frontiers and appeared earlier, and the keyword of "microbiota" began to appear in the past 3 to 5 years. Conclusion:The annual number of publications would continue to grow. Besides the traditional Helicobacter pylori related researches, future research hotspots will focus on microbiota and its mechanism of action.