Global, regional and national burden of bladder cancer and its attributable risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease study 2019

IntroductionThe current study determined the level and trends associated with the incidence, death and disability rates for bladder cancer and its attributable risk factors in 204 countries and territories, from 1990 to 2019, by age, sex and sociodemographic index (SDI; a composite measure of sociodemographic factors).MethodsVarious data sources from different countries, including vital registration and cancer registries were used to generate estimates. Mortality data and incidence data transformed to mortality estimates using the mortality to incidence ratio (MIR) were used in a cause of death ensemble model to estimate mortality. Mortality estimates were divided by the MIR to produce incidence estimates. Prevalence was calculated using incidence and MIR-based survival estimates. Age-specific mortality and standardised life expectancy were used to estimate years of life lost (YLLs). Prevalence was multiplied by disability weights to estimate years lived with disability (YLDs), while disability-adjusted life years (DALYs) are the sum of the YLLs and YLDs. All estimates were presented as counts and age-standardised rates per 100 000 population.ResultsGlobally, there were 524 000 bladder cancer incident cases (95% uncertainty interval 476 000 to 569 000) and 229 000 bladder cancer deaths (211 000 to 243 000) in 2019. Age-standardised death rate decreased by 15.7% (8.6 to 21.0), during the period 1990–2019. Bladder cancer accounted for 4.39 million (4.09 to 4.70) DALYs in 2019, and the age-standardised DALY rate decreased significantly by 18.6% (11.2 to 24.3) during the period 1990–2019. In 2019, Monaco had the highest age-standardised incidence rate (31.9 cases (23.3 to 56.9) per 100 000), while Lebanon had the highest age-standardised death rate (10.4 (8.1 to 13.7)). Cabo Verde had the highest increase in age-standardised incidence (284.2% (214.1 to 362.8)) and death rates (190.3% (139.3 to 251.1)) between 1990 and 2019. In 2019, the global age-standardised incidence and death rates were higher among males than females, across all age groups and peaked in the 95+ age group. Globally, 36.8% (28.5 to 44.0) of bladder cancer DALYs were attributable to smoking, more so in males than females (43.7% (34.0 to 51.8) vs 15.2% (10.9 to 19.4)). In addition, 9.1% (1.9 to 19.6) of the DALYs were attributable to elevated fasting plasma glucose (FPG) (males 9.3% (1.6 to 20.9); females 8.4% (1.6 to 19.1)).ConclusionsThere was considerable variation in the burden of bladder cancer between countries during the period 1990–2019. Although there was a clear global decrease in the age-standardised death, and DALY rates, some countries experienced an increase in these rates. National policy makers should learn from these differences, and allocate resources for preventative measures, based on their country-specific estimates. In addition, smoking and elevated FPG play an important role in the burden of bladder cancer and need to be addressed with prevention programmes.

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Global, Regional, and National Burden of Breast Cancer and Its Attributable Risk Factors Among Women, 1990–2017

10.21203/rs.3.rs-97176/v1 ◽

2020 ◽

Cited By ~ 1

Author(s):

Saeid Safiri ◽

Mohsen Naghavi

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Death Rate ◽

National Level ◽

High Body Mass Index ◽

Attributable Risk ◽

Death Rates ◽

Awareness Campaigns ◽

Life Years ◽

Increasing Trend

Abstract Introduction: Breast cancer is the most common cancer in women worldwide. However, no comprehensive study has been conducted to compare the incidence, mortality, and disability-adjusted life years (DALYs) for female breast cancer among different countries. The current study examined the level and trends of incidence, death, and DALYs for breast cancer and its attributable risk factors among women in 195 countries from 1990 to 2017 by age, socio-demographic index (SDI; a composite of socio-demographic factors), and healthcare access and quality (HAQ; an indicator of health system performance) index.Methods: Vital registration, verbal autopsy, and cancer registries were used across the globe to generate estimates. Incidence, mortality, and DALYs were estimated. All estimates are presented as counts and age-standardised rates per 100,000 person-years. Results: Between 1990 and 2017 the global incidence of breast cancer increased significantly by 17.1% (95% uncertainty interval [UI]: 7.1–23.6; with 1.9 million incidences in 2017 [95% UI 1.9–2.0]; age-standardised rate of 45.9 [95% UI: 44.2–47.4]). However, over this same period the age-standardised death rate significantly decreased by 10.6% (95% UI: -19.5 to -4.4), with 600.7 thousand deaths in 2017 (95% UI: 578.7–630.0; age-standardised death rate of 14.1 95% UI: 13.6–14.8). Global DALYs also significantly decreased between 1990 and 2017 by 9.3% (95% UI: -19.9 to -1.6) with 17.4 million DALYs reported in 2017 (95% UI: 16.6–18.4; age-standardised rate of 414.7; 95% UI: 395.5– 437.6). Lebanon [138.3 (95% UI: 106.5–170.7)], the Netherlands [109.8 (95% UI: 97.4–122.7)], and the UK [102.6 (95% UI: 99.6–105.8)] had the three highest age-standardised incidence rates in 2017. Meanwhile, Pakistan [34.1 (95% UI: 20.9–71.3)], Tonga [34.0 (95% UI: 26.8–41.9)], and the Bahamas [33.3 (95% UI: 28.9–37.8)] had the three highest age-standardised death rates in 2017. Between 1990 and 2017, Saudi Arabia [232% (95% UI: 93–410)], Mauritius [174% (95% UI: 134–222)], and Taiwan [172% (95% UI: 141–208)] showed an increasing trend for the highest age-standardised incidence rate of breast cancer. Meanwhile, Mauritius [90% (95% UI: 66–117)], Philippines [76% (95% UI: 43–115)], and the Dominican Republic [69% (95% UI: 11–125)] produced the greatest significant increasing trend in age-standardised death rates. An increasing trend between population ageing and age-standardised incidence and death rates were observed globally, peaking among the oldest population grouping [incidence: 535.6 (95% UI: 511.8–560.7); death: 251.4 (95% UI: 242.6–260.9)]. Non-linear associations were observed between age-standardised DALY rates with SDI and HAQ. Alcohol consumption [9.2% (95% UI: 7.7–10.7)], high fasting plasma glucose [6.1% (95% UI: 1.1–13.6)], and high body mass index [4.5% (95% UI: 1.4–8.5)] were the three largest contributors to breast cancer DALYs globally.Conclusions: Remarkable inter-country variation exists in the burden of breast cancer. While there is a global downward trend in breast cancer age-standardised mortality rates, some countries are experiencing increases in age-standardised incidence and death rates from breast cancer. Prevention measures should be tailored to national-level estimates specific for each country and strengthened through early detection and treatment and public policy awareness campaigns aimed to reduce exposure to modifiable risk factors, particularly for countries with high incidence levels and/or increasing trends.

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Global burden of breast cancer and attributable risk factors in 195 countries and territories, from 1990 to 2017: results from the Global Burden of Disease Study 2017

Journal of Hematology & Oncology ◽

10.1186/s13045-019-0828-0 ◽

2019 ◽

Vol 12 (1) ◽

Cited By ~ 39

Author(s):

Na Li ◽

Yujiao Deng ◽

Linghui Zhou ◽

Tian Tian ◽

Si Yang ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Burden Of Disease ◽

Attributable Risk ◽

Global Burden Of Disease ◽

Global Burden ◽

Cancer Burden ◽

Cancer Data ◽

Life Years ◽

Incident Cases

Abstract Background Statistical data on the incidence, mortality, and burden of breast cancer and the relevant risk factors are valuable for policy-making. We aimed to estimate breast cancer incidence, deaths, and disability-adjusted life years (DALYs) by country, gender, age group, and social-demographic status between 1990 and 2017. Methods We extracted breast cancer data from the 2017 Global Burden of Disease (GBD) study from 1990 through 2017 in 195 countries and territories. Data about the number of breast cancer incident cases, deaths, DALYs, and the age-standardized rates were collected. We also estimated the risk factors attributable to breast cancer deaths and DALYs using the comparative risk assessment framework of the GBD study. Results In 2017, the global incidence of breast cancer increased to 1,960,681 cases. The high social-development index (SDI) quintile included the highest number of breast cancer death cases. Between 2007 and 2017, the ASDR of breast cancer declined globally, especially in high SDI and high middle SDI countries. The related DALYs were 17,708,600 in 2017 with high middle SDI quintile as the highest contributor. Of the deaths and DALYs, alcohol use was the greatest contributor in most GBD regions and other contributors included high body mass index (BMI) and high fasting plasma glucose. Conclusion The increasing global breast cancer burden is mainly observed in lower SDI countries; in higher SDI countries, the breast cancer burden tends to be relieving. Therefore, steps against attributable risk factors should be taken to reduce breast cancer burden in lower SDI countries.

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The Global, Regional, and National Burden of Nasopharyngeal Carcinoma and Its Attributable Risk Factors in 194 Countries and Territories, 2007–2017

10.21203/rs.3.rs-778985/v1 ◽

2021 ◽

Author(s):

Zhisen Shen ◽

Yujie Cao ◽

Lin Luo ◽

Liyuan Han ◽

Jun Li ◽

...

Keyword(s):

Risk Factors ◽

Nasopharyngeal Carcinoma ◽

Dominican Republic ◽

South Asia ◽

Incidence Rate ◽

Death Rate ◽

Attributable Risk ◽

Uncertainty Interval ◽

Death Rates ◽

The Caribbean

Abstract BackgroundSo far, no research about the burden of the incidence rate, Disability-Adjusted Life Years (DALYs), and death rate associated with nasopharyngeal carcinoma (NPC) has been reported on the global, regional, and national levels. In this paper, we provide an overview of the most recent global epidemiology of nasopharyngeal cancer with data obtained from the Global Health Data Exchange (GHDx) repository.MethodsWe utilized the reports of the Global Burden of Diseases (GBD), Injuries, and Risk Factors Study in 2017 to estimate the burden of NPC in 194 countries and territories by age, sex, and Socio-Demographic Index (SDI) from 2007 to 2017. Moreover, we assessed the risk factors of NPC-related DALYs and deaths through the Comparative Risk Assessment Framework.ResultsIn the year 2017, 10.978 million new NPC cases with a 95% uncertainty interval of 10.444 to 11.556 million were recorded globally, whereas the DALYs and deaths were 2.09 million cases with a 95%UI 2 to 2.17 million and 695.5 thousand cases with 95% UI 668.7 to 722.7 thousand, respectively. From 2007 to 2017, the estimated incidence rate of NPC decreased by 2.3% with 95% uncertainty interval -7% to 3.28%, the estimated DALY rate decreased by 4.95% with 95% uncertainty interval from -8.46% to -1.24%, and the estimated death rate decreased by 3.01% with 95% uncertainty interval -6.36% to 0.43%. The age-standardized incidence, DALY, and death rates in 2017 were all the highest among the countries located in the middle-SDI quintiles region. At the GBD regional level, the most severe age-standardized incidence, DALY, and death rates in 2017 occurred in Oceania, followed by Southeast Asia and East Asia. From 2007 to 2017, the Caribbean and South Asia have the most increase in percentage in age-standardized incidence, DALY, and death rates. At the national level, countries like Ukraine, Jamaica, and the Dominican Republic reported the largest percentage increases in the age-standardized incidence, DALY, and death rates in a decade. From 2007 to 2017, DALYs and death rate of NPC increased by 18.99% (95%UI:13.34% - 25.73%) and 23.5% (95%UI:17.76% - 29.84%), respectively. While the estimated age-standardized attributable risk DALY rate and the age-standardized attributable risk mortality rate decreased by 5.55% (95% UI: -9.93% - 0.34%) and 4.25% (95% UI: -8.64% - 0.56%). ConclusionThe middle-SDI quintiles had the highest age-standardized incidence, DALY, and death rates in 2017. The largest increases in age-standardized incidence, DALY, and death rates were reported in the Caribbean and South Asia from 2007 to 2017, especially in countries such as Ukraine, Jamaica, Dominican Republic, and Dominica. In these regions, Alcohol consumption, Smoking, and A diet short of fruits were the primary three risk factors contributing to both DALYs and deaths in 2017.

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Global, regional, and national burden of kidney, bladder, and prostate cancers and their attributable risk factors, 1990–2019

Military Medical Research ◽

10.1186/s40779-021-00354-z ◽

2021 ◽

Vol 8 (1) ◽

Author(s):

Hao Zi ◽

Shao-Hua He ◽

Xie-Yuan Leng ◽

Xiao-Feng Xu ◽

Qiao Huang ◽

...

Keyword(s):

Risk Factors ◽

Kidney Cancer ◽

High Body Mass Index ◽

Attributable Risk ◽

Global Public Health ◽

Life Years ◽

Prostate Cancers ◽

High Fasting Plasma Glucose ◽

Incident Cases ◽

Related Mortality

Abstract Background The burden of kidney, bladder, and prostate cancers has changed in recent decades. This study aims to investigate the global and regional burden of, and attributable risk factors for genitourinary cancers during the past 30 years. Methods We extracted data of kidney, bladder, and prostate cancers from the Global Burden of Disease 2019 database, including incidence, mortality, disability-adjusted life-years (DALYs), and attributable risk factors from 1990 to 2019. Estimated annual percentage changes (EAPC) were calculated to assess the changes in age-standardized incidence rate, age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR). The associations between cancers burden and socio-demographic index (SDI) were also analyzed. Results Compared with 1990, the global incident cases in 2019 were higher by 154.78%, 123.34%, and 169.11% for kidney, bladder, and prostate cancers, respectively. During the 30-year study period, there was a downward trend in ASMR and ASDR for bladder cancer (EAPC = − 0.68 and − 0.83, respectively) and prostate cancer (EAPC = − 0.75 and − 0.71, respectively), but an upward trend for kidney cancer (EAPC = 0.35 and 0.12, respectively). Regions and countries with higher SDI had higher incidence, mortality, and DALYs for all three types of cancers. The burden of bladder and prostate cancers was mainly distributed among older men, whereas the burden of kidney cancer increased among middle-aged men. Smoking related mortality and DALYs decreased, but high body mass index (BMI) and high fasting plasma glucose (FPG) related mortality and DALYs increased among kidney, bladder, and prostate cancers during the study period. Conclusions Kidney, bladder, and prostate cancers remain major global public health challenges, but with distinct trend for different disease entity across different regions and socioeconomic status. More proactive intervention strategies, at both the administrative and academic levels, based on the dynamic changes, are needed.

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Relationship Between Insomnia, Depression, and Mortality: A 12-Year Follow-Up of Older Adults in the Community

International Psychogeriatrics ◽

10.1017/s1041610200006414 ◽

2000 ◽

Vol 12 (3) ◽

pp. 295-306 ◽

Cited By ~ 120

Author(s):

Lena Mallon ◽

Jan-Erik Broman ◽

Jerker Hetta

Keyword(s):

Risk Factors ◽

Older Adults ◽

Natural History ◽

Confidence Interval ◽

Odds Ratio ◽

Death Rate ◽

Mortality Data ◽

Total Death ◽

History Of

The purpose of the study was to investigate the natural history of insomnia and its association with depression and mortality. In 1983, 1,870 randomly selected subjects aged 45–65 years answered a questionnaire on sleep and health. Of the 1,604 survivors in 1995, 1,244 (77.6%) answered a new questionnaire with almost identical questions. Mortality data were collected for the 266 subjects that had died during the follow-up period. Chronic insomnia was reported by 36.0% of women and 25.4% of men (χ2 = 9.7; p < .01). About 75% of subjects with insomnia at baseline continued to have insomnia at follow-up. Insomnia in women predicted subsequent depression (odds ratio [OR] = 4.1; 95% confidence interval [CI] 2.1–7.2) but was not related to mortality. In men, insomnia predicted mortality (OR = 1.7; 95% CI 1.2–2.3), but after adjustment for an array of possible risk factors, this association was no longer significant. Men with depression at baseline had an adjusted total death rate that was 1.9 times higher than in the nondepressed men (95% CI: 1.2–3.0).

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Global estimated Disability-Adjusted Life-Years (DALYs) of diarrheal diseases: A systematic analysis of data from 28 years of the global burden of disease study

PLoS ONE ◽

10.1371/journal.pone.0259077 ◽

2021 ◽

Vol 16 (10) ◽

pp. e0259077

Author(s):

Natacha U. Karambizi ◽

Christopher S. McMahan ◽

Carl N. Blue ◽

Lesly A. Temesvari

Keyword(s):

Risk Factors ◽

Low Income ◽

Diarrheal Disease ◽

High Income ◽

Low Income Countries ◽

Global Burden ◽

Years Of Life Lost ◽

Apparent Lack ◽

Disability Adjusted Life ◽

Life Years

Background Diarrheal disease (DD)-associated mortality has declined since 1990; however, the incidence of DD has experienced a less-pronounced decrease. Thus, it is important to track progress in managing DD by following loss of healthy years. A disability-adjusted life-year (DALY), which combines data on years-of-life lost (YLL) and years-lived with-disability (YLD), is a metric that can track such a burden. Methods and findings Using all 28 years of data in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, we compared DD DALYs among different demographic subsets including sex, age, country, and World Bank (WB) income level. We also evaluated DD DALYs as a function of the socio-demographic index (SDI), a measure of a region’s socio-demographic development. On a global level, DD DALYs have decreased by approximately 85.43% from 1990 to 2017. Incidence and prevalence have decreased by 1.53% and 4.45%, respectively. A dramatic decrease in DD DALYs were observed for WB low-income countries, but not for WB high-income constituents. The temporal decrease in DD DALY rates in WB low-income countries was likely driven by a decrease in YLL. Alternatively, temporal increases in both YLL and YLD may have contributed to the apparent lack of progress in WB high-income countries. Regardless of WB income classification, children under the age of five and the elderly were the most vulnerable to DD. In nearly every year from 1990 to 2017, DD DALYs for females were higher than those for males in WB high-income regions, but lower than those for males in WB low-income constituents. The reason for these differences is not known. We also observed that the rate of DD DALYs was highly correlated to SDI regardless of WB income classification. Conclusions To the best of our knowledge, this is the only temporal study of DD DALYs that encompasses all 28 years of data available from the GBD. Overall, our analyses show that temporal reductions in DD DALYs are not equivalent across regions, sexes and age groups. Therefore, careful attention to local and demography-specific risk factors will be necessary to tailor solutions in region- and demography-specific manners.

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Updated estimates of comorbidities associated with risk for COVID-19 complications based on US data

10.1101/2020.05.02.20088781 ◽

2020 ◽

Author(s):

Mary L. Adams ◽

Joseph Grandpre ◽

David L. Katz

Keyword(s):

Risk Factors ◽

Household Income ◽

Sedentary Lifestyle ◽

Vegetable Consumption ◽

Population Attributable Risk ◽

Attributable Risk ◽

High School Education ◽

Mortality Data ◽

Health Promotion Campaign ◽

Increasing Risk

AbstractWe updated previous estimates (wwwnc.cdc.gov/eid/article/26/8/20-0679_article) of adults with any underlying condition increasing risk of complications from COVID-19 using recent US hospitalization data instead of mortality data from China. This substitutes obesity for cancer in the definition and increased the percentage of adults reporting ≥1 condition to 56.0% (95% CI 55.7-56.4). When controlled for all measures listed, factors increasing odds of reporting any of the underlying conditions include being male, older, African American, American Indian, household income <$25,000, < high school education, underinsurance, living in the South or Midwest (vs. West), plus the risk factors of ever smoking, sedentary lifestyle, and inadequate fruit and vegetable consumption. Population-attributable risk for the listed risk factors was 13.0%, 12.6%, and 15.0% respectively. Results have potential implications for policies based on risk-stratification of the population and for improvement of risk status through lifestyle change. National support for a “health promotion” campaign would be timely.

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Years of life lost by CNCD attributed to occupational hazards in Brazil: GBD 2016 study

Revista de Saúde Pública ◽

10.11606/s1518-8787.2020054001257 ◽

2020 ◽

Vol 54 ◽

pp. 28

Author(s):

Ada Ávila Assunção ◽

Elisabeth Barboza França

Keyword(s):

Risk Factors ◽

Descriptive Analysis ◽

Premature Death ◽

Noncommunicable Diseases ◽

Global Burden ◽

Years Of Life Lost ◽

Occupational Hazards ◽

Age Group ◽

Occupational Hazard ◽

Life Years

OBJECTIVE: To assess the years of life lost due to premature death and disability-adjusted life years (DALY) as a result of chronic noncommunicable diseases attributable to occupational hazard factors, and to compare their position according to the risk ranking for chronic noncommunicable diseases in 1990 and 2016. METHODS: Data for the DALY indicator, estimated from the Global Burden of Disease 2016 (GBD 2016) study, were analyzed for noncommunicable chronic diseases attributable to occupational, and other risk factors, selected in Brazil. A descriptive analysis was performed comparing the proportion of DALY by sex and age group (15 to 49 and 50 to 69 years old), as well as the ranking of occupational hazard factors in 1990 and 2016. RESULTS: In 2016, ergonomic risk factors, carcinogenic agents, and noise in the workplace were among the 25 largest contributors to DALY for chronic noncommunicable diseases affecting the age group between 15 and 49 years. The contribution of all occupational hazard factors increased in 2016, except for occupational aerodispersoids affecting men. Concerning the age group between 50 and 69, occupational carcinogens stand out, with an increase of 26.0% for men, and 17.1% for women in 2016. Risk factors evaluated according to their 1990 and 2016 ranking show that occupational hazards have all scored higher on the second evaluation (2016), especially when compared with other risks. CONCLUSIONS: The global burden of chronic noncommunicable diseases attributed to occupational hazard factors has become increasingly important. We suggest the strengthening of the approach of occupational hazard factors in the agendas for tackling these diseases in Brazil.

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Decline in Mortality Among Young Americans During the 20th Century: Prospects for Reaching National Mortality Reduction Goals for 1990

PEDIATRICS ◽

10.1542/peds.82.4.582 ◽

1988 ◽

Vol 82 (4) ◽

pp. 582-595

Author(s):

Robert A. Hoekelman ◽

I. Barry Pless

Keyword(s):

Health Care ◽

Death Rate ◽

Access To Health Care ◽

Medical Science ◽

The United States ◽

Renal Diseases ◽

Mortality Data ◽

Mortality Reduction ◽

Death Rates ◽

National Mortality

A review of mortality data for persons younger than 25 years of age in the United States reveals striking declines in death rates since the turn of the century. Mortality among infants during their first year of life decreased from 1 in 6 in 1900 to 1 in 100 in 1986. Between 1900 and 1984 the annual death rate for children 1 through 4 years of age decreased from 1 in 50 to 1 in 2,000, for children 5 through 14 years of age, from 1 in 250 to 1 in 4,000, and for persons 15 through 24 years of age, from 1 in 165 to 1 in 1,000. Public health measures, advances in medical science, legislative initiatives, and the organization and delivery of health care have all contributed to these improvements in varying degrees during different decades. For the decade 1975 through 1984, the overall death rate decreased by 20%, with declines for all causes except suicide, cardiovascular diseases, and renal diseases. All of the surgeon general's mortality reduction goals for 1990 for America's youth should be reached except those for infant mortality and suicide. Improvement in these death rates will require better access to health care by those in need and reductions in environmental stress.

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The burden of tuberculosis and attributable risk factors in Brazil, 1990–2017: results from the Global Burden of Disease Study 2017

Population Health Metrics ◽

10.1186/s12963-020-00203-6 ◽

2020 ◽

Vol 18 (S1) ◽

Author(s):

Francisco Rogerlândio Martins-Melo ◽

Juliana Maria Trindade Bezerra ◽

David Soeiro Barbosa ◽

Mariângela Carneiro ◽

Kleydson Bonfim Andrade ◽

...

Keyword(s):

Risk Factors ◽

Alcohol Use ◽

National Level ◽

Age Groups ◽

Absolute Number ◽

Hiv Positive ◽

Global Burden ◽

Years Of Life Lost ◽

Life Years ◽

Hiv Negative

Abstract Background Tuberculosis (TB) continues to be an important cause of fatal and non-fatal burden in Brazil. In this study, we present estimates for TB burden in Brazil from 1990 to 2017 using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017). Methods This descriptive study used GBD 2017 findings to report years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) of TB in Brazil by sex, age group, HIV status, and Brazilian states, from 1990 to 2017. We also present the TB burden attributable to independent risk factors such as smoking, alcohol use, and diabetes. Results are reported in absolute number and age-standardized rates (per 100,000 inhabitants) with 95% uncertainty intervals (UIs). Results In 2017, the number of DALYs due to TB (HIV-negative and HIV-positive combined) in Brazil was 284,323 (95% UI: 240,269–349,265). Among HIV-negative individuals, the number of DALYs was 196,366 (95% UI: 189,645–202,394), while 87,957 DALYs (95% UI: 50,624–146,870) were estimated among HIV-positive individuals. Between 1990 and 2017, the absolute number and age-standardized rates of DALYs due to TB at the national level decreased by 47.0% and 68.5%, respectively. In 2017, the sex–age-specific TB burden was highest among males and in children under-1 year and the age groups 45–59 years. The Brazilian states with the highest age-standardized DALY rates in 2017 were Rio de Janeiro, Pernambuco, and Amazonas. Age-standardized DALY rates decreased for all 27 Brazilian states between 1990 and 2017. Alcohol use accounted for 47.5% of national DALYs due to TB among HIV-negative individuals in 2017, smoking for 17.9%, and diabetes for 7.7%. Conclusions GBD 2017 results show that, despite the remarkable progress in reducing the DALY rates during the period, TB remains as an important and preventable cause of health lost to due premature death and disability in Brazil. The findings reinforce the importance of strengthening TB control strategies in Brazil through integrated and multisectoral actions that enable the access to prevention, early diagnosis, and timely treatment, with emphasis on high-risk groups and populations most vulnerable to the disease in the country.

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