Trends in the Incidence and Mortality of Diabetes in China from 1990 to 2017: A Joinpoint and Age-Period-Cohort Analysis

Background: The prevalence of diabetes mellitus is rapidly increasing in China, but the secular trends in incidence and mortality remain unknown. This study aims to examine time trends from 1990 to 2017 and the net age, period, and cohort effects on diabetes incidence and mortality. Methods: Incidence and mortality rates of diabetes (1990–2017) were collected for each 5-year age group (from 5–9 to 80–84 age group) stratified by gender from the Global Burden of Disease 2017 Study. The average annual percentage changes in incidence and mortality were analyzed by joinpoint regression analysis; the net age, period, and cohort effects on the incidence and mortality were estimated by age-period-cohort analysis. Results: The joinpoint regression analysis showed that age-standardized incidence significantly rose by 0.92% (95% CI: 0.6%, 1.3%) in men and 0.69% in women (95% CI: 0.3%, 1.0%) from 1990 to 2017; age-standardized mortality rates rose by 0.78% (95% CI: 0.6%, 1.0%) in men and decreased by 0.12% (95% CI: −0.4%, 0.1%) in women. For age-specific rates, incidence increased in most age groups, with exception of 30–34, 60–64, 65–69 and 70–74 age groups in men and 25–29, 30–34, 35–39 and 70–74 age groups in women; mortality in men decreased in the younger age groups (from 20–24 to 45–49 age group) while increased in the older age groups (from 50–54 to 80–84 age group), and mortality in women decreased for all age groups with exception of the age group 75–79 and 80–84. The age effect on incidence showed no obvious changes with advancing age while mortality significantly increased with advancing age; period effect showed that both incidence and mortality increased with advancing time period while the period trend on incidence began to decrease since 2007; cohort effect on incidence and mortality decreased from earlier birth cohorts to more recent birth cohorts while incidence showed no material changes from 1982–1986 to 2012–2016 birth cohort. Conclusions: Mortality decreased in younger age groups but increased in older age groups. Incidence increased in most age groups. The net age or period effect showed an unfavorable trend while the net cohort effect presented a favorable trend. Aging likely drives a continued increase in the mortality of diabetes. Timely population-level interventions aiming for obesity prevention, healthy diet and regular physical activity should be conducted, especially for men and earlier birth cohorts at high risk of diabetes.

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Trends in incidence and mortality of tuberculosis in India over past three decades: a joinpoint and age–period–cohort analysis

BMC Pulmonary Medicine ◽

10.1186/s12890-021-01740-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Deepak Dhamnetiya ◽

Priyanka Patel ◽

Ravi Prakash Jha ◽

Neha Shri ◽

Mayank Singh ◽

...

Keyword(s):

Cohort Effect ◽

Mortality Rates ◽

Control Programme ◽

Period Effect ◽

Joinpoint Regression ◽

Birth Cohorts ◽

Male And Female ◽

Tuberculosis Control Programme ◽

Incidence And Mortality ◽

National Tuberculosis

Abstract Background Tuberculosis, as a communicable disease, is an ongoing global epidemic that accounts for high burden of global mortality and morbidity. Globally, with an estimated 10 million new cases and around 1.4 million deaths, TB has emerged as one of the top 10 causes of morbidity and mortality in 2019. Worst hit 8 countries account for two thirds of the new TB cases in 2019, with India leading the count. Despite India's engagement in various TB control activities since its first recognition through the resolution passed in the All-India Sanitary Conference in 1912 and launch of first National Tuberculosis Control Programme in 1962, it has remained a major public health challenge to overcome. To accelerate progress towards the goal of ending TB by 2025, 5 years ahead of the global SDG target, it is imperative to outline the incidence and mortality trends of tuberculosis in India. This study aims to provide deep insights into the recent trends of TB incidence and mortality in India from 1990 to 2019. Methods This is an observational study based on the most recent data from the Global Burden of Disease (GBD) Study 2019. We extracted numbers, age-specific and age-standardized incidence and mortality rates of Tuberculosis for the period 1990–2019 from the Global Health Data Exchange. The average annual percent change (AAPC) along with 95% Confidence Interval (CI) in incidence and mortality were derived by joinpoint regression analysis; the net age, period, and cohort effects on the incidence and mortality rates were estimated by using Age–Period–Cohort model. Results During the study period, age-standardized incidence and mortality rates of TB in India declines from 390.22 to 223.01 and from 121.72 to 36.11 per 100,000 population respectively. The Joinpoint regression analysis showed a significant decreasing pattern in incidence rates in India between 1990 and 2019 for both male and female; but larger decline was observed in case of females (AAPC: − 2.21; 95% CI: − 2.29 to − 2.12; p < 0.001) as compared to males (AAPC: − 1.63; 95% CI: − 1.71 to − 1.54; p < 0.001). Similar pattern was observed for mortality where the declining trend was sharper for females (AAPC: − 4.35; 95% CI: − 5.12 to − 3.57; p < 0.001) as compared to males (AAPC: − 3.88; 95% CI: − 4.63 to − 3.11; p < 0.001). For age-specific rates, incidence and mortality rates of TB decreased for both male and female across all ages during this period. The age effect showed that both incidence and mortality significantly increased with advancing age; period effect showed that both incidence and mortality decreased with advancing time period; cohort effect on TB incidence and mortality also decreased from earlier birth cohorts to more recent birth cohorts. Conclusion Mortality and Incidence of TB decreased across all age groups for both male and female over the period 1990–2019. The incidence as well as mortality was higher among males as compared to females. The net age effect showed an unfavourable trend while the net period effect and cohort effect presented a favourable trend. Aging was likely to drive a continued increase in the mortality of TB. Though the incidence and mortality of tuberculosis significantly decreased from 1990 to 2019, the annual rate of reduction is not sufficient enough to achieve the aim of India’s National Strategic plan 2017–2025. Approximately six decades since the launch of the National Tuberculosis Control Programme, TB still remains a major public health problem in India. Government needs to strengthen four strategic pillars “Detect–Treat–Prevent–Build” (DTPB) in order to achieve TB free India as envisaged in the National Tuberculosis Elimination Programme (2020).

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Trends of Stomach Cancer in Central Serbia

Medicina ◽

10.3390/medicina57070665 ◽

2021 ◽

Vol 57 (7) ◽

pp. 665

Author(s):

Miodrag M. Stojanovic ◽

Natasa K. Rancic ◽

Marija R. Andjelkovic Apostolovic ◽

Aleksandra M. Ignjatovic ◽

Mirko V. Ilic

Keyword(s):

Stomach Cancer ◽

Preventive Measures ◽

Age Groups ◽

Optimal Number ◽

P Value ◽

Age Group ◽

Joinpoint Regression ◽

Mortality Trends ◽

Incidence Trend ◽

Incidence And Mortality

Somach cancer is the third most common cause of cancer-related deaths worldwide. The objective of the paper was to analyze the incidence and mortality trends of stomach cancer in Central Serbia in the period between 1999–2017. Materials and Methods: trends and annual percentage change (APC) of the incidence and mortality rate with corresponding 95% confidence intervals (CI) were calculated by joinpoint regression analyses. The optimal number of Joinpoints was identified using the Monte Carlo permutation method. The trend was considered to be significantly increasing (positive change) or decreasing (negative change) when the p-value was below 0.05 (p < 0.05). Results: the total number of new cases was 16,914 (10,873 males and 6041 females) and the total number of mortality cases was 14,790 (9348 in and 5442 in females). Almost one third (30.8%) of new cases were registered in the 60–69-year age group, and new cases were significantly more frequent in males than in females (30.8% vs. 29.02%, p < 0.001). Joinpoint regression analysis showed a significant decrease of incidence trend in females during the 2000–2015 period with APC of −2.13% (95% CI: −3.8 to −0.5, p < 0.001). An insignificant decrease in incidence trend was in males with APC of −0.72% (95% CI: −2.3 to 0.9, p = 0.30). According to the joinpoint analysis, a significant decrease of mortality trends both in males during 2000–2015 with APC of −2.21% (95% CI: −1.6 to −7.5, p ≤ 0.001 and in females, during the same period, with APC of −1.75% (95% CI: −2.9 to −0.6, p < 0.001) was registered. From 2015 to 2017, a significant increase of mortality was registered with APC of 44.5% (95% CI: from 24.2 to −68.1, p ≤ 0.001) in females and in males with APC of 53.15% (95% CI: 13.5 to −106.6, p ≤ 0.001). Conclusion: a significant decrease of stomach cancer incidence trend in females and insignificant decrease of incidence trend in males were determined in Central Serbia. Based on presented results, the mortality trend decreased significantly both in males and in females during 2000–2015, and from 2015 to 2017 we recorded a significant increase in mortality in both sexes. We found significantly more new cases in women than in men in the age group of 40–49, and the mortality of stomach cancer was significantly more frequent among females compared to males in the age groups 30–39, as well as in the 50–59 age group. There is a need for improving recording and registration of new cases of stomach cancer, especially in females. Urgent primary and secondary preventive measures are needed—introducing stomach cancer screening and early detection of premalignant changes. Urgent primary and secondary preventive measures are needed.

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Secular Trends in the Incidence of Migraine in China From 1990 to 2019: a Joinpoint and Age-period-cohort Analysis

10.21203/rs.3.rs-288649/v1 ◽

2021 ◽

Author(s):

Yufeng Wang ◽

Xueying Huang ◽

Huan Ma ◽

Suru Yue ◽

Jie Liu ◽

...

Keyword(s):

Cohort Analysis ◽

Cohort Effect ◽

Incidence Rates ◽

Period Effect ◽

Birth Cohorts ◽

Annual Percent Change ◽

Intervention Measures ◽

Disease Pattern ◽

The 1960S ◽

Disease Study

Abstract Background Migraine is a common disorder of the nervous system in China, imposing heavy burdens on individuals and societies. Optimal healthcare planning requires understanding the magnitude and changing trend of migraine incidence in China. However, the secular trend of migraine incidence in China remains unclear. Methods Data were collected from the Global Burden of Disease Study 2019 in China from 1990 to 2019 to investigate changes in the incidence rate of migraine. The average annual percent change and relative risk were calculated using joinpoint regression and an age–period–cohort model, respectively. Results From 1990 to 2019, the age-standardized incidence rates of migraine in China increased by 0.26% (95% CI: 0.22 to 0.31) and 0.23% (95% CI: 0.19 to 0.28) per year in males and females, respectively. The age effect exerted the most significant impact on the incidence of migraine. The period effect showed a slightly decreasing trend in the incidence of migraine. In terms of the cohort effect, people born after the 1960s presented a higher risk of migraine as compared with the total cohort, with the occurrence risk of migraine increasing with birth cohorts. Conclusion Migraine incidence shows an overall increasing trend in China, with a significant gender difference. An intensive understanding of the risk characteristics and disease pattern of migraine could allow the early detection of persons with a high risk of developing migraine and promote the development of timely intervention measures to relieve this burden effectively.

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Gender Disparities and Long-Term Changes of HIV/AIDS Incidence Rate in China and the U.S. From 1994-2019: Age-period-cohort Analysis

10.21203/rs.3.rs-113701/v1 ◽

2020 ◽

Author(s):

Yudiyang Ma ◽

Yiran Cui ◽

Qian Hu ◽

Chuanhua Yu

Keyword(s):

Gender Gap ◽

Cohort Analysis ◽

Transmitted Disease ◽

Age Groups ◽

Cohort Effect ◽

Female Gender ◽

Gender Disparities ◽

Period Effect ◽

The U.S ◽

Hiv Aids

Abstract Background: HIV/AIDS is a serious sexually transmitted disease with poor prognosis. So statistical data on burden of HIV/AIDS incidence and epidemic characteristics are valuable for policy making and reducing healthcare costs. This study aims to explore gender disparities of HIV/AIDS incidence and relative risks of HIV/AIDS incidence by gender and age groups in China and U.S. Methods: We extracted data from the 2019 Global Burden of Disease study and compared epidemic characteristic and gender disparities between China and U.S. Then we employed APC model to estimate age-period-cohort effect of HIV/AIDS incidence in both countries. Results: ASIR in China kept growing between 1994 and 2004 then fell to the level of mid-1990s but in U.S. ASIR increased in the past decade. There existed a huge and continuous expanding gender gap in U.S. while it came to widen in China before 2005 then shrunk during 2005-2019. APC analysis showed the age effect and period effect were consistent to the result of incidence comparison between male and female: gender disparities increased with progress of time in both countries and men had higher incidence of HIV/AIDS when they became old in China. Cohort effect indicated later birth groups bear relatively higher risks of incidence than earlier birth groups. Conclusions: large gender disparities could worsen the HIV epidemic situation. In the U.S., disparities continuously expanded meanwhile incidence of HIV/AIDS was increasing, while gap was under control in China and incidence curbed. Analyzing by APC model, besides younger age groups exposed to high risks of HIV/AIDS incidence in both countries, elder citizens in China faced higher risks which implies aging of population may lead another wave of HIV/AIDS epidemic. Therefore, both young and old age groups deserve to be noticed by police-makers and narrow gender disparities should put on agenda.

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Long-Term Trends of Liver Cancer Incidence and Mortality in China 1990–2017: A Joinpoint and Age–Period–Cohort Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16162878 ◽

2019 ◽

Vol 16 (16) ◽

pp. 2878 ◽

Cited By ~ 2

Author(s):

Fang Wang ◽

Sumaira Mubarik ◽

Yu Zhang ◽

Lu Wang ◽

Yafeng Wang ◽

...

Keyword(s):

Liver Cancer ◽

Cancer Incidence ◽

Cohort Analysis ◽

Cohort Effects ◽

Mortality Data ◽

Period Effect ◽

Birth Cohorts ◽

Incidence And Mortality ◽

Long Term Trends

Liver cancer (LC) is one of the most common causes of cancer-related deaths: this study aims to present the long-term trends and age–period–cohort effects of the incidence of and mortality from LC in China during 1990–2017. Incidence and mortality data were obtained from the Global Burden of Disease Study 2017. We determined trends in the age-standardized incidence rate (ASIR) and mortality rate (ASMR) using Joinpoint regression. An age–period–cohort (APC) analysis was performed to describe the long-term trends with intrinsic estimator methods. The ASMR decreased markedly before 2013 and increased thereafter, with overall average annual percent change (AAPC) values of −0.5% (95% confidence interval (CI): −0.6%, −0.3%) for men and −1.3% (−1.6%, −1.0%) for women during 1990–2017. The ASIR significantly increased by 0.2% (0.1%, 0.3%) in men and decreased by 1.1% (−1.2%, −1.0%) in women from 1990 to 2017. The risks of LC incidence and mortality increased with age in both genders. The period effect risk ratios (RRs) of incidence and mortality displayed similar monotonic increasing trends in men and remained stable in women. The cohort effect showed an overall downward trend and almost overlapping incidence and mortality in both genders, and later birth cohorts experienced lower RRs than previous birth cohorts. Older age, recent period, and birth before 1923 were associated with a higher risk of liver cancer incidence and mortality. The net age and period effects showed an increasing trend, while the cohort effects presented a decreasing trend in incidence and mortality risk. As China’s population aging worsens and with the popularization of unhealthy lifestyles, the burden caused by liver cancer will remain a huge challenge in China’s future.

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Suicide in New Zealand 1957–1986: The Influence of Age, Period and Birth-Cohort

Australian & New Zealand Journal of Psychiatry ◽

10.1080/00048679109077733 ◽

1991 ◽

Vol 25 (2) ◽

pp. 181-190 ◽

Cited By ~ 1

Author(s):

Keren Skegg ◽

Brian Cox

Keyword(s):

New Zealand ◽

Carbon Monoxide Poisoning ◽

Age Groups ◽

Cohort Effect ◽

Mortality Rates ◽

Cohort Effects ◽

Period Effect ◽

Birth Cohorts ◽

Elderly Men ◽

Suicide Rates

New Zealand suicide rates from 1957 to 1986 were analysed for age, period and cohort effects. Cumulative suicide rates were relatively stable but more complex patterns were revealed by detailed analysis. There was a steadily increasing rate in young men and a recent increase in elderly men. Reduced mortality rates in equivalent categories of accidental and “undetermined” deaths could have accounted for only a proportion of these increases. A cohort effect was noted in men, with increasing risks of suicide in the young for successive birth-cohorts born from 1947 onwards. In women a period effect was likely, with increasing rates for all age-groups between 1957–61 and 1962–66, followed by a decline recently among all except the youngest age-groups. These trends in women may have been largely due to changes in barbiturate prescribing. In both sexes poisoning declined as a method of suicide, while hanging and carbon monoxide poisoning increased. Firearm suicides also increased in men. The implications of these results for prevention are considered.

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Gender differential secular trend in lifetime smoking prevalence among adolescents: an age-period-cohort analysis

BMC Public Health ◽

10.1186/s12889-019-7735-8 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Jun Hyun Hwang ◽

Soon-Woo Park

Keyword(s):

Smoking Prevalence ◽

Secular Trend ◽

Cohort Analysis ◽

Age Groups ◽

Cohort Effect ◽

Age Effect ◽

Period Effect ◽

Survey Period ◽

Cohort Groups ◽

Gender Differential

Abstract Background There has been a gender difference in adolescents’ lifetime smoking prevalence trends over the last 10 years. This study aimed to explain the gender differential secular trend in adolescents’ lifetime smoking prevalence using age-period-cohort (APC) analysis and suggests possible causes for this trend, including Korean tobacco control policies during the last 10 years. Methods We utilized the 2006–2017 Korea Youth Risk Behavior Web-based Survey enrolling grades 7 to 12. Using year of survey and year of entry into middle school, we classified 859,814 students who had ever smoked into 6 age groups, 12 periods, and 17 school admission cohorts. Using APC analysis with the intrinsic estimator method, the effects of age, period, and school admission cohort on lifetime smoking prevalence were analyzed according to gender. Results Overall, there was a similar tendency of all the three effects on lifetime smoking prevalence between genders: an increasing age effect with grade, negative period effect with survey period, and similar pattern of school admission cohort groups. However, compared to boys, girls experienced reduction in the increasing age effect in the 12th grade, consistent and steeper decreasing trend in the period effect from 2006 to 2016, and shorter and lower school admission cohort effect. Conclusions Gender differential response to chronological changes in lifetime smoking prevalence was measured by the APC effect, which affected the gender differential secular trend in lifetime smoking prevalence. Therefore, considering the APC effect could help us understand the trend in smoking rates, as well as the contextual factors that affect it.

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Trends in Incidence and Mortality of Tuberculosis in India over past three decades: A Joinpoint and Age-Period- Cohort Analysis

10.21203/rs.3.rs-342519/v1 ◽

2021 ◽

Author(s):

Deepak Dhamnetiya ◽

Priyanka Patel ◽

Ravi Prakash Jha ◽

Neha Shri ◽

Mayank Singh ◽

...

Keyword(s):

Public Health ◽

Cohort Analysis ◽

Cohort Effect ◽

Mortality Rates ◽

Downward Trend ◽

Birth Cohorts ◽

Mortality Trends ◽

Annual Percent Change ◽

Tuberculosis Incidence ◽

Incidence And Mortality

Abstract BackgroundThe morbidity and mortality burden of tuberculosis has been a major public health challenge in India. Despite various commitments to end the global TB epidemic, India has the highest burden of TB and MDR-TB. To accelerate progress towards the goal of ending TB by 2025, it is imperative to outline the incidence and trend of tuberculosis in India. This study provides the trends in the burden of TB in India, along with age, period and cohort effect of TB. MethodsWe have extracted the TB incidence and mortality estimates from GBD database over the period 1990 to 2019. Joinpoint regression was used to determine the magnitude of time trends in incidence and mortality rates of Tuberculosis by calculating the average annual percent change (AAPC) and its 95% confidence interval (CI). We have analyzed the tuberculosis incidence and mortality trends in India to distinguish age, period and cohort effects by using age-period-cohort (APC) model.ResultsThere has been a decline in age standardized incidence rate in the period 1990-2019. Results from the APC table showed that the incidence and mortality due to tuberculosis in India decreased with the recent cohort. The period RRs of incidence had a downward trend in India in the period 1990-2019. Age standardized incidence and mortality rates of tuberculosis was found higher among males. The period RRs of incidence had a downward trend. Findings show that incidence and mortality were higher in older ages. The cohort effect on the incidence of tuberculosis was found higher among 1990-94 birth cohorts than in the later birth cohorts 2010-14. Wald test results demonstrated that the cohort and period RRs for both sexes and the net drift and local drifts for tuberculosis incidence and mortality were statistically significant.ConclusionHigher incidence and mortality in the older age groups is attributed to poor nutrition and socio-economic status. Improvement in India’s public health facility and strategic programs aimed at eliminating tuberculosis might be the reason behind declining RRs in India. The decline in the cohort RRs signifies the effective measures taken to reduce the burden of tuberculosis in the country.

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Comparison of Prevalence of Periodontitis with Different Indices in Population of District Ghaziabad

Dental Journal of Advance Studies ◽

10.1055/s-0038-1672041 ◽

2016 ◽

Vol 04 (01) ◽

pp. 023-030

Author(s):

Vimal Kumar ◽

Pallak Arora ◽

Manish Khatri ◽

Shivani Sharma ◽

Sumit Malhotra ◽

...

Keyword(s):

Periodontal Disease ◽

Total Population ◽

Age Groups ◽

Cross Sectional Study ◽

Sample Population ◽

Age Group ◽

Cross Sectional ◽

Multi Stage ◽

Younger Age ◽

Study Population

Abstract Objective: To estimate the prevalence of periodontal disease with different indices. Methods & materials: The study population consisted of multistage stratified random sample of 1300 subjects from total population of district Ghaziabad. A cross-sectional study was conducted with multi stage stratified random sampling techniques to select the sample population. The subjects were divided into different age groups and the periodontal assessment was made on the basis of CPITN index and ESI Index. Results: The CPITN has shown to estimate incorrect periodontal disease prevalence because of its underestimation of the disease severity. A huge difference was noticed in the prevalence rate of periodontitis when subjects were examined with ESI index. Conclusion Periodontal disease was found to be highly prevalent in the study population and severity of disease increased with age. More number of subjects in younger age group were found to be healthy.

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Age period cohort analysis of chewing ability in Korea from 2007 to 2018

Scientific Reports ◽

10.1038/s41598-021-94086-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Nam-Hee Kim ◽

Ichiro Kawachi

Keyword(s):

Cohort Analysis ◽

Cohort Effect ◽

Cohort Effects ◽

Period Effect ◽

The Past ◽

Health And Nutrition ◽

Period Effects ◽

Chewing Ability ◽

Main Variable ◽

Observation Period

AbstractThere have been marked improvements in oral health in Korea during the past 10 years, including chewing ability. We sought to disentangle age, period, and cohort effects in chewing ability between 2007 and 2018. We analyzed data from the Korea National Health and Nutrition Examination Survey. The main variable was chewing difficulty, which was assessed among participants aged 20 years and older. APC analysis revealed three trends in chewing difficulty: (1) there was an increase in chewing difficulty starting at around 60 years of age (age effect), (2) there was a steady decrease in chewing difficulty during the observation period (period effect), and (3) chewing ability improved with each successive generation born after 1951 (cohort effect). Regarding recent improvements in chewing ability, cohort effects were somewhat more important than period effects.

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