Desai, Hardik Dineshbhai

10575 Background: Cancer stands as the 2nd leading cause of deaths and disability in the United States (US), and among the numerous contributing factors, modifiable risk factors play a significant role in exacerbating this burden. Within the spectrum of cancers, alcohol consumption ranks as the second leading attributable cause of death, as per the Global Burden of Disease Cancer Attributable Risk Factor Study. Methods: Employing the GBD protocol, we conducted an estimation of deaths, disability-adjusted life years (DALYs) attributable to cancer caused by alcohol consumption in the US. This comprehensive analysis was stratified by age, gender, year, and geographical location throughout the US, from 1990 to 2019. To project future trends, we utilized time-series regression techniques to forecast deaths until the year 2040. Results: The total number of cancer-related deaths in the US surged from 19,898 (95%UI: 17,791-22,149) in 1990 to 34,455 (30,542-38,388) in 2019. Concurrently, DALYs increased from 532,533 (480,249-586,646) in 1990 to 854,351 (764,549-949,378) in 2019, and YLLs rose from 501,639 (452,446- 554,400) in 1990 to 802,493 (717,123-891,789) in 2019. The highest annual percentage change (APC) in ASR for mortality was observed in West Virginia, with a 32% increase, followed by Tennessee at 27%. Conversely, the District of Columbia witnessed the most significant decrease, with a 30% reduction from 1990 to 2019. In terms of DALYs rates, the highest increases were observed in West Virginia (27%) and Oklahoma (21%). Males bore a greater overall burden compared to females, with an APC in deaths of 97% vs 40% and an APC in DALYs of 87% vs 26%. The highest number of deaths occurred in the 60-64 age group, with 5,228 cases in 2019, while DALYs reached 154,034 in the same year. Projections indicate that the total number of deaths is expected to increase by 49,230 by the year 2040. Conclusions: In 2019, cancer-related deaths attributed to alcohol use represented 4.42% of all cancer mortality cases. From both a public health and clinician perspective, the study's results highlight the urgent need for comprehensive strategies to address the growing burden of cancer associated with alcohol use. Efforts should focus on prevention, early intervention, and support for individuals struggling with alcohol-related cancer risks. [Table: see text]

Background: Cardiovascular Disease (CVDs) is the leading cause of deaths amongst G20 countries accounting for 35.44% deaths in the G20 Countries. The G20 countries, being major economies, have a significant impact on global environmental conditions. Method: Using Global Burden of Disease tool, we estimated the deaths and Disability adjusted life years (DALYs) stratified by age, sex, year, and location due to CVD attributable to environmental risk factors across the G20 Countries from 1990-2019. Results: From 1990-2019, the annual percentage change showed a 37% rise in deaths, rising from 2,608,027-3,571,390. During the same period, DALYs surged by 25%, going from 63,297,319-78,964,495. However, when evaluating the age-standardized rates, both deaths and DALYs displayed a decrease from 1990 to 2019. In 2019, Saudi Arabia recorded the highest ASMR rate at 114 (with a range of 92-137) per 100,000. Bulgaria closely followed with a rate of 113 (87-141). In terms of age-standardized DALYs rates, Saudi Arabia again stood out, registering the highest in 1990 with a value of 2573 ( 2069-3145). Evaluating by age groups, 80-84 year old witnessed the most significant death count in 2019 (527,371). Meanwhile, the age group of 65-69 years saw the highest DALYs count in 2019, (10.4 million). Over the last three decades, males consistently experienced higher counts of both deaths and DALYs compared to females. Conclusion: Environmental risk factors contributed to 26.78% of CVD-related deaths and 29% of DALYs, underscoring the critical role of environment in cardiovascular health outcomes in G20 Countries. it's essential to integrate environmental risk assessments into routine check-ups and tailor treatment plans that address specific environmental exposures linked to CVD. There's an urgent need for policy reforms promoting environmental health, coupled with widespread community education about the environmental determinants of cardiovascular diseases.

Background: Peripheral Artery Disease (PAD) ranks as the 10th primary cause of mortality and the 11th for disability among all cardiovascular diseases in the U.S. Method: We employed the Global Burden of Disease 2019 framework. PAD non-fatal health outcomes were analyzed using the DisMod MR 2.1 (Bayesian meta-regression tool) and determined fatal health outcome with the cause of death ensemble model (CODEm), segmented by age, gender, year, and location from 1990-2019 across the U.S. Results: The annual percentage change (APC) revealed a 26% (9.9-12.4 million) increase in overall prevalence and incidence, a significant 152% (5,757-14,527) rise in deaths, and a 98% (119,253-236,031) uptick in DALYs during 1990-2019. Notably, while the age-standardized incidence rate dipped by 28% (267-193), death and DALY rates climbed by 33% (1.7-2.27) and 11% (36-39) respectively. Delaware witnessed the highest APC in deaths 118% (2.33-5.08) per 100,000, trailed by Colorado with a 58% (35-55) rise in DALYs. Individuals under 70 experienced a 118% (1052-2294) surge in APC for deaths and a 28% (458,357-588,135) increase in incidence. In absolute numbers, males bore a heavier PAD burden, yet females exhibited elevated age-standardized rates from 1990-2019. Conclusion: The study underscores a concerning rise in PAD in the U.S. from 1990-2019, accounted for 1.52% deaths of all cardiovascular related casualties in 2019. Delaware and Colorado have notably high increases in PAD-related outcomes. From both a clinical and public health perspective, addressing high fasting plasma glucose and sodium-rich diets is crucial, as they stand as leading risk factors in PAD's burgeoning prevalence.

Background: Atrial Fibrillation and Atrial Flutter (Afib) ranks 6th in mortality and 7th in disability amongst all cardiovascular disease the G20 nations. Method: We employed 2019 Global Burden of Disease methodology. Afib and Flutter, non-fatal health outcomes, such as incidence and prevalence, were estimated using the Bayesian meta-regression tool (DisMod MR 2.1). Fatal health outcomes were assessed using the Cause of Death Ensemble Model (CODEm), considering factors like age, gender, year, and location throughout the G20 from 1990 to 2019. Results: From 1990 to 2019, prevalence rose from 23.2 million (95%UI: 17.6-29.7) to 48.9 million (37.5-61.6). The annual percentage change (APC) in incidence surged by 102% (1.8-3.8 million), DALYs by 119% (3-6 million), and deaths by 168% (93,864-251,272). Despite these increases, the age-standardized rate per 100,000 person-years declined over the past three decades. In 2019, the U.S. reported the highest age-standardized incidence rate at 109.52 (88.97-131.92) per 100,000, while Sweden had the top mortality rate of 8.63 (4-10.32) per 100,000. The age group 65-69 had the peak incidence count of 700,768 (362,032-1,158,177). Meanwhile, the highest death count was in the 85-89 age bracket with 59,325 (48,618-70,077), and the most DALYs were in the 80-84 age group with 1,083,488 (882,995-1,323,533) in 2019. Males consistently faced a higher burden than females over this period. Conclusion: AFib and AF accounted for 1.88% deaths amongst all cardiovascular casualties in 2019. Clinicians in the G20 countries must prioritize early detection and intervention for Afib and flutter, especially in males and the elderly, given its escalating prevalence and its ranking as a major cause of death and disability. Public health strategies in the G20 nations should focus on targeted awareness and interventions to combat the rising burden of atrial fibrillation, with countries like the United States and Sweden requiring heightened attention due to their notably high incidence and mortality rates.

Introduction: Congenital heart disease (CHD) is the 1st leading cause of deaths among all deaths associated with congenital birth defects in (Organization for Economic Cooperation and Development) OECD countries, constituting a significant health concern that imposes a substantial burden on healthcare systems and society. Methods: Using the Global Burden of Disease methodology, this study assesses the prevalence, incidence, mortality, and disability-adjusted life years (DALYs) associated with CHD in 38 OECD countries by sex, year, and location, covering the period from 1990 to 2019. The results are presented in both all age counts and age standardized rates (ASR) per 100,000 person-years. Results: From 1990 to 2019, the total number of prevalent cases of CHD increased from 1,469,128 (95%UI: 1,292,909-1,671,743) to 1,590,654 (1,387,114-1,815,338). In contrast, CHD-related deaths decreased from 37,291 (31,629-47,869) in 1990 to 13,886 (10,668-16,919) in 2019. The annual percentage of change (APC) in age-standardized mortality (ASMR) decreased by 60%, while the ASIR showed almost no change but decreased by 3%. Notably, the highest APC in ASIR was observed in Czechia (27%), Sweden (21%), Hungary (18%), and the United States (11%), while Turkey (28%) and Canada (21%) had the lowest APC increases. The highest APC increase in ASIR among females was observed in France (29%) Conclusions: Despite a decrease in the burden of CHD over the last three decades, it remains a significant concern in OECD countries. The impact of CHD is felt by individuals, families, healthcare systems, and the economy, emphasizing the ongoing need for comprehensive strategies to address this burden.