TY  - JOUR
PY  - 2013//
TI  - Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010
JO  - Lancet
A1  - Lozano, Rafael
A1  - Naghavi, Mohsen
A1  - Foreman, Kyle
A1  - Lim, Stephen
A1  - Shibuya, Kenji
A1  - Aboyans, Victor
A1  - Abraham, Jerry
A1  - Adair, Timothy
A1  - Aggarwal, Rakesh
A1  - Ahn, Stephanie Y.
A1  - Alvarado, Miriam
A1  - Anderson, H. Ross
A1  - Anderson, Laurie M.
A1  - Andrews, Kathryn G.
A1  - Atkinson, Charles
A1  - Baddour, Larry M.
A1  - Barker-Collo, Suzanne
A1  - Bartels, David H.
A1  - Bell, Michelle L.
A1  - Benjamin, Emelia J.
A1  - Bennett, Derrick
A1  - Bhalla, Kavi S.
A1  - Bikbov, Boris
A1  - Abdulhak, Aref Bin
A1  - Birbeck, Gretchen
A1  - Blyth, Fiona
A1  - Bolliger, Ian W.
A1  - Boufous, Soufiane
A1  - Bucello, Chiara
A1  - Burch, Michael
A1  - Burney, Peter
A1  - Carapetis, Jonathan
A1  - Chen, Honglei
A1  - Chou, David
A1  - Chugh, Sumeet S.
A1  - Coffeng, Luc E.
A1  - Colan, Steven D.
A1  - Colquhoun, Samantha
A1  - Colson, K. Ellicott
A1  - Condon, John
A1  - Connor, Myles D.
A1  - Cooper, Leslie T.
A1  - Corriere, Matthew
A1  - Cortinovis, Monica
A1  - de Vaccaro, Karen Courville
A1  - Couser, William
A1  - Cowie, Benjamin C.
A1  - Criqui, Michael H.
A1  - Cross, Marita
A1  - Dabhadkar, Kaustubh C.
A1  - Dahodwala, Nabila
A1  - De Leo, Diego
A1  - Degenhardt, Louisa
A1  - Delossantos, Allyne
A1  - Des Jarlais, Don C.
A1  - Dharmaratne, Samath D.
A1  - Dorsey, E. Ray
A1  - Driscoll, Tim
A1  - Duber, Herbert
A1  - Ebel, Beth E.
A1  - Erwin, Patricia J.
A1  - Espindola, Patricia
A1  - Ezzati, Majid
A1  - Feigin, Valery L.
A1  - Flaxman, Abraham D.
A1  - Forouzanfar, Mohammad H.
A1  - Fowkes, Francis Gerry R.
A1  - Franklin, Richard Charles
A1  - Fransen, Marlene
A1  - Freeman, Michael K.
A1  - Gabriel, Sherine E.
A1  - Gakidou, Emmanuela
A1  - Gaspari, Flavio
A1  - Gillum, Richard F.
A1  - Gonzalez-Medina, Diego
A1  - Halasa, Yara A.
A1  - Haring, Diana
A1  - Harrison, James Edward
A1  - Havmoeller, Rasmus
A1  - Hay, Roderick J.
A1  - Hotez, Peter J.
A1  - Hoy, Damian G.
A1  - Jacobsen, Kathryn H.
A1  - James, Spencer L.
A1  - Jasrasaria, Rashmi
A1  - Jayaraman, Sudha
A1  - Johns, Nicole
A1  - Karthikeyan, Ganesan
A1  - Kassebaum, Nicholas
A1  - Keren, Andre
A1  - Khoo, Jon-Paul
A1  - Knowlton, Lisa Marie
A1  - Kobusingye, Olive Chifefe
A1  - Koranteng, Adofo
A1  - Krishnamurthi, Rita
A1  - Lipnick, Michael
A1  - Lipshultz, Steven E.
A1  - Ohno, Summer Lockett
A1  - Mabweijano, Jacqueline
A1  - Macintyre, Michael F.
A1  - Mallinger, Leslie
A1  - March, Lyn
A1  - Marks, Guy B.
A1  - Marks, Robin
A1  - Matsumori, Akira
A1  - Matzopoulos, Richard
A1  - Mayosi, Bongani M.
A1  - McAnulty, John H.
A1  - McDermott, Mary M.
A1  - McGrath, John
A1  - Mensah, George A.
A1  - Merriman, Tony R.
A1  - Michaud, Catherine
A1  - Miller, Matthew C.
A1  - Miller, Ted R.
A1  - Mock, Charles
A1  - Mocumbi, Ana Olga
A1  - Mokdad, Ali A.
A1  - Moran, Andrew
A1  - Mulholland, Kim
A1  - Nair, M. Nathan
A1  - Naldi, Luigi
A1  - Narayan, K. M. Venkat
A1  - Nasseri, Kiumarss
A1  - Norman, Philip
A1  - O'Donnell, Martin
A1  - Omer, Saad B.
A1  - Ortblad, Katrina
A1  - Osborne, Richard
A1  - Ozgediz, Doruk
A1  - Pahari, Bishnu
A1  - Pandian, Jeyaraj Durai
A1  - Rivero, Andrea Panozo
A1  - Padilla, Rogelio Perez
A1  - Perez-Ruiz, Fernando
A1  - Perico, Norberto
A1  - Phillips, David
A1  - Pierce, Kelsey
A1  - Pope, C. Arden
A1  - Porrini, Esteban
A1  - Pourmalek, Farshad
A1  - Raju, Murugesan
A1  - Ranganathan, Dharani
A1  - Rehm, Jürgen T.
A1  - Rein, David B.
A1  - Remuzzi, Guiseppe
A1  - Rivara, Frederick P.
A1  - Roberts, Thomas
A1  - De Leòn, Felipe Rodriguez
A1  - Rosenfeld, Lisa C.
A1  - Rushton, Lesley
A1  - Sacco, Ralph L.
A1  - Salomon, Joshua A.
A1  - Sampson, Uchechukwu
A1  - Sanman, Ella
A1  - Schwebel, David C.
A1  - Segui-Gomez, Maria
A1  - Shepard, Donald S.
A1  - Singh, David
A1  - Singleton, Jessica
A1  - Sliwa, Karen
A1  - Smith, Emma
A1  - Steer, Andrew
A1  - Taylor, Jennifer A.
A1  - Thomas, Bernadette
A1  - Tleyjeh, Imad M.
A1  - Towbin, Jeffrey A.
A1  - Truelsen, Thomas
A1  - Undurraga, Eduardo A.
A1  - Venketasubramanian, N.
A1  - Vijayakumar, Lakshmi
A1  - Vos, Theo
A1  - Wagner, Gregory R.
A1  - Wang, Mengru
A1  - Wang, Wenzhi
A1  - Watt, Kerrianne
A1  - Weinstock, Martin A.
A1  - Weintraub, Robert
A1  - Wilkinson, James D.
A1  - Woolf, Anthony D.
A1  - Wulf, Sarah
A1  - Yeh, Pon-Hsiu
A1  - Yip, Paul
A1  - Zabetian, Azadeh
A1  - Zheng, Zhi-Jie
A1  - Lopez, Alan D.
A1  - Murray, Christopher Jl
A1  - Denenberg, Julie
A1  - Hoen, Bruno
SP  - 2095
EP  - 2128
VL  - 380
IS  - 9859
N2  - BACKGROUND: Reliable and timely information on the leading causes of death in populations, and how these are changing, is a crucial input into health policy debates. In the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010), we aimed to estimate annual deaths for the world and 21 regions between 1980 and 2010 for 235 causes, with uncertainty intervals (UIs), separately by age and sex. METHODS: We attempted to identify all available data on causes of death for 187 countries from 1980 to 2010 from vital registration, verbal autopsy, mortality surveillance, censuses, surveys, hospitals, police records, and mortuaries. We assessed data quality for completeness, diagnostic accuracy, missing data, stochastic variations, and probable causes of death. We applied six different modelling strategies to estimate cause-specific mortality trends depending on the strength of the data. For 133 causes and three special aggregates we used the Cause of Death Ensemble model (CODEm) approach, which uses four families of statistical models testing a large set of different models using different permutations of covariates. Model ensembles were developed from these component models. We assessed model performance with rigorous out-of-sample testing of prediction error and the validity of 95% UIs. For 13 causes with low observed numbers of deaths, we developed negative binomial models with plausible covariates. For 27 causes for which death is rare, we modelled the higher level cause in the cause hierarchy of the GBD 2010 and then allocated deaths across component causes proportionately, estimated from all available data in the database. For selected causes (African trypanosomiasis, congenital syphilis, whooping cough, measles, typhoid and parathyroid, leishmaniasis, acute hepatitis E, and HIV/AIDS), we used natural history models based on information on incidence, prevalence, and case-fatality. We separately estimated cause fractions by aetiology for diarrhoea, lower respiratory infections, and meningitis, as well as disaggregations by subcause for chronic kidney disease, maternal disorders, cirrhosis, and liver cancer. For deaths due to collective violence and natural disasters, we used mortality shock regressions. For every cause, we estimated 95% UIs that captured both parameter estimation uncertainty and uncertainty due to model specification where CODEm was used. We constrained cause-specific fractions within every age-sex group to sum to total mortality based on draws from the uncertainty distributions. FINDINGS: In 2010, there were 52·8 million deaths globally. At the most aggregate level, communicable, maternal, neonatal, and nutritional causes were 24·9% of deaths worldwide in 2010, down from 15·9 million (34·1%) of 46·5 million in 1990. This decrease was largely due to decreases in mortality from diarrhoeal disease (from 2·5 to 1·4 million), lower respiratory infections (from 3·4 to 2·8 million), neonatal disorders (from 3·1 to 2·2 million), measles (from 0·63 to 0·13 million), and tetanus (from 0·27 to 0·06 million). Deaths from HIV/AIDS increased from 0·30 million in 1990 to 1·5 million in 2010, reaching a peak of 1·7 million in 2006. Malaria mortality also rose by an estimated 19·9% since 1990 to 1·17 million deaths in 2010. Tuberculosis killed 1·2 million people in 2010. Deaths from non-communicable diseases rose by just under 8 million between 1990 and 2010, accounting for two of every three deaths (34·5 million) worldwide by 2010. 8 million people died from cancer in 2010, 38% more than two decades ago; of these, 1·5 million (19%) were from trachea, bronchus, and lung cancer. Ischaemic heart disease and stroke collectively killed 12·9 million people in 2010, or one in four deaths worldwide, compared with one in five in 1990; 1·3 million deaths were due to diabetes, twice as many as in 1990. The fraction of global deaths due to injuries (5·1 million deaths) was marginally higher in 2010 (9·6%) compared with two decades earlier (8·8%). This was driven by a 46% rise in deaths worldwide due to road traffic accidents (1·3 million in 2010) and a rise in deaths from falls. Ischaemic heart disease, stroke, chronic obstructive pulmonary disease (COPD), lower respiratory infections, lung cancer, and HIV/AIDS were the leading causes of death in 2010. Ischaemic heart disease, lower respiratory infections, stroke, diarrhoeal disease, malaria, and HIV/AIDS were the leading causes of years of life lost due to premature mortality (YLLs) in 2010, similar to what was estimated for 1990, except for HIV/AIDS and preterm birth complications. YLLs from lower respiratory infections and diarrhoea decreased by 45-54% since 1990; ischaemic heart disease and stroke YLLs increased by 17-28%. Regional variations in leading causes of death were substantial. Communicable, maternal, neonatal, and nutritional causes still accounted for 76% of premature mortality in sub-Saharan Africa in 2010. Age standardised death rates from some key disorders rose (HIV/AIDS, Alzheimer's disease, diabetes mellitus, and chronic kidney disease in particular), but for most diseases, death rates fell in the past two decades; including major vascular diseases, COPD, most forms of cancer, liver cirrhosis, and maternal disorders. For other conditions, notably malaria, prostate cancer, and injuries, little change was noted. INTERPRETATION: Population growth, increased average age of the world's population, and largely decreasing age-specific, sex-specific, and cause-specific death rates combine to drive a broad shift from communicable, maternal, neonatal, and nutritional causes towards non-communicable diseases. Nevertheless, communicable, maternal, neonatal, and nutritional causes remain the dominant causes of YLLs in sub-Saharan Africa. Overlaid on this general pattern of the epidemiological transition, marked regional variation exists in many causes, such as interpersonal violence, suicide, liver cancer, diabetes, cirrhosis, Chagas disease, African trypanosomiasis, melanoma, and others. Regional heterogeneity highlights the importance of sound epidemiological assessments of the causes of death on a regular basis. FUNDING: Bill & Melinda Gates Foundation.<p />  <p>Language: en</p>
LA  - en
SN  - 0140-6736
UR  - http://dx.doi.org/10.1016/S0140-6736(12)61728-0
ID  - ref1
ER  -