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Background We aimed to investigate global, regional, and national burden of chronic kidney disease (CKD) and its underlying etiologies from 1990 to 2021. Methods We summarized the results of the Global Burden of Disease (GBD) 2021 to derive the disease burden of CKD by considering four distinct types of epidemiological data, namely incidence, prevalence, mortality, and disability-adjusted life years (DALYs). The Joinpoint regression analysis, which is skilled in calculating annual percentage change (APC) and average annual percentage change (AAPC), was used to estimate global trends for CKD from 1990 to 2021. Results The age-standardized mortality rate (ASMR) and age-standardized DALYs rate of CKD were more prominent in regions with Low and Low-middle socio-demographic index (SDI) quintiles. From 1990 to 2021, the countries with the largest increases in ASMR were Ukraine. Globally, the most common cause of death for CKD was type 2 diabetes mellitus (T2DM), while the most common cause of prevalence, incidence, and DALYs was the other and unspecified causes. The main causes of death and DALYs from CKD varied in different parts of the world. The disease burden of CKD increased with age. In most age groups, the global prevalence and incidence of CKD were higher in females than males. At all ages, the global mortality rate and DALYs rate of CKD were higher in males compared to females. Joint point regression analysis found that from 1990 to 2021 the global age-standardized prevalence rate (ASPR) revealed a downward trend, while age-standardized incidence rate (ASIR), ASMR, and age-standardized DALYs rate showed an upward trend, with the most notable increase in ASMR during the 1997–2000 period and in age-standardized DALYs rate during the 1996–2003 period. Conclusions The study unveiled the uneven global distribution of the burden of CKD and its attributable causes. From 1990 to 2021, an increase in the burden of incidence, mortality, and DALYs due to CKD was observed. Population growth and aging will contribute to a further increase in the burden of CKD. Healthcare providers should develop health policies, and optimize the allocation of medical resources, based on age, sex, region, and disease type.

Background Millions of tons of lead were added to gasoline worldwide beginning in 1922, and leaded gasoline has been a major source of population lead exposure. In 1960s, lead began to be removed from automotive gasoline. Removal was completed in 2021. Objectives To determine whether removal of lead from automotive gasoline is associated with declines in population mean blood lead levels (BPb). Methods We examined published studies that reported population blood leaded levels for two or more years, and we calculated average concentrations of lead in gasoline corresponding to the years and locations of the blood lead level measurements. Results Removal of lead from gasoline is associated with declines in BPb in all countries examined. In some countries, BPb continues to fall after lead has been eliminated from gasoline. Following elimination of lead from gasoline, BPb less than 1 μg/dL have been observed in several European and North American countries, and BPb less than 3 μg/dL have been documented in several studies from South America. Discussion There remain many countries for which no multi-year studies of populations BPb have been identified, including all of Central America, high population countries including Pakistan and Indonesia, and major lead producers including Australia and Russia. Conclusion Removal of lead from gasoline has been a public health success. Elimination of lead from gasoline has enabled many countries to achieve population mean BPb levels of 1 μg/dL or lower. These actions have saved lives, increased children’s intelligence and created great economic benefit in countries worldwide.

Background Hypertensive heart disease (HHD) is a major public health issue worldwide. We analyzed the global, regional, and national burden of HHD between the years 1990 and 2019 in relation to age, gender, and socioeconomic factors. Methods The prevalence and death rates, the disability adjusted life-years (DALY), and the corresponding age-standardized rates of HHD were extracted from the Global Burden of Disease study 2019. The epidemiological trends were evaluated by calculating the estimated annual percentage changes (EAPC) of the above variates. Results A total of 19.60 million HHD cases were documented in 2019 compared to 7.82 million in 1990, corresponding to an EAPC of 0.17. Contrarily, the global age-standardized death rate (ASDR) and age-standardized DALYs decreased with respective EAPCs of − 0.74 and − 1.02. HHD mostly occurred in people aged over 65. The disease burden of HHD varied considerably between countries, and univariate linear regression indicated that many socioeconomic variables had significantly negative correlations with age-standardized DALY rate. Conclusion HHD cases have increased over the last three decades; however the mortality rate has declined. Multi-faceted improvements in health, education and income could help to alleviate the disease burden of HHD, specially in some regions with lower socio-demographic index and higher ASDR.

Wenzhou has improved its environmental quality because of comprehensive environmental remediation; nevertheless, the semen quality of infertile males remains unclear. This study determined whether better environmental quality improved semen quality in this region. We recorded semen quality data from 22 962 infertile males from January 2014 to November 2019 at the Center for Reproductive Health of The First Affiliated Hospital of Wenzhou Medical University (Wenzhou, China). Patients were predominantly 30-35 years old (33.1%) and workers (82.0%), with high school education or lower (77.6%); more than a half of the patients (52.6%) were Wenzhou household registration; and most patients (77.5%) had abnormal semen quality. Patients who were older than 40 years and workers, and those with Wenzhou household registration, had significantly worse semen quality (all P < 0.05). From 2014 to 2019, progressive sperm motility, total sperm motility, and semen volume showed increasing linear trends in all patients (P = 0.021, 0.030, and 0.005, respectively), yet normal sperm morphology showed a linearly decreasing trend (P = 0.046). Sensitivity analyses for subgroups yielded similar results. In conclusion, the improvement of environmental quality and better function of the accessory glands are associated with progressive sperm motility, total sperm motility, and semen volume. Normal sperm morphology is influenced by occupational exposures and personal lifestyle and does not improve with environmental quality.

Background A national colorectal cancer (CRC) screening programme was launched in 2002 in Germany. A comprehensive evaluation of the programme effectiveness using real-world data is still lacking. In addition, there are regional reports on increasing colorectal cancer incidence in younger populations. Therefore, we aimed to describe and compare the overall, age- and stage-specific incidence trends for colorectal, colon and rectal cancer. Methods We used data from seven population-based cancer registries in Germany. We report absolute and relative changes in incidence rates between the early screening phase (2003–2005) and the most recent time period available (2015–2017), as well as annual percent changes. We analysed incidences according to tumour site (colorectum, colon, and rectum) and to six age groups (young adults: 15–34, 35–39, 40–49, screening-entitled/older adults: 50–54, 55–69 and 70 + years old). Results In our sample of 271,011 colorectal adenocarcinomas, about two-thirds were located in the colon and 95% of them occurred in the age group 50+ (50–54: 5%, 55–69: 32.8%, 70+: 57.2%). For the time period 2003–2005 the age-specific incidence rates of individuals in the age group 55–69 were about 76/100,00 for colon and 54/100,000 for rectal cancer (age group 70 + colon: 179/100,000; rectum: 84/100,000). The incidence rates in young adults were less than 13% of that of individuals in the age group 55–69 (< 5% of individuals aged 70+; <33% of individuals aged 50–54). Over time, incidence decreased in individuals at the age of 55+, for all subsites considered as well as for early and late stage cancers (with few exceptions), while incidence of young adult CRC (both early and late stage) increased steepest in the youngest age groups. For late stage rectal cancer, a shift was observed in all age groups from UICC stage IV to stage III being the most frequent stage. Conclusions Six years after the introduction of the national colonoscopy screening program, late stage CRC incidence began to decline substantially in the screening-eligible age groups (55-69, 70+). It is likely that this decline and the increase in early stage CRC observed in younger age groups can be attributed to the program. Long lasting public awareness campaigns for CRC screening might have led to opportunistic screening in younger adults. Whether these benefits outweigh the possible harm of screening in younger age groups remains unclear.

Background Between 1980 and 2018 Greenland has had one of the highest suicide rates in the world with an average rate of 96 suicides per 100,000 people annually. The aim of this study is to investigate suicide rates in Greenland according to age, birth cohort, period, sex, place of residence and suicide method from 1970 until 2018. Methods Suicide rates were examined using register and census data from 1970–2018 among Greenland Inuit. Rates were calculated by Poisson regression in Stata and by use of Excel. In analyses of the period trends, rates were standardized according to the World Standard Population 2000–2025. Results The suicide rate has been declining since a peak at 120 suicides per 100,000 people annually in the 1980s but remained high at a rate of 81.3 suicides per 100,000 people annually from 2015–2018. Descriptive analyses point to the decrease in male suicides as the primary factor for the overall decreasing rates while the rate among women has been increasing. Simultaneously, the proportion of women who used a violent suicide method increased from 60% in 1970–1979 to 90% in 2010–2018. The highest rates are seen among young people, especially young men aged 20–24 years and youth suicide rates increased with later birth cohorts. When the rates started to increase in the 1980s both the capital Nuuk and East Greenland had the highest rates. Since then, the rate in Nuuk has declined while the rate in East Greenland was three times the national rate from 2015–2018. Conclusions From 1970 to 1989 the suicide rate increased from 28.7 to 120.5 per 100,000 people mirroring a rapid societal transition in the post-colonial period. The rate has slowly declined from the peak in the 1980s but remains at a very high level. Young people in general are at risk, but the steady increase in the rate among women is worrying and there is a need to investigate underlying causes for this development.

Background Urinary tract cancers (UTC), particularly bladder and kidney cancers, are associated with high mortality rates globally. In Iran, and specifically in Golestan province, an increasing trend in the incidence of these cancers has been reported. This study aims to analyze cancer trends and inform health policy planning to reduce the burden of these diseases in Golestan. Methods Data was collected from the Golestan Population-Based Cancer Registry (GPCR) covering cases of UTC, particularly kidney and bladder cancer from 2004 to 2019. Crude and age-standardized rates (ASR) of kidney and bladder cancers were calculated and presented per 100,000 person-years. Estimated annual percent changes (EAPC) of the ASRs were calculated to investigate time trends in incidence rates. Results The ASR for kidney cancer was 2.32 per 100,000, with rates of 2.75 for men and 1.91 for women. Bladder cancer had an ASR of 5.93, with 9.46 in men and 2.52 in women. Urban populations experienced higher incidence rates as 2.71 for kidney cancer and 7.01 for bladder cancer versus 1.87 and 4.80 in rural areas, respectively. The estimated annual percentage change in incidence was 3.68% for kidney and 1.56% for bladder cancer. Conclusion Our findings suggest high rates and increasing trends in incidence of kidney and bladder cancers in Golestan. The study indicates higher kidney and bladder cancer rates in men and urban residents. Further investigations are warranted to assess the effects of risk factors like smoking, opioid drug use and agricultural factors on incidence of urinary tract cancers in this population.

Background Human brucellosis (HB) remains a significant public health concern in Iran, where its burden may be shaped by socio-developmental factors. This ecological time trend analysis explores long-term patterns in HB incidence in the context of human development. Methods We conducted Joinpoint regression analysis to assess temporal trends in HB incidence from 2000 to 2023 in Iran. The Human Development Index (HDI) was included as a predictor to examine associations using Spearman correlation and linear regression on log-transformed HDI. Residual diagnostics and robust regression techniques were applied. Results The overall annual percentage change (AAPC) in HB incidence showed a slight but statistically significant upward trend (+ 0.45%; p  = 0.023). Joinpoint regression identified four statistically significant changes in trend. A moderate negative correlation was observed between HB incidence and HDI (Spearman’s ρ = − 0.54). Linear regression indicated an inverse association between log(HDI) and HB incidence (β = − 65.96, p  = 0.044), though the explained variance was limited (R² = 0.226). Conclusion The findings suggest that higher levels of human development may be associated with reduced HB incidence at the national level. However, this association is likely influenced by unmeasured factors such as access to veterinary care, cultural practices, and surveillance quality. Caution is warranted in interpreting these findings due to the ecological study design and potential underreporting.

Background Iodine deficiency remains a significant public health issue, especially among women of childbearing age. Assessing iodine nutrition in this population is crucial for the timely prevention of iodine deficiency disorders. Methods This cross-sectional and trend analysis utilized data from nine NHANES survey cycles (2001–2020). Urinary iodine concentrations (UIC) were analyzed from 6,828 women aged 14–45 years, categorized into the following subgroups: pregnant ( n  = 504), lactating ( n  = 149), and non-pregnant non-lactating women ( n  = 385). Iodine adequacy was defined using WHO criteria: median UIC of 150–249 µg/L for pregnant women, ≥ 100 µg/L for lactating women, and 100–199 µg/L for non-pregnant non-lactating women. Weighted median UIC, the proportion of individuals below these thresholds, and their respective time trends were assessed using survey-based methods to account for the complex sampling design. Results The median UIC among all women of childbearing age significantly declined from 135.0 µg/L (2001–2002) to 103.5 µg/L (2017–2020), while the proportion of population with UIC < 100 µg/L increased from 37.6% to 47.7%. The median UIC for both pregnant and lactating women fell below the adequate range during 2007–2014 (138.6 µg/L and 70.6 µg/L, respectively) and 2015–2020 (142.8 µg/L and 100.7 µg/L, respectively). Non-Hispanic Black pregnant women and older lactating women (35–45 years) exhibited notably lower median UIC. Conclusions Iodine deficiency persists as a public health concern among U.S. women of childbearing age, particularly among pregnant and lactating subgroups. Continuous monitoring and targeted public health interventions are recommended to ensure adequate iodine nutrition in these high-risk populations.

Background Repeated prevalence studies are necessary to monitor the government's progress toward preventing community violence over time. This study aims to identify possible changes in self-reported physical violence, forcible rape, and physical partner violence in the Norwegian general population between 2013 and 2022. Methods The 2022 and 2013 studies employed a cross-sectional design, utilizing identical sampling procedures and measures in 2022. Participants aged 18–74, including males and females, were randomly selected from the Norwegian National Population Registry. Data were collected through phone interviews. The response rate in 2022 was 25.3% of those who answered the phone and 42.9% in 2013. The total number of respondents was 4,295 in 2022 and 4,527 in 2013. Results Confidence intervals from bootstrapped analyses were used to evaluate crude differences in prevalence estimates between 2013 and 2022 for women and men separately. Among women, the lifetime prevalence of self-reported forcible rape increased from 9.4% in 2013 to 14.4% in 2022 (∆prevalence = 5.0%, 95% CI 3.1–6.8); severe physical violence in adulthood increased from 22.5% to 29.4% (∆prevalence = 6.9%, 95% CI 4.4–9.5); and physical partner violence in adulthood increased from 9.2% to 11.2% (∆prevalence = 2.0%, 95% CI 0.7–3.4). There were no statistically significant changes in self-reported forcible rape, physical violence, and physical partner violence among men between 2013 and 2022. Logistic regression analyses (adjusted for gender, age, education, financial situation, and marital status) corroborated these findings showing overall increased odds of self-reported forcible rape (adjusted odds ratio [aOR] = 1.70, 95% CI = 1.42–2.04), severe physical partner violence (aOR = 1.32, 95% CI = 1.09–1.58) and severe physical violence (aOR = 1.25, 95% CI = 1.14–1.37) in the 2022 survey compared to the 2013 survey. Conclusions Forcible rape, physical violence, and physical partner violence were highly prevalent in 2022 and remain significant challenges in Norway. The reported exposure to all three severe violence forms increased among females between 2013 and 2022. These findings call for immediate action and underscore the need for continued governmental efforts toward preventing violence. Given the high prevalence, these efforts should be targeted towards the general population.