Public Health最新文献

{"title":"Virtual cycling in urban green and blue vs gray spaces: The efficacy of mental health and physical activity","authors":"Hsin-Yen Yen ,&nbsp;Hao-Yun Huang","doi":"10.1016/j.puhe.2025.105723","DOIUrl":"10.1016/j.puhe.2025.105723","url":null,"abstract":"<div><h3>Objectives</h3><div>An urban environment may be stressful, potentially leading to poor mental health. Natural elements are important in urban environments with many restorative and potential health benefits compared to artificial elements. Virtual reality can simulate an urban environment in a digital world. The purpose of this study was to compare the different effects on mental health and physical activity outcomes between cycling in virtual urban green-blue and gray spaces.</div></div><div><h3>Study design</h3><div>A randomized controlled trial conducted from September 2021 to June 2022.</div></div><div><h3>Methods</h3><div>In total, 62 participants were randomly assigned to either the green-blue or gray group. All participants received a virtual cycling intervention for 30 min per session, once a week for 12 weeks. Different 360° videos of urban views were shown on head-mounted display headsets between the two groups. Virtual green and blue spaces consisted of bike trails that passed through natural elements with landscapes and waterscapes, while virtual gray spaces consisted of bike trails that passed through more-artificial elements in cities. Outcomes at the baseline and post-intervention were measured by self-reported questionnaires and objective instruments.</div></div><div><h3>Results</h3><div>Participants in the green-blue group had improved positive affect, perceived stress, and light-intensity physical activity compared to the gray group. Participants in the green-blue group had lower perceived exertion and virtual reality sickness, and higher enjoyment than those in the gray group.</div></div><div><h3>Conclusions</h3><div>Virtual reality cycling in the urban green and blue spaces is recommended for mental health and PA promotion for urban adult populations.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"243 ","pages":"Article 105723"},"PeriodicalIF":3.9,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143839446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between trajectories of life-course group sports participation and dementia: A 3-year longitudinal study","authors":"M. Yamakita ,&nbsp;T. Tsuji ,&nbsp;S. Kanamori ,&nbsp;J. Saito ,&nbsp;Y. Kai ,&nbsp;Y. Tani ,&nbsp;T. Fujiwara ,&nbsp;N. Kondo ,&nbsp;K. Kondo","doi":"10.1016/j.puhe.2025.03.033","DOIUrl":"10.1016/j.puhe.2025.03.033","url":null,"abstract":"<div><h3>Objectives</h3><div>The evidence for a causal effect of physical activity (PA) on dementia risk remains inconclusive. Group sports participation may impact dementia risk differently compared to PA. This study aimed to examine the association between long-term group sports participation trajectories across the life course and dementia onset among older Japanese adults.</div></div><div><h3>Study design</h3><div>Cohort study.</div></div><div><h3>Methods</h3><div>This cohort study included 8277 adults aged ≥65 years from the Japan Gerontological Evaluation Study. Life-course group sports participation was assessed through self-reported questionnaires, and Group-Based Trajectory Modelling (GBTM) was used to identify participation trajectories. Dementia onset was determined using public long-term care insurance-system registries, and Cox proportional hazards models were employed to assess associations between trajectory groups and dementia onset.</div></div><div><h3>Results</h3><div>GBTM identified four trajectories: persistently low (n = 5164, 62.4 %), dropout after high school (n = 2150, 26.0 %), dropout after young adulthood (n = 446, 5.4 %), and increase in midlife (n = 517, 6.2 %). During a mean follow-up of 3.2 years, 311 participants developed dementia. After adjusting for confounders, the dropout after young adulthood group had a significantly higher dementia risk than did the persistently low group (hazard ratio, 95 % confidence interval, 1.85, 1.09–3.16). No significant differences were observed between the dropout after high school (1.13, 0.84–1.52) and the increase in midlife (1.36, 0.78–2.39) groups compared to the persistently low group.</div></div><div><h3>Conclusions</h3><div>The risk of dementia may vary depending on life-course group sports participation patterns. Further studies are needed to establish these findings, including examining specific types of sports and individual PA levels.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"243 ","pages":"Article 105721"},"PeriodicalIF":3.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the COVID-19 pandemic and COVID-19 downgrade on non-COVID-19 respiratory diseases in Japan","authors":"Satoko Yamaguchi ,&nbsp;Akira Okada ,&nbsp;Sachiko Ono ,&nbsp;Reiko Inoue ,&nbsp;Kayo Ikeda Kurakawa ,&nbsp;Shinji Sunaga ,&nbsp;Toshimasa Yamauchi ,&nbsp;Masaomi Nangaku ,&nbsp;Takashi Kadowaki","doi":"10.1016/j.puhe.2025.03.031","DOIUrl":"10.1016/j.puhe.2025.03.031","url":null,"abstract":"<div><h3>Objectives</h3><div>A worldwide decrease in the incidence of respiratory diseases during the coronavirus disease (COVID-19) pandemic has been reported, largely due to non-pharmaceutical interventions (NPIs). However, the impact of lifting NPIs remains unclear. In Japan, NPIs were lifted rather drastically when COVID-19 was downgraded on May 8, 2023. This study aimed to evaluate the impact of the COVID-19 pandemic and its downgrade on non-COVID-19 respiratory diseases using nationwide databases.</div></div><div><h3>Study design</h3><div>Retrospective cohort study.</div></div><div><h3>Methods</h3><div>Monthly hospitalisation and prescription rates between January 2017 and October 2023 were collected from the JMDC insurance claims database covering 16,485,812 insured individuals. The monthly mortality rates in Japan were collected from an open data source published by Ministry of Health, Labour and Welfare of Japan. Interrupted time series analyses using seasonal autoregressive integrated moving average models were performed.</div></div><div><h3>Results</h3><div>While hospitalisation rates for diseases such as pneumonia, asthma, and aspiration pneumonia decreased during the pandemic, a step increase in hospitalisations for these diseases and prescriptions for anti-asthma drugs was observed following the COVID-19 downgrade. The pandemic impacted all age groups; however, the impact of COVID-19 downgrade was more pronounced in children aged 0–5 years. Although mortality from non-COVID-19 respiratory diseases decreased during the pandemic, no immediate step increase in mortality was observed following the downgrade.</div></div><div><h3>Conclusions</h3><div>Although hospitalisations for pneumonia and prescriptions for anti-asthma drugs increased immediately after downgrading COVID-19, no step increase in mortality was observed presumably because older people were less affected than children.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"243 ","pages":"Article 105719"},"PeriodicalIF":3.9,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143829771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The potential for primary and secondary prevention of liver cancer death in Australians with alcohol-related liver disease or metabolic-associated steatotic liver disease: A modelling study","authors":"Joachim Worthington ,&nbsp;Emily He ,&nbsp;Georgia Carney ,&nbsp;Paul Grogan ,&nbsp;Megan Varlow ,&nbsp;Karen Canfell ,&nbsp;Eleonora Feletto","doi":"10.1016/j.puhe.2025.03.030","DOIUrl":"10.1016/j.puhe.2025.03.030","url":null,"abstract":"<div><h3>Objectives</h3><div>Hepatocellular carcinoma (HCC), the most common form of primary liver cancer, is increasing in incidence and mortality in Australia, and the proportion attributable to excess alcohol intake, overweight and obesity is rising. People with alcohol-related liver disease (ARLD) or metabolic dysfunction-associated steatotic liver disease (MASLD) are at high risk, but prevention via weight loss, alcohol cessation, and routine surveillance can reduce the likelihood of HCC death. We aimed to estimate the potential for HCC prevention in Australians with ARLD and MASLD.</div></div><div><h3>Study design</h3><div>Simulation modelling study.</div></div><div><h3>Methods</h3><div>The existing <em>Policy1-Liver</em> model of liver disease was extended to capture disease progression in people with ARLD and MASLD. A weight loss intervention, alcohol cessation, and routine HCC surveillance using FIB-4, transient elastography, and ultrasound were simulated, and the impacts on HCC burden and costs were estimated.</div></div><div><h3>Results</h3><div>A once-off 10% weight loss intervention would reduce risk of MASLD-related HCC death by 25.9%. Up to 417 Australian HCC deaths would be preventable annually through this intervention. Alcohol cessation could double quality-adjusted life expectancy of people with ARLD.</div><div>Routine HCC surveillance would reduce ARLD-related HCC death risk by 18.6 % and MASLD-related HCC death risk by 18.1%, and prevent up to 254 MASLD- and ARLD-related HCC deaths in Australia annually. Surveillance would be cost-effective, except for those with early-stage MASLD.</div></div><div><h3>Conclusions</h3><div>Weight loss, alcohol cessation, and routine HCC surveillance can improve health outcomes for people with ARLD or MASLD. Modelling to support cost-effective prevention can help guide policy decisions and future investment in liver cancer control in Australia.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"243 ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"People empowerment in the healthcare system: A conceptual model and roadmap","authors":"Marzieh Zarinbal ,&nbsp;Hamidreza Izadbakhsh ,&nbsp;Nasim Ghanbar Tehrani","doi":"10.1016/j.puhe.2025.03.032","DOIUrl":"10.1016/j.puhe.2025.03.032","url":null,"abstract":"<div><h3>Objectives</h3><div>People empowerment is the process of assisting individuals in representing their activities with responsibility and self-determination, and acting on their own authority. While most studies have focused on training and informing patients, other aspects of empowerment are often overlooked. Therefore, the main objective of this paper is to present a conceptual model that empowers not only patients but all people.</div></div><div><h3>Study design</h3><div>Public health policy.</div></div><div><h3>Methods</h3><div>The conceptual model is developed based on strategies outlined in 2009 World Bank report and is extended through a two-stage field interview. In the first stage, 15 healthcare policymakers were interviewed and in the second stage, a workshop was held with one hundred healthcare experts.</div></div><div><h3>Results</h3><div>The first stage interviews confirmed the effectiveness of the five empowerment strategies provided by World Bank report. Additionally, a new group of strategies was recommended, particularly for countries with less accountable healthcare systems. These strategy groups are Information and education, accountability, advocacy, financial empowerment, local organizational capacity, and participation. The second stage of interviews confirmed the results and provids valuable insights. To operationalize this model for the country a roadmap consisting of several projects is also developed.</div></div><div><h3>Conclusions</h3><div>From an implementation perspective, not all strategies are equally important; Some are prerequisites for others. Certain strategies can be considered as fundamental strategies. Some are functional, while others could be considered as the outcomes.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"243 ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of adverse childhood experiences on health outcomes of indigenous populations over the life course: A systematic review","authors":"K.M. Shahunja ,&nbsp;Md Ashraful Alam ,&nbsp;Edmund Wedam Kanmiki ,&nbsp;Thilini Nisansala Egoda Kapuralalage ,&nbsp;Thuy Linh Duong ,&nbsp;Sarah Graham ,&nbsp;Abdullah A. Mamun","doi":"10.1016/j.puhe.2025.105724","DOIUrl":"10.1016/j.puhe.2025.105724","url":null,"abstract":"<div><h3>Objective</h3><div>Adverse childhood experiences (ACEs) are recognised as a strong risk factor affecting health outcomes. This systematic review seeks to synthesize evidence from global studies, investigating the associations of ACEs with the development of various health issues beyond childhood in Indigenous populations.</div></div><div><h3>Study design</h3><div>Systematic review.</div></div><div><h3>Methods</h3><div>We systematically searched for research articles published up to February 2024, in databases of peer-reviewed literature. We searched for articles on different types of ACEs recorded and their associated problematic health outcomes in different Indigenous populations across the world. Observational studies and administrative linkage study design were eligible for inclusion. Summary results of individual studies and variations of different ACE measuring tools are presented. We further explored the potential link between ACEs and various health outcomes by constructing an acyclic graph based on available evidence.</div></div><div><h3>Results</h3><div>We screened 2468 articles, and 56 were included in our review. Although tools for measuring ACEs were diverse, most of the studies used either the CDC-Kaiser study tool or tools by Bernstein et al. which were developed for the mainstream population. No Indigenous-specific tool was found that was used to assess ACEs in Indigenous populations. The studies assessed several types of ACEs, with sexual abuse and physical abuse being the most common. All the studies reported a significant association between ACEs and adverse health outcomes where mental health issues were more examined than physical health issues.</div></div><div><h3>Conclusion</h3><div>As we found that there was no validated Indigenous-specific tool for the Indigenous population, it is crucial to develop ACE measurement tools tailored to Indigenous populations that can capture trauma events related to their unique history and cultural context. Considering the higher prevalence of several physical health problems, especially cardiovascular and metabolic diseases in this population, more research should be conducted to identify their links with ACEs.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"243 ","pages":"Article 105724"},"PeriodicalIF":3.9,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143826068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The trend in pancreatic cancer incidence from 2009 to 2019 and the prediction from 2020 to 2030: An analysis of provincial data in China","authors":"Hao Yu ,&nbsp;Yuchen Jiang ,&nbsp;Weigang Miao ,&nbsp;Wenbin Hu ,&nbsp;Yixu Jin ,&nbsp;Zhouquan Fan ,&nbsp;Pengfei Luo ,&nbsp;Ran Tao ,&nbsp;Fangyu Zhu ,&nbsp;Renqiang Han ,&nbsp;Jinyi Zhou","doi":"10.1016/j.puhe.2025.03.007","DOIUrl":"10.1016/j.puhe.2025.03.007","url":null,"abstract":"<div><h3>Objective</h3><div>As a malignant tumour with a very high mortality rate, the incidence of pancreatic cancer is on the rise globally, but the long-term trend at the provincial level in China is not yet clear. This study aimed to investigate the trend of pancreatic cancer incidence in Jiangsu Province from 2009 to 2019 and to predict pancreatic cancer incidence from 2020 to 2030.</div></div><div><h3>Study design</h3><div>Descriptive study.</div></div><div><h3>Methods</h3><div>Data on pancreatic cancer incidence in Jiangsu Province were obtained from the Jiangsu Cancer Registry. Trends in pancreatic cancer incidence from 2009 to 2019 were examined based on the Joinpoint regression model. Age-period-cohort (APC) models were introduced to estimate the independent effects of age, period, and cohort on the incidence of pancreatic cancer and to project pancreatic cancer incidence from 2020 to 2030.</div></div><div><h3>Results</h3><div>From 2009 to 2019, the number of pancreatic cancer cases in Jiangsu Province increased from 1146 to 2088, and the age-standardized incidence rate (ASIR) increased from 4.59 to 5.64 per 100,000 people. In 2019, the ASIR was higher in males than in females, and the ASIR was higher in urban areas than in rural areas. The APC analysis also showed that the age effect was the most important factor influencing pancreatic cancer incidence in Jiangsu Province. Predictions suggest that pancreatic cancer incidence will continue to increase from 2020 to 2030.</div></div><div><h3>Conclusions</h3><div>From 2009 to 2019, the pancreatic cancer incidence in Jiangsu Province showed an increasing trend. The incidence rate is higher among males and urban residents. It is expected that the incidence of pancreatic cancer will continue to increase in the next decade. Therefore, pancreatic cancer prevention and control efforts should continue to focus on older adults and males. This study develops an advanced provincial prediction model, which provides a quantitative basis for allocating screening resources to high-risk populations and provides a reference paradigm for cancer prevention and control strategies in other developing countries undergoing industrialization.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"243 ","pages":"Article 105693"},"PeriodicalIF":3.9,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143826069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of acute myocardial infarction in patients with non-typhoidal Salmonella infection: A nationwide matched population-based cohort study","authors":"Wen-Yee Chen ,&nbsp;Han-Lin Shih ,&nbsp;Yi-Ting Lee ,&nbsp;Renin Chang ,&nbsp;Wen-Miin Liang ,&nbsp;Yao-Min Hung ,&nbsp;Cheuk-Kwan Sun","doi":"10.1016/j.puhe.2025.03.019","DOIUrl":"10.1016/j.puhe.2025.03.019","url":null,"abstract":"<div><h3>Objectives</h3><div>We used a nationwide cohort to explore the association of non-typhoidal <em>Salmonella</em> (NTS) with risk of incident acute myocardial infarction (AMI).</div></div><div><h3>Study design</h3><div>Nationwide matched population-based cohort study.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed a national insurance database, in which the NTS cohort (N = 15,152) and non-NTS cohort (N = 60,608) were individually-matched at 1:4 ratio by the index date, age, gender, and propensity score of comorbidities. Participants were identified by International Classification of Diseases, 9th Revision (ICD-9) codes from January 1, 2000 to December 31, 2014 and follow-up to Dec 31, 2017. Cox proportional hazard-models taking competing risk of death into account were adopted to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) of AMI. Multiple sensitivity analyses were conducted focusing on gender and comorbidities.</div></div><div><h3>Results</h3><div>The sub-distribution HR (sHR) of new-onset AMI was 1.63 (95 % CI, 1.32–2.01; <em>p</em> &lt; 0.0001). Our findings were consistent across gender (female, sHR = 1.42; 0.98–2.07 and male, sHR = 1.72; 1.34–2.22). While a positive association between NTS infection and AMI risk was noted in individuals without comorbidities, the correlation persisted in those with diabetes (sHR = 1.85; 1.34–2.55), moderate to severe kidney disease (sHR = 3.02; 1.49–6.13), acquired immunodeficiency syndrome (sHR = 1.64; 1.33–2.02), gastroenteritis (sHR = 2.75; 1.32–5.74) and hypertension (sHR = 1.66; 1.28–2.15)</div></div><div><h3>Conclusions</h3><div>The risk of AMI was significantly higher in the NTS cohort than that in the non-NTS cohort, indicating that NTS infection may be a potentially modifiable risk factor for AMI that warrants further studies for verification.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"242 ","pages":"Pages 406-412"},"PeriodicalIF":3.9,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143807673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence strategies based on random forests for detection of AI-generated content in public health","authors":"Igor V. Pantic ,&nbsp;Snezana Mugosa","doi":"10.1016/j.puhe.2025.03.029","DOIUrl":"10.1016/j.puhe.2025.03.029","url":null,"abstract":"<div><h3>Objectives</h3><div>To train and test a Random Forest machine learning model with the ability to distinguish AI-generated from human-generated textual content in the domain of public health, and public health policy.</div></div><div><h3>Study design</h3><div>Supervised machine learning study.</div></div><div><h3>Methods</h3><div>A dataset comprising 1000 human-generated and 1000 AI-generated paragraphs was created. Textual features were extracted using TF-IDF vectorization which calculates term frequency (TF) and Inverse document frequency (IDF), and combines the two measures to produce a score for individual terms. The Random Forest model was trained and tested using the Scikit-Learn library and Jupyter Notebook service in the Google Colab cloud-based environment, with Google CPU hardware acceleration.</div></div><div><h3>Results</h3><div>The model achieved a classification accuracy of 81.8 % and an area under the ROC curve of 0.9. For human-generated content, precision, recall, and F1-score were 0.85, 0.78, and 0.81, respectively. For AI-generated content, these metrics were 0.79, 0.86, and 0.82. The MCC value of 0.64 indicated moderate to strong predictive power. The model demonstrated robust sensitivity (recall for AI-generated class) of 0.86 and specificity (recall for human-generated class) of 0.78.</div></div><div><h3>Conclusions</h3><div>The model exhibited acceptable performance, as measured by classification accuracy, area under the receiver operating characteristic curve, and other metrics. This approach can be further improved by incorporating additional supervised machine learning techniques and serves as a foundation for the future development of a sophisticated and innovative AI system. Such a system could play a crucial role in combating misinformation and enhancing public trust across various government platforms, media outlets, and social networks.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"242 ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143785046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden of colorectal cancer attributable to high body-mass index in 204 countries and territories, 1990–2021: Results from the Global Burden of Disease Study 2021","authors":"Qiuxia Zhang ,&nbsp;Jia Feng ,&nbsp;Zhijie Xu ,&nbsp;Yi Guo ,&nbsp;Baolin Zhu ,&nbsp;Ping Qian","doi":"10.1016/j.puhe.2025.02.040","DOIUrl":"10.1016/j.puhe.2025.02.040","url":null,"abstract":"<div><h3>Objectives</h3><div>A strong association between high Body Mass Index (BMI) and Colorectal Cancer (CRC) has been well established. However, the global burden of CRC attributable to high BMI remains underexplored. This study aims to examine and analyze the burden of CRC linked to high BMI at global, regional, and national levels from 1990 to 2021.</div></div><div><h3>Study design</h3><div>A descriptive analysis of the Global Burden of Disease (GBD) Study 2021.</div></div><div><h3>Methods</h3><div>Data on the number of deaths and disability-adjusted life years (DALYs), as well as age-standardized mortality rate (ASMR) and age-standardized DALYs rate (ASDR), were extracted from the GBD 2021. Average annual percentage change (AAPC) was calculated to evaluate the temporal change in ASDR and ASMR using Joinpoint regression analysis. The Population Attributable Fractions (PAF) were used to analyze the CRC burden attributed to risk factors.</div></div><div><h3>Results</h3><div>In 2021, the global deaths and DALYs of CRC attributed to high BMI were 99,270 deaths and 2,364,660 years respectively, more than double the figures from 1990. High SDI regions bore the greatest burden while low-middle and middle SDI regions experienced a faster rise, with individuals over 60 and males being the most affected. East Asia, particularly China, had the heaviest burden globally. ASMR and ASDR were correlated with SDI. The top five risk factors for CRC burden were a diet low in whole grains (17.72 %), a diet low in milk (15.10 %), a diet high in red meat (14.55 %), high BMI (9.69 %) and a diet low in calcium (8.20 %) in 2021.</div></div><div><h3>Conclusion</h3><div>High BMI is a significant risk factor for CRC, with aging, population growth, gender, and SDI contributing to geographic and temporal variations in the burden. These findings highlight the urgent need for targeted prevention strategies, especially in high-risk populations, and emphasize the role of obesity prevention, early screening, lifestyle and dietary modifications, and interventions such as AI-driven technologies to reduce the CRC burden.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"242 ","pages":"Pages 388-398"},"PeriodicalIF":3.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143785190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}