Burden of non-communicable diseases among adolescents aged 10–24 years in the EU, 1990–2019: a systematic analysis of the Global Burden of Diseases Study 2019
Authors: Benedetta Armocida, Lorenzo Monasta, Susan Sawyer, Flavia Bustreo, Giulia Segafredo, Giulio Castelpietra, Luca Ronfani, Maja Pasovic, Simon Hay, Benedetta Armocida, Lorenzo Monasta, Susan M Sawyer, Flavia Bustreo, Giulia Segafredo, Giulio Castelpietra, Luca Ronfani, Maja Pasovic, Simon I Hay, Derrick Bary Abila, Hassan Abolhassani, Manfred Mario Kokou Accrombessi, Victor Adekanmbi, Keivan Ahmadi, Hanadi Al Hamad, Mamoon A Aldeyab, Adel Al-Jumaily, Robert Ancuceanu, Catalina Liliana Andrei, Tudorel Andrei, Ashokan Arumugam, Sameh Attia, Avinash Aujayeb, Marcel Ausloos, Jennifer L Baker, Francesco Barone-Adesi, Fabio Barra, Sandra Barteit, Sanjay Basu, Bernhard T Baune, Yannick Béjot, Luis Belo, Derrick A Bennett, Boris Bikbov, Andras Bikov, Oleg Blyuss, Susanne Breitner, Hermann Brenner, Giulia Carreras, Márcia Carvalho, Alberico L Catapano, Joht Singh Chandan, Periklis Charalampous, Simiao Chen, Joao Conde, Natália Cruz-Martins, Giovanni Damiani, Anna Dastiridou, Alejandro de la Torre-Luque, Mostafa Dianatinasab, Diana Dias da Silva, Abdel Douiri, Elena Dragioti, Luchuo Engelbert Bain, Adeniyi Francis Fagbamigbe, Seyed-Mohammad Fereshtehnejad, Pietro Ferrara, José Miguel P Ferreira de Oliveira, Simone Ferrero, Lorenzo Ferro Desideri, Florian Fischer, Diogo A Fonseca, Piyada Gaewkhiew, Santosh Gaihre, Silvano Gallus, Mariana Gaspar Fonseca, Paramjit Singh Gill, James C Glasbey, Giuseppe Gorini, Vijai Kumar Gupta, Mekdes Kondale Gurara, Josep Maria Haro, M Tasdik Hasan, Rasmus J Havmoeller, Behzad Heibati, Merel E Hellemons, Claudiu Herteliu, Salman Hussain, Gaetano Isola, Olatunji Johnson, Jost B Jonas, Jacek Jerzy Jozwiak, Mikk Jürisson, Zubair Kabir, André Karch, Joonas H Kauppila, Gbenga A Kayode, Moien AB Khan, Khaled Khatab, Mika Kivimäki, Miloslav Klugar, Jitka Klugarová, Kamrun Nahar Koly, Ai Koyanagi, Om P Kurmi, Dian Kusuma, Carlo La Vecchia, Ben Lacey, Tea Lallukka, Demetris Lamnisos, Berthold Langguth, Anders O Larsson, Paolo Lauriola, Paul H Lee, Matilde Leonardi, An Li, Christine Linehan, Rubén López-Bueno, Stefan Lorkowski, Joana A Loureiro, Raimundas Lunevicius, Laura A Magee, Francesca Giulia Magnani, Azeem Majeed, Konstantinos Christos Makris, Alexander G Mathioudakis, Manu Raj Mathur, John J McGrath, Ritesh G Menezes, Alexios-Fotios A Mentis, Atte Meretoja, Tomislav Mestrovic, Junmei Miao Jonasson, Tomasz Miazgowski, Andreea Mirica, Marcello Moccia, Shafiu Mohammed, Mariam Molokhia, Stefania Mondello, Ulrich Otto Mueller, Francesk Mulita, Daniel Munblit, Ionut Negoi, Ruxandra Irina Negoi, Evangelia Nena, Nurulamin M Noor, Christoph Nowak, George Ntaios, Vincent Ebuka Nwatah, Bogdan Oancea, Ayodipupo Sikiru Oguntade, Alberto Ortiz, Adrian Otoiu, Alicia Padron-Monedero, Raffaele Palladino, Adrian Pana, Demosthenes Panagiotakos, Songhomitra Panda-Jonas, Shahina Pardhan, Jay Patel, Paolo Pedersini, José L Peñalvo, Umberto Pensato, Renato B Pereira, Norberto Perico, Ionela-Roxana Petcu, Suzanne Polinder, Maarten J Postma, Mohammad Rabiee, Navid Rabiee, Alberto Raggi, Shadi Rahimzadeh, David Laith Rawaf, Salman Rawaf, Faizan Ur Rehman, Giuseppe Remuzzi, Abanoub Riad, Alina Rodriguez, Simona Sacco, Mohammad Reza Saeb, Mahdi Safdarian, Brijesh Sathian, Davide Sattin, Sonia Saxena, Nikolaos Scarmeas, Winfried Schlee, Falk Schwendicke, Morteza Shamsizadeh, Nigussie Tadesse Sharew, Rahman Shiri, Siddharudha Shivalli, Velizar Shivarov, João Pedro Silva, Colin R Simpson, Søren T Skou, Bogdan Socea, Ireneous N Soyiri, Paschalis Steiropoulos, Kurt Straif, Xiaohui Sun, Rafael Tabarés-Seisdedos, Arulmani Thiyagarajan, Fotis Topouzis, Marcos Roberto Tovani-Palone, Thomas Clement Truelsen, Brigid Unim, Jef Van den Eynde, Tommi Juhani Vasankari, Massimiliano Veroux, Santos Villafaina, Matej Vinko, Francesco S Violante, Victor Volovici, Yanzhong Wang, Ronny Westerman, Mohammad Esmaeil Yadegarfar, Sanni Yaya, Vesna Zadnik, Alimuddin Zumla, Pablo Perel, David Beran, Pablo Perel, David Beran
Journal: The Lancet Child & Adolescent Health (2022)

Disability and mortality burden of non-communicable diseases (NCDs) have risen worldwide; however, the NCD burden among adolescents remains poorly described in the EU.Estimates were retrieved from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Causes of NCDs were analysed at three different levels of the GBD 2019 hierarchy, for which mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) were extracted. Estimates, with the 95% uncertainty intervals (UI), were retrieved for EU Member States from 1990 to 2019, three age subgroups (10-14 years, 15-19 years, and 20-24 years), and by sex. Spearman's correlation was conducted between DALY rates for NCDs and the Socio-demographic Index (SDI) of each EU Member State.In 2019, NCDs accounted for 86·4% (95% uncertainty interval 83·5-88·8) of all YLDs and 38·8% (37·4-39·8) of total deaths in adolescents aged 10-24 years. For NCDs in this age group, neoplasms were the leading causes of both mortality (4·01 [95% uncertainty interval 3·62-4·25] per 100 000 population) and YLLs (281·78 [254·25-298·92] per 100 000 population), whereas mental disorders were the leading cause for YLDs (2039·36 [1432·56-2773·47] per 100 000 population) and DALYs (2040·59 [1433·96-2774·62] per 100 000 population) in all EU Member States, and in all studied age groups. In 2019, among adolescents aged 10-24 years, males had a higher mortality rate per 100 000 population due to NCDs than females (11·66 [11·04-12·28] vs 7·89 [7·53-8·23]), whereas females presented a higher DALY rate per 100 000 population due to NCDs (8003·25 [5812·78-10 701·59] vs 6083·91 [4576·63-7857·92]). From 1990 to 2019, mortality rate due to NCDs in adolescents aged 10-24 years substantially decreased (-40·41% [-43·00 to -37·61), and also the YLL rate considerably decreased (-40·56% [-43·16 to -37·74]), except for mental disorders (which increased by 32·18% [1·67 to 66·49]), whereas the YLD rate increased slightly (1·44% [0·09 to 2·79]). Positive correlations were observed between DALY rates and SDIs for substance use disorders (rs=0·58, p=0·0012) and skin and subcutaneous diseases (rs=0·45, p=0·017), whereas negative correlations were found between DALY rates and SDIs for cardiovascular diseases (rs=-0·46, p=0·015), neoplasms (rs=-0·57, p=0·0015), and sense organ diseases (rs=-0·61, p=0·0005).NCD-related mortality has substantially declined among adolescents in the EU between 1990 and 2019, but the rising trend of YLL attributed to mental disorders and their YLD burden are concerning. Differences by sex, age group, and across EU Member States highlight the importance of preventive interventions and scaling up adolescent-responsive health-care systems, which should prioritise specific needs by sex, age, and location.Bill & Melinda Gates Foundation.