Tag: The Lancet

Europe faces ‘cancer epidemic’ after estimated 1m cases missed during Covid

Mary Pat Campbell

Link: https://www.theguardian.com/society/2022/nov/15/europe-faces-cancer-epidemic-after-estimated-1m-cases-missed-during-covid

Excerpt:

Experts have warned that Europe faces a “cancer epidemic” unless urgent action is taken to boost treatment and research, after an estimated 1m diagnoses were missed during the pandemic.

The impact of Covid-19 and the focus on it has exposed “weaknesses” in cancer health systems and in the cancer research landscape across the continent, which, if not addressed as a matter of urgency, will set back cancer outcomes by almost a decade, leading healthcare and scientific experts say.

A report, European Groundshot – Addressing Europe’s Cancer Research Challenges: a Lancet Oncology Commission, brought together a wide range of patient, scientific, and healthcare experts with detailed knowledge of cancer across Europe.

One unintended consequence of the pandemic was the adverse effects that the rapid repurposing of health services and national lockdowns, and their continuing legacy, have had on cancer services, on cancer research, and on patients with cancer, the experts said.

“To emphasise the scale of this problem, we estimate that about 1m cancer diagnoses might have been missed across Europe during the Covid-19 pandemic,” they wrote in The Lancet Oncology. “There is emerging evidence that a higher proportion of patients are diagnosed with later cancer stages compared with pre-pandemic rates as a result of substantial delays in cancer diagnosis and treatment. This cancer stage shift will continue to stress European cancer systems for years to come.

Author(s): Andrew Gregory

Publication Date: 15 Nov 2022

Publication Site: The Guardian UK

The longevity society

Mary Pat Campbell

Link:https://www.thelancet.com/journals/lanhl/article/PIIS2666-7568(21)00247-6/fulltext

Graphic:

Excerpt:

As the demographic transition enters a new stage of a longevity transition, focus needs to extend beyond an ageing society towards a longevity society. An ageing society focuses on changes in the age structure of the population, whereas a longevity society seeks to exploit the advantages of longer lives through changes in how we age. Achieving a longevity society requires substantial changes in the life course and social norms, and involves an epidemiological transition towards a focus on delaying the negative effects of ageing. The broad changes required to achieve healthy longevity include an increased focus on healthy life expectancy, a shift from intervention towards preventive health, a major public health agenda to avoid increases in health inequality, the establishment of longevity councils to ensure coordinated policy across government departments, and intergenerational assessment of policies, to ensure that in adapting to longer lives, policies are not skewed towards older people. A longevity society represents a new stage for humanity and requires deep-seated notions about age and ageing to be challenged if society is to make the best use of the additional time that longevity brings.

Author(s): Prof. Andrew J. Scott

Publication Date: December 2021

Publication Site: The Lancet, Healthy Longevity

DOI:https://doi.org/10.1016/S2666-7568(21)00247-6

Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic

Mary Pat Campbell

Link: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02143-7/fulltext?dgcid=tlcom_php_carousel_worldmentalhealthday21_

Graphic:

Excerpt:

We identified 5683 unique data sources, of which 48 met inclusion criteria (46 studies met criteria for major depressive disorder and 27 for anxiety disorders). Two COVID-19 impact indicators, specifically daily SARS-CoV-2 infection rates and reductions in human mobility, were associated with increased prevalence of major depressive disorder (regression coefficient [B] 0·9 [95% uncertainty interval 0·1 to 1·8; p=0·029] for human mobility, 18·1 [7·9 to 28·3; p=0·0005] for daily SARS-CoV-2 infection) and anxiety disorders (0·9 [0·1 to 1·7; p=0·022] and 13·8 [10·7 to 17·0; p<0·0001]. Females were affected more by the pandemic than males (B 0·1 [0·1 to 0·2; p=0·0001] for major depressive disorder, 0·1 [0·1 to 0·2; p=0·0001] for anxiety disorders) and younger age groups were more affected than older age groups (−0·007 [–0·009 to −0·006; p=0·0001] for major depressive disorder, −0·003 [–0·005 to −0·002; p=0·0001] for anxiety disorders). We estimated that the locations hit hardest by the pandemic in 2020, as measured with decreased human mobility and daily SARS-CoV-2 infection rate, had the greatest increases in prevalence of major depressive disorder and anxiety disorders. We estimated an additional 53·2 million (44·8 to 62·9) cases of major depressive disorder globally (an increase of 27·6% [25·1 to 30·3]) due to the COVID-19 pandemic, such that the total prevalence was 3152·9 cases (2722·5 to 3654·5) per 100 000 population. We also estimated an additional 76·2 million (64·3 to 90·6) cases of anxiety disorders globally (an increase of 25·6% [23·2 to 28·0]), such that the total prevalence was 4802·4 cases (4108·2 to 5588·6) per 100 000 population. Altogether, major depressive disorder caused 49·4 million (33·6 to 68·7) DALYs and anxiety disorders caused 44·5 million (30·2 to 62·5) DALYs globally in 2020.

DOI:https://doi.org/10.1016/S0140-6736(21)02143-7

Author(s): COVID-19 Mental Disorders Collaborators

Publication Date: 8 Oct 2021

Publication Site: The Lancet

Association of BMI with overall and cause-specific mortality: a population-based cohort study of 3·6 million adults in the UK

Mary Pat Campbell

Link: https://www.thelancet.com/journals/landia/article/PIIS2213-8587(18)30288-2/fulltext

Graphic:

Excerpt:

3 632 674 people were included in the full study population; the following results are from the analysis of never-smokers, which comprised 1 969 648 people and 188 057 deaths. BMI had a J-shaped association with overall mortality; the estimated hazard ratio per 5 kg/m2 increase in BMI was 0·81 (95% CI 0·80–0·82) below 25 kg/m2 and 1·21 (1·20–1·22) above this point. BMI was associated with all cause of death categories except for transport-related accidents, but the shape of the association varied. Most causes, including cancer, cardiovascular diseases, and respiratory diseases, had a J-shaped association with BMI, with lowest risk occurring in the range 21–25 kg/m2. For mental and behavioural, neurological, and accidental (non-transport-related) causes, BMI was inversely associated with mortality up to 24–27 kg/m2, with little association at higher BMIs; for deaths from self-harm or interpersonal violence, an inverse linear association was observed. Associations between BMI and mortality were stronger at younger ages than at older ages, and the BMI associated with lowest mortality risk was higher in older individuals than in younger individuals. Compared with individuals of healthy weight (BMI 18·5–24·9 kg/m2), life expectancy from age 40 years was 4·2 years shorter in obese (BMI ≥30·0 kg/m2) men and 3·5 years shorter in obese women, and 4·3 years shorter in underweight (BMI <18·5 kg/m2) men and 4·5 years shorter in underweight women. When smokers were included in analyses, results for most causes of death were broadly similar, although marginally stronger associations were seen among people with lower BMI, suggesting slight residual confounding by smoking.

Author(s):

Krishnan Bhaskaran, PhD
Prof Isabel dos-Santos-Silva, PhD
Prof David A Leon, PhD
Ian J Douglas, PhD
Prof Liam Smeeth, PhD

Publication Date: 1 December 2018

Publication Site: The Lancet

Projections of temperature-related excess mortality under climate change scenarios

Mary Pat Campbell

Link: https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(17)30156-0/fulltext

Graphic:

Excerpt:

Our dataset comprised 451 locations in 23 countries across nine regions of the world, including 85 879 895 deaths. Results indicate, on average, a net increase in temperature-related excess mortality under high-emission scenarios, although with important geographical differences. In temperate areas such as northern Europe, east Asia, and Australia, the less intense warming and large decrease in cold-related excess would induce a null or marginally negative net effect, with the net change in 2090–99 compared with 2010–19 ranging from −1·2% (empirical 95% CI −3·6 to 1·4) in Australia to −0·1% (−2·1 to 1·6) in east Asia under the highest emission scenario, although the decreasing trends would reverse during the course of the century. Conversely, warmer regions, such as the central and southern parts of America or Europe, and especially southeast Asia, would experience a sharp surge in heat-related impacts and extremely large net increases, with the net change at the end of the century ranging from 3·0% (−3·0 to 9·3) in Central America to 12·7% (−4·7 to 28·1) in southeast Asia under the highest emission scenario. Most of the health effects directly due to temperature increase could be avoided under scenarios involving mitigation strategies to limit emissions and further warming of the planet.

Author(s):

Antonio Gasparrini, PhD
Yuming Guo, PhD
Francesco Sera, MSc
Ana Maria Vicedo-Cabrera, PhD
Veronika Huber, PhD
Prof Shilu Tong, PhD
Micheline de Sousa Zanotti Stagliorio Coelho, PhD
Prof Paulo Hilario Nascimento Saldiva, PhD
Eric Lavigne, PhD
Patricia Matus Correa, MSc
Nicolas Valdes Ortega, MSc
Haidong Kan, PhD
Samuel Osorio, MSc
Jan Kyselý, PhD
Aleš Urban, PhD
Prof Jouni J K Jaakkola, PhD
Niilo R I Ryti, PhD
Mathilde Pascal, PhD
Prof Patrick G Goodman, PhD
Ariana Zeka, PhD
Paola Michelozzi, MSc
Matteo Scortichini, MSc
Prof Masahiro Hashizume, PhD
Prof Yasushi Honda, PhD
Prof Magali Hurtado-Diaz, PhD
Julio Cesar Cruz, MSc
Xerxes Seposo, PhD
Prof Ho Kim, PhD
Aurelio Tobias, PhD
Carmen Iñiguez, PhD
Prof Bertil Forsberg, PhD
Daniel Oudin Åström, PhD
Martina S Ragettli, PhD
Prof Yue Leon Guo, PhD
Chang-fu Wu, PhD
Antonella Zanobetti, PhD
Prof Joel Schwartz, PhD
Prof Michelle L Bell, PhD
Tran Ngoc Dang, PhD
Prof Dung Do Van, PhD
Clare Heaviside, PhD
Sotiris Vardoulakis, PhD
Shakoor Hajat, PhD
Prof Andy Haines, FMedSci
Prof Ben Armstrong, PhD

Publication Date: 1 December 2017

Publication Site: The Lancet