Testicular cancer predominantly affects adolescents and young adults (AYAs) aged 15–39 years. This study analyzed the global, regional, and national burden of testicular cancer among AYAs (1990 to 2021). Data from the Global Burden of Disease study was used to calculate age-standardized rates of incidence (ASIR), prevalence (ASPR), and disability-adjusted life years (ASDR). Trends were assessed using the Joinpoint regression and Bayesian age-period-cohort models, with projections up to 2035. Results showed the global ASIR of 4.05 (95% CI: 3.80–4.35), ASPR of 31.05 (95% CI: 28.88–33.68), and ASDR of 24.82 (95% CI: 22.99–26.91) per 100,000 in 2021, respectively. From 1990 to 2021, ASIR and ASPR increased, while ASDR remained relatively stable. Significant geographical disparities were observed, with Europe and Latin America showing higher burdens compared to Asia and Africa. The 25–29 age group had the highest age-specific rate of incidence (5.58; 95% UI: 5.25–5.97) and disability-adjusted life years (34.09; 95% UI: 31.55–37.11) per 100,000, while the 30–34 age group had the highest age-specific prevalence rate (43.12; 95% UI: 40.51–46.56) per 100,000 in 2021. By 2035, the global numbers of incidence and prevalence cases were projected to increase, with DALYs and age-standardized rates declining. These findings are crucial for informing global strategies in testicular cancer prevention.

Background: Thyroid cancer (TC) is the most common malignancy of the endocrine system and head-and-neck region, yet data on its burden in adolescents and young adults (AYAs) is lacking. This study aimed to estimate the global burden of TC among AYAs from 1990 to 2021. Methods: Utilizing the Global Burden of Disease (GBD) 2021 data, we analyzed age-standardized rates of incidence, prevalence, and disability-adjusted life-years (DALYs) on global, regional, and national scales. Joinpoint regression was employed to determine average annual percentage change (AAPC), with frontier analysis revealing regions for improvement. Decomposition analysis assessed the impacts of population aging, growth, and epidemiological changes. Projections for disease burden extending to 2040 were generated using the Bayesian Age-Period-Cohort model. Result: In 2021, there were 48.2 thousand incident cases, 436.1 thousand prevalent cases, and 183.5 thousand DALYs worldwide. Meantime, the age-standardized incidence rates (ASIR), age-standardized prevalence rates (ASPR), and age-standardized DALYs rates (ASDR) were 1.6, 14.3 and 6.1 per 100 000, respectively. From 1990 to 2021, the ASIR, ASPR and ASDR increased with AAPCs of 1.73, 1.77, and 0.38, respectively. Socio-demographic resources in Saudi Arabia, Taiwan (Province of China), Iceland, United Arab Emirates, and United States Virgin Islands have the potential to lower ASDR due to TC among AYAs. Furthermore, 13.3 thousand and 34.9 thousand new cases occurred in the males and females in 2021. Among 5 age groups, the highest numbers of incidence, prevalence, and DALYs, along with ASRs, were observed in the 35–39 age group. Global projections indicated a continuous rise in numbers of incidence, prevalence, and DALYs, with estimates of 60.2 thousand, 558.4 thousand, and 199.7 thousand by 2040, respectively. Conclusion: The global burden of TC among AYAs was on the rise, with significant disparities by regions, genders, and age groups, highlighting the necessity for targeted and effective interventions.

Introduction: Immune checkpoint inhibitors (ICIs) have redefined cancer therapeutics. However, they may provoke immune-related adverse events (irAEs), with diabetes potentially altering their patterns. We aimed to investigate whether diabetic cancer patients exhibit a distinctive or intensified irAE pattern. Methods: We performed a real-world, retrospective pharmacovigilance study of ICIs using the FDA Adverse Event Reporting System from 2011 to 2025. Reports listing anti-PD-1 (Nivolumab, Pembrolizumab, Cemiplimab), anti-PD-L1 (Atezolizumab, Avelumab, Durvalumab), and anti-CTLA-4 (Ipilimumab, Tremelimumab) agents as suspected drugs were extracted. Disproportionality signals were identified with 4 algorithms: Bayesian Confidence Propagation Neural Network, Reporting Odds Ratio, Proportional Reporting Ratio, and Multi-item Gamma Poisson Shrinker. Time-to-onset was calculated from therapy start to event date, modelled with Weibull distributions, and compared across subgroups with non-parametric tests. Results: Of 22,775,812 FAERS reports, 1886 involved ICIs used in cancer patients with comorbid diabetes. 423 (22.4 %) were fatal and 1463 (77.6 %) non-fatal. Men predominated (71.5 %), and 63.0 % of patients were aged 65-85 years. Combination therapy (anti-CTLA-4 plus PD-1 or PD-L1) accounted for the highest death proportion (29.6 %). Disproportionality analysis revealed the strongest preferred-term signals for pneumonitis/interstitial lung disease, hypothyroidism, and colitis among all diabetic cancer patients receiving ICI therapy. At the system-organ-class level, endocrine, hepatobiliary, and blood/lymphatic disorders showed the most consistent risk across agents. Weibull modelling demonstrated an early-failure pattern (shape β < 1) with a median time-to-onset of 126.6 days overall, shortening to 90.9 days with combination therapy. Fatal subgroup occurred sooner than non-fatal subgroup (median 106.7 vs 132.5 days; P = 0.004). Conclusion: Diabetic cancer patients experienced the full spectrum of ICI-associated toxicities, with combination treatments linked to greater lethality. Multidisciplinary surveillance during the first 3-4 months of therapy, glycemic control, and long-term follow-up may be essential to optimize benefit and minimize harm in this expanding population.

Background: High body mass index (BMI) is a well-established modifiable risk factor for cancer. This study aims to assess temporal trends and contributing factors in cancer mortality attributable to high BMI in Asia from 1992 to 2021.Methods: Data were obtained from the Global Burden of Disease (GBD) study. We analyzed mortality attributable to high BMI for total cancer and 11 specific subtypes across 34 Asian countries and five GBD regions from 1992 to 2021. Age-standardized mortality rates (ASMRs), average annual percentage change (AAPC), and age-period-cohort effects were calculated. Decomposition analysis quantified the contributions of aging, population growth, and epidemiological change to the changes in cancer deaths.Result: From 1992 to 2021, high BMI-related cancer deaths in Asia rose from 29,908 to 123,693, with ASMR increasing from 1.42 to 2.46 per 100,000 (AAPC: 1.92%, 95% CI: 1.85–1.98). South Asia experienced the most rapid ASMR growth (AAPC: 3.16%), while High-income Asia Pacific showed a decline after 1997. Sex-specific analyses revealed that colorectal, liver, and leukemia in males and colorectal, breast, and uterine cancers in females contributed most to ASMRs. Decomposition analysis indicated that the change in deaths was mainly driven by epidemiological change (118.20%), followed by population growth (115.54%) and aging (79.83%). Age-period-cohort analysis demonstrated rising mortality risks in successive birth cohorts, particularly in East and South Asia, while period and cohort effects declined in High-income Asia Pacific. Local drift analyses showed increasing mortality trends in older age groups across most regions.Conclusion: The burden of cancer ASMR attributable to high BMI in Asia has risen substantially over the past three decades. Substantial heterogeneity exists across regions, countries, sexes, and cancer types. Targeted prevention strategies and cancer control policies are urgently needed to address this rising public health challenge.

Background: This study aimed to investigate the spatial and temporal variations of tracheal, bronchus, and lung cancer (TBLC) attributable to particulate matter pollution across 34 Asian countries and territories from 1990 to 2021.Methods: Disability-adjusted life years (DALYs) linked to ambient particulate-matter pollution (APMP) and household air pollution (HAP) were obtained from the Global Burden of Disease (GBD) 2021 dataset, and performed analyses stratified by location, gender, and age. Trends in age-standardized DALY rates (ASDRs) were quantified with Joinpoint regression. Decomposition analysis was applied to identify the contributions of population aging, population growth, and epidemiological changes to the alterations in DALYs.Results: From 1990 to 2021, APMP-related ASDR increased significantly in Asia, while HAP-related ASDR declined. In 2021, East Asia recorded the greatest APMP-associated DALYs across five GBD regions, while both South Asia and East Asia bore the heaviest HAP-related burden. China reported the highest absolute DALYs for each pollutant. Population aging and growth accounted for most of the increase in APMP-related DALYs in Asia, whereas epidemiological change chiefly explained the reduction in HAP-related DALYs. ASDRs were consistently higher in males, with wider sex disparities for APMP-related ASDR. Middle-aged and older adult populations were the most vulnerable age groups.Conclusion: Although TBLC burden attributable to HAP has fallen, disease linked to APMP remains a pressing public-health concern. Coordinated regional action and targeted interventions, particularly for men and older individuals, are essential to reduce pollution-driven TBLC across Asia.

Background: High body mass index (BMI) is a significant modifiable risk factor for cancer, yet its global burden in older adults (aged ≥60 years) remains incompletely understood. Methods: Using Global Burden of Disease Study 2021 data, we estimated disability-adjusted life-years (DALYs) and age-standardized DALY rates (ASDRs) for total and 11 high BMI-related cancers from 1990 to 2021. Trends were assessed using average annual percentage change. Inequalities were measured using the slope index of inequality and concentration index. Additionally, decomposition and frontier analyses were utilized to examine driving factors and explore improvement potential. Results: Global cancer-related DALYs attributable to high BMI in older adults increased from 2.11 million in 1990 to 5.40 million in 2021, with ASDR rising from 439.99 to 497.15 per 100,000 population. Males showed greater increases despite lower ASDR. From 1990 to 2021, Asia and Africa experienced the steepest increases, while Europe and America recorded the highest ASDRs in 2021. High Socio-demographic Index (SDI) regions consistently reported the highest ASDRs in both 1990 and 2021, whereas low-middle SDI regions exhibited the most rapid increase during this period. The global ASDRs for most cancers increased from 1990 to 2021, with colorectal cancer demonstrating the highest ASDR among men and breast cancer among women in 2021. DALY growth was largely attributed to population expansion (133.04%) through decomposition analysis. Inequalities have narrowed but remained predominantly concentrated in higher SDI countries. Frontier analysis identified several high SDI countries, such as the United Arab Emirates, Slovakia, and Qatar, with substantial potential for burden reduction. Conclusion: The cancer burden attributable to high BMI in older adults has risen substantially since 1990, with marked geographic, socioeconomic, and cancer-site disparities. Targeted high BMI reduction strategies in aging populations are critical to mitigating future cancer burden and reducing inequalities.