Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010

A systematic analysis for the Global Burden of Disease Study 2010

Rafael Lozano, Mohsen Naghavi, Kyle Foreman, Stephen Lim, Kenji Shibuya, Victor Aboyans, Jerry Abraham, Timothy Adair, Rakesh Aggarwal, Stephanie Y. Ahn, Mohammad A. AlMazroa, Miriam Alvarado, H. Ross Anderson, Laurie M. Anderson, Kathryn G. Andrews, Charles Atkinson, Larry M. Baddour, Suzanne Barker-Collo, David H. Bartels, Michelle L. Bell & 171 others Emelia J. Benjamin, Derrick Bennett, Kavi Bhalla, Boris Bikbov, Aref Bin Abdulhak, Gretchen Birbeck, Fiona Blyth, Ian Bolliger, Soufiane Boufous, Chiara Bucello, Michael Burch, Peter Burney, Jonathan Carapetis, Honglei Chen, David Chou, Sumeet S. Chugh, Luc E. Coffeng, Steven D. Colan, Samantha Colquhoun, K. Ellicott Colson, John Condon, Myles D. Connor, Leslie T. Cooper, Matthew Corriere, Monica Cortinovis, Karen Courville De Vaccaro, William Couser, Benjamin C. Cowie, Michael H. Criqui, Marita Cross, Kaustubh C. Dabhadkar, Nabila Dahodwala, Diego De Leo, Louisa Degenhardt, Allyne Delossantos, Julie Denenberg, Don C. Des Jarlais, Samath D. Dharmaratne, E. Ray Dorsey, Tim Driscoll, Herbert Duber, Beth Ebel, Patricia J. Erwin, Patricia Espindola, Majid Ezzati, Valery Feigin, Abraham D. Flaxman, Mohammad H. Forouzanfar, Francis Gerry R. Fowkes, Richard Franklin, Marlene Fransen, Michael K. Freeman, Sherine E. Gabriel, Emmanuela Gakidou, Flavio Gaspari, Richard F. Gillum, Diego Gonzalez-Medina, Yara A. Halasa, Diana Haring, James E. Harrison, Rasmus Havmoeller, Roderick J. Hay, Bruno Hoen, Peter J. Hotez, Damian Hoy, Kathryn H. Jacobsen, Spencer L. James, Rashmi Jasrasaria, Sudha Jayaraman, Nicole Johns, Ganesan Karthikeyan, Nicholas Kassebaum, Andre Keren, Jon Paul Khoo, Lisa Marie Knowlton, Olive Kobusingye, Adofo Koranteng, Rita Krishnamurthi, Michael Lipnick, Steven E. Lipshultz, Summer Lockett Ohno, Jacqueline Mabweijano, Michael F. MacIntyre, Leslie Mallinger, Lyn March, Guy B. Marks, Robin Marks, Akira Matsumori, Richard Matzopoulos, Bongani M. Mayosi, John H. McAnulty, Mary M. McDermott, John McGrath, Ziad A. Memish, George A. Mensah, Tony R. Merriman, Catherine Michaud, Matthew Miller, Ted R. Miller, Charles Mock, Ana Olga Mocumbi, Ali A. Mokdad, Andrew Moran, Kim Mulholland, M. Nathan Nair, Luigi Naldi, K. M.Venkat Narayan, Kiumarss Nasseri, Paul Norman, Martin O'Donnell, Saad B. Omer, Katrina Ortblad, Richard Osborne, Doruk Ozgediz, Bishnu Pahari, Jeyaraj Durai Pandian, Andrea Panozo Rivero, Rogelio Perez Padilla, Fernando Perez-Ruiz, Norberto Perico, David Phillips, Kelsey Pierce, C. Arden Pope, Esteban Porrini, Farshad Pourmalek, Murugesan Raju, Dharani Ranganathan, Jürgen T. Rehm, David B. Rein, Guiseppe Remuzzi, Frederick P. Rivara, Thomas Roberts, Felipe Rodriguez De León, Lisa C. Rosenfeld, Lesley Rushton, Ralph L. Sacco, Joshua A. Salomon, Uchechukwu Sampson, Ella Sanman, David C. Schwebel, Maria Segui-Gomez, Donald S. Shepard, David Singh, Jessica Singleton, Karen Sliwa, Emma Smith, Andrew Steer, Jennifer A. Taylor, Bernadette Thomas, Imad M. Tleyjeh, Jeffrey Towbin, Thomas Truelsen, Eduardo A. Undurraga, N. Venketasubramanian, Lakshmi Vijayakumar, Theo Vos, Gregory R. Wagner, Mengru Wang, Wenzhi Wang, Kerrianne Watt, Martin A. Weinstock, Robert Weintraub, James D. Wilkinson, Anthony D. Woolf, Sarah Wulf, Pon Hsiu Yeh, Paul Yip, Azadeh Zabetian, Zhi Jie Zheng, Alan D. Lopez, Christopher J.L. Murray

Research output: Contribution to journalArticle

6560 Citations (Scopus)

Abstract

Background: Reliable and timely information on the leading causes of death in populations, and how these are changing, is a crucial input into health policy debates. In the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010), we aimed to estimate annual deaths for the world and 21 regions between 1980 and 2010 for 235 causes, with uncertainty intervals (UIs), separately by age and sex. Methods: We attempted to identify all available data on causes of death for 187 countries from 1980 to 2010 from vital registration, verbal autopsy, mortality surveillance, censuses, surveys, hospitals, police records, and mortuaries. We assessed data quality for completeness, diagnostic accuracy, missing data, stochastic variations, and probable causes of death. We applied six different modelling strategies to estimate cause-specific mortality trends depending on the strength of the data. For 133 causes and three special aggregates we used the Cause of Death Ensemble model (CODEm) approach, which uses four families of statistical models testing a large set of different models using different permutations of covariates. Model ensembles were developed from these component models. We assessed model performance with rigorous out-of-sample testing of prediction error and the validity of 95% UIs. For 13 causes with low observed numbers of deaths, we developed negative binomial models with plausible covariates. For 27 causes for which death is rare, we modelled the higher level cause in the cause hierarchy of the GBD 2010 and then allocated deaths across component causes proportionately, estimated from all available data in the database. For selected causes (African trypanosomiasis, congenital syphilis, whooping cough, measles, typhoid and parathyroid, leishmaniasis, acute hepatitis E, and HIV/AIDS), we used natural history models based on information on incidence, prevalence, and case-fatality. We separately estimated cause fractions by aetiology for diarrhoea, lower respiratory infections, and meningitis, as well as disaggregations by subcause for chronic kidney disease, maternal disorders, cirrhosis, and liver cancer. For deaths due to collective violence and natural disasters, we used mortality shock regressions. For every cause, we estimated 95% UIs that captured both parameter estimation uncertainty and uncertainty due to model specification where CODEm was used. We constrained cause-specific fractions within every age-sex group to sum to total mortality based on draws from the uncertainty distributions. Findings: In 2010, there were 52·8 million deaths globally. At the most aggregate level, communicable, maternal, neonatal, and nutritional causes were 24·9% of deaths worldwide in 2010, down from 15·9 million (34·1%) of 46·5 million in 1990. This decrease was largely due to decreases in mortality from diarrhoeal disease (from 2·5 to 1·4 million), lower respiratory infections (from 3·4 to 2·8 million), neonatal disorders (from 3·1 to 2·2 million), measles (from 0·63 to 0·13 million), and tetanus (from 0·27 to 0·06 million). Deaths from HIV/AIDS increased from 0·30 million in 1990 to 1·5 million in 2010, reaching a peak of 1·7 million in 2006. Malaria mortality also rose by an estimated 19·9% since 1990 to 1·17 million deaths in 2010. Tuberculosis killed 1·2 million people in 2010. Deaths from non-communicable diseases rose by just under 8 million between 1990 and 2010, accounting for two of every three deaths (34·5 million) worldwide by 2010. 8 million people died from cancer in 2010, 38% more than two decades ago; of these, 1·5 million (19%) were from trachea, bronchus, and lung cancer. Ischaemic heart disease and stroke collectively killed 12·9 million people in 2010, or one in four deaths worldwide, compared with one in five in 1990; 1·3 million deaths were due to diabetes, twice as many as in 1990. The fraction of global deaths due to injuries (5·1 million deaths) was marginally higher in 2010 (9·6%) compared with two decades earlier (8·8%). This was driven by a 46% rise in deaths worldwide due to road traffic accidents (1·3 million in 2010) and a rise in deaths from falls. Ischaemic heart disease, stroke, chronic obstructive pulmonary disease (COPD), lower respiratory infections, lung cancer, and HIV/AIDS were the leading causes of death in 2010. Ischaemic heart disease, lower respiratory infections, stroke, diarrhoeal disease, malaria, and HIV/AIDS were the leading causes of years of life lost due to premature mortality (YLLs) in 2010, similar to what was estimated for 1990, except for HIV/AIDS and preterm birth complications. YLLs from lower respiratory infections and diarrhoea decreased by 45-54% since 1990; ischaemic heart disease and stroke YLLs increased by 17-28%. Regional variations in leading causes of death were substantial. Communicable, maternal, neonatal, and nutritional causes still accounted for 76% of premature mortality in sub-Saharan Africa in 2010. Age standardised death rates from some key disorders rose (HIV/AIDS, Alzheimer's disease, diabetes mellitus, and chronic kidney disease in particular), but for most diseases, death rates fell in the past two decades; including major vascular diseases, COPD, most forms of cancer, liver cirrhosis, and maternal disorders. For other conditions, notably malaria, prostate cancer, and injuries, little change was noted. Interpretation: Population growth, increased average age of the world's population, and largely decreasing age-specific, sex-specific, and cause-specific death rates combine to drive a broad shift from communicable, maternal, neonatal, and nutritional causes towards non-communicable diseases. Nevertheless, communicable, maternal, neonatal, and nutritional causes remain the dominant causes of YLLs in sub-Saharan Africa. Overlaid on this general pattern of the epidemiological transition, marked regional variation exists in many causes, such as interpersonal violence, suicide, liver cancer, diabetes, cirrhosis, Chagas disease, African trypanosomiasis, melanoma, and others. Regional heterogeneity highlights the importance of sound epidemiological assessments of the causes of death on a regular basis.

Original languageEnglish (US)
Pages (from-to)2095-2128
Number of pages34
JournalThe Lancet
Volume380
Issue number9859
DOIs
StatePublished - Dec 1 2012

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Cause of Death
Age Groups
Mortality
Uncertainty
Acquired Immunodeficiency Syndrome
Respiratory Tract Infections
Mothers
HIV
Myocardial Ischemia
Liver Neoplasms
Stroke
Malaria
African Trypanosomiasis
Premature Mortality
Global Burden of Disease
Africa South of the Sahara
Measles
Statistical Models
Chronic Renal Insufficiency
Violence

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010 : A systematic analysis for the Global Burden of Disease Study 2010. / Lozano, Rafael; Naghavi, Mohsen; Foreman, Kyle; Lim, Stephen; Shibuya, Kenji; Aboyans, Victor; Abraham, Jerry; Adair, Timothy; Aggarwal, Rakesh; Ahn, Stephanie Y.; AlMazroa, Mohammad A.; Alvarado, Miriam; Anderson, H. Ross; Anderson, Laurie M.; Andrews, Kathryn G.; Atkinson, Charles; Baddour, Larry M.; Barker-Collo, Suzanne; Bartels, David H.; Bell, Michelle L.; Benjamin, Emelia J.; Bennett, Derrick; Bhalla, Kavi; Bikbov, Boris; Bin Abdulhak, Aref; Birbeck, Gretchen; Blyth, Fiona; Bolliger, Ian; Boufous, Soufiane; Bucello, Chiara; Burch, Michael; Burney, Peter; Carapetis, Jonathan; Chen, Honglei; Chou, David; Chugh, Sumeet S.; Coffeng, Luc E.; Colan, Steven D.; Colquhoun, Samantha; Colson, K. Ellicott; Condon, John; Connor, Myles D.; Cooper, Leslie T.; Corriere, Matthew; Cortinovis, Monica; Courville De Vaccaro, Karen; Couser, William; Cowie, Benjamin C.; Criqui, Michael H.; Cross, Marita; Dabhadkar, Kaustubh C.; Dahodwala, Nabila; De Leo, Diego; Degenhardt, Louisa; Delossantos, Allyne; Denenberg, Julie; Des Jarlais, Don C.; Dharmaratne, Samath D.; Dorsey, E. Ray; Driscoll, Tim; Duber, Herbert; Ebel, Beth; Erwin, Patricia J.; Espindola, Patricia; Ezzati, Majid; Feigin, Valery; Flaxman, Abraham D.; Forouzanfar, Mohammad H.; Fowkes, Francis Gerry R.; Franklin, Richard; Fransen, Marlene; Freeman, Michael K.; Gabriel, Sherine E.; Gakidou, Emmanuela; Gaspari, Flavio; Gillum, Richard F.; Gonzalez-Medina, Diego; Halasa, Yara A.; Haring, Diana; Harrison, James E.; Havmoeller, Rasmus; Hay, Roderick J.; Hoen, Bruno; Hotez, Peter J.; Hoy, Damian; Jacobsen, Kathryn H.; James, Spencer L.; Jasrasaria, Rashmi; Jayaraman, Sudha; Johns, Nicole; Karthikeyan, Ganesan; Kassebaum, Nicholas; Keren, Andre; Khoo, Jon Paul; Knowlton, Lisa Marie; Kobusingye, Olive; Koranteng, Adofo; Krishnamurthi, Rita; Lipnick, Michael; Lipshultz, Steven E.; Lockett Ohno, Summer; Mabweijano, Jacqueline; MacIntyre, Michael F.; Mallinger, Leslie; March, Lyn; Marks, Guy B.; Marks, Robin; Matsumori, Akira; Matzopoulos, Richard; Mayosi, Bongani M.; McAnulty, John H.; McDermott, Mary M.; McGrath, John; Memish, Ziad A.; Mensah, George A.; Merriman, Tony R.; Michaud, Catherine; Miller, Matthew; Miller, Ted R.; Mock, Charles; Mocumbi, Ana Olga; Mokdad, Ali A.; Moran, Andrew; Mulholland, Kim; Nair, M. Nathan; Naldi, Luigi; Narayan, K. M.Venkat; Nasseri, Kiumarss; Norman, Paul; O'Donnell, Martin; Omer, Saad B.; Ortblad, Katrina; Osborne, Richard; Ozgediz, Doruk; Pahari, Bishnu; Pandian, Jeyaraj Durai; Panozo Rivero, Andrea; Perez Padilla, Rogelio; Perez-Ruiz, Fernando; Perico, Norberto; Phillips, David; Pierce, Kelsey; Pope, C. Arden; Porrini, Esteban; Pourmalek, Farshad; Raju, Murugesan; Ranganathan, Dharani; Rehm, Jürgen T.; Rein, David B.; Remuzzi, Guiseppe; Rivara, Frederick P.; Roberts, Thomas; Rodriguez De León, Felipe; Rosenfeld, Lisa C.; Rushton, Lesley; Sacco, Ralph L.; Salomon, Joshua A.; Sampson, Uchechukwu; Sanman, Ella; Schwebel, David C.; Segui-Gomez, Maria; Shepard, Donald S.; Singh, David; Singleton, Jessica; Sliwa, Karen; Smith, Emma; Steer, Andrew; Taylor, Jennifer A.; Thomas, Bernadette; Tleyjeh, Imad M.; Towbin, Jeffrey; Truelsen, Thomas; Undurraga, Eduardo A.; Venketasubramanian, N.; Vijayakumar, Lakshmi; Vos, Theo; Wagner, Gregory R.; Wang, Mengru; Wang, Wenzhi; Watt, Kerrianne; Weinstock, Martin A.; Weintraub, Robert; Wilkinson, James D.; Woolf, Anthony D.; Wulf, Sarah; Yeh, Pon Hsiu; Yip, Paul; Zabetian, Azadeh; Zheng, Zhi Jie; Lopez, Alan D.; Murray, Christopher J.L.

In: The Lancet, Vol. 380, No. 9859, 01.12.2012, p. 2095-2128.

Research output: Contribution to journalArticle

Lozano, R, Naghavi, M, Foreman, K, Lim, S, Shibuya, K, Aboyans, V, Abraham, J, Adair, T, Aggarwal, R, Ahn, SY, AlMazroa, MA, Alvarado, M, Anderson, HR, Anderson, LM, Andrews, KG, Atkinson, C, Baddour, LM, Barker-Collo, S, Bartels, DH, Bell, ML, Benjamin, EJ, Bennett, D, Bhalla, K, Bikbov, B, Bin Abdulhak, A, Birbeck, G, Blyth, F, Bolliger, I, Boufous, S, Bucello, C, Burch, M, Burney, P, Carapetis, J, Chen, H, Chou, D, Chugh, SS, Coffeng, LE, Colan, SD, Colquhoun, S, Colson, KE, Condon, J, Connor, MD, Cooper, LT, Corriere, M, Cortinovis, M, Courville De Vaccaro, K, Couser, W, Cowie, BC, Criqui, MH, Cross, M, Dabhadkar, KC, Dahodwala, N, De Leo, D, Degenhardt, L, Delossantos, A, Denenberg, J, Des Jarlais, DC, Dharmaratne, SD, Dorsey, ER, Driscoll, T, Duber, H, Ebel, B, Erwin, PJ, Espindola, P, Ezzati, M, Feigin, V, Flaxman, AD, Forouzanfar, MH, Fowkes, FGR, Franklin, R, Fransen, M, Freeman, MK, Gabriel, SE, Gakidou, E, Gaspari, F, Gillum, RF, Gonzalez-Medina, D, Halasa, YA, Haring, D, Harrison, JE, Havmoeller, R, Hay, RJ, Hoen, B, Hotez, PJ, Hoy, D, Jacobsen, KH, James, SL, Jasrasaria, R, Jayaraman, S, Johns, N, Karthikeyan, G, Kassebaum, N, Keren, A, Khoo, JP, Knowlton, LM, Kobusingye, O, Koranteng, A, Krishnamurthi, R, Lipnick, M, Lipshultz, SE, Lockett Ohno, S, Mabweijano, J, MacIntyre, MF, Mallinger, L, March, L, Marks, GB, Marks, R, Matsumori, A, Matzopoulos, R, Mayosi, BM, McAnulty, JH, McDermott, MM, McGrath, J, Memish, ZA, Mensah, GA, Merriman, TR, Michaud, C, Miller, M, Miller, TR, Mock, C, Mocumbi, AO, Mokdad, AA, Moran, A, Mulholland, K, Nair, MN, Naldi, L, Narayan, KMV, Nasseri, K, Norman, P, O'Donnell, M, Omer, SB, Ortblad, K, Osborne, R, Ozgediz, D, Pahari, B, Pandian, JD, Panozo Rivero, A, Perez Padilla, R, Perez-Ruiz, F, Perico, N, Phillips, D, Pierce, K, Pope, CA, Porrini, E, Pourmalek, F, Raju, M, Ranganathan, D, Rehm, JT, Rein, DB, Remuzzi, G, Rivara, FP, Roberts, T, Rodriguez De León, F, Rosenfeld, LC, Rushton, L, Sacco, RL, Salomon, JA, Sampson, U, Sanman, E, Schwebel, DC, Segui-Gomez, M, Shepard, DS, Singh, D, Singleton, J, Sliwa, K, Smith, E, Steer, A, Taylor, JA, Thomas, B, Tleyjeh, IM, Towbin, J, Truelsen, T, Undurraga, EA, Venketasubramanian, N, Vijayakumar, L, Vos, T, Wagner, GR, Wang, M, Wang, W, Watt, K, Weinstock, MA, Weintraub, R, Wilkinson, JD, Woolf, AD, Wulf, S, Yeh, PH, Yip, P, Zabetian, A, Zheng, ZJ, Lopez, AD & Murray, CJL 2012, 'Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: A systematic analysis for the Global Burden of Disease Study 2010', The Lancet, vol. 380, no. 9859, pp. 2095-2128. https://doi.org/10.1016/S0140-6736(12)61728-0
Lozano, Rafael ; Naghavi, Mohsen ; Foreman, Kyle ; Lim, Stephen ; Shibuya, Kenji ; Aboyans, Victor ; Abraham, Jerry ; Adair, Timothy ; Aggarwal, Rakesh ; Ahn, Stephanie Y. ; AlMazroa, Mohammad A. ; Alvarado, Miriam ; Anderson, H. Ross ; Anderson, Laurie M. ; Andrews, Kathryn G. ; Atkinson, Charles ; Baddour, Larry M. ; Barker-Collo, Suzanne ; Bartels, David H. ; Bell, Michelle L. ; Benjamin, Emelia J. ; Bennett, Derrick ; Bhalla, Kavi ; Bikbov, Boris ; Bin Abdulhak, Aref ; Birbeck, Gretchen ; Blyth, Fiona ; Bolliger, Ian ; Boufous, Soufiane ; Bucello, Chiara ; Burch, Michael ; Burney, Peter ; Carapetis, Jonathan ; Chen, Honglei ; Chou, David ; Chugh, Sumeet S. ; Coffeng, Luc E. ; Colan, Steven D. ; Colquhoun, Samantha ; Colson, K. Ellicott ; Condon, John ; Connor, Myles D. ; Cooper, Leslie T. ; Corriere, Matthew ; Cortinovis, Monica ; Courville De Vaccaro, Karen ; Couser, William ; Cowie, Benjamin C. ; Criqui, Michael H. ; Cross, Marita ; Dabhadkar, Kaustubh C. ; Dahodwala, Nabila ; De Leo, Diego ; Degenhardt, Louisa ; Delossantos, Allyne ; Denenberg, Julie ; Des Jarlais, Don C. ; Dharmaratne, Samath D. ; Dorsey, E. Ray ; Driscoll, Tim ; Duber, Herbert ; Ebel, Beth ; Erwin, Patricia J. ; Espindola, Patricia ; Ezzati, Majid ; Feigin, Valery ; Flaxman, Abraham D. ; Forouzanfar, Mohammad H. ; Fowkes, Francis Gerry R. ; Franklin, Richard ; Fransen, Marlene ; Freeman, Michael K. ; Gabriel, Sherine E. ; Gakidou, Emmanuela ; Gaspari, Flavio ; Gillum, Richard F. ; Gonzalez-Medina, Diego ; Halasa, Yara A. ; Haring, Diana ; Harrison, James E. ; Havmoeller, Rasmus ; Hay, Roderick J. ; Hoen, Bruno ; Hotez, Peter J. ; Hoy, Damian ; Jacobsen, Kathryn H. ; James, Spencer L. ; Jasrasaria, Rashmi ; Jayaraman, Sudha ; Johns, Nicole ; Karthikeyan, Ganesan ; Kassebaum, Nicholas ; Keren, Andre ; Khoo, Jon Paul ; Knowlton, Lisa Marie ; Kobusingye, Olive ; Koranteng, Adofo ; Krishnamurthi, Rita ; Lipnick, Michael ; Lipshultz, Steven E. ; Lockett Ohno, Summer ; Mabweijano, Jacqueline ; MacIntyre, Michael F. ; Mallinger, Leslie ; March, Lyn ; Marks, Guy B. ; Marks, Robin ; Matsumori, Akira ; Matzopoulos, Richard ; Mayosi, Bongani M. ; McAnulty, John H. ; McDermott, Mary M. ; McGrath, John ; Memish, Ziad A. ; Mensah, George A. ; Merriman, Tony R. ; Michaud, Catherine ; Miller, Matthew ; Miller, Ted R. ; Mock, Charles ; Mocumbi, Ana Olga ; Mokdad, Ali A. ; Moran, Andrew ; Mulholland, Kim ; Nair, M. Nathan ; Naldi, Luigi ; Narayan, K. M.Venkat ; Nasseri, Kiumarss ; Norman, Paul ; O'Donnell, Martin ; Omer, Saad B. ; Ortblad, Katrina ; Osborne, Richard ; Ozgediz, Doruk ; Pahari, Bishnu ; Pandian, Jeyaraj Durai ; Panozo Rivero, Andrea ; Perez Padilla, Rogelio ; Perez-Ruiz, Fernando ; Perico, Norberto ; Phillips, David ; Pierce, Kelsey ; Pope, C. Arden ; Porrini, Esteban ; Pourmalek, Farshad ; Raju, Murugesan ; Ranganathan, Dharani ; Rehm, Jürgen T. ; Rein, David B. ; Remuzzi, Guiseppe ; Rivara, Frederick P. ; Roberts, Thomas ; Rodriguez De León, Felipe ; Rosenfeld, Lisa C. ; Rushton, Lesley ; Sacco, Ralph L. ; Salomon, Joshua A. ; Sampson, Uchechukwu ; Sanman, Ella ; Schwebel, David C. ; Segui-Gomez, Maria ; Shepard, Donald S. ; Singh, David ; Singleton, Jessica ; Sliwa, Karen ; Smith, Emma ; Steer, Andrew ; Taylor, Jennifer A. ; Thomas, Bernadette ; Tleyjeh, Imad M. ; Towbin, Jeffrey ; Truelsen, Thomas ; Undurraga, Eduardo A. ; Venketasubramanian, N. ; Vijayakumar, Lakshmi ; Vos, Theo ; Wagner, Gregory R. ; Wang, Mengru ; Wang, Wenzhi ; Watt, Kerrianne ; Weinstock, Martin A. ; Weintraub, Robert ; Wilkinson, James D. ; Woolf, Anthony D. ; Wulf, Sarah ; Yeh, Pon Hsiu ; Yip, Paul ; Zabetian, Azadeh ; Zheng, Zhi Jie ; Lopez, Alan D. ; Murray, Christopher J.L. / Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010 : A systematic analysis for the Global Burden of Disease Study 2010. In: The Lancet. 2012 ; Vol. 380, No. 9859. pp. 2095-2128.
@article{3963f93e5de849aa8d46e1050e55dcd8,
title = "Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: A systematic analysis for the Global Burden of Disease Study 2010",
abstract = "Background: Reliable and timely information on the leading causes of death in populations, and how these are changing, is a crucial input into health policy debates. In the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010), we aimed to estimate annual deaths for the world and 21 regions between 1980 and 2010 for 235 causes, with uncertainty intervals (UIs), separately by age and sex. Methods: We attempted to identify all available data on causes of death for 187 countries from 1980 to 2010 from vital registration, verbal autopsy, mortality surveillance, censuses, surveys, hospitals, police records, and mortuaries. We assessed data quality for completeness, diagnostic accuracy, missing data, stochastic variations, and probable causes of death. We applied six different modelling strategies to estimate cause-specific mortality trends depending on the strength of the data. For 133 causes and three special aggregates we used the Cause of Death Ensemble model (CODEm) approach, which uses four families of statistical models testing a large set of different models using different permutations of covariates. Model ensembles were developed from these component models. We assessed model performance with rigorous out-of-sample testing of prediction error and the validity of 95{\%} UIs. For 13 causes with low observed numbers of deaths, we developed negative binomial models with plausible covariates. For 27 causes for which death is rare, we modelled the higher level cause in the cause hierarchy of the GBD 2010 and then allocated deaths across component causes proportionately, estimated from all available data in the database. For selected causes (African trypanosomiasis, congenital syphilis, whooping cough, measles, typhoid and parathyroid, leishmaniasis, acute hepatitis E, and HIV/AIDS), we used natural history models based on information on incidence, prevalence, and case-fatality. We separately estimated cause fractions by aetiology for diarrhoea, lower respiratory infections, and meningitis, as well as disaggregations by subcause for chronic kidney disease, maternal disorders, cirrhosis, and liver cancer. For deaths due to collective violence and natural disasters, we used mortality shock regressions. For every cause, we estimated 95{\%} UIs that captured both parameter estimation uncertainty and uncertainty due to model specification where CODEm was used. We constrained cause-specific fractions within every age-sex group to sum to total mortality based on draws from the uncertainty distributions. Findings: In 2010, there were 52·8 million deaths globally. At the most aggregate level, communicable, maternal, neonatal, and nutritional causes were 24·9{\%} of deaths worldwide in 2010, down from 15·9 million (34·1{\%}) of 46·5 million in 1990. This decrease was largely due to decreases in mortality from diarrhoeal disease (from 2·5 to 1·4 million), lower respiratory infections (from 3·4 to 2·8 million), neonatal disorders (from 3·1 to 2·2 million), measles (from 0·63 to 0·13 million), and tetanus (from 0·27 to 0·06 million). Deaths from HIV/AIDS increased from 0·30 million in 1990 to 1·5 million in 2010, reaching a peak of 1·7 million in 2006. Malaria mortality also rose by an estimated 19·9{\%} since 1990 to 1·17 million deaths in 2010. Tuberculosis killed 1·2 million people in 2010. Deaths from non-communicable diseases rose by just under 8 million between 1990 and 2010, accounting for two of every three deaths (34·5 million) worldwide by 2010. 8 million people died from cancer in 2010, 38{\%} more than two decades ago; of these, 1·5 million (19{\%}) were from trachea, bronchus, and lung cancer. Ischaemic heart disease and stroke collectively killed 12·9 million people in 2010, or one in four deaths worldwide, compared with one in five in 1990; 1·3 million deaths were due to diabetes, twice as many as in 1990. The fraction of global deaths due to injuries (5·1 million deaths) was marginally higher in 2010 (9·6{\%}) compared with two decades earlier (8·8{\%}). This was driven by a 46{\%} rise in deaths worldwide due to road traffic accidents (1·3 million in 2010) and a rise in deaths from falls. Ischaemic heart disease, stroke, chronic obstructive pulmonary disease (COPD), lower respiratory infections, lung cancer, and HIV/AIDS were the leading causes of death in 2010. Ischaemic heart disease, lower respiratory infections, stroke, diarrhoeal disease, malaria, and HIV/AIDS were the leading causes of years of life lost due to premature mortality (YLLs) in 2010, similar to what was estimated for 1990, except for HIV/AIDS and preterm birth complications. YLLs from lower respiratory infections and diarrhoea decreased by 45-54{\%} since 1990; ischaemic heart disease and stroke YLLs increased by 17-28{\%}. Regional variations in leading causes of death were substantial. Communicable, maternal, neonatal, and nutritional causes still accounted for 76{\%} of premature mortality in sub-Saharan Africa in 2010. Age standardised death rates from some key disorders rose (HIV/AIDS, Alzheimer's disease, diabetes mellitus, and chronic kidney disease in particular), but for most diseases, death rates fell in the past two decades; including major vascular diseases, COPD, most forms of cancer, liver cirrhosis, and maternal disorders. For other conditions, notably malaria, prostate cancer, and injuries, little change was noted. Interpretation: Population growth, increased average age of the world's population, and largely decreasing age-specific, sex-specific, and cause-specific death rates combine to drive a broad shift from communicable, maternal, neonatal, and nutritional causes towards non-communicable diseases. Nevertheless, communicable, maternal, neonatal, and nutritional causes remain the dominant causes of YLLs in sub-Saharan Africa. Overlaid on this general pattern of the epidemiological transition, marked regional variation exists in many causes, such as interpersonal violence, suicide, liver cancer, diabetes, cirrhosis, Chagas disease, African trypanosomiasis, melanoma, and others. Regional heterogeneity highlights the importance of sound epidemiological assessments of the causes of death on a regular basis.",
author = "Rafael Lozano and Mohsen Naghavi and Kyle Foreman and Stephen Lim and Kenji Shibuya and Victor Aboyans and Jerry Abraham and Timothy Adair and Rakesh Aggarwal and Ahn, {Stephanie Y.} and AlMazroa, {Mohammad A.} and Miriam Alvarado and Anderson, {H. Ross} and Anderson, {Laurie M.} and Andrews, {Kathryn G.} and Charles Atkinson and Baddour, {Larry M.} and Suzanne Barker-Collo and Bartels, {David H.} and Bell, {Michelle L.} and Benjamin, {Emelia J.} and Derrick Bennett and Kavi Bhalla and Boris Bikbov and {Bin Abdulhak}, Aref and Gretchen Birbeck and Fiona Blyth and Ian Bolliger and Soufiane Boufous and Chiara Bucello and Michael Burch and Peter Burney and Jonathan Carapetis and Honglei Chen and David Chou and Chugh, {Sumeet S.} and Coffeng, {Luc E.} and Colan, {Steven D.} and Samantha Colquhoun and Colson, {K. Ellicott} and John Condon and Connor, {Myles D.} and Cooper, {Leslie T.} and Matthew Corriere and Monica Cortinovis and {Courville De Vaccaro}, Karen and William Couser and Cowie, {Benjamin C.} and Criqui, {Michael H.} and Marita Cross and Dabhadkar, {Kaustubh C.} and Nabila Dahodwala and {De Leo}, Diego and Louisa Degenhardt and Allyne Delossantos and Julie Denenberg and {Des Jarlais}, {Don C.} and Dharmaratne, {Samath D.} and Dorsey, {E. Ray} and Tim Driscoll and Herbert Duber and Beth Ebel and Erwin, {Patricia J.} and Patricia Espindola and Majid Ezzati and Valery Feigin and Flaxman, {Abraham D.} and Forouzanfar, {Mohammad H.} and Fowkes, {Francis Gerry R.} and Richard Franklin and Marlene Fransen and Freeman, {Michael K.} and Gabriel, {Sherine E.} and Emmanuela Gakidou and Flavio Gaspari and Gillum, {Richard F.} and Diego Gonzalez-Medina and Halasa, {Yara A.} and Diana Haring and Harrison, {James E.} and Rasmus Havmoeller and Hay, {Roderick J.} and Bruno Hoen and Hotez, {Peter J.} and Damian Hoy and Jacobsen, {Kathryn H.} and James, {Spencer L.} and Rashmi Jasrasaria and Sudha Jayaraman and Nicole Johns and Ganesan Karthikeyan and Nicholas Kassebaum and Andre Keren and Khoo, {Jon Paul} and Knowlton, {Lisa Marie} and Olive Kobusingye and Adofo Koranteng and Rita Krishnamurthi and Michael Lipnick and Lipshultz, {Steven E.} and {Lockett Ohno}, Summer and Jacqueline Mabweijano and MacIntyre, {Michael F.} and Leslie Mallinger and Lyn March and Marks, {Guy B.} and Robin Marks and Akira Matsumori and Richard Matzopoulos and Mayosi, {Bongani M.} and McAnulty, {John H.} and McDermott, {Mary M.} and John McGrath and Memish, {Ziad A.} and Mensah, {George A.} and Merriman, {Tony R.} and Catherine Michaud and Matthew Miller and Miller, {Ted R.} and Charles Mock and Mocumbi, {Ana Olga} and Mokdad, {Ali A.} and Andrew Moran and Kim Mulholland and Nair, {M. Nathan} and Luigi Naldi and Narayan, {K. M.Venkat} and Kiumarss Nasseri and Paul Norman and Martin O'Donnell and Omer, {Saad B.} and Katrina Ortblad and Richard Osborne and Doruk Ozgediz and Bishnu Pahari and Pandian, {Jeyaraj Durai} and {Panozo Rivero}, Andrea and {Perez Padilla}, Rogelio and Fernando Perez-Ruiz and Norberto Perico and David Phillips and Kelsey Pierce and Pope, {C. Arden} and Esteban Porrini and Farshad Pourmalek and Murugesan Raju and Dharani Ranganathan and Rehm, {J{\"u}rgen T.} and Rein, {David B.} and Guiseppe Remuzzi and Rivara, {Frederick P.} and Thomas Roberts and {Rodriguez De Le{\'o}n}, Felipe and Rosenfeld, {Lisa C.} and Lesley Rushton and Sacco, {Ralph L.} and Salomon, {Joshua A.} and Uchechukwu Sampson and Ella Sanman and Schwebel, {David C.} and Maria Segui-Gomez and Shepard, {Donald S.} and David Singh and Jessica Singleton and Karen Sliwa and Emma Smith and Andrew Steer and Taylor, {Jennifer A.} and Bernadette Thomas and Tleyjeh, {Imad M.} and Jeffrey Towbin and Thomas Truelsen and Undurraga, {Eduardo A.} and N. Venketasubramanian and Lakshmi Vijayakumar and Theo Vos and Wagner, {Gregory R.} and Mengru Wang and Wenzhi Wang and Kerrianne Watt and Weinstock, {Martin A.} and Robert Weintraub and Wilkinson, {James D.} and Woolf, {Anthony D.} and Sarah Wulf and Yeh, {Pon Hsiu} and Paul Yip and Azadeh Zabetian and Zheng, {Zhi Jie} and Lopez, {Alan D.} and Murray, {Christopher J.L.}",
year = "2012",
month = "12",
day = "1",
doi = "10.1016/S0140-6736(12)61728-0",
language = "English (US)",
volume = "380",
pages = "2095--2128",
journal = "The Lancet",
issn = "0140-6736",
publisher = "Elsevier Limited",
number = "9859",

}

TY - JOUR

T1 - Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010

T2 - A systematic analysis for the Global Burden of Disease Study 2010

AU - Lozano, Rafael

AU - Naghavi, Mohsen

AU - Foreman, Kyle

AU - Lim, Stephen

AU - Shibuya, Kenji

AU - Aboyans, Victor

AU - Abraham, Jerry

AU - Adair, Timothy

AU - Aggarwal, Rakesh

AU - Ahn, Stephanie Y.

AU - AlMazroa, Mohammad A.

AU - Alvarado, Miriam

AU - Anderson, H. Ross

AU - Anderson, Laurie M.

AU - Andrews, Kathryn G.

AU - Atkinson, Charles

AU - Baddour, Larry M.

AU - Barker-Collo, Suzanne

AU - Bartels, David H.

AU - Bell, Michelle L.

AU - Benjamin, Emelia J.

AU - Bennett, Derrick

AU - Bhalla, Kavi

AU - Bikbov, Boris

AU - Bin Abdulhak, Aref

AU - Birbeck, Gretchen

AU - Blyth, Fiona

AU - Bolliger, Ian

AU - Boufous, Soufiane

AU - Bucello, Chiara

AU - Burch, Michael

AU - Burney, Peter

AU - Carapetis, Jonathan

AU - Chen, Honglei

AU - Chou, David

AU - Chugh, Sumeet S.

AU - Coffeng, Luc E.

AU - Colan, Steven D.

AU - Colquhoun, Samantha

AU - Colson, K. Ellicott

AU - Condon, John

AU - Connor, Myles D.

AU - Cooper, Leslie T.

AU - Corriere, Matthew

AU - Cortinovis, Monica

AU - Courville De Vaccaro, Karen

AU - Couser, William

AU - Cowie, Benjamin C.

AU - Criqui, Michael H.

AU - Cross, Marita

AU - Dabhadkar, Kaustubh C.

AU - Dahodwala, Nabila

AU - De Leo, Diego

AU - Degenhardt, Louisa

AU - Delossantos, Allyne

AU - Denenberg, Julie

AU - Des Jarlais, Don C.

AU - Dharmaratne, Samath D.

AU - Dorsey, E. Ray

AU - Driscoll, Tim

AU - Duber, Herbert

AU - Ebel, Beth

AU - Erwin, Patricia J.

AU - Espindola, Patricia

AU - Ezzati, Majid

AU - Feigin, Valery

AU - Flaxman, Abraham D.

AU - Forouzanfar, Mohammad H.

AU - Fowkes, Francis Gerry R.

AU - Franklin, Richard

AU - Fransen, Marlene

AU - Freeman, Michael K.

AU - Gabriel, Sherine E.

AU - Gakidou, Emmanuela

AU - Gaspari, Flavio

AU - Gillum, Richard F.

AU - Gonzalez-Medina, Diego

AU - Halasa, Yara A.

AU - Haring, Diana

AU - Harrison, James E.

AU - Havmoeller, Rasmus

AU - Hay, Roderick J.

AU - Hoen, Bruno

AU - Hotez, Peter J.

AU - Hoy, Damian

AU - Jacobsen, Kathryn H.

AU - James, Spencer L.

AU - Jasrasaria, Rashmi

AU - Jayaraman, Sudha

AU - Johns, Nicole

AU - Karthikeyan, Ganesan

AU - Kassebaum, Nicholas

AU - Keren, Andre

AU - Khoo, Jon Paul

AU - Knowlton, Lisa Marie

AU - Kobusingye, Olive

AU - Koranteng, Adofo

AU - Krishnamurthi, Rita

AU - Lipnick, Michael

AU - Lipshultz, Steven E.

AU - Lockett Ohno, Summer

AU - Mabweijano, Jacqueline

AU - MacIntyre, Michael F.

AU - Mallinger, Leslie

AU - March, Lyn

AU - Marks, Guy B.

AU - Marks, Robin

AU - Matsumori, Akira

AU - Matzopoulos, Richard

AU - Mayosi, Bongani M.

AU - McAnulty, John H.

AU - McDermott, Mary M.

AU - McGrath, John

AU - Memish, Ziad A.

AU - Mensah, George A.

AU - Merriman, Tony R.

AU - Michaud, Catherine

AU - Miller, Matthew

AU - Miller, Ted R.

AU - Mock, Charles

AU - Mocumbi, Ana Olga

AU - Mokdad, Ali A.

AU - Moran, Andrew

AU - Mulholland, Kim

AU - Nair, M. Nathan

AU - Naldi, Luigi

AU - Narayan, K. M.Venkat

AU - Nasseri, Kiumarss

AU - Norman, Paul

AU - O'Donnell, Martin

AU - Omer, Saad B.

AU - Ortblad, Katrina

AU - Osborne, Richard

AU - Ozgediz, Doruk

AU - Pahari, Bishnu

AU - Pandian, Jeyaraj Durai

AU - Panozo Rivero, Andrea

AU - Perez Padilla, Rogelio

AU - Perez-Ruiz, Fernando

AU - Perico, Norberto

AU - Phillips, David

AU - Pierce, Kelsey

AU - Pope, C. Arden

AU - Porrini, Esteban

AU - Pourmalek, Farshad

AU - Raju, Murugesan

AU - Ranganathan, Dharani

AU - Rehm, Jürgen T.

AU - Rein, David B.

AU - Remuzzi, Guiseppe

AU - Rivara, Frederick P.

AU - Roberts, Thomas

AU - Rodriguez De León, Felipe

AU - Rosenfeld, Lisa C.

AU - Rushton, Lesley

AU - Sacco, Ralph L.

AU - Salomon, Joshua A.

AU - Sampson, Uchechukwu

AU - Sanman, Ella

AU - Schwebel, David C.

AU - Segui-Gomez, Maria

AU - Shepard, Donald S.

AU - Singh, David

AU - Singleton, Jessica

AU - Sliwa, Karen

AU - Smith, Emma

AU - Steer, Andrew

AU - Taylor, Jennifer A.

AU - Thomas, Bernadette

AU - Tleyjeh, Imad M.

AU - Towbin, Jeffrey

AU - Truelsen, Thomas

AU - Undurraga, Eduardo A.

AU - Venketasubramanian, N.

AU - Vijayakumar, Lakshmi

AU - Vos, Theo

AU - Wagner, Gregory R.

AU - Wang, Mengru

AU - Wang, Wenzhi

AU - Watt, Kerrianne

AU - Weinstock, Martin A.

AU - Weintraub, Robert

AU - Wilkinson, James D.

AU - Woolf, Anthony D.

AU - Wulf, Sarah

AU - Yeh, Pon Hsiu

AU - Yip, Paul

AU - Zabetian, Azadeh

AU - Zheng, Zhi Jie

AU - Lopez, Alan D.

AU - Murray, Christopher J.L.

PY - 2012/12/1

Y1 - 2012/12/1

N2 - Background: Reliable and timely information on the leading causes of death in populations, and how these are changing, is a crucial input into health policy debates. In the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010), we aimed to estimate annual deaths for the world and 21 regions between 1980 and 2010 for 235 causes, with uncertainty intervals (UIs), separately by age and sex. Methods: We attempted to identify all available data on causes of death for 187 countries from 1980 to 2010 from vital registration, verbal autopsy, mortality surveillance, censuses, surveys, hospitals, police records, and mortuaries. We assessed data quality for completeness, diagnostic accuracy, missing data, stochastic variations, and probable causes of death. We applied six different modelling strategies to estimate cause-specific mortality trends depending on the strength of the data. For 133 causes and three special aggregates we used the Cause of Death Ensemble model (CODEm) approach, which uses four families of statistical models testing a large set of different models using different permutations of covariates. Model ensembles were developed from these component models. We assessed model performance with rigorous out-of-sample testing of prediction error and the validity of 95% UIs. For 13 causes with low observed numbers of deaths, we developed negative binomial models with plausible covariates. For 27 causes for which death is rare, we modelled the higher level cause in the cause hierarchy of the GBD 2010 and then allocated deaths across component causes proportionately, estimated from all available data in the database. For selected causes (African trypanosomiasis, congenital syphilis, whooping cough, measles, typhoid and parathyroid, leishmaniasis, acute hepatitis E, and HIV/AIDS), we used natural history models based on information on incidence, prevalence, and case-fatality. We separately estimated cause fractions by aetiology for diarrhoea, lower respiratory infections, and meningitis, as well as disaggregations by subcause for chronic kidney disease, maternal disorders, cirrhosis, and liver cancer. For deaths due to collective violence and natural disasters, we used mortality shock regressions. For every cause, we estimated 95% UIs that captured both parameter estimation uncertainty and uncertainty due to model specification where CODEm was used. We constrained cause-specific fractions within every age-sex group to sum to total mortality based on draws from the uncertainty distributions. Findings: In 2010, there were 52·8 million deaths globally. At the most aggregate level, communicable, maternal, neonatal, and nutritional causes were 24·9% of deaths worldwide in 2010, down from 15·9 million (34·1%) of 46·5 million in 1990. This decrease was largely due to decreases in mortality from diarrhoeal disease (from 2·5 to 1·4 million), lower respiratory infections (from 3·4 to 2·8 million), neonatal disorders (from 3·1 to 2·2 million), measles (from 0·63 to 0·13 million), and tetanus (from 0·27 to 0·06 million). Deaths from HIV/AIDS increased from 0·30 million in 1990 to 1·5 million in 2010, reaching a peak of 1·7 million in 2006. Malaria mortality also rose by an estimated 19·9% since 1990 to 1·17 million deaths in 2010. Tuberculosis killed 1·2 million people in 2010. Deaths from non-communicable diseases rose by just under 8 million between 1990 and 2010, accounting for two of every three deaths (34·5 million) worldwide by 2010. 8 million people died from cancer in 2010, 38% more than two decades ago; of these, 1·5 million (19%) were from trachea, bronchus, and lung cancer. Ischaemic heart disease and stroke collectively killed 12·9 million people in 2010, or one in four deaths worldwide, compared with one in five in 1990; 1·3 million deaths were due to diabetes, twice as many as in 1990. The fraction of global deaths due to injuries (5·1 million deaths) was marginally higher in 2010 (9·6%) compared with two decades earlier (8·8%). This was driven by a 46% rise in deaths worldwide due to road traffic accidents (1·3 million in 2010) and a rise in deaths from falls. Ischaemic heart disease, stroke, chronic obstructive pulmonary disease (COPD), lower respiratory infections, lung cancer, and HIV/AIDS were the leading causes of death in 2010. Ischaemic heart disease, lower respiratory infections, stroke, diarrhoeal disease, malaria, and HIV/AIDS were the leading causes of years of life lost due to premature mortality (YLLs) in 2010, similar to what was estimated for 1990, except for HIV/AIDS and preterm birth complications. YLLs from lower respiratory infections and diarrhoea decreased by 45-54% since 1990; ischaemic heart disease and stroke YLLs increased by 17-28%. Regional variations in leading causes of death were substantial. Communicable, maternal, neonatal, and nutritional causes still accounted for 76% of premature mortality in sub-Saharan Africa in 2010. Age standardised death rates from some key disorders rose (HIV/AIDS, Alzheimer's disease, diabetes mellitus, and chronic kidney disease in particular), but for most diseases, death rates fell in the past two decades; including major vascular diseases, COPD, most forms of cancer, liver cirrhosis, and maternal disorders. For other conditions, notably malaria, prostate cancer, and injuries, little change was noted. Interpretation: Population growth, increased average age of the world's population, and largely decreasing age-specific, sex-specific, and cause-specific death rates combine to drive a broad shift from communicable, maternal, neonatal, and nutritional causes towards non-communicable diseases. Nevertheless, communicable, maternal, neonatal, and nutritional causes remain the dominant causes of YLLs in sub-Saharan Africa. Overlaid on this general pattern of the epidemiological transition, marked regional variation exists in many causes, such as interpersonal violence, suicide, liver cancer, diabetes, cirrhosis, Chagas disease, African trypanosomiasis, melanoma, and others. Regional heterogeneity highlights the importance of sound epidemiological assessments of the causes of death on a regular basis.

AB - Background: Reliable and timely information on the leading causes of death in populations, and how these are changing, is a crucial input into health policy debates. In the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010), we aimed to estimate annual deaths for the world and 21 regions between 1980 and 2010 for 235 causes, with uncertainty intervals (UIs), separately by age and sex. Methods: We attempted to identify all available data on causes of death for 187 countries from 1980 to 2010 from vital registration, verbal autopsy, mortality surveillance, censuses, surveys, hospitals, police records, and mortuaries. We assessed data quality for completeness, diagnostic accuracy, missing data, stochastic variations, and probable causes of death. We applied six different modelling strategies to estimate cause-specific mortality trends depending on the strength of the data. For 133 causes and three special aggregates we used the Cause of Death Ensemble model (CODEm) approach, which uses four families of statistical models testing a large set of different models using different permutations of covariates. Model ensembles were developed from these component models. We assessed model performance with rigorous out-of-sample testing of prediction error and the validity of 95% UIs. For 13 causes with low observed numbers of deaths, we developed negative binomial models with plausible covariates. For 27 causes for which death is rare, we modelled the higher level cause in the cause hierarchy of the GBD 2010 and then allocated deaths across component causes proportionately, estimated from all available data in the database. For selected causes (African trypanosomiasis, congenital syphilis, whooping cough, measles, typhoid and parathyroid, leishmaniasis, acute hepatitis E, and HIV/AIDS), we used natural history models based on information on incidence, prevalence, and case-fatality. We separately estimated cause fractions by aetiology for diarrhoea, lower respiratory infections, and meningitis, as well as disaggregations by subcause for chronic kidney disease, maternal disorders, cirrhosis, and liver cancer. For deaths due to collective violence and natural disasters, we used mortality shock regressions. For every cause, we estimated 95% UIs that captured both parameter estimation uncertainty and uncertainty due to model specification where CODEm was used. We constrained cause-specific fractions within every age-sex group to sum to total mortality based on draws from the uncertainty distributions. Findings: In 2010, there were 52·8 million deaths globally. At the most aggregate level, communicable, maternal, neonatal, and nutritional causes were 24·9% of deaths worldwide in 2010, down from 15·9 million (34·1%) of 46·5 million in 1990. This decrease was largely due to decreases in mortality from diarrhoeal disease (from 2·5 to 1·4 million), lower respiratory infections (from 3·4 to 2·8 million), neonatal disorders (from 3·1 to 2·2 million), measles (from 0·63 to 0·13 million), and tetanus (from 0·27 to 0·06 million). Deaths from HIV/AIDS increased from 0·30 million in 1990 to 1·5 million in 2010, reaching a peak of 1·7 million in 2006. Malaria mortality also rose by an estimated 19·9% since 1990 to 1·17 million deaths in 2010. Tuberculosis killed 1·2 million people in 2010. Deaths from non-communicable diseases rose by just under 8 million between 1990 and 2010, accounting for two of every three deaths (34·5 million) worldwide by 2010. 8 million people died from cancer in 2010, 38% more than two decades ago; of these, 1·5 million (19%) were from trachea, bronchus, and lung cancer. Ischaemic heart disease and stroke collectively killed 12·9 million people in 2010, or one in four deaths worldwide, compared with one in five in 1990; 1·3 million deaths were due to diabetes, twice as many as in 1990. The fraction of global deaths due to injuries (5·1 million deaths) was marginally higher in 2010 (9·6%) compared with two decades earlier (8·8%). This was driven by a 46% rise in deaths worldwide due to road traffic accidents (1·3 million in 2010) and a rise in deaths from falls. Ischaemic heart disease, stroke, chronic obstructive pulmonary disease (COPD), lower respiratory infections, lung cancer, and HIV/AIDS were the leading causes of death in 2010. Ischaemic heart disease, lower respiratory infections, stroke, diarrhoeal disease, malaria, and HIV/AIDS were the leading causes of years of life lost due to premature mortality (YLLs) in 2010, similar to what was estimated for 1990, except for HIV/AIDS and preterm birth complications. YLLs from lower respiratory infections and diarrhoea decreased by 45-54% since 1990; ischaemic heart disease and stroke YLLs increased by 17-28%. Regional variations in leading causes of death were substantial. Communicable, maternal, neonatal, and nutritional causes still accounted for 76% of premature mortality in sub-Saharan Africa in 2010. Age standardised death rates from some key disorders rose (HIV/AIDS, Alzheimer's disease, diabetes mellitus, and chronic kidney disease in particular), but for most diseases, death rates fell in the past two decades; including major vascular diseases, COPD, most forms of cancer, liver cirrhosis, and maternal disorders. For other conditions, notably malaria, prostate cancer, and injuries, little change was noted. Interpretation: Population growth, increased average age of the world's population, and largely decreasing age-specific, sex-specific, and cause-specific death rates combine to drive a broad shift from communicable, maternal, neonatal, and nutritional causes towards non-communicable diseases. Nevertheless, communicable, maternal, neonatal, and nutritional causes remain the dominant causes of YLLs in sub-Saharan Africa. Overlaid on this general pattern of the epidemiological transition, marked regional variation exists in many causes, such as interpersonal violence, suicide, liver cancer, diabetes, cirrhosis, Chagas disease, African trypanosomiasis, melanoma, and others. Regional heterogeneity highlights the importance of sound epidemiological assessments of the causes of death on a regular basis.

UR - http://www.scopus.com/inward/record.url?scp=84871036375&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84871036375&partnerID=8YFLogxK

U2 - 10.1016/S0140-6736(12)61728-0

DO - 10.1016/S0140-6736(12)61728-0

M3 - Article

VL - 380

SP - 2095

EP - 2128

JO - The Lancet

JF - The Lancet

SN - 0140-6736

IS - 9859

ER -