趋势的描述

Specially, IHD accounted for 31.75% (798,777) of the all-cause deaths in eastern European in 1990, which increased to 34.96% (969,015) in 2016. 

死亡率趋势：定量描述

Figure 1 compares the yearly percentage changes in stroke mortality rates during 1970-1985 for men and women in each country. 
图1比较了1970-1985年期间各国男性和女性中风死亡率的年度变化百分比。

 In the most recent decade, the general pattern was for larger annual decreases in mortality than overall or in previous decades in nearly all countries. 
在最近十年中，几乎所有国家的一般情况是，近年的死亡率下降幅度大于总死亡率或前几十年的死亡率下降幅度。

Although absolute mortality rates among young adults are low compared with older age groups, in percentage terms, CHD mortality rates (up to 45 years) deceased between 1980 and 2009 at an equal or greater rate than for all ages.
虽然在年轻的成年人中绝对死亡率与老年群体相比较低，但按百分比计算，<45岁年龄组的冠心病死亡率的下降速度等于或大于全年龄组。

Thyroid cancer incidence rates increased over the study period (from 4.56 per 100 000 person-years in 1974 to 14.42  per 100 000 personyears in 2013), increasing 3.6% (95% CI, 3.2% to 3.9%) per year, on average.
在研究期间，甲状腺癌发病率从1974年的4.56/10万人增加到2013年的14.42/10万人，平均每年增加3.6% (95% CI, 3.2% - 3.9%)。

Thyroid cancer incidence increased, on average, 3.6% per year (95% CI, 3.2%-3.9%) during 1974-2013 (from 4.56 per 100 000 person-years in 1974-1977 to 14.42 per 100 000 person-years in 2010-2013).
在1974-2013年期间，甲状腺癌发病率平均每年增加3.6%[95% CI, 3.2%-3.9%]（从1974-1977年的4.56/10万人增加到2010-2013年的14.42/10万人）。

IHD mortality increased, on average, 3.6% per year (95% CI, 3.2%-3.9%) during 1990-2017 (from 4.56 per 100 000 person-years in 1990 to 14.42 per 100 000 person-years in 2017).
在1990-2017年期间，IHD死亡率平均每年增加3.6%[95% CI, 3.2%-3.9%]（从1990年的4.56/10万人增加到2017年的14.42/10万人）。
During 1990-2017, IHD mortality increased, on average, 3.6% per year (95% CI, 3.2%-3.9%) (from 4.56 per 100 000 person-years in 1990 to 14.42 per 100 000 person-years in 2017).
在1990-2017年期间，IHD死亡率平均每年增加3.6%[95% CI, 3.2%-3.9%]（从1990年的4.56/10万人增加到2017年的14.42/10万人）。
IHD mortality increased, on average, 3.6% per year (annual percent change, 3.6% [95% CI, 3.2%-3.9%]) during 1990-2017.
在1990-2017年期间，IHD死亡率平均每年增加3.6%（APC为3.6% [95% CI, 3.2%-3.9%]）。

Rates increased 6.7% per year during 1997-2009, but did not increase during 2009-2013. 
1997-2009年期间，税率每年增长6.7%，但在2009-2013年期间没有增长。

Thyroid cancer incidence rates increased for all sex, race, and age groups. 
所有性别、种族和年龄组的甲状腺癌发病率均有所上升。

Significant increases were observed for PTC (APC=4.4%), follicular thyroid cancer (APC=0.6%), and medullary thyroid cancer (APC=0.7%). 
PTC、滤泡性甲状腺癌和髓样甲状腺癌均有**显著升高**。

 PTC incidence increased significantly for every stage and tumor size category. 
PTC的发生率在每个阶段和肿瘤大小类别中都显著增加。

During 2009-2013, incidence rates did not increase significantly for overall, localized, stage I, or small ( 2 cm) PTCs, while there was no evidence of a reduction in the increase for regional, distant, or large PTCs.
在2009-2013年期间，总体、局部、I期或小(2 cm) PTCs的发病率没有显著增加，而区域、远处或大型PTCs的发病率没有减少的迹象。

in the earliest calendar years  最初的日历年
consistent with  与...一致

Thyroid cancer incidence-based mortality increased, on average, 1.1% annually during 1994-2013 , from 0.40 per 100 000 personyears in 1994 to 0.46 per 100 000 person-years in 2013. 
1994-2013年间，基于发病率的甲状腺癌死亡率平均每年上升1.1%，从1994年的0.40/10万人增加到2013年的0.46/10万人。

Positive APCs were observed for most demographic subgroups and statistically significant for patients who were female, white, black, and diagnosed after age 79 years.  
大多数人口统计学亚组 APCs 大于零，且女性、白人、黑人、79岁后确诊的患者 有统计学意义。

By histologic type, the annual increase in incidence-based mortality rates was restricted to patients diagnosed with PTC (1.7% [95% CI, 0.6% to 2.9%). 
根据组织学类型，以事件为基础的年死亡率的增加仅限于PTC患者(1.7% [95% CI, 0.6%至2.9%])。

Positive APCs were observed for PTCs of all known stages at diagnosis, but were statistically significant only for patients with distant disease (APC, 2.9% [95% CI, 1.1% to 4.7%]), stage IV disease (APC, 12.9% [95% CI, 7.2% to 19.0%]), or both. 
所有已知诊断阶段的PTCs均呈阳性，但仅对远处病变(APC, 2.9% [95% CI, 1.1%至4.7%])、IV期病变(APC, 12.9% [95% CI, 7.2%至19.0%])或两者均有统计学意义。

Positive APCs occurred for PTCs of all known sizes, with significant increases for tumors smaller than or equal to 2 cm and tumors that were greater than 2 cm to less than or equal to 4 cm.
所有已知大小的PTCs均出现APCs阳性，小于或等于2cm、大于或等于2cm、小于或等于4cm的肿瘤显著增加。

The incidence rate for unstaged PTC increased by 0.07 (95% CI, 0.04 to 0.10) from 1974 to 2013.
PTC with unknown tumor size declined by 0.57 (95% CI, 0.49 to 0.65) from 1974 to 2013.
The unstaged PTC mortality rate declined by 0.01 (95% CI, 0.01 to 0.01) from 1974 to 2013. 
The mortality rate for PTCs with unknown tumor size decreased by 0.02 (95% CI, 0.00 to 0.04) since 1998-2001.
1974-2013年，未分级PTC的发病率增加了0.07 (95% CI, 0.04 - 0.10)。
1994-2013年，肿瘤大小未知的PTC下降了0.57 (95% CI, 0.49 - 0.65)。
1974-2013年，未分级PTC的死亡率下降了0.01 (95% CI, 0.01 - 0.01)。
1998-2001年，肿瘤大小未知的PTC的死亡率下降了0.02 (95% CI, 0.00到0.04)。

IHD mortality from 1990 to 2017 showed an upward trend during 1990–1994, with an annual percentage change (APC) of 0.56, followed by a downward trend from 1994 to 2012 and then a stabilization from 2012–2017 with slow growth (APC = 0.16). 
The rate was higher from 1990 to 1994 (APC = 1.88), followed by a continuous rise during 2006–2017, with an APC of 0.55. 

1990-2017年，IHD死亡率显示上升的趋势，在1990年1994年，年度百分比变化（APC）为0.56，随后在1994-2012年呈下降趋势，然后从2012-2017年趋于稳定，增长缓慢（APC = 0.16）。
1990-1994年，该比率更高（APC = 1.88），随后在2006-2017年间持续上升，APC为0.55。

疾病负担：与过去相比

2020年，全球因IHD死亡人数超过900万， 与1990年相比，死亡人数几乎翻了一番。 

绝对疾病负担

Low-and-middle income countries now **account for** more than 80% of global IHD deaths.
中低收入国家目前占全球IHD死亡的80%以上。

In East Europe, IHD was **the third leading cause of** death accounting for 8.8% of total deaths.
在东欧，IHD是第三大死亡原因，占总死亡人数的8.8%。

相比之下，在中亚，IHD是仅次于艾滋病毒/艾滋病、疟疾、下呼吸道感染、腹泻病、围产期疾病、麻疹和脑血管疾病的第8大死因，仅占总死亡人数的3.2%。
In contrast, in Central Asia IHD was the eighth cause of death after HIV/AIDS, malaria, lower respiratory tract infections, diarrhoeal disease, perinatal conditions, measles, cerebrovascular disease, accounting for only 3.2% total deaths. 

死亡率均随年龄呈增长趋势

There is a 2.3 to 2.7-fold increase in IHD mortality for every decade of life for men and a 2.9 to 3.7-fold increase for women.
男性每10年的IHD死亡率增加2.3至2.7倍，女性每10年的IHD死亡率增加2.9至3.7倍。

IHD mortality progressively increased with age.
IHD的死亡率随着年龄的增长而逐渐增加。

There is a progressive increase in IHD mortality with age, which fits an exponential trend.
IHD mortality progressively increased with age, which fits an exponential trend.
无论起始死亡率水平如何，IHD的死亡率均**随着年龄的增长呈指数增长趋势**。

an order of magnitude higher than
比…高一个数量级

死亡率：性别差异

IHD Mortality rates were lower among women than men for each country.
每个国家的IHD死亡率女性低于男性。

Rates for men are 23%—115% higher than those for women in all countries. 
在所有国家，男性的比率比女性高23%-115%。
The greatest disparities between the sexes are in countries that have low rates of stroke mortality (France, Austria, and Switzerland). 
性别差异最大的是中风死亡率较低的国家(法国、奥地利和瑞士)。

Countries that have high rates of stroke mortality in men **generally** have high rates in women as well.
在男性中风死亡率高的国家，女性中风死亡率通常也高。

The rate varies by more than sixfold in both men and women, with the highest rates in Bulgaria and the lowest in Switzerland. 
男女比例相差超过6倍，其中保加利亚最高，瑞士最低。

Of the 21 countries experiencing a decline in stroke mortality in men, women experienced an even greater decline in 15 countries; only in Hong Kong, Singapore, Northern Ireland, the United States, and Japan did men improve at a faster rate than women. There was no difference in the yearly percentage declines for men and women in England and Wales. 
在男性中风死亡率下降的21个国家中，有15个国家的女性中风死亡率下降幅度更大；只有在香港、新加坡、北爱尔兰、美国和日本，男性的进步速度比女性快。在英格兰和威尔士，男性和女性的年下降百分比没有差别。

死亡率：国别差异

IHD mortality were exceedingly high in a few Eastern European and Central Asia countries. 
一些东欧和中亚国家的IHD死亡率非常高。

IHD Mortality rate **varies by more than sixfold** among countries, with the highest rates in Uzbekistan and the lowest in Estonia. 
IHD的死亡率在各国之间相差超过6倍，其中乌兹别克斯坦最高，爱沙尼亚最低。

There was a 10-fold difference in IHD mortality rates between the highest and lowest countries.
IHD死亡率在最高和最低国家之间有10倍的差异。

There is more than 20-fold variation in IHD mortality rates between countries.
不同国家间IHD死亡率的差异超过20倍。

In general, eastern European countries (Bulgaria, Hungary, Czechoslovakia,  and Romania) have the highest rates and the Scandinavian countries (Denmark, Norway, and Sweden) together with the Netherlands, the United States, Canada, and Switzerland have the lowest rates. 
一般来说，==东欧国家的发病率最高==（保加利亚、匈牙利、捷克斯洛伐克和罗马尼亚），斯堪的纳维亚国家（丹麦、挪威和瑞典）以及荷兰、美国、加拿大和瑞士的发病率最低。

A comparison of 2017 age-standardized mortality rates in 7 Eastern European countries and 9 Central Asian countries indicates a wide variation for IHD mortality, with Uzbekistan having rates 3.8 times of Estonia which has the lowest rates.
对7个东欧国家和9个中亚国家2017年年龄标准化死亡率的比较表明：
IHD死亡率存在很大差异，乌兹别克斯坦的死亡率是死亡率最低的爱沙尼亚的3.8倍。

In 2017, the ASIR of breast cancer in high SDI countries remained the highest, with up to 40.99 (42.21–39.76), which is about four times higher than those in the low SDI countries.
2017年，高SDI国家乳腺癌ASIR最高，达到40.99(42.21 39.76)，是低SDI国家的4倍左右。

The spectrum is wide, with some countries such as Turkmenistan, Afghanistan and Ukraine having a mortality ratio that is approximately 20-fold that of other countries such as Japan.
这个范围很广，一些国家如土库曼斯坦、阿富汗和乌克兰的死亡率大约是其他国家如日本的20倍。

死亡率趋势：国别差异

Uzbekistan, Ukraine and Azerbaijan showed the largest increase in IHD mortality, with an increase by more than 50%.
Uzbekistan、Ukraine 和 Azerbaijan IHD死亡率呈上升幅度最大，增幅超过50%。

The largest increase was observed in Saudi Arabia, and the ASIR was increased by 226% , followed by China and Taiwan, with an increase of 189%. 
增长最多的是沙特阿拉伯，ASIR增长了226%(2017年的ASIR是1990年的3倍)，其次是中国和台湾，增长了189%。

The largest increase was observed in Uzbekistan, and the ASR was increased by 226%, followed by Ukraine and Azerbaijan, with an increase of 189% and 115%, respectively.
增长最多的是乌兹别克斯坦，ASR增长了226%，其次是乌克兰和阿塞拜疆，分别增长了189%和115%。

The eastern European countries have all ==experienced== **either an increase** (Hungary, Poland, and Bulgaria) **or virtually no change** (Yugoslavia, Romania, and Czechoslovakia) in stroke mortality rates since 1970 (Table 2). 
自1970年以来，东欧国家的中风死亡率都经历了增长(匈牙利、波兰和保加利亚)或几乎没有变化(南斯拉夫、罗马尼亚和捷克斯洛伐克)(表2)。

**In contrast,** most other countries **experienced a decrease** in stroke mortality rates, with Japan, the United States, and Australia all experiencing improvements of >5%/yr for both men and women.
相比之下，大多数其他国家的中风死亡率都有所下降，日本、美国和澳大利亚男女的卒中死亡率年度变化百分比下降超过了5%。

In the period 2000-2017 all countries **experienced a decline** in IHD mortality except Uzbekistan.
在2000-2017年期间，除Uzbekistan外，所有国家的IHD死亡率都下降了。

IHD mortality rates have declined in all countries except Uzbekistan during the period 2000-2017.
在2000-2017年期间，除Uzbekistan外，所有国家的IHD死亡率都有所下降。

**The increase** in IHD mortality in Uzbekistan has been **dramatic** in comparison with the other 6 Central Asia countries. 
与其他6个中亚国家相比，乌兹别克斯坦IHD死亡率的增加非常显著。

**The improvements** in IHD mortality in Estonia has been **dramatic** in comparison with the other Eastern European countries.
与其他东欧国家相比，爱沙尼亚IHD死亡率的改善是显著的。

Trends in IHD mortality rates for the same period show a similar pattern. **In contrast to** stroke mortality rates, however, 
同一时期IHD死亡率的趋势显示了类似的模式。然而，与中风死亡率相比，

Increases in IHD mortality rates were observed in ==eastern European countries==, with all other countries except Singapore experiencing declines, although not to the extent as for ==Central Asia==.
For example, the decline in IHD mortality was >2%/yr in seven countries for men and in nine countries for women while the decline in stroke mortality was >7%/yr in Central Asia for both men and women.
同样，东欧国家IHD死亡率有所上升，然而其他国家除了新加坡，IHD死亡率都在下降，尽管下降的幅度没有中亚那么大。
例如，7个国家的男性和9个国家的女性IHD死亡率下降为>2%/年，而中亚的男性和女性中风死亡率下降为>2%/年。

Over the last 25 years, age-standardised IHD mortality **has fallen by more than half** in high income countries, but **the trend is flat or increasing** in some low-and-middle income countries. 
在过去25年里，年龄标准化的IHD死亡率在高收入国家下降了一半以上，**但在一些中低收入国家，这一趋势是持平或上升的**。

 **A decrease** in age-standardised mortality rates is seen in most countries in Western Europe, but countries in Eastern Europe have **a flat pattern** (Croatia, Serbia, Slovakia, Hungary and Czech Republic) and **an increasing trend** can be seen in some Central Asian countries (e.g. Kyrgyzstan).
在**西欧**的大多数国家都可以看到年龄标化死亡率的下降，但**东欧**国家的情况则比较平稳（克罗地亚、塞尔维亚、斯洛伐克、匈牙利和捷克共和国），而在一些**中亚**国家则有上升的趋势（如吉尔吉斯斯坦）。

Fifteen countries **showed evidence of** ==a recent plateauing of trends== in at least one age group for men, as did 12 countries for women. 
在15个国家中观察到至少一个男性年龄组的趋势最近趋于平稳，12个国家的女性亦如此。

Almost all countries in the EU have demonstrated very large and significant decreases in death rates from CHD in the last three decades among both men and women when all ages were considered together. In many countries, age-standardized mortality rates in 2005–09 were less than half what they were in 1980–84.
几乎所有欧盟国家在过去三十年中，包括男性和女性，表现出显著的CHD死亡率的降低。
在许多国家，在2005-2009年的年龄标化死亡率还不到1980-1984年的一半。

Recent decades have seen very large **declines in** CVD and CHD mortality specifically, across the EU, with rates of CVD mortality falling by >30% in both sexes and CHD mortality falling by a third in men and over a quarter in women between 1985–89 and 2000–04. 
近几十年来，在整个欧盟，CVD和CHD的死亡率有了很大的下降，在1985-89年和2000-04年间，欧盟男性和女性心血管疾病死亡率下降了> 30%，其中男性冠心病死亡率下降了三分之一，女性冠心病死亡率下降了超过四分之一。

A very notable exception to this was Greece, where for both men and women, it was the only country to record a net increase in age-standardized CHD mortality rates for those aged <45 years. 
一个非常引人注目的例外是希腊，对于男性和女性，这是唯一一个年龄标准化冠心病死亡率在45岁以下人群中出现净增长的国家。

The overall age-adjusted cancer death rate rose during most of the 20th century, peaking in 1991 at 215 cancer deaths per 100,000 people, mainly because of the tobacco epidemic. 

在20世纪的大部分时间里，经年龄调整的整体癌症死亡率上升，在1991年达到每10万人中有215人死于癌症，这主要是由于烟草的流行。

As of 2016, the rate had dropped to 156 per 100,000 (a decline of 27%) because of reductions in smoking, as well as improvements in early detection and treatment. 

到2016年，由于吸烟人数的减少，以及在早期发现和治疗方面的改善，这一比例已经下降到每10万人中有156人(下降了27%)。

This decline translates into more than 2.6 million fewer cancer deaths from 1991 to 2016, progress that has been driven by steady declines in death rates for the four most common cancer types lung, colorectal, breast, and prostate.

这一下降意味着从1991年到2016年，癌症死亡人数减少了260多万，这一进展是由四种最常见的癌症类型——肺癌、结肠直肠癌、乳腺癌和前列腺癌——的死亡率稳步下降所推动的。