The burden of young-onset pancreatic cancer and its risk factors from 1990 to 2019: A systematic analysis of the global burden of disease study 2019.

OBJECTIVE: To investigate worldwide incidence, deaths, disability-adjusted life years (DALYs) and risk factors for young-onset pancreatic cancer (YOPC) using the Global Burden of Disease Study 2019-20 data. METHODS: We queried the Global Health Data Exchange tool for "pancreatic cancer" and "incidence", "deaths" as the "measure", and "DALYs" as the "cause" for the age group of 15-49 years to determine global, regional, and national trends in the incidence, deaths, and DALYs of YOPC. Sociodemographic index (SDI) was used to evaluate the associations between socioeconomic development and YOPC. Risk factors including smoking, tobacco use, hi2gh body mass index (BMI), and high fasting plasma glucose (FPG) were evaluated, and their attributable burden was estimated. RESULTS: Global incidence, death, and DALY rates of YOPC significantly increased from 1990 to 2019 ((0.30 (p = 0.001), 0.25 (p = 0.001), and 11.18 (p = 0.002), respectively). Regions with the highest and lowest incidence, death, and DALY rates of YOPC were Eastern Europe and Central Sub-Saharan Africa, respectively. Incidence, death, and DALY rates increased with increasing age and SDI. Leading risk factors for YOPC in 2019 were smoking and tobacco use. DALYs attributable to smoking and tobacco use decreased from 1990 to 2019, especially in females, while those attributable to high BMI and FPG increased during the same period. CONCLUSIONS: The global incidence, death and DALY rates of YOPC have significantly increased over 3 decades. Certain regions and nations are witnessing a higher increase in this trend. There is an urgent need for global efforts targeting preventable causes of YOPC.

Access Clinic: A student-run clinic model to address gaps in the healthcare needs of the homeless population in Adelaide.

BACKGROUND: The average life expectancy of people who are homeless is approximately 20 years lower than the general population. Lack of access to healthcare is one of the key contributors to the increased morbidity and mortality. OBJECTIVE: The aim of this article is to describe a student-run clinic that was established at a homeless shelter in Adelaide, Australia, to improve healthcare access for individuals who are homeless. DISCUSSION: By enhancing the target population's health literacy, the clinic functioned as a bridge between healthcare services and individuals experiencing homelessness who were disengaged from society. Such clinics, if encouraged, can foster a symbiotic relationship where students learn clinical medicine while gaining experience in providing healthcare to vulnerable individuals, and individuals who are homeless can access much-needed services in an environment they already engage with and feel safe in.