Changes in Noncommunicable Diseases Burden in Montenegro: Global Burden of Disease 2021

Abstract Background The objective of this study was to analyze the burden of non-communicable diseases (NCDs) in Montenegro (ME), using Global Burden of Disease (GBD) 2021 estimates. The results for 2021 were then compared to those from 1990, for 5 neighboring Western Balkan countries (WB5), which share high burden of NCDs, notably cancer and cardiovascular disease, with mortality rates higher than those of the EU. Methods We extracted the results of the GBD 2021 study using GBD results tool. We analyzed changes in NCDs from 1990 to 2021 in ME and compared the results with those of the WB5 for the main causes of death and disability, through averages of all six countries and individual countries ranking. Results ME performed significantly worse in 2021 compared to 1990 in age-standardized YLL, YLD and DALY rates. DALY for NCDs increased by 41% for men and 44% for women. This increase was primarily due to the rise in YLLs (+7,267/100,000 in men; +6,549/100,000 in women), followed by the contribution of YLDs (+2,207/100,000 in men; +3,206/100,000 in women). Compared to the WB5, ME DALY ranking for NCDs in 2021 was worse than in 1990. In 2021, the YLD rates for NCDs in ME were lower than the comparator countries average, but YLL and DALY rates were higher. Ischemic heart disease (+1,021 DALYs/100,000) and stroke (+550 DALYs/100,000) had the highest DALY rates in men, while stroke (+1,118 DALYs/100,000) was the highest in women. Tracheal, bronchus and lung cancer had high rates in both, men (+537 DALYs/100,000) and women (+190 DALYs/100,000), while breast cancer in women (+181 DALYs/100,000). Conclusions NCDs burden in ME increased between 1990 and 2021, primarily due to an increase in mortality. This has contributed to a decline in its ranking among comparator countries in terms of DALY rates for NCDs. Considering that the diseases with the highest burden are preventable, strategies for prevention and early detection should be integrated into routine primary healthcare activities. Key messages • Ischemic heart disease and stroke are leading contributors to the NCDs burden in Montenegro. • Investing in targeted prevention strategies is crucial to reducing the NCDs burden.