Observational Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 14, 2023; 29(42): 5751-5767
Published online Nov 14, 2023. doi: 10.3748/wjg.v29.i42.5751
Global burden of inflammatory bowel disease 1990-2019: A systematic examination of the disease burden and twenty-year forecast
Cheng-Jun Li, Yi-Kai Wang, Shun-Ming Zhang, Mu-Dan Ren, Shui-Xiang He
Cheng-Jun Li, Mu-Dan Ren, Shui-Xiang He, Department of Gastroenterology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Yi-Kai Wang, Department of Infectious Diseases, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710004, Shaanxi Province, China
Shun-Ming Zhang, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, Shaanxi Province, China
Author contributions: Li CJ and He SX conceptualized and designed the study; Zhang SM and Ren MD collected the data; Li CJ and Wang YK analyzed and interpreted the data; Li CJ wrote this paper; and all authors have read and approved the final manuscript.
Supported by the Key Research and Development Program of Shaanxi, No. 2021ZDLSF02-06.
Institutional review board statement: The study was wavied by the IRB of the First Affiliated Hospital of Xi’an Jiaotong University due to all the data used in this study were from the Global Burden of Diseases (GBD) 2019 database. This database comprises publicly accessible data, freely available in an open-access repository, ensuring that all information used was already in the public domain.
Informed consent statement: There was no requirement to give informed consent in this study, because all the data used in this study were from the Global Burden of Diseases (GBD) 2019 database. This database comprises publicly accessible data, freely available in an open-access repository, ensuring that all information used was already in the public domain.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Dataset can be available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shui-Xiang He, PhD, Professor, Department of Gastroenterology, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277 Yanta West Road, Xi’an 710061, Shaanxi Province, China. dyyyjxk@mail.xjtu.edu.cn
Received: July 25, 2023
Peer-review started: July 25, 2023
First decision: September 30, 2023
Revised: October 13, 2023
Accepted: October 30, 2023
Article in press: October 30, 2023
Published online: November 14, 2023
Processing time: 107 Days and 14.7 Hours
Abstract
BACKGROUND

Inflammatory bowel disease (IBD) is an idiopathic intestinal disease with various levels and trends in different countries and regions. Understanding the current burden and trends of IBD in various geographical locations is essential to establish effective strategies for prevention and treatment. We report the average annual percentage change (AAPC) and estimated annual percentage change (EAPC) in age-standardized rates (ASR) of IBD in different regions based on the Global Burden of Disease (GBD) study from 1990-2019, and the relationships between IBD and the human development index (HDI) and socio-demographic index (SDI). The prevalence trends of IBD were predicted by gender from 2019-2039.

AIM

To comprehensively investigate IBD data, providing further insights into the management of this chronic disease.

METHODS

We collected the information on the incidence of IBD from the GBD study from 1990-2019 to calculate the AAPC and EAPC in ASR of IBD in different regions. The relationships between IBD, HDI, and SDI were analyzed. The Nordpred and Bayesian age-period-cohort models were used to predict the prevalence trends of IBD by gender from 2019-2039, and the reliability of the results was validated. Statistics of all the data in this study were performed using R software (version 4.2.1).

RESULTS

North America consistently had the highest IBD ASR, while Oceania consistently had the lowest. East Asia had the fastest average annual growth in ASR (2.54%), whereas Central Europe had the fastest decline (1.38%). Countries with a low age-standardized incidence rates in 1990 showed faster growth in IBD while there was no significant correlation in 2019. Additionally, IBD increased faster in countries with a low age-standardized death rates in 1990, whereas the opposite was true in 2019. Analysis of SDI and IBD ASR showed that countries with a high SDI generally had a higher IBD ASR. Finally, the projections showed a declining trend in the incidence of IBD from 2019-2039, but a gradual increase in the number of cases.

CONCLUSION

As the global population increases and ages, early monitoring and prevention of IBD is important to reduce the disease burden, especially in countries with a high incidence of IBD.

Keywords: Inflammatory bowel disease; Incidence; Average annual percentage change; Age-standardized rates; Prevalence trends; Global Burden of Disease

Core Tip: This study comprehensively analyzed the burden of inflammatory bowel disease (IBD) from 1990 to 2019 at the global, regional, and national levels. The association and significance of various demographic indicators were analyzed in different areas. Furthermore, the number and incidence rate of IBD for the next twenty years (from 2019 to 2039) were predicted and validated based on the R software. This study provides new hypotheses for the management of IBD to alleviate the global burden of this chronic disease.