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
ARTICLE HIGHLIGHTS
Research background

Inflammatory bowel disease (IBD) is an intestinal inflammatory disorder of unknown origin with a prevalence that varies across different countries and regions. To develop effective strategies for the prevention and treatment of IBD, a comprehensive understanding of the current burden and distinct trends in various geographical areas are crucial. There is a scarcity of research for the prediction of the global burden of IBD and future epidemiological trends.

Research motivation

Data from the Global Burden of Disease (GBD) database 2019 were used to assess the burden of IBD across 204 countries and regions using various indicators from 1990-2019. Previous studies lacked the use of specific models for forecasting future trends in IBD and did not validate the reliability of their findings. Our findings offer new insights regarding the management of IBD.

Research objectives

This study aimed to conduct a thorough investigation of IBD data and predict future epidemiological trends to provide the latest estimates of the global burden of IBD and improve the management strategies.

Research methods

The incidence data for IBD were collected from the GBD study from 1990-2019. The average annual percentage change and estimated annual percentage change (EAPC) in age-standardized rates (ASR) of IBD were calculated for various regions. The relationships among IBD, the human development index, and the socio-demographic index (SDI) were analyzed. The Nordpred and Bayesian age-period-cohort models were used to predict the prevalence trends of IBD from 2019-2039.

Research results

North America consistently maintained the highest IBD ASR, while Oceania consistently had the lowest ASR. East Asia had the fastest average annual growth in ASR (2.54%), whereas Central Europe had the most rapid decline (1.38%) in ASR. Nations that had low age-standardized incidence rates in 1990 exhibited accelerated IBD growth, although no significant correlation was observed in 2019. Additionally, IBD grew faster in countries with low age-standardized death rates in 1990, whereas the opposite was true in 2019. An examination of the SDI and IBD ASR revealed that countries with a high SDI generally exhibited a higher IBD ASR. Finally, the projections indicated a decreasing trend in IBD incidence from 2019-2039 but a gradual increase in the total number of cases.

Research conclusions

IBD poses a substantial disease burden globally, particularly in regions with higher SDI scores, which are associated with increased IBD incidence. Nevertheless, in recent years, the incidence of IBD has rapidly increased in emerging industrialized and developing nations. Therefore, it is imperative to prioritize the prevention, management, and reduction of IBD cases, with particular consideration for the associated factors.

Research perspectives

The investigation of regional variations in the incidence of IBD is required, and it is imperative to investigate the associations between IBD and various risk factors.