Trends and Future Predictions of the Global Burden of Non-Malignant Upper Gastrointestinal Diseases

Academic Background

Non-malignant upper gastrointestinal diseases, including Peptic Ulcer Disease (PUD), Gastritis and Duodenitis (GD), and Gastroesophageal Reflux Disease (GERD), pose significant challenges to global healthcare systems. These conditions not only impact patient health but also highlight issues related to socioeconomic development and the accessibility and efficiency of healthcare systems. Despite the high prevalence of these diseases worldwide, their burden varies significantly across regions, ages, and genders. To better understand the global burden of these diseases and their relationship with the Sociodemographic Index (SDI), researchers utilized the Global Burden of Disease (GBD) database to comprehensively assess the global burden of PUD, GD, and GERD from 1990 to 2019 and forecast trends for the next decade.

Source of the Paper

The study was conducted by Zihao Bai, Hao Wang, Chong Shen, Jia An, Zhaocong Yang, and Xuming Mo from Nanjing Children’s Hospital and the Department of Cardiothoracic Surgery at Nanjing Medical University. The paper was published online on July 3, 2024, in the International Journal of Surgery, titled “The global, regional, and national patterns of change in the burden of nonmalignant upper gastrointestinal diseases from 1990 to 2019 and the forecast for the next decade.”

Research Process

Data Sources and Methods

The study data were sourced from the GBD 2019 database, which integrates various data sources, including censuses, household surveys, disease registries, and healthcare utilization records. Researchers extracted Disability-Adjusted Life Years (DALYs) data for PUD, GD, and GERD and conducted health inequality analyses in conjunction with the SDI. The study employed the Inequality Slope Index and the Concentration Index to measure disparities in disease burden across countries. Additionally, decomposition analysis was performed to assess the contributions of population growth, aging, and epidemiological changes to the disease burden.

Research Findings

Global Changes in Disease Burden

The study found that from 1990 to 2019, the age-standardized DALYs rates for non-malignant upper gastrointestinal diseases declined globally, but significant geographic heterogeneity remained, closely linked to the SDI. Low-SDI countries experienced higher disease burdens, with population growth and aging identified as the primary drivers of the increasing burden. Despite varying development levels, many countries still have considerable potential to reduce the burden of these diseases.

Inequality Analysis of Disease Burden

The study revealed that the burden of PUD was most pronounced in low-SDI countries, although its inequality decreased from 1990 to 2019. In contrast, GERD exhibited the least health inequality, which remained relatively stable over the past few decades. The burden of GD was particularly high in low-middle-SDI countries.

Future Predictions

Using the Bayesian Age-Period-Cohort Model (BAPC), the study projected that by 2030, global DALYs for PUD would decrease by 11.7%, while DALYs for GERD and GD would increase by 21.3% and 13.2%, respectively. Significant variations in disease burden trends were observed across different SDI regions, with high-SDI regions expected to see an increase in GERD burden, while low-SDI regions would experience a notable decline in PUD burden.

Conclusions and Significance

The study provides a comprehensive assessment of the global burden of non-malignant upper gastrointestinal diseases, revealing significant disparities across regions, ages, and genders. The findings indicate that while the global disease burden has declined, it remains high in low-SDI countries, necessitating targeted prevention and treatment strategies for high-risk groups. Additionally, the study underscores the profound impact of population growth and aging on disease burden, offering valuable insights for future public health policy development.

Research Highlights

1. Global Perspective: The study covers 204 countries and regions, offering a comprehensive evaluation of the global burden of non-malignant upper gastrointestinal diseases.
2. Health Inequality Analysis: By incorporating the SDI, the study highlights significant disparities in disease burden across different socioeconomic contexts.
3. Future Predictions: Using the BAPC model, the study forecasts disease burden trends for the next decade, providing forward-looking guidance for public health policy formulation.
4. Decomposition Analysis: The study quantifies the contributions of population growth, aging, and epidemiological changes to disease burden, offering new perspectives on the mechanisms driving these changes.

Additional Valuable Information

The study also notes that while the global burden of PUD and GD has declined, the burden of GERD continues to rise, particularly in high-SDI regions. This suggests that current public health strategies need improvement in controlling GERD. Furthermore, the study emphasizes the importance of strengthening global and regional collaboration, improving access to diagnostic and treatment services, and developing targeted health interventions for high-risk groups.

This research provides new insights into the global burden of non-malignant upper gastrointestinal diseases and offers critical references for the formulation and implementation of future public health policies.