Temporal Trends of Inflammatory Bowel Disease Burden in China from 1990 to 2030 with Comparisons to Japan, South Korea, the European Union, the United States of America, and the World

Clin Epidemiol. 2023 May 8:15:583-599. doi: 10.2147/CLEP.S402718. eCollection 2023.

Abstract

Purpose: To identify and predict the epidemiological burden and trends of inflammatory bowel disease (IBD) in China and compare them globally.

Methods: We collected incidence, prevalence, deaths, years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life-years (DALYs), and the age-standardized rates (ASRs) of IBD from 1990 to 2019 in China, four developed countries and the world, from the Global Burden of Disease Study 2019. The average annual percentage change (AAPC) was calculated to evaluate the temporal trends.

Results: From 1990 to 2019, the numbers of incident and prevalent cases, age-standardized incidence rate (ASIR), and age-standardized prevalence rate (ASPR) of IBD increased in China, regardless of gender and age; decreased YLLs and increased YLDs caused a stable number of DALYs; the age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) decreased. In 2019, the ASIR, ASPR, ASMR, and ASDR were 3.01/100,000 person-years (/100,000) (95% UI: 2.59, 3.50), 47.06/100,000 (95% UI: 40.05, 54.99), 0.30/100,000 (95% UI: 0.24, 0.35), and 13.1/100,000 (95% UI: 10.29, 16.31), respectively; almost all disease burden data were higher in males. In 2017, the ASDR in different socio-demographic index provinces ranged from 24.62/100,000 (95% UI: 16.95, 33.81) to 63.97/100,000 (95% UI: 44.61, 91.48). When compared globally, the ASIR and ASPR in China had opposite trends and the highest AAPCs. In 2019, the ASIR and ASPR in China were in the middle of the world and lower than in some developed countries. The numbers and ASRs of incidence, prevalence, and DALYs were expected to increase by 2030.

Conclusion: The IBD burden in China significantly increased from 1990 to 2019 and was expected to rise further by 2030. China had the world's opposite and most dramatic trends in ASIR and ASPR from 1990 to 2019. Strategies should be adjusted to adapt to the significantly increased disease burden.

Keywords: China; disease burden; inflammatory bowel disease; projection; temporal trend.

Grants and funding

This work was supported by the National Key Research and Development Program of China (grant numbers: 2018YFB1307700), the National Natural Science Foundation of China (grant numbers: 82270570 and 82103912), and the Emergency and Critical Care Medicine Program of Clinical Research Center of Shandong University (No. 2021SDUCRCB003); and the China Postdoctoral Science Foundation (2021M700080). The funders were not involved in the collection, analysis, or interpretation of data, or the writing or submitting of this report. The corresponding author had full access to all of the data and the final responsibility to submit it for publication.