Peptic ulcer disease burden, trends, and inequalities in 204 countries and territories, 1990-2019: a population-based study

Zhongmian Zhang; Weitian Yan; Xiyan Zhang; Jiaqi Wang; Zhonghan Zhang; Zili Lin; Lan Wang; Jiaqin Chen; Daming Liu; Wen Zhang; Zhihong Li

doi:10.1177/17562848231210375

Peptic ulcer disease burden, trends, and inequalities in 204 countries and territories, 1990-2019: a population-based study

Therap Adv Gastroenterol. 2023 Nov 14:16:17562848231210375. doi: 10.1177/17562848231210375. eCollection 2023.

Authors

Zhongmian Zhang¹, Weitian Yan², Xiyan Zhang¹, Jiaqi Wang¹, Zhonghan Zhang³, Zili Lin¹, Lan Wang¹, Jiaqin Chen¹, Daming Liu⁴, Wen Zhang⁴, Zhihong Li⁴

Affiliations

¹ Department of Gastroenterology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
² Department of Rheumatology, Yunnan Provincial Hospital of Traditional Chinese Medicine, Yunnan University of Chinese Medicine, Kunming, China.
³ College of Psychology and Mental Health, North China University of Science and Technology, Tangshan, China.
⁴ Department of Gastroenterology, Dongzhimen Hospital, Beijing University of Chinese Medicine, No. 5 Haiyuncang Hutong, Dongcheng District, Beijing 100700, China.

Abstract

Background: Peptic ulcer disease has been a major threat to the world's population, which remains a significant cause of hospitalization worldwide and healthcare resource utilization.

Objectives: We aimed to describe the global burden, trends, and inequalities of peptic ulcer disease.

Design: An observational study was conducted.

Methods: In this secondary analysis of the Global Burden of Disease, Injuries, and Risk Factors Study 2019, we extracted data for age-standardized incidence rates (ASIRs), disability-adjusted life year rates (ASDRs), and mortality rates (ASMRs); then, we stratified by age, level of regionals, and country; subsequently, we calculated estimated annual percentage changes (EAPC) of ASIR, ASDR, ASMR, and quantified cross-country inequalities in peptic ulcer disease mortality.

Results: Globally, ASIR showed a continuous downward trend, from 63.84 in 1990 to 44.26 per 100,000 population in 2019, with an annual decrease of 1.42% [EAPC = -1.42 (95% CI: -1.55 to -1.29)]. ASDR showed a continuing downward trend, and the EAPC was -3.47% (-3.58 to -3.37). ASMR showed a persistent decline, declining by nearly half in 2019 compared to 1990 (3.0 versus 7.39 per 100,000 population), with an annual decrease of 2.55% [EAPC = -3.36 (95% CI: -3.47 to -3.25)]. A significant reduction in sociodemographic index (SDI)-related inequality, from an excess of 190.43 disability-adjusted life years (DALY) per 100,000 (95% CI: -190.83 to -190.02) between the poorest and richest countries in 1990 to 62.85 DALY per 100,000 (95% CI -62.81 to -62.35) in 2019.

Conclusion: Global peptic ulcer disease morbidity and mortality rates decreased significantly from 1990 to 2019. These health gains were in accordance with a substantial reduction in the magnitude of SDI-related inequalities across countries, which is paired with overall socioeconomic and health improvements observed in the region.

Keywords: Global Burden of Disease; age-standardized DALYs rates; age-standardized incidence rates; age-standardized mortality rates; inequalities; peptic ulcer disease.