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. 2022 Feb 10;22(1):58.
doi: 10.1186/s12876-022-02130-2.

The global, regional and national burden of peptic ulcer disease from 1990 to 2019: a population-based study

Xin Xie  1   2 , Kaijie Ren  1 , Zhangjian Zhou  3 , Chengxue Dang  1   4 , Hao Zhang  5   6
Affiliations

The global, regional and national burden of peptic ulcer disease from 1990 to 2019: a population-based study

Xin Xie et al. BMC Gastroenterol. .

Abstract

Background: Peptic ulcer disease (PUD) is a common digestive disorder, of which the prevalence decreased in the past few decades. However, the decreasing tendency has plateaued in recent years due to changes in risk factors associated with the etiology of PUD, such as non-steroidal anti-inflammatory drug use. In this study, we investigated the epidemiological and the sociodemographic characteristics of PUD in 204 countries and territories from 1990 to 2019 based on data from the Global Burden of Disease, Injuries and Risk Factors (GBD) Study.

Methods: Demographic characteristics and annual prevalence, incidence, mortality, disability-adjusted life years (DALYs) and age-standardized death rate (ASR) data associated with PUD were obtained and analyzed. According to the sociodemographic index (SDI), the numbers of patients, ASRs, estimated annual percentage changes and geographical distributions were assessed with a generalized linear model and presented in world maps. All evaluations of numbers and rates were calculated per 100,000 population with 95% uncertainty intervals (UIs).

Results: In 2019, the global prevalence of PUD was approximately 8.09 [95% UI 6.79-9.58] million, representing a 25.82% increase from 1990. The age-standardized prevalence rate was 99.40 (83.86-117.55) per 100,000 population in 2019, representing a decrease of 143.37 (120.54-170.25) per 100,000 population from 1990. The age-standardized DALY rate in 2019 was decreased by 60.64% [74.40 (68.96-81.95) per 100,000 population] compared to that in 1990. In both sexes, the numbers and ASRs of the prevalence, incidence, deaths and DALYs were higher in males than in females over 29 years. Regionally, South Asia had the highest age-standardized prevalence rate [156.62 (130.58-187.05) per 100,000 population] in 2019. A low age-standardized death rate was found in the high-income super-region. Among nations, Kiribati had the highest age-standardized prevalence rate [330.32 (286.98-379.81) per 100,000 population]. Regarding socioeconomic status, positive associations between the age-standardized prevalence, incidence, death rate, DALYs and SDI were observed globally in 2019.

Conclusions: Morbidity and mortality due to PUD decreased significantly from 1990 to 2019, while a gradual upward inclination has been observed in recent 15 years, which might be associated with changes in risk factors for PUD. Attention and efforts by healthcare administrators and society are needed for PUD prevention and control.

Keywords: Disease burden; Global Burden of Disease; Injuries and Risk Factors Study; Peptic ulcer disease; Sociodemographic characteristics.

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Conflict of interest statement

All authors declare that they have no conflicts of interests.

Figures

Fig. 1
Fig. 1
Prevalence rates and deaths with age-standardized rate changes in all years from 1990 to 2019. a The numbers of prevalent cases and age-standardized prevalence rates in males and females. b The numbers of deaths and age-standardized death rates in males and females
Fig. 2
Fig. 2
Prevalent and incident cases with age-standardized rate changes in 2019. a The numbers of prevalent cases and age-standardized prevalence rates in males and females. b The numbers of incident cases and age-standardized death rates in males and females
Fig. 3
Fig. 3
Distribution of age-standardized prevalence rates and EAPCs in age-standardized prevalence rates of PUD globally. a The age-standardized prevalence rate (per 100,000 population) in both sexes globally in 2019. b The EAPC in the age-standardized prevalence rate in both sexes globally from 1990 to 2019. Maps in Fig. 3 were designed and plotted by ArcGIS (version 9.0). ATG Antigua and Barbuda, BRB Barbados, COM Comoros, DMA Dominica, FJI Fiji, FSM Federated States of Micronesia, GRD Grenada, KIR Kiribati, LCA Saint Lucia, MDV Maldives, MHL Marshall Islands, MLT Malta, MUS Mauritius, SGP Singapore, SLB Solomon Islands, SYC Seychelles, TLS Timor-Leste, TON Tonga, TTO Trinidad and Tobago, VCT Saint Vincent and the Grenadines, VUT Vanuatu, WSM Samoa
Fig. 4
Fig. 4
Trends of age-standardized prevalence and death rates (per 100,000 population) in 21 GBD regions by SDI from 1990 to 2019. a Trends of age-standardized prevalence rates; b trends of age-standardized death rates by SDI
Fig. 5
Fig. 5
Age-standardized prevalence rates (per 100,000 population) of PUD in 204 countries globally by SDI in 2019. The gray line represents the expected age-standardized prevalence rate based on the SDI in 2019
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