Global Burden of Peptic Ulcer Disease (1990-2021) and Projections to 2050: A Comprehensive Analysis of Age, Sex, and Socioeconomic Disparities.

backgroundPeptic ulcer disease (PUD) represents an ongoing global public health concern and is responsible for significant illness and mortality. Despite considerable advancements in medical therapy, the distribution and overall burden of PUD vary substantially across different regions and population segments worldwide. This research provides a comprehensive analysis of the global PUD burden, examining trends from 1990 to 2021 and forecasting patterns until 2050. The findings of this research, which use the most up-to-date epidemiological data available, are significant for epidemiology and disease management.

methodsWe leveraged data from the Global Burden of Disease (GBD) 2021 study, which covers 195 countries and territories. Our analysis assessed key metrics of disease impact, including disability-adjusted life years (DALYs), mortality rates, incidence and prevalence data, years lived with disability (YLDs), and years of life lost (YLLs). We calculated age-standardized rates (ASRs) to allow for consistent comparisons across populations. Temporal changes were quantified using estimated annual percentage changes (EAPCs) derived from linear regression. Furthermore, we applied hierarchical cluster analysis to investigate regional patterns in the PUD burden. These methods were chosen because of their robustness and ability to provide a comprehensive understanding of the global burden of PUD.

resultsPUD was responsible for an estimated 6.06 million DALYs in 2021 (ASR: 71.56 per 100,000). This burden increased substantially with advancing age, peaking among individuals aged 80 and above. Compared with females, males had higher DALY rates (ASR: 87.02 vs 57.05 per 100,000) and considerably higher mortality rates. Regions with low and low-middle sociodemographic index (SDI) presented the highest ASRs (e.g., 178.38 per 100,000 in low-SDI areas). The highest DALY rates were observed in South Asia and parts of sub-Saharan Africa. Between 1990 and 2021, the global DALY ASR decreased markedly (EAPC: -2.96), though absolute DALY numbers remained elevated in populous, low- to middle-SDI regions. Model-based projections (exponential smoothing and ARIMA), assuming the continuation of recent trends, suggest that ASRs may continue to decline through 2050.

conclusionsOver the past three decades, the global age-standardized burden of PUD has markedly decreased. However, significant challenges remain, particularly for older adults, males, and individuals in low-SDI areas, such as South Asia and sub-Saharan Africa. Although forecasts suggest further reductions in ASRs, the overall burden, influenced by population changes, underscores the crucial need for ongoing, targeted prevention and control efforts. This should prioritize Helicobacter pylori detection and eradication, safer NSAID use with gastroprotection in high-risk patients, and improved access to timely diagnosis and emergency care for ulcer complications in low-SDI regions. These efforts should focus on high-risk groups and regions to ensure equitable progress and should be a priority for all healthcare professionals, researchers, and public health policymakers.