The burden of inflammatory bowel disease in Asia (1990-2023) and projections to 2050: A comprehensive analysis of the 2023 global burden of disease study.

backgroundInflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), is becoming an increasingly important public health concern in Asia, with rising incidence and prevalence reported across the region. Despite progress in global burden studies, data gaps remain in Asia due to variations in healthcare and socio-demographic factors. This study aims to address these gaps by assessing the burden of IBD across Asia from 1990 to 2023, focusing on regional trends in UC and CD.

methodWe utilized data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023, focusing on the incidence, disability-adjusted life years (DALYs), prevalence, and mortality of IBD, UC, and CD across 47 Asian countries, which were categorized into five sub-regions: East Asia, Southeast Asia, South Asia, Central Asia, and West Asia. Temporal trends in age-standardized incidence, prevalence, DALY, and mortality rates for IBD, UC, and CD were analyzed by age, sex, and Socio-Demographic Index (SDI), calculating the estimated annual percentage changes(EAPC). Non-seasonal autoregressive integrated moving average (ARIMA) models selected using the corrected Akaike information criterion (AICc) were used to project age-standardized incidence, prevalence, and mortality rates through 2050. Out-of-sample validation was performed using 1990-2019 as the training period and 2020-2023 as the validation period. OUTCOME: In 2023, Asia recorded 160,998 new cases of IBD (age-standardized incidence rate: 3.42 per 100,000), with a total of 568,342 DALYs (age-standardized DALY rate: 12.08 per 100,000). The prevalence of IBD reached 1,395,394 cases (age-standardized prevalence rate: 29.69 per 100,000), and there were 13,905 deaths (age-standardized mortality rate: 0.30 per 100,000). From 1990 to 2023, the age-standardized incidence and prevalence rates of IBD increased by 1.95% annually, while the age-standardized DALY rate decreased by 0.19% annually. The age-standardized mortality rate remained broadly stable, with a slight annual decrease of 0.13%. Higher SDI was associated with a higher age-standardized prevalence rate, whereas associations with incidence, DALYs, and mortality were not significant after multiple-testing correction. The projections suggested continued increases in incidence and prevalence through 2050, whereas mortality rates remained broadly stable. Sensitivity analyses supported the robustness of the increasing incidence and prevalence trends, while DALY- and mortality-related findings were less stable. Out-of-sample validation suggested that the ARIMA models generally reproduced the broad direction of recent trends, although prediction performance varied across measures.

conclusionFrom 1990 to 2023, the incidence and prevalence of IBD in Asia have risen significantly, which may result in considerable social and economic challenges for healthcare systems and governments in the future. These findings emphasize the importance of policy makers adopting strategies to address the increasing burden of IBD, such as training specialized healthcare professionals to manage this complex disease.