# Trends in the burden of gastroesophageal reflux disease in China and Global from 1990 to 2021 and predictive analysis for 2040

**Authors:** Zexu Tang, Zelin Chen, Yongjian Huang, Jinwen Fang, Xiangyang Yang, Chunzhu Li, Huiying Zhang, E. Xie, Devesh Kapoor, Devesh Kapoor, Devesh Kapoor, Devesh Kapoor, Devesh Kapoor

PMC · DOI: 10.1371/journal.pone.0341619 · PLOS One · 2026-02-02

## TL;DR

This study examines how the burden of GERD in China changed from 1990 to 2021 and predicts future trends up to 2040.

## Contribution

The study provides new insights into the declining GERD burden in China versus global increases and projects future disease trends.

## Key findings

- China showed declining GERD incidence, prevalence, and DALYs from 1990 to 2021, unlike global trends.
- GERD burden was higher in females and increased with age, especially among middle-aged and elderly.
- Projections suggest a continued rise in GERD burden in China by 2040.

## Abstract

This study analyzed the temporal trends in the age- and gender-specific disease burden of gastroesophageal reflux disease (GERD) in China from 1990 to 2021, comparing its incidence, prevalence, and disability-adjusted life years (DALYs) with global estimates.

Data were extracted from the Global Burden of Disease (GBD) database 1990–2021. The Joinpoint regression model was used to quantify trends via annual average percentage change (AAPC) and 95% confidence intervals. Multidimensional comparisons were conducted by age, gender, and time.

From 1990 to 2021, China exhibited declining trends in age-standardized incidence, prevalence, and DALYs rates for GERD, in contrast to increasing trends globally. Disease burden was higher among females and increased with age, with the middle-aged and elderly experiencing the greatest rise. Projections indicate a continued increase in GERD burden in China by 2040.

Despite recent declines, GERD remains a significant public health challenge in China due to its large population and rapid aging. Targeted prevention and intervention strategies are urgently needed.

## Linked entities

- **Diseases:** gastroesophageal reflux disease (MONDO:0007186), GERD (MONDO:0007186)

## Full-text entities

- **Genes:** APC (APC regulator of Wnt signaling pathway) [NCBI Gene 324] {aka BTPS2, DESMD, DP2, DP2.5, DP3, GS}
- **Diseases:** GBD (MESH:D001037), heartburn (MESH:D006356), Cancer (MESH:D009369), ORCID iD (MESH:C535742), hiatal hernia (MESH:D006551), AAPC (MESH:D009402), obesity (MESH:D009765), esophageal strictures (MESH:D004940), gastrointestinal symptoms (MESH:D012817), mucosal injury (MESH:D052016), perforations (MESH:D057112), strictures (MESH:D003251), BAPC (MESH:D010505), digestive disease (MESH:D004066), ACADEMIC EDITOR (MESH:D007859), refractory (MESH:D000069279), anxiety (MESH:D001007), inflammation[49 (MESH:D007249), gastrointestinal disorder (MESH:D005767), acid regurgitation (MESH:D008944), Depression (MESH:D003866), motility disorders (MESH:D015835), injuries (MESH:D014947), GERD[37 (MESH:D005764), esophageal mucosal injury (MESH:D004941), Death (MESH:D003643), cardiovascular disease (MESH:D002318), Burden of Disease (MESH:D004194)
- **Chemicals:** PONE-D-25-31063R3 (-), fat (MESH:D005223), salt (MESH:D012492), sugar (MESH:D000073893), glycemia (MESH:D001786), Alcohol (MESH:D000438)
- **Species:** Homo sapiens (human, species) [taxon 9606], Nicotiana tabacum (American tobacco, species) [taxon 4097]
- **Cell lines:** 284-293 — Homo sapiens (Human), Transformed cell line (CVCL_0045), Line 86-96 — Homo sapiens (Human), Lung large cell carcinoma, Cancer cell line (CVCL_6757)

## Full text

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## Figures

6 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12863522/full.md

## References

55 references — full list in the complete paper: https://tomesphere.com/paper/PMC12863522/full.md

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Source: https://tomesphere.com/paper/PMC12863522