The temporal trends of incidence, prevalence, mortality, and disability-adjusted life years of inflammatory bowel disease in the Chinese population aged 0–54 years and prediction to 2030

TL;DR

This study analyzes the rising incidence and prevalence of inflammatory bowel disease in young and middle-aged Chinese populations from 1992 to 2021 and predicts future trends through 2030.

Contribution

The paper provides the first comprehensive analysis of IBD trends in the 0–54 age group in China and offers projections through 2030.

Findings

IBD incidence and prevalence rates increased significantly from 1992 to 2021 in both males and females.

Mortality and disability-adjusted life years decreased during the same period.

Projections suggest continued increases in incidence and prevalence but decreases in mortality and disability by 2030.

Abstract

The Global Burden of Disease (GBD) Study 2021 highlights that the age-standardized incidence rate of inflammatory bowel disease (IBD) in China reaches its peak prior to the age of 55 years, comprehensive analyses of the temporal trends in IBD burden among populations aged 0–54 years remain limited. To address this gap, we quantified the epidemiological trends of IBD in this age stratum from 1992 to 2021 and projected future trends through 2030.

Age-standardized incidence (ASIR), prevalence (ASPR), mortality (ASMR) and disability adjusted life years (ASDR) rates for all ages attributable to IBD, together with the corresponding absolute numbers, were extracted from the GBD 2021database for the period 1992–2021. All metrics were stratified by gender and 5-year age groups. The ASIR, ASPR, ASMR, ASDR were re-estimated using the World Health Organization’s standard population. Temporal trends were analyzed using Joinpoint regression to calculate average annual percentage changes (AAPCs), and an age-period-cohort model was utilized to elucidate the distinct influences of age, period and birth cohort on IBD burden. Finally, autoregressive integrated moving average (ARIMA) models were constructed to forecast ASIR, ASPR, ASMR and ASDR rates for the population aged 0–54 years through 2030.

From 1992 to 2021, IBD affected 227,772 new cases, with 1,530,231 prevalent cases and 17,291 deaths, resulting in a total of 1,264,376 disability-adjusted life years (DALYs) among populations aged 0–54 years. The ASIR exhibited a gradual increase in both males (AAPC = 2.23, 95%CI: 2.09–2.34%, p < 0.001) and females (AAPC = 2.24, 95%CI: 2.09–2.36%, p < 0.001). Similarly, the ASPR also demonstrated an upward trend for males (AAPC = 1.65, 95%CI: 1.52–1.77%, p < 0.001) and females (AAPC = 1.55, 95%CI: 1.40–1.67%, p < 0.001). Conversely, the ASMR and ASDR significantly decreased in both males and females during the same period. The AAPC for ASMR was −3.41% for males (95%CI, −3.67 to −3.21%, p < 0.001) and −5.94% for females (95%CI, −6.10 to −5.77%, p < 0.001). For ASDR, the AAPC was −2.95% for males (95%CI, −3.09 to −2.80%, p < 0.001) and −4.72% for females (95%CI, −4.86 to −4.58%, p < 0.001). The effects of age, period, and cohort on the incidence, prevalence, mortality, and DALYs associated with IBD varied significantly. Projections indicate that by 2030, the ASIR and ASPR are projected to rise, whereas the ASMR and ASDR are expected to decline.

The burden of IBD in China is substantial and continues to intensify among populations aged 0–54 years. To mitigate this growing medical burden, it is imperative to establish a comprehensive three-tiered prevention strategy, promote effective health education, implement early screening programs, ensure timely diagnosis and treatment, and improve the quality of life of individuals living with IBD.

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