Global burden, trends, and projections of five major upper gastrointestinal diseases, 1990–2046: an analysis of GBD 2021
- 1Department of Gastroenterology, The Second Affiliated Hospital of Xi’an Jiaotong University
- 2Key Laboratory of Gastrointestinal Motility Disorders of Shaanxi Province (Digestive Disease Laboratory, The Second Affiliated Hospital of Xi’an Jiaotong University), Xi’an Jiaotong University
- 3Bioinspired Engineering and Biomechanics Center (BEBC), Xi’an Jiaotong University
Abstract
Background: Upper gastrointestinal (GI) diseases, including gastroesophageal reflux disease (GERD), peptic ulcer disease (PUD), gastritis and duodenitis (GD), stomach cancer, and esophageal cancer, pose significant global health and economic challenges. This study analyzes their trends, regional disparities, risk factors, and future projections from 1990 to 2046.
Methods: Using the 2021 Global Burden of Disease database, we analyzed incidence, prevalence, mortality, and disability-adjusted life years (DALYs) across 204 countries, 21 regions, and five Socio-demographic Index (SDI) levels. Temporal trends were assessed with estimated annual percentage change and joinpoint regression. Decomposition analysis evaluated the contributions of population growth, aging, and epidemiological changes to changes in absolute disease burden. Risk-attributable fractions identified socioeconomic and behavioral factors, and Bayesian models projected future burdens.
Results: From 1990 to 2021, global burdens of PUD, GD, stomach cancer, and esophageal cancer decreased, while GERD increased, particularly in middle SDI regions. Regional and sex disparities persisted, with higher burdens in lower SDI areas. Aging drove absolute disease burden in high-middle SDI regions, while population growth dominated in lower SDI regions. Smoking and alcohol significantly contributed to upper GI cancers. Projections suggest continued GERD increases and a modest PUD rebound, especially in aging and resource-limited populations.
Conclusion: Evolving upper GI disease patterns highlight persistent health inequities. Targeted public health interventions are essential to mitigate future burdens and promote equitable digestive health outcomes globally.
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BibTeX
@article{liang2026global,
title = {{Global burden, trends, and projections of five major upper gastrointestinal diseases, 1990–2046: an analysis of GBD 2021}},
author = {Xiru Liang and Yutong Cheng and Qiuai Shu and Ziwei Wang and Haitao Shi and Ning Xie and Yan Cheng},
journal = {Frontiers in Public Health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1898446},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1898446/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Global burden, trends, and projections of five major upper gastrointestinal diseases, 1990–2046: an analysis of GBD 2021
AU - Xiru Liang
AU - Yutong Cheng
AU - Qiuai Shu
AU - Ziwei Wang
AU - Haitao Shi
AU - Ning Xie
AU - Yan Cheng
PY - 2026
DA - 2026/10/15
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1898446
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1898446/full
AB - Background: Upper gastrointestinal (GI) diseases, including gastroesophageal reflux disease (GERD), peptic ulcer disease (PUD), gastritis and duodenitis (GD), stomach cancer, and esophageal cancer, pose significant global health and economic challenges. This study analyzes their trends, regional disparities, risk factors, and future projections from 1990 to 2046. Methods: Using the 2021 Global Burden of Disease database, we analyzed incidence, prevalence, mortality, and disability-adjusted life years (DALYs) across 204 countries, 21 regions, and five Socio-demographic Index (SDI) levels. Temporal trends were assessed with estimated annual percentage change and joinpoint regression. Decomposition analysis evaluated the contributions of population growth, aging, and epidemiological changes to changes in absolute disease burden. Risk-attributable fractions identified socioeconomic and behavioral factors, and Bayesian models projected future burdens. Results: From 1990 to 2021, global burdens of PUD, GD, stomach cancer, and esophageal cancer decreased, while GERD increased, particularly in middle SDI regions. Regional and sex disparities persisted, with higher burdens in lower SDI areas. Aging drove absolute disease burden in high-middle SDI regions, while population growth dominated in lower SDI regions. Smoking and alcohol significantly contributed to upper GI cancers. Projections suggest continued GERD increases and a modest PUD rebound, especially in aging and resource-limited populations. Conclusion: Evolving upper GI disease patterns highlight persistent health inequities. Targeted public health interventions are essential to mitigate future burdens and promote equitable digestive health outcomes globally.
SN - 2296-2565
ER -