Global, regional, and national burden of nonmalignant digestive diseases, 1990-2023: a systematic analysis from the GBD study 2023.

BACKGROUND

This study assesses the global burden of 21 digestive diseases using data from the Global Burden of Disease (GBD) 2023 study.

METHODS

We analyzed prevalence, incidence, deaths, and disability-adjusted life years (DALYs) by calculating age-standardized rates (ASRs), examining temporal trends, and evaluating associated risk factors.

RESULTS

In 2023, the global age-standardized DALY rate (ASDR) for digestive diseases was 1017.15 (95% uncertainty interval [UI] [905.18, 1124.33] per 100,000, with an age-standardized mortality rate (ASMR) of 27.18 [24.26, 30.06]. Cirrhosis and other chronic liver diseases followed, with an ASDR of 487.22 [430.22, 548.90] and an ASMR of 14.27 [12.73, 15.97]. Gastroesophageal reflux disease (GERD) was the only cause that presented upward trends in total percent change (TPC). The highest incidence of digestive diseases was observed in the United States Virgin Islands (9304.43 in 2023), while Egypt recorded the highest burden of cirrhosis (1389.31 in 2023). ASDR peaked among infants (<1 year) and older adults (≥95 years). Males aged 30-94 years carried a disproportionately high burden of cirrhosis, indicating an urgent need for age- and sex-specific interventions. For the ASDR of overall digestive diseases, metabolic risks-primarily high body mass index (BMI)-demonstrated notable regional variation. Middle and high-middle Socio-demographic Index (SDI) regions aligned with the global average (approximately 34 per 100,000), while low and low-middle SDI regions remained significantly lower (around 16 per 100,000).

CONCLUSION

The declining trend in alcohol-related digestive diseases contrasts sharply with the rising burden of conditions driven by metabolic risks, such as NAFLD and GERD. Targeted interventions are urgently needed to address the high burden of common gastrointestinal disorders in high-risk regions and aging populations, as well as cirrhosis among middle-aged and younger men.