Global burden of inflammatory bowel disease in Asia, 1990-2023: A global burden of disease study 2023
Hayoon Jung, Jaehee Yoon, Jaeyu Park, Yejun Son, Tae H. Kim, Dong K. YonAbstract
Background:
The burden of inflammatory bowel disease (IBD) is increasing rapidly across Asia, yet country-level evidence by subtype, age, and sex remains limited. Thus, we aimed to investigate long-term burdens and regional disparities in IBD burden across 34 Asian countries.
Methods:
Using the Global Burden of Disease Study (GBD) 2023 estimates, we assessed the burden of IBD, including ulcerative colitis (UC) and Crohn’s disease (CD), across 34 countries in five Asian regions, from 1990 to 2023. IBD was defined using International Classification of Diseases, Tenth Revision (ICD-10) codes K50 for CD, K51 for UC, and K52 for indeterminate colitis to define IBD-related cases. Age-standardized disability-adjusted life year rates (ASDRs) and age-standardized prevalence rates (ASPRs) were estimated with 95% uncertainty intervals (UIs), and temporal trends were evaluated using joinpoint regression, average annual percentage changes (AAPCs), and period-specific β coefficients for pre- and post-COVID-19 trends. The Das Gupta decomposition analysis was used to quantify the contributions of population growth, population aging, and epidemiological change to changes in disability-adjusted life-years (DALYs) and prevalence.
Results:
From 1990 to 2023, ASPRs increased, whereas ASDRs declined for overall IBD, UC, and CD across the five Asian regions, although the magnitude varied by subregion. In 2023, Central Asia had the highest regional ASDR for overall IBD (17.08 [95% UI, 14.21–20.20] per 100,000 population), whereas Bangladesh had the highest national ASDR (24.58 [15.26–33.84]) and the highest UC ASDR. South Asia had the highest regional ASPR (48.83 [41.42–57.55]), whereas the Republic of Korea had the highest national ASPR (57.70 [49.62–67.05]) and the highest CD ASPR. AAPC analyses showed positive ASPR trends and negative ASDR trends across all five regions, with Mauritius and Thailand as the only countries showing increasing ASDR AAPCs. DALY rates increased sharply at older ages and were generally higher in males, but females had higher DALY rates at ages 95 years and older in East Asia and Southeast Asia. Decomposition analysis showed that DALYs and prevalence increased across all five subregions, with population growth and aging contributing positively and epidemiological effects generally contributing negatively to DALYs; Mauritius and Thailand were notable exceptions with positive epidemiological contributions to DALY increases.
Conclusion:
Marked heterogeneity and a rising IBD burden across Asia underscore an urgent public health challenge. Subtype-specific surveillance, earlier diagnosis, and long-term care strategies should be tailored to national burden patterns and health-system capacity.