Global burden of gastroesophageal reflux disease, 1990-2021, with projections to 2040: an update from the global burden of disease study 2021 #MMPMID41343725
Dong Y; Xu S; Zhao G; Zeng X
Dis Esophagus 2025[Nov]; 38 (6): ? PMID41343725show ga
Gastroesophageal reflux disease (GERD) imposes substantial global burden. Its recent trends and long-term projections have not been reassessed since the Global Burden of Disease (GBD) 2019 cycle. Using GBD 2021 data, incident and prevalent cases, years lived with disability, and age-standardized rates (ASRs) were estimated for 204 countries from 1990 to 2021. Decomposition analysis categorized changes into population aging, population growth, and epidemiological change. Projections to 2040 used a Bayesian age-period-cohort model, with Nordpred and ARIMA used to assess robustness. From 1990 to 2021, incident cases increased from 180.0 million to 324.1 million (+80.1%), and prevalent cases increased from 450.8 million to 825.6 million (+83.2%). The global age-standardized incidence rate (ASIR) reached 3882 per 100,000 with a peak at ages 30-39 years. ASRs varied by Socio-demographic Index (SDI) levels and exhibited a non-linear negative association overall: decreases at SDI <0.4 and > 0.6, with modest increases at 0.4-0.6. Decomposition analysis indicated population growth contributed most to the incidence increase (+95%), with smaller contributions from aging (+3%) and epidemiological change (+2%). Projections suggest that ASIR will increase to approximately 3939 per 100,000 and ASPR to approximately 9990 per 100,000, whereas ASYR is projected to increase only slightly. Projections were consistent across models. The global burden of GERD continues to rise, primarily associated with demographic expansion and modifiable lifestyle factors. In the absence of enhanced prevention, equitable diagnostic access, and obesity control, incidence and prevalence are anticipated to increase further through 2040. These findings provide region-specific evidence to inform resource allocation and targeted interventions.
Dis+Esophagus 2025 ; 38 (6): ?
