RISING INCIDENCE, MORTALITY, AND DISABILITY-ADJUSTED LIFE YEARS OF INFLAMMATORY BOWEL DISEASE IN THE UNITED STATES: A SYSTEMIC ANALYSIS OF THE GLOBAL BURDEN OF DISEASE STUDY

Abstract

Abstract INTRODUCTION: In North America, Inflammatory Bowel Disease (IBD) poses a significant burden, yet detailed data on its incidence, mortality, and disability-adjusted life years (DALYs) within the United States is scarce. Our study aims to systematically analyze these aspects of IBD while considering gender, age, and state-level variations. Methods: Utilizing the Global Burden of Disease database, we systematically analyzed IBD incidence, mortality, and DALYs in the United States from 1999 to 2019. We further stratified these metrics by gender and age groups (25-49 years, 50-75 years, and 75+ years) and calculated annual percentage changes (APC) using linear regression. Results: Between 1999 and 2019, IBD incidence cases increased from 65,555 to 85,388. The incidence rate per 100,000 person-years rose from 23.5 (95% UI: 21.4-26.2) to 26.0 (95% UI: 23.8-28.9), with APC of 1.0. Females consistently had higher incidence rates, increasing from 34,236 (95% UI: 31,052-38,351) in 1999 to 43,882 (95% UI: 39,953-48,871) in 2019. Incidence rates also rose, with males at 0.6% APC and females at 0.4%. In 2019, the 24-49 years age group had the highest incidence rate at 35.1 (95% UI: 30.3-40.1) per 100,000, with a 0.5% APC increase from 1999 to 2019.Mortality increased, with 5,910 IBD-related deaths in 2019. The mortality rate per 100,000 population rose from 1.1 (95% UI: 1.0-1.3) to 1.8 (95% UI: 1.4-2.0), reflecting a 2.4% APC. Although females had a higher mortality rate in 2019 (2.2 per 100,000), males had a 2.7% APC increase from 1999 to 2019. Geographically, notable differences in APC for incidence rates across states were observed. The highest increases were seen in Ohio (1.06%), North Dakota (1.04%), and Maine (0.96%), while Nevada had a slight decrease in APC (-0.02%). Mortality rate changes also varied by state, with substantial increases in Alaska (3.75%), Vermont (3.19%), and Tennessee (3.13%). Regarding DALYs, significant APC rate changes were observed in New Mexico (1.53%), Vermont (1.38%), and Mississippi (1.37%), while the lowest changes were seen in the District of Columbia (0.24%). Conclusions: This comprehensive analysis of IBD in the US from 1999 to 2019 reveals trends and disparities. IBD incidence steadily increased during this period, with notable rises in cases and rates. Gender-wise, females had higher incidence rates, while males displayed a slightly steeper increase. Geographic disparities were evident, with varying trends in incidence and mortality rates across states. Ohio, North Dakota, and Maine had the highest incidence increases, while Alaska, Vermont, and Tennessee saw significant mortality rate increases. Our study highlights the changing epidemiology of IBD and the need for targeted intervention to address changes in incidence and disease burden. Fig 1. * Denotes P