TRENDS OF INFLAMMATORY BOWEL DISEASE BURDEN IN THE UNITED STATES (1990-2019), PROJECTIONS OF DEATHS TO 2040: INSIGHTS FROM THE 2019 GLOBAL BURDEN OF DISEASE STUDY

Abstract

Abstract BACKGROUND Inflammatory Bowel Disease (IBD) ranks as the 9th primary cause of deaths and 7th for disabilities among all digestive diseases, affecting over 3 million Americans with a continuous upsurge. METHOD Utilizing the Global Burden of Disease methodology, we evaluated the prevalence, incidence, mortality, and Disability Adjusted Life Years (DALYs) of IBD from 1990 to 2019 in the U.S. based on age, sex, and year via a standardized statistical model. Furthermore, we forecasted deaths and Years of Life Lost (YLLs) up to 2040 through a regression framework. RESULTS IBD prevalence showed a decline from 982,981 (95%UI: 846,832-1,129,782) in 1990 to 762,889 (712,356-813,653) in 2019. From 1990-2019, the total annual incidence reduced by 12% (4-18), while deaths surged by 172% (81-199), and DALYs increased by 16% (2-34) (Figure 1). The Age-Standardized Rate (ASR) for mortality rose from 0.62 (0.60-0.82) per 100,000 cases in 1990 to 1.02 (0.8-1.11) in 2019. In raw counts, Nevada saw the most significant rise in incidence (87%), deaths (486%), and DALYs (174%) from 1990-2019. Based on ASR, West Virginia and Kentucky led in mortality increases with 87% and 83% respectively (Figure 2). In 2019, the age group 80-84 reported the highest deaths (848), while ages 25-29 saw the most significant incidence (8429), and ages 60-64 the highest DALYs (20933). Comparing genders, females had a steeper increase in DALYs (17% vs. 13% for males), whereas males saw a higher rise in deaths (181% vs. 167% for females) between 1990-2019. By 2040, IBD-related age-standardized mortality rates are predicted to climb by 0.9 per 100,000. CONCLUSION In 2019, IBD was responsible for 4.56% of all digestive disease deaths. Highlighting a comprehensive challenge for the U.S. healthcare, IBD's impact is not just clinical or economic but also profoundly psychosocial. Emphasizing early detection, cutting-edge treatments, and comprehensive patient support is crucial to lessen the severe implications of IBD in the U.S.