Global Trends and Future Projections in the Burden of Inflammatory Bowel Disease Among Adolescents and Young Adults (15–49 Years) From 1990 to 2021

Abstract

Aims

Inflammatory bowel disease (IBD) is an immune-mediated disorder with rising global incidence. Adolescents and young adults (15–49 years) bear major psychological, social, and economic burdens, yet few studies have examined their disease trends. We aimed to estimate global, regional, and national incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of IBD in this age group and to project future burden.

Methods and Results

Using data from the Global Burden of Disease 2021, we analyzed age-standardized rates of incidence, prevalence, mortality, and DALYs (ASIR, ASPR, ASMR and ASDR) among people aged 15–49 across 204 countries and territories. Estimated annual percentage changes, Joinpoint regression, and age-period-cohort modelling were employed to evaluate temporal patterns, while Bayesian modelling projected trends to 2050. Inequalities were evaluated using the Socio-demographic Index (SDI). In 2021, global ASIR was 5.01/100,000 and ASPR was 41.56/100,000. ASMR and ASDR were 0.13/10,000 and 13.56/100,000 person-years, respectively. From 1990 to 2021, ASIR and ASPR increased slightly overall, with the most rapid rise in East Asia. ASMR and ASDR declined globally but remained highest in Western Sub-Saharan Africa. SDI was positively correlated with incidence and prevalence, and negatively with mortality. Projections to 2050 indicate continued declines in incidence and prevalence, stable DALYs, and a slight increase in mortality.

Conclusion

IBD remains a significant burden in people aged 15–49. Growing incidence in East Asia and sustained mortality in disadvantaged regions highlight the need for early diagnosis, equitable care, and targeted public health strategies.