Trends and cross-country inequalities in the global burden of inguinal, femoral, and abdominal hernia from 1990 to 2021, with projections from 2022 to 2035: a cross-sectional study.

Background: The global burden of inguinal, femoral, and abdominal hernias remains significant, particularly in low- and middle-income countries, despite medical advancements. This study aims to examine trends and cross-country inequalities in the burden of these hernias from 1990 to 2021 and project future trends to 2035.

Methods: Utilizing Global Burden of Diseases (GBD) 2021 data, we analyzed prevalence, incidence, mortality, and disability-adjusted life years (DALYs) across 204 countries and territories. Development levels were quantified using the sociodemographic index (SDI). Analyses included descriptive statistics, joinpoint regression, Spearman correlation, frontier analysis, and a Bayesian age-period-cohort model for forecasting.

Results: From 1990 to 2021, global prevalence increased from 13.7 million to 16.4 million, while the age-standardized rate (ASR) decreased by 24.74%. Incident cases rose from 5.8 million to 7.2 million, with a 16% decline in ASR. Deaths increased from 42,118 to 48,012, but ASR fell by 45.16%. DALYs decreased from 2.6 million to 2.3 million, with a 42.31% drop in ASR. Projections to 2035 indicate continued growth in cases, with varying ASR trends. Inequality analyses revealed persistent disparities, disproportionately affecting populations with higher socioeconomic development.

Conclusions: Significant disparities persist in the global burden of hernias, with increasing cases despite declining ASRs. Continued growth and inequalities underscore the need for targeted interventions and policies.