Global burden of inflammatory bowel disease in Group 20 countries, 1990 to 2021: A systematic analysis with projections to 2050

Inflammatory bowel disease (IBD), a chronic gastrointestinal disorder, poses significant global health challenges. Analyzing its burden across Group of Twenty (G20) nations helps identify region-specific priorities and guide health policy. This study aims to evaluate temporal trends in IBD incidence, prevalence, mortality, and disability-adjusted life years (DALYs) across G20 countries from 1990 to 2021 and project future burdens through 2050. Data from the Global Burden of Disease 2021 Study were analyzed. Age-standardized rates (ASRs) of IBD metrics were assessed by sex, region, and sociodemographic index. Temporal trends were quantified using annual percentage change, and predictive modeling was performed using autoregressive integrated moving average, exponential smoothing, and Bayesian age-period-cohort models, validated by root mean square error, mean absolute error, and R² statistics. Between 1990 and 2021, G20 nations experienced declining ASRs for prevalence (48.02 → 44.88/100,000) and mortality (0.60 → 0.52/100,000) but rising incidence (4.22 → 4.45/100,000) and DALYs (17.79 → 18.07/100,000). Absolute cases and deaths nearly doubled. Females had higher prevalence and disability burden, whereas males exhibited higher incidence and mortality. Canada and Germany recorded the highest DALY rates. Projections to 2050 suggest continued growth in absolute burden but declining ASRs, largely driven by population aging and epidemiologic transition. Despite reductions in standardized rates, IBD's absolute burden continues to increase among G20 countries. Persistent sex and regional disparities highlight the need for equitable, sociodemographic index-specific prevention, and management strategies.