S3199 Temporal Trends in the Incidence of Gastroesophageal Reflux Disease and Peptic Ulcer Disease in the United Kingdom Over the Past 3 Decades

Introduction: Peptic ulcer disease (PUD) and gastroesophageal reflux disease (GERD) are among the most prevalent gastrointestinal diseases and impose a significant burden due to the associated morbidity and diminished quality of life. Therefore, it is of importance to evaluate the temporal trends in the incidence of PUD and GERD in the United Kingdom (U.K.) to identify areas requiring introduction of health policy measures. Methods: Temporal trends in the age-standardized incidence rate (ASIR) of GERD and PUD in the U.K., and across the 4 nations (England, Wales, Scotland, and Northern Ireland), over the period 1990-2019 were evaluated by retrieving data from the Global Burden of Disease database. Joinpoint analysis was utilized to calculate the Annual Percent Change (APC) and the Average Annual Percent Change (AAPC). Results: Over the period 1990-2019, an estimated total of 665,172 PUD cases with equal distribution between men and women were reported across the U.K.. A statistically significant decline in PUD ASIR was observed in the U.K. with an AAPC of -1.90 (95% CI -1.92 to -1.88; P < 0.001). Further analysis demonstrated a statistically significant decline in the ASIR across the 4 nations with the highest decline observed in Northern Ireland (AAPC -2.153; 95% CI -2.169 to -2.141; P < 0.001), closely followed by Scotland (AAPC -2.151; 95% CI -2.165 to -2.137; P < 0.001), Wales (AAPC -1.88; 95% CI -1.89 to -1.87; P < 0.001) and England (AAPC -1.87, 95%CI -1.89 to -1.86, P < 0.001). Stratification by gender revealed statistically significant decline in the ASIR in men (AAPC -1.95; 95% CI -1.96 to -1.93; P < 0.001) and women (AAPC -1.91; 95% CI -1.93 to -1.89; P < 0.001). In regard to GERD, a statistically nonsignificant change in the ASIR was observed in the U.K. with an AAPC of -0.015 (95% CI -0.029 to 0.001; P = 0.06). Further analysis revealed a minimal, but statistically significant, change in the ASIR across the 4 nations. England experienced a statistically significant decline with an AAPC of -0.02 (95% CI -0.04 to -0.01; P = 0.009). Northern Ireland, Scotland, and Wales experienced a statistically significant minor decline in the ASIR with an AAPC of -0.002, -0.004 and -0.008, respectively. Conclusion: Over the period 1990-2019, the U.K. witnessed a statistically significant decline in the incidence of PUD across all 4 nations and in both men and women. On the other hand, the incidence of GERD did not undergo any significant change during the same period.