The global prevalence of hemorrhoids: a systematic review and meta-analysis

Abstract Objective Hemorrhoidal disease is a common anorectal condition, yet its global prevalence remains unclear. Thus, this systematic review and meta-analysis aimed to estimate worldwide prevalence and explore variation by region, sex, diagnostic approach, and study setting. Design Systematic review and meta-analysis reported following PRISMA guidelines. Data sources PubMed, Scopus, Hinari, Lens.org, and Google Scholar were searched from inception to 2 April 2025. Eligibility criteria Observational studies reporting hemorrhoid prevalence in population aged 18 and older were included. Data extraction and synthesis Two reviewers independently extracted data and assessed quality using the Joanna Briggs Institute checklist. Pooled prevalence was calculated using a random-effects model with the Freeman–Tukey double arcsine transformation to stabilize variances, along with 95% confidence intervals. Subgroup and sensitivity analyses were performed, and heterogeneity was quantified using I². Results Analysis of 76 reports estimated a pooled global prevalence of 17% (13%–21%), with a 95% prediction interval of 0.2%–60.7%. Sex-specific data were available in 27 of the 76 reports, from which a total of 1,040,364 cases were identified; of these, males accounted for 59% (50, 68%) and 41% (33, 50%) in females. Pooled prevalence also varied across countries (5.4% in France to 27.4% in Turkey), diagnostic methods (colonoscopy 21.5%, self-report 18.3%, physician-diagnosed 15.1%), and study settings (institutional 19.8% vs population 17.9%). Across continents, prevalence was highest in Asia (20.8%), followed by America (18.4%), Europe (17.8%), and Africa (15.7%). Considerable heterogeneity was observed across analysis (I² >99%, p < 0.001). Conclusion This comprehensive global review reveals a substantial burden of hemorrhoids, with notable sex and regional differences. High heterogeneity and variability in diagnostic approaches warrant cautious interpretation. Standardized methods and greater awareness are needed to enhance comparability across studies and support earlier diagnosis and intervention.