Trends in incidence, prevalence, and mortality of peptic ulcer disease in Asia (1990–2023) and projections to 2040

Background: This study provides the first comprehensive assessment of the burden of peptic ulcer disease (PUD) in Asia, analyzing epidemiological trends from 1990 to 2023 with projections to 2040. Methods: Using data from the Global Burden of Disease Study 2023, we analyzed PUD metrics across 48 Asian countries and territories. Age-standardized rates were calculated by the direct method. Temporal trends were evaluated by Joinpoint regression, and future burden was projected to 2040 using autoregressive integrated moving average (ARIMA) modeling. Results: In 2023, Asia recorded 1.87 million incident PUD cases (age-standardized incidence rate: 39.34 per 100,000), 4.32 million prevalent cases (age-standardized prevalence rate: 90.58 per 100,000), and 131,011 deaths (age-standardized death rate: 2.85 per 100,000). PUD caused 3.46 million Disability-adjusted life years, with premature mortality accounting for >90% of the total burden. From 1990 to 2023, Joinpoint regression revealed significant declining trends across all age-standardized metrics (annual percentage change range: −1.32%–− 3.27%; all P < .05). ARIMA projections to 2040 suggest continued decreases in all rates, with years lived with disability expected to exceed years of life losts as the dominant component of disease burden. Conclusion: Despite declining incidence, PUD continues to impose a substantial disease burden across Asia. The persistent toll: driven by an expanding and aging population: underscores the need for sustained prevention efforts, including population-based Helicobacter pylori screening, rational non-steroidal anti-inflammatory drugs prescribing, and health system capacity for emergency endoscopic intervention and long-term chronic disease management.