Digestive diseases affect more than 300 million people in Europe and are linked to substantial economic costs, according to data published in the United European Gastroenterology (UEG) Journal and presented at UEG Week 2022.
As noted in the report, there has been a worrying increase in the prevalence of digestive diseases since the year 2000, including chronic liver disease, pancreatitis, gastroesophageal reflux disease, gastritis, intestinal vascular disorders and celiac disease in children.
Between 2000 and 2019, incidence and mortality rates for all digestive cancers collectively increased by 26% and 17%, respectively.
Liver and pancreatic cancers have seen age-standardized increases in incidence and mortality in most European countries. The authors identified alcohol consumption, obesity, and other modifiable lifestyle factors as major contributors to a significant portion of the overall burden of these conditions.
The incidence of colorectal cancer in young adults has also increased, which is a matter of concern.
They also found that the burden of digestive diseases, measured by disability-adjusted life years (DALYs), is generally higher in central and eastern European countries than in western and southern European countries. This has been particularly observed in chronic liver disease, pancreatitis, gastritis and duodenitis, intestinal vascular disorders and peptic ulcer.
Among UEG member countries, Egypt had the highest age-standardized DALY rate for digestive diseases, which is largely attributed to the high burden of liver disease due to viral hepatitis in the country.
The authors, who conducted the study on behalf of UEG, also noted increasing trends in digestive disease burden due to high body mass index (BMI) across Europe, and alcohol consumption remains a major contributor to the burden of disease.
“One of the positive news emerging from the study is the decrease in smoking-related health burden in almost all European countries, following national intervention strategies,” they noted.
They also noted that social and economic differences at the population level between countries explain many differences in the burden of digestive diseases. As measured by the Human Development Index, poorer countries have been found to bear a greater burden due to most digestive diseases.
Regarding the economic burden, the report showed that the estimated average costs of providing inpatient health services for digestive diseases – outside of treatment and diagnostic procedures – as a percentage of gross domestic product were 0.12% in the 31 UEG member countries included in the report.
According to the authors, this represents around $20 billion in potential costs in the EU in 2021.
They also found that if premature mortality from digestive diseases could be reduced by 25% across the 31 countries, the estimated savings from preventing lost productivity would be around €11.4 billion in 2019. These savings would climb to around 22.8 euros. billion and 34.2 billion euros for reductions of 50% and 75%, respectively.
“The health, economic and social burden of digestive diseases is increasing at an alarming rate,” said Helena Cortez-Pinto, MD, PhD, UEG President. “Our health systems and economies are already in a fragile state and urgent action is needed to address these burdens, through public education, modulation of lifestyle choices and research, in order to reverse these alarming trends”.
This report also included an analysis of the Horizon 2020 project, the European Union (EU) research and innovation funding program between 2014 and 2020, to understand how research related to digestive diseases was funded and identify funding models versus other conditions.
Among other findings, the authors found that inflammatory bowel disease, nonalcoholic fatty liver disease, chronic hepatitis B, and celiac disease received the most funding. However, research on most types of digestive disease was still underfunded relative to the burden compared to other non-digestive diseases.
According to the authors, these areas where funding and research are low, although labeled as high priorities, may reflect research gaps warranting further analysis.
“Digestive diseases, such as irritable bowel syndrome, pancreatitis and alcohol-related liver disease, which have received little research funding from Horizon 2020, have been highlighted as priority areas by national societies,” the authors wrote. “Furthermore, disease prevention research appears to be understudied, but seen as an important area to prioritize and may represent a promising development path.”
The authors hope to see these findings applied to accelerate progress in reducing the burden of digestive disease and to identify and prioritize digestive disease states that are underfunded and underresearched despite their high burden.
Rose TC, Pennington A, Kypridemos C, et al. Analysis of the burden and economic impact of digestive diseases and investigation of research gaps and priorities in the field of digestive health in the European Region – White Paper 2: Executive Summary. United European Gastroenterol J. 2022;10(7):657-662. doi:10.1002/ueg2.12298