Burden of Gastroesophageal reflux disease in China and Global from 1990 to 2021 with forecast to 2041: An analysis and comparison

Background: Gastroesophageal reflux disease (GERD) is a major cause of gastrointestinal morbidity worldwide. However, long-term trends in its burden across different regions and the relationship with socio-demographic development remain incompletely understood. Methods: We extracted data on GERD incidence, prevalence, and disability-adjusted life years (DALYs) from the Global Burden of Disease (GBD) 2021 database for China and globally between 1990 and 2021. Age-standardized rates (ASRs) were analyzed using Joinpoint regression to estimate annual percentage changes. An autoregressive integrated moving average (ARIMA) model was applied to forecast trends through 2041. Correlations between GERD burden and the Socio-demographic Index (SDI) were evaluated using Pearson’s coefficients. Results: In 2021, China reported an age-standardized prevalence rate (ASPR) of 4,540.66, incidence rate (ASIR) of 1,844.31, and DALY rate (ASDR) of 35.12 per 100,000, all substantially lower than global values (ASPR: 9,838.6; ASIR: 3,881.86; ASDR: 75.56 per 100,000). From 1990 to 2021, China’s absolute GERD cases increased by 60.6% (prevalence) and 55.2% (incidence), driven mainly by aging and population growth, while global cases rose by over 80%. Joinpoint analysis revealed accelerated growth in China after 2010, and ARIMA projections estimate a 7–12% rise in global GERD ASRs by 2041, with the DALY gap between China and global levels widening. Globally, SDI was positively correlated with GERD ASRs, whereas these associations were weak and nonsignificant in China. Conclusion: GERD poses a growing public health challenge, with a stable yet substantial burden in China and a continuing global increase through 2041. These findings highlight the urgent need for age- and context-specific prevention, early detection, and multidisciplinary management strategies to mitigate the future health and economic impact of GERD.