Temporal trends in the disease burden of thalassemia in China from 1990 to 2021 and forecast to 2030

Background China accounts for the highest number of newly diagnosed thalassemia cases globally and harbors the largest population of thalassemia patients. However, its burden and disparities remain insufficiently characterized. To guide resource allocation and prevention strategies, this study analyzed the distribution and trends of thalassemia burden in China from 1990 to 2021. Methods We utilized data from the Global Burden of Disease (GBD) Study 2021 to assess the burden of thalassemia in China. This analysis involved estimating the absolute numbers and corresponding age-standardized rates (ASRs) of incidence, prevalence, mortality, and disability-adjusted life years (DALYs). Additionally, we employed the autoregressive integrated moving average (ARIMA) model to forecast trends through 2030. Results In 2021, China recorded the highest number of incident cases worldwide, with 40,143.5 cases (95% UI: 29,325.4–54,927.5), and its age-standardized incidence rate (ASIR) was 7.6 (95% UI: 5.5–10.4) per 100,000 population. From 1990 to 2021, both the ASIR and age-standardized mortality rate (ASMR) of thalassemia in China declined, with estimated annual percentage changes (EAPCs) of -0.60 (95% CI: -0.71 to -0.48) and − 4.90 (95% CI: -5.06 to -4.73), respectively. In 2021, the ASIR, age-standardized prevalence rate (ASPR), ASMR, and age-standardized DALYs rate (ASDR) of thalassemia in China were higher in males than females, and the incidence, prevalence, mortality, and DALY rates peaked in the < 5 age group for both sexes. Projections for the next 9 years indicate a steady decline in the ASMR and ASDR; however, the ASIR and ASPR are expected to rise further. Conclusions Thalassemia represents a major public health challenge in China, with a persistently high disease burden. A pressing need exists to raise public awareness of the risk factors associated with thalassemia and to implement effective preventive strategies to reduce the future burden of this disorder.