European Report Highlights Health, Economic Impacts of Digestive Diseases

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 stated in the report, there is a concerning increase in the prevalence of digestive diseases since the year 2000, including chronic liver disease, pancreatitis, gastroesophageal reflux disease, gastritis, vascular intestinal disorders, and celiac disease in children.

Between 2000 and 2019, the rates of incidence and mortality for all digestive cancers collectively increased by 26% and 17%, respectively.

Liver and pancreatic cancer have seen increases in age-standardized incidence and mortality in most European countries. The authors identified alcohol consumption, obesity, and other modifiable lifestyle factors as key contributors towards a large share of the overall burden of these conditions.

Incidence of colorectal cancer among young adults has also increased, marking an area of concern.

They also found that the burden of digestive diseases, as measured by disability-adjusted life years (DALYs), is generally higher in countries in Central and Eastern Europe compared with countries in Western and Southern Europe. This was particularly seen in chronic liver diseases, pancreatitis, gastritis and duodenitis, vascular intestinal disorders, and peptic ulcer disease.

Of the UEG member countries, Egypt had the highest age-standardized DALY rate for digestive disease, highly attributable to the high burden of liver disease due to viral hepatitis experienced in the country.

The authors, who conducted the study on behalf of UEG, also noted upward trends of digestive disease burden due to high body mass index (BMI) across Europe, and alcohol consumption remains a major contributor to disease burden.

“One element of positive news to come out of the study is the decrease in health burden related to smoking across almost all European countries, following national intervention strategies,” they noted.

They also noted that population-level social and economic differences between countries explain many differences in digestive disease burden. As measured by the Human Development Index, countries that face more disadvantages were found to experience a greater burden from most digestive diseases.

Regarding the economic burden, the report showed that average estimated costs of inpatient health service delivery for digestive diseases—aside from treatment and diagnostic procedures—represented by a percentage of Gross Domestic Product was 0.12% across the 31 UEG member countries included in the report.

According to the authors, this reflects approximately $20 billion in potential costs across the EU in 2021.

They also discovered that, if digestive disease-related premature mortality could be reduced by 25% across the 31 countries, the estimated savings from the prevention of productivity losses would amount to approximately €11.4 billion in 2019. These saving would climb to approximately €22.8 billion and €34.2 billion 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, president of UEG. “Our healthcare systems and economies are already in a fragile state and urgent action is required to tackle 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's (EU’s) research and innovation funding program lasting between 2014 and 2020, to understand how digestive disease-related research was funded and identify funding patterns compared with other conditions.

Among other findings, the authors discovered that inflammatory bowel disease, nonalcoholic fatty liver disease, chronic hepatitis B, and celiac disease received the most funding. However, research for most types of digestive disease were still underfunded in relation to burden compared with other non-digestive disease.

According to the authors, these areas with low funding and research, despite being labelled as high priorities, may reflect research gaps warranting further analysis.

“Digestive diseases, such as irritable bowel syndrome, pancreatitis, and alcohol‐related liver disease, which received little in the way of Horizon 2020 research funding were highlighted as areas for prioritization by the national societies,” the authors wrote. “Additionally, disease prevention research appeared to be under‐researched yet regarded as an important area for prioritization and may represent a promising avenue for development.”

The authors hope to see these findings applied toward accelerating progress in reducing the burden of digestive diseases, and toward identifying and prioritizing digestive disease states that are under-funded and under-researched despite their high burden.

Reference

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 Book 2: Executive summary. United European Gastroenterol J. 2022;10(7):657-662. doi:10.1002/ueg2.12298