A36 THE GLOBAL INCIDENCE OF PEPTIC ULCER DISEASE AND ITS COMPLICATIONS AT THE TURN OF THE 21ST CENTURY: A SYSTEMATIC REVIEW.

Abstract

The incidence of peptic ulcer disease (PUD) and its complications varies across the world and has changed over the past few decades with the discovery of H. pylori as a major etiological factor in the disease pathogenesis, as well as the increasing use of NSAIDs. We conducted a systematic review to determine differences in the worldwide incidence of PUD and its complications in different regions at the turn of the 21st century.To determine differences in the worldwide incidence of PUD and its complications in different regions at the turn of the 21st century.We performed a systematic literature search of MEDLINE and PubMed (1 Jan. 2000 – 30 Jun. 2017; 4188 abstracts) to identify observational population-based studies reporting the incidence of PUD or its complications from 2000 or later. PUD was defined as either gastric or duodenal ulcers. Complications of PUD were defined as bleeding or perforation. We created a map to illustrate worldwide differences in the incidence of PUD.Amongst 4188 abstracts screened, 178 full-text articles were identified and 18 incidence studies were retrieved: 14 from Europe, 2 from Asia, and 2 from North America. Figure 1 illustrates the incidence of PUD and complicated PUD throughout the world. The highest annual incidence of all PUD (complicated and uncomplicated) was 141.8 per 100,000 persons in Spain, and the lowest was 23.9 in the UK. The highest annual incidence of bleeding PUD was 72.5 per 100,000 persons in Greece, and the lowest was 8.3 in the UK. The highest annual incidence of perforated PUD was 4.4 per 100,000 persons in South Korea, and the lowest was 2.2 in the UK.This systematic review provides a global overview of the incidence of PUD and its complications at the turn of the 21st century. This disease entity remains a common problem around the world. However, our systematic review highlights the need for incidence data in many regions of the world, particularly from developing countries. Future studies in these regions are required to provide further insight into the geographic patterns of PUD.None