Global Burden of Interstitial Lung Disease and Sarcoidosis Doubles Since 1990, India Among Top Three Countries: Research
China: The global burden of interstitial lung disease and pulmonary sarcoidosis (ILD&PS) has increased sharply between 1990 and 2021, with India ranking among the top three countries in terms of both prevalence and mortality. In 2021 alone, the country recorded over 6.5 lakh cases and nearly 47,000 deaths related to ILD&PS. The disease was most common among individuals aged over 50 years and showed higher rates in men. Projections indicate that the burden will continue to rise steadily until 2040.
The findings are from a study published in Frontiers in Medicine by Xinxin Zhang and colleagues from The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China. The researchers conducted a comprehensive assessment of ILD&PS burden globally, regionally, and nationally, along with projections extending to the year 2040.
Using data from the Global Burden of Disease (GBD) 2021 study, the team analyzed prevalence, incidence, deaths, and disability-adjusted life years (DALYs) associated with ILD&PS. Subgroup evaluations by age and sex were also carried out, and the Bayesian age-period-cohort (BAPC) model was used to forecast future disease patterns.
The study led to the following findings:
- The global burden of interstitial lung disease and pulmonary sarcoidosis showed a sharp upward trend over the past three decades.
- From 1990 to 2021, global prevalence rose by 128%, incidence by 148%, DALYs by 169%, and mortality by 242%.
- Age-standardized rates also increased steadily during this period, indicating a consistent global escalation.
- The greatest rise in age-standardized rates was observed in regions with a high sociodemographic index (SDI).
- Australasia and Andean Latin America demonstrated considerable variation in disease burden across regions.
- A positive correlation was found between SDI and disease burden, showing that even developed regions are experiencing an increase despite better healthcare systems.
- The disease burden was higher in men than in women.
- Adults aged over 50 years were most affected.
- Researchers suggested that biological susceptibility, occupational factors, and age-related vulnerability may contribute to the observed trends.
According to projections, the overall number of cases and deaths is expected to continue rising until 2040, though age-standardized rates may stabilize or slightly decline. This suggests that while the population-adjusted risk might plateau, the total disease load will grow due to aging populations and expanding global demographics.
The authors urged policymakers and healthcare systems to strengthen preventive measures, early diagnosis, and targeted management strategies, especially in high-burden countries like India. Focused interventions, they suggested, are essential to mitigate the growing health and economic impact of ILD&PS.
However, the researchers acknowledged several limitations. Misclassification between ILD and sarcoidosis, inconsistencies in diagnostic criteria, and underreporting in resource-limited regions may have affected accuracy. Additionally, the projections may underestimate the influence of emerging environmental and occupational risk factors.
The study highlights a significant and rising global burden of interstitial lung disease and pulmonary sarcoidosis over the past 32 years, particularly among men and older adults. The authors emphasized the need for region-specific strategies to improve prevention, diagnosis, and treatment, aiming to curb the growing global health impact by 2040.
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