Diverticular Disease Epidemiology: Rising Rates of Diverticular Disease Mortality Across Developing Nations

BACKGROUND: The incidence of diverticular disease is growing in the Western world. However, the global burden of disease is unknown in the developing world. OBJECTIVE: This study aimed to determine the global burden of diverticular disease as measured by disease-specific mortality while identifying indicators of rising disease rates. DESIGN: We undertook an ecological analysis based on data from the World Health Organization Mortality Database. Then, we analyzed global age-adjusted mortality rates from diverticular disease and compared them to national rates of overweight adults, health expenditures, and dietary composition. SETTINGS: National vital statistics data were collected. PATIENTS: Diverticular disease deaths from January 1, 1994 through December 31, 2016 were evaluated. MAIN OUTCOME MEASURES: The primary outcome measured was the national age-adjusted mortality rate. RESULTS: The average age-adjusted mortality rate for diverticular disease was 0.51 +/- 0.31/100,000 with a range of 0.11 to 1.75/100,000. During the study period, we noted that 57% of nations had increasing diverticular disease mortality rates, whereas only 7% had decreasing rates. More developed nations (40%) than developing nations (24%) were categorized as having high diverticular disease mortality burden over the time period of the study, and developed nations had higher percentages of overweight adults (58.9 +/- 3.1%) than developing nations (50.6 +/- 6.7%; p < 0.0001). However, developing nations revealed more rapid increases in diverticular disease mortality (0.027 +/- 0.024/100,000 per year) than developed nations (0.005 +/- 0.025/100,000 per year; p = 0.001), as well as faster expanding proportions of overweight adults (0.76 +/- 0.12% per year) than in already developed nations (0.53 +/- 0.10% per year; p<0.0001). LIMITATIONS: Ecological studies cannot define cause and effect. CONCLUSIONS: There is considerable variability in diverticular disease mortality across the globe. Developing nations were characterized by rapid increases in diverticular disease mortality and expanding percentages of overweight adults. Public health interventions in developing nations are needed to alter mortality rates from diverticular disease.

Automated summary

The study revealed significant variability in diverticular disease mortality rates across the globe, with developing nations experiencing increasing mortality rates and expanding percentages of overweight adults. Public health interventions are needed in developing nations to alter mortality rates from diverticular disease.