Sarcoidosis and ILD burden rising globally, new analysis finds
Study links rise to aging populations and longer life expectancy
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The global burden of pulmonary sarcoidosis and other interstitial lung diseases (ILDs) increased significantly between 1990 and 2023, with rises in new and total cases, deaths, and loss of healthy years, a study showed.
The data also showed that the burden varies by region and is highest among adults — particularly those ages 70 and older — and among men ages 65 and older. The global burden is expected to continue increasing through 2050, largely due to population growth and aging, especially in higher-income regions where people tend to live longer.
“Addressing this challenge requires urgent, hierarchical strategies focusing on high-risk groups and strengthening … disease management to mitigate future impact,” the researchers wrote.
The study, “Global, regional, and national burden of interstitial lung disease and pulmonary sarcoidosis from 1990 to 2023, and projections to 2050: A systematic analysis for the Global Burden of Disease Study 2023,” was published in Chinese Medical Journal Pulmonary and Critical Care Medicine by a team of researchers in China.
What sarcoidosis and ILD do to the lungs
Sarcoidosis is marked by the formation of small clumps of inflammatory cells, called granulomas, in different tissues and organs. It most often affects the lungs, known as pulmonary sarcoidosis, where it can cause inflammation and scarring, also called fibrosis.
Pulmonary sarcoidosis is clinically recognized as a type of ILD, a group of disorders marked by inflammation and scarring in the lungs, particularly in the tiny air sacs and surrounding tissue that help oxygen move into the bloodstream.
“A comprehensive, up-to-date assessment of their epidemiological trends is crucial for informing policy,” the researchers wrote. Epidemiological trends refer to patterns and changes in how often diseases occur and how they affect populations over time.
“Our previous study indicated that from 1990 to 2019, the global incidence, deaths and DALYs [disability-adjusted life years] due to ILD and pulmonary sarcoidosis increased by 118.6 %, 166.63 % and 122.87 % respectively,” the researchers wrote.
DALYs represent the number of years lost due to illness, disability, or early death. One DALY equals one year of healthy life lost.
Researchers analyze global trends in sarcoidosis and ILD
The team analyzed the global burden of ILD and pulmonary sarcoidosis from 1990 to 2023 using the Global Burden of Disease Study 2023, which includes data from 204 countries and territories.
Researchers used International Classification of Diseases (ICD) codes covering sarcoidosis and other ILDs to estimate age-standardized rates of new cases, total cases, deaths, and DALYs.
Results showed that the global burden of ILD and pulmonary sarcoidosis increased substantially from 1990 to 2023. The number of new cases rose from about 167,000 to 428,000, while the total number of people living with the diseases increased from about 2.1 million to 4.6 million.
The number of deaths increased from about 46,000 to 113,000, and DALYs rose from 1.31 million to 4.46 million.
After adjusting for age, the global incidence rate increased from 3.95 to 4.75 new cases per 100,000 people, with an average annual increase of 0.6%. The researchers also reported an “accelerated increase of 0.77% per year from 2008 to 2023.”
Other age-standardized analyses showed that the age-standardized prevalence rate increased by 0.32% per year, the age-standardized death rate increased by 1.97% per year, and the age-standardized DALY rate increased by 1.34% per year.
Burden varies widely by region, age, and sex
Significant regional differences were observed in 2023. Andean Latin America and high-income Asia Pacific had the highest disease burden across multiple measures, while Southeast Asia had the lowest. At the country level, Peru had the highest age-standardized incidence, death, and DALY rates, while Mauritius had the highest age-standardized prevalence rate.
Between 1990 and 2023, Eastern Europe experienced the largest declines in age-standardized incidence, prevalence, death, and DALY rates. Australasia experienced the largest increase in the age-standardized incidence rate, and also showed the most significant increases in prevalence, death, and DALY rates. Australasia is a region comprising Australia, New Zealand, and surrounding islands.
Overall, disease burden was strongly linked to age and sex. The highest incidence, prevalence, and DALY rates in 2023 were seen among people ages 70 to 74, while death rates were highest among those ages 80-84. Among people ages 65 and older, men had consistently higher incidence, prevalence, death, and DALY rates than women.
Further analyses estimated that the global burden of sarcoidosis and ILD will continue rising through 2050, with death rates projected to increase by 83.53%, and DALY rates projected to rise by about 60.43%, largely due to population growth and aging.
This predicted rise is “primarily attributable to population growth and aging, particularly in high-income regions,” the researchers wrote. “Hierarchical strategies, high-risk population focus (men over 65 years), and multi-disciplinary collaboration in disease management are critical for global burden control.”
