Burden of Gastrointestinal Disease in the United States: 2012 Update

• Published in: Gastroenterology (New York, N.Y. 1943) Vol. 143; no. 5; pp. 1179 - 1187.e3
• Main Authors: Peery, Anne F, Dellon, Evan S, Lund, Jennifer, Crockett, Seth D, McGowan, Christopher E, Bulsiewicz, William J, Gangarosa, Lisa M, Thiny, Michelle T, Stizenberg, Karyn, Morgan, Douglas R, Ringel, Yehuda, Kim, Hannah P, DiBonaventura, Marco Dacosta, Carroll, Charlotte F, Allen, Jeffery K, Cook, Suzanne F, Sandler, Robert S, Kappelman, Michael D, Shaheen, Nicholas J
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-11-2012
• Subjects: Endoscopy, Digestive System - economics; Endoscopy, Digestive System - utilization; Epidemiologic Analysis; Gastroenterology and Hepatology; Gastrointestinal Diseases - diagnosis; Gastrointestinal Diseases - epidemiology; Gastrointestinal Diseases - mortality; Gastrointestinal Endoscopy; Gastrointestinal Neoplasms - diagnosis; Gastrointestinal Neoplasms - epidemiology; Health Care Surveys - statistics & numerical data; Health Services; Health Surveys - statistics & numerical data; Hospitalization - statistics & numerical data; Humans; Incidence; Medicaid - statistics & numerical data; Medicare - statistics & numerical data; Quality of Life; SEER Program - statistics & numerical data; Statistics; Survival Rate; United States - epidemiology; Vital Statistics; United States; Health Services; NAMCS; National Vital Statistics System; Gastrointestinal Endoscopy; Clinical Outcomes Research Initiative; CPT; esophagogastroduodenoscopy; NVSS; United States National Health and Wellness Survey; endoscopic retrograde cholangiopancreatography; current procedural terminology; Epidemiologic Analysis; SEER; Surveillance, Epidemiology, and End Results; National Ambulatory Medical Care Survey; GI; EGD; Nationwide Inpatient Sample; Statistics; gastrointestinal; ICD-9; NHWS; NIS; ERCP; International Classification of Diseases, 9th Revision; CORI
• ISSN: 0016-5085; 1528-0012
• DOI: 10.1053/j.gastro.2012.08.002

Background & Aims Gastrointestinal (GI) diseases account for substantial morbidity, mortality, and cost. Statistical analyses of the most recent data are necessary to guide GI research, education, and clinical practice. We estimate the burden of GI disease in the United States. Methods We collected information on the epidemiology of GI diseases (including cancers) and symptoms, along with data on resource utilization, quality of life, impairments to work and activity, morbidity, and mortality. These data were obtained from the National Ambulatory Medical Care Survey; National Health and Wellness Survey; Nationwide Inpatient Sample; Surveillance, Epidemiology, and End Results Program; National Vital Statistics System; Thompson Reuters MarketScan; Medicare; Medicaid; and the Clinical Outcomes Research Initiative's National Endoscopic Database. We estimated endoscopic use and costs and examined trends in endoscopic procedure. Results Abdominal pain was the most common GI symptom that prompted a clinic visit (15.9 million visits). Gastroesophageal reflux was the most common GI diagnosis (8.9 million visits). Hospitalizations and mortality from Clostridium difficile infection have doubled in the last 10 years. Acute pancreatitis was the most common reason for hospitalization (274,119 discharges). Colorectal cancer accounted for more than half of all GI cancers and was the leading cause of GI-related mortality (52,394 deaths). There were 6.9 million upper, 11.5 million lower, and 228,000 biliary endoscopies performed in 2009. The total cost for outpatient GI endoscopy examinations was $32.4 billion. Conclusions GI diseases are a source of substantial morbidity, mortality, and cost in the United States.