Epidemiology

Accurate estimates require endoscopic studies because symptoms are insensitive and nonspecific indicators of peptic ulcer. One systematic review of the literature reported an annual incidence of 0.10% to 0.19% for physician diagnosed peptic ulcer disease and a 1-year prevalence of 0.12% to 1.50%.[1] The prevalence of gastric ulcer varies significantly worldwide; 4.1 % in Sweden and 6.1% in China.[2][3]

The incidence of peptic ulcer increases with age; gastric ulcers peak in the fifth to seventh decades and duodenal ulcers 10 to 20 years earlier.[4] Both sexes are similarly affected.

The epidemiology of peptic ulcer disease largely reflects the epidemiology of the two major etiologic factors, Helicobacter pylori infection and use of nonsteroidal anti-inflammatory drugs (NSAIDs). In the developed world, H pylori incidence has been slowly declining over the past 50 years and NSAID use has increased. Most studies report that peptic ulcers are decreasing in prevalence over time.​​[5][6][7]​​[8][9]

Nevertheless they remain a problem, especially in the developing world where H pylori infection is highly prevalent.[10]​ A 2019 literature review of the epidemiology of peptic ulcer disease (PUD) in Africa found heterogeneity in the prevalence and incidence of PUD across the continent. However, most of the tertiary-center studies found a higher prevalence of PUD in Africa when compared with similar studies in western countries.[11]

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