OBJECTIVE To analyze the changing trend of disease burden of appendicitis among Chinese children and adolescents (less than 20 years old) from 1990 to 2023, identify the driving factors for the disease attack, and predict the burden in 2024-2040.

METHODS The Joinpoint regression model was employed to analyze the annual changing trends of age-standardized incidence rates and age-standardized disability-adjusted life year (DALY) rate of appendicitis among this group of people based on the 2023 Global Burden of Disease Study data. The related effects were assessed by age-period-cohort model, the driving factors for the number of appendicitis cases were identified through decomposition analysis, and the future burdens of diseases were predicted with the help of autoregressive integrated moving average model.

RESULTS The result revealed that the number of cases of appendicitis, incidence, number of DALY and DALY rate declined among this group of population from 1990 to 2023. The average annual variation percentages of age-standardized incidence rate and age-standardized DALY rate were -0.55% and -3.72%, respectively (all P < 0.001). Joinpoint analysis indicated that the age-standardized incidence rate fluctuated in four stages, while the age-standardized DALY rate decreased for a long time. The risk of onset increased with the age in a stepwise manner, the period effect firstly rose and then declined, and the cohort effect showed an overall downward trend. The growth of population was the core factor driving the increase in the number of cases, while the epidemiological change was the major force leading the decline of number of cases. The model predicted that by the year of 2040, the numbers of appendicitis cases and DALYs among this population would drop to 187 100 cases and 5 500 person per year, respectively, with incidence and DALY rate declining to 94.87 per 100 000 and 2.19 per 100 000, respectively.

CONCLUSIONS The burden of appendicitis and disability among Chinese children and adolescents has significantly decreased in 1990-2023. The growth of population and epidemiological change jointly drive the variation in the number of cases. The future burden of disease may continue to decline. It is necessary to formulate targeted prevention and control measures based on the age, cohort characteristics and driving factors.