Abstract
OBJECTIVE: To examine global retinoblastoma(RB) burden from 1990 to 2021, its cross-national inequalities, the effect of public health policies, and to project disease burden trends to 2035. METHODS: The study examined the global, regional, and national disease burden of RB from 1990 to 2021, applying data from the Global Burden of Disease (GBD) to assess incidence, prevalence, disability-adjusted life years (DALYs), and death. Estimated annual percentage change (EAPC), connection point regression, and autoregressive moving average (ARIMA) models were used to evaluate the overall, segmented, and projection trend of the disease burden. In addition, we also examined the inequity of disease burden at various levels of the socio-demographic index (SDI) and compared the policy effects for rare diseases in countries with differing levels of socio-economic development. RESULTS: From 1990 to 2021, the global incidence and prevalence of RB continued to rise, while the death rate and DALYs generally trended downward; however, significant differences were observed between regions and countries. By 2035, the number of incidence and prevalence is expected to decline slightly year by year, while the number of DALYs and deaths is expected to continue to rise. Countries with low Socio-demographic Index (SDI) bear a disproportionately higher disease burden. Moreover, between 1990 and 2021, absolute inequality decreased, while relative inequality increased. In addition, the impact analysis on the policy of rare diseases in countries at different levels of development shows that there is a clear correlation between a more comprehensive policy framework and the reduction of the burden of RB, among which the improvement in Central Europe is the most significant. CONCLUSION: The study reveals that the global burden of RB is generally in a downward trend; however, low SDI regions continue to bear a disproportionately higher burden, underscoring persistent health inequalities. Policy improvement plays a key role in reducing the burden of disease. To further narrow regional disparities and reduce the overall burden, policy building needs to be strengthened globally, particularly in underdeveloped areas. The findings of this study may also provide valuable references for the prevention and treatment of other rare diseases and the promotion of health equity.