Incidence of inflammatory bowel disease by race and ethnicity in a population-based inception cohort from 1970 through 2010

Background: Although inflammatory bowel disease (IBD) has been more predominant in white populations, an increasing incidence of IBD in nonwhites has been reported. We sought to evaluate the incidence rates and temporal trends of IBD by race and ethnicity. Methods: The resources of the Rochester Epidemiologic Project were used to identify 814 county residents newly diagnosed with IBD from 1970 through 2010. Race was categorized into whites and nonwhites. Ethnicity was categorized into Hispanic and non-Hispanic. Incidence rates were estimated and adjusted for age and sex to the 2010 United States (US) population. Trends in incidence rates were evaluated by Poisson regression. Results: The adjusted annual incidence rate of IBD for whites was 21.6 cases per 100,000 person-years [95% confidence interval (CI), 20.0–23.1] and for nonwhites it was 13 per 100,000 (95% CI, 8.3–17.5). The incidence rates for whites and nonwhites increased by 39% and 134%, respectively, from 1970 through 2010. The adjusted annual incidence rate of IBD for Hispanics was 15 cases per 100,000 person-years (95% CI, 6.3–23.6) and for non-Hispanics was 20 per 100,000 (95% CI, 18.5–21.6). The incidence rate for Hispanics decreased by 56%, while the rate for non-Hispanics increased by 33%, from 1985 through 2010. In a Poisson regression, white race ( p < 0.0001), a later year of diagnosis ( p < 0.001), male sex ( p < 0.001) and younger age ( p = 0.009) were significantly associated with a higher incidence rate of IBD. Conclusions: There were significant racial and ethnic differences in the incidence and temporal trends of IBD over the last four decades in this US population-based cohort.

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Severe COVID-19 in inflammatory bowel disease patients in a population-based setting

PLoS ONE ◽

10.1371/journal.pone.0258271 ◽

2021 ◽

Vol 16 (10) ◽

pp. e0258271

Author(s):

Rob H. Creemers ◽

Ashkan Rezazadeh Ardabili ◽

Daisy M. Jonkers ◽

Mathie P. G. Leers ◽

Mariëlle J. Romberg-Camps ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

General Population ◽

Incidence Rate ◽

Bowel Disease ◽

Clinical Course ◽

Population Based ◽

Incidence Rates ◽

Systemic Medication ◽

Increased Risk ◽

Inflammatory Bowel

Objective Data on the course of severe COVID-19 in inflammatory bowel disease (IBD) patients remains limited. We aimed to determine the incidence rate and clinical course of severe COVID-19 in the heavily affected South-Limburg region in the Netherlands. Methods All COVID-19 patients admitted to the only two hospitals covering the whole South-Limburg region between February 27, 2020 and January 4, 2021 were included. Incidence rates for hospitalization due to COVID-19 were determined for the IBD (n = 4980) and general population (n = 597,184) in South-Limburg. Results During a follow-up of 4254 and 510,120 person-years, 20 IBD patients (0.40%; 11 ulcerative colitis (UC), 9 Crohn’s disease (CD)) and 1425 (0.24%) patients from the general population were hospitalized due to proven COVID-19 corresponding to an incidence rate of 4.7 (95% Confidence interval (CI) 3.0–7.1) and 2.8 (95% CI 2.6–2.9) per 1000 patient years, respectively (Incidence rate ratio: 1.68, 95% CI 1.08–2.62, p = 0.019). Median age (IBD: 63.0 (IQR 58.0–75.8) years vs. general population: 72.0 (IQR 62.0–80.0) years, p = 0.10) and mean BMI (IBD: 24.4 (SD 3.3) kg/m2 vs. general population 24.1 (SD 4.9) kg/m2, p = 0.79) at admission were comparable in both populations. As for course of severe COVID-19, similar rates of ICU admission (IBD: 12.5% vs. general population: 15.7%, p = 1.00), mechanical ventilation (6.3% vs. 11.2%, p = 1.00) and death were observed (6.3% vs. 21.8%, p = 0.22). Conclusion We found a statistically significant higher rate of hospitalization due to COVID-19 in IBD patients in a population-based setting in a heavily impacted Dutch region. This finding reflects previous research that showed IBD patients using systemic medication were at an increased risk of serious infection. However, although at an increased risk of hospitalization, clinical course of severe COVID-19 was comparable to hospitalized patients without IBD.

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A 30-year Trend Analysis in the Epidemiology of Inflammatory Bowel Disease in the Songpa-Kangdong District of Seoul, Korea in 1986–2015

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz081 ◽

2019 ◽

Vol 13 (11) ◽

pp. 1410-1417 ◽

Cited By ~ 21

Author(s):

Sang Hyoung Park ◽

Ye-Jee Kim ◽

Kyoung Hoon Rhee ◽

Young-Ho Kim ◽

Sung Noh Hong ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Temporal Trends ◽

Perianal Fistula ◽

Population Based ◽

Incidence Rates ◽

Female Ratio ◽

Male Predominance ◽

Adjusted Incidence Rate ◽

Inflammatory Bowel

Abstract Background and Aims Although the incidence of inflammatory bowel disease [IBD] is increasing in Asia, data on long-term epidemiological trends are limited. We performed a 30-year longitudinal study to investigate temporal trends in the epidemiology of Crohn’s disease [CD] and ulcerative colitis [UC] in Seoul, Korea. Methods This population-based study included 1431 IBD patients [418 CD, 1013 UC] diagnosed between 1986 and 2015 in the Songpa-Kangdong district of Seoul, Korea. Temporal trends in incidence, prevalence, and disease phenotype at diagnosis were analysed. Results The adjusted mean annual incidence rates of CD and UC per 100 000 inhabitants increased from 0.06 (95% confidence interval [CI], 0.05–0.07) and 0.29 [95% CI, 0.27–0.31], respectively, in 1986–1990 to 2.44 [95% CI, 2.38–2.50] and 5.82 [95% CI, 5.73–5.92], respectively, in 2011–2015. Average annual percentage change in IBD incidence was 12.3% in 1986–1995, 12.3% in 1996–2005, and 3.3% in 2006–2015. The male-to-female ratio of the adjusted incidence rate was 3.3:1 for CD and 1.2:1 for UC. Perianal fistula/abscess was present in 43.3% of patients before or at CD diagnosis. At diagnosis, 54.3% of UC patients presented only with proctitis. The adjusted prevalence rate in 2015 was 31.59/100 000 [95% CI, 31.10–32.07] for CD and 76.66/100 000 [95% CI, 75.91–77.42] for UC. Conclusions The incidence and prevalence of IBD in Korea have continued to increase over the past three decades. Korean patients have distinct demographic and phenotypic characteristics, including a male predominance and high frequency of perianal fistula/abscess in CD and high proportion of proctitis in UC.

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Population-Based Evidence From a Western Canadian Province of the Decreasing Incidence Rates and Trends of Inflammatory Bowel Disease Among Adults

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwaa028 ◽

2020 ◽

Author(s):

Jessica Amankwah Osei ◽

Juan Nicolás Peña-Sánchez ◽

Sharyle A Fowler ◽

Nazeem Muhajarine ◽

Gilaad G Kaplan ◽

...

Keyword(s):

Ulcerative Colitis ◽

Health Care ◽

Inflammatory Bowel Disease ◽

Incidence Rate ◽

Bowel Disease ◽

Population Based ◽

Incidence Rates ◽

Annual Incidence ◽

Average Annual Incidence ◽

Inflammatory Bowel

Abstract Background and Aims Canada has one of the highest inflammatory bowel disease (IBD) incidence rates worldwide. Higher IBD incidence rates have been identified among urban regions compared to rural regions. The study objectives were to (i) estimate IBD incidence rates in Saskatchewan from 1999 to 2016 and (ii) test for differences in IBD incidence rates for rural and urban regions of Saskatchewan. Methods A population-based study was conducted using provincial administrative health databases. Individuals aged 18+ years with newly diagnosed Crohn’s disease or ulcerative colitis were identified using a validated case definition. Generalized linear models with a negative binomial distribution were used to estimate incidence rates and incidence rate ratios (IRRs) adjusted for age group, sex and rurality with 95% confidence intervals (CIs). Results The average annual incidence rate of IBD among adults in Saskatchewan decreased from 75/100,000 (95% CI 67 to 84) in 1999 to 15/100,000 (95% CI 12 to 18) population in 2016. The average annual incidence of IBD declined significantly by 6.9% (95% CI −7.6 to −6.2) per year. Urban residents had a greater overall risk of IBD (IRR = 1.19, 95% CI 1.11 to 1.27) than rural residents. This risk difference was statistically significant for Crohn’s disease (IRR = 1.25, 95% CI 1.14 to 1.36), but not for ulcerative colitis (IRR = 1.08, 95% CI 0.97 to 1.19). Conclusions The incidence of IBD in Saskatchewan dropped significantly from 1999 to 2016 with urban dwellers having a 19% higher risk of IBD onset compared to their rural counterparts. Health care providers and decision-makers should plan IBD-specific health care programs considering these specific IBD rates.

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Inflammatory bowel disease and new-onset psychiatric disorders in pregnancy and post partum: a population-based cohort study

Gut ◽

10.1136/gutjnl-2018-317610 ◽

2019 ◽

Vol 68 (9) ◽

pp. 1597-1605 ◽

Cited By ~ 5

Author(s):

Simone N Vigod ◽

Paul Kurdyak ◽

Hilary K Brown ◽

Geoffrey C Nguyen ◽

Laura E Targownik ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Mental Illness ◽

Cohort Study ◽

Bowel Disease ◽

Post Partum ◽

Population Based ◽

Incidence Rates ◽

Increased Risk ◽

Inflammatory Bowel ◽

New Onset

ObjectivePatients with inflammatory bowel disease (IBD) have an elevated risk of mental illness. We determined the incidence and correlates of new-onset mental illness associated with IBD during pregnancy and post partum.DesignThis cohort study using population-based health administrative data included all women with a singleton live birth in Ontario, Canada (2002–2014). The incidence of new-onset mental illness from conception to 1-year post partum was compared between 3721 women with and 798 908 without IBD, generating adjusted HRs (aHR). Logistic regression was used to identify correlates of new-onset mental illness in the IBD group.ResultsAbout 22.7% of women with IBD had new-onset mental illness versus 20.4% without, corresponding to incidence rates of 150.2 and 132.8 per 1000 patient-years (aHR 1.12, 95% CI 1.05 to 1.20), or one extra case of new-onset mental illness per 43 pregnant women with IBD. The risk was elevated in the post partum (aHR 1.20, 95% CI 1.09 to 1.31), but not during pregnancy, and for Crohn’s disease (aHR 1.12, 95% CI 1.02 to 1.23), but not ulcerative colitis. The risk was specifically elevated for a new-onset mood or anxiety disorder (aHR 1.14, 95% CI 1.04 to 1.26) and alcohol or substance use disorders (aHR 2.73, 95% CI 1.42 to 5.26). Predictors of a mental illness diagnosis were maternal age, delivery year, medical comorbidity, number of prenatal visits, family physician obstetrical care and infant mortality.ConclusionWomen with IBD were at an increased risk of new-onset psychiatric diagnosis in the postpartum period, but not during pregnancy. Providers should look to increase opportunities for prevention, early identification and treatment accordingly.

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A60 THE INCIDENCE OF INFLAMMATORY BOWEL DISEASE IS DECREASING IN SASKATCHEWAN: A POPULATION-BASED COHORT STUDY

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwz047.059 ◽

2020 ◽

Vol 3 (Supplement_1) ◽

pp. 71-73

Author(s):

J A Osei ◽

J Peña-Sánchez ◽

S Fowler ◽

N Muhajarine ◽

G G Kaplan ◽

...

Keyword(s):

Health Care ◽

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Population Based ◽

Incidence Rates ◽

Age Group ◽

Newly Diagnosed ◽

Average Annual Incidence ◽

Inflammatory Bowel ◽

Group Sex

Abstract Background Canada has one of the highest inflammatory bowel disease (IBD) incidence rates worldwide, although within Canada rates vary. Evidence show increasing incidence rates of IBD in Ontario (i.e. adults aged 30–60), stable in Alberta and decreasing in Manitoba. Additionally, higher incident rates of IBD have been identified among urban regions compared to rural regions. There is limited data on the incidence of IBD in Saskatchewan. Aims The study objectives were to 1) estimate IBD incidence rates in Saskatchewan from 1999 to 2016, and 2) test for differences in IBD incidence rates for rural and urban regions of Saskatchewan. Methods A population-based study was conducted using linked provincial administrative health databases. Individuals age 18+ old with newly diagnosed Crohn’s disease (CD) or ulcerative colitis (UC) were identified using a validated case definition. Generalized linear models with a negative binomial distribution were used to estimate incidence rates and incidence rate ratios (IRR) adjusted for age group, sex, and rurality with 95% confidence intervals (95%CI). Results In total, 4,908 newly diagnosed individuals with IBD were included. The average annual incidence rate of IBD decreased from 75 (95%CI 67–84) per 100,000 people in 1999 to 15 (95%CI 12–18) per 100,000 population in 2016. This decrease was evident in both UC (from 36/100,000 [95%CI 31–42] in 1999 to 6/100,000 [95%CI 4–8] in 2016) and CD (37/100,000 [95%CI 32–42] in 1999 to 8/100,000 [95%CI 6–10] in 2016). A significant decline of 6.9% (95%CI 6.2–7.6) in the average annual incidence of IBD was estimated between 1999 and 2016 (see Figure 1). Urban residents had a greater overall risk of IBD (IRR=1.19, 95%CI 1.11–1.27) than rural residents. This risk difference was statistically significant for CD (IRR=1.25, 95%CI 1.14–1.36), but not UC (IRR=1.08, 95%CI 0.97–1.19). Conclusions A decreasing trend in IBD incidence in Saskatchewan was identified after adjusting for age group, sex, and rural/urban region of residence. Around 150 new cases of IBD are still diagnosed annually in Saskatchewan, but this estimate is lower than estimates from other provinces. Urban dwellers have a 25% higher risk of CD onset compared to their rural counterparts. This finding could suggest the presence of specific risk factors in urban settings that require further investigation. Health care providers and decision-makers should plan IBD-specific health care programs taking into account these specific IBD rates in Saskatchewan. Funding Agencies College of Medicine, University of Saskatchewan

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Increasing Prevalence and Stable Incidence Rates of Inflammatory Bowel Disease Among First Nations: Population-Based Evidence From a Western Canadian Province

Inflammatory Bowel Diseases ◽

10.1093/ibd/izab096 ◽

2021 ◽

Author(s):

Juan Nicolás Peña-Sánchez ◽

Jessica Amankwah Osei ◽

Jose Diego Marques Santos ◽

Derek Jennings ◽

Mustafa Andkhoie ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

First Nations ◽

Indigenous Peoples ◽

Bowel Disease ◽

Population Based ◽

Incidence Rates ◽

Canadian Province ◽

Trends Over Time ◽

Inflammatory Bowel ◽

Over Time

Abstract Background There is limited to no evidence of the prevalence and incidence rates of inflammatory bowel disease (IBD) among Indigenous peoples. In partnership with Indigenous patients and family advocates, we aimed to estimate the prevalence, incidence, and trends over time of IBD among First Nations (FNs) since 1999 in the Western Canadian province of Saskatchewan. Methods We conducted a retrospective population-based study linking provincial administrative health data from the 1999-2000 to 2016-2017 fiscal years. An IBD case definition requiring multiple health care contacts was used. The prevalence and incidence data were modeled using generalized linear models and a negative binomial distribution. Models considered the effect of age groups, sex, diagnosis type (ulcerative colitis [UC], Crohn disease [CD]), and fiscal years to estimate prevalence and incidence rates and trends over time. Results The prevalence of IBD among FNs increased from 64/100,000 (95% confidence interval [CI], 62-66) in 1999-2000 to 142/100,000 (95% CI, 140-144) people in 2016-2017, with an annual average increase of 4.2% (95% CI, 3.2%-5.2%). Similarly, the prevalence of UC and CD, respectively, increased by 3.4% (95% CI, 2.3%-4.6%) and 4.1% (95% CI, 3.3%-4.9%) per year. In contrast, the incidence rates of IBD, UC, and CD among FNs depicted stable trends over time; no statistically significant changes were observed in the annual change trend tests. The ratio of UC to CD was 1.71. Conclusions We provided population-based evidence of the increasing prevalence and stable incidence rates of IBD among FNs. Further studies are needed in other regions to continue understanding the patterns of IBD among Indigenous peoples.

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The Changing Epidemiology of Inflammatory Bowel Disease: What Goes Up May Come Down

Inflammatory Bowel Diseases ◽

10.1093/ibd/izz186 ◽

2019 ◽

Vol 26 (4) ◽

pp. 591-592 ◽

Cited By ~ 2

Author(s):

Hamed Khalili

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Disease Incidence ◽

Temporal Trends ◽

Epidemiologic Studies ◽

Incidence Rates ◽

Western World ◽

Geographic Variations ◽

Newly Industrialized Countries ◽

Inflammatory Bowel

Abstract Recent epidemiologic studies have shown that although the incidence of inflammatory bowel disease (IBD) is rapidly increasing in newly industrialized countries, at the turn of the 21st century the incidence had stabilized in the Western world. In this issue of Inflammatory Bowel Diseases, Torabi and colleagues present their findings on the temporal trends and geographic variations in IBD incidence in Manitoba from 1990 to 2012 using the Manitoba Health population registry and the University of Manitoba IBD epidemiology database. Their results demonstrate an overall decrease in the incidence of IBD during the study period. They also found significant regional variations in disease incidence within Manitoba, with rates of new diagnosis of IBD remaining high in several regions. Lastly, the study found that a higher proportion of the indigenous population had a lower rate of IBD. These findings provide new insights on the changing epidemiology of IBD in the Western world. The overall declining incidence of IBD and identification of persistently low and high-risk populations in Manitoba, which traditionally has had some of the highest incidence rates of IBD, is intriguing and can provide new avenues of research for epidemiologists in the field.

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Clostridioides difficile Infection in Children With Inflammatory Bowel Disease

Inflammatory Bowel Diseases ◽

10.1093/ibd/izz285 ◽

2019 ◽

Vol 26 (11) ◽

pp. 1700-1706

Author(s):

Abin Chandrakumar ◽

Hussein Zohni ◽

Wael El-Matary

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Cox Regression ◽

Population Based ◽

Incidence Rates ◽

Categorical Variables ◽

Fisher Exact Test ◽

Clostridioides Difficile ◽

Increased Risk ◽

Inflammatory Bowel

Abstract Background The study’s objective was to investigate the incidence and risk factors associated with Clostridioides difficile (previously known as Clostridium) infection (CDI) in children with inflammatory bowel disease (IBD) in the province of Manitoba. Methods Our longitudinal population-based cohort was comprised of all children and young adults aged <17 years diagnosed with IBD in the Canadian province of Manitoba between 2011 and 2019. The diagnosis of CDI was confirmed based on the Triage C. difficile immunoassay and polymerase chain reaction assay to detect the presence of toxigenic C. difficile. The Fisher exact test was used to examine the relationship between categorical variables. A Cox regression model was used to estimate the risk of CDI development in IBD patients. Results Among 261 children with IBD, 20 (7.7%) developed CDI with an incidence rate of 5.04 cases per 1000 person-years, and the median age at diagnosis (interquartile range) was 12.96 (9.33–15.81) years. The incidence rates of CDI among UC and CD patients were 4.16 cases per 1000 person-years and 5.88 cases per 1000 person-years, respectively (P = 0.46). Compared with children without CDI, those who had CDI were at increased risk of future exposure to systemic corticosteroids (adjusted hazard ratio [aHR], 4.38; 95% confidence interval [CI], 1.46–13.10) and anti–tumor necrosis factor (anti-TNF) biologics (aHR, 3.31; 95% CI, 1.11–9.90). The recurrence rate of CDI in our pediatric IBD population was 25%. Conclusions Our findings confirm that children with IBD are at high risk of developing CDI, which may predict future escalation of IBD therapy.

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