World Congress at ACG2017
Presidential Plenary Session 2 (Free Paper/Abstract Presentations)
9 - Evolving Trends in the Epidemiology of IBD in the 21st Century: A Systematic Review of Population-Based Studies
Monday, October 16
10:06 AM - 10:18 AM
Location: Valencia Ballroom (Level 4)
.jpg "Gilaad Kaplan, MD, MPH photo")
Gilaad Kaplan, MD, MPH
Associate Professor
University of Calgary
Calgary, Alberta, Canada
Presenting Author(s)
Category: IBD
Siew C. Ng, MBBS, PhD1, Hai Yun Shi, MD2, Nima Hamidi, MD3, Fox Underwood, MSc3, Whitney Tang, MD2, Eric Benchimol, MD, PhD4, Remo Panaccione, MD, FRCP5, Subrata Ghosh, MD6, Justin Wu, MD2, Francis Chan, MD2, Joseph Sung, MD2, Gilaad Kaplan, MD, MPH 3
1Chinese University of Hong Kong, Shatin, Hong Kong; 2Chinese University of Hong Kong, Hong Kong, Hong Kong; 3University of Calgary, Calgary, AB, Canada; 4Children's Hospital of Eastern Ontario, Ottawa, ON, Canada; 5University of Calgary, Department of Medicine, Calgary, AB, Canada; 6Institute of Translational Medicine, Birmingham, United Kingdom
Introduction: In the 21st century IBD has evolved into a global disease. We evaluated population-based studies reporting the incidence of IBD across the world since 1990 based on different geographical regions and performed temporal trend analyses of incidence rates.
Methods: We performed a systematic review, through 31 December 2016, to identify population-based studies reporting incidence of Crohn’s disease (CD) or ulcerative colitis (UC) from 1990 or after. Choropleth maps were created for the incidence of CD and UC for the time period 1990 to 2016. We performed temporal trend analyses using Poisson regression reported as annual percent change (APC) with 95% confidence intervals (CI).
Results: Amongst 11,170 reports screened, 226 full-text reviews were identified and 113 incidence studies included. The incidence of CD and UC (Figure 1 and 2)are presented in worldwide maps. Overall, 70.0% of CD and 83.3% of UC studies demonstrated stable or decreasing incidence of IBD in North America, Europe, and Oceania. Since 1990, incidence has been rising in newly industrialized countries outside the Western world. For example, Brazil (CD: APC = +11.1, 95% CI: 4.8, 17.8; UC: APC = +14.9, 95% CI: 10.4, 19.6), Taiwan (CD: APC = +4.0, 95% CI: 1.0, 7.1; UC: APC = +4.8, 95% CI: 1.8, 8.0).
Discussion: This systematic review provides a comprehensive global overview of the incidence of IBD over the past generation. We have observed a paradigm shift in the epidemiology of IBD. Since 1990, the incidence of IBD has stabilized in the Western world. In contrast, newly industrialized countries are showing rising incidence analogous to trends observed in the Western world during the latter part of the 20th century.
Methods: We performed a systematic review, through 31 December 2016, to identify population-based studies reporting incidence of Crohn’s disease (CD) or ulcerative colitis (UC) from 1990 or after. Choropleth maps were created for the incidence of CD and UC for the time period 1990 to 2016. We performed temporal trend analyses using Poisson regression reported as annual percent change (APC) with 95% confidence intervals (CI).
Results: Amongst 11,170 reports screened, 226 full-text reviews were identified and 113 incidence studies included. The incidence of CD and UC (Figure 1 and 2)are presented in worldwide maps. Overall, 70.0% of CD and 83.3% of UC studies demonstrated stable or decreasing incidence of IBD in North America, Europe, and Oceania. Since 1990, incidence has been rising in newly industrialized countries outside the Western world. For example, Brazil (CD: APC = +11.1, 95% CI: 4.8, 17.8; UC: APC = +14.9, 95% CI: 10.4, 19.6), Taiwan (CD: APC = +4.0, 95% CI: 1.0, 7.1; UC: APC = +4.8, 95% CI: 1.8, 8.0).
Discussion: This systematic review provides a comprehensive global overview of the incidence of IBD over the past generation. We have observed a paradigm shift in the epidemiology of IBD. Since 1990, the incidence of IBD has stabilized in the Western world. In contrast, newly industrialized countries are showing rising incidence analogous to trends observed in the Western world during the latter part of the 20th century.
Supported by Industry Grant: No
Figure 1: Map of worldwide incidence in quintiles for Crohn’s disease.
Figure 2: Map of worldwide incidence in quintiles for ulcerative colitis.
Citation: . EVOLVING TRENDS IN THE EPIDEMIOLOGY OF IBD IN THE 21ST CENTURY: A SYSTEMATIC REVIEW OF POPULATION-BASED STUDIES. Program No. 9. World Congress of Gastroenterology at ACG2017 Meeting Abstracts. Orlando, FL: American College of Gastroenterology.