Inflammatory bowel disease incidence in Czech children: A regional prospective study, 2000-2015
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摘要
AIM To examine the incidence and trends in pediatric inflammatory bowel diseases(IBDs) over 2000-2015 and project the incidence to 2018. METHODS A 16-year prospective study of IBD patients < 19 years of age was conducted in the Czech Republic(the Pilsen region). All incident IBD cases within a well-defined geographical area were retrieved from a prospectively collected computerized clinical database. Historical Czech data were used for comparison(1990-2001). Our catchment population was determined from the census data. We calculated the incidence by relating the number of newly diagnosed cases to the size of thepediatric population-at-risk in each calendar year. Age/sex, disease type, place of residence, and race/ethnicity were identified. RESULTS In total, 170 new IBD cases [105 Crohn's disease(CD), 48 ulcerative colitis(UC), and 17 IBD-unclassified(IBD-U)] were identified. The median age at IBD diagnosis was 14.2 years, 59.4% were males, and 97.1% were Caucasians. A male preponderance of IBD(P = 0.026) and CD(P = 0.016) was observed. With 109209 person-years in the catchment area, the average incidence of IBD per 100000 person-years was 10.0(6.2 for CD, 2.8 for UC, and 1.0 for IBD-U) for children aged 0 to 19 years; for those aged 0 to 15 years, the incidence rate was 7.3(4.6 for CD, 2.0 for UC, and 0.7 for IBD-U). An increase in incidence with age was observed(P = 0.0003). Over the 16-year period, the incidence increased for IBD patients(P = 0.01) and CD in particular(P < 0.0001), whereas the incidence for UC(P = 0.09) and IBD-U(P = 0.339) remained unchanged. IBD-projected data from 2016 to 2018 were 12.1, 12.3 and 12.6 per 100000 personyears, respectively.CONCLUSION Pediatric-onset IBD incidence is around its highest point. The increase, which is particularly pronounced for CD, may be challenging to relate to causes of pediatric disease.
AIM To examine the incidence and trends in pediatric inflammatory bowel diseases(IBDs) over 2000-2015 and project the incidence to 2018. METHODS A 16-year prospective study of IBD patients < 19 years of age was conducted in the Czech Republic(the Pilsen region). All incident IBD cases within a well-defined geographical area were retrieved from a prospectively collected computerized clinical database. Historical Czech data were used for comparison(1990-2001). Our catchment population was determined from the census data. We calculated the incidence by relating the number of newly diagnosed cases to the size of thepediatric population-at-risk in each calendar year. Age/sex, disease type, place of residence, and race/ethnicity were identified. RESULTS In total, 170 new IBD cases [105 Crohn's disease(CD), 48 ulcerative colitis(UC), and 17 IBD-unclassified(IBD-U)] were identified. The median age at IBD diagnosis was 14.2 years, 59.4% were males, and 97.1% were Caucasians. A male preponderance of IBD(P = 0.026) and CD(P = 0.016) was observed. With 109209 person-years in the catchment area, the average incidence of IBD per 100000 person-years was 10.0(6.2 for CD, 2.8 for UC, and 1.0 for IBD-U) for children aged 0 to 19 years; for those aged 0 to 15 years, the incidence rate was 7.3(4.6 for CD, 2.0 for UC, and 0.7 for IBD-U). An increase in incidence with age was observed(P = 0.0003). Over the 16-year period, the incidence increased for IBD patients(P = 0.01) and CD in particular(P < 0.0001), whereas the incidence for UC(P = 0.09) and IBD-U(P = 0.339) remained unchanged. IBD-projected data from 2016 to 2018 were 12.1, 12.3 and 12.6 per 100000 personyears, respectively.CONCLUSION Pediatric-onset IBD incidence is around its highest point. The increase, which is particularly pronounced for CD, may be challenging to relate to causes of pediatric disease.
AIM To examine the incidence and trends in pediatric inflammatory bowel diseases(IBDs) over 2000-2015 and project the incidence to 2018. METHODS A 16-year prospective study of IBD patients < 19 years of age was conducted in the Czech Republic(the Pilsen region). All incident IBD cases within a well-defined geographical area were retrieved from a prospectively collected computerized clinical database. Historical Czech data were used for comparison(1990-2001). Our catchment population was determined from the census data. We calculated the incidence by relating the number of newly diagnosed cases to the size of thepediatric population-at-risk in each calendar year. Age/sex, disease type, place of residence, and race/ethnicity were identified. RESULTS In total, 170 new IBD cases [105 Crohn's disease(CD), 48 ulcerative colitis(UC), and 17 IBD-unclassified(IBD-U)] were identified. The median age at IBD diagnosis was 14.2 years, 59.4% were males, and 97.1% were Caucasians. A male preponderance of IBD(P = 0.026) and CD(P = 0.016) was observed. With 109209 person-years in the catchment area, the average incidence of IBD per 100000 person-years was 10.0(6.2 for CD, 2.8 for UC, and 1.0 for IBD-U) for children aged 0 to 19 years; for those aged 0 to 15 years, the incidence rate was 7.3(4.6 for CD, 2.0 for UC, and 0.7 for IBD-U). An increase in incidence with age was observed(P = 0.0003). Over the 16-year period, the incidence increased for IBD patients(P = 0.01) and CD in particular(P < 0.0001), whereas the incidence for UC(P = 0.09) and IBD-U(P = 0.339) remained unchanged. IBD-projected data from 2016 to 2018 were 12.1, 12.3 and 12.6 per 100000 personyears, respectively.CONCLUSION Pediatric-onset IBD incidence is around its highest point. The increase, which is particularly pronounced for CD, may be challenging to relate to causes of pediatric disease.
引文
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2 Benchimol EI,Fortinsky KJ,Gozdyra P,Van den Heuvel M,Van Limbergen J,Griffiths AM.Epidemiology of pediatric inflammatory bowel disease:a systematic review of international trends.Inflamm Bowel Dis 2011;17:423-439[PMID:20564651DOI:10.1002/ibd.21349]
3 Benchimol EI,Guttmann A,Griffiths AM,Rabeneck L,Mack DR,Brill H,Howard J,Guan J,To T.Increasing incidence of paediatric inflammatory bowel disease in Ontario,Canada:evidence from health administrative data.Gut 2009;58:1490-1497[PMID:19651626 DOI:10.1136/gut.2009.188383]
4 Muhvi?-Urek M,Tomac-Stojmenovi?M,Mijandru?i?-Sin?i?B.Oral pathology in inflammatory bowel disease.World J Gastroenterol 2016;22:5655-5667[PMID:27433081 DOI:10 .3748/wjg.v22.i25.5655]
5 Molodecky NA,Soon IS,Rabi DM,Ghali WA,Ferris M,Chernoff G,Benchimol EI,Panaccione R,Ghosh S,Barkema HW,Kaplan GG.Increasing incidence and prevalence of the inflammatory bowel diseases with time,based on systematic review.Gastroenterology2012;142:46-54.e42;quiz e30[PMID:22001864 DOI:10.1053/j.gastro.2011.10.001]
6 Urlep D,Blagus R,Orel R.Incidence Trends and Geographical Variability of Pediatric Inflammatory Bowel Disease in Slovenia:A Nationwide Study.Biomed Res Int 2015;2015:921730[PMID:26688822 DOI:10.1155/2015/921730]
7 Larsen MD,Baldal ME,Nielsen RG,Nielsen J,Lund K,N?rg?rd BM.The incidence of Crohn’s disease and ulcerative colitis since1995 in Danish children and adolescents<17 years-based on nationwide registry data.Scand J Gastroenterol 2016;51:1100-1105[PMID:27160395 DOI:10.3109/00365521.2016.1172340]
8 Martín-de-Carpi J,Rodríguez A,Ramos E,Jiménez S,Martínez-Gómez MJ,Medina E.Increasing incidence of pediatric inflammatory bowel disease in Spain(1996-2009):the SPIRIT Registry.Inflamm Bowel Dis 2013;19:73-80[PMID:22535573DOI:10.1002/ibd.22980]
9 Henderson P,Hansen R,Cameron FL,Gerasimidis K,Rogers P,Bisset WM,Reynish EL,Drummond HE,Anderson NH,Van Limbergen J,Russell RK,Satsangi J,Wilson DC.Rising incidence of pediatric inflammatory bowel disease in Scotland.Inflamm Bowel Dis 2012;18:999-1005[PMID:21688352 DOI:10.1002/ibd.21797]
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