Details

Autor(en) / Beteiligte

• Windsor, J W
• Buie, M
• Coward, S
• Gearry, R
• Hansen, T
• King, J A
• Kotze, P
• Ma, C
• Ng, S
• Panaccione, N
• Panaccione, R
• Quan, J
• Seow, C
• Underwood, F
• Kaplan, G G

Titel

A28 RELATIVE RATES OF ULCERATIVE COLITIS TO CROHN’S DISEASE: PARALLEL EPIDEMIOLOGIES IN NEWLY VS. HIGHLY INDUSTRIALIZED COUNTRIES

Ist Teil von

• Journal of the Canadian Association of Gastroenterology, 2020-02, Vol.3 (Supplement_1), p.34-35

Ort / Verlag

US: Oxford University Press

Erscheinungsjahr

2020

Link zum Volltext

Quelle

Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals

Beschreibungen/Notizen

• Abstract Background Inflammatory bowel disease (IBD) first presents in a population as cases of ulcerative colitis (UC) followed by cases of Crohn’s disease (CD). Newly industrialized countries (NIC) show a prallel epidemiology of IBD to highly industrialized countries (HIC) in the previous century; one marker of this is the relative incidence/prevalence rates of UC to CD, which approximates 1 over time. Aims Provide evidence for the UC:CD ratio as a proxy for disease penatrance in a population. Methods Systematic review of MedLine and Embase for studies reporting incidence or prevalence of UC and CD. Log-linear regression (by region and NIC/HIC [2019 United Nations definitions]) was used to calculate average annual percent change (AAPC) and associated 95% confidence intervals (CI). Data were plotted on an online, interactive map to show trends (link provided). Results We extracted data from 218 studies compising population-level data from 69 countries. We found negative AAPCs as the prevalence ratio of UC:CD significantly decreased over time in East Asia, West Asia, North Europe, and South Europe; 6/12 global regions displayed significantly decreasing incidence ratios. No AAPC was found to be significantly increasing (Table 1). When examing HIC/NIC, we found a significant effect of NIC on the UC:CD prevalence ratio after 2000 (AAPC:−3.83;95%CI:−6.28,−1.31) while HIC regions remained stable (AAPC:2.14;95%CI:−1.40,5.82). Looking at all available data, both HICs and NICs show significantly decreasing UC:CD prevalence ratios (HIC:AAPC:−3.72;95% CI:−4.46,−2.97; NIC:AAPC:−2.62;95%CI:−4.13,−1.08). Conclusions In some HICs (eg. Canada), the UC:CD incidence ratio was <1 in the earliest available data (1966), explaining the stable AAPC in North America (AAPC:−0.24;95%CI:−1.12,0.65). However, in NICs (eg. Southern Asia), the AAPC is rapidly decreasing (AAPC:−24.68;95%CI:−37.85,−8.71) as areas like Sri Lanka rapidly fall from an incidence ratio of 7.5 (2007) to 2.8 (2012), mimicking trends in IBD epidimeology of HICs in the previous century. Region AAPC (95%CI) Incidence Prevalence North America −0.24 (−1.12, 0.65) −0.59 (−3.71, 2.63) Latin America & The Caribbean (including South America) −1.99 (−4.99, 1.11) 4.06 (−2.94, 11.56) Oceania −0.52 (−8.35, 7.98) 0.73 (−28.28, 41.47) Eastern Asia −1.80 (−4.19, 0.65) −2.05* (−3.49, −0.58) Southeastern Asia −5.21 (−11.19, 1.16) −3.47 (−7.23, 0.44) Southern Asia −24.68* (−37.85, −8.71) −9.03 (−21.07, 4.84) Western Asia −2.30* (−4.23, −0.32) −3.62* (−5.92, −1.26) Eastern Europe −1.80 (−4.19, 0.65) −3.92 (−8.78, 1.21) Northern Europe −2.21*(−2.89, −1.53) −2.80*(−3.84, −1.75) Southern Europe −1.65* (−2.48, −0.80) −3.02* (−5.23, −0.77 Western Europe 1.54 (−0.68, 3.82) 1.36 (−5.54, 8.77) Africa −10.06* (−18.68, −0.52) Insufficient data *Significant finding. a. Countries divided by HIC/NIC; b. most recent UC:CD incidence ratio; c. most recent UC:CD prevalence ratio (multiple studies reporting the same, most-recent year had values averaged). Funding Agencies None