Changing patterns in the epidemiology and outcomes of inflammatory bowel disease in the United Kingdom: 2000-2018.
Adolescent
Adult
Aged
Aged, 80 and over
Body Mass Index
Colitis, Ulcerative
/ epidemiology
Colorectal Neoplasms
/ epidemiology
Comorbidity
Crohn Disease
/ epidemiology
Female
Humans
Incidence
Male
Middle Aged
Prevalence
Retrospective Studies
Smoking
/ epidemiology
United Kingdom
/ epidemiology
Young Adult
Journal
Alimentary pharmacology & therapeutics
ISSN: 1365-2036
Titre abrégé: Aliment Pharmacol Ther
Pays: England
ID NLM: 8707234
Informations de publication
Date de publication:
05 2020
05 2020
Historique:
received:
07
11
2019
revised:
01
12
2019
accepted:
09
03
2020
pubmed:
3
4
2020
medline:
17
9
2020
entrez:
3
4
2020
Statut:
ppublish
Résumé
Data regarding incidence, prevalence and long-term outcomes of inflammatory bowel diseases in the UK are limited or outdated. To investigate incidence and prevalence of Crohn's disease and ulcerative colitis and risk of colorectal cancer and all-cause mortality in these diseases. Inflammatory bowel disease cases between 2000 and 2018 were identified from a national primary care database. Inflammatory bowel disease prevalence was forecast until 2025. The association between inflammatory bowel disease and colorectal cancer and all-cause mortality was investigated using age/sex-matched retrospective cohort studies. Hazard ratios were adjusted for age, sex, deprivation, comorbidity, smoking status and body mass index. Ulcerative colitis prevalence increased from 390 to 570 per 100 000 population from 2000 to 2017. Prevalence of Crohn's disease increased from 220 to 400 per 100 000. In 2017 male Crohn's disease prevalence was 0.35% (95% confidence interval 0.34-0.36); female prevalence was 0.44% (0.43-0.45). Prevalence of inflammatory bowel disease is predicted to be 1.1% by 2025. Incidence of ulcerative colitis and Crohn's disease was 23.2 (22.8-23.6) and 14.3 (14.0-14.7) per 100 000 person-years respectively. Subjects with ulcerative colitis were more likely to develop colorectal cancer than controls (adjusted Hazard Ratio 1.40 [1.23-1.59]). Colorectal cancer rates remained stable in inflammatory bowel diseases over time. Ulcerative colitis and Crohn's disease were associated with increased risk of all-cause mortality (1.17 [1.14-1.21] and 1.42 [1.36-1.48] respectively). The UK prevalence of inflammatory bowel disease is greater than previous reports suggest and we predict an 11% increase in prevalence by the year 2025. Mortality risk in inflammatory bowel disease and colorectal cancer risk in ulcerative colitis are increased compared to matched controls.
Sections du résumé
BACKGROUND
Data regarding incidence, prevalence and long-term outcomes of inflammatory bowel diseases in the UK are limited or outdated.
AIMS
To investigate incidence and prevalence of Crohn's disease and ulcerative colitis and risk of colorectal cancer and all-cause mortality in these diseases.
METHODS
Inflammatory bowel disease cases between 2000 and 2018 were identified from a national primary care database. Inflammatory bowel disease prevalence was forecast until 2025. The association between inflammatory bowel disease and colorectal cancer and all-cause mortality was investigated using age/sex-matched retrospective cohort studies. Hazard ratios were adjusted for age, sex, deprivation, comorbidity, smoking status and body mass index.
RESULTS
Ulcerative colitis prevalence increased from 390 to 570 per 100 000 population from 2000 to 2017. Prevalence of Crohn's disease increased from 220 to 400 per 100 000. In 2017 male Crohn's disease prevalence was 0.35% (95% confidence interval 0.34-0.36); female prevalence was 0.44% (0.43-0.45). Prevalence of inflammatory bowel disease is predicted to be 1.1% by 2025. Incidence of ulcerative colitis and Crohn's disease was 23.2 (22.8-23.6) and 14.3 (14.0-14.7) per 100 000 person-years respectively. Subjects with ulcerative colitis were more likely to develop colorectal cancer than controls (adjusted Hazard Ratio 1.40 [1.23-1.59]). Colorectal cancer rates remained stable in inflammatory bowel diseases over time. Ulcerative colitis and Crohn's disease were associated with increased risk of all-cause mortality (1.17 [1.14-1.21] and 1.42 [1.36-1.48] respectively).
CONCLUSIONS
The UK prevalence of inflammatory bowel disease is greater than previous reports suggest and we predict an 11% increase in prevalence by the year 2025. Mortality risk in inflammatory bowel disease and colorectal cancer risk in ulcerative colitis are increased compared to matched controls.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
922-934Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2020 The Authors. Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd.
Références
Rocchi A, Benchimol EI, Bernstein CN, et al. Inflammatory bowel disease: a Canadian burden of illness review. Can J Gastroenterol J Can Gastroenterol. 2012;26:811-817.
Luces C, Bodger K. Economic burden of inflammatory bowel disease: a UK perspective. Expert Rev Pharmacoecon Outcomes Res. 2006;6:471-482.
Molodecky NA, Soon IS, Rabi DM, et al. Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology. 2012;142:46-54.e42; quiz e30.
Ng SC, Shi HY, Hamidi N, et al. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. Lancet Lond Engl. 2018;390:2769-2778.
Selinger CP, Andrews J, Dent OF, et al. Cause-specific mortality and 30-year relative survival of Crohn’s disease and ulcerative colitis. Inflamm Bowel Dis. 2013;19:1880-1888.
Eaden JA, Abrams KR, Mayberry JF. The risk of colorectal cancer in ulcerative colitis: a meta-analysis. Gut. 2001;48:526-535.
Castaño-Milla C, Chaparro M, Gisbert JP. Systematic review with meta-analysis: the declining risk of colorectal cancer in ulcerative colitis. Aliment Pharmacol Ther. 2014;39:645-659.
Jess T, Simonsen J, Jørgensen KT, Pedersen BV, Nielsen NM, Frisch M. Decreasing risk of colorectal cancer in patients with inflammatory bowel disease over 30 years. Gastroenterology. 2012;143:375-381.e1; quiz e13-14.
Rubin GP, Hungin AP, Kelly PJ, Ling J. Inflammatory bowel disease: epidemiology and management in an English general practice population. Aliment Pharmacol Ther. 2000;14:1553-1559.
Clinical guideline [CG166] Ulcerative colitis: management, June 2013. http://www.nice.org.uk/guidance/CG166
Burisch J, Pedersen N, Čuković-Čavka S, et al. East-West gradient in the incidence of inflammatory bowel disease in Europe: the ECCO-EpiCom inception cohort. Gut. 2014;63:588-597.
Jones G-R, Lyons M, Plevris N, et al. DOP87 Multi-parameter datasets are required to identify the true prevalence of IBD: the Lothian IBD Registry (LIBDR). J Crohns Colitis. 2019;13(Suppl 1):S082-S083
Blak BT, Thompson M, Dattani H, Bourke A. Generalisability of The Health Improvement Network (THIN) database: demographics, chronic disease prevalence and mortality rates. Inform Prim Care. 2011;19:251-255.
Nhs NB. What are the read codes? Health Libr Rev. 1994;11:177-182.
Maguire A, Blak BT, Thompson M. The importance of defining periods of complete mortality reporting for research using automated data from primary care. Pharmacoepidemiol Drug Saf. 2009;18:76-83.
Townsend P, Phillimore P, Beattie A. Health and Deprivation: Inequality and the North. London; New York: Croom Helm; 1988.
Lewis JD, Brensinger C, Bilker WB, Strom BL. Validity and completeness of the general practice research database for studies of inflammatory bowel disease. Pharmacoepidemiol Drug Saf. 2002;11:211-218.
Lewis JD, Schinnar R, Bilker WB, Wang X, Strom BL. Validation studies of the health improvement network (THIN) database for pharmacoepidemiology research. Pharmacoepidemiol Drug Saf. 2007;16:393-401.
Office of National Statistics. Estimates of population for the UK. https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/datasets/populationestimatesforukenglandandwalesscotlandandnorthernireland. Accessed December 12, 2019.
Nuttall M, van der Meulen J, Emberton M. Charlson scores based on ICD-10 administrative data were valid in assessing comorbidity in patients undergoing urological cancer surgery. J Clin Epidemiol. 2006;59:265-273.
Office of National Statistics. Data related to deaths. https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/datalist?filter=datasets. Accessed December 12, 2019.
Stata Statistical Software: Release 15. College Station, TX: StataCorp LP.: StataCorp; 2017.
Coward S, Clement F, Benchimol EI, et al. Past and future burden of inflammatory bowel diseases based on modeling of population-based data. Gastroenterology. 2019;156:1345-1353.e4.
Overview of the UK population: November 2018. https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/articles/overviewoftheukpopulation/november2018.
National Population Projections: 2016-based statistical bulletin. https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationprojections/bulletins/nationalpopulationprojections/2016basedstatisticalbulletin.
Ghosh N, Premchand P. A UK cost of care model for inflammatory bowel disease. Frontline Gastroenterol. 2015;6:169-174.
Frolkis AD, Dykeman J, Negrón ME, et al. Risk of surgery for inflammatory bowel diseases has decreased over time: a systematic review and meta-analysis of population-based studies. Gastroenterology. 2013;145:996-1006.
Nimmons D, Limdi JK. Elderly patients and inflammatory bowel disease. World J Gastrointest Pharmacol Ther. 2016;7:51-65.
Hou JK, Kramer JR, Richardson P, Mei M, El-Serag HB. El-Serag HB. The incidence and prevalence of inflammatory bowel disease among U.S. veterans: a national cohort study. Inflamm Bowel Dis. 2013;19:1059-1064.
Park SH, Kim Y-J, Rhee KH, et al. A 30-year Trend Analysis in the Epidemiology of Inflammatory Bowel Disease in the Songpa-Kangdong District of Seoul, Korea in 1986-2015. J Crohns Colitis. 2019;13(11):1410-1417. https://doi.org/10.1093/ecco-jcc/jjz081.
Leddin D, Tamim H, Levy AR. Decreasing incidence of inflammatory bowel disease in eastern Canada: a population database study. BMC Gastroenterol. 2014;14:140.
Romberg-Camps MJL, Hesselink-van de Kruijs MAM, Schouten LJ, et al. Inflammatory Bowel Disease in South Limburg (the Netherlands) 1991-2002: Incidence, diagnostic delay, and seasonal variations in onset of symptoms. J Crohns Colitis. 2009;3:115-124.
Bitton A, Vutcovici M, Patenaude V, Sewitch M, Suissa S, Brassard P. Epidemiology of inflammatory bowel disease in Québec: recent trends. Inflamm Bowel Dis. 2014;20:1770-1776.
Carr I, Mayberry JF. The effects of migration on ulcerative colitis: a three-year prospective study among Europeans and first- and second- generation South Asians in Leicester (1991-1994). Am J Gastroenterol. 1999;94:2918-2922.
Pinsk V, Lemberg DA, Grewal K, Barker CC, Schreiber RA, Jacobson K. Inflammatory bowel disease in the South Asian pediatric population of British Columbia. Am J Gastroenterol. 2007;102:1077-1083.
Probert CS, Jayanthi V, Hughes AO, Thompson JR, Wicks AC, Mayberry JF. Prevalence and family risk of ulcerative colitis and Crohn’s disease: an epidemiological study among Europeans and south Asians in Leicestershire. Gut. 1993;34:1547-1551.
Ruel J, Ruane D, Mehandru S, Gower-Rousseau C, Colombel J-F. IBD across the age spectrum: is it the same disease? Nat Rev Gastroenterol Hepatol. 2014;11:88-98.
Brant SR, Nguyen GC. Is there a gender difference in the prevalence of Crohn’s disease or ulcerative colitis? Inflamm Bowel Dis. 2008;14(Suppl 2):S2-3.
García Rodríguez LA, González-Pérez A, Johansson S, Wallander M-A. Risk factors for inflammatory bowel disease in the general population. Aliment Pharmacol Ther. 2005;22:309-315.
Shah SC, Khalili H, Chen C-Y, et al. Sex-based differences in the incidence of inflammatory bowel diseases-pooled analysis of population-based studies from the Asia-Pacific region. Aliment Pharmacol Ther. 2019;49:904-911.
Ortizo R, Lee SY, Nguyen ET, Jamal MM, Bechtold MM, Nguyen DL. Exposure to oral contraceptives increases the risk for development of inflammatory bowel disease: a meta-analysis of case-controlled and cohort studies. Eur J Gastroenterol Hepatol. 2017;29:1064-1070.
Cancer Research UK. https://www.cancerresearchuk.org./health-professional/cancer-statistics/statistics-by-cancer-type/pancreatic-cancer/survival#heading-Zero
Burisch J, Munkholm P. Inflammatory bowel disease epidemiology. Curr Opin Gastroenterol. 2013;29:357-362.
Aniwan S, Harmsen WS, Tremaine WJ, Kane SV, Loftus EV. Overall and cause-specific mortality of inflammatory bowel disease in Olmsted County, Minnesota, from 1970 through 2016. Mayo Clin Proc. 2018;93:1415-1422.
Jones G-R, Lyons M, Plevris N, et al. IBD prevalence in Lothian, Scotland, derived by capture-recapture methodology. Gut. 2019;68:1953-1960.
Mathur R, Bhaskaran K, Edwards E, et al. Population trends in the 10-year incidence and prevalence of diabetic retinopathy in the UK: a cohort study in the Clinical Practice Research Datalink 2004-2014. BMJ Open. 2017;7:e014444.
Quint JK, Millett ERC, Joshi M, et al. Changes in the incidence, prevalence and mortality of bronchiectasis in the UK from 2004 to 2013: a population-based cohort study. Eur Respir J. 2016;47:186-193.
Bloom CI, Saglani S, Feary J, Jarvis D, Quint JK. Changing prevalence of current asthma and inhaled corticosteroid treatment in the UK: population-based cohort 2006-2016. Eur Respir J. 2019;53:1802130.
Taleban S, Colombel J-F, Mohler MJ, Fain MJ. Inflammatory bowel disease and the elderly: a review. J Crohns Colitis. 2015;9:507-515.
Zhu Z, Mei Z, Guo Y, et al. Reduced risk of inflammatory bowel disease-associated colorectal neoplasia with use of thiopurines: a systematic review and meta-analysis. J Crohns Colitis. 2018;12:546-558.
Bewtra M, Kaiser LM, TenHave T, Lewis JD. Crohn’s disease and ulcerative colitis are associated with elevated standardized mortality ratios: a meta-analysis. Inflamm Bowel Dis. 2013;19:599-613.
Jess T, Gamborg M, Munkholm P, Sørensen TIA. Overall and cause-specific mortality in ulcerative colitis: meta-analysis of population-based inception cohort studies. Am J Gastroenterol. 2007;102:609-617.
Card T, Hubbard R, Logan RFA. Mortality in inflammatory bowel disease: a population-based cohort study. Gastroenterology. 2003;125:1583-1590.
Manninen P, Karvonen A-L, Huhtala H, et al. Mortality in ulcerative colitis and Crohn’s disease. A population-based study in Finland. J Crohns Colitis. 2012;6:524-528.
Duricova D, Pedersen N, Elkjaer M, Gamborg M, Munkholm P, Jess T. Overall and cause-specific mortality in Crohn’s disease: a meta-analysis of population-based studies. Inflamm Bowel Dis. 2010;16:347-353.
Jess T, Frisch M, Simonsen J. Trends in overall and cause-specific mortality among patients with inflammatory bowel disease from 1982 to 2010. Clin Gastroenterol Hepatol. 2013;11:43-48.
Olén O, Askling J, Sachs MC, et al. Mortality in adult-onset and elderly-onset IBD: a nationwide register-based cohort study 1964-2014. Gut. 2020;69:453-461.
Canavan C, Abrams KR, Mayberry JF. Meta-analysis: mortality in Crohn’s disease. Aliment Pharmacol Ther. 2007;25:861-870.