Trends in Epidemiology of Pediatric Inflammatory Bowel Disease in Canada: Distributed Network Analysis of Multiple Population-Based Provincial Health Administrative Databases

被引:231
作者
Benchimol, Eric I. [1 ,2 ,3 ,4 ]
Bernstein, Charles N. [5 ,6 ]
Bitton, Alain [7 ]
Carroll, Matthew W. [8 ]
Singh, Harminder [5 ,6 ]
Otley, Anthony R. [9 ]
Vutcovici, Maria [7 ]
El-Matary, Wael [10 ]
Nguyen, Geoffrey C. [4 ,11 ]
Griffiths, Anne M. [12 ]
Mack, David R. [1 ,2 ]
Jacobson, Kevan [13 ]
Mojaverian, Nassim [4 ]
Tanyingoh, Divine [14 ,15 ]
Cui, Yunsong [16 ]
Nugent, Zoann J. [5 ]
Coulombe, Janie [7 ]
Targownik, Laura E. [5 ,6 ]
Jones, Jennifer L. [16 ]
Leddin, Desmond [16 ]
Murthy, Sanjay K. [4 ,14 ,15 ]
Kaplan, Gilaad G. [17 ]
机构
[1] Childrens Hosp Eastern Ontario, Div Gastroenterol Hepatol & Nut, IBD Ctr, Div Gastroenterol, Ottawa, ON, Canada
[2] Univ Ottawa, Dept Pediat, Ottawa, ON, Canada
[3] Univ Ottawa, Sch Epidemiol Publ Hlth & Prevent Med, Ottawa, ON, Canada
[4] Inst Clin Evaluat Sci, Toronto, ON, Canada
[5] Univ Manitoba, IBD Clin & Res Ctr, Winnipeg, MB, Canada
[6] Univ Manitoba, Dept Internal Med, Winnipeg, MB, Canada
[7] McGill Univ, Hlth Ctr, Div Gastroenterol, Montreal, PQ, Canada
[8] Univ Alberta, Dept Pediat, Div Pediat Gastroenterol & Nutr, Edmonton, AB, Canada
[9] Dalhousie Univ, Dept Pediat, Halifax, NS, Canada
[10] Univ Manitoba, Dept Pediat, Winnipeg, MB, Canada
[11] Univ Toronto, Mt Sinai Hosp, Ctr Inflammatory Bowel Dis, Dept Med, Toronto, ON, Canada
[12] Univ Toronto, Hosp Sick Children, Dept Paediat, Div Gastroenterol Hepatol & Nutr, Toronto, ON, Canada
[13] Univ British Columbia, Child & Family Res Inst, Dept Pediat, Vancouver, BC, Canada
[14] Univ Calgary, Dept Med, Calgary, AB, Canada
[15] Univ Calgary, Dept Community Hlth Sci, Calgary, AB, Canada
[16] Dalhousie Univ, Dept Med, Halifax, NS, Canada
[17] Univ Ottawa, Ottawa Hosp, Dept Med, Res Inst, Ottawa, ON, Canada
[18] Canadian Gastrointestinal Epidemiol Consortium Ca, Toronto, ON, Canada
基金
加拿大健康研究院;
关键词
CROHNS-DISEASE; ULCERATIVE-COLITIS; INCREASING INCIDENCE; CHILDREN; PREVALENCE; BURDEN; DEFINITION; COUNTY; COHORT; AGE;
D O I
10.1038/ajg.2017.97
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
OBJECTIVES: The incidence of pediatric-onset inflammatory bowel disease (IBD) is increasing worldwide. We used population-based health administrative data to determine national Canadian IBD incidence, prevalence, and trends over time of childhood-onset IBD. METHODS: We identified children <16 years (y) diagnosed with IBD 1999-2010 from health administrative data in five provinces (Alberta, Manitoba, Nova Scotia, Ontario, Quebec), comprising 79.2% of the Canadian population. Standardized incidence and prevalence were calculated per 100,000 children. Annual percentage change (APC) in incidence and prevalence were determined using Poisson regression analysis. Provincial estimates were meta-analyzed using random-effects models to produce national estimates. RESULTS: 5,214 incident cases were diagnosed during the study period (3,462 Crohn's disease, 1,382 ulcerative colitis, 279 type unclassifiable). The incidence in Canada was 9.68 (95% CI 9.11 to 10.25) per 100,000 children. Incidence was similar amongst most provinces, but higher in Nova Scotia. APC in incidence did not significantly change over the study period in the overall cohort (+2.06%, 95% CI -0.64% to +4.76%). However, incidence significantly increased in children aged 0-5y (+7.19%, 95% +2.82% to +11.56%). Prevalence at the end of the study period in Canada was 38.25 (95% CI 35.78 to 40.73) per 100,000 children. Prevalence increased significantly over time, APC +4.56% (95% CI +3.71% to +5.42%). CONCLUSIONS: Canada has amongst the highest incidence of childhood-onset IBD in the world. Prevalence significantly increased over time. Incidence was not statistically changed with the exception of a rapid increase in incidence in the youngest group of children.
引用
收藏
页码:1120 / 1134
页数:15
相关论文
共 46 条
[1]  
[Anonymous], 2009, POPULATION SELECTED
[2]   The role of the environment in the development of pediatric inflammatory bowel disease topical collection on pediatric gastroenterology [J].
Aujnarain A. ;
Mack D.R. ;
Benchimol E.I. .
Current Gastroenterology Reports, 2013, 15 (6)
[3]   Increasing incidence of paediatric inflammatory bowel disease in Ontario, Canada: evidence from health administrative data [J].
Benchimol, E. I. ;
Guttmann, A. ;
Griffiths, A. M. ;
Rabeneck, L. ;
Mack, D. R. ;
Brill, H. ;
Howard, J. ;
Guan, J. ;
To, T. .
GUT, 2009, 58 (11) :1490-1497
[4]   The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) Statement [J].
Benchimol, Eric I. ;
Smeeth, Liam ;
Guttmann, Astrid ;
Harron, Katie ;
Moher, David ;
Petersen, Irene ;
Sorensen, Henrik T. ;
von Elm, Erik ;
Langan, Sinead M. .
PLOS MEDICINE, 2015, 12 (10)
[5]   Inflammatory Bowel Disease in Immigrants to Canada And Their Children: A Population-Based Cohort Study [J].
Benchimol, Eric I. ;
Mack, David R. ;
Guttmann, Astrid ;
Nguyen, Geoffrey C. ;
To, Teresa ;
Mojaverian, Nassim ;
Quach, Pauline ;
Manuel, Douglas G. .
AMERICAN JOURNAL OF GASTROENTEROLOGY, 2015, 110 (04) :553-563
[6]   Incidence, Outcomes, and Health Services Burden of Very Early Onset Inflammatory Bowel Disease [J].
Benchimol, Eric I. ;
Mack, David R. ;
Nguyen, Geoffrey C. ;
Snapper, Scott B. ;
Li, Wenbin ;
Mojaverian, Nassim ;
Quach, Pauline ;
Muise, Aleixo M. .
GASTROENTEROLOGY, 2014, 147 (04) :803-U156
[7]   Changing Age Demographics of Inflammatory Bowel Disease in Ontario, Canada: A Population-based Cohort Study of Epidemiology Trends [J].
Benchimol, Eric I. ;
Manuel, Douglas G. ;
Guttmann, Astrid ;
Nguyen, Geoffrey C. ;
Mojaverian, Nassim ;
Quach, Pauline ;
Mack, David R. .
INFLAMMATORY BOWEL DISEASES, 2014, 20 (10) :1761-1769
[8]   Epidemiology of Pediatric Inflammatory Bowel Disease: A Systematic Review of International Trends [J].
Benchimol, Eric I. ;
Fortinsky, Kyle J. ;
Gozdyra, Peter ;
Van den Heuvel, Meta ;
Van Limbergen, Johan ;
Griffiths, Anne M. .
INFLAMMATORY BOWEL DISEASES, 2011, 17 (01) :423-439
[9]   The epidemiology of inflammatory bowel disease in Canada: A population-based study [J].
Bernstein, Charles N. ;
Wajda, Andre ;
Svenson, Lawrence W. ;
MacKenzie, Adrian ;
Koehoorn, Mieke ;
Jackson, Maureen ;
Fedorak, Richard ;
Israel, David ;
Blanchard, James F. .
AMERICAN JOURNAL OF GASTROENTEROLOGY, 2006, 101 (07) :1559-1568
[10]  
Bernstein CN, 1999, AM J EPIDEMIOL, V149, P916, DOI 10.1093/oxfordjournals.aje.a009735