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Rising incidence of pediatric inflammatory bowel disease in Scotland
Paul Henderson1, Richard Hansen, Fiona L Cameron
1Department of Child Life and Health, University of Edinburgh, Edinburgh, UK.
Insights
Pediatric inflammatory bowel disease (PIBD) incidence in Scotland has significantly increased by 76% since the mid-1990s, with diagnoses occurring at a younger age. This rise in pediatric IBD cases warrants further investigation into potential causes.
Area of Science:
- Pediatric Gastroenterology
- Epidemiology
- Public Health
Background:
- Understanding trends in pediatric inflammatory bowel disease (PIBD) is crucial for identifying etiological factors.
- Previous data on PIBD incidence in Scotland exists from 1990-1995.
Purpose of the Study:
- To compare the current incidence and demographic attributes of PIBD in Scotland with historical data.
- To analyze changes in PIBD diagnosis rates and age over time.
Main Methods:
- A national cohort of incident PIBD cases diagnosed in children under 16 in Scotland from 2003-2008 was analyzed.
- Age/sex-adjusted incidences were calculated and compared to historical data (1990-1995) using Poisson regression.
Main Results:
- The adjusted incidence of PIBD in Scotland (2003-2008) was 7.82/100,000/year, a 76% increase from 1990-1995.
- Significant increases were observed in Crohn's disease (CD) and ulcerative colitis (UC) incidence.
- The median age at diagnosis decreased from 12.7 to 11.9 years, with a continued male predominance.
Conclusions:
- The incidence of PIBD in Scottish children continues to rise significantly.
- PIBD is being diagnosed at a younger age in the Scottish pediatric population.
- The underlying reasons for the increasing incidence and earlier diagnosis remain unclear and require further research.
Background:
An accurate indication of the changing incidence of pediatric inflammatory bowel disease (PIBD) within a population is useful in understanding concurrent etiological factors. We aimed to compare the current incidence and other demographic attributes of PIBD in the Scottish population to previous data.
Methods:
A national cohort of prospectively and retrospectively acquired incident cases of PIBD diagnosed less than 16 years old in pediatric services in Scotland was captured for the period 2003-2008; historical Scottish data were used for comparison (1990-1995). Age/sex-adjusted incidences were calculated and statistical comparisons made using Poisson regression.
Results:
During the 2003-2008 study period 436 patients were diagnosed with PIBD in Scotland, giving an adjusted incidence of 7.82/100,000/year. The incidence of Crohn's disease (CD) was 4.75/100,000/year, ulcerative colitis (UC) 2.06/100,000/year, and inflammatory bowel disease-unclassified (IBDU) 1.01/100,000/year. Compared with data from 1990-1995 when 260 IBD patients were diagnosed, significant rises in the incidence of IBD (from 4.45/100,000/year, P < 0.0001), CD (from 2.86/100,000/year, P < 0.0001), and UC (from 1.59/100,000/year, P = 0.023) were seen. There was also a significant reduction in the median age at IBD diagnosis from 12.7 years to 11.9 years between the periods (P = 0.003), with a continued male preponderance.
Conclusions:
The number of Scottish children diagnosed with IBD continues to rise, with a statistically significant 76% increase since the mid-1990 s. Furthermore, PIBD is now being diagnosed at a younger age. The reason for this continued rise is not yet clear; however, new hypotheses regarding disease pathogenesis and other population trends may provide further insights in future years.
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