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Trends in Epidemiology of Pediatric Inflammatory Bowel Disease in Canada: Distributed Network Analysis of Multiple
Eric I Benchimol1,2,3,4, Charles N Bernstein5,6, Alain Bitton7
1Division of Gastroenterology, Children's Hospital of Eastern Ontario IBD Centre, Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Eastern Ontario, Ottawa, Canada.
Insights
Childhood-onset inflammatory bowel disease (IBD) incidence is high in Canada, with prevalence significantly increasing over time. A notable rise in IBD incidence was observed in very young children (0-5 years).
Area of Science:
- Pediatric Gastroenterology
- Epidemiology
- Public Health
Background:
- Pediatric-onset inflammatory bowel disease (IBD) incidence is rising globally.
- Understanding national trends in childhood IBD is crucial for public health planning.
Purpose of the Study:
- To determine the national incidence, prevalence, and temporal trends of childhood-onset IBD in Canada.
- To analyze IBD incidence and prevalence in children under 16 years old.
Main Methods:
- Utilized population-based health administrative data from five Canadian provinces (1999-2010).
- Calculated standardized incidence and prevalence per 100,000 children.
- Employed Poisson regression and random-effects meta-analysis for trend assessment.
Main Results:
- Identified 5,214 incident pediatric IBD cases.
- Canadian incidence was 9.68 per 100,000 children; prevalence reached 38.25 per 100,000.
- Overall incidence remained stable, but increased significantly in children aged 0-5 years (+7.19% annually).
- Prevalence showed a significant annual increase of +4.56%.
Conclusions:
- Canada exhibits one of the highest childhood-onset IBD incidence rates globally.
- A significant increase in pediatric IBD prevalence was observed over the study period.
- A concerning rapid rise in incidence was noted in the youngest children (0-5 years).
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.