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Inflammatory bowel disease incidence in Czech children: A regional prospective study, 2000-2015
Jan Schwarz1, Josef Sýkora1, Dominika Cvalínová1
1Jan Schwarz, Josef Sýkora, Dominika Cvalínová, Renáta Pomahačová, Department of Paediatrics, Charles University, Faculty of Medicine in Pilsen, Faculty Hospital, 30460 Pilsen, Czech Republic.
Insights
Pediatric inflammatory bowel diseases (IBD) incidence is rising, particularly Crohn's disease (CD), with rates projected to continue increasing. This trend highlights challenges in understanding the causes of pediatric IBD.
Area of Science:
- Gastroenterology
- Epidemiology
- Pediatrics
Background:
- Pediatric inflammatory bowel diseases (IBD) represent a growing global health concern.
- Understanding the incidence and trends of IBD in children is crucial for public health planning and research.
Purpose of the Study:
- To analyze the incidence and temporal trends of pediatric inflammatory bowel diseases (IBD) in the Czech Republic from 2000 to 2015.
- To project the incidence of pediatric IBD up to 2018.
Main Methods:
- A 16-year prospective study was conducted in the Pilsen region of the Czech Republic, analyzing all incident IBD cases in individuals under 19 years of age.
- Data were retrieved from a computerized clinical database, with historical data (1990-2001) used for comparison. Incidence rates were calculated per 100,000 person-years.
Main Results:
- A total of 170 new IBD cases were identified, with Crohn's disease (CD) being the most common (105 cases).
- The overall incidence of IBD in children aged 0-19 years was 10.0 per 100,000 person-years, with a notable increase over the study period (P = 0.01), especially for CD (P < 0.0001).
- Projected IBD incidence rates for 2016-2018 indicated a continued upward trend.
Conclusions:
- The incidence of pediatric-onset IBD is at a near-peak level.
- The increasing trend, particularly for Crohn's disease, presents challenges in identifying specific etiological factors in pediatric populations.
Aim:
To examine the incidence and trends in pediatric inflammatory bowel diseases (IBDs) over 2000-2015 and project the incidence to 2018.
Methods:
A 16-year prospective study of IBD patients < 19 years of age was conducted in the Czech Republic (the Pilsen region). All incident IBD cases within a well-defined geographical area were retrieved from a prospectively collected computerized clinical database. Historical Czech data were used for comparison (1990-2001). Our catchment population was determined from the census data. We calculated the incidence by relating the number of newly diagnosed cases to the size of the pediatric population-at-risk in each calendar year. Age/sex, disease type, place of residence, and race/ethnicity were identified.
Results:
In total, 170 new IBD cases [105 Crohn's disease (CD), 48 ulcerative colitis (UC), and 17 IBD-unclassified (IBD-U)] were identified. The median age at IBD diagnosis was 14.2 years, 59.4% were males, and 97.1% were Caucasians. A male preponderance of IBD (P = 0.026) and CD (P = 0.016) was observed. With 109209 person-years in the catchment area, the average incidence of IBD per 100000 person-years was 10.0 (6.2 for CD, 2.8 for UC, and 1.0 for IBD-U) for children aged 0 to 19 years; for those aged 0 to 15 years, the incidence rate was 7.3 (4.6 for CD, 2.0 for UC, and 0.7 for IBD-U). An increase in incidence with age was observed (P = 0.0003). Over the 16-year period, the incidence increased for IBD patients (P = 0.01) and CD in particular (P < 0.0001), whereas the incidence for UC (P = 0.09) and IBD-U (P = 0.339) remained unchanged. IBD-projected data from 2016 to 2018 were 12.1, 12.3 and 12.6 per 100000 person-years, respectively.
Conclusion:
Pediatric-onset IBD incidence is around its highest point. The increase, which is particularly pronounced for CD, may be challenging to relate to causes of pediatric disease.
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