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Current global trends in the incidence of pediatric-onset inflammatory bowel disease
Josef Sýkora1, Renáta Pomahačová1, Marcela Kreslová1
1Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Charles University in Prague, Faculty of Medicine in Pilsen, Faculty Hospital, Pilsen 304 60, Czech Republic.
Insights
The global incidence of pediatric inflammatory bowel disease (IBD) is rising, with significant geographical variations. Environmental risk factors require further investigation in pediatric cohorts.
Area of Science:
- Gastroenterology
- Epidemiology
- Pediatrics
Background:
- Inflammatory bowel disease (IBD) encompasses Crohn's disease and ulcerative colitis.
- Pediatric-onset IBD represents a growing global health concern.
- Understanding IBD incidence and trends is crucial for public health strategies.
Purpose of the Study:
- To conduct a comprehensive review of the incidence and trends of pediatric-onset IBD.
- To synthesize current data on global IBD prevalence and geographical distribution.
- To identify temporal changes in IBD incidence worldwide.
Main Methods:
- Systematic literature search of MEDLINE, EMBASE, and Cochrane Library (1985-2018).
- Inclusion of population-based studies on pediatric IBD (<19 years at diagnosis).
- Utilized choropleth maps and temporal trend analyses for data visualization.
Main Results:
- 140 studies from 38 countries were analyzed.
- Highest pediatric IBD incidences observed in Europe (23/100,000), North America (15.2/100,000), and Asia/Oceania (11.4/100,000).
- Increasing incidence trends noted for Crohn's disease (67%) and ulcerative colitis (46%), with rising risk in migrant populations.
Conclusions:
- IBD incidence exhibits significant global geographical variation.
- The increasing incidence of pediatric IBD signifies its emergence as a global disease.
- Further research into environmental risk factors for pediatric IBD is warranted.
Aim:
To perform a comprehensive review and provide an up-to-date synopsis of the incidence and trends of inflammatory bowel disease (IBD).
Methods:
We systematically searched the MEDLINE (source PubMed), EMBASE and Cochrane Library databases in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (period: 1985-2018) to identify studies reporting population-based data on the incidence of pediatric-onset (< 19 years at diagnosis) IBD in full manuscripts. Two authors carried out screening and data extraction. Choropleth interactive maps and temporal trends were used to illustrate the international differences and incidences of and changes in IBD and subtypes.
Results:
In total, one hundred forty studies reporting data from 38 countries were considered in this review. The highest annual pediatric incidences of IBD were 23/100000 person-years in Europe, 15.2/100000 in North America, and 11.4/100000 in Asia/the Middle East and Oceania. The highest annual incidences of Crohn's disease (CD) were 13.9/100000 in North America and 12.3/100000 in Europe. The highest annual incidences of ulcerative colitis (UC) were 15.0/100000 in Europe and 10.6/100000 in North America. The highest annual incidences of IBD-unclassified (IBD-U) were 3.6/100000 in Europe and 2.1/100000 in North America. In the time-trend analyses, 67% of CD, 46% of UC and 11% of IBD-U studies reported an increasing incidence (P < 0.05). The risk of IBD is increasing among first-generation of migrant populations.
Conclusion:
Globally, the incidence of IBD varies greatly by geographical areas. The steadily increasing incidence of pediatric IBD over time indicates its emergence as a global disease, suggesting that studies should investigate the environmental risk factors among pediatric cohorts.
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