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A Systematic Review and Meta-analysis of Paediatric Inflammatory Bowel Disease Incidence and Prevalence Across Europe
S E Roberts1, K Thorne1, N Thapar2,3,4,5
1Medical School, Swansea University, Swansea, Wales, UK.
Insights
Paediatric inflammatory bowel disease (IBD) incidence is rising across Europe, particularly in Northern regions. This systematic review highlights significant increases in Crohn's disease (CD) and ulcerative colitis (UC) over 50 years.
Area of Science:
- Gastroenterology
- Epidemiology
- Paediatric Medicine
Background:
- Inflammatory bowel disease (IBD) significantly impacts children and adolescents.
- IBD encompasses chronic gastrointestinal disorders like Crohn's disease (CD) and ulcerative colitis (UC).
Purpose of the Study:
- To systematically review and analyze the incidence and prevalence of paediatric IBD across 51 European countries.
- To identify geographical and temporal trends in paediatric IBD across Europe.
Main Methods:
- A comprehensive systematic review and meta-analysis was conducted.
- Databases searched included PubMed, CINAHL, and the Cochrane Library, supplemented by reference lists, grey literature, and websites.
- Data collection spanned from 1970 to 2018.
Main Results:
- Incidence rates for paediatric CD and UC are higher in Northern Europe compared to other regions.
- Significant increases in paediatric CD and UC incidence have been observed across Europe over the past 50 years.
- Incidence rates for paediatric CD have reached up to 9-10 per 100,000 population in some areas, with UC rates generally lower.
Conclusions:
- The incidence of paediatric IBD is increasing throughout Europe.
- Evidence suggests a stronger north-south gradient than an east-west gradient in paediatric IBD incidence.
- Further multinational prospective studies utilizing IBD registries and standardized methodologies are recommended.
Background And Aims:
Inflammatory bowel disease [IBD] is often one of the most devastating and debilitating chronic gastrointestinal disorders in children and adolescents. The main objectives here were to systematically review the incidence and prevalence of paediatric IBD across all 51 European states.
Methods:
We undertook a systematic review and meta-analysis based on PubMed, CINAHL, the Cochrane Library, searches of reference lists, grey literature and websites, covering the period from 1970 to 2018.
Results:
Incidence rates for both paediatric Crohn's disease [CD] and ulcerative colitis [UC] were higher in northern Europe than in other European regions. There have been large increases in the incidence of both paediatric CD and UC over the last 50 years, which appear widespread across Europe. The largest increases for CD have been reported from Sweden, Wales, England, the Czech Republic, Denmark and Hungary, and for UC from the Czech Republic, Ireland, Sweden and Hungary. Incidence rates for paediatric CD have increased up to 9 or 10 per 100 000 population in parts of Europe, including Scandinavia, while rates for paediatric UC are often slightly lower than for CD. Prevalence reported for CD ranged from 8.2 per 100 000 to approximately 60 and, for UC, from 8.3 to approximately 30.
Conclusions:
The incidence of paediatric IBD continues to increase throughout Europe. There is stronger evidence of a north-south than an east-west gradient in incidence across Europe. Further prospective studies are needed, preferably multinational and based on IBD registries, using standardized definitions, methodology and timescales.
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