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Global Incidence, Prevalence, and Risk Factors of Microscopic Colitis, 1984-2020: A Systematic Review and
Hyun-June Yu1, Soeun Kim2, Jiyeon Oh1
1Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea; Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea.
Summary
Microscopic colitis (MC) incidence and prevalence are increasing globally, particularly in females and older individuals. This trend is linked to medication use and smoking, necessitating further research into risk factors.
Area of Science:
- Gastroenterology
- Epidemiology
- Internal Medicine
Background:
- Previous studies offered initial insights into microscopic colitis (MC) epidemiology.
- An updated analysis of MC global trends is necessary to understand its current burden.
Purpose of the Study:
- To examine recent global trends in MC incidence and prevalence.
- To stratify MC data by subtype (collagenous colitis [CC] and lymphocytic colitis [LC]), age, sex, Human Development Index, and region.
- To update meta-analyses of MC risk factors, including medication use and smoking.
Main Methods:
- A systematic search of multiple databases (PubMed/MEDLINE, EMBASE, Google Scholar, Web of Science, Cochrane Library) was conducted.
- Population-based observational studies defining MC histologically via colonic biopsy were included.
- Pooled incidence and prevalence rates were calculated using a random-effects model, assessing risk factors like medication and smoking.
Main Results:
- 42 studies (1984-2020) with over 75 million participants revealed pooled MC incidence of 9.36/100,000 person-years and prevalence of 34.08/100,000 persons.
- Significant increases in MC and CC incidence were observed from 2000-2012.
- MC incidence was associated with female sex, older age, specific regions, medication exposure, and smoking; females were diagnosed younger than males.
Conclusions:
- This study provides updated global estimates and recent regional trends for microscopic colitis burden.
- Observed heterogeneity and geographic variations underscore the need for further research.
- Hormonal and environmental risk factors require deeper investigation.
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