Issue 22

Clinical Question

Is the pediatric incidence of IBD increasing in Canada?

Bottom Line

While the overall incidence of IBD among children is stable, its incidence is increasing rapidly among the youngest age group. The long-term outcomes of very-early onset IBD needs further study.

References

Benchimol EI, Bernstein CN, Bitton A, et al. Trends in Epidemiology of Pediatric Inflammatory Bowel Disease in Canada: Distributed Network Analysis of Multiple Population-Based Provincial Health Administrative Databases. Am J Gastroenterol. 2017 Jul;112(7):1120–34. https://www.ncbi.nlm.nih.gov/pubmed/28417994

Synopsis

Using International Classification of Disease (ICD) 9 and 10 codes for Crohn’s disease (CD) and ulcerative colitis (UC), administrative databases were searched for children aged less than 16 years at the time of first diagnosis between 1999–2010 (Ontario and Manitoba), 1999–2008 (Alberta and Quebec) and 2000–2008 (Nova Scotia). Prevalence and incident cohorts were developed from which national estimates were developed.

A total of 5,214 incident cases (CD=3,642; UC=1,382; indeterminate=279) were identified and followed. The median age at time of diagnosis for the entire cohort was 12.3 years (interquartile range: 10.5–14.1) with females comprising 43.3%. No durable significant differences between provinces were identified. The standardized incidence rate for all provinces was 9.68 (95% CI 9.1–10.2) per 100,000 children less than 16 years. The annual incidence increased significantly only in children aged 0–5 years, by 7.19%. The prevalence increased significantly, by 4.56% per year.

Details

Study Design: Retrospective cohort study
Funding: Crohn’s and Colitis Canada, Ontario Research Fund, Canadian Institutes of Health Research, Canadian Children IBD Network, and Canadian Association of Gastroenterology
Allocation: n/a
Setting: Provincial health administrative databases for: Alberta, Manitoba, Nova Scotia, Ontario, and Quebec
Level of Evidence: 2b (Oxford Levels of Evidence)

The summary and conclusion in this issue of E-mentoring in IBD pertains to the manuscript(s) being reviewed, and should be considered in the context of what is already known surrounding the topic and incorporated into practice as deemed appropriate by the individual learner.