Incidence and phenotype of inflammatory bowel disease based on results from the Asia-pacific Crohn's and colitis epidemiology study.
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Ng Siew C, Tang Whitney, Ching Jessica Y, Wong May, Chow Chung Mo, Hui A J, Wong T C, Leung Vincent K, Tsang Steve W, Yu Hon Ho, Li Mo Fong, Ng Ka Kei, Kamm Michael A, Studd Corrie, Bell Sally, Leong Rupert, de Silva H Janaka, Kasturiratne Anuradhani, Mufeena M N F, Ling Khoon Lin, Ooi Choon Jin, Tan Poh Seng, Ong David, Goh Khean L, Hilmi Ida, Pisespongsa Pises, Manatsathit Sathaporn, Rerknimitr Rungsun, Aniwan Satimai, Wang Yu Fang, Ouyang Qin, Zeng Zhirong, Zhu Zhenhua, Chen Min Hu, Hu Pin Jin, Wu Kaichun, Wang Xin, Simadibrata Marcellus, Abdullah Murdani, Wu Justin Cy, Sung Joseph J Y, Chan Francis K L, Asia–Pacific Crohn's and Colitis Epidemiologic Study (ACCESS) Study Group
Аннотация
METHODS: We performed a prospective, population-based study of IBD incidence in predefined catchment areas, collecting data for 1 year, starting on April 1, 2011. New cases were ascertained from multiple overlapping sources and entered into a Web-based database. Cases were confirmed using standard criteria. Local endoscopy, pathology, and pharmacy records were searched to ensure completeness of case capture.
RESULTS: We identified 419 new cases of IBD (232 of ulcerative colitis [UC], 166 of Crohn's disease [CD], and 21 IBD-undetermined). The crude annual overall incidence values per 100,000 individuals were 1.37 for IBD in Asia (95% confidence interval: 1.25-1.51; 0.76 for UC, 0.54 for CD, and 0.07 for IBD-undetermined) and 23.67 in Australia (95% confidence interval: 18.46-29.85; 7.33 for UC, 14.00 for CD, and 2.33 for IBD-undetermined). China had the highest incidence of IBD in Asia (3.44 per 100,000 individuals). The ratios of UC to CD were 2.0 in Asia and 0.5 in Australia. Median time from symptom onset to diagnosis was 5.5 months (interquartile range, 1.4-15 months). Complicated CD (stricturing, penetrating, or perianal disease) was more common in Asia than Australia (52% vs 24%; P = .001), and a family history of IBD was less common in Asia (3% vs 17%; P < .001).
CONCLUSIONS: We performed a large-scale population-based study and found that although the incidence of IBD varies throughout Asia, it is still lower than in the West. IBD can be as severe or more severe in Asia than in the West. The emergence of IBD in Asia will result in the need for specific health care resources, and offers a unique opportunity to study etiologic factors in developing nations.