IBD incidence, prevalence on the rise in Denmark with shift toward older patients
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The incidence and prevalence of inflammatory bowel disease have increased in Denmark over the past two decades, most notably prevalence of ulcerative colitis among adults older than 40 years, according to a study in Gastroenterology.
“The global epidemiology of IBD is changing, and it is suggested that IBD may be reaching a plateau in developed countries,” Manasi Agrawal, MD, MS, assistant professor of medicine at the Icahn School of Medicine at Mount Sinai and gastroenterologist at Mount Sinai Hospital in New York City, told Healio.
“We conducted this study to determine how IBD epidemiology has evolved in the last two decades in Denmark, a developed country with high IBD incidence,” Agrawal noted. “This is relevant toward understanding persistent risk factors for IBD, and for preparing health care systems to manage IBD.”
Agrawal and colleagues conducted a nationwide cohort study at PREDICT Center for Molecular Prediction of Inflammatory Bowel Disease, a national center of excellence in Denmark, under the leadership of Tine Jess, MD, DMSc, PREDICT professor and director.
Researchers collected IBD-related outpatient and inpatient data from Danish registers between 1995 and 2016 and identified 47,830 individuals who met the study criteria of an IBD diagnosis, defined as having at least two registrations related to Crohn’s disease or ulcerative colitis over the course of 2 years. Of these, 33% were diagnosed with CD and 67% with UC.
For CD, the incidence rate per 100,000 person years increased from 9.1 (95% CI, 8.3-10) in 1995 to 17.8 (95% CI, 16.8-19) in 2016. During that same period, the incidence rate per 100,000 person years for UC increased from 21 (95% CI, 19.8-22.3) to 28.4 (95% CI, 27-29.8).
The sharpest incidence increases occurred in children aged younger than 18 years for CD and young adults aged 18 to 39 years for UC, whereas the prevalence of IBD increased among the two older age groups — individuals aged 40 to 64 years and individuals aged 65 years and older. In fact, the prevalence of IBD doubled between 1996 and 2016, with the greatest 2.5-fold increase in UC prevalence among individuals older than 40 years. Also, the median age of individuals with IBD increased by 6 to 7 years during the study.
“We found that IBD incidence and prevalence have increased, and that the median age of the IBD population has shifted towards an older age in the last two decades,” Agrawal said. “These findings emphasize the importance of preparing health care systems and research strategies toward the rising burden of IBD, including the care of older IBD patients.”
The next step in this research, according to Agrawal, is to “understand environmental risk factors that are leading to persistent increase in IBD burden, toward IBD prediction and prevention.”
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