IBD affects an estimated 2.39 million Americans, varies by race, ethnicity
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Key takeaways:
- The incidence of inflammatory bowel disease is 10.9 per 100,000 person-years and peaks in the third decade of life.
- IBD is less commonly diagnosed in Black, Asian and Hispanic Americans.
Although inflammatory bowel disease is a widespread, chronic condition in the United States, it is less commonly diagnosed in Black, Asian and Hispanic Americans, according to data reported in Gastroenterology.
North America is considered to have among the highest prevalence and incidence of IBD in the world, but there are limited data on the racial and geographic distribution of the disease in the United States, James D. Lewis, MD, MSCE, professor of medicine and associate director of the inflammatory bowel disease program at University of Pennsylvania Perelman School of Medicine, and colleagues wrote.
“We sought to obtain generalizable estimates of incidence and prevalence of IBD derived from nearly all segments of the U.S. population and to provide estimates in racial and ethnic subgroups,” Lewis told Healio.
Using data from four administrative claims datasets, including commercial health insurance, Medicaid and Medicare, researchers identified a combined cohort of 42,964,750 person-years of follow-up. The age- and sex-standardized incidence of IBD was 10.9 (95% CI, 10.6-11.2) per 100,000 person-years.
Sensitivity analyses yielded a pooled incidence rate of 15.9 (95% CI, 5.5-16.3) per 100,000 person-years. Researchers noted the incidence of IBD, ulcerative colitis and Crohn’s disease peaked in the third decade of life, decreased to a “relatively stable level” across the fourth to eighth decades and declined in those aged 80 years and older.
“Although the highest incidence of IBD was observed in people in their third decade of life, the incidence remains relatively high through the mid-60s and some patients are diagnosed even later than that,” Lewis said. “Thus, providers need to consider IBD as a new diagnosis in patients of all ages.”
Researchers also reported a higher incidence of ulcerative colitis (6.3; 95% CI, 6.1-6.6) compared with Crohn’s disease (4.1; 95% CI, 3.9-4.3) in adults; this trend was reversed in children.
To assess prevalence, Lewis and colleagues evaluated data from 14,420,692 individuals with at least 4 years of continuous insurance. The age-, sex- and insurance-standardized prevalence was 721 (95% CI, 717-726) per 100,000 for IBD overall, while the prevalence of UC and CD was 378 (95% CI, 375-382) and 305 (95% CI, 302-308), respectively.
“As expected, the prevalence of IBD overall, ulcerative colitis and Crohn’s disease generally increased with age,” researchers wrote, “although there was a drop in the prevalence among those over 80 years of age, particularly among those with Crohn’s disease.”
Further, the prevalence of IBD was 812 (95% CI, 802-823) among white individuals, 504 (95% CI, 482-526) among Black individuals, 403 (95% CI, 373-433) among Asian individuals and 458 (95% CI, 440-476) per 100,000 among Hispanic Americans.
Based on 2020 calculations of the U.S. population, researchers estimated nearly 2.39 million Americans are diagnosed with IBD, with the highest prevalence in the Northeast and the lowest in the West.
“IBD affects more than 0.7% of Americans and the prevalence varies by race, ethnicity and geographic location,” Lewis told Healio. “Moreover, the prevalence appears to have continued to rise over the last decade. ... The burden of caring for these lifelong diseases is high and will likely increase as life expectancy increases.”
He continued: “This study raised several questions: For example, why is the prevalence of IBD diagnosis lower in Black, Asian and Hispanic Americans compared to white Americans? Moreover, why is the prevalence of IBD diagnosis lower in children with Medicaid insurance but not in adults?”
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