Incidence and Phenotype of Inflammatory Bowel Disease Based on Results From the Asia-Pacific Crohn's and Colitis Epidemiology Study

Background & Aims Inflammatory bowel diseases (IBD) are becoming more common in Asia, but epidemiologic data are lacking. The Asia-Pacific Crohn’s and Colitis Epidemiology Study aimed to determine the incidence and phenotype of IBD in 8 countries across Asia and in Australia. Methods We performe...

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Published in:	Gastroenterology (New York, N.Y. 1943) Vol. 145; no. 1; pp. 158 - 165.e2
Main Authors:	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
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-07-2013
Subjects:	ACCESS Adult Asia - epidemiology Australia - epidemiology Female Gastroenterology and Hepatology Humans Incidence Inflammation Inflammatory Bowel Diseases - diagnosis Inflammatory Bowel Diseases - drug therapy Inflammatory Bowel Diseases - epidemiology Intestine Male Middle Aged Phenotype Prospective Studies Rate Australia Asia CD Rate CI Inflammation IBD inflammatory bowel disease UC IBD-U Intestine inflammatory bowel disease−undetermined confidence interval ulcerative colitis ACCESS Crohn’s disease
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Summary:	Background & Aims Inflammatory bowel diseases (IBD) are becoming more common in Asia, but epidemiologic data are lacking. The Asia-Pacific Crohn’s and Colitis Epidemiology Study aimed to determine the incidence and phenotype of IBD in 8 countries across Asia and in Australia. 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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0016-5085 1528-0012
DOI:	10.1053/j.gastro.2013.04.007