Incidence in pediatric IBD is rising: Help from health administrative data
✍ Scribed by Salvatore Cucchiara; Laura Stronati
- Publisher
- John Wiley and Sons
- Year
- 2011
- Tongue
- English
- Weight
- 53 KB
- Volume
- 17
- Category
- Article
- ISSN
- 1078-0998
No coin nor oath required. For personal study only.
✦ Synopsis
T he authors aimed, first, to develop and validate a diag- nostic algorithm for pediatric inflammatory bowel disease (IBD) using a health administrative database at the Institute for Clinical Evaluation Sciences in Toronto in order to identify subjects with early-onset IBD. This algorithm was then used to assess the incidence and the prevalence of IBD among children in the Ontario region.
The database used included: 1) data from all hospital discharges that were reported to the Canadian Institute for Health; 2) billing claims for all physician services from Ontario Health Insurance Plan; and 3) Registered Persons Database (demographic data including region of residence). The authors used the IBD clinical database from SickKids in Toronto to identify patients with childhood-onset IBD in the area of Toronto. With this database the authors identified 183 Toronto children with an IBD diagnosis between 1991 and 1995 to serve as a positive reference standard. In the same time interval more than 930,000 children ages <15 years and who resided in Toronto served as a negative reference standard.
From 1994 to 2005 there was a marked rise in the age-and sex-standardized prevalence of IBD per 100,000 population from 42.1 to 56.3, respectively (P < 0.0001). Prevalence of Crohn's disease (CD) has increased from 23.9 to 31.6 (P < 0.0001) and that of ulcerative colitis (UC) from 16.2 to 19.7 (P < 0.0001). The Ontario Crohn's and Colitis Cohort (OCCC), created using the validated algorithm, contains 3169 cases of pediatric IBD, diagnosed from 1994 to 2005. The IBD incidence rate has increased from 9.5 to 11.4 per 100,000 (P ¼ 0.03), with the incidence of CD changing from 5.0 to 6.0 per 100,000 (P ¼ 0.19). The incidence rate of UC has remained unchanged (from 4.1 to 4.2 per 100,000).
Interestingly, if time trends in incidence stratified by age groups were considered, significant increases in incidence were seen in patients with IBD in the 6-month to 4year-old (50%/year, P ¼ 0.03) and 5-9-year-old (7.6%/year,