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. 2013 May;19(6):1218-23.
doi: 10.1097/MIB.0b013e318280b13e.

Incidence, clinical characteristics, and natural history of pediatric IBD in Wisconsin: a population-based epidemiological study

Tonya Adamiak  1 , Dorota Walkiewicz-Jedrzejczak, Daryl Fish, Christopher Brown, Jeanne Tung, Khalid Khan, William Faubion Jr, Roger Park, Janice Heikenen, Michael Yaffee, Maria T Rivera-Bennett, Marcy Wiedkamp, Michael Stephens, Richard Noel, Melodee Nugent, Justin Nebel, Pippa Simpson, Michael D Kappelman, Subra Kugathasan
Affiliations

Incidence, clinical characteristics, and natural history of pediatric IBD in Wisconsin: a population-based epidemiological study

Tonya Adamiak et al. Inflamm Bowel Dis. 2013 May.

Abstract

Background: Epidemiological studies of pediatric inflammatory bowel diseases (IBD) are needed to generate etiological hypotheses and inform public policy; yet, rigorous population-based studies of the incidence and natural history of Crohn's disease (CD) and ulcerative colitis (UC) in the United States are limited.

Methods: We developed a field-tested prospective system for identifying all new cases of IBD among Wisconsin children over an 8-year period (2000-2007). Subsequently, at the end of the study period, we retrospectively reconfirmed each case and characterized the clinical course of this incident cohort.

Results: The annual incidence of IBD among Wisconsin children was 9.5 per 100,000 (6.6 per 100,000 for CD and 2.4 per 100,000 for UC). Approximately 19% of incident cases occurred in the first decade of life. Over the 8-year study period, the incidence of both CD and UC remained relatively stable. Additionally, (1) childhood IBD affected all racial groups equally, (2) over a follow-up of 4 years, 17% of patients with CD and 13% of patients with patients with UC required surgery, and (3) 85% and 40% of children with CD were treated with immunosuppressives and biologics, respectively, compared with 62% and 30% of patients with UC.

Conclusions: As in other North American populations, these data confirm a high incidence of pediatric-onset IBD. Importantly, in this Midwestern U.S. population, the incidence of CD and UC seems to be relatively stable over the last decade. The proportions of children requiring surgery and undergoing treatment with immunosuppressive and biological medications underscore the burden of these conditions.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Incidence of pediatric IBD by age group. Incidence of IBD is depicted here along with the subgroups of CD, UC and indeterminate colitis. Overall, the incidence of CD was almost 3 times more common than UC. This difference was most apparent in the older age groups.
FIGURE 2
FIGURE 2
Incidence of pediatric IBD by year. Incidence of IBD per year is shown here along with the subgroups of CD, UC and indeterminate colitis (IC). There was no overall increase in incidence occurred over the 8-year period studied.
FIGURE 3
FIGURE 3
Cumulative medication exposure among the IBD patients. Patients with CD (A) were significantly more likely to be exposed to immunosuppressive medications compared with patients with UC (B). Patients with CD and UC were equally likely to be exposed to biological medications.
See this image and copyright information in PMC

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Supplementary concepts