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. 2020 Jul 19;10(7):e036584.
doi: 10.1136/bmjopen-2019-036584.

Incidence and prevalence of inflammatory bowel disease in UK primary care: a population-based cohort study

Thomas Joshua Pasvol  1 , Laura Horsfall  2 , Stuart Bloom  3 , Anthony Walter Segal  4 , Caroline Sabin  5   6 , Nigel Field  5   7 , Greta Rait  2   6
Affiliations

Incidence and prevalence of inflammatory bowel disease in UK primary care: a population-based cohort study

Thomas Joshua Pasvol et al. BMJ Open. .

Erratum in

Abstract

Objectives: We describe temporal trends in the recorded incidence of inflammatory bowel disease (IBD) in UK primary care patients between 2000 and 2018.

Design: A cohort study.

Setting: The IQVIA Medical Research data (IMRD) primary care database.

Participants: All individuals registered with general practices contributing to IMRD during the period 01 January 2000-31 December 2018.

Main outcome measures: The primary outcome was the recorded diagnosis of IBD.

Results: 11 325 025 individuals were included and 65 700 IBD cases were identified, of which 22 560 were incident diagnoses made during the study period. Overall, there were 8077 incident cases of Crohn's disease (CD) and 12 369 incident cases of ulcerative colitis (UC). Crude incidence estimates of 'IBD overall', CD and UC were 28.6 (28.2 to 28.9), 10.2 (10.0 to 10.5) and 15.7 (15.4 to 15.9)/100 000 person years, respectively. No change in IBD incidence was observed for adults aged 17-40 years and children aged 0-9 years. However, for adults aged over 40 years, incidence fell from 37.8 (34.5 to 41.4) to 23.6 (21.3 to 26.0)/100 000 person years (average decrease 2.3% (1.9 to 2.7)/year (p<0.0001)). In adolescents aged 10-16 years, incidence rose from 13.1 (8.4 to 19.5) to 25.4 (19.5 to 32.4)/100 000 person years (average increase 3.0% (1.7 to 4.3)/year (p<0.0001)). Point prevalence estimates on 31 December 2018 for IBD overall, CD and UC were 725, 276 and 397 per 100 000 people, respectively.

Conclusions: This is one of the largest studies ever undertaken to investigate trends in IBD epidemiology. Although we observed stable or falling incidence of IBD in adults, our results are consistent with some of the highest reported global incidence and prevalence rates for IBD, with a 94% rise in incidence in adolescents. Further investigation is required to understand the aetiological drivers.

Keywords: epidemiology; gastroenterology; inflammatory bowel disease.

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Conflict of interest statement

Competing interests: TJP and AWS report research grants from The Charles Wolfson Charitable Trust and The Harbour Foundation for the submitted work.

Figures

Figure 1
Figure 1
Crude incidence estimates for any inflammatory bowel diseases (IBD), stratified by Montreal/Paris age classification and calendar year, over the period 2000–2017.
Figure 2
Figure 2
Crude incidence estimates of inflammatory bowel diseases (IBD), stratified by calendar year, over the period 2000–2017. CD, Crohn’s disease; UC, ulcerative colitis.
Figure 3
Figure 3
Crude incidence estimates of inflammatory bowel diseases (IBD) in children <17 years, stratified by calendar year, over the period 2000–2017. CD, Crohn’s disease; UC, ulcerative colitis.
Figure 4
Figure 4
Map showing overall crude incidence of Crohn’s disease and ulcerative colitis stratified by geographical region.
See this image and copyright information in PMC

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