Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Dec;163(6):1547-1554.e5.
doi: 10.1053/j.gastro.2022.07.062. Epub 2022 Aug 8.

The Rising Burden of Inflammatory Bowel Disease in Denmark Over Two Decades: A Nationwide Cohort Study

Manasi Agrawal  1 , Heidi S Christensen  2 , Martin Bøgsted  2 , Jean-Frederic Colombel  3 , Tine Jess  4 , Kristine H Allin  4
Affiliations

The Rising Burden of Inflammatory Bowel Disease in Denmark Over Two Decades: A Nationwide Cohort Study

Manasi Agrawal et al. Gastroenterology. 2022 Dec.

Abstract

Background & aims: Shifts in epidemiological stages of inflammatory bowel disease (IBD) carry implications toward understanding IBD etiology and managing clinical care. We conducted a temporal analysis of the epidemiology of IBD between 1995 and 2016 in the Danish nationwide cohort.

Methods: We used the Danish registers to obtain data on demographics and IBD-related outpatient and inpatient contacts between 1995 and 2016. IBD diagnosis was defined as having ≥2 registrations related to Crohn's disease (CD) or ulcerative colitis (UC) within a 2-year period. We estimated overall and annual incidence rates and prevalence of CD and UC standardized with respect to age and sex.

Results: A total of 47,830 individuals met the criteria for IBD diagnosis, of which 33% were diagnosed with CD and 67% with UC. Between 1995 and 2016, the incidence rate (95% confidence interval) per 100,000 person-years rose from 9.1 (8.3-10.0) to 17.8 (16.8-19.0) for CD, and from 21.0 (19.8-22.3) to 28.4 (27.0-29.8) for UC. The highest increase in CD and UC incidence rates occurred in children and young adults, respectively. The prevalence of IBD doubled from 1995 to 2016; the greatest increase (2.5-fold) was in UC prevalence among individuals aged >40 years. During this period, the median age of the IBD population increased by 6 to 7 years.

Conclusions: In Denmark, the incidence and prevalence of IBD have increased during the last 2 decades. The IBD population is shifting toward an older age. These findings have implications towards understanding environmental shifts as well as preparing health care systems for an aging IBD population.

Keywords: Crohn’s Disease; Epidemiology; Incidence; Inflammatory Bowel Disease; Prevalence.

PubMed Disclaimer

Figures

Figure 1:
Figure 1:
Changes in the incidence rates of Crohn’s disease and ulcerative colitis between 1995 and 2016. (A) changes in overall incidence rates (B) changes in age-specific incidence rates and (C) changes in sex-specific incidence rates
Figure 2:
Figure 2:
Forest plot depicting estimated incidence rate ratios and 95% confidence intervals for a one-year increase between 1995 and 2016 by age group and sex
Figure 3:
Figure 3:
Change in the prevalence of Crohn’s disease and ulcerative colitis between 1995 and 2016. (A) changes in overall prevalence (B) changes in age-specific prevalence and (C) changes in sex-specific prevalence
Figure 4:
Figure 4:
Distribution of (A) age at inflammatory bowel disease diagnosis and (B) age of individuals with inflammatory bowel disease between 1995 and 2016
See this image and copyright information in PMC

Comment in

  • The Burden of IBD: Comparing Denmark and Sweden.
    Forss A, Ludvigsson JF, Olén O. Forss A, et al. Gastroenterology. 2023 Jun;164(7):1343-1344. doi: 10.1053/j.gastro.2022.10.015. Epub 2022 Oct 22. Gastroenterology. 2023. PMID: 36279924 No abstract available.

References

    1. Torres J, Mehandru S, Colombel JF, et al. Crohn’s disease. Lancet 2017;389:1741–1755. - PubMed
    1. Ungaro R, Mehandru S, Allen PB, et al. Ulcerative colitis. Lancet 2017;389:1756–1770. - PMC - PubMed
    1. Park KT, Ehrlich OG, Allen JI, et al. The Cost of Inflammatory Bowel Disease: An Initiative From the Crohn’s & Colitis Foundation. Inflamm Bowel Dis 2019. - PMC - PubMed
    1. Ng SC, Shi HY, Hamidi N, et al. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. Lancet 2018;390:2769–2778. - PubMed
    1. Virta LJ, Saarinen MM, Kolho KL. Inflammatory Bowel Disease Incidence is on the Continuous Rise Among All Paediatric Patients Except for the Very Young: A Nationwide Registry-based Study on 28-Year Follow-up. J Crohns Colitis 2017;11:150–156. - PubMed

Publication types