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. 2024 Oct 18:47:101097.
doi: 10.1016/j.lanepe.2024.101097. eCollection 2024 Dec.

Incidence, prevalence and clinical presentation of inflammatory bowel diseases in Northern France: a 30-year population-based study

Hélène Sarter  1   2 , Thibaut Crétin  3   4 , Guillaume Savoye  5 , Mathurin Fumery  6 , Ariane Leroyer  1   2 , Luc Dauchet  1   7 , Thierry Paupard  8 , Hugues Coevoet  9 , Pauline Wils  2   3 , Nicolas Richard  5 , Dominique Turck  2   10 , Delphine Ley  2   10 , Corinne Gower-Rousseau  11 ; EPIMAD study Group
Collaborators, Affiliations

Incidence, prevalence and clinical presentation of inflammatory bowel diseases in Northern France: a 30-year population-based study

Hélène Sarter et al. Lancet Reg Health Eur. .

Abstract

Background: In industrialized countries, the incidence of inflammatory bowel disease (IBD) appears stabilized. This study examined the incidence and phenotype of IBD in Northern France over a 30-year period.

Methods: Including all IBD patients recorded in the EPIMAD population-based registry from 1988 to 2017 in Northern France, we described the incidence and clinical presentation of IBD according to age, sex and time.

Findings: A total of 22,879 incident IBD cases were documented (59% (n = 13,445) of Crohn's disease (CD), 38% (n = 8803) of ulcerative colitis (UC), 3% (n = 631) of IBD unclassified (IBDU)). Over the study period, incidence of IBD, CD and UC was 12.7, 7.2 and 5.1 per 105 person-years, respectively. The incidence of CD increased from 5.1/105 in 1988-1990 to 7.9/105 in 2015-2017 (annual percent change (APC): +1.9%, p < 0.0001). The incidence of UC increased from 4.5/105 to 6.1/105 (APC: +1.3%, p < 0.0001). The largest increase was observed in children (+4.3% in CD, p < 0.0001; +5.4% in UC, p < 0.0001) followed by young adults aged 17-39 years (+1.9% in CD, p < 0.0001; +1.5% in UC, p < 0.0001). The increase in UC incidence was significantly higher in women than in men (+1.9% in women, +0.8% in men; p = 0.006). We estimated that in our area, by 2030, nearly 0.6% of the population will have IBD.

Interpretation: The persistent increase of IBD incidence among children and young adults but also in women with UC in Northern France, suggests the persistence of substantial predisposing environmental factors.

Funding: Santé Publique France; INSERM; Amiens, Lille and Rouen University Hospitals.

Keywords: Crohn’s disease; Incidence; Inflammatory bowel disease; Population-based registry; Prevalence; Ulcerative colitis.

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Conflict of interest statement

Guillaume Savoye has served as speaker for MSD France, Ferring France, Abbvie France, and Vifor France. Mathurin Fumery has received lecture/consultant fees from Abbvie, Ferring, Tillots, MSD, Biogen, Amgen, Fresenius, Hospira, Pfizer, Celgene, Gilead, Boerhringer, Galapagos, Janssen and Takeda. Delphine Ley has received consultant fees from Sandoz and AbbVie. Thierry Paupard has received lecture/consultant fees from Abbvie, Amgen, Takeda, Janssen, Biogen, and Celltrion. Dominique Turck has received lecture fees from Sandoz. Nicolas Richard has received lecture/consultant fees from AbbVie and Takeda. The other authors state that they have no competing interests regarding this work to disclose.

Figures

Fig. 1
Fig. 1
Incidences rates of CD (n = 13,445, panel a) and UC (n = 8,803, panel b) in Northern France over the study period (1988–2017), by sex and 5-year age groups; Women/Men incidence rate ratio (IRR) according to age group in CD (panel c) and UC (panel d). Incidence rates with confidence intervals are given in Supplementary Table S6.
Fig. 2
Fig. 2
Changes over time in standardized incidence rates for IBD (n = 22,879), CD (n = 13,445) and UC (n = 8803) in Northern France from 1988 to 2017.
Fig. 3
Fig. 3
Changes over time in the standardized incidence rates for CD (n = 13,445) and UC n = 8803) in Northern France from 1988 to 2017 by sex and age group. a) CD incidence according to sex. b) CD incidence according to age. c) UC incidence according to sex. d) UC incidence according to age. Incidence rates with confidence intervals are given in Supplementary Table S7.
Fig. 4
Fig. 4
Annual percent change (APC) in %/year over the 1988–2017 period in patients with CD (n = 13,445) and patients with UC (n = 8803) in Northern France by age group and sex.
Fig. 5
Fig. 5
Prevalence according to age in 2010, 2020 and 2030.
Fig. 6
Fig. 6
Changes in disease sites in patients with a) CD (n = 13,445) and b) UC (n = 8803) in Northern France from 1988 to 2017.
See this image and copyright information in PMC

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