Incidence and phenotype of inflammatory bowel disease based on results from the Asia-Pacific Crohn's and colitis epidemiology study

Siew C. Ng, Whitney Tang, Jessica Y. Ching, May Wong, Chung Mo Chow, A. J. Hui, T. C. Wong, Vincent K. Leung, Steve W. Tsang, Hon Ho Yu, Mo Fong Li, Ka Kei Ng, Michael A. Kamm, Corrie Studd, Sally Bell, Rupert Leong, H. Janaka De Silva, Anuradhani Kasturiratne, M. N.F. Mufeena, Khoon Lin LingChoon Jin Ooi, Poh Seng Tan, David Ong, Khean L. Goh, Ida Hilmi, Pises Pisespongsa, Sathaporn Manatsathit, Rungsun Rerknimitr, Satimai Aniwan, Yu Fang Wang, Qin Ouyang, Zhirong Zeng, Zhenhua Zhu, Min Hu Chen, Pin Jin Hu, Kaichun Wu, Xin Wang, Marcellus Simadibrata, Murdani Abdullah, Justin Cy Wu, Joseph J.Y. Sung, Francis K.L. Chan

Research output: Contribution to journalArticlepeer-review

524 Citations (Scopus)

Abstract

Background & Aims: Inflammatory bowel diseases (IBD) are becoming more common in Asia, but epidemiologic data are lacking. The Asia-Pacific Crohn's and Colitis Epidemiology Study aimed to determine the incidence and phenotype of IBD in 8 countries across Asia and in Australia. Methods: We performed a prospective, population-based study of IBD incidence in predefined catchment areas, collecting data for 1 year, starting on April 1, 2011. New cases were ascertained from multiple overlapping sources and entered into a Web-based database. Cases were confirmed using standard criteria. Local endoscopy, pathology, and pharmacy records were searched to ensure completeness of case capture. Results: We identified 419 new cases of IBD (232 of ulcerative colitis [UC], 166 of Crohn's disease [CD], and 21 IBD-undetermined). The crude annual overall incidence values per 100,000 individuals were 1.37 for IBD in Asia (95% confidence interval: 1.25-1.51; 0.76 for UC, 0.54 for CD, and 0.07 for IBD-undetermined) and 23.67 in Australia (95% confidence interval: 18.46-29.85; 7.33 for UC, 14.00 for CD, and 2.33 for IBD-undetermined). China had the highest incidence of IBD in Asia (3.44 per 100,000 individuals). The ratios of UC to CD were 2.0 in Asia and 0.5 in Australia. Median time from symptom onset to diagnosis was 5.5 months (interquartile range, 1.4-15 months). Complicated CD (stricturing, penetrating, or perianal disease) was more common in Asia than Australia (52% vs 24%; P =.001), and a family history of IBD was less common in Asia (3% vs 17%; P <.001). Conclusions: We performed a large-scale population-based study and found that although the incidence of IBD varies throughout Asia, it is still lower than in the West. IBD can be as severe or more severe in Asia than in the West. The emergence of IBD in Asia will result in the need for specific health care resources, and offers a unique opportunity to study etiologic factors in developing nations.

Original languageEnglish
Pages (from-to)158-165.e2
JournalGastroenterology
Volume145
Issue number1
DOIs
Publication statusPublished - Jul 2013

Keywords

  • ACCESS
  • Inflammation
  • Intestine
  • Rate

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