TY - JOUR
T1 - Incidence, clinical characteristics, and natural history of pediatric IBD in Wisconsin
T2 - A population-based epidemiological study
AU - Adamiak, Tonya
AU - Walkiewicz-Jedrzejczak, Dorota
AU - Fish, Daryl
AU - Brown, Christopher
AU - Tung, Jeanne
AU - Khan, Khalid
AU - Faubion, William
AU - Park, Roger
AU - Heikenen, Janice
AU - Yaffee, Michael
AU - Rivera-Bennett, Maria T.
AU - Wiedkamp, Marcy
AU - Stephens, Michael
AU - Noel, Richard
AU - Nugent, Melodee
AU - Nebel, Justin
AU - Simpson, Pippa
AU - Kappelman, Michael D.
AU - Kugathasan, Subra
PY - 2013/5
Y1 - 2013/5
N2 - 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.
AB - 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.
KW - Children
KW - Crohn's disease
KW - Epidemiology
KW - IBD
KW - Ulcerative colitis
UR - http://www.scopus.com/inward/record.url?scp=84879233354&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84879233354&partnerID=8YFLogxK
U2 - 10.1097/MIB.0b013e318280b13e
DO - 10.1097/MIB.0b013e318280b13e
M3 - Article
C2 - 23528339
AN - SCOPUS:84879233354
VL - 19
SP - 1218
EP - 1223
JO - Inflammatory Bowel Diseases
JF - Inflammatory Bowel Diseases
SN - 1078-0998
IS - 6
ER -