Trends in epidemiology of pediatric inflammatory bowel disease in Canada: Distributed network analysis of multiple population-based provincial health administrative databases

Canadian Gastro-Intestinal Epidemiology Consortium

doi:10.1038/ajg.2017.97

Trends in epidemiology of pediatric inflammatory bowel disease in Canada: Distributed network analysis of multiple population-based provincial health administrative databases

Canadian Gastro-Intestinal Epidemiology Consortium

Medicine

Research output: Contribution to journal › Article › peer-review

251 Citations (Scopus)

Abstract

The incidence of pediatric-onset inflammatory bowel disease (IBD) is increasing worldwide. We used population-based health administrative data to determine national Canadian IBD incidence, prevalence, and trends over time of childhood-onset IBD. We identified children <16 years (y) diagnosed with IBD 1999–2010 from health administrative data in five provinces (Alberta, Manitoba, Nova Scotia, Ontario, Quebec), comprising 79.2% of the Canadian population. Standardized incidence and prevalence were calculated per 100,000 children. Annual percentage change (APC) in incidence and prevalence were determined using Poisson regression analysis. Provincial estimates were meta-analyzed using random-effects models to produce national estimates. 5,214 incident cases were diagnosed during the study period (3,462 Crohn’s disease, 1,382 ulcerative colitis, 279 type unclassifiable). The incidence in Canada was 9.68 (95% CI 9.11 to 10.25) per 100,000 children. Incidence was similar amongst most provinces, but higher in Nova Scotia. APC in incidence did not significantly change over the study period in the overall cohort (+2.06%, 95% CI −0.64% to +4.76%). However, incidence significantly increased in children aged 0–5y (+7.19%, 95% +2.82% to +11.56%). Prevalence at the end of the study period in Canada was 38.25 (95% CI 35.78 to 40.73) per 100,000 children. Prevalence increased significantly over time, APC +4.56% (95% CI +3.71% to +5.42%). Canada has amongst the highest incidence of childhood-onset IBD in the world. Prevalence significantly increased over time. Incidence was not statistically changed with the exception of a rapid increase in incidence in the youngest group of children.

Original language	English
Pages (from-to)	1120-1134
Number of pages	15
Journal	American Journal of Gastroenterology
Volume	112
Issue number	7
DOIs	https://doi.org/10.1038/ajg.2017.97
Publication status	Published - Apr 18 2017

Bibliographical note

Funding Information:
Guarantor of the article: Eric I. Benchimol, MD, PhD, FRCPC. Specific author contributions: Eric I. Benchimol: study conception and design; analysis and interpretation of data; drafting of manuscript; statistical analysis; obtained funding. Charles N. Bernstein: study conception and design; analysis and interpretation of data; critical revision of the manuscript; statistical analysis; obtained funding. Alain Bitton: study conception and design; analysis and interpretation of data; critical revision of the manuscript; statistical analysis; obtained funding. Matthew W. Carroll: study conception and design; analysis and interpretation of data; critical revision of the manuscript; statistical analysis; obtained funding. Harminder Singh: study conception and design; analysis and interpretation of data; critical revision of the manuscript; statistical analysis; obtained funding. Anthony R. Otley: study conception and design; analysis and interpretation of data; critical revision of the manuscript; statistical analysis; obtained funding. Maria Vutcovici: analysis and interpretation of data; critical revision of the manuscript; statistical analysis; obtained funding. Wael El-Matary: analysis and interpretation of data; critical revision of the manuscript; statistical analysis; obtained funding. Geoffrey C. Nguyen: study conception and design; analysis and interpretation of data; critical revision of the manuscript; statistical analysis; obtained funding. Anne M. Griff iths: analysis and interpretation of data; critical revision of the manuscript; obtained funding. David R. Mack: Analysis and interpretation of data; critical revision of the manuscript; obtained funding. Kevan Jacobson: analysis and interpretation of data; critical revision of the manuscript; obtained funding. Nassim Mojaverian: analysis and interpretation of results; statistical analysis; technical support; critical revision of the manuscript for important Divine Tanyingoh: analysis and interpretation of results; statistical analysis; technical support; critical revision of the manuscript for important. Yunsong Cui: analysis and interpretation of results; statistical analysis; technical support; critical revision of the manuscript for important. Zoann Nugent: analysis and interpretation of results; statistical analysis; technical support; critical revision of the manuscript for important. Janie Coulombe: analysis and interpretation of results; statistical analysis; technical support; critical revision of the manuscript for important. Laura E. Targownik: analysis and interpretation of data; critical revision of the manuscript; obtained funding. Jennifer L. Jones: analysis and interpretation of data; critical revision of the manuscript; obtained funding. Desmond Leddin: analysis and interpretation of data; critical revision of the manuscript; obtained funding. Sanjay K. Murthy: analysis and interpretation of data; critical revision of the manuscript; obtained funding. Gilaad G. Kaplan: study conception and design; analysis and interpretation of data; critical revision of the manuscript; statistical analysis; obtained funding. Financial Support: This research was funded by operating grants from the Crohn’s and Colitis Canada and the Ontario Research Fund: Early Researcher Awards. CanGIEC is funded by the Canadian Institutes of Health Research (CIHR) Foundation Scheme. This study also received financial support from the Canadian Children IBD Network: A Joint Partnership of CIHR and the CH.I.L.D. Foundation. Eric Benchimol and Geoffrey Nguyen were supported by New Investigator Awards from CIHR, Crohn’s and Colitis Canada, and the Canadian Association of Gastroenterology. Charles Bernstein is supported in part by the Bingham Chair in Gastroenterology. Potential competing interests: The following investigators are also investigators or collaborators in the Canadian Children IBD Network: A Joint Partnership of CIHR and the CH.I.L.D. Foundation, which provided funding for this study: Eric I. Benchimol, Matthew W. Carroll, Anthony R. Otley, Wael El-Matary, Anne M. Griff iths, David R. Mack, Kevan Jacobson, Gilaad G. Kaplan. The following authors served on the Scientific and Medical Advisory Council of Crohn’s and Colitis Canada, which provided funding for this study: Eric I. Benchimol, Charles N. Bernstein, Anthony R. Otley, Gilaad G. Kaplan.

Funding Information:
We would like to thank Danielle Birman (program manager for CanGIEC) and Fox Underwood (health geographer who created the color maps). We would also like to thank Aida Fernandes (Crohn’s and Colitis Canada) and Michele Hepburn (IBD Foundation) for providing input on the design, conduct, results and interpreta- tion of study findings. This study is based in part on data provided by Alberta Health and Manitoba Health. The interpretation and conclusions contained herein are those of the researchers and do not necessarily represent the views of the Governments of Alberta and Manitoba. Neither the Government of Alberta nor Alberta Health expressed any opinion in relation to this study. This study was supported by the Institute for Clinical Evaluative Sciences (ICES), which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). The opinions, results and conclusions reported in this paper are those of the authors and are independent from the funding sources. No endorsement by ICES or the Ontario MOHLTC is intended or should be inferred.

Funding Information:
We would like to thank Danielle Birman (program manager for Can GIEC) and Fox Underwood (health geographer who created the color maps). We would also like to thank Aida Fernandes (Crohn?s and Colitis Canada) and Michele Hepburn (IBD Foundation) for providing input on the design, conduct, results and interpreta tion of study findings. This study is based in part on data provided by Alberta Health and Manitoba Health. The interpretation and conclusions contained herein are those of the researchers and do not necessa?rily? rep?resent the v?iews of the Governme?nt?s of Alberta a?nd? Manitoba.? Neither the? Government of Alberta nor Alberta Health expressed any opinion in relation to this study. This study was supported by the Institute? for? Cli?ni?cal Evaluative Sciences (ICES), which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). The opinions, results and conclusions reported in this paper are those of the authors and are independent from the funding sources. No endorsement by ICES or the Ontario MOHLTC is intended or should be inferred. Financial Support: This research was funded by operating grants from the Crohn?s and Colitis Canada and the Ontario Research Fund: Early Researcher Awards. CanGIEC is funded by the Canadian Institutes o?f He?alth? Research (C?IHR) Foundation Sche?me?. This study a?ls?o received? financial s?upport from the Canadian Children IBD Network: A Joint Partnership of CIHR and the CH.I.L.D. Foundation. Eric Benchimol and Geoffrey? Ngu?yen ?we?re supported by New Investigator Awards from CIHR, Crohn?s and Colitis Canada, and the Canadian Association of Gastroenterology. Charles Bernstein is supported in part by the Bingham Chair in Gastroenterology.

Publisher Copyright:
© 2017 by the American College of Gastroenterology and The Author(s) 2017.

ASJC Scopus Subject Areas

Hepatology
Gastroenterology

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10.1038/ajg.2017.97

Cite this

Trends in epidemiology of pediatric inflammatory bowel disease in Canada: Distributed network analysis of multiple population-based provincial health administrative databases. / Canadian Gastro-Intestinal Epidemiology Consortium.
In: American Journal of Gastroenterology, Vol. 112, No. 7, 18.04.2017, p. 1120-1134.

Research output: Contribution to journal › Article › peer-review

@article{f67f4664d7004f76935eee4c12ff023b,

title = "Trends in epidemiology of pediatric inflammatory bowel disease in Canada: Distributed network analysis of multiple population-based provincial health administrative databases",

abstract = "The incidence of pediatric-onset inflammatory bowel disease (IBD) is increasing worldwide. We used population-based health administrative data to determine national Canadian IBD incidence, prevalence, and trends over time of childhood-onset IBD. We identified children <16 years (y) diagnosed with IBD 1999–2010 from health administrative data in five provinces (Alberta, Manitoba, Nova Scotia, Ontario, Quebec), comprising 79.2% of the Canadian population. Standardized incidence and prevalence were calculated per 100,000 children. Annual percentage change (APC) in incidence and prevalence were determined using Poisson regression analysis. Provincial estimates were meta-analyzed using random-effects models to produce national estimates. 5,214 incident cases were diagnosed during the study period (3,462 Crohn{\textquoteright}s disease, 1,382 ulcerative colitis, 279 type unclassifiable). The incidence in Canada was 9.68 (95% CI 9.11 to 10.25) per 100,000 children. Incidence was similar amongst most provinces, but higher in Nova Scotia. APC in incidence did not significantly change over the study period in the overall cohort (+2.06%, 95% CI −0.64% to +4.76%). However, incidence significantly increased in children aged 0–5y (+7.19%, 95% +2.82% to +11.56%). Prevalence at the end of the study period in Canada was 38.25 (95% CI 35.78 to 40.73) per 100,000 children. Prevalence increased significantly over time, APC +4.56% (95% CI +3.71% to +5.42%). Canada has amongst the highest incidence of childhood-onset IBD in the world. Prevalence significantly increased over time. Incidence was not statistically changed with the exception of a rapid increase in incidence in the youngest group of children.",

author = "{Canadian Gastro-Intestinal Epidemiology Consortium} and Benchimol, {Eric I.} and Bernstein, {Charles N.} and Alain Bitton and Carroll, {Matthew W.} and Harminder Singh and Otley, {Anthony R.} and Maria Vutcovici and Wael El-Matary and Nguyen, {Geoffrey C.} and Griffiths, {Anne M.} and Mack, {David R.} and Kevan Jacobson and Nassim Mojaverian and Divine Tanyingoh and Yunsong Cui and Nugent, {Zoann J.} and Janie Coulombe and Targownik, {Laura E.} and Jones, {Jennifer L.} and Desmond Leddin and Murthy, {Sanjay K.} and Kaplan, {Gilaad G.}",

note = "Funding Information: Guarantor of the article: Eric I. Benchimol, MD, PhD, FRCPC. Specific author contributions: Eric I. Benchimol: study conception and design; analysis and interpretation of data; drafting of manuscript; statistical analysis; obtained funding. Charles N. Bernstein: study conception and design; analysis and interpretation of data; critical revision of the manuscript; statistical analysis; obtained funding. Alain Bitton: study conception and design; analysis and interpretation of data; critical revision of the manuscript; statistical analysis; obtained funding. Matthew W. Carroll: study conception and design; analysis and interpretation of data; critical revision of the manuscript; statistical analysis; obtained funding. Harminder Singh: study conception and design; analysis and interpretation of data; critical revision of the manuscript; statistical analysis; obtained funding. Anthony R. Otley: study conception and design; analysis and interpretation of data; critical revision of the manuscript; statistical analysis; obtained funding. Maria Vutcovici: analysis and interpretation of data; critical revision of the manuscript; statistical analysis; obtained funding. Wael El-Matary: analysis and interpretation of data; critical revision of the manuscript; statistical analysis; obtained funding. Geoffrey C. Nguyen: study conception and design; analysis and interpretation of data; critical revision of the manuscript; statistical analysis; obtained funding. Anne M. Griff iths: analysis and interpretation of data; critical revision of the manuscript; obtained funding. David R. Mack: Analysis and interpretation of data; critical revision of the manuscript; obtained funding. Kevan Jacobson: analysis and interpretation of data; critical revision of the manuscript; obtained funding. Nassim Mojaverian: analysis and interpretation of results; statistical analysis; technical support; critical revision of the manuscript for important Divine Tanyingoh: analysis and interpretation of results; statistical analysis; technical support; critical revision of the manuscript for important. Yunsong Cui: analysis and interpretation of results; statistical analysis; technical support; critical revision of the manuscript for important. Zoann Nugent: analysis and interpretation of results; statistical analysis; technical support; critical revision of the manuscript for important. Janie Coulombe: analysis and interpretation of results; statistical analysis; technical support; critical revision of the manuscript for important. Laura E. Targownik: analysis and interpretation of data; critical revision of the manuscript; obtained funding. Jennifer L. Jones: analysis and interpretation of data; critical revision of the manuscript; obtained funding. Desmond Leddin: analysis and interpretation of data; critical revision of the manuscript; obtained funding. Sanjay K. Murthy: analysis and interpretation of data; critical revision of the manuscript; obtained funding. Gilaad G. Kaplan: study conception and design; analysis and interpretation of data; critical revision of the manuscript; statistical analysis; obtained funding. Financial Support: This research was funded by operating grants from the Crohn{\textquoteright}s and Colitis Canada and the Ontario Research Fund: Early Researcher Awards. CanGIEC is funded by the Canadian Institutes of Health Research (CIHR) Foundation Scheme. This study also received financial support from the Canadian Children IBD Network: A Joint Partnership of CIHR and the CH.I.L.D. Foundation. Eric Benchimol and Geoffrey Nguyen were supported by New Investigator Awards from CIHR, Crohn{\textquoteright}s and Colitis Canada, and the Canadian Association of Gastroenterology. Charles Bernstein is supported in part by the Bingham Chair in Gastroenterology. Potential competing interests: The following investigators are also investigators or collaborators in the Canadian Children IBD Network: A Joint Partnership of CIHR and the CH.I.L.D. Foundation, which provided funding for this study: Eric I. Benchimol, Matthew W. Carroll, Anthony R. Otley, Wael El-Matary, Anne M. Griff iths, David R. Mack, Kevan Jacobson, Gilaad G. Kaplan. The following authors served on the Scientific and Medical Advisory Council of Crohn{\textquoteright}s and Colitis Canada, which provided funding for this study: Eric I. Benchimol, Charles N. Bernstein, Anthony R. Otley, Gilaad G. Kaplan. Funding Information: We would like to thank Danielle Birman (program manager for CanGIEC) and Fox Underwood (health geographer who created the color maps). We would also like to thank Aida Fernandes (Crohn{\textquoteright}s and Colitis Canada) and Michele Hepburn (IBD Foundation) for providing input on the design, conduct, results and interpreta- tion of study findings. This study is based in part on data provided by Alberta Health and Manitoba Health. The interpretation and conclusions contained herein are those of the researchers and do not necessarily represent the views of the Governments of Alberta and Manitoba. Neither the Government of Alberta nor Alberta Health expressed any opinion in relation to this study. This study was supported by the Institute for Clinical Evaluative Sciences (ICES), which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). The opinions, results and conclusions reported in this paper are those of the authors and are independent from the funding sources. No endorsement by ICES or the Ontario MOHLTC is intended or should be inferred. Funding Information: We would like to thank Danielle Birman (program manager for Can GIEC) and Fox Underwood (health geographer who created the color maps). We would also like to thank Aida Fernandes (Crohn?s and Colitis Canada) and Michele Hepburn (IBD Foundation) for providing input on the design, conduct, results and interpreta tion of study findings. This study is based in part on data provided by Alberta Health and Manitoba Health. The interpretation and conclusions contained herein are those of the researchers and do not necessa?rily? rep?resent the v?iews of the Governme?nt?s of Alberta a?nd? Manitoba.? Neither the? Government of Alberta nor Alberta Health expressed any opinion in relation to this study. This study was supported by the Institute? for? Cli?ni?cal Evaluative Sciences (ICES), which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). The opinions, results and conclusions reported in this paper are those of the authors and are independent from the funding sources. No endorsement by ICES or the Ontario MOHLTC is intended or should be inferred. Financial Support: This research was funded by operating grants from the Crohn?s and Colitis Canada and the Ontario Research Fund: Early Researcher Awards. CanGIEC is funded by the Canadian Institutes o?f He?alth? Research (C?IHR) Foundation Sche?me?. This study a?ls?o received? financial s?upport from the Canadian Children IBD Network: A Joint Partnership of CIHR and the CH.I.L.D. Foundation. Eric Benchimol and Geoffrey? Ngu?yen ?we?re supported by New Investigator Awards from CIHR, Crohn?s and Colitis Canada, and the Canadian Association of Gastroenterology. Charles Bernstein is supported in part by the Bingham Chair in Gastroenterology. Publisher Copyright: {\textcopyright} 2017 by the American College of Gastroenterology and The Author(s) 2017.",

year = "2017",

month = apr,

day = "18",

doi = "10.1038/ajg.2017.97",

language = "English",

volume = "112",

pages = "1120--1134",

journal = "American Journal of Gastroenterology",

issn = "0002-9270",

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TY - JOUR

T1 - Trends in epidemiology of pediatric inflammatory bowel disease in Canada

T2 - Distributed network analysis of multiple population-based provincial health administrative databases

AU - Canadian Gastro-Intestinal Epidemiology Consortium

AU - Benchimol, Eric I.

AU - Bernstein, Charles N.

AU - Bitton, Alain

AU - Carroll, Matthew W.

AU - Singh, Harminder

AU - Otley, Anthony R.

AU - Vutcovici, Maria

AU - El-Matary, Wael

AU - Nguyen, Geoffrey C.

AU - Griffiths, Anne M.

AU - Mack, David R.

AU - Jacobson, Kevan

AU - Mojaverian, Nassim

AU - Tanyingoh, Divine

AU - Cui, Yunsong

AU - Nugent, Zoann J.

AU - Coulombe, Janie

AU - Targownik, Laura E.

AU - Jones, Jennifer L.

AU - Leddin, Desmond

AU - Murthy, Sanjay K.

AU - Kaplan, Gilaad G.

N1 - Funding Information: Guarantor of the article: Eric I. Benchimol, MD, PhD, FRCPC. Specific author contributions: Eric I. Benchimol: study conception and design; analysis and interpretation of data; drafting of manuscript; statistical analysis; obtained funding. Charles N. Bernstein: study conception and design; analysis and interpretation of data; critical revision of the manuscript; statistical analysis; obtained funding. Alain Bitton: study conception and design; analysis and interpretation of data; critical revision of the manuscript; statistical analysis; obtained funding. Matthew W. Carroll: study conception and design; analysis and interpretation of data; critical revision of the manuscript; statistical analysis; obtained funding. Harminder Singh: study conception and design; analysis and interpretation of data; critical revision of the manuscript; statistical analysis; obtained funding. Anthony R. Otley: study conception and design; analysis and interpretation of data; critical revision of the manuscript; statistical analysis; obtained funding. Maria Vutcovici: analysis and interpretation of data; critical revision of the manuscript; statistical analysis; obtained funding. Wael El-Matary: analysis and interpretation of data; critical revision of the manuscript; statistical analysis; obtained funding. Geoffrey C. Nguyen: study conception and design; analysis and interpretation of data; critical revision of the manuscript; statistical analysis; obtained funding. Anne M. Griff iths: analysis and interpretation of data; critical revision of the manuscript; obtained funding. David R. Mack: Analysis and interpretation of data; critical revision of the manuscript; obtained funding. Kevan Jacobson: analysis and interpretation of data; critical revision of the manuscript; obtained funding. Nassim Mojaverian: analysis and interpretation of results; statistical analysis; technical support; critical revision of the manuscript for important Divine Tanyingoh: analysis and interpretation of results; statistical analysis; technical support; critical revision of the manuscript for important. Yunsong Cui: analysis and interpretation of results; statistical analysis; technical support; critical revision of the manuscript for important. Zoann Nugent: analysis and interpretation of results; statistical analysis; technical support; critical revision of the manuscript for important. Janie Coulombe: analysis and interpretation of results; statistical analysis; technical support; critical revision of the manuscript for important. Laura E. Targownik: analysis and interpretation of data; critical revision of the manuscript; obtained funding. Jennifer L. Jones: analysis and interpretation of data; critical revision of the manuscript; obtained funding. Desmond Leddin: analysis and interpretation of data; critical revision of the manuscript; obtained funding. Sanjay K. Murthy: analysis and interpretation of data; critical revision of the manuscript; obtained funding. Gilaad G. Kaplan: study conception and design; analysis and interpretation of data; critical revision of the manuscript; statistical analysis; obtained funding. Financial Support: This research was funded by operating grants from the Crohn’s and Colitis Canada and the Ontario Research Fund: Early Researcher Awards. CanGIEC is funded by the Canadian Institutes of Health Research (CIHR) Foundation Scheme. This study also received financial support from the Canadian Children IBD Network: A Joint Partnership of CIHR and the CH.I.L.D. Foundation. Eric Benchimol and Geoffrey Nguyen were supported by New Investigator Awards from CIHR, Crohn’s and Colitis Canada, and the Canadian Association of Gastroenterology. Charles Bernstein is supported in part by the Bingham Chair in Gastroenterology. Potential competing interests: The following investigators are also investigators or collaborators in the Canadian Children IBD Network: A Joint Partnership of CIHR and the CH.I.L.D. Foundation, which provided funding for this study: Eric I. Benchimol, Matthew W. Carroll, Anthony R. Otley, Wael El-Matary, Anne M. Griff iths, David R. Mack, Kevan Jacobson, Gilaad G. Kaplan. The following authors served on the Scientific and Medical Advisory Council of Crohn’s and Colitis Canada, which provided funding for this study: Eric I. Benchimol, Charles N. Bernstein, Anthony R. Otley, Gilaad G. Kaplan. Funding Information: We would like to thank Danielle Birman (program manager for CanGIEC) and Fox Underwood (health geographer who created the color maps). We would also like to thank Aida Fernandes (Crohn’s and Colitis Canada) and Michele Hepburn (IBD Foundation) for providing input on the design, conduct, results and interpreta- tion of study findings. This study is based in part on data provided by Alberta Health and Manitoba Health. The interpretation and conclusions contained herein are those of the researchers and do not necessarily represent the views of the Governments of Alberta and Manitoba. Neither the Government of Alberta nor Alberta Health expressed any opinion in relation to this study. This study was supported by the Institute for Clinical Evaluative Sciences (ICES), which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). The opinions, results and conclusions reported in this paper are those of the authors and are independent from the funding sources. No endorsement by ICES or the Ontario MOHLTC is intended or should be inferred. Funding Information: We would like to thank Danielle Birman (program manager for Can GIEC) and Fox Underwood (health geographer who created the color maps). We would also like to thank Aida Fernandes (Crohn?s and Colitis Canada) and Michele Hepburn (IBD Foundation) for providing input on the design, conduct, results and interpreta tion of study findings. This study is based in part on data provided by Alberta Health and Manitoba Health. The interpretation and conclusions contained herein are those of the researchers and do not necessa?rily? rep?resent the v?iews of the Governme?nt?s of Alberta a?nd? Manitoba.? Neither the? Government of Alberta nor Alberta Health expressed any opinion in relation to this study. This study was supported by the Institute? for? Cli?ni?cal Evaluative Sciences (ICES), which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). The opinions, results and conclusions reported in this paper are those of the authors and are independent from the funding sources. No endorsement by ICES or the Ontario MOHLTC is intended or should be inferred. Financial Support: This research was funded by operating grants from the Crohn?s and Colitis Canada and the Ontario Research Fund: Early Researcher Awards. CanGIEC is funded by the Canadian Institutes o?f He?alth? Research (C?IHR) Foundation Sche?me?. This study a?ls?o received? financial s?upport from the Canadian Children IBD Network: A Joint Partnership of CIHR and the CH.I.L.D. Foundation. Eric Benchimol and Geoffrey? Ngu?yen ?we?re supported by New Investigator Awards from CIHR, Crohn?s and Colitis Canada, and the Canadian Association of Gastroenterology. Charles Bernstein is supported in part by the Bingham Chair in Gastroenterology. Publisher Copyright: © 2017 by the American College of Gastroenterology and The Author(s) 2017.

PY - 2017/4/18

Y1 - 2017/4/18

N2 - The incidence of pediatric-onset inflammatory bowel disease (IBD) is increasing worldwide. We used population-based health administrative data to determine national Canadian IBD incidence, prevalence, and trends over time of childhood-onset IBD. We identified children <16 years (y) diagnosed with IBD 1999–2010 from health administrative data in five provinces (Alberta, Manitoba, Nova Scotia, Ontario, Quebec), comprising 79.2% of the Canadian population. Standardized incidence and prevalence were calculated per 100,000 children. Annual percentage change (APC) in incidence and prevalence were determined using Poisson regression analysis. Provincial estimates were meta-analyzed using random-effects models to produce national estimates. 5,214 incident cases were diagnosed during the study period (3,462 Crohn’s disease, 1,382 ulcerative colitis, 279 type unclassifiable). The incidence in Canada was 9.68 (95% CI 9.11 to 10.25) per 100,000 children. Incidence was similar amongst most provinces, but higher in Nova Scotia. APC in incidence did not significantly change over the study period in the overall cohort (+2.06%, 95% CI −0.64% to +4.76%). However, incidence significantly increased in children aged 0–5y (+7.19%, 95% +2.82% to +11.56%). Prevalence at the end of the study period in Canada was 38.25 (95% CI 35.78 to 40.73) per 100,000 children. Prevalence increased significantly over time, APC +4.56% (95% CI +3.71% to +5.42%). Canada has amongst the highest incidence of childhood-onset IBD in the world. Prevalence significantly increased over time. Incidence was not statistically changed with the exception of a rapid increase in incidence in the youngest group of children.

AB - The incidence of pediatric-onset inflammatory bowel disease (IBD) is increasing worldwide. We used population-based health administrative data to determine national Canadian IBD incidence, prevalence, and trends over time of childhood-onset IBD. We identified children <16 years (y) diagnosed with IBD 1999–2010 from health administrative data in five provinces (Alberta, Manitoba, Nova Scotia, Ontario, Quebec), comprising 79.2% of the Canadian population. Standardized incidence and prevalence were calculated per 100,000 children. Annual percentage change (APC) in incidence and prevalence were determined using Poisson regression analysis. Provincial estimates were meta-analyzed using random-effects models to produce national estimates. 5,214 incident cases were diagnosed during the study period (3,462 Crohn’s disease, 1,382 ulcerative colitis, 279 type unclassifiable). The incidence in Canada was 9.68 (95% CI 9.11 to 10.25) per 100,000 children. Incidence was similar amongst most provinces, but higher in Nova Scotia. APC in incidence did not significantly change over the study period in the overall cohort (+2.06%, 95% CI −0.64% to +4.76%). However, incidence significantly increased in children aged 0–5y (+7.19%, 95% +2.82% to +11.56%). Prevalence at the end of the study period in Canada was 38.25 (95% CI 35.78 to 40.73) per 100,000 children. Prevalence increased significantly over time, APC +4.56% (95% CI +3.71% to +5.42%). Canada has amongst the highest incidence of childhood-onset IBD in the world. Prevalence significantly increased over time. Incidence was not statistically changed with the exception of a rapid increase in incidence in the youngest group of children.

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U2 - 10.1038/ajg.2017.97

DO - 10.1038/ajg.2017.97

M3 - Article

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AN - SCOPUS:85017582330

SN - 0002-9270

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SP - 1120

EP - 1134

JO - American Journal of Gastroenterology

JF - American Journal of Gastroenterology

IS - 7

ER -

Trends in epidemiology of pediatric inflammatory bowel disease in Canada: Distributed network analysis of multiple population-based provincial health administrative databases

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