Incidence and prevalence of inflammatory bowel disease in UK primary care: a population-based cohort study

Objectives We describe temporal trends in the recorded incidence of inflammatory bowel disease (IBD) in UK primary care patients between 2000 and 2018.Design A cohort study.Setting The IQVIA Medical Research data (IMRD) primary care database.Participants All individuals registered with general pract...

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Main Authors: Nigel Field, Stuart Bloom, Greta Rait, Caroline Sabin, Thomas Joshua Pasvol, Anthony Walter Segal
Format: Article
Language:English
Published: BMJ Publishing Group 2020-07-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/7/e036584.full
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author Nigel Field
Stuart Bloom
Greta Rait
Caroline Sabin
Thomas Joshua Pasvol
Anthony Walter Segal
author_facet Nigel Field
Stuart Bloom
Greta Rait
Caroline Sabin
Thomas Joshua Pasvol
Anthony Walter Segal
author_sort Nigel Field
collection DOAJ
description Objectives We describe temporal trends in the recorded incidence of inflammatory bowel disease (IBD) in UK primary care patients between 2000 and 2018.Design A cohort study.Setting The IQVIA Medical Research data (IMRD) primary care database.Participants All individuals registered with general practices contributing to IMRD during the period 01 January 2000–31 December 2018.Main outcome measures The primary outcome was the recorded diagnosis of IBD.Results 11 325 025 individuals were included and 65 700 IBD cases were identified, of which 22 560 were incident diagnoses made during the study period. Overall, there were 8077 incident cases of Crohn’s disease (CD) and 12 369 incident cases of ulcerative colitis (UC). Crude incidence estimates of ‘IBD overall’, CD and UC were 28.6 (28.2 to 28.9), 10.2 (10.0 to 10.5) and 15.7 (15.4 to 15.9)/100 000 person years, respectively. No change in IBD incidence was observed for adults aged 17–40 years and children aged 0–9 years. However, for adults aged over 40 years, incidence fell from 37.8 (34.5 to 41.4) to 23.6 (21.3 to 26.0)/100 000 person years (average decrease 2.3% (1.9 to 2.7)/year (p<0.0001)). In adolescents aged 10–16 years, incidence rose from 13.1 (8.4 to 19.5) to 25.4 (19.5 to 32.4)/100 000 person years (average increase 3.0% (1.7 to 4.3)/year (p<0.0001)). Point prevalence estimates on 31 December 2018 for IBD overall, CD and UC were 725, 276 and 397 per 100 000 people, respectively.Conclusions This is one of the largest studies ever undertaken to investigate trends in IBD epidemiology. Although we observed stable or falling incidence of IBD in adults, our results are consistent with some of the highest reported global incidence and prevalence rates for IBD, with a 94% rise in incidence in adolescents. Further investigation is required to understand the aetiological drivers.
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spelling doaj-art-4d411fe97b7c4052b8a69d8f8963cf462025-08-20T02:51:07ZengBMJ Publishing GroupBMJ Open2044-60552020-07-0110710.1136/bmjopen-2019-036584Incidence and prevalence of inflammatory bowel disease in UK primary care: a population-based cohort studyNigel Field0Stuart Bloom1Greta Rait2Caroline Sabin3Thomas Joshua Pasvol4Anthony Walter Segal5Institute for Global Health, University College London, London, UKUniversity College London Hospitals, London, UKDepartment of Primary Care and Population Health and Priment Clinical Trials Unit, University College London, London, UKInstitute for Global Health, University College London, London, UKThe Research Department of Primary Care and Population Health, University College London, London, UKMedicine, University College London, London, UKObjectives We describe temporal trends in the recorded incidence of inflammatory bowel disease (IBD) in UK primary care patients between 2000 and 2018.Design A cohort study.Setting The IQVIA Medical Research data (IMRD) primary care database.Participants All individuals registered with general practices contributing to IMRD during the period 01 January 2000–31 December 2018.Main outcome measures The primary outcome was the recorded diagnosis of IBD.Results 11 325 025 individuals were included and 65 700 IBD cases were identified, of which 22 560 were incident diagnoses made during the study period. Overall, there were 8077 incident cases of Crohn’s disease (CD) and 12 369 incident cases of ulcerative colitis (UC). Crude incidence estimates of ‘IBD overall’, CD and UC were 28.6 (28.2 to 28.9), 10.2 (10.0 to 10.5) and 15.7 (15.4 to 15.9)/100 000 person years, respectively. No change in IBD incidence was observed for adults aged 17–40 years and children aged 0–9 years. However, for adults aged over 40 years, incidence fell from 37.8 (34.5 to 41.4) to 23.6 (21.3 to 26.0)/100 000 person years (average decrease 2.3% (1.9 to 2.7)/year (p<0.0001)). In adolescents aged 10–16 years, incidence rose from 13.1 (8.4 to 19.5) to 25.4 (19.5 to 32.4)/100 000 person years (average increase 3.0% (1.7 to 4.3)/year (p<0.0001)). Point prevalence estimates on 31 December 2018 for IBD overall, CD and UC were 725, 276 and 397 per 100 000 people, respectively.Conclusions This is one of the largest studies ever undertaken to investigate trends in IBD epidemiology. Although we observed stable or falling incidence of IBD in adults, our results are consistent with some of the highest reported global incidence and prevalence rates for IBD, with a 94% rise in incidence in adolescents. Further investigation is required to understand the aetiological drivers.https://bmjopen.bmj.com/content/10/7/e036584.full
spellingShingle Nigel Field
Stuart Bloom
Greta Rait
Caroline Sabin
Thomas Joshua Pasvol
Anthony Walter Segal
Incidence and prevalence of inflammatory bowel disease in UK primary care: a population-based cohort study
BMJ Open
title Incidence and prevalence of inflammatory bowel disease in UK primary care: a population-based cohort study
title_full Incidence and prevalence of inflammatory bowel disease in UK primary care: a population-based cohort study
title_fullStr Incidence and prevalence of inflammatory bowel disease in UK primary care: a population-based cohort study
title_full_unstemmed Incidence and prevalence of inflammatory bowel disease in UK primary care: a population-based cohort study
title_short Incidence and prevalence of inflammatory bowel disease in UK primary care: a population-based cohort study
title_sort incidence and prevalence of inflammatory bowel disease in uk primary care a population based cohort study
url https://bmjopen.bmj.com/content/10/7/e036584.full
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