Abstract
BackgroundNova Scotia has one of the highest incidences of inflammatory bowel disease (IBD) in the world. We wished to determine trends of IBD over time.MethodsAll Provincial residents have government provided health insurance and all interactions with the hospital, and physician billing systems, are captured on an administrative database. We used a validated measure to define incident cases of Crohn’s (CD), ulcerative colitis (UC) and undifferentiated IBD (IBDU). Incidence rates of these diseases for the years 1996–2009 were calculated.ResultsOver the study period, 7,153 new cases of IBD were observed of which 3,046 cases were categorized as CD (42.6%), 2,960 as UC (41.4%) and 1,147 as IBDU (16.0%). Annual age standardized incidence rates were very high but have declined for CD from 27.4 to 17.7/100,000 population and for UC from 21.4 to 16.7/100,000. The decline was seen in all age groups and both genders. The decrease was not explained by a small increase in IBDU.ConclusionThe incidence of CD and UC are decreasing in Nova Scotia. If replicated elsewhere this indicates a reversal after a long period of increasing occurrence of IBD. This has implications for both epidemiology and health planning.
Highlights
Nova Scotia has one of the highest incidences of inflammatory bowel disease (IBD) in the world
Over the 14 year period under study, across all age groups and both genders, a total of 7,153 incident cases of IBD were identified with 3,046 cases categorized as Crohn’s Disease (CD) (42.6%), 2,960 cases categorized as Ulcerative Colitis (UC) (41.4%) and 1,147 cases categorized as Undifferentiated inflammatory bowel disease (IBDU) (16.0%)
The directly age-standardized rates of CD, UC and IBDU allowed for comparisons across years with adjustment for age distribution over time
Summary
Nova Scotia has one of the highest incidences of inflammatory bowel disease (IBD) in the world. IBDU is diagnosed when the illness has features of both CD and UC [1]. The aetiology of these conditions remains unclear [2,3,4,5,6]. Incidence and prevalence rates are rising in many regions of the world including developing nations [2]. The prevalence and incidence of IBD has been studied extensively in recent years. The disease affects both genders and all ages. Molodecky et al [3] conducted a
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