Epidemiology Of Inflammatory Bowel Disease Research Articles

INVIROMENTAL FACTORS IN THE CONTEXT OF INFLAMMATORY BOWEL DISEASE (REVIEW)

Inflammatory bowel diseases, including ulcerative colitis and Crohn's disease, are characterized by a chronic recurrent course. With no established etiology, воспалительных заболеваний кишечника is considered as a multifactorial disease, affecting psychological and social well-being and significantly impairing the quality of life of patients. The burden of inflammatory bowel disease is increasing worldwide, with incidence rates and trends varying significantly between countries and regions. Changing trends in the epidemiology of inflammatory bowel disease are occurring in parallel with industrialization and significant invairomental changes associated with the westernization of society, confirming the role of non-genetic risks in the etiopathogenesis of inflammatory bowel disease. A combination of factors, including the improved socioeconomic status of newly industrialized countries initiating invairomental dynamics, increases the risk of inflammatory bowel disease. The impact of invairomental factors is a possible missing link in understanding the etiology and increasing prevalence of inflammatory bowel disease in recent years. Studying the relationship between environmental factors and inflammatory bowel disease may improve the understanding of etiopathogenesis, identify strategies for prognosis and prevention, and prepare health care systems for the growing burden of inflammatory bowel disease.

Epidemiology of Inflammatory Bowel Disease across the Ages in the Era of Advanced Therapies.

The incidence of inflammatory bowel diseases [IBD] has risen over the past decade to become a global issue. The objectives of this review were to describe the incidence and/or prevalence of IBD in the era of advanced therapies, and to describe the association between environmental risk factors and both pathogenesis and disease course across the ages. We performed a search of English language publications listed in PubMed regarding the epidemiology of IBD and key environmental factors implicated in IBD from January 2000 to December 2023. Annual incidence rates varied by geographical region with IBD estimates ranging from 10.5 to 46.14 per 100 000 in Europe, 1.37 to 1.5 per 100 000 in Asia and the Middle East, 23.67 to 39.8 per 100 000 in Oceania, 0.21 to 3.67 per 100 000 in South America, and 7.3 to 30.2 per 100 000 in North America. The burden of IBD among children and adolescents, and older people is rising globally. Key environmental factors implicated in IBD pathogenesis include exposure to tobacco smoking, antibiotics, non-steroidal anti-inflammatory drugs, oral contraceptives, infections, and ultra-high processed foods. Breastfeeding and a high-quality diet rich in fruit, vegetables, fish, and other fibre sources are important protective factors. Smoking has consistently been shown to negatively impact disease outcomes for Crohn's disease. The epidemiology of IBD has undergone considerable change in recent decades, with an increase in the burden of disease worldwide. Optimally studying and targeting environmental triggers in IBD may offer future opportunities for disease modification.

Hereditary Colorectal Cancer Syndromes and Inflammatory Bowel Diseases: Risk Management and Surveillance Strategies.

Background and aims: Hereditary colorectal cancer syndromes (HCCS), including familial adenomatous polyposis (FAP) and Lynch syndrome (LS), are the two most important high-risk conditions for colorectal cancer (CRC). Inflammatory bowel disease (IBD) increases the risk by two to six times compared with that in the general population. The intersection of these two conditions has rarely been documented in literature. We aimed to summarize the prevalence, pathogenesis, and current evidence-based management of IBD and HCCS and the underlying molecular mechanisms of accelerated carcinogenesis due to combined inflammation and genetic predisposition. Methods: PubMed and Scopus were searched until June 2024 to identify relevant studies investigating the epidemiology, pathogenesis, and management of IBD and coexisting hereditary CRC syndromes. Results: Co-occurrence of IBD and hereditary CRC syndromes is exceptionally uncommon. Individuals with LS and IBD tend to develop CRC at a younger age than those without IBD, with patients with ulcerative colitis facing particularly elevated risks. The interaction between mismatch deficiency and chronic inflammation requires further investigation.

Emerging patterns of inflammatory bowel disease in sub-Saharan Africa: 175 cases from an IBD network.

There is a knowledge gap on the epidemiology of inflammatory bowel disease in Africa. To begin to address this issue we formed a case reporting network of practitioners with an interest in inflammatory bowel disease across sub-Saharan Africa. Here we report a series of 175 cases from 12 countries over 2 years.

On probiotic integration in the management of inflammation and the maintenance of the intestinal epithelial barrier’s integrity

Inflammatory bowel disease epidemiology has grown dramatically in recent years, particularly in developed and developing Western countries. Many factors, including stress, diet, and medications, cause and exacerbate inflammatory conditions. Inflammation is closely related to the concept of intestinal barrier integrity. When integrity is compromised, toxins and pathogens can enter the bloodstream. In recent years, there has been a growing interest in using probiotic bacteria to prevent or treat a variety of pathologies, including inflammatory bowel disease. Some studies have looked at the effectiveness of multi-strain probiotic supplements in preventing intestinal barrier dysfunction in in vitro models of lipopolysaccharide-induced inflammation. To mimic the intestinal barrier, human colon adenocarcinoma cell lines were established in Transwell co-culture models. The epithelium permeability was assessed by measuring the transepithelial electrical resistance. The expression of individual proteins involved in barrier function was assessed. The immunomodulatory effects of probiotic formulations were studied in both human macrophage cell lines and ex vivo human peripheral blood mononuclear cell-derived macrophages. The intestinal epithelial layer was also interfaced with a human mast cell line. Selected probiotics have demonstrated high potential for use in maintaining intestinal barrier integrity and possessing anti-inflammatory properties.

Epidemiology of Elderly Onset IBD: A Nationwide Population-Based Cohort Study

We examined the incidence and natural history of patients with very elderly onset (herein referred to as very late-onset) inflammatory bowel diseases (IBDs) (≥ 70 years of age at diagnosis), compared with patients diagnosed between 60 and 69 years of age in Denmark. In the Danish National Patient Register, between 1980 and 2018, we identified all individuals ≥ 60 years of age with newly diagnosed Crohn's disease (CD) and ulcerative colitis (UC) and examined trends in incidence, cumulative risk of hospitalization, treatment patterns, IBD-related surgery, serious infection, cancer and cardiovascular and venous thromboembolic risks among very late-onset (70-79 years of age or 80+ years) vs late-onset (60-69 years of age) IBD, using nonparametric competing risk analysis treating death as competing risk. We identified 3459 patients with onset of CD at ≥60 years of age (47% ≥ 70 years of age) and 10,774 patients with onset of UC ≥60 years of age (51% ≥ 70 years of age). Over the last 3 decades, incidence changes for very late-onset and late-onset IBD have followed the same patterns. Also, both for CD and UC, cumulative incidence of IBD-related hospitalization and corticosteroid use was comparable in very late-onset vs late-onset patients. However, the burden of disease-modifying therapy, either immunomodulator or tumor necrosis factor antagonist use, and major IBD-related surgery was significantly lower in patients with very late-onset than in late-onset IBD. On the other hand, the 5-year risk of serious infections and cardiovascular events was higher in patients with very late-onset IBD. This nationwide cohort study shows that patients diagnosed with very late-onset (≥ 70 years of age) IBD have a higher relative burden of disease- and aging-related complications, with limited use of steroid-sparing strategies and surgery, compared with late-onset IBD.

Geographical and sociodemographic epidemiology of inflammatory bowel disease in young females from 2010 to 2019

Background and aimsInflammatory Bowel Disease (IBD) represents a significant health threat worldwide. However, there are deficiencies in large-scale epidemiological research focusing on these issues, especially among young women. We aim to examine the trend of IBD in young females globally. MethodsWe utilized data from the Global Burden of Disease (GBD) study between 2010 and 2019 to conduct a comprehensive analysis of the prevalence, mortality, and disability-adjusted life years (DALYs) from IBD in young females (15–49 years), stratified by region, nation, and sociodemographic index (SDI). ResultsGlobally, there were 1.27 million (95 % UI 1.10 to 1.45 million) cases and 314,120 (95 % UI 240,880 to 395,420) DALYs from IBD in young females in 2019. Geographically, Europe had the highest burden of IBD in young females (n = 421,320). From 2010 to 2019, the prevalence rate increased in Africa (APC 0.34 %, 95 % CI 0.25 to 0.44 %), the Eastern Mediterranean (APC 0.77 %, 95 % CI 0.74 to 0.81 %), Europe (APC 0.48 %, 95 % CI 0.44 to 0.51 %) and the Western Pacific region (APC 1.01 %, 95 % CI 0.89 to 1.14 %). Countries with lower SDI exhibited higher DALYs to prevalence ratio. Over the study period, the percentage of young women with IBD compared to young adults increased by 0.24 %. This percentage varies significantly between countries, from 26 % to 62 %. ConclusionThe burden of IBD in young females is high and increasing. Countries with lower SDIs generate higher disability per case. This necessitates immediate and inclusive measures to tackle the rising burden of IBD in this vulnerable group. Lay SummaryFrom 2010 to 2019, in the largest global epidemiology database, prevalence rates of inflammatory bowel disease in young females increased in many regions. Countries with lower socioeconomic development, as indicated by sociodemographic index, generated a higher burden compared to countries with higher development

The Rising Burden Of Inflammatory Bowel Disease In Canada

The Impact of Inflammatory Bowel Disease report, produced by the Canadian Gastro-Intestinal Epidemiology Consortium (cangiec.ca) for Crohn’s and Colitis Canada is a serial policy report produced every 3–5 years that summarizes the existing literature on the epidemiology, burden, and impact of inflammatory bowel disease (IBD) in Canada and identifies knowledge gaps. Its goal is to inform people living with IBD and their caregivers, donors, physicians, researchers, policy makers, and other stakeholders about the current burden of IBD in Canada. It plays an integral role for Crohn’s and Colitis Canada’s advocacy efforts. In addition, the report informs the research funding policy of the health charity, which is the second largest non-governmental funder of IBD research in the world. The latest iteration of this report was released on June 1, 2023 and is available here. This article summarizes the current epidemiology of IBD in Canada and discusses its implications for clinical care in 2024 and beyond.

Epidemiological Profile of IBD in the Northern Region: "Pilot Study"

Inflammatory bowel disease (IBD) refers to three chronic inflammatory disorders, ulcerative colitis (UC), Crohn disease (CD) and indeterminate colitis. Classically IBD is described as a disease of rich countries, and historical data on the geographical distribution of IBD around the world have shown a high incidence and prevalence in high-income countries, like Northern Europe and the USA. More recently, IBD emerged with increasing frequency in many parts of the planet especially in developing countries [1], including Morocco, becoming a global infection. UC remains more frequent than CD except in certain countries including France [2]. Although progress has recently been made, particularly in the genetic field, in understanding their physiopathology, the cause(s) of these two diseases remains unknown to date. A better knowledge of the descriptive epidemiology of IBD, in particular the differences in incidence in relation to time, age or geographical distribution, can lead to etiological leads. Study the epidemiology of IBD is a challenge, in part because it is difficult to diagnose, but it is important because of its direct and indirect costs. Data from Moroccan studies remain rare. Our study on the epidemiology of inflammatory bowel disease (IBD) is the first in the northern region.

Changing epidemiology of inflammatory bowel disease in children and adolescents

BackgroundThe incidence of inflammatory bowel disease (IBD) is rising worldwide, but epidemiological data on children and adolescents are lacking. Understanding the global burden of IBD among children and adolescents is essential for global standardization of methodology and treatment options.MethodsThis is a cross-sectional study based on aggregated data. We estimated the prevalence and incidence of IBD in children and adolescents between 1990 and 2019 according to the Global Burden of Disease Study 2019 (GBD 2019). Age-standardized rates (ASRs) and estimated annual percentage changes (EAPCs) were used to compare the burden and trends between different regions and countries.ResultsIn 2019, there were 25,659 new cases and 88,829 prevalent cases of IBD among children and adolescents globally, representing an increase of 22.8% and 18.5%, respectively, compared to 1990. Over the past 30 years, the incidence and prevalence of IBD among children and adolescents have been highest in high SDI regions, with the most significant increases in East Asia and high-income Asia Pacific. At the age level, incidence and prevalence were significantly higher in the 15–19-year-old age group, while the < 5-year-old group showed the most significant increase in incidence and prevalence.ConclusionThe incidence of IBD in children and adolescents is significantly on the rise in some countries and regions, and IBD will remain an important public health issue with extensive healthcare and economic costs in the future. The reported IBD burden in children and adolescents at the global, regional, and national levels will assist in the development of more precise health policies.

Sacroiliitis in inflammatory bowel disease.

This review summarizes the recent evidence regarding the epidemiology of inflammatory bowel disease (IBD) associated sacroiliitis, including the prevalence, pathogenesis, role of imaging, and therapeutic challenges. Sacroiliitis is an underappreciated musculoskeletal manifestation of IBD, a chronic inflammatory condition of the gut affecting the younger population. Untreated sacroiliitis can lead to joint destruction and chronic pain, further adding to morbidity in IBD patients. Recent publications suggest sacroiliitis can be detected on abdominal imaging obtained in IBD patients to study bowel disease, but only a small fraction of these patients were seen by rheumatologists. Early detection of IBD-associated sacroiliitis could be achieved by utilization of clinical screening tools in IBD clinics, careful examination of existing computed tomography and MRI studies, and timely referral to rheumatologist for further evaluation and treatment. Current treatment approaches for IBD and sacroiliitis include several targeted biologic therapies, but IBD-associated sacroiliitis has limited options, as these therapies may not overlap in both conditions. With the advances in imaging, sacroiliitis is an increasingly recognized comorbidity in IBD patients. Future studies focusing on this unique patient population will expand our understanding of complex pathophysiology of IBD-associated sacroiliitis and lead to identification of novel targeted therapies for this condition.

Clinical Phenotype and Disease Course of Inflammatory Bowel Disease in Iran: Results of the Iranian Registry of Crohn's and Colitis (IRCC).

Data on the epidemiology of inflammatory bowel disease (IBD) in the Middle East are scarce. We aimed to describe the clinical phenotype, disease course, and medication usage of IBD cases from Iran in the Middle East. We conducted a cross-sectional study of registered IBD patients in the Iranian Registry of Crohn's and Colitis (IRCC) from 2017 until 2022. We collected information on demographic characteristics, past medical history, family history, disease extent and location, extra-intestinal manifestations, IBD medications, and activity using the IBD-control-8 questionnaire and the Manitoba IBD index, admissions history, history of colon cancer, and IBD-related surgeries. In total, 9746 patients with ulcerative colitis (UC) (n=7793), and Crohn's disease (CD) (n=1953) were reported. The UC to CD ratio was 3.99. The median age at diagnosis was 29.2 (IQR: 22.6,37.6) and 27.6 (IQR: 20.6,37.6) for patients with UC and CD, respectively. The male-to-female ratio was 1.28 in CD patients. A positive family history was observed in 17.9% of UC patients. The majority of UC patients had pancolitis (47%). Ileocolonic involvement was the most common type of involvement in CD patients (43.7%), and the prevalence of stricturing behavior was 4.6%. A prevalence of 0.3% was observed for colorectal cancer among patients with UC. Moreover,15.2% of UC patients and 38.4% of CD patients had been treated with anti-tumor necrosis factor (anti-TNF). In this national registry-based study, there are significant differences in some clinical phenotypes such as the prevalence of extra-intestinal manifestations and treatment strategies such as biological use in different geographical locations.

The Epidemiology of Inflammatory Bowel Diseases During the COVID-19 Pandemic: Comparison of Two Nationwide Cohorts.

We aimed to explore the epidemiology of inflammatory bowel diseases [IBD] in association with the COVID-19 pandemic in two countries with different lockdown policies. We utilized nationwide IBD cohorts in Israel and Sweden to explore the incidence of IBD during the pandemic compared to 3 years prior [2017-2019]. We examined temporal trends through the presence of inflection points by Joinpoint regression analysis and reported average monthly percentage changes [AMPC]. A total of 155 837 patients with IBD were included [Israel, 58 640; Sweden, 97 197]. The annual incidence of IBD was stable until 2019 in both countries but then decreased in Israel (AAPC -16.6% [95% confidence interval, CI, -19.9% to -10.0%]) and remained stable in Sweden (AAPC -3.5% [95% CI -11.6% to 3.7%]). When exploring the monthly incidence during the pandemic, in Israel the rate remained stable until November 2020 (AMPC 2.3% [95% CI -13.4% to 29.9%]) and then decreased sharply (AMPC -6.4% [95% CI -20.8% to 17.0%] until February 2021 and to -20.1% [95% CI -38.9% to -4.7%] from February 2021), while in Sweden, which had a less stringent lockdown policy, it decreased slightly until July 2020 (AMPC -3.3% [95% CI -21.6% to 20.3%]), but increased thereafter (AMPC 13.6% [95% CI -12.6% to 27.0%]). The change of incidence rate in Sweden occurred mainly in elderly-onset patients, the only population with significant restrictions during the pandemic. The incidence of IBD decreased during the pandemic in association with lockdowns, more so in Israel, which had more stringent policies. Future studies are needed to determine the long-term effect of the pandemic on IBD.

Commentary on the Epidemiology of Inflammatory Bowel Disease in Compounding Prevalence Nations: Toward Sustaining Healthcare Delivery

Commentary on the Epidemiology of Inflammatory Bowel Disease in Compounding Prevalence Nations: Toward Sustaining Healthcare Delivery

TRENDS IN INFLAMMATORY BOWEL DISEASE INCIDENCE AND PREVALENCE ACROSS EPIDEMIOLOGIC STAGES: A GLOBAL SYSTEMATIC REVIEW WITH META-ANALYSIS

Abstract BACKGROUND Rising incidence and prevalence of inflammatory bowel disease (IBD) observed historically in early-industrialized regions now also appear in newly-industrialized and emerging regions. The epidemiology of IBD has been proposed to progress across epidemiologic stages: 1. Emergence (low incidence and prevalence); 2. Acceleration in Incidence (rapid rising incidence); and 3. Compounding Prevalence (stabilizing incidence, rapid rising prevalence). AIM To gather real-world data on the incidence and prevalence of IBD and characterize global regions in each epidemiologic stage by meta-analyses. METHODS Two previous systematic reviews (database inception–2010; 2010–2016) were updated with a search of MEDLINE, Embase, PubMed, and Web of Science (2017–2023) to identify all population-based studies reporting the incidence or prevalence of Crohn’s disease (CD) or ulcerative colitis (UC). International partners provided a secondary review of the included studies from their local regions. Incidence and prevalence rates (per 100,000 population), stratified by epidemiologic stage, were meta-analyzed to determine pooled rates with associated 95% confidence intervals (95%CI). A Cochrane Q test was used to investigate differences between epidemiologic stages for both CD and UC. RESULTS After assessing 1,250 manuscripts, a total of 491 studies (439 incidence, 228 prevalence) from 80 global regions spanning 1920-2022 were identified by the systematic review (Figure 1). All data identified with our search strategy are available to view in an open-access, online interactive data repository (https://gives21.shinyapps.io/dashboard/) created with Shiny for R. The pooled incidence of CD and UC per 100,000 person-years rose from 0.28 (95%CI: 0.21, 0.36) and 0.57 (95%CI: 0.47, 0.69) in Stage 1 to 2.13 (95%CI: 1.88, 2.42) and 4.05 (95%CI: 3.65, 4.50) in Stage 2 to 9.34 (95%CI: 8.73, 9.99) and 14.07 (95%CI: 13.09, 15.12) in Stage 3 (Table 1). Similarly, the pooled prevalence of CD and UC per 100,000 persons rose from 1.96 (95%CI: 1.41, 2.74) and 6.35 (95%CI: 4.45, 9.07) in Stage 1 to 22.18 (95%CI: 17.96, 27.38) and 45.36 (95%CI: 37.84, 54.38) in Stage 2 to 186.18 (95%CI: 163.18, 212.42) and 255.92 (95%CI: 230.60, 284.02) in Stage 3 (Table 1). Subgroup analysis confirmed differences in both incidence and prevalence for CD and UC between epidemiologic stages (p&amp;lt;0.001). DISCUSSION This is the most comprehensive systematic review on the incidence and prevalence of IBD. The amalgamated real-world data from this study highlight the rising global burden of IBD across three distinct epidemiologic stages: 1. Emergence, 2. Acceleration in Incidence, and 3. Compounding Prevalence. Figure 1 Systematic review study selection flowchart including a brief overview of two previous systematic reviews: Molodecky, N.A. et al. Gastroenterology. 2012;142(1):46-54 and Ng, S.C. et al. Lancet. 2017;390(10114):2769-78. Table 1 Pooled incidence and prevalence rates per 100,000 population for Crohn’s disease and ulcerative colitis. Cochrane Q subgroup analysis for difference in estimates between epidemiologic stages. † Represents the number of study-subregion groups used in the calculation of pooled rates and their 95% confidence intervals.

RISING INCIDENCE, MORTALITY, AND DISABILITY-ADJUSTED LIFE YEARS OF INFLAMMATORY BOWEL DISEASE IN THE UNITED STATES: A SYSTEMIC ANALYSIS OF THE GLOBAL BURDEN OF DISEASE STUDY

Abstract INTRODUCTION: In North America, Inflammatory Bowel Disease (IBD) poses a significant burden, yet detailed data on its incidence, mortality, and disability-adjusted life years (DALYs) within the United States is scarce. Our study aims to systematically analyze these aspects of IBD while considering gender, age, and state-level variations. Methods: Utilizing the Global Burden of Disease database, we systematically analyzed IBD incidence, mortality, and DALYs in the United States from 1999 to 2019. We further stratified these metrics by gender and age groups (25-49 years, 50-75 years, and 75+ years) and calculated annual percentage changes (APC) using linear regression. Results: Between 1999 and 2019, IBD incidence cases increased from 65,555 to 85,388. The incidence rate per 100,000 person-years rose from 23.5 (95% UI: 21.4-26.2) to 26.0 (95% UI: 23.8-28.9), with APC of 1.0. Females consistently had higher incidence rates, increasing from 34,236 (95% UI: 31,052-38,351) in 1999 to 43,882 (95% UI: 39,953-48,871) in 2019. Incidence rates also rose, with males at 0.6% APC and females at 0.4%. In 2019, the 24-49 years age group had the highest incidence rate at 35.1 (95% UI: 30.3-40.1) per 100,000, with a 0.5% APC increase from 1999 to 2019.Mortality increased, with 5,910 IBD-related deaths in 2019. The mortality rate per 100,000 population rose from 1.1 (95% UI: 1.0-1.3) to 1.8 (95% UI: 1.4-2.0), reflecting a 2.4% APC. Although females had a higher mortality rate in 2019 (2.2 per 100,000), males had a 2.7% APC increase from 1999 to 2019. Geographically, notable differences in APC for incidence rates across states were observed. The highest increases were seen in Ohio (1.06%), North Dakota (1.04%), and Maine (0.96%), while Nevada had a slight decrease in APC (-0.02%). Mortality rate changes also varied by state, with substantial increases in Alaska (3.75%), Vermont (3.19%), and Tennessee (3.13%). Regarding DALYs, significant APC rate changes were observed in New Mexico (1.53%), Vermont (1.38%), and Mississippi (1.37%), while the lowest changes were seen in the District of Columbia (0.24%). Conclusions: This comprehensive analysis of IBD in the US from 1999 to 2019 reveals trends and disparities. IBD incidence steadily increased during this period, with notable rises in cases and rates. Gender-wise, females had higher incidence rates, while males displayed a slightly steeper increase. Geographic disparities were evident, with varying trends in incidence and mortality rates across states. Ohio, North Dakota, and Maine had the highest incidence increases, while Alaska, Vermont, and Tennessee saw significant mortality rate increases. Our study highlights the changing epidemiology of IBD and the need for targeted intervention to address changes in incidence and disease burden. Fig 1. * Denotes P

P1097 The effect of lockdowns during the COVID-19 pandemic on the epidemiology of inflammatory bowel diseases: a comparison of two nationwide cohorts

Abstract Background Mechanistic evidence suggest a link between COVID-19 infections and the development of immune mediated diseases. Additionally, the lockdowns during the pandemic limited the accessibility to medical care, possibly leading to reduced number of diagnosed patients with inflammatory bowel disease (IBD). We aimed to explore these contending trends on the epidemiology of IBD during the COVID-19 pandemic in two countries with different lockdown policies. Methods We utilized nationwide IBD cohorts in Israel and Sweden to explore the incidence of IBD during the pandemic (2020-2021) compared to three years prior (2017- 2019). We examined temporal trends through the presence of inflection points by Joinpoint regression analysis and reported average monthly percentage changes (AMPC). Results A total of 155,837 patients with IBD were included (Israel, 58,640; Sweden, 97,197). The incidence of IBD was stable during the three years prior to the beginning of the COVID-19 pandemic in February 2020 (AMPC: Israel 0.0% [95%CI -0.5% to 0.4%]; Sweden 0.2% [95%CI -0.3% to 0.7]). Thereafter, the incidence rate in Israel remained stable until November 2020 (AMPC 2.3% [95% CI -13.4% to 29.9%]) and then decreased sharply (AMPC -6.4% [95%CI-20.8% to 17.0%]) until February 2021 and -20.1% [95%CI -38.9% to -4.7%]) from February 2021), while in Sweden, which had a less stringent lockdown policy, the incidence rate decreased slightly until July 2020 (AMPC -3.3% [95%CI -21.6% to 20.3%]), but increased thereafter (AMPC 13.6% [95%CI -12.6% to 27.0%]; Figure). In Israel, the reduced incidence rate during the pandemic (February 2020 to July 2021) was notable mainly in the adult-onset disease, while in Sweden, although the overall incidence rate increased steadily across all age groups, the largest change was apparent among the elderly. Conclusion In this study of two nationwide cohorts we found that the initial decrease in incidence of IBD was most apparent in Israel with a more stringent lookdown policy and among elderly in Sweden, the only population there with significant social restrictions during the pandemic. Taken together, it is likely that the reduced incidence stemmed from the limited access to the healthcare system. Future studies are needed to determine the long-term effect of the pandemic on IBD incidence.

P1131 Epidemiological Characteristics of Inflammatory Bowel Diseases in The Last Decade: Multi-Center Türkiye Data

Abstract Background This study aims to assess the past decade's epidemiology of inflammatory bowel disease (IBD) patients in Türkiye and identify year-to-year variations. Methods A total of 3463 patients diagnosed between 2010 and 2022 were included. The patients' demographic and phenotypic characteristics, smoking habits, and family histories were assessed. Differences between geographic regions and age groups were analyzed. Results Among patients, 1523 (44%) had Crohn's disease (CD), 1768 (51.1%) had ulcerative colitis (UC), and 23 (0.7%) had indeterminate colitis (Table). Male proportions were higher in both CD and UC patients, with the most common age range for diagnosis being 21-30 years (Figure). Over time, newly diagnosed cases and rates per population increased according to Turkish Statistical Institute data (Figure). Patients were divided into two groups based on diagnosis years (2010-2016 and 2016-2022), CD initially dominated, but UC prevalence grew in the last 6 years (p&amp;lt;=0.001). Recently diagnosed CD patients showed higher inflammatory involvement (78.0% vs. 63.4%; p&amp;lt;=0.001), and the inflammatory phenotype rose post-2016 (75.2% vs. 60.4%; p&amp;lt;=0.001). CD patients had more smokers (24.2% vs. 10.9%; p&amp;lt;=0.001) and family history of IBD (6.8% vs. 4.5%; p=0.004) than UC patients. Patients over 60 years old had a higher male gender ratio (64.4% vs. 55.9%; p&amp;lt;=0.001) and UC frequency (62.2% vs. 52%; p&amp;lt;=0.001) compared to those under 60 years old. The inflammatory phenotype in CD patients was lower in those under 60 years old compared to those over 60 years old (70.4% vs. 85.4%; p&amp;lt;=0.001). The frequency of pancolitis in UC patients was lower in those over 60 years old (31.3% vs. 41.4%; p&amp;lt;=0.001). Conclusion In Türkiye, IBD is more prevalent in males and is frequently diagnosed between ages 20 to 30. In CD, inflammatory and ileocolonic involvement is most common, while in UC, pancolitis is observed. The earlier diagnosis peak and increased pancolitis in UC patients might relate to tertiary centers' inclusion with transition clinics and focus on severe cases. Recently, newly diagnosed UC cases have notably surpassed CD cases.

Global patterns in the epidemiology, cancer risk, and surgical implications of inflammatory bowel disease.

Inflammatory bowel disease (IBD), mainly including ulcerative colitis and Crohn's disease, imposes a huge medical and economic burden worldwide. Recently, the diagnosis, treatment, and surveillance of IBD have advanced rapidly, which has changed the epidemiology, cancer risk, and surgery risk of IBD. Here, we reviewed the recent literature on the epidemiology, IBD-related cancer, and IBD-related surgery. We created a choropleth map to show the worldwide incidence trend for Crohn's disease and ulcerative colitis. We also found that the cancer risk and surgery risk of IBD are declining and discussed some risk factors associated with them. Based on the recent trend, we proposed several suggestions and hoped to reduce the global burden of IBD as far as possible.

A Systematic Review on the Increasing Incidence of Inflammatory Bowel Disease in Southeast Asia: Looking Beyond the Urbanization Phenomenon.

The incidence of inflammatory bowel disease (IBD) has been increasing in Southeast Asia (SEA) in tandem with its economic growth and urbanization over the past 2 decades. Specific characteristics of IBD in SEA are similar to East Asia and the West, such as the declining ratio of ulcerative colitis to Crohn's disease. However, exceptionally low familial aggregation is seen. Smoking is also not a common risk factor in patients with Crohn's disease. The incidence of perianal disease is higher in SEA than in Australia and is comparable to the West. In a multiracial population, such as Singapore and Malaysia, Indians have the highest incidence and prevalence rates, which are likely to be due to important putative mutations. For instance, a higher frequency of the NOD2 predisposing mutation SNP5 and IBD risk allele IGR2198a and IGR2092a were found in Indians. Although differences in the genetic constitution play an important role in the epidemiology and prognosis of IBD in SEA, the emergence of this disease offers a unique opportunity to identify potential exposomes that contribute to its pathogenesis.