Dramatic Increase in Incidence of Ulcerative Colitis and Crohn's Disease (1988-2011): A Population-Based Study of French Adolescents.

Journal: The American Journal Of Gastroenterology
Published:
Abstract

Objectives: Few data are available to describe the changes in incidence of pediatric-onset inflammatory bowel disease (IBD). The aim of this study was to describe changes in incidence and phenotypic presentation of pediatric-onset IBD in northern France during a 24-year period.

Methods: Pediatric-onset IBD (<17 years) was issued from a population-based IBD study in France between 1988 and 2011. Age groups and digestive location were defined according to the Paris classification.

Results: 1,350 incident cases were recorded (8.3% of all IBD) including 990 Crohn's disease (CD), 326 ulcerative colitis (UC) and 34 IBD unclassified (IBDU). Median age at diagnosis was similar in CD (14.4 years (Q1=11.8-Q3=16.0)) and UC (14.0 years (11.0-16.0)) and did not change over time. There were significantly more males with CD (females/males=0.82) than UC (females/males=1.25) (P=0.0042). Median time between onset of symptoms and IBD diagnosis was consistently 3 months (1-6). Mean incidence was 4.4/105 for IBD overall (3.2 for CD, 1.1 for UC and 0.1 for IBDU). From 1988-1990 to 2009-2011, a dramatic increase in incidences of both CD and UC were observed in adolescents (10-16 years): for CD from 4.2 to 9.5/105 (+126%; P<0.001) and for UC, from 1.6 to 4.1/105 (+156%; P<0.001). No modification in age or location at diagnosis was observed in either CD or UC.

Conclusions: In this population-based study, CD and UC incidences increased dramatically in adolescents across a 24-year span, suggesting that one or more strong environmental factors may predispose this population to IBD.

Authors
Silvia Ghione, Hélène Sarter, Laura Armengol Debeir, Delphine Ley, Laurent Peyrin Biroulet, Corinne Gower Rousseau, J Andre, M Antonietti, A Aouakli, A Armand, I Aroichane, F Assi, J Aubet, E Auxenfants, F Ayafi Ramelot, D Bankovski, B Barbry, N Bardoux, P Baron, A Baudet, B Bazin, A Bebahani, J Becqwort, V Benet, H Benali, C Benguigui, Ben Soussan, A Bental, I Berkelmans, J Bernet, K Bernou, C Bernou Dron, P Bertot, N Bertiaux Vandaële, V Bertrand, E Billoud, N Biron, B Bismuth, M Bleuet, F Blondel, V Blondin, P Bohon, E Boniface, P Bonnière, E Bonvarlet, P Bonvarlet, A Boruchowicz, R Bostvironnois, M Boualit, B Bouche, C Boudaillez, C Bourgeaux, M Bourgeois, A Bourguet, A Bourienne, J Branche, G Bray, F Brazier, P Breban, H Brihier, V Brung Lefebvre, P Bulois, P Burgiere, J Butel, J Canva, V Canva Delcambre, J Capron, F Cardot, P Carpentier, E Cartier, J Cassar, M Cassagnou, J Castex, P Catala, S Cattan, S Catteau, B Caujolle, G Cayron, C Chandelier, M Chantre, J Charles, T Charneau, M Chavance Thelu, D Chirita, A Choteau, J Claerbout, P Clergue, H Coevoet, G Cohen, R Collet, J Colombel, S Coopman, J Corvisart, A Cortot, F Couttenier, J Crinquette, V Crombe, I Dadamessi, V Dapvril, T Davion, S Dautreme, J Debas, N Degrave, F Dehont, C Delatre, R Delcenserie, O Delette, T Delgrange, L Delhoustal, J Delmotte, S Demmane, G Deregnaucourt, P Descombes, J Desechalliers, P Desmet, P Desreumaux, G Desseaux, P Desurmont, A Devienne, E Devouge, M Devred, A Devroux, A Dewailly, S Dharancy, A Di Fiore, D Djeddi, R Djedir, M Dreher Duwat, R Dubois, C Dubuque, P Ducatillon, J Duclay, B Ducrocq, F Ducrot, P Ducrotte, A Dufilho, C Duhamel, D Dujardin, C Dumant Forest, J Dupas, F Dupont, Y Duranton, A Duriez, K El Achkar, M El Farisi, C Elie, M Elie Legrand, A Elkhaki, M Eoche, D Evrard, J Evrard, A Fatome, B Filoche, L Finet, M Flahaut, C Flamme, D Foissey, P Fournier, M Foutrein Comes, P Foutrein, D Fremond, T Frere, M Fumery, P Gallet, C Gamblin, P Ganga Zandzou, R Gérard, G Geslin, Y Gheyssens, N Ghossini, S Ghrib, T Gilbert, B Gillet, D Godard, P Godard, J Godchaux, R Godchaux, G Goegebeur, O Goria, F Gottrand, P Gower, B Grandmaison, M Groux, C Guedon, J Guillard, L Guillem, F Guillemot, D Guimber, B Haddouche, S Hakim, D Hanon, V Hautefeuille, P Heckestweiller, G Hecquet, J Hedde, H Hellal, P Henneresse, B Heyman, M Heraud, S Herve, P Hochain, L Houssin Bailly, P Houcke, B Huguenin, S Iobagiu, A Ivanovic, I Iwanicki Caron, E Janicki, M Jarry, J Jeu, J Joly, C Jonas, F Katherin, A Kerleveo, A Khachfe, A Kiriakos, J Kiriakos, O Klein, M Kohut, R Kornhauser, D Koutsomanis, J Laberenne, G Laffineur, M Lagarde, P Lannoy, J Lapchin, M Lapprand, D Laude, R Leblanc, P Lecieux, N Leclerc, C Le Couteulx, J Ledent, J Lefebvre, P Lefiliatre, C Legrand, A Le Grix, P Lelong, B Leluyer, C Lenaerts, L Lepileur, A Leplat, E Lepoutre Dujardin, H Leroi, M Leroy, J Lesage, X Lesage, I Lescanne Darchis, J Lescut, D Lescut, B Leurent, P Levy, M Lhermie, A Lion, B Lisambert, F Loire, S Louf, A Louvet, M Luciani, D Lucidarme, J Lugand, O Macaigne, D Maetz, D Maillard, H Mancheron, O Manolache, A Marks Brunel, R Marti, F Martin, G Martin, E Marzloff, P Mathurin, J Mauillon, V Maunoury, J Maupas, B Mesnard, P Metayer, L Methari, B Meurisse, F Meurisse, L Michaud, X Mirmaran, P Modaine, A Monthe, L Morel, P Mortier, E Moulin, O Mouterde, J Mudry, M Nachury, Nʼguyen Khac, B Notteghem, V Ollevier, A Ostyn, A Ouraghi, D Ouvry, B Paillot, N Panien Claudot, C Paoletti, A Papazian, B Parent, B Pariente, J Paris, P Patrier, L Paupart, B Pauwels, M Pauwels, R Petit, M Piat, S Piotte, C Plane, B Plouvier, E Pollet, P Pommelet, D Pop, C Pordes, G Pouchain, P Prades, A Prevost, J Prevost, B Quesnel, A Queuniet, J Quinton, A Rabache, P Rabelle, G Raclot, S Ratajczyk, D Rault, V Razemon, N Reix, M Revillon, C Richez, P Robinson, J Rodriguez, J Roger, J Roux, A Rudelli, A Saber, G Savoye, P Schlosseberg, M Segrestin, D Seguy, M Serin, A Seryer, F Sevenet, N Shekh, J Silvie, V Simon, C Spyckerelle, N Talbodec, A Techy, J Thelu, A Thevenin, H Thiebault, J Thomas, J Thorel, G Tielman, M Tode, J Toisin, J Tonnel, J Touchais, Y Touze, J Tranvouez, C Triplet, D Turck, S Uhlen, E Vaillant, C Valmage, D Vanco, H Vandamme, E Vanderbecq, Vander Eecken, P Vandermolen, P Vandevenne, L Vandeville, A Vandewalle, C Vandewalle, P Vaneslander, J Vanhoove, A Vanrenterghem, P Varlet, I Vasies, G Verbiese, G Vernier Massouille, P Vermelle, C Verne, P Vezilier Cocq, B Vigneron, M Vincendet, J Viot, Y Voiment, A Wacrenier, L Waeghemaecker, J Wallez, M Wantiez, F Wartel, J Weber, J Willocquet, N Wizla, E Wolschies, A Zalar, B Zaouri, A Zellweger, C Ziade