The Epidemiology of Inflammatory Bowel Disease in Canada: A ... : Official journal of the American College of Gastroenterology | ACG (original) (raw)

ORIGINAL CONTRIBUTION: INFLAMMATORY BOWEL DISEASE

A Population-Based Study

Bernstein, Charles N. M.D.1,2; Wajda, Andre M.S.1; Svenson, Lawrence W. B.Sc.4; MacKenzie, Adrian B.Sc.6; Koehoorn, Mieke Ph.D.7; Jackson, Maureen M.Sc.9; Fedorak, Richard M.D.5; Israel, David M.D.8; Blanchard, James F. M.D., Ph.D.1,3

1Inflammatory Bowel Disease Clinical and Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada

2Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada

3Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada

4Public Health Surveillance and Environmental Health, Alberta Health and Wellness, Edmonton, Alberta, Canada

5Department of Internal Medicine, University of Alberta, Edmonton, Alberta, Canada

6Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada

7Health Care and Epidemiology, University of British Columbia, Vancouver, British Columbia, Canada

8Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada

9Saskatchewan Health, Regina, Saskatchewan, Canada

Reprint requests and correspondence: Charles N. Bernstein, M.D., University of Manitoba, 804F-715 McDermot Avenue, Winnipeg, Manitoba, Canada R3E 3P4.

Received August 19, 2005; accepted January 17, 2006.

Abstract

BACKGROUND

Previously, we have demonstrated a high incidence and prevalence of Crohn's disease (CD) and ulcerative colitis (UC) in the Canadian province of Manitoba. However, the epidemiology of inflammatory bowel disease (IBD) in other regions of Canada has not been defined. The aim of this study was to estimate the incidence and prevalence of CD and UC in diverse regions of Canada and the overall burden of IBD in Canada.

METHODS

We applied a common case identification algorithm, previously validated in Manitoba to the provincial health databases in British Columbia (BC), Alberta (AB), Saskatchewan (SK), Manitoba (MB), and Nova Scotia (NS) to determine the age-adjusted incidence rates per 100,000 person-years for 1998–2000 and prevalence per 100,000 for mid 2000 and to estimate the IBD burden in Canada. Poisson regression was used to assess differences in incidence rates and prevalence by gender, age, and province.

RESULTS

The incidence rate for CD ranged from 8.8 (BC) to 20.2 (NS), and for UC ranged from 9.9 (BC) to 19.5 (NS). The prevalence of CD was approximately 15- to 20-fold higher than the incidence rate, ranging from 161 (BC) to 319 (NS). This was similar for the prevalence of UC, which ranged from 162 (BC) to 249 (MB). Adjusting for age and province, the female:male ratio for incidence ratio was 1.31 (p < 0.0001) for CD and 1.02 (n.s.) for UC and was mostly stable across the five provinces.

CONCLUSIONS

Approximately 0.5% of the Canadian population has IBD. Canada has the highest incidence and prevalence of CD yet reported.