Changing patterns in the epidemiology and outcomes of inflammatory bowel disease in the United Kingdom: 2000‐2018

Abstract

Background: Data regarding incidence, prevalence and long-term outcomes of inflammatory bowel diseases in the UK are limited or outdated. Aims:To investigate incidence and prevalence of Crohn's disease and ulcerative colitis and risk of colorectal cancer and all-cause mortality in these diseases.Methods: Inflammatory bowel disease cases between 2000 and 2018 were identified from a national primary care database. Inflammatory bowel disease prevalence was forecast until 2025. The association between inflammatory bowel disease and colorectal cancer and all-cause mortality was investigated using age/sex-matched retrospective cohort studies. Hazard ratios were adjusted for age, sex, deprivation, comorbidity, smoking status and body mass index.Results: Ulcerative colitis prevalence increased from 390 to 570 per 100 000 population from 2000 to 2017. Prevalence of Crohn's disease increased from 220 to 400 per 100 000. In 2017 male Crohn's disease prevalence was 0.35% (95% confidence interval 0.34-0.36); female prevalence was 0.44% (0.43-0.45). Prevalence of inflammatory bowel disease is predicted to be 1.1% by 2025. Incidence of ulcerative colitis and Crohn's disease was 23.2 (22.8-23.6) and 14.3 (14.0-14.7) per 100 000 person-years respectively. Subjects with ulcerative colitis were more likely to develop colorectal cancer than controls (adjusted Hazard Ratio 1.40 [1.23-1.59]). Colorectal cancer rates remained stable in inflammatory bowel diseases over time. Ulcerative colitis and Crohn's disease were associated with increased risk of all-cause mortality (1.17 [1.14-1.21] and 1.42 [1.36-1.48] respectively). Conclusions: The UK prevalence of inflammatory bowel disease is greater than previous reports suggest and we predict an 11% increase in prevalence by the year 2025. Mortality risk in inflammatory bowel disease and colorectal cancer risk in ulcerative colitis are increased compared to matched controls. | 923 KING et al. Studies reporting increased mortality riskStudies reporting decrease/equivalent mortality risk Crohn's Disease Ulcerative Colitis Crohn's Disease Ulcerative ColitisAbbreviations: HR, hazard ratio; SMR, standardised mortality ratio.

COVID-19-related health anxieties and impact of specific interventions in patients with inflammatory bowel disease in the UK

“…1 Sweeping changes to elective and emergency hospital services were rapidly enforced resulting in patients facing unprecedented changes to their care. 2 3 Inflammatory bowel disease (IBD) affects over 600 000 people in the UK 4 . With many patients with IBD requiring immunosuppressive therapies, it is likely that the COVID-19 pandemic resulted in significant anxieties.…”

The risk of later surgery at the anastomotic site following right hemicolectomy for Crohn's disease in a national cohort of 12 230 patients

“…The end of the follow‐up period for further surgery was 31st December 2018, providing a minimum of two and a maximum of 12 years' follow‐up. The annual point prevalence of CD in England, derived from a previous primary care study, was used to examine the trends in index right hemicolectomy over the study period 17 …”

“…Index right hemicolectomy counts for CD in England were divided by number of CD patients in England per year of the study and presented as rate per 1000 patients with CD. The number of adults with CD in England per year of the study period was derived from Office for National Statistics (ONS) population data for England and estimates of CD prevalence in England derived from a nationally representative primary care database 17,18 . A linear regression model was fitted to the trend of yearly right hemicolectomy rates over the study period to assess change.…”

Editorial: increasing IBD prevalence and its complications in the context of the COVID‐19 pandemic. Authors' reply

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