Family history and disease outcomes in patients with Crohn’s disease: A comparison between China and the United States

Abstract

AIMTo investigate the differences in family history of inflammatory bowel disease (IBD) and clinical outcomes among individuals with Crohn’s disease (CD) residing in China and the United States.METHODSWe performed a survey-based cross-sectional study of participants with CD recruited from China and the United States. We compared the prevalence of IBD family history and history of ileal involvement, CD-related surgeries and IBD medications in China and the United States, adjusting for potential confounders.RESULTSWe recruited 49 participants from China and 145 from the United States. The prevalence of family history of IBD was significantly lower in China compared with the United States (China: 4.1%, United States: 39.3%). The three most commonly affected types of relatives were cousin, sibling, and parent in the United States compared with child and sibling in China. Ileal involvement (China: 63.3%, United States: 63.5%) and surgery for CD (China: 51.0%, United States: 49.7%) were nearly equivalent in the two countries.CONCLUSIONThe lower prevalence of familial clustering of IBD in China may suggest that the etiology of CD is less attributed to genetic background or a family-shared environment compared with the United States. Despite the potential difference in etiology, surgery and ileal involvement were similar in the two countries. Examining the changes in family history during the continuing rise in IBD may provide further insight into the etiology of CD.

The association between environmental factors and the development of Crohn’s disease with focusing on passive smoking: A multicenter case-control study in Japan

“…However, we could not confirm the association between IBD family history and CD in the subjects of the present study. The prevalence of family history of IBD was significantly lower in China compared with the United States (China: 4.1%, United States: 39.3%) [6]. In a study targeting Japanese, there are reports that the disease characteristics of CD differ depending on the presence or absence of IBD family history [19].…”

“…There is a report that a history of appendicitis is a risk factor for CD [3, 4], but there is a report stating that it is difficult to clarify [5], and definite conclusions have not been reached. The presence of a family history of inflammatory bowel disease (IBD) in CD patients was significantly lower in China than in the United States [6]. The association between smoking and CD is reported as follows: passive smoking in childhood is associated with the development of CD [7], smoking currently is associated with an elevated risk of CD [8–10], and smoking in patients with CD has an adverse effect [11].…”

Current diagnosis and management of Crohn’s disease in China: results from a multicenter prospective disease registry

“…While CD is well known in Western countries, it was reported in China about 30 years later: the first case of CD was reported in China in 1956 [8]. Although the overall incidence of CD in China is much lower than in Western countries, the incidence is increasing rapidly with urbanization and socioeconomic development [9]. The current estimated incidence is 0.51–1.09 cases per 100,000 persons in China [10, 11].…”

Smoking and Inflammatory Bowel Disease: A Comparison of China, India, and the USA

“…There is also a significant difference in the prevalence of IBD family history among IBD patients. The prevalence of having any family history of IBD was reported to be 8–40% among Western IBD patients [13–15], but only 0–4% among Asian IBD population [6, 15–17]. Environmental risk factors including smoking, appendectomy, hygiene, infections, antibiotics, other medications, diet, and other lifestyle factors have been studied in the Western population, but have been studied to a much more limited extent in Asian IBD patients [18].…”