IBD prevalence in Lothian, Scotland, derived by capture–recapture methodology

Abstract

ObjectiveIBD prevalence is estimated to be rising, but no detailed, recent UK data are available. The last reported prevalence estimate in the UK was 0.40% in 2003. We aimed to establish the current, and project future, prevalence in Lothian, Scotland.DesignWe conducted an all-age multiparameter search strategy using inpatient IBD international classification of disease (ICD-10) coding (K50/51)(1997–2018), IBD pathology coding (1990–2018), primary and secondary care prescribing data (2009–2018) and a paediatric registry, (1997–2018) to identify ‘possible’ IBD cases up to 31/08/2018. Diagnoses were manually confirmed through electronic health record review as per Lennard-Jones/Porto criteria. Autoregressive integrated moving average (ARIMA) regression was applied to forecast prevalence to 01/08/2028.ResultsIn total, 24 601 possible IBD cases were identified of which 10 499 were true positives. The point prevalence for IBD in Lothian on 31/08/2018 was 784/100 000 (UC 432/100 000, Crohn’s disease 284/100 000 and IBD unclassified (IBDU) 68/100 000). Capture–recapture methods identified an additional 427 ‘missed’ cases (95% CI 383 to 477) resulting in a ‘true’ prevalence of 832/100 000 (95% CI 827 to 837).Prevalence increased by 4.3% per year between 2008 and 2018 (95% CI +3.7 to +4.9%, p<0.0001). ARIMA modelling projected a point prevalence on 01/08/2028 of 1.02% (95% CI 0.97% to 1.07%) that will affect an estimated 1.53% (95% CI 1.37% to 1.69%) of those >80 years of age.ConclusionsWe report a rigorously validated IBD cohort with all-age point prevalence on 31/08/2018 of 1 in 125, one of the highest worldwide.

Incidence and prevalence of inflammatory bowel disease in UK primary care: a population-based cohort study

“…Our prevalence estimates were very similar to those reported in a well-validated IBD cohort in Lothian, Scotland 10 ; our estimate of IBD prevalence for Scotland on 31 August 2018 was 810 per 100 000 compared with 832 per 100 000 reported by their group. Although our study lacked linkage to secondary care records, the similar prevalence estimates would support the argument that few cases were missed.…”

“…More recently, estimates of incidence and prevalence of IBD were reported in a rigorously validated IBD cohort of 10 926 cases in Lothian, Scotland. 10 However, it remains unknown if these findings are generalisable across the UK. In the UK, over 60 000 000 people are registered with a general practice (GP; about 91% of the population).…”

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

“…This study has demonstrated a high prevalence of inflammatory bowel disease in the UK but did not use codes for indeterminate colitis and may therefore still underestimate the true level of inflammatory bowel disease in the UK. However, a significant rise in prevalence across, in particular, western societies has been previously described 23,45 . This has been attributed to falls in historic levels of mortality in the inflammatory bowel diseases, improved population‐wide longevity and high incidence.…”

Serum galectins as potential biomarkers of inflammatory bowel diseases

“…Both CD and UC typically cause symptoms of diarrhoea, abdominal pain, fatigue and weight loss [1]. The prevalence of IBD in Western countries is high and a recent Scottish study estimated a prevalence of 784/ 100, 000 population [2]. The diagnosis of IBD usually relies on a combination of symptoms, laboratory tests such as C-reactive protein (CRP), faecal calprotectin (FC) and endoscopic evaluation.…”