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Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

East-West gradient in the incidence of inflammatory bowel disease in Europe: the ECCO-EpiCom inception cohort

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

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  • J Burisch
  • N Pedersen
  • S Cukovic-Cavka
  • M Brinar
  • I Kaimakliotis
  • D Duricova
  • O Shonová
  • I Vind
  • S Avnstrøm
  • Niels Thorsgaard
  • V Andersen
  • S Krabbe
  • Jens Frederik Dahlerup
  • R Salupere
  • K R Nielsen
  • J Olsen
  • Pekka Manninen
  • P Collin
  • E V Tsianos
  • K H Katsanos
  • Karin Due Ladefoged
  • L Lakatos
  • E Björnsson
  • G Ragnarsson
  • Y Bailey
  • S Odes
  • D Schwartz
  • M Martinato
  • G Lupinacci
  • M Milla
  • A De Padova
  • R D'Incà
  • M Beltrami
  • L Kupcinskas
  • G Kiudelis
  • S Turcan
  • O Tighineanu
  • I Mihu
  • F Magro
  • L F Barros
  • A Goldis
  • D Lazar
  • E Belousova
  • I Nikulina
  • Veronica Moset Hernandez
  • D Martinez-Ares
  • S Almer
  • Y Zhulina
  • E Langholz
  • P Munkholm
  • for the EpiCom-group
Vis graf over relationer
OBJECTIVE: The incidence of inflammatory bowel disease (IBD) is increasing in Eastern Europe. The reasons for these changes remain unknown. The aim of this study was to investigate whether an East-West gradient in the incidence of IBD in Europe exists. DESIGN: A prospective, uniformly diagnosed, population based inception cohort of IBD patients in 31 centres from 14 Western and eight Eastern European countries covering a total background population of approximately 10.1 million people was created. One-third of the centres had previous experience with inception cohorts. Patients were entered into a low cost, web based epidemiological database, making participation possible regardless of socioeconomic status and prior experience. RESULTS: 1515 patients aged 15 years or older were included, of whom 535 (35%) were diagnosed with Crohn's disease (CD), 813 (54%) with ulcerative colitis (UC) and 167 (11%) with IBD unclassified (IBDU). The overall incidence rate ratios in all Western European centres were 1.9 (95% CI 1.5 to 2.4) for CD and 2.1 (95% CI 1.8 to 2.6) for UC compared with Eastern European centres. The median crude annual incidence rates per 100 000 in 2010 for CD were 6.5 (range 0-10.7) in Western European centres and 3.1 (range 0.4-11.5) in Eastern European centres, for UC 10.8 (range 2.9-31.5) and 4.1 (range 2.4-10.3), respectively, and for IBDU 1.9 (range 0-39.4) and 0 (range 0-1.2), respectively. In Western Europe, 92% of CD, 78% of UC and 74% of IBDU patients had a colonoscopy performed as the diagnostic procedure compared with 90%, 100% and 96%, respectively, in Eastern Europe. 8% of CD and 1% of UC patients in both regions underwent surgery within the first 3 months of the onset of disease. 7% of CD patients and 3% of UC patients from Western Europe received biological treatment as rescue therapy. Of all European CD patients, 20% received only 5-aminosalicylates as induction therapy. CONCLUSIONS: An East-West gradient in IBD incidence exists in Europe. Among this inception cohort-including indolent and aggressive cases-international guidelines for diagnosis and initial treatment are not being followed uniformly by physicians.
OriginalsprogEngelsk
TidsskriftGut
Vol/bind63
Udgave nummer4
Sider (fra-til)588-597
Antal sider9
ISSN0017-5749
DOI
StatusUdgivet - apr. 2014

ID: 40915081