In the Journals

IBD incidence rapidly increasing in young Canadian children

The incidence of inflammatory bowel disease has significantly increased among Canadian children aged younger than 5 years since the turn of the century, according to the results of a population-based study.

These findings confirm “that Canada has amongst the highest incidence and prevalence of childhood-onset IBD in the world,” according to the study investigators, who estimated that about 600 to 650 Canadian children are diagnosed with IBD every year, and 2,695 children aged younger than 16 years were living with IBD in Canada in 2008.

Eric I. Benchimol, MD

Eric I. Benchimol

“The number of children under five being diagnosed with IBD is alarming because it was almost unheard of 20 years ago, and it is now much more common,” Eric I. Benchimol, MD, a researcher at the Institute for Clinical Evaluative Sciences and a pediatric gastroenterologist at the Children’s Hospital of Eastern Ontario Inflammatory Bowel Disease Center in Ottawa, Canada, said in a press release.

To evaluate the recent incidence, prevalence and trends in childhood-onset IBD in Canada, Benchimol and colleagues used health administrative data from five provinces to identify children aged younger than 16 years who were diagnosed with IBD between 1999 and 2010. During this period, 3,462 children were diagnosed with Crohn’s disease, 1,382 with ulcerative colitis and 279 with unclassifiable IBD, for an overall IBD incidence of 9.68 (95% CI, 9.11-10.25) per 100,000 children.

Throughout the study period, the annual percentage change in overall IBD incidence remained statistically stable, increasing by just 2.06% per year, but the incidence increased significantly among children aged younger than 5 years, rising by 7.19% per year.

Further, the annual percentage change in the prevalence of IBD increased significantly throughout the study period (4.56%), and at the end of the study period IBD prevalence was 38.25 (95% CI, 35.78-40.73) per 100,000 children.

The investigators noted their findings confirmed the predominant form of pediatric-onset IBD was Crohn’s disease, and that more boys were affected than girls. Further, the significant heterogeneity observed between provinces in incidence and trends over time indicates “significant regional variation,” they added.

“These findings have important implications on the children, their families, and the health care system, because these children will live longer with the disease, have a more extensive disease phenotype, and result in higher direct costs for IBD care compared with adults,” Benchimol and colleagues concluded. “In addition, the increasingly early age of onset implies early-life environmental triggers in at-risk patients.”

“What our research tells us is that we need to focus future research on identification of triggers in young children with IBD, understand the biology behind changes resulting in the disease, and intervene to prevent the occurrence of IBD in this vulnerable age group,” Benchimol said in the press release. – by Adam Leitenberger

Disclosures: Benchimol and additional researchers report they are investigators or collaborators in the Canadian Children IBD Network, which provided funding for the study, and served on the scientific and medical advisory council of Crohn’s and Colitis Canada, which also provided funding for the study.

The incidence of inflammatory bowel disease has significantly increased among Canadian children aged younger than 5 years since the turn of the century, according to the results of a population-based study.

These findings confirm “that Canada has amongst the highest incidence and prevalence of childhood-onset IBD in the world,” according to the study investigators, who estimated that about 600 to 650 Canadian children are diagnosed with IBD every year, and 2,695 children aged younger than 16 years were living with IBD in Canada in 2008.

Eric I. Benchimol, MD

Eric I. Benchimol

“The number of children under five being diagnosed with IBD is alarming because it was almost unheard of 20 years ago, and it is now much more common,” Eric I. Benchimol, MD, a researcher at the Institute for Clinical Evaluative Sciences and a pediatric gastroenterologist at the Children’s Hospital of Eastern Ontario Inflammatory Bowel Disease Center in Ottawa, Canada, said in a press release.

To evaluate the recent incidence, prevalence and trends in childhood-onset IBD in Canada, Benchimol and colleagues used health administrative data from five provinces to identify children aged younger than 16 years who were diagnosed with IBD between 1999 and 2010. During this period, 3,462 children were diagnosed with Crohn’s disease, 1,382 with ulcerative colitis and 279 with unclassifiable IBD, for an overall IBD incidence of 9.68 (95% CI, 9.11-10.25) per 100,000 children.

Throughout the study period, the annual percentage change in overall IBD incidence remained statistically stable, increasing by just 2.06% per year, but the incidence increased significantly among children aged younger than 5 years, rising by 7.19% per year.

Further, the annual percentage change in the prevalence of IBD increased significantly throughout the study period (4.56%), and at the end of the study period IBD prevalence was 38.25 (95% CI, 35.78-40.73) per 100,000 children.

The investigators noted their findings confirmed the predominant form of pediatric-onset IBD was Crohn’s disease, and that more boys were affected than girls. Further, the significant heterogeneity observed between provinces in incidence and trends over time indicates “significant regional variation,” they added.

“These findings have important implications on the children, their families, and the health care system, because these children will live longer with the disease, have a more extensive disease phenotype, and result in higher direct costs for IBD care compared with adults,” Benchimol and colleagues concluded. “In addition, the increasingly early age of onset implies early-life environmental triggers in at-risk patients.”

“What our research tells us is that we need to focus future research on identification of triggers in young children with IBD, understand the biology behind changes resulting in the disease, and intervene to prevent the occurrence of IBD in this vulnerable age group,” Benchimol said in the press release. – by Adam Leitenberger

Disclosures: Benchimol and additional researchers report they are investigators or collaborators in the Canadian Children IBD Network, which provided funding for the study, and served on the scientific and medical advisory council of Crohn’s and Colitis Canada, which also provided funding for the study.

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