Forecasting the Incidence and Prevalence of Inflammatory Bowel Disease: A Canadian Nationwide Analysis

Stephanie Coward; Eric I Benchimol; Charles N Bernstein; Antonio Avina-Zubieta; Alain Bitton; Matthew W Carroll; Yungsong Cui; Frank Hoentjen; Lindsay Hracs; Kevan Jacobson; Jennifer L Jones; James King; M Ellen Kuenzig; Na Lu; Wael El-Matary; Sanjay K Murthy; Zoann Nugent; Anthony R Otley; Remo Panaccione; Juan Nicolás Peña-Sánchez; Harminder Singh; Laura E Targownik; Dominic White; Joseph W Windsor; Gilaad G Kaplan; Canadian Gastro-Intestinal Epidemiology Consortium (CanGIEC)

doi:10.14309/ajg.0000000000002687

Forecasting the Incidence and Prevalence of Inflammatory Bowel Disease: A Canadian Nationwide Analysis

Am J Gastroenterol. 2024 Mar 18. doi: 10.14309/ajg.0000000000002687. Online ahead of print.

Authors

Stephanie Coward¹, Eric I Benchimol^{2

3

4

5}, Charles N Bernstein⁶, Antonio Avina-Zubieta⁷, Alain Bitton⁸, Matthew W Carroll⁹, Yungsong Cui¹⁰, Frank Hoentjen¹¹, Lindsay Hracs¹, Kevan Jacobson¹², Jennifer L Jones¹³, James King¹, M Ellen Kuenzig^{4

14}, Na Lu¹⁵, Wael El-Matary¹⁶, Sanjay K Murthy¹⁷, Zoann Nugent¹⁸, Anthony R Otley¹⁹, Remo Panaccione¹, Juan Nicolás Peña-Sánchez²⁰, Harminder Singh^{21

22}, Laura E Targownik²³, Dominic White²⁴, Joseph W Windsor¹, Gilaad G Kaplan¹; Canadian Gastro-Intestinal Epidemiology Consortium (CanGIEC)

Affiliations

¹ Division of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
² SickKids Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada.
³ Department of Paediatrics and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
⁴ Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada.
⁵ ICES, Toronto, Ontario, Canada.
⁶ Department of Medicine, and the University of Manitoba IBD Clinical and Research Centre, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
⁷ Division of Rheumatology, University of British Columbia, Vancouver, British Columbia, Canada.
⁸ Division of Gastroenterology and Hepatology, McGill University and McGill University Health Centre, Montreal, Quebec, Canada.
⁹ Division of Gastroenterology and Nutrition, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
¹⁰ Atlantic PATH, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
¹¹ Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Canada.
¹² Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Faculty of Medicine, British Columbia Children's Hospital and British Columbia Children Hospital Research Institute, Vancouver, British Columbia, Canada.
¹³ Department of Medicine & Clinical Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada.
¹⁴ SickKids Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, Ontario, Canada.
¹⁵ Arthritis Research Canada, Vancouver, British Columbia, Canada.
¹⁶ Department of Pediatrics, and the Children's Hospital Research Institute of Manitoba, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
¹⁷ The Ottawa Hospital IBD Centre and Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
¹⁸ University of Manitoba, Winnipeg, Manitoba, Canada.
¹⁹ Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.
²⁰ Department of Community Health & Epidemiology, University of Saskatchewan, Saskatoon, Canada.
²¹ Departments of Medicine and Community Health Sciences, the University of Manitoba IBD Clinical and Research Centre, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
²² CancerCare Manitoba Research Institute, CancerCare Manitoba, Winnipeg, Manitoba, Canada.
²³ Division of Gastroenterology and Hepatology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
²⁴ Newfoundland and Labrador Centre for Health Information, St. John's, Newfoundland, Canada.

PMID: 38299598
DOI: 10.14309/ajg.0000000000002687

Abstract

Introduction: Canada has a high burden of inflammatory bowel disease (IBD). Historical trends of IBD incidence and prevalence were analyzed to forecast the Canadian burden over the next decade.

Methods: Population-based surveillance cohorts in 8 provinces derived from health administrative data assessed the national incidence (2007-2014) and prevalence (2002-2014) of IBD. Autoregressive integrated moving average models were used to forecast incidence and prevalence, stratified by age, with 95% prediction intervals (PI), to 2035. The average annual percentage change (AAPC) with 95% confidence interval (CI) was calculated for the forecasted incidence and prevalence.

Results: The national incidence of IBD is estimated to be 29.9 per 100,000 (95% PI 28.3-31.5) in 2023. With a stable AAPC of 0.36% (95% CI -0.05 to 0.72), the incidence of IBD is forecasted to be 31.2 per 100,000 (95% PI 28.1-34.3) in 2035. The incidence in pediatric patients (younger than 18 years) is increasing (AAPC 1.27%; 95% CI 0.82-1.67), but it is stable in adults (AAPC 0.26%; 95% CI -0.42 to 0.82). The prevalence of IBD in Canada was 843 per 100,000 (95% PI 716-735) in 2023 and is expected to steadily climb (AAPC 2.43%; 95% CI 2.32-2.54) to 1,098 per 100,000 (95% PI 1,068-1,127) by 2035. The highest prevalence is in seniors with IBD (1,174 per 100,000 in 2023; AAPC 2.78%; 95% CI 2.75-2.81).

Discussion: Over the next decade, the Canadian health care systems will contend with the juxtaposition of rising incidence of pediatric IBD and a rising prevalence of overall IBD driven by the aging population.

Abstract

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