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

J Burisch; Natalia Pedersen; S Čuković-Čavka; M Brinar; I Kaimakliotis; D Duricova; O Shonová; Ida Vind; S Avnstrøm; N Thorsgaard; Vinnie Andersen; S Krabbe; J F Dahlerup; R Salupere; K R Nielsen; J Olsen; P Manninen; P Collin; E V Tsianos; K H Katsanos; K 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; V Hernandez; D Martinez-Ares; S Almer; Y Zhulina; J Halfvarson; P Munkholm; EpiCom Group

doi:10.1136/gutjnl-2013-304636

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

J Burisch, Natalia Pedersen, S Čuković-Čavka, M Brinar, I Kaimakliotis, D Duricova, O Shonová, Ida Vind, S Avnstrøm, N Thorsgaard, Vinnie Andersen, S Krabbe, J F Dahlerup, R Salupere, K R Nielsen, J Olsen, P Manninen, P Collin, E V Tsianos, K H KatsanosK 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, V Hernandez, D Martinez-Ares, S Almer, Y Zhulina, J Halfvarson, P Munkholm, EpiCom Group

Institut for Klinisk Medicin

210 Citationer (Scopus)

Abstract

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.

Originalsprog	Engelsk
Tidsskrift	Gut
Vol/bind	63
Udgave nummer	4
Sider (fra-til)	588-597
Antal sider	10
ISSN	0017-5749
DOI	https://doi.org/10.1136/gutjnl-2013-304636
Status	Udgivet - apr. 2014

Adgang til dokumentet

10.1136/gutjnl-2013-304636

Citationsformater

Burisch, J., Pedersen, N., Čuković-Čavka, S., Brinar, M., Kaimakliotis, I., Duricova, D., Shonová, O., Vind, I., Avnstrøm, S., Thorsgaard, N., Andersen, V., Krabbe, S., Dahlerup, J. F., Salupere, R., Nielsen, K. R., Olsen, J., Manninen, P., Collin, P., Tsianos, E. V., ... EpiCom Group (2014). East-West gradient in the incidence of inflammatory bowel disease in Europe: the ECCO-EpiCom inception cohort. Gut, 63(4), 588-597. https://doi.org/10.1136/gutjnl-2013-304636

Burisch, J, Pedersen, N, Čuković-Čavka, S, Brinar, M, Kaimakliotis, I, Duricova, D, Shonová, O, Vind, I, Avnstrøm, S, Thorsgaard, N, Andersen, V, Krabbe, S, Dahlerup, JF, Salupere, R, Nielsen, KR, Olsen, J, Manninen, P, Collin, P, Tsianos, EV, Katsanos, KH, Ladefoged, K, Lakatos, L, Björnsson, E, Ragnarsson, G, Bailey, Y, Odes, S, Schwartz, D, Martinato, M, Lupinacci, G, Milla, M, De Padova, A, D'Incà, R, Beltrami, M, Kupcinskas, L, Kiudelis, G, Turcan, S, Tighineanu, O, Mihu, I, Magro, F, Barros, LF, Goldis, A, Lazar, D, Belousova, E, Nikulina, I, Hernandez, V, Martinez-Ares, D, Almer, S, Zhulina, Y, Halfvarson, J, Munkholm, P & EpiCom Group 2014, 'East-West gradient in the incidence of inflammatory bowel disease in Europe: the ECCO-EpiCom inception cohort', Gut, bind 63, nr. 4, s. 588-597. https://doi.org/10.1136/gutjnl-2013-304636

@article{f3c1d9c73bc44951bcfb5a4b8c1c52a7,

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

abstract = "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.",

keywords = "Adolescent, Adult, Aged, Aged, 80 and over, Colitis, Ulcerative, Colonoscopy, Crohn Disease, Europe, Europe, Eastern, Female, Humans, Incidence, Inflammatory Bowel Diseases, Male, Middle Aged, Prospective Studies, Young Adult",

author = "J Burisch and Natalia Pedersen and S {\v C}ukovi{\'c}-{\v C}avka and M Brinar and I Kaimakliotis and D Duricova and O Shonov{\'a} and Ida Vind and S Avnstr{\o}m and N Thorsgaard and Vinnie Andersen and S Krabbe and Dahlerup, {J F} and R Salupere and Nielsen, {K R} and J Olsen and P Manninen and P Collin and Tsianos, {E V} and Katsanos, {K H} and K Ladefoged and L Lakatos and E Bj{\"o}rnsson and G Ragnarsson and Y Bailey and S Odes and D Schwartz and M Martinato and G Lupinacci and M Milla and {De Padova}, A and R D'Inc{\`a} and M Beltrami and L Kupcinskas and G Kiudelis and S Turcan and O Tighineanu and I Mihu and F Magro and Barros, {L F} and A Goldis and D Lazar and E Belousova and I Nikulina and V Hernandez and D Martinez-Ares and S Almer and Y Zhulina and J Halfvarson and P Munkholm and {EpiCom Group}",

year = "2014",

month = apr,

doi = "10.1136/gutjnl-2013-304636",

language = "English",

volume = "63",

pages = "588--597",

journal = "Gut",

issn = "0017-5749",

publisher = "B M J Group",

number = "4",

}

TY - JOUR

T1 - East-West gradient in the incidence of inflammatory bowel disease in Europe

T2 - the ECCO-EpiCom inception cohort

AU - Burisch, J

AU - Pedersen, Natalia

AU - Čuković-Čavka, S

AU - Brinar, M

AU - Kaimakliotis, I

AU - Duricova, D

AU - Shonová, O

AU - Vind, Ida

AU - Avnstrøm, S

AU - Thorsgaard, N

AU - Andersen, Vinnie

AU - Krabbe, S

AU - Dahlerup, J F

AU - Salupere, R

AU - Nielsen, K R

AU - Olsen, J

AU - Manninen, P

AU - Collin, P

AU - Tsianos, E V

AU - Katsanos, K H

AU - Ladefoged, K

AU - Lakatos, L

AU - Björnsson, E

AU - Ragnarsson, G

AU - Bailey, Y

AU - Odes, S

AU - Schwartz, D

AU - Martinato, M

AU - Lupinacci, G

AU - Milla, M

AU - De Padova, A

AU - D'Incà, R

AU - Beltrami, M

AU - Kupcinskas, L

AU - Kiudelis, G

AU - Turcan, S

AU - Tighineanu, O

AU - Mihu, I

AU - Magro, F

AU - Barros, L F

AU - Goldis, A

AU - Lazar, D

AU - Belousova, E

AU - Nikulina, I

AU - Hernandez, V

AU - Martinez-Ares, D

AU - Almer, S

AU - Zhulina, Y

AU - Halfvarson, J

AU - Munkholm, P

AU - EpiCom Group

PY - 2014/4

Y1 - 2014/4

N2 - 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.

AB - 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.

KW - Adolescent

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Colitis, Ulcerative

KW - Colonoscopy

KW - Crohn Disease

KW - Europe

KW - Europe, Eastern

KW - Female

KW - Humans

KW - Incidence

KW - Inflammatory Bowel Diseases

KW - Male

KW - Middle Aged

KW - Prospective Studies

KW - Young Adult

U2 - 10.1136/gutjnl-2013-304636

DO - 10.1136/gutjnl-2013-304636

M3 - Journal article

C2 - 23604131

SN - 0017-5749

VL - 63

SP - 588

EP - 597

JO - Gut

JF - Gut

IS - 4

ER -

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

Abstract

Adgang til dokumentet

Fingeraftryk

Citationsformater