Incidence of inflammatory bowel disease across Europe: Is there a difference between north and south? Results of the European collaborative study on inflammatory bowel disease (EC-IBD)

被引:770
作者
Shivananda, S
LennardJones, J
Logan, R
Fear, N
Price, A
Carpenter, L
vanBlankenstein, M
Bjornsson, S
Johannsson, JH
Oddsson, E
Moum, B
Vatn, M
Aadland, E
Fausa, O
Lygren, I
Sauar, J
Schulz, T
Stray, N
Stave, R
Langholz, E
Binder, V
Vedtofte, P
Sonne, J
Collins, R
OMorain, C
Mayberry, J
Carr, I
Russel, M
Stockbrugger, R
Goebell, H
KatschinskiBreuer, B
Dupas, JL
Bianchi, P
Ranzi, T
Campanini, MC
Curzio, M
Gullotta, R
Bodoni, P
Politi, P
Lupinacci, G
Zambelli, A
Fornaciari, G
Beltrami, M
Mortilla, MG
Nicoli, F
Serra, L
Trallori, G
Bonanomi, A
dAlbasio, G
Pacini, F
机构
[1] REYKJAVIK CITY HOSP, DEPT MED, REYKJAVIK, ICELAND
[2] UNIV HOSP, REYKJAVIK, ICELAND
[3] AUST AGDER CENT HOSP, ARENDAL, NORWAY
[4] ULLEVAL UNIV, RIKSHOSP UNIV, DEPT MED A, OSLO, NORWAY
[5] TELEMARK CENT HOSP, PORSGRUNN, NORWAY
[6] DIAKONHJEMMET HOSP OSLO, OSLO, NORWAY
[7] LOVISENBERG HOSP, OSLO, NORWAY
[8] MEATH HOSP, DEPT GASTROENTEROL, DUBLIN 8, IRELAND
[9] ADELAIDE HOSP, DUBLIN 8, IRELAND
[10] GENTOFTE UNIV HOSP, DK-2900 COPENHAGEN, DENMARK
[11] GLOSTRUP CTY HOSP, COPENHAGEN, DENMARK
[12] HERLEV HOSP, DEPT MED C, COPENHAGEN, DENMARK
[13] HERLEV HOSP, DEPT MED F, COPENHAGEN, DENMARK
[14] LEICESTER GEN HOSP, DEPT GASTROENTEROL, LEICESTER LE5 4PW, LEICS, ENGLAND
[15] ACAD ZIEKENHUIS, DEPT GASTROENTEROL, MAASTRICHT, NETHERLANDS
[16] UNIV ESSEN GESAMTHSCH KLINIKUM, DEPT GASTROENTEROL, D-4300 ESSEN, GERMANY
[17] CHU AMIENS, DEPT HEPATOGASTROENTEROL, AMIENS, FRANCE
[18] UNIV MILAN, DEPT GASTROENTEROL, MILAN, ITALY
[19] ARCISPEDALE S MARIA NUOVA, DEPT INTERNAL MED 3, REGGIO EMILIA, ITALY
[20] POLICLIN CAREGGI, DIV GASTROENTEROL, FLORENCE, ITALY
[21] HOSP XERAL CIES, POVISA POLICLIN VIGO, DEPT DIGEST DIS, VIGO, SPAIN
[22] HOSP MEIXOEIRO, DEPT DIGEST DIS, VIGO, SPAIN
[23] CONSORCI HOSP PARC TAULI, DEPT ENDOSCOPY, SABADELL, SPAIN
[24] CONSORCI HOSP PARC TAULI, DEPT EPIDEMIOL, SABADELL, SPAIN
[25] HOSP SAN MARCOS, BRAGA, PORTUGAL
[26] HOSP SAO JOAO, DEPT GASTROENTEROL, OPORTO, PORTUGAL
[27] UNIV IOANNINA, DEPT INTERNAL MED, IOANNINA, GREECE
[28] HOSP UNIV SANTA MARIA, DEPT MED 2, LISBON, PORTUGAL
[29] ALMADA REG HLTH DEPT, DEPT GASTROENTEROL & PATHOL, LISBON, PORTUGAL
[30] OSPED V CERVELLO, DEPT MED, PALERMO, ITALY
[31] UNIV GEN HOSP HERAKLION, DEPT GASTROENTEROL, IRAKLION, GREECE
[32] SOROKA UNIV HOSP, GASTROENTEROL UNIT, BEER SHEVA, ISRAEL
[33] UNIV ROTTERDAM HOSP, ROTTERDAM DIJKZIGT, DEPT INTERNAL MED 2, DIV GASTROENTEROL, ROTTERDAM, NETHERLANDS
[34] MED COMP CONSULTANTS, ROTTERDAM, NETHERLANDS
关键词
Crohn's disease; ulcerative colitis; epidemiology;
D O I
10.1136/gut.39.5.690
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background-It has been suggested that the incidence of inflammatory bowel disease (IBD), which includes ulcerative colitis (UC) and Crohn's disease (CD), is three or more times higher in northern than in southern Europe. The aim of this EC funded study was to investigage this apparent variation by ascertaining-the incidence of IBD across Europe. Methods-For the period 1 October 1991 to 30 September 1993 all new patients diagnosed with IBD were prospectively identified in 20 European centres according to a standard protocol for case ascertainment and definition. Findings-Altogether 2201 patients aged 15 years or more were identified, of whom 1379 were diagnosed as UC (including proctitis), 706 as CD, and 116 as indeterminate. The overall incidence per 100 000 at ages 15-64 years (standardised for age and sex) of UC was 10 . 4 (95% confidence interval (95% CI) 7 . 6 to 13 . 1) and that of CD was 5 . 6 (95% CI 2 . 8 to 8 . 3). Rates of UC in northern centres were 40% higher than those in the south (rate ratio (RR) = 1 . 4 (95% CI 1 . 2 to 1 . 5)) and for CD they were 80% higher (RR = 1 . 8 (95% CI 1 . 5 to 2 . 1)). For UC the highest reported incidence was in Iceland (24 . 5, 95% CI 17 . 4 to 31 . 5) and for CD, Maastricht (The Netherlands; 9 . 2, 95% CI 6 . 5 to 11.8) and Amiens (north west France; 9 . 2, 95% CI 6 . 3 to 12 . 2). The lowest incidence of UC was in Almada (southern Portugal) (1 . 6, 95% CI 0 . 0 to 3 . 2) and of CD in Ioannina (north west Greece) (0 . 9, 95% CI 0 . 0 to 2 . 2). An unexpected finding was a difference in the age specific incidence of UC in men and women with the incidence in women but not men declining with age. Interpretation-The higher overall incidence rates in northern centres did not seem to be explained by differences in tobacco consumption or education. Nevertheless, the magnitude of the observed excess for both conditions is less than expected on the basis of previous studies. This may reflect recent increases in the incidence of IBD in southern Europe whereas those in the north may have stabilised.
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收藏
页码:690 / 697
页数:8
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