Decreasing incidence of inflammatory bowel disease in Eastern Canada: a population database study
Open accessAbstract
BACKGROUND: Nova Scotia has one of the highest incidences of inflammatory bowel disease (IBD) in the world. We wished to determine trends of IBD over time. METHODS: All Provincial residents have government provided health insurance and all interactions with the hospital, and physician billing systems, are captured on an administrative database. We used a validated measure to define incident cases of Crohn's (CD), ulcerative colitis (UC) and undifferentiated IBD (IBDU). Incidence rates of these diseases for the years 1996-2009 were calculated. RESULTS: Over the study period, 7,153 new cases of IBD were observed of which 3,046 cases were categorized as CD (42.6%), 2,960 as UC (41.4%) and 1,147 as IBDU (16.0%). Annual age standardized incidence rates were very high but have declined for CD from 27.4 to 17.7/100,000 population and for UC from 21.4 to 16.7/100,000. The decline was seen in all age groups and both genders. The decrease was not explained by a small increase in IBDU. CONCLUSION: The incidence of CD and UC are decreasing in Nova Scotia. If replicated elsewhere this indicates a reversal after a long period of increasing occurrence of IBD. This has implications for both epidemiology and health planning.
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The Ceiling Incidence Range in the Western world is 23.8-29.3 per 100,000 for Crohn's disease and 23.1-57.9 per 100,000 for ulcerative colitis.
“For Crohn’s disease, the Ceiling Incidence Range is in the range 23.8–29.3 per 100,000 (refs4,40,43), and for ulcerative colitis, it is in the range 23.1–57.9 per 100,000 (refs4,43,44).”
From The four epidemiological stages in the global evolution of inflammatory bowel disease (2021) · cites this paper as [43]
The high reported incidence of IBD in Nova Scotia, Canada, might be methodological because incidence calculations relied on administrative databases using non-validated coding algorithms subject to misclassification biases.
“The high incidence of IBD in Nova Scotia might be methodological in origin because incidence calculations relied on administrative databases using non-validated coding algorithms, which are subject to misclassification biases that might have inflated the incidence45.”
From The four epidemiological stages in the global evolution of inflammatory bowel disease (2021) · cites this paper as [43]
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- Authors
- Leddin, D., Tamim, H., & Levy, A. R.
- Affiliations
- Dalhousie University (CA)
- Corresponding author
- Leddin, Desmond
- Venue
- BMC Gastroenterology
- Published
- 2014-08-09
- Volume
- 14
- Issue
- 1
- Pages
- 140-140
- ISSN
- 1471-230X (ISSN-L)
- PMC
- PMC4134124
- OpenAlex
- W2012614695
- Cited by
- 61
- References
- 21
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 4 · 2022: 4 · 2021: 5 · 2020: 7 · 2019: 12 · 2018: 9 · 2017: 4 · 2016: 6 · 2015: 2 · 2014: 3
- FWCI
- 3.28
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Gastroenterology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
- Health Sciences › Medicine › Oncology › Colorectal Cancer Screening and Detection
- Keywords
- inflammatory bowel disease, Crohn's disease, ulcerative colitis, incidence trends, incidence decline, Nova Scotia, eastern Canada, administrative health databases
- MeSH terms
- Adult, Colitis, Ulcerative, Crohn Disease, Female, Humans, Male, Middle Aged, Nova Scotia, Inflammatory Bowel Diseases, Incidence, Databases, Factual, Young Adult
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