Inflamm Bowel Dis. 2024 Feb 19:izad302. doi: 10.1093/ibd/izad302. Online ahead of print.

Zachary Green ^1 2, James J Ashton ^1 3, Astor Rodrigues ⁴, Christine Spray ⁵, Lucy Howarth ⁴, Akshatha Mallikarjuna ⁵, Neil Chanchlani ⁶, James Hart ⁶, Christopher Bakewell ¹, Kwang Yang Lee ⁵, Amar Wahid ², R Mark Beattie ¹

Author information

¹Department of Paediatric Gastroenterology, Southampton Children's Hospital, Southampton, United Kingdom.

²Department of Paediatric Gastroenterology, Noah's Ark Children's Hospital for Wales, Cardiff, United Kingdom.

³Department of Human Genetics and Genomic Medicine, University of Southampton, Southampton, United Kingdom.

⁴Department of Paediatric Gastroenterology, Oxford University Hospitals, Oxford, United Kingdom.

⁵Department of Paediatric Gastroenterology, Bristol Children's Hospital, Bristol, United Kingdom.

⁶Department of Paediatrics, Royal Devon University Healthcare NHS Foundation Trust, Exeter, United Kingdom.

Abstract

Background: Pediatric inflammatory bowel disease (pIBD) incidence has increased over the last 25 years. We aim to report contemporaneous trends across the South West United Kingdom.

Methods: Data were provided from centers covering the South West United Kingdom (Bristol, Oxford, Cardiff, Exeter, and Southampton), with a total area at-risk population (<18 years of age) of 2 947 534. Cases were retrieved from 2013 to 2022. Incident rates were reported per 100 000 at-risk population, with temporal trends analyzed through correlation. Subgroup analysis was undertaken for age groups (0-6, 6-11, and 12-17 years of age), sex, and disease subtype. Choropleth maps were created for local districts.

Results: In total, 2497 pIBD cases were diagnosed between 2013 and 2022, with a mean age of 12.6 years (38.7% female). Diagnosis numbers increased from 187 to 376, with corresponding incidence rates of 6.0 per 100 000 population per year (2013) to 12.4 per 100 000 population per year (2022) (b = 0.918, P < .01). Female rates increased from 5.1 per 100 000 population per year in 2013 to 11.0 per 100 000 population per year in 2022 (b = 0.865, P = .01). Male rates increased from 5.7 per 100 000 population per year to 14.4 per 100 000 population per year (b = 0.832, P = .03). Crohn's disease incidence increased from 3.1 per 100 000 population per year to 6.3 per 100 000 population per year (b = 0.897, P < .01). Ulcerative colitis increased from 2.3 per 100 000 population per year to 4.3 per 100 000 population per year (b = 0.813, P = .04). Inflammatory bowel disease unclassified also increased, from 0.6 per 100 000 population per year to 1.8 per 100 000 population per year (b = 0.851, P = .02). Statistically significant increases were seen in those ≥12 to 17 years of age, from 11.2 per 100 000 population per year to 24.6 per 100 000 population per year (b = 0.912, P < .01), and the 7- to 11-year-old age group, with incidence rising from 4.4 per 100 000 population per year to 7.6 per 100 000 population per year (b = 0.878, P = .01). There was no statistically significant increase in very early onset inflammatory bowel disease (≤6 years of age) (b = 0.417, P = .231).

Conclusions: We demonstrate significant increases in pIBD incidence across a large geographical area including multiple referral centers. Increasing incidence has implications for service provision for services managing pIBD.