IBD rapidly becoming a global disease

The incidence and prevalence of inflammatory bowel disease in the developing world is set to catch up with rates seen in the western world, a large systematic review reveals.

Writing in The Lancet the authors from Hong Kong and Canada warn that an increasing global burden of inflammatory bowel disease will bring “important challenges to health-care systems around the world as they work to care for this complex and costly disease.”

The systematic review included 147 population-based studies on the incidence and prevalence of inflammatory bowel disease spanning from 1990 to 2016.

The data revealed that since 1990 incidence rates had shifted in western countries, with 73% of studies on Crohn’s disease and 83% of studies on ulcerative colitis showing stable or falling incidence.

Nevertheless, the figures showed disease burden remained high with prevalence surpassing 0·3% in North America, Australia, and most countries in Europe.

In contrast newly industrialised countries like Africa, Asia, and South America were mirroring the progression of inflammatory bowel disease seen in the western world during the 1900s.

Figures showed the annual percentage change for Crohn’s disease was +11·1% [95% CI 4·8–17·8] and ulcerative colitis +14·9% [10·4–19·6]).

“The peak in the incidence of inflammatory bowel disease has probably not yet transpired in these countries,”  the study authors wrote.

They concluded that changing the global burden of inflammatory bowel disease during the next decade would require a two-pronged solution involving research into interventions and innovations in the delivery of care.

Writing in an accompanying editorial Melbourne based gastroenterologist Professor Michael Kamm said the rapid changes in inflammatory bowel disease epidemiology presented a challenge but also an opportunity.

“Research discoveries about disease causality made in newly industrialised countries will undoubtedly benefit the global community,” he wrote.

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