Incidence and phenotype of inflammatory bowel disease based on results from the Asia-Pacific Crohn's and colitis epidemiology study

Siew C. Ng; Whitney Tang; Jessica Y. Ching; May Wong; Chung Mo Chow; A. J. Hui; T. C. Wong; Vincent K. Leung; Steve W. Tsang; Hon Ho Yu; Mo Fong Li; Ka Kei Ng; Michael A. Kamm; Corrie Studd; Sally Bell; Rupert Leong; H. Janaka De Silva; Anuradhani Kasturiratne; M. N F Mufeena; Khoon Lin Ling; Choon Jin Ooi; Poh Seng Tan; David Ong; Khean L. Goh; Ida Hilmi; Pises Pisespongsa; Sathaporn Manatsathit; Rungsun Rerknimitr; Satimai Aniwan; Yu Fang Wang; Qin Ouyang; Zhirong Zeng; Zhenhua Zhu; Min Hu Chen; Pin Jin Hu; Kaichun Wu; Xin Wang; Marcellus Simadibrata; Murdani Abdullah; Justin Cy Wu; Joseph J Y Sung; Francis K L Chan

doi:10.1053/j.gastro.2013.04.007

Incidence and phenotype of inflammatory bowel disease based on results from the Asia-Pacific Crohn's and colitis epidemiology study

Siew C. Ng^*, Whitney Tang, Jessica Y. Ching, May Wong, Chung Mo Chow, A. J. Hui, T. C. Wong, Vincent K. Leung, Steve W. Tsang, Hon Ho Yu, Mo Fong Li, Ka Kei Ng, Michael A. Kamm, Corrie Studd, Sally Bell, Rupert Leong, H. Janaka De Silva, Anuradhani Kasturiratne, M. N F Mufeena, Khoon Lin LingChoon Jin Ooi, Poh Seng Tan, David Ong, Khean L. Goh, Ida Hilmi, Pises Pisespongsa, Sathaporn Manatsathit, Rungsun Rerknimitr, Satimai Aniwan, Yu Fang Wang, Qin Ouyang, Zhirong Zeng, Zhenhua Zhu, Min Hu Chen, Pin Jin Hu, Kaichun Wu, Xin Wang, Marcellus Simadibrata, Murdani Abdullah, Justin Cy Wu, Joseph J Y Sung, Francis K L Chan

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

674 Citations (Scopus)

Abstract

Background & Aims: Inflammatory bowel diseases (IBD) are becoming more common in Asia, but epidemiologic data are lacking. The Asia-Pacific Crohn's and Colitis Epidemiology Study aimed to determine the incidence and phenotype of IBD in 8 countries across Asia and in Australia. Methods: We performed a prospective, population-based study of IBD incidence in predefined catchment areas, collecting data for 1 year, starting on April 1, 2011. New cases were ascertained from multiple overlapping sources and entered into a Web-based database. Cases were confirmed using standard criteria. Local endoscopy, pathology, and pharmacy records were searched to ensure completeness of case capture. Results: We identified 419 new cases of IBD (232 of ulcerative colitis [UC], 166 of Crohn's disease [CD], and 21 IBD-undetermined). The crude annual overall incidence values per 100,000 individuals were 1.37 for IBD in Asia (95% confidence interval: 1.25-1.51; 0.76 for UC, 0.54 for CD, and 0.07 for IBD-undetermined) and 23.67 in Australia (95% confidence interval: 18.46-29.85; 7.33 for UC, 14.00 for CD, and 2.33 for IBD-undetermined). China had the highest incidence of IBD in Asia (3.44 per 100,000 individuals). The ratios of UC to CD were 2.0 in Asia and 0.5 in Australia. Median time from symptom onset to diagnosis was 5.5 months (interquartile range, 1.4-15 months). Complicated CD (stricturing, penetrating, or perianal disease) was more common in Asia than Australia (52% vs 24%; P =.001), and a family history of IBD was less common in Asia (3% vs 17%; P <.001). Conclusions: We performed a large-scale population-based study and found that although the incidence of IBD varies throughout Asia, it is still lower than in the West. IBD can be as severe or more severe in Asia than in the West. The emergence of IBD in Asia will result in the need for specific health care resources, and offers a unique opportunity to study etiologic factors in developing nations.

Original language	English
Pages (from-to)	158-165
Number of pages	8
Journal	Gastroenterology
Volume	145
Issue number	1
DOIs	https://doi.org/10.1053/j.gastro.2013.04.007
Publication status	Published - Jul 2013
Externally published	Yes

Keywords

ACCESS
Inflammation
Intestine
Rate

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10.1053/j.gastro.2013.04.007

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Ng, S. C., Tang, W., Ching, J. Y., Wong, M., Chow, C. M., Hui, A. J., Wong, T. C., Leung, V. K., Tsang, S. W., Yu, H. H., Li, M. F., Ng, K. K., Kamm, M. A., Studd, C., Bell, S., Leong, R., De Silva, H. J., Kasturiratne, A., Mufeena, M. N. F., ... Chan, F. K. L. (2013). Incidence and phenotype of inflammatory bowel disease based on results from the Asia-Pacific Crohn's and colitis epidemiology study. Gastroenterology, 145(1), 158-165. https://doi.org/10.1053/j.gastro.2013.04.007

@article{ccd670c65d554731b57df90865ffa146,

title = "Incidence and phenotype of inflammatory bowel disease based on results from the Asia-Pacific Crohn's and colitis epidemiology study",

abstract = "Background & Aims: Inflammatory bowel diseases (IBD) are becoming more common in Asia, but epidemiologic data are lacking. The Asia-Pacific Crohn's and Colitis Epidemiology Study aimed to determine the incidence and phenotype of IBD in 8 countries across Asia and in Australia. Methods: We performed a prospective, population-based study of IBD incidence in predefined catchment areas, collecting data for 1 year, starting on April 1, 2011. New cases were ascertained from multiple overlapping sources and entered into a Web-based database. Cases were confirmed using standard criteria. Local endoscopy, pathology, and pharmacy records were searched to ensure completeness of case capture. Results: We identified 419 new cases of IBD (232 of ulcerative colitis [UC], 166 of Crohn's disease [CD], and 21 IBD-undetermined). The crude annual overall incidence values per 100,000 individuals were 1.37 for IBD in Asia (95% confidence interval: 1.25-1.51; 0.76 for UC, 0.54 for CD, and 0.07 for IBD-undetermined) and 23.67 in Australia (95% confidence interval: 18.46-29.85; 7.33 for UC, 14.00 for CD, and 2.33 for IBD-undetermined). China had the highest incidence of IBD in Asia (3.44 per 100,000 individuals). The ratios of UC to CD were 2.0 in Asia and 0.5 in Australia. Median time from symptom onset to diagnosis was 5.5 months (interquartile range, 1.4-15 months). Complicated CD (stricturing, penetrating, or perianal disease) was more common in Asia than Australia (52% vs 24%; P =.001), and a family history of IBD was less common in Asia (3% vs 17%; P <.001). Conclusions: We performed a large-scale population-based study and found that although the incidence of IBD varies throughout Asia, it is still lower than in the West. IBD can be as severe or more severe in Asia than in the West. The emergence of IBD in Asia will result in the need for specific health care resources, and offers a unique opportunity to study etiologic factors in developing nations.",

keywords = "ACCESS, Inflammation, Intestine, Rate",

author = "Ng, {Siew C.} and Whitney Tang and Ching, {Jessica Y.} and May Wong and Chow, {Chung Mo} and Hui, {A. J.} and Wong, {T. C.} and Leung, {Vincent K.} and Tsang, {Steve W.} and Yu, {Hon Ho} and Li, {Mo Fong} and Ng, {Ka Kei} and Kamm, {Michael A.} and Corrie Studd and Sally Bell and Rupert Leong and {De Silva}, {H. Janaka} and Anuradhani Kasturiratne and Mufeena, {M. N F} and Ling, {Khoon Lin} and Ooi, {Choon Jin} and Tan, {Poh Seng} and David Ong and Goh, {Khean L.} and Ida Hilmi and Pises Pisespongsa and Sathaporn Manatsathit and Rungsun Rerknimitr and Satimai Aniwan and Wang, {Yu Fang} and Qin Ouyang and Zhirong Zeng and Zhenhua Zhu and Chen, {Min Hu} and Hu, {Pin Jin} and Kaichun Wu and Xin Wang and Marcellus Simadibrata and Murdani Abdullah and Wu, {Justin Cy} and Sung, {Joseph J Y} and Chan, {Francis K L}",

year = "2013",

month = jul,

doi = "10.1053/j.gastro.2013.04.007",

language = "English",

volume = "145",

pages = "158--165",

journal = "Gastroenterology",

issn = "0016-5085",

publisher = "W. B. Saunders",

number = "1",

}

Ng, SC, Tang, W, Ching, JY, Wong, M, Chow, CM, Hui, AJ, Wong, TC, Leung, VK, Tsang, SW, Yu, HH, Li, MF, Ng, KK, Kamm, MA, Studd, C, Bell, S, Leong, R, De Silva, HJ, Kasturiratne, A, Mufeena, MNF, Ling, KL, Ooi, CJ, Tan, PS, Ong, D, Goh, KL, Hilmi, I, Pisespongsa, P, Manatsathit, S, Rerknimitr, R, Aniwan, S, Wang, YF, Ouyang, Q, Zeng, Z, Zhu, Z, Chen, MH, Hu, PJ, Wu, K, Wang, X, Simadibrata, M, Abdullah, M, Wu, JC, Sung, JJY & Chan, FKL 2013, 'Incidence and phenotype of inflammatory bowel disease based on results from the Asia-Pacific Crohn's and colitis epidemiology study', Gastroenterology, vol. 145, no. 1, pp. 158-165. https://doi.org/10.1053/j.gastro.2013.04.007

TY - JOUR

T1 - Incidence and phenotype of inflammatory bowel disease based on results from the Asia-Pacific Crohn's and colitis epidemiology study

AU - Ng, Siew C.

AU - Tang, Whitney

AU - Ching, Jessica Y.

AU - Wong, May

AU - Chow, Chung Mo

AU - Hui, A. J.

AU - Wong, T. C.

AU - Leung, Vincent K.

AU - Tsang, Steve W.

AU - Yu, Hon Ho

AU - Li, Mo Fong

AU - Ng, Ka Kei

AU - Kamm, Michael A.

AU - Studd, Corrie

AU - Bell, Sally

AU - Leong, Rupert

AU - De Silva, H. Janaka

AU - Kasturiratne, Anuradhani

AU - Mufeena, M. N F

AU - Ling, Khoon Lin

AU - Ooi, Choon Jin

AU - Tan, Poh Seng

AU - Ong, David

AU - Goh, Khean L.

AU - Hilmi, Ida

AU - Pisespongsa, Pises

AU - Manatsathit, Sathaporn

AU - Rerknimitr, Rungsun

AU - Aniwan, Satimai

AU - Wang, Yu Fang

AU - Ouyang, Qin

AU - Zeng, Zhirong

AU - Zhu, Zhenhua

AU - Chen, Min Hu

AU - Hu, Pin Jin

AU - Wu, Kaichun

AU - Wang, Xin

AU - Simadibrata, Marcellus

AU - Abdullah, Murdani

AU - Wu, Justin Cy

AU - Sung, Joseph J Y

AU - Chan, Francis K L

PY - 2013/7

Y1 - 2013/7

N2 - Background & Aims: Inflammatory bowel diseases (IBD) are becoming more common in Asia, but epidemiologic data are lacking. The Asia-Pacific Crohn's and Colitis Epidemiology Study aimed to determine the incidence and phenotype of IBD in 8 countries across Asia and in Australia. Methods: We performed a prospective, population-based study of IBD incidence in predefined catchment areas, collecting data for 1 year, starting on April 1, 2011. New cases were ascertained from multiple overlapping sources and entered into a Web-based database. Cases were confirmed using standard criteria. Local endoscopy, pathology, and pharmacy records were searched to ensure completeness of case capture. Results: We identified 419 new cases of IBD (232 of ulcerative colitis [UC], 166 of Crohn's disease [CD], and 21 IBD-undetermined). The crude annual overall incidence values per 100,000 individuals were 1.37 for IBD in Asia (95% confidence interval: 1.25-1.51; 0.76 for UC, 0.54 for CD, and 0.07 for IBD-undetermined) and 23.67 in Australia (95% confidence interval: 18.46-29.85; 7.33 for UC, 14.00 for CD, and 2.33 for IBD-undetermined). China had the highest incidence of IBD in Asia (3.44 per 100,000 individuals). The ratios of UC to CD were 2.0 in Asia and 0.5 in Australia. Median time from symptom onset to diagnosis was 5.5 months (interquartile range, 1.4-15 months). Complicated CD (stricturing, penetrating, or perianal disease) was more common in Asia than Australia (52% vs 24%; P =.001), and a family history of IBD was less common in Asia (3% vs 17%; P <.001). Conclusions: We performed a large-scale population-based study and found that although the incidence of IBD varies throughout Asia, it is still lower than in the West. IBD can be as severe or more severe in Asia than in the West. The emergence of IBD in Asia will result in the need for specific health care resources, and offers a unique opportunity to study etiologic factors in developing nations.

AB - Background & Aims: Inflammatory bowel diseases (IBD) are becoming more common in Asia, but epidemiologic data are lacking. The Asia-Pacific Crohn's and Colitis Epidemiology Study aimed to determine the incidence and phenotype of IBD in 8 countries across Asia and in Australia. Methods: We performed a prospective, population-based study of IBD incidence in predefined catchment areas, collecting data for 1 year, starting on April 1, 2011. New cases were ascertained from multiple overlapping sources and entered into a Web-based database. Cases were confirmed using standard criteria. Local endoscopy, pathology, and pharmacy records were searched to ensure completeness of case capture. Results: We identified 419 new cases of IBD (232 of ulcerative colitis [UC], 166 of Crohn's disease [CD], and 21 IBD-undetermined). The crude annual overall incidence values per 100,000 individuals were 1.37 for IBD in Asia (95% confidence interval: 1.25-1.51; 0.76 for UC, 0.54 for CD, and 0.07 for IBD-undetermined) and 23.67 in Australia (95% confidence interval: 18.46-29.85; 7.33 for UC, 14.00 for CD, and 2.33 for IBD-undetermined). China had the highest incidence of IBD in Asia (3.44 per 100,000 individuals). The ratios of UC to CD were 2.0 in Asia and 0.5 in Australia. Median time from symptom onset to diagnosis was 5.5 months (interquartile range, 1.4-15 months). Complicated CD (stricturing, penetrating, or perianal disease) was more common in Asia than Australia (52% vs 24%; P =.001), and a family history of IBD was less common in Asia (3% vs 17%; P <.001). Conclusions: We performed a large-scale population-based study and found that although the incidence of IBD varies throughout Asia, it is still lower than in the West. IBD can be as severe or more severe in Asia than in the West. The emergence of IBD in Asia will result in the need for specific health care resources, and offers a unique opportunity to study etiologic factors in developing nations.

KW - ACCESS

KW - Inflammation

KW - Intestine

KW - Rate

UR - http://www.scopus.com/inward/record.url?scp=84879479335&partnerID=8YFLogxK

U2 - 10.1053/j.gastro.2013.04.007

DO - 10.1053/j.gastro.2013.04.007

M3 - Article

C2 - 23583432

AN - SCOPUS:84879479335

SN - 0016-5085

VL - 145

SP - 158

EP - 165

JO - Gastroenterology

JF - Gastroenterology

IS - 1

ER -

Incidence and phenotype of inflammatory bowel disease based on results from the Asia-Pacific Crohn's and colitis epidemiology study

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