Siew C Ng1, Wai Keung Leung, Hai Yun Shi, Michael K K Li, Chi Man Leung, Carmen K M Ng, Fu Hang Lo, Yee Tak Hui, Steven W C Tsang, Yiu Kay Chan, Ching Kong Loo, Kam Hon Chan, Aric J Hui, Wai Hung Chow, Marcus Harbord, Jessica Y L Ching, Mandy Lee, Victor Chan, Whitney Tang, Ivan F N Hung, Judy Ho, Wai Cheung Lao, Marc T L Wong, Shun Fung Sze, Edwin H S Shan, Belsy C Y Lam, Raymond W H Tong, Lai Yee Mak, Sai Ho Wong, Justin C Y Wu, Francis K L Chan, Joseph J Y Sung. 1. 1Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, LKS Institute of Health Science, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China;2Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China;3Department of Medicine and Geriatrics, Tuen Mun Hospital, Hong Kong, China;4Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China;5Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, China;6Department of Medicine and Geriatrics, United Christian Hospital, Hong Kong, China;7Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China;8Department of Medicine, Tseung Kwan O Hospital, Hong Kong, China;9Department of Medicine and Geriatrics, Caritas Medical Centre, Hong Kong, China;10Department of Medicine and Geriatrics, Kwong Wah Hospital, Hong Kong, China;11Department of Medicine, North District Hospital, Hong Kong, China;12Department of Medicine, Alice Ho Miu Ling Nethersole Hospital, Hong Kong, China;13Department of Medicine, Yan Chai Hospital, Hong Kong, China;14Department of Gastroenterology, Chelsea and Westminster Hospital, London, United Kingdom; and15Department of Colorectal Surgery, University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
Abstract
BACKGROUND: Incidence of inflammatory bowel disease (IBD) is increasing in Asia, but population-based prevalence data are limited. This study examined IBD incidence and prevalence based on results of a territory-wide IBD registry in Hong Kong. METHODS: We collected data on 2575 patients with IBD (1541 ulcerative colitis [UC], 983 Crohn's disease [CD], 51 IBD unclassified) from 1981 to 2014 using hospital and territory-wide administrative coding system. Prevalence and incidence, disease phenotype, surgery, and mortality were analyzed. RESULTS: Adjusted prevalence of IBD, UC, CD, and IBD unclassified per 100,000 individuals in 2014 were 44.0, 24.5, 18.6, and 0.9, respectively. Age-adjusted incidence of IBD per 100,000 individuals increased from 0.10 (95% confidence interval, 0.06-0.16) in 1985 to 3.12 (95% confidence interval, 2.88-3.38) in 2014. UC:CD incidence ratio reduced from 8.9 to 1.0 over 30 years (P < 0.001). A family history of IBD was reported in 3.0% of patients. Stricturing or penetrating disease was found in 41% and perianal disease in 25% of patients with CD. 5-aminosalicylate use was common in UC (96%) and CD (89%). Cumulative rates of surgery for CD were 20.3% at 1 year and 25.7% at 5 years, and the corresponding rates for UC were 1.8% and 2.1%, respectively. Mortality for CD and UC was not significantly different from the general population. CONCLUSIONS: In a population-based study in Hong Kong, prevalence of IBD is lower than in the west although comparable to that of other East Asian countries. Complicated CD is common. Overall mortality remains low in Asians with IBD.
BACKGROUND: Incidence of inflammatory bowel disease (IBD) is increasing in Asia, but population-based prevalence data are limited. This study examined IBD incidence and prevalence based on results of a territory-wide IBD registry in Hong Kong. METHODS: We collected data on 2575 patients with IBD (1541 ulcerative colitis [UC], 983 Crohn's disease [CD], 51 IBD unclassified) from 1981 to 2014 using hospital and territory-wide administrative coding system. Prevalence and incidence, disease phenotype, surgery, and mortality were analyzed. RESULTS: Adjusted prevalence of IBD, UC, CD, and IBD unclassified per 100,000 individuals in 2014 were 44.0, 24.5, 18.6, and 0.9, respectively. Age-adjusted incidence of IBD per 100,000 individuals increased from 0.10 (95% confidence interval, 0.06-0.16) in 1985 to 3.12 (95% confidence interval, 2.88-3.38) in 2014. UC:CD incidence ratio reduced from 8.9 to 1.0 over 30 years (P < 0.001). A family history of IBD was reported in 3.0% of patients. Stricturing or penetrating disease was found in 41% and perianal disease in 25% of patients with CD. 5-aminosalicylate use was common in UC (96%) and CD (89%). Cumulative rates of surgery for CD were 20.3% at 1 year and 25.7% at 5 years, and the corresponding rates for UC were 1.8% and 2.1%, respectively. Mortality for CD and UC was not significantly different from the general population. CONCLUSIONS: In a population-based study in Hong Kong, prevalence of IBD is lower than in the west although comparable to that of other East Asian countries. Complicated CD is common. Overall mortality remains low in Asians with IBD.
Authors: Bharati Kochar; Edward L Barnes; Hans H Herfarth; Christopher F Martin; Ashwin N Ananthakrishnan; Dermot McGovern; Millie Long; Robert S Sandler Journal: Inflamm Intest Dis Date: 2017-11-18