Incidence, prevalence and clinical presentation of inflammatory bowel diseases in Northern France: a 30-year population-based study

[kiny]

full study:
https://www.thelancet.com/action/showPdf?pii=S2666-7762(24)00264-3


Abstract:
Incidence, prevalence and clinical presentation of inflammatory bowel diseases in Northern France: a 30-year population-based study

Oct 2024

University of Lille, Lille F-59000, France

Hélène Sarter, Thibaut Crétin, Guillaume Savoye,Mathurin Fumery,Ariane Leroyer,Luc Dauchet,Thierry Paupard,Hugues Coevoet,Pauline Wils, Nicolas Richard,Dominique Turck,Delphine Ley and Corinne Gower-Rousseau

Background
In industrialized countries, the incidence of inflammatory bowel disease (IBD) appears stabilized. This study examined the incidence and phenotype of IBD in Northern France over a 30-year period.

Methods
Including all IBD patients recorded in the EPIMAD population-based registry from 1988 to 2017 in Northern France, we described the incidence and clinical presentation of IBD according to age, sex and time.

Findings
A total of 22,879 incident IBD cases were documented (59% (n = 13,445) of Crohn’s disease (CD), 38% (n = 8803) of ulcerative colitis (UC), 3% (n = 631) of IBD unclassified (IBDU)). Over the study period, incidence of IBD, CD and UC was 12.7, 7.2 and 5.1 per 105 person-years, respectively. The incidence of CD increased from 5.1/105 in 1988–1990 to 7.9/105 in 2015–2017 (annual percent change (APC): +1.9%, p < 0.0001). The incidence of UC increased from 4.5/105 to 6.1/105 (APC: +1.3%, p < 0.0001). The largest increase was observed in children (+4.3% in CD, p < 0.0001; +5.4% in UC, p < 0.0001) followed by young adults aged 17–39 years (+1.9% in CD, p < 0.0001; +1.5% in UC, p < 0.0001). The increase in UC incidence was significantly higher in women than in men (+1.9% in women, +0.8% in men; p = 0.006). We estimated that in our area, by 2030, nearly 0.6% of the population will have IBD.

Interpretation
The persistent increase of IBD incidence among children and young adults but also in women with UC in Northern France, suggests the persistence of substantial predisposing environmental factors.

 

[kiny]

There's many studies like this, but I chose to post this one, because it's from Northern France. Northern France is a rather interesting region when it comes to crohn's disease research.

Incidence of Crohn's Disease is abnormally high compared to the rest of France.

But far more interesting still, Northern France and Belgium are the regions where Van Kruiningen discovered Crohn's Disease features familiar and region-specific clustering, implicating a strong environmental factor.

Crohn's disease clustering was later found in other regions around the world, but the democratisation of travel makes more recent studies less valuable.



Crohn's disease is still predominantly a disease with high incidence rates around puberty. The best explanation so far has been the high activity of peyer's patches around puberty.

UC is not nearly as dominant at puberty, again, showing these are very different diseases with likely different causes.