Incidence, clinical presentation and location at diagnosis of pediatric inflammatory bowel disease: a prospective population-based study in northern France (1988-1999).
OBJECTIVE
To assess the incidence and location at diagnosis of inflammatory bowel disease in children and adolescents in northern France between 1988 and 1999.


METHODS
A 12-year prospective population-based study was conducted by gastroenterologists and pediatric gastroenterologists of northern France (1,312,141 children <17 years of age).


RESULTS
From 1988 to 1999, 509 cases of childhood inflammatory bowel disease were recorded (7.2% of all inflammatory bowel disease cases in Northern France): 367 Crohn disease, 122 ulcerative colitis and 20 indeterminate colitis. The mean standardized incidence was 3.1/10(5) for inflammatory bowel disease as a whole (2.3 for Crohn disease, 0.8 for ulcerative colitis and 0.12 for indeterminate colitis). Crohn disease location at diagnosis was: small bowel and colon (71%), colon only (10%) and small bowel only (19%). Location of initial ulcerative colitis was: proctitis (11%), left colitis (57%) and pancolitis (32%). Although ulcerative colitis incidence remained stable (0.8), Crohn disease incidence increased from 2.1 in 1988 to 1990 to 2.6 in 1997 to 1999 (P = 0.2).


CONCLUSIONS
The incidence of Crohn disease in the children of northern France showed an increasing trend (20%; not significant) during the 12-year period while the incidence of ulcerative colitis remained stable. In the entire population(children and adults)the incidence of Crohn disease increased significantly (+23%; P < 0.001), while the incidence of ulcerative colitis decreased (-17%; P < 0.0001).
Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lille University Hospital, Lille, France.
Stéphane
S
Auvin
Florence
F
Molinié
Corinne
C
Gower-Rousseau
Franck
F
Brazier
Véronique
V
Merle
Bruno
B
Grandbastien
Raymond
R
Marti
Eric
E
Lerebours
Jean-Louis
JL
Dupas
Jean-Frédéric
JF
Colombel
Jean-Louis
JL
Salomez
Antoine
A
Cortot
Dominique
D
Turck
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000453:epidemiology / Q000473:pathology; D003106:Colon / Q000473:pathology*; D003424:Crohn Disease / Q000453:epidemiology / Q000473:pathology; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D015212:Inflammatory Bowel Diseases / Q000453:epidemiology* / Q000473:pathology*; D007421:Intestine, Small / Q000473:pathology*; D008137:Longitudinal Studies; D008297:Male; D016017:Odds Ratio; D011159:Population Surveillance; D011446:Prospective Studies