The epidemiology of inflammatory bowel disease in Canada: a population-based study.
BACKGROUND
Previously, we have demonstrated a high incidence and prevalence of Crohn's disease (CD) and ulcerative colitis (UC) in the Canadian province of Manitoba. However, the epidemiology of inflammatory bowel disease (IBD) in other regions of Canada has not been defined. The aim of this study was to estimate the incidence and prevalence of CD and UC in diverse regions of Canada and the overall burden of IBD in Canada.


METHODS
We applied a common case identification algorithm, previously validated in Manitoba to the provincial health databases in British Columbia (BC), Alberta (AB), Saskatchewan (SK), Manitoba (MB), and Nova Scotia (NS) to determine the age-adjusted incidence rates per 100,000 person-years for 1998-2000 and prevalence per 100,000 for mid 2000 and to estimate the IBD burden in Canada. Poisson regression was used to assess differences in incidence rates and prevalence by gender, age, and province.


RESULTS
The incidence rate for CD ranged from 8.8 (BC) to 20.2 (NS), and for UC ranged from 9.9 (BC) to 19.5 (NS). The prevalence of CD was approximately 15- to 20-fold higher than the incidence rate, ranging from 161 (BC) to 319 (NS). This was similar for the prevalence of UC, which ranged from 162 (BC) to 249 (MB). Adjusting for age and province, the female:male ratio for incidence ratio was 1.31 (p < 0.0001) for CD and 1.02 (n.s.) for UC and was mostly stable across the five provinces.


CONCLUSIONS
Approximately 0.5% of the Canadian population has IBD. Canada has the highest incidence and prevalence of CD yet reported.
Bernstein
Charles N
CN
Inflammatory Bowel Disease Clinical and Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada.
Wajda
Andre
A
Svenson
Lawrence W
LW
MacKenzie
Adrian
A
Koehoorn
Mieke
M
Jackson
Maureen
M
Fedorak
Richard
R
Israel
David
D
Blanchard
James F
JF
D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D002170:Canada / Q000453:epidemiology; D002648:Child; D005260:Female; D006801:Humans; D015994:Incidence; D015212:Inflammatory Bowel Diseases / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D016012:Poisson Distribution; D015995:Prevalence; D012307:Risk Factors