title: Comparison of clinical characteristics and management of inflammatory bowel disease in Hong Kong versus Melbourne.
abstract: OBJECTIVE
  Inflammatory bowel disease (IBD), common in Melbourne, was rare but is now increasing in incidence in Hong Kong (HK). To investigate whether these are the same diseases in the West and East, potential causes of changing incidence, and to plan resource needs, an appreciation of clinical characteristics in contrasting populations is essential.
  
  
  METHODS
  Disease characteristics were collected from prospectively populated IBD databases in two specialist centers in Melbourne, Australia and HK.
  
  
  RESULTS
  Of 795 patients (Crohn's disease [CD] : ulcerative colitis [UC] Melbourne 272:159 and HK 161:203), the age of diagnosis was higher, there were proportionally more male patients with CD but no UC sex difference, fewer patients were current or ex-smokers (CD 8% vs 50%; UC 17% vs 35%) and a family history of IBD was less common (2% vs 11%; P < 0.001) in HK compared to Melbourne. Stricturing and perianal CD were more common in HK (12% vs 6%; P < 0.001; and 29% vs 16%; P = 0.001, respectively). In HK for UC, more patients had extensive disease at diagnosis (42% vs 22%) but colectomy was less common (7% vs 20%; P < 0.001). In Melbourne there was greater steroid use at diagnosis and patients were more likely to receive an immunomodulator or anti-tumor necrosis factor agent.
  
  
  CONCLUSIONS
  IBD in HK was diagnosed at an older age, and had more complicated disease behavior than in Melbourne. Medical therapy, however, was less intense in HK. These differences may relate to real differences in disease or delayed diagnosis due to late presentation and less disease recognition in HK.
authors.affiliation: Department of Gastroenterology, St Vincent's Hospital and University of Melbourne, Australia.
authors.forename: Lani
authors.initials: L
authors.lastname: Prideaux
authors.forename: Michael A
authors.initials: MA
authors.lastname: Kamm
authors.forename: Peter
authors.initials: P
authors.lastname: De Cruz
authors.forename: James
authors.initials: J
authors.lastname: Williams
authors.forename: Sally J
authors.initials: SJ
authors.lastname: Bell
authors.forename: William R
authors.initials: WR
authors.lastname: Connell
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Brown
authors.forename: Mark
authors.initials: M
authors.lastname: Lust
authors.forename: Paul V
authors.initials: PV
authors.lastname: Desmond
authors.forename: Heyson
authors.initials: H
authors.lastname: Chan
authors.forename: Dorothy K L
authors.initials: DK
authors.lastname: Chow
authors.forename: Justin C Y
authors.initials: JC
authors.lastname: Wu
authors.forename: Rupert W
authors.initials: RW
authors.lastname: Leong
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Sung
authors.forename: Francis K L
authors.initials: FK
authors.lastname: Chan
authors.forename: Siew C
authors.initials: SC
authors.lastname: Ng
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001003:Anal Canal / Q000473:pathology; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003082:Colectomy / Q000706:statistics & numerical data; D003093:Colitis, Ulcerative / Q000175:diagnosis* / Q000235:genetics / Q000628:therapy*; D003251:Constriction, Pathologic / Q000209:etiology; D003424:Crohn Disease / Q000175:diagnosis* / Q000235:genetics / Q000628:therapy*; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D006723:Hong Kong; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D015122:Mercaptopurine / Q000627:therapeutic use; D008727:Methotrexate / Q000627:therapeutic use; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D013256:Steroids / Q000627:therapeutic use; D000079424:Tumor Necrosis Factor Inhibitors; D014739:Victoria; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D013256:Steroids; D000079424:Tumor Necrosis Factor Inhibitors; D016572:Cyclosporine; D015122:Mercaptopurine; D008727:Methotrexate