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50 per cent increase in inflammatory bowel disease in Ontario children

August 5, 2009 Toronto

An increasing number of Ontario children are suffering from Crohn's disease and ulcerative colitis, collectively known as Inflammatory Bowel Disease (IBD). Researchers at the Institute for Clinical Evaluative Sciences (ICES) have found a 50 per cent rise in the prevalence of IBD in Ontario children, and a rising incidence of Crohn's disease in children under 10 years old.

The study of more than 3,000 IBD patients diagnosed as children in Ontario between 1994 and 2005 found:

  • The number of children living with IBD in Ontario has increased by 50 per cent since 1994. The prevalence in under 18-year-olds has increased from 42.1 per 100,000 children in 1994 to 56.3 per 100,000 in 2005.
  • The risk of developing IBD has increased in under 10-year-old children, while the risk is stable in pre-teens and teenagers.
  • Ontario has one of the highest rates of pediatric IBD in the world.

“This research shows a clear change in the likelihood of IBD in Ontario children,” says Dr. Eric Benchimol, principal investigator and research fellow at ICES and The Hospital for Sick Children. "IBD is a lifelong illness with no cure. We need to understand why young children are developing it more frequently. This increase could be due to an environmental change, the changing Ontario population, earlier diagnosis by trained specialists, or a combination of all three. We also need to understand the implications of earlier disease onset.”

This study is in line with another study that shows Canada has one of the highest incidences of adult IBD in the world.

“This study is an important complement to the Crohn’s and Colitis Foundation of Canada’s report ‘The Burden of Inflammatory Bowel Disease in Canada,' which was publicly released in November 2008 (www.ccfc.ca). We previously had very little information on the rates of childhood IBD. The CCFC is committed to raising awareness of IBD, educating Canadian society about IBD, and informing healthy public policy decisions related to IBD," says Dr. Kevin Glasgow, CEO of the CCFC.

Author affiliations: ICES (Benchimol, Guttmann, Rabeneck, To, Guan); Division of Gastroenterology, Hepatology & Nutrition (Benchimol, Griffiths); Division of Paediatric Medicine (Guttmann) Child Health Evaluative Sciences, The Hospital for Sick Children (Benchimol, To); Department of Health Policy, Management and Evaluation (Benchimol, Guttmann, Rabeneck, To); Department of Paediatrics (Benchimol, Guttmann, Griffiths); Department of Medicine (Rabeneck); Dalla Lana School of Public Health, University of Toronto (Rabeneck, To); Division of Gastroenterology, Sunnybrook Health Sciences Centre (Rabeneck); Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Eastern Ontario (Mack); Division of Gastroenterology and Nutrition, McMaster Children's Hospital (Brill); Department of Paediatrics, London Health Sciences Centre (Howard).

The study "Increasing incidence of paediatric inflammatory bowel disease in Ontario, Canada: evidence from health administrative data" was published on the website of the journal Gut (gut.bmj.com).

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of health care issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting health care needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.

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