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Past and future burden of inflammatory bowel diseases based on modeling of population-based data

Coward S, Clement F, Benchimol EI, Bernstein CN, Avina-Zubieta JA, Bitton A, Carroll MW, Hazlewood G, Jacobson K, Jelinski S, Deardon R, Jones JL, Kuenzig ME, Leddin D, McBrien KA, Murthy SK, Nguyen GC, Otley AR, Panaccione R, Rezaie A, Rosenfeld G, Pena-Sanchez JN, Singh H, Targownik LE, Kaplan GG. Gastroenterology. 2019; Jan 10 [Epub ahead of print].

Background and Aims — Inflammatory bowel diseases (IBD) exist worldwide, with high prevalence in North America. IBD is complex and costly, and its increasing prevalence places a greater stress on healthcare systems. We aimed to determine the past, current, and future prevalence of IBD in Canada.

Methods — We performed a retrospective cohort study using population-based health administrative data from: Alberta (2002-2015), British Columbia (1997-2014), Manitoba (1990-2013), Nova Scotia (1996-2009), Ontario (1999-2014), Quebec (2001-2008), and Saskatchewan (1998-2016). Autoregressive integrated moving average regression was applied, and prevalence, with 95% prediction intervals (PI), was forecasted to 2030. Average annual percentage change, with 95% CIs, was assessed with log binomial regression.

Results — In 2018, the prevalence of IBD in Canada is estimated at 725 per 100,000 (95% PI, 716–735) and annual average percent change is estimated at 2.86% (95% CI, 2.80%–2.92%). Forecasted prevalence in 2030 is forecasted to be 981 per 100,000 (95% PI, 963–999) with a forecasted prevalence of 159 per 100,000 (95% PI, 133–185) in children; 1118 per 100,000 (95% PI, 1069–1168) in adults; and, 1370 per 100,000 (95% PI, 1312–1429) in the elderly. In 2018, 267,983 (95% PI, 264,579–271,387) Canadians are estimated to be living with IBD, which is forecasted to grow to 402,853 (95% PI, 395,466–410,240) by 2030.

Conclusion — Forecasting prevalence will allow health policy makers to develop policy that is necessary to address the challenges faced by health systems in providing high quality and cost-effective care.