Forecasting the incidence and prevalence of inflammatory bowel disease: a Canadian nationwide analysis

Objective — Canada has a high burden of inflammatory bowel disease (IBD). Historical trends of IBD incidence and prevalence were analyzed to forecast the Canadian burden over the next decade.

Methods — Population-based surveillance cohorts in eight provinces derived from health administrative data assessed the national incidence (2007–2014) and prevalence (2002–2014) of IBD. Autoregressive integrated moving average models were used to forecast incidence and prevalence, stratified by age, with 95% prediction intervals (PIs), to 2035. The average annual percentage change (AAPC), with 95% confidence interval (CI) were calculated for the forecasted incidence and prevalence.

Results — The national incidence of IBD is estimated to be 29.9 per 100,000 (95%PI: 28.3, 31.5) in 2023. With a stable AAPC of 0.36% (95%CI: −0.05, 0.72), the incidence of IBD is forecasted to be 31.2 per 100,000 (95%PI: 28.1, 34.3) in 2035. The incidence in pediatrics (<18 years) is increasing (AAPC:1.27%; 95%CI: 0.82, 1.67), but stable in adults (AAPC: 0.26%; 95%CI: −0.42, 0.82). The prevalence of IBD in Canada was 843 per 100,000 (95%PI: 716, 735) in 2023 and is expected to steadily climb (AAPC: 2.43%; 95%CI: 2.32, 2.54) to 1,098 per 100,000 (95%PI: 1068, 1127) by 2035. The highest prevalence is in seniors with IBD (1174 per 100,000 in 2023; AAPC: 2.78%; 95%CI: 2.75, 2.81).

Conclusion — Over the next decade, the Canadian healthcare systems will contend with the juxtaposition of rising incidence of pediatric IBD and a rising prevalence of overall IBD driven by the aging population.