Epidemiological Aspects of Crohn’s Disease

Chapter

Abstract

Crohn’s Disease (CD) is considered a result of multifactorial interplay between genetic, immune-related, environmental, and infectious triggers all contributing into evolution of clinical disease.

The age of onset of Crohn’s disease has a bimodal distribution. The first peak occurs between the ages of 15 and 30 years (late adolescence and early adulthood), and the second occurs mainly in women between the ages of 60 and 70 years.

In general, the frequency of CD is similar in males and females, with some studies showing a very slight female predominance.

The rate of Crohn’s disease is 1.1–1.8 times higher in women than in men. This pattern is reversed with pediatric CD, which has a higher incidence in boys than in girls (pediatric male-to-female ratio, ~1.6:1).

References

  1. 1.
    Duerr RH. Update on the genetics of inflammatory bowel disease. J Clin Gastroenterol. 2003;37(5):358–67.CrossRefPubMedGoogle Scholar
  2. 2.
    Gaya DR, Russell RK, Nimmo ER, et al. New genes in inflammatory bowel disease: lessons for complex diseases? Lancet. 2006;367:1271–84.CrossRefPubMedGoogle Scholar
  3. 3.
    Molodecky NA, Soon IS, Rabi DM, et al. Increasing incidence and prevalence of the inflammatory bowel diseases with time. Based on systematic review. Gastroenterology. 2012;142:46–54.CrossRefPubMedGoogle Scholar
  4. 4.
    Binder V. Epidemiology of I BD during the twentieth century: an integrated view. Best Pract Res Clin Gastroenterol. 2004;18:463–79.CrossRefPubMedGoogle Scholar
  5. 5.
    Hovde Ø, Moum BA. Epidemiology and clinical course of Crohn’s disease: results from observational studies. World J Gastroenterol. 2012;18(15):1723–31.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Jess T, Loftus Jr EV, Harmsen WS, et al. Survival and cause specific mortality in patients with inflammatory bowel disease: a long term outcome study in Olmsted County, Minnesota, 1940-2004. Gut. 2006;55:1248–54.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Ogunbi SO, Ransom JA, Sullivan K, et al. Inflammatory bowel disease in African-American children living in Georgia. J Pediatr. 1998;133:103–7.CrossRefPubMedGoogle Scholar
  8. 8.
    Mendelhoff AI, Calkin BM. The epidemiology of inflammatory bowel disease. In: Kirsner JB, Shorter RG, editors. Inflammatory bowel disease. 3rd ed. Philadelphia: Lea and Febriger; 1988. p. 3–34.Google Scholar
  9. 9.
    Depew WT. Clinical presentation and course of Crohn’s disease in south-eastern Ontario. Can J Gastroenterol. 1988;2:107–16.CrossRefGoogle Scholar
  10. 10.
    Appleyard CB, Hernandez G, Rios-Bedoya CF. Basic epidemiology of inflammatory bowel disease in Puerto Rico. Inflamm Bowel Dis. 2004;10:106–11.CrossRefPubMedGoogle Scholar
  11. 11.
    Linares de la Cal JA, Canton C, Pajares JM, et al. Inflammatory bowel disease in Argentina and Panama (1987-1993). Eur J Gastroenterol Hepatol. 1997;9:1129.CrossRefPubMedGoogle Scholar
  12. 12.
    Figueroa CC, Quera PR, Valenzuela EJ, et al. Inflammatory bowel disease: experience of two Chilean centers. Rev Med Chil. 2005;133:1295–304.Google Scholar
  13. 13.
    Souza MH, Troncon LE, Rodrigues CM, et al. T rends in the occurrence (1980-1999) and clinical features of Crohn’s disease and ulcerative colitis in a university hospital in southeastern Brazil. Arq Gastroenterol. 2002;39:98–105.CrossRefPubMedGoogle Scholar
  14. 14.
    Shivananda S, Lennard-Jones J, Logan R, et al. Incidence of inflammatory bowel disease across Europe: is there a difference between north and south? Results of the European Collaborative Study on Inflammatory Bowel Disease (ECIBD). Gut. 1996;39:690–7.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Ekbom A, Helmick C, Zack M, et al. The epidemiology of inflammatory bowel disease: a large, population-based study in Sweden. Gastroenterology. 1991;100:350–8.CrossRefPubMedGoogle Scholar
  16. 16.
    Moum B, Vatn MH, Ekbom A, et al. Incidence of Crohn’s disease in four counties in southeastern Norway, 1990-93. A prospective population- based study. The Inflammatory Bowel South-Eastern Norway (IBSEN) Study Group of Gastroenterologists. Scand J Gastroenterol. 1996;31:355–61.CrossRefPubMedGoogle Scholar
  17. 17.
    Sepp E, Julge K, Vasar M, et al. Intestinal microflora of Estonian and Swedish infants. Acta Paediatr. 1997;86:956–61.CrossRefPubMedGoogle Scholar
  18. 18.
    Armitage EL, Aldhous MC, Anderson N, et al. Incidence of juvenile-onset Crohn’s disease in Scotland: association with northern latitude and affluence. Gastroenterology. 2004;127(4):1051–7.CrossRefPubMedGoogle Scholar
  19. 19.
    Fellows IW, Freeman JG, Holmes GK. Crohn’s disease in the city of Derby, 1951-85. Gut. 1990;31:1262–5.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Economou M, Zambeli E, Michopoulos S, et al. Incidence and prevalence of Crohn’s disease and its etiological influences. Ann Gastroenterol. 2009;22(3):158–67.Google Scholar
  21. 21.
    Mate-Jimenez J, Munoz S, Vicent D, et al. Incidence and prevalence of ulcerative colitis and Crohn’s disease in urban and rural areas of Spain from 1981 to 1988. J Clin Gastroenterol. 1994;18:27–31.CrossRefPubMedGoogle Scholar
  22. 22.
    Di Domenicantonio R, Cappai G, Arcà M, et al. Occurrence of inflammatory bowel disease in central Italy: a study based on health information systems. Dig Liver Dis. 2014;46:777–82.CrossRefPubMedGoogle Scholar
  23. 23.
    Economou M, Filis G, Tsianou Z, et al. Crohn’s disease incidence evolution in North-western Greece is not associated with alteration of NOD2/CARD15 variants. World J Gastroenterol. 2007;13:5116–20.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Ahuja V, Tandon RK. Inflammatory bowel disease in the Asia-Pacific area: a comparison with developed countries and regional differences. J Dig Dis. 2010;11:134–47.CrossRefPubMedGoogle Scholar
  25. 25.
    Thoreson R, Cullen JJ. Pathophysiology of inflammatory bowel disease: an overview. Surg Clin North Am. 2007;87(3):575–85.CrossRefPubMedGoogle Scholar
  26. 26.
    Hampe J, Grebe J, Nikolaus S, et al. Association of NOD2 (CARD 15) genotype with clinical course of Crohn’s disease: a cohort study. Lancet. 2002;359(9318):1661–5.CrossRefPubMedGoogle Scholar
  27. 27.
    Glas J, Seiderer J, Wetzke M, et al. rs1004819 is the main disease-associated IL23R variant in German Crohn’s disease patients: combined analysis of IL23R, CARD15, and OCTN1/2 variants. PLoS One. 2007;2(9):e819.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Barrett JC, Hansoul S, Nicolae DL, Cho JH, Duerr RH, Rioux JD, et al. Genome-wide association defines more than 30 distinct susceptibility loci for Crohn’s disease. Nat Genet. 2008;40(8):955–62.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Hampe J, Franke A, Rosenstiel P, Till A, Teuber M, Huse K, et al. A genome-wide association scan of nonsynonymous SNPs identifies a susceptibility variant for Crohn disease in ATG16L1. Nat Genet. 2007;39(2):207–11.CrossRefPubMedGoogle Scholar
  30. 30.
    Wellcome Trust Case Control Consortium. Genome-wide association study of 14,000 cases of seven common diseases and 3,000 shared controls. Nature. 2007;447(7145):661–78.CrossRefGoogle Scholar
  31. 31.
    Sandborn WJ, Hanauer SB, Rutgeerts P, et al. Adalimumab for maintenance treatment of Crohn’s disease: results of the CLASSIC II trial. Gut. 2007;56(9):1232–9).Google Scholar
  32. 32.
    Lindberg E, Järnerot G, Huitfeldt B. Smoking in Crohn’s disease: effect on localisation and clinical course. Gut. 1992;33(6):779–82.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    D’Souza S, Levy E, Mack D, Israel D, Lambrette P, Ghadirian P. Dietary patterns and risk for Crohn’s disease in children. Inflamm Bowel Dis. 2008;14(3):367–73.CrossRefPubMedGoogle Scholar
  34. 34.
    Davis RL, Kramarz P, Bohlke K, Benson P, Thompson RS, Mullooly J, et al. Measles-mumps-rubella and other measles-containing vaccines do not increase the risk for inflammatory bowel disease: a case-control study from the Vaccine Safety Datalink project. Arch Pediatr Adolesc Med. 2001;155(3):354–9.CrossRefPubMedGoogle Scholar
  35. 35.
    Kaplan GG, Jackson T, Sands BE, Frisch M, Andersson RE, Korzenik J. The risk of developing Crohn’s disease after an appendectomy: a meta-analysis. Am J Gastroenterol. 2008;103:2925–31.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of Sciences for Health Promotion and Mother to Child care “G.D’Alessandro”- University of PalermoPreventive Medicine and Public Health – University of PalermoPalermoItaly

Personalised recommendations