英国炎症性肠病的流行病学和结局变化模式：2000-2018 年。
Changing patterns in the epidemiology and outcomes of inflammatory bowel disease in the United Kingdom: 2000-2018.
机构信息
Sandwell & West Birmingham Hospitals NHS Trust, West Bromwich, UK.
Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
出版信息
Aliment Pharmacol Ther. 2020 May;51(10):922-934. doi: 10.1111/apt.15701. Epub 2020 Apr 1.
BACKGROUND
Data regarding incidence, prevalence and long-term outcomes of inflammatory bowel diseases in the UK are limited or outdated.
AIMS
To investigate incidence and prevalence of Crohn's disease and ulcerative colitis and risk of colorectal cancer and all-cause mortality in these diseases.
METHODS
Inflammatory bowel disease cases between 2000 and 2018 were identified from a national primary care database. Inflammatory bowel disease prevalence was forecast until 2025. The association between inflammatory bowel disease and colorectal cancer and all-cause mortality was investigated using age/sex-matched retrospective cohort studies. Hazard ratios were adjusted for age, sex, deprivation, comorbidity, smoking status and body mass index.
RESULTS
Ulcerative colitis prevalence increased from 390 to 570 per 100 000 population from 2000 to 2017. Prevalence of Crohn's disease increased from 220 to 400 per 100 000. In 2017 male Crohn's disease prevalence was 0.35% (95% confidence interval 0.34-0.36); female prevalence was 0.44% (0.43-0.45). Prevalence of inflammatory bowel disease is predicted to be 1.1% by 2025. Incidence of ulcerative colitis and Crohn's disease was 23.2 (22.8-23.6) and 14.3 (14.0-14.7) per 100 000 person-years respectively. Subjects with ulcerative colitis were more likely to develop colorectal cancer than controls (adjusted Hazard Ratio 1.40 [1.23-1.59]). Colorectal cancer rates remained stable in inflammatory bowel diseases over time. Ulcerative colitis and Crohn's disease were associated with increased risk of all-cause mortality (1.17 [1.14-1.21] and 1.42 [1.36-1.48] respectively).
CONCLUSIONS
The UK prevalence of inflammatory bowel disease is greater than previous reports suggest and we predict an 11% increase in prevalence by the year 2025. Mortality risk in inflammatory bowel disease and colorectal cancer risk in ulcerative colitis are increased compared to matched controls.
背景
英国有关炎症性肠病的发病率、患病率和长期结果的数据有限或已过时。
目的
研究克罗恩病和溃疡性结肠炎的发病率和患病率，以及这些疾病中结直肠癌和全因死亡率的风险。
方法
从全国初级保健数据库中确定了 2000 年至 2018 年期间的炎症性肠病病例。预测了到 2025 年炎症性肠病的患病率。使用年龄/性别匹配的回顾性队列研究来研究炎症性肠病与结直肠癌和全因死亡率之间的关联。风险比通过年龄、性别、贫困程度、合并症、吸烟状况和体重指数进行调整。
结果
溃疡性结肠炎的患病率从 2000 年至 2017 年从每 100000 人 390 例增加到 570 例。克罗恩病的患病率从每 100000 人 220 例增加到 400 例。2017 年男性克罗恩病的患病率为 0.35%（95%置信区间 0.34-0.36）；女性患病率为 0.44%（0.43-0.45）。预计到 2025 年，炎症性肠病的患病率将达到 1.1%。溃疡性结肠炎和克罗恩病的发病率分别为每 100000 人 23.2（22.8-23.6）和 14.3（14.0-14.7）例。溃疡性结肠炎患者比对照组更容易发生结直肠癌（调整后的风险比为 1.40[1.23-1.59]）。随着时间的推移，结直肠癌在炎症性肠病中的发生率保持稳定。溃疡性结肠炎和克罗恩病与全因死亡率增加相关（分别为 1.17[1.14-1.21]和 1.42[1.36-1.48]）。
结论
英国炎症性肠病的患病率高于之前的报告，我们预计到 2025 年患病率将增加 11%。与匹配对照组相比，炎症性肠病患者的死亡率风险和溃疡性结肠炎的结直肠癌风险增加。
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