Current and projected incidence trends of pediatric-onset inflammatory bowel disease in Germany based on the Saxon Pediatric IBD Registry 2000-2014 -a 15-year evaluation of trends

PLoS One. 2022 Sep 9;17(9):e0274117. doi: 10.1371/journal.pone.0274117. eCollection 2022.

Abstract

Aims: An increasing number of children and adolescents worldwide suffer from inflammatory bowel disease (IBD) such as Crohn's disease (CD) and ulcerative colitis (UC). The present work aims to investigate the incidence, prevalence and future trends of IBD in children and adolescents in Saxony, Germany.

Methods: The Saxon Pediatric IBD Registry collected data on patients up to 15 years of age from all 31 pediatric hospitals and pediatric gastroenterologists in Saxony over a 15-year period (2000-2014). In 2019, an independent survey estimated a registry completeness of 95.7%. Age-standardized incidence rates (ASR) per 100,000 person-years (PY) and prevalence per 100,000 children and adolescents were calculated. Evaluation was also been performed in sex and age subgroups. Joinpoint and Poisson regression were used for trend analyses and projections.

Results: 532 patients with confirmed IBD during 2000-2014 were included in the epidemiological evaluation. 63.5% (n = 338) patients had CD, 33.1% (n = 176) had UC and 3.4% (n = 18) had unclassified IBD (IBD-U). The 15-year IBD prevalence was 111.8 [95%-CI: 102.3-121.3] per 100,000. The incidence ASR of IBD per 100,000 PY over the whole observation period was 7.5 [6.9-8.1]. ASR for the subtypes were 4.8 [4.3-5.3] for CD, 2.5 [2.1-2.9] for UC and 0.3 [0.1-0.4] for IBD-U. The trend analysis of ASR using the joinpoint regression confirmed a significant increase for incidence of IBD as well as CD. For IBD, the ASR per 100,000 PY increased from 4.6 [2.8-6.3] in 2000 to 8.2 [7.5-13.6] in 2014; projected incidence rates for IBD in Germany are 12.9 [6.5-25.5] in the year 2025 and 14.9 [6.7-32.8] in 2030, respectively. Thus, the number of new IBD diagnoses in Germany would more than triple (325%) in 2030 compared to 2000. The increase is expected to be faster in CD than UC, and be more in males than in females. The expected number of newly diagnosed children with IBD in Germany is projected to rise to about 1,584 [1,512-1,655] in 2025, and to about 1,918 [1,807-2,29] in 2030.

Conclusion: The incidence of IBD in children and adolescents in Saxony increased at a similar rate as in other developed countries during the observation period. Given this trend, the health care system must provide adequate resources for the care of these young patients in the future.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Chronic Disease
  • Colitis, Ulcerative* / epidemiology
  • Crohn Disease* / epidemiology
  • Female
  • Germany / epidemiology
  • Humans
  • Incidence
  • Inflammatory Bowel Diseases* / epidemiology
  • Male
  • Registries

Grants and funding

short: All authors, with the exception of IK, worked for the registry voluntarily and free of charge. The Registry received support from German Competence Network for Bowel Disease (BMBF) = Kompetenznetz Darmerkrankungen (https://www.kompetenznetz-darmerkrankungen.de) and from GPGE = Gesellschaft für Pädiatrische Gastroenterologie und Ernährung e.V. (www.gpge.eu). IK received the scholarship ESF = European Social Fund and the Federal State of Saxony; Grant No. 100316833 (www.esf.de). We acknowledge the support by the Open Access Publication Funds of the SLUB/TU Dresden. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Version no. 2 - more Text: All authors, with the exception of IK, worked for the registry voluntarily and free of charge. The epidemiological studies on the Saxon Pediatric IBD Registry were sometimes supported and funded, respectively by the German Competence Network for Bowel Disease (BMBF) = Kompetenznetz Darmerkrankungen (https://www.kompetenznetz-darmerkrankungen.de) and the Society for Pediatric Gastroenterology and Nutrition (GPGE) = Gesellschaft für Pädiatrische Gastroenterologie und Ernährung e.V. (www.gpge.eu). This, however, did not bias our results in any way. And the European Social Fund (ESF) and the Federal State of Saxony; Grant No. 100316833 (www.esf.de) funded IK; the completion and validation of the data as well as the evaluation since 2017. We acknowledge the support by the Open Access Publication Funds of the Saxon State Library - Dresden State and University Library (SLUB Dresden) for funding of the open access publication. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.