Intest Res.  2019 Jan;17(1):54-62. 10.5217/ir.2018.00096.

Epidemiological trend in inflammatory bowel disease in Taiwan from 2001 to 2015: a nationwide populationbased study

Affiliations
  • 1Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan. shuchenwei@ntu.edu.tw
  • 2Department of Endoscopy Center, Changhua Christian Hospital, Changhua, Taiwan.
  • 3Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei, Taiwan.
  • 4Department of Integrated Diagnostics & Therapeutics, National Taiwan University Hospital, Taipei, Taiwan.
  • 5Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan.
  • 6Department of Public Health, National Taiwan University, Taipei, Taiwan.
  • 7Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan, Taiwan.
  • 8Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, Taiwan.
  • 9Department of Inflammatory Bowel Disease Clinical and Study Integrated Center, National Taiwan University Hospital, Taipei, Taiwan.

Abstract

BACKGROUND/AIMS
Incidences of inflammatory bowel disease (IBD), ulcerative colitis (UC), and Crohn's disease (CD), have been increasing in Asia. In this study, we report the relevant clinical characteristics and determined the epidemiological trend of IBD in Taiwan from 2001 to 2015.
METHODS
A retrospective study was conducted to analyze data recorded from January 2001 through December 2015 in the registered database compiled by the National Health Insurance and provided by the Ministry of Health and Welfare, Taiwan.
RESULTS
A total of 3,806 patients with catastrophic IBD illness were registered from 2001 to 2015 in Taiwan (CD, 919; UC, 2,887). The crude incidence of CD increased from 0.17/100,000 in 2001 to 0.47/100,000 in 2015, whereas that of UC increased from 0.54/100,000 in 2001 to 0.95/100,000 in 2015. The prevalence of CD increased from 0.6/100,000 in 2001 to 3.9/100,000 in 2015, whereas that of UC increased from 2.1/100,000 in 2001 to 12.8/100,000 in 2015. The male-to-female ratio in the study sample was 2.19 for CD and 1.62 for UC. The median age of those registered with CD was lower than that of those registered for UC: 38.86 and 44.86 years, respectively. A significantly greater increase in CD incidence rate was identified among 20 to 39-year-old compared with other age groups.
CONCLUSIONS
Using Taiwan's nationwide insurance database, we determined that the number of patients with CD increased more rapidly during the study period than the number of patients with UC, especially among age 20 to 39-year-old, resulting in a decreased UC-to-CD ratio.

Keyword

Crohn disease; Colitis, ulcerative; Incidence; Prevalence; Taiwan

MeSH Terms

Adult
Asia
Colitis, Ulcerative
Crohn Disease
Humans
Incidence
Inflammatory Bowel Diseases*
Insurance
National Health Programs
Prevalence
Retrospective Studies
Taiwan*

Figure

  • Fig. 1. Incidence of IBD from 2001 to 2015 in Taiwan.

  • Fig. 2. Prevalence of IBD from 2001 to 2015 in Taiwan.

  • Fig. 3. Incidence rate ratio of UC to CD over time. Comparisons between stages 3 and 1 and stages 3 and 2 revealed significant differences. No significant difference was observed between stages 1 and 2. aComparison the UC/CD ratio between stages 1, 2, and 3.

  • Fig. 4. Incidence of CD from 2001 to 2015 stratified by patient age.

  • Fig. 5. Sex ratio (male to female) of patients with IBD in Taiwan from 2001 to 2015.

  • Fig. 6. Age distribution of patients with CD and UC from 2001 to 2015 in Taiwan.

  • Fig. 7. Temporal trends in the UC-to-CD ratio from populationbased studies in Western and Asian countries. Data Sources: Hong Kong (1981–2014) [12], Canada (1996–2009) [22], Korea (2006–2012) [19], Korea (1986–2005) [13], Denmark (1980–2013) [23], Quebec (2001–2008) [24], the Faroe Islands (1960–2014) [9], Taiwan (2001–2015): present study.


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