Racial/Ethnic and Regional Differences in the Prevalence of Inflammatory Bowel Disease in the United StatesWang Y.R.a, b · Loftus Jr. E.V.c · Cangemi J.R.a · Picco M.F.a
aDivision of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Fla., bLeonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pa., and cDivision of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minn., USA
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Background: The magnitude of racial/ethnic and regional differences in the prevalence of inflammatory bowel disease (IBD) in the United States remains largely unknown. Aims: To estimate differences in the prevalence of IBD by race/ethnicity and region. Methods: The Medical Expenditure Panel Survey, a nationally representative survey of US households and medical conditions, was used. A multivariate logistic model was used in statistical analysis. Results: Among 202,468 individuals surveyed during 1996-2007, 316 were diagnosed with IBD (26 Blacks, 21 Hispanics, and 5 Asians). The prevalence of IBD was higher in Whites [Crohn's disease: 154; ulcerative colitis (UC): 89] than Blacks (Crohn's disease: 68; UC: 25), Hispanics (Crohn's disease: 15; UC: 35), and Asians (Crohn's: 45; UC: 40) (all p < 0.05, except for UC in Asians). The differences in Crohn's disease between Whites and minorities and the difference in UC between Whites and Blacks remained significant in multivariate analysis. In multivariate analysis, there was no regional difference in the prevalence of Crohn's disease, but the prevalence of UC was higher in the Northeast than the South (p < 0.05). Conclusions: There were significant racial/ethnic differences in the prevalence of IBD in the USA. The underlying etiology of these differences warrants additional research.
© 2013 S. Karger AG, Basel
- Loftus EV Jr: Clinical epidemiology of inflammatory bowel disease: incidence, prevalence, and environmental influences. Gastroenterology 2004:126:1504-1517.
- Loftus EV Jr, Silverstein MD, Sandborn, et al: Crohn's disease in Olmsted County, Minnesota, 1940-1993: incidence, prevalence, and survival. Gastroenterology 1998;114:1161-1168.
- Loftus EV Jr, Silverstein MD, Sandborn WJ, et al: Ulcerative colitis in Olmsted Country, Minnesota, 1940-1993: incidence, prevalence, and survival. Gut 2000;46:336-343.
- Loftus CG, Loftus EV Jr, Harmsen WS, et al: Update on the incidence and prevalence of Crohn's disease and ulcerative colitis in Olmsted Country, Minnesota, 1940-2000. Inflamm Bowel Dis 2007;13:254-261.
- Kappelman MD, Rifas-Shiman SL, Kleinman K, et al: The prevalence and geographic distribution of Crohn's disease and ulcerative colitis in the United States. Clin Gastroenterol Hepatol 2007;5:1424-1429.
- Loftus EV Jr: The burden of inflammatory bowel disease in the United States: a moving target? Clin Gastroenterol Hepatol 2007;5:1383-1384.
- Herrinton LJ, Liu L, Lafata JE, et al: Estimation of the period prevalence of inflammatory bowel disease among nine health plans using computerized diagnoses and outpatient pharmacy dispensings. Inflamm Bowel Dis 2007;13:451-461.
- Herrinton LJ, Liu L, Lewis JD, et al: Incidence and prevalence of inflammatory bowel disease in a Northern California managed care organization, 1996-2002. Am J Gastroenterol 2008;103:1998-2006.
- Kurata JH, Kantor-Fish S, Frankl H, et al: Crohn's disease among ethnic groups in a large health maintenance organization. Gastroenterology 1992;102:1940-1948.
- Pinchbeck BR, Kirdeikis J, Thomson AB: Inflammatory bowel disease in northern Alberta. An epidemiologic study. J Clin Gastroenterol 1988;10:505-515.
- Bernstein CN, Blanchard JF, Rawsthorne P, et al: Epidemiology of Crohn's disease and ulcerative colitis in a central Canadian province: a population-based study. Am J Epidemiol 1999:149:916-924.
- Straus WL, Eisen GM, Sandler RS, et al: Crohn's disease: does race matter? The Mid-Atlantic Crohn's Disease Study Group. Am J Gastroenterol 2000;95:479-483.
- Lee YM, Fock K, See SJ, et al: Racial differences in the prevalence of ulcerative colitis and Crohn's disease in Singapore. J Gastroenterol Hepatol 2000;15:622-625.
- Sood A, Midha V, Sood N, et al: Incidence and prevalence of ulcerative colitis in Punjab, North India. Gut 2003;52:1587-1590.
- Reddy SI, Burakoff R: Inflammatory bowel disease in African Americans. Inflamm Bowel Dis 2003;9:380-385.
- Basu D, Lopez L, Kulkarni A, et al: Impact of race and ethnicity on inflammatory bowel disease. Am J Gastroenterol 2005;100:2254-2261.
- Cross RK, Jung C, Wasan S, et al: Racial differences in disease phenotypes in patients with Crohn's disease. Inflamm Bowel Dis 2006;12:192-198.
- Hilmi I, Tan YM, Goh KL: Crohn's disease in adults: observations in a multiracial Asian population. World J Gastroenterol 2006;12:1435-1438.
- Nguyen GC, Torres EA, Regueiro M, et al: Inflammatory bowel disease characteristics among African Americans, Hispanics, and non-Hispanics whites: characterization of a large North American cohort. Am J Gastroenterol 2006;101:1012-1023.
- Fujimoto T, Kato J, Kuriyama M, et al: Change of clinical characteristics of ulcerative colitis in Japan: analysis of 844 hospital-based patients from 1981 to 2000. Eur J Gastroenterol Hepatol 2007;19:229-235.
- Mahid SS, Mulhall AM, Gholson RD, et al: Inflammatory bowel disease and African Americans: a systematic review. Inflamm Bowel Dis 2008;14:960-967.
- Chow DK, Leong RW, Tsoi KK, et al: Long-term follow-up of ulcerative colitis in the Chinese population. Am J Gastroenterol 2009;104:647-654.
- Hou JK, El-Serag H, Thirumurthi S: Distribution and manifestations of inflammatory bowel disease in Asians, Hispanics, and African Americans: a systemic review. Am J Gastroenterol 2009;104:2100-2109.
- Zheng JJ, Zhu XS, Huangfu Z, et al: Prevalence and incidence rates of Crohn's disease in mainland China: a meta-analysis of 55 years of research. J Dig Dis 2010;11:161-166.
- Sonnenberg A, McCarty DJ, Jacobsen SJ: Geographic variation of inflammatory bowel disease within the United States. Gastroenterology 1991;100:143-149.
- Sewell JL, Yee HF, Inadomi JM: Hospitalizations are increasing among minority patients with Crohn's disease and ulcerative colitis. Inflamm Bowel Dis 2010;16:204-207.
- Sullivan PW, Morrato EH, Ghushchyan V, et al: Obesity, inactivity, and the prevalence of diabetes and diabetes-related cardiovascular comorbidities in the U.S., 2000-2002. Diabetes Care 2005;28:1599-1603.
- Machlin S, Cohen J, Elixhauser A, et al: Sensitivity of household reported medical conditions in the Medical Expenditure Panel Survey. Med Care 2009;47:618-625.
Johnson AE, Sanchez ME: Household and medical reports on medical conditions: National Medical Expenditure Survey. J Econ Soc Meas 1993;19:199-223.
- Edwards WS, Win DM, Kurlantzick V, et al: Evaluation of National Health Interview Survey diagnostic reporting. National Center for Health Statistics, Vital Health 1994;2:120.
- Hendriksen C, Kreiner S, Binder V: Long term prognosis in ulcerative colitis - based on results from a regional patient group from the county of Copenhagen. Gut 1985;26:158-163.
- Bamias G, Nyce MR, De La Rue SA, et al: New concepts in the pathophysiology of inflammatory bowel disease. Ann Intern Med 2005;143:895-904.
- Dassopoulos T, Nguyen GC, Talor MV, et al: NOD2 mutations and anti-Saccharomyces cerevisiae antibodies are risk factors for Crohn's disease in African Americans. Am J Gastroenterol 2010;105:378-386.
- Leong RW, Armuzzi A, Ahmad T, et al: NOD/CARD15 gene polymorphisms and Crohn's disease in the Chinese population. Aliment Pharmacol Ther 2003;17:1465-1470.
- Li M, Gao X, Guo CC, et al: OCTN and CARD15 gene polymorphism in Chinese patients with inflammatory bowel disease. World J Gastroenterol 2008;14:4923-4927.
- Gent AE, Hellier MD, Grace RH, et al: Inflammatory bowel disease and domestic hygiene in infancy. Lancet 1994;343:766-767.
- Green C, Elliott L, Beaudoin C, et al: A population-based ecologic study of inflammatory bowel disease: searching for etiologic clues. Am J Epidemiol 2006;164:615-623.
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