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Changes in clinical characteristics, course, and prognosis of inflammatory bowel disease during the last 5 decades : A population-based study from Copenhagen, Denmark

Jess, Tine; Riis, Lene; Vind, Ida; Winther, Karen Vanessa; Borg, Sixten LU ; Binder, Vibeke; Langholz, Ebbe; Thomsen, Ole Østergaard and Munkholm, Pia (2007) In Inflammatory Bowel Diseases 13(4). p.481-489
Abstract

Background: It remains uncertain whether the increasing incidence of inflammatory bowel disease (IBD) during the last decades has been accompanied by an alteration in the presentation, course, and prognosis of the disease. To answer this question, 3 consecutive population-based IBD cohorts from Copenhagen, Denmark (1962-2005), were assessed and evaluated. Methods: Phenotype, initial disease course, use of medications, cumulative surgery rate, standardized incidence ratio of colorectal cancer (CRC), and standardized mortality ratio (SMR) were compared in the 3 cohorts, which had a total of 641 patients with Crohn's disease (CD) and 1575 patients with ulcerative colitis (UC). Results: From 1962 to 2005, the proportion of IBD patients... (More)

Background: It remains uncertain whether the increasing incidence of inflammatory bowel disease (IBD) during the last decades has been accompanied by an alteration in the presentation, course, and prognosis of the disease. To answer this question, 3 consecutive population-based IBD cohorts from Copenhagen, Denmark (1962-2005), were assessed and evaluated. Methods: Phenotype, initial disease course, use of medications, cumulative surgery rate, standardized incidence ratio of colorectal cancer (CRC), and standardized mortality ratio (SMR) were compared in the 3 cohorts, which had a total of 641 patients with Crohn's disease (CD) and 1575 patients with ulcerative colitis (UC). Results: From 1962 to 2005, the proportion of IBD patients suffering from CD increased (P < 0.001), time from onset of symptoms to diagnosis of CD decreased (P = 0.001), and median age at diagnosis of UC increased (P < 0.01). The prevalence of upper gastrointestinal involvement and pure colonic CD varied significantly between cohorts. UC patients diagnosed in the 1990s had a higher prevalence of proctitis, received more medications, and had a milder initial disease course than did previous patients. The surgery rate decreased significantly in CD but not in UC. The risk of CRC in IBD was close to expected over the entire period, whereas the mortality of patients with CD increased (overall SMR, 1.31; 95% CI, 1.07-1.60). Conclusions: Despite variations in the presentation and initial course of IBD during the last 5 decades, its long-term prognosis remained fairly stable. Treatment of IBD changed recently, and future studies should address the effect of these changes on long-term prognosis.

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author
publishing date
type
Contribution to journal
publication status
published
keywords
Epidemiology, Inflammatory bowel disease, Prognosis, Treatment
in
Inflammatory Bowel Diseases
volume
13
issue
4
pages
9 pages
publisher
John Wiley & Sons
external identifiers
  • scopus:34247586997
ISSN
1078-0998
DOI
10.1002/ibd.20036
language
English
LU publication?
no
id
dd7955e2-fe82-47bb-83fd-f7913818345a
date added to LUP
2018-10-20 09:42:26
date last changed
2019-09-15 05:10:16
@article{dd7955e2-fe82-47bb-83fd-f7913818345a,
  abstract     = {<p>Background: It remains uncertain whether the increasing incidence of inflammatory bowel disease (IBD) during the last decades has been accompanied by an alteration in the presentation, course, and prognosis of the disease. To answer this question, 3 consecutive population-based IBD cohorts from Copenhagen, Denmark (1962-2005), were assessed and evaluated. Methods: Phenotype, initial disease course, use of medications, cumulative surgery rate, standardized incidence ratio of colorectal cancer (CRC), and standardized mortality ratio (SMR) were compared in the 3 cohorts, which had a total of 641 patients with Crohn's disease (CD) and 1575 patients with ulcerative colitis (UC). Results: From 1962 to 2005, the proportion of IBD patients suffering from CD increased (P &lt; 0.001), time from onset of symptoms to diagnosis of CD decreased (P = 0.001), and median age at diagnosis of UC increased (P &lt; 0.01). The prevalence of upper gastrointestinal involvement and pure colonic CD varied significantly between cohorts. UC patients diagnosed in the 1990s had a higher prevalence of proctitis, received more medications, and had a milder initial disease course than did previous patients. The surgery rate decreased significantly in CD but not in UC. The risk of CRC in IBD was close to expected over the entire period, whereas the mortality of patients with CD increased (overall SMR, 1.31; 95% CI, 1.07-1.60). Conclusions: Despite variations in the presentation and initial course of IBD during the last 5 decades, its long-term prognosis remained fairly stable. Treatment of IBD changed recently, and future studies should address the effect of these changes on long-term prognosis.</p>},
  author       = {Jess, Tine and Riis, Lene and Vind, Ida and Winther, Karen Vanessa and Borg, Sixten and Binder, Vibeke and Langholz, Ebbe and Thomsen, Ole Østergaard and Munkholm, Pia},
  issn         = {1078-0998},
  keyword      = {Epidemiology,Inflammatory bowel disease,Prognosis,Treatment},
  language     = {eng},
  month        = {04},
  number       = {4},
  pages        = {481--489},
  publisher    = {John Wiley & Sons},
  series       = {Inflammatory Bowel Diseases},
  title        = {Changes in clinical characteristics, course, and prognosis of inflammatory bowel disease during the last 5 decades : A population-based study from Copenhagen, Denmark},
  url          = {http://dx.doi.org/10.1002/ibd.20036},
  volume       = {13},
  year         = {2007},
}