Search in the Abstract Database

Search Abstracts 2011

* = Presenting author

P320. Prevalence of inflammatory bowel disease is high in Finland

A. Jussila1, L. Virta2, M. Färkkilä3

1Tampere University Hospital, Tampere, Finland; 2The Social Insurance Institution of Finland, Turku, Finland; 3Helsinki Central University Hospital, Helsinki, Finland

Background: Inflammatory bowel diseases (IBD) are associated with substantial morbidity and excess health care resource use. In Finland all patients with IBD are reimbursed for their medication by the National Health Insurance and this register serves as data source of this study. The Social Insurance Institution in Finland has recorded IBD patients from 1986 and diagnose codes (CD, UC) are available 1986–1993 and again from 2000.

Aim: To estimate the nationwide prevalence of IBD in Finland during 1993–2008 and to test the north-south gradient hypothesis by analyzing the comprehensive reimbursement database.

Patients and Methods: The Finnish population is about 5.3×106. This study included patients who had special reimbursement (72%) of medications for IBD in the years 1993 and 2008. The prevalence rates and PR ratios were calculated per 100.000 persons assuming a Poisson distribution.

Results: Total, 31,708 IBD-cases of IBD were recorded at December 31, 2008. This gives a nationwide point prevalence of IBD 595/100,000. The prevalence of IBD has increased nearly threefold from 1993 to 2008 (Table 1). It was notably higher in males than in females during both time periods, especially in age group over 44 years (Table 1). The highest prevalence (914) was seen at age 35–44 in 2008. In both genders the prevalence decreased with increasing age (Figure 1). In 2008 the highest prevalence (702) was seen in Oulu University Hospital region (North) and lowest (554) in Helsinki (South); regional PRR 1.31 (1.27–1.36), p < 0.001. Also in 1993 the highest prevalence of IBD and UC were seen in the Oulu University Hospital region. For CD no statistically significant difference in the prevalence between geographical regions were observed and no north-south gradient was seen.

Conclusions: Prevalence of IBD is high in Finland and has increased from 1993 to 2008. IBD is markedly more common in male over 44 years. A clear north-south gradient was shown for UC, but not for CD. To the best of our knowledge, the prevalence for IBD in this nation-wide study is one of the highest ever reported.

Table 1
  AllPrevalence rateMalePrevalence rateFemalePrevalence rateGender PRR aged <45 yGender PRR aged >45 y
Year N(95%CI)N(95%CI)N(95%CI)(95%CI)(95% CI)
1993UC9013177 (174–181)4982202 (196–207)4031155 (150–159)1.04 (80.98–1.10)1.74 (1.63–1.85)
1993CD194538 (37–40)95639 (36–41)98938 (36–40)0.96 (0.86–1.18)1.01 (0.86–1.18)
1993IBD10958216 (212–220)5938240 (234–247)5020192 (187–198)1.02 (0.97–1.07)1.61 (1.52–1.71)
2008IBD31703595 (589–602)16680639 (629–648)15023553 (545–562 (1.03 (0.99–1.06)1.26 (1.22–1.30)

1. Kappelman MD, Rifas-Shiman SL, Kleinman K et al. The prevalence and geographic distribution of Crohn's disease and ulcerative colitis in the Unites States. Clin Gastroenterol Hepatol. 2007;5:1424–9.

2. Nerich V, Monnet E, Etienne A et al. Geographical variations of inflammatory bowel disease in France: a study based on national health insurance data. Inflamm Bowel Dis 2006; 12:218–26.