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P081. Clinical and phenotypic characteristics of ulcerative colitis at diagnosis according to age: A population-based study

C. Charpentier1, G. Savoye2, M. Fumery3, J. Salleron4, V. Merle5, J.‑L. Dupas6, A. Cortot7, L. Peyrin-Biroulet8, E. Lerebours9, C. Gower-Rousseau10, J.‑F. Colombel11

1Rouen University and Hospital, Gastroenterology, Rouen, France; 2Hôpital Charles Nicolle, Department of Gastroenterology, Rouen, France; 3Amiens University and Hospital, Gastroenterology, Amiens, France; 4Lille University Hospital, Epidemiology Unit, Lille, France; 5Hospital and University, Rouen, France; 6Amiens University Hospital North Hospital, Dept. of Hepagastroenterology, Amiens, France; 7Lille University Hospital, Lille, France; 8University Hospital of Nancy, Hepato-Gastroenterology, Vandoeuvre-Lès-Nancy, France; 9Hôpital Charles Nicolle, Rouen, France; 10Lille University Hospital, Epidemiology Unit, EPIMAD Registry, Lille, France; 11Centre Hospitalier Universitaire de Lille, Hôpital Claude Huriez, Lille, France

Background: Little is known about variations in clinical and phenotypic characteristics of ulcerative colitis (UC) at diagnosis in relation with age. The aim of our study was to compare the clinical and phenotypic characteristics of UC between 4 groups of age in a population-based cohort.

Methods: Four incident cohorts of patients with definite or probable UC recruited from 1988 to 2010 were extracted from the EPIMAD Registry [1]: (1) <17 years (G1), (2) 17–39 years (G2), (3) 40–59 years (G3) and (4) >60 years (G4).

Results: A total of 5253 patients were included: 255 in G1 (5%), 2949 in G2 (56%), 1430 in G3 (27%), and 639 in G4 (12%). Median age at UC diagnosis was 14 [CI95%;12–16], 29 [24–34], 49 [45–54] and 68 [64–74], respectively. The clinical and phenotypic characteristics of the study groups at UC diagnosis are presented in the table.

At UC diagnosisG1 (N = 255)G2 (N = 2949)G3 (N = 1430)G4 (N = 639)P
UC incidence (/105) [95% CI]1.1 [1.0–1.3]7.5 [7.2–7.8]4.7 [4.4–4.9]3.1 [2.9–3.4]<10−4
Female gender (%)56503440<10−4
Family history of IBD (%)14744<10−4
Active smokers (%)216116<10−4
Rectal syndrome (%)94949287<10−4
Abdominal pain (%)55544742<10−4
E1 disease30545633<10−4
E2 disease15131525<10−4
E3 disease55332942<10−4

Conclusions: In one of the largest population-based cohort described so far, the oldest and youngest populations were characterized by a higher frequency of pancolitis and lower frequency of proctitis as compared to the middle age populations. In parallel, there were less active smokers in the oldest and youngest cohorts. Clinical presentation was milder in the elderly and therefore a higher index of suspicion is needed to diagnose UC in this population.

1. Gower-Rousseau C (1994), Incidence of inflammatory bowel disease in northern France (1988–1990). Gut.