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P673 A model of inflammatory bowel disease (IBD) population-based registry; incidence of IBD in the Romagna region

D. Valpiani1, I. Manzi*1, L. Samperi1, S. Gasperoni2, O. Triossi2, M. Di Marco3, A. De Padova3, L. Solmi3, C. Bernabini4, O. Giuliani5, S. Giorgetti5, F. Falcini5, E. Ricci1

1AUSL Romagna, presidio di Forli’, Gastroenterologia ed Endoscopia Digestiva, Forli’, Italy, 2AUSL Romagna, presidio di Ravenna, Gastroenterologia ed Endoscopia Digestiva, Ravenna, Italy, 3AUSL Romagna, presidio di Rimini, Gastroenterologia ed Endoscopia Digestiva, Rimini, Italy, 4AUSL Romagna, presidio di Cesena, Gastroenterologia ed Endoscopia Digestiva, Cesena, Italy, 5Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Registro Tumori della Romagna, Meldola, Italy

Background

Crohn’s disease (CD) and ulcerative colitis (UC) are inflammatory chronic bowel disease (IBD) with high social economic burden. Large population-based epidemiologic studies are lacking in Italy. The project involved the whole Romagna region (almost 1 100 000 inhabitants from the Ravenna, Rimini, Forlì, and Cesena districts).

Methods

The database is built using the Romagna Cancer Registry methodology, with the same operating system and similar web-based insertion files. From 2008–2013, we evaluated all resident patients with IBD (CD and UC) in Romagna region. We obtain information from hospital and general practitioner databases, histological and endoscopic findings, hospital discharge summaries, and the Romagna Cancer Registry. A data manager matched and then inserted all information in the web-based dedicated database, and then colleagues of Romagna Cancer Registry provided statistical analysis.

Results

The total number of IBD cases in Romagna was 1 234, 366 CD cases (184 males and 182 females) and 868 UC cases (502 males and 366 females). In the analysed period, the average annual incidence standardised rate for the European population/100 000 inhabitants was 5.99 for CD males (95% CI 5.08–6.90) and 6.09 for CD females (95% CI 5.14–7.02). For UC it was 14.69 for males (95% CI 13.34–16.02) and 10.82 for females (95% CI 9.62–12). In addition, there were 31 patients with inflammatory bowel disease unclassified.

Table 1 IBD incidence in the Romagna region 2008–2013

CDStandardised ratio/100 000CI 95%
Males1845.995.08–6.9
Females1826.095.14–7.02
Total3666.045.38–6.69
UCStandardised ratio/100 000CI 95%
Males50214.6913.34–16.02
Females36610.829.62–12.00
Total86812.6911.79–13.58

Conclusion

This is the first Italian population-based registry for IBD. Our data seem to confirm the probable underestimated relevance of IBD in Italy described in previous studies. Particularly for CD, incidence is more in accordance with Northern Europe data. We need a longer follow-up for a better validation, especially regarding UC, but in the future, this tool might be an adaptable model to a major reality and very beneficial for a better resource planning in IBD healthcare.