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Poster presentations: Epidemiology 2020

P741 Incidence and clinical phenotype of inflammatory bowel disease in the north–west of Spain (Vigo) between 1991 and 2011

M.L. De Castro Parga1, V. De Castro Luisa Hernández2, J.R. Pineda2, J. Martinez Cadilla2, M. Figueira2, L. Sanromán2, S. Pereira2, J.I. Rodriguez-Prada2

1Department of Gastroenterology, Hospital Alvaro Cunqueiro, University Hospital Complex of Vigo, Spain, 2University Hospital Complex of Vigo, Department of Gastroenterology, Vigo, Spain

Background

The incidence of inflammatory bowel disease (IBD) seems to have stabilised in the last two decades in some western countries. Our aim was to analyse changes in the epidemiology of IBD between 1991 and 2011 in the area of Vigo (north–west of Spain).

Methods

Retrospective and descriptive study of two inception cohorts of IBD patients aged 15 years or more, that were enrolled in the area of Vigo in two European epidemiological studies: EC-IBD performed from 1991 to 1993 and EpiCom performed in 2010 and 2011. The population of Vigo at those moments was of 408.387 and 493.516 inhabitants, respectively.

Results

In 1991–1993, 102 new IBD cases were diagnosed: 65 ulcerative colitis (UC), 35 Crohn’s disease (CD) and 1 IBD unclassified (IBDU) that showed an incidence of 12.5 cases/100 000 inhabitants per year (8/100 000 inhabitants/year for UC, 4.3/100 000 inhabitants/year for CD and 0.1/100 000 inhabitants/year in IBDU). Regarding 2010–2011, there were 192 cases: 88 UC, 83 CD, 21 IBDU, which an incidence of 19.5 cases/100 000 inhabitants per year (8.9/100 000 inhabitants/year for UC, 8.4/100 000 inhabitants/ year for CD and 2/100 000 inhabitants/year for IBDU) (Figure 1). IBD patients in the second cohort were older: 43.5 (16.4) and 35.8 (16.2) years (p = 0.0005) than the first ones, and IBD diseases also differed in both cohorts (p = 0.001) with more CD (p = 0.03) and IBDU (p = 0.013) in 2010–2011. In 2010–2011 cohort UC patients were older: 39.2 (15.1) vs. 46.1 (16.4) years (p = 0.008) with no differences in gender or phenotype. CD patients were older as well: 29.1 (15.7) vs. 40.4 (15.8) year (p = 0.001), with more patients over their 40s (p = 0.005), and an increase in ileal vs. colonic location (53% vs. 20%, p = 0.006) (Table 1).

Cohort EC-IBD 1991–1993 N = 102Cohort Epicom 2010–2011 N = 192
Age35.8 (16.2)43.5 (16.4)p = 0.0005
Gender: female/male41.2–58.8%39.6–60.4%
UC CD IBDU64.4–34.7- 1%45.8- 43.2–10.9%p = 0.001
Perianal disease3.9%2.6%
Extra intestinal manifestations7%7%
Ulcerative colitis
Age39.2 (15.1)46.1 (16.4)p = 0.008
Gender: female/male50.8–49.2%35.2–64.8%
Phenotype: E1/E2/E330.8–47.7–18.5 %27.3–37.5– 35.2%
CROHN DISEASE
Age29.1 (15.7)40.4 (15.8)p = 0.001
Gender: female/male25.7–74.3%38.6–61.4%
A1/A2/A317–71.4–11.4%1.2–51.8–47%p = 0.005
L1/L2/L324.2–33.3–42.4%53.1–19.8–23.5%p = 0.006
L4 location6.3%9.9%
B1/B2/B378.8–9.1–12.1%65.1–22.9–12%

Conclusion

Between 1991 and 2011, an increase in the incidence of IBD in Vigo was demonstrated, mainly in CD and IBDU. The age at IBD diagnosis increased significatively, both in UC and CD.