Abstract
Background
The prevalence of Inflammatory Bowel Disease (IBD), consisting of Crohn’s disease (CD) and ulcerative colitis (UC), is rising in Canada. Because IBD is a complex and costly disease, estimates of changing prevalence over time are necessary to inform the Canadian healthcare system on the evolving burden of IBD.
Aims
To analyze historical prevalence and predict the future prevalence of IBD in Canada.
Methods
Annual population-based prevalent cohorts from Alberta (2002–2015), Manitoba (1990–2013), Ontario (1999–2014), Quebec (2001–2008), and Nova Scotia (1996–2009) were obtained from the Canadian Gastro-Intestinal Epidemiology Consortium. Data were adjusted based on annual age and sex distribution in Canada. Log binomial regression on adjusted data was performed with either a linear, linear spline, or restricted cubic spline model, depending on model fit, and yielded average annual percentage change (AAPC) with 95% confidence intervals (CI). Predictive models for CD, UC, and IBD to 2030 were calculated for each province, and then combined into a single model for Canada with provincial data from 2002 to 2008. Prediction intervals (PI) were calculated for predicted prevalence.
Results
Prevalence of CD, UC, and IBD for each province in 2008 and provincial predicted prevalence in 2018 and 2030 is reported in Table 1. The estimated prevalence of IBD in Canada in 2008 was 489 per 100,000 persons. In Canada, the predicted AAPC after 2008 is: CD: 2.76% (95%CI:2.74–2.78%); UC: 2.90% (95%CI:2.88–2.92%); and IBD 2.88% (95%CI:2.87–2.90%) (Figure 1). The prevalence of IBD in Canada is predicted to climb to 0.95% in 2030 (Table 1, Figure 1), which represents an increase in the number of people with IBD in Canada from 257,564 (95%PI:254,356–260,772) in 2018 to 388,042 (95%PI:381,808–394,276) in 2030.
Conclusions
By 2030, 0.95% of the Canadian population is predicted to have IBD. Clinical and policy driven healthcare innovations are required over the next decade to stem the impact of IBD in Canada and ensure these individuals receive the necessary care.
Table 1: Past and Future Prevalence of IBD in Canada (Prevalence per 100,000 persons)
| IBD | CD | UC | |||||||
|---|---|---|---|---|---|---|---|---|---|
| 2008 | 2018 | 2030 | 2008 | 2018 | 2030 | 2008 | 2018 | 2030 | |
| Actual | Predicted | Actual | Predicted | Actual | Predicted | ||||
| Canada | 489 | 697 | 945 | 259 | 363 | 487 | 210 | 300 | 408 |
| AB | 510 | 646 | 780 | 275 | 317 | 351 | 176 | 222 | 264 |
| MB | 546 | 597 | 664 | 275 | 288 | 307 | 271 | 309 | 357 |
| NS | 860 | 1136 | 1469 | 410 | 516 | 642 | 345 | 543 | 698 |
| ON | 487 | 630 | 782 | 237 | 293 | 350 | 235 | 302 | 372 |
| QC | 429 | 639 | 890 | 270 | 412 | 581 | 159 | 230 | 314 |
AB: Alberta; MB: Manitoba; NS: Nova Scotia; ON: Ontario; QC: Quebec
Funding Agencies
CIHRIzaak Walton Killam Memorial Scholarship; Eyes High Doctoral Recruitment Scholarship