Epidemiology of Inflammatory Bowel Diseases in Israel: A Nationwide Epi-Israeli IBD Research Nucleus Study

Abstract

Background There are currently no nationwide data on the epidemiology of inflammatory bowel diseases (IBD) in Israel. We aimed to determine the population-based epidemiological trends of IBD in the diverse Israeli population. Methods Health-administrative data were retrieved from all 4 Israeli health maintenance organizations, insuring 98% of the population, using validated identification algorithms. National trends were determined using Joinpoint regression analysis calculating annual percent change and average annual percent change (AAPC). Results By 2019, there were 46,074 patients with IBD in Israel, corresponding to a national prevalence of 519/100,000 (0.52%), of whom 54.1% had Crohn disease (CD) and 45.9% had ulcerative colitis (UC). The number of Jewish patients doubled from 18,701 in 2005 (354/100,000) to 38,950 (589/100,000) in 2018 (AAPC, +4.0%; P < 0.05), and the number of Arab patients increased 3-fold from 1096 (102.1/100,000) to 3534 (240.7/100,000; AAPC, +6.8%; P < 0.05) during the same years. However, the increase rate has gradually decelerated over time (annual percent change during 2005-2008, 2009-2014, and 2005-2018 was +6.7%, +4.2%, and +2.3%, respectively; P < 0.05). Pediatric prevalence increased from 37.4 to 52.2/100,000, with CD predominating in both Jews and Arabs. The incidence of CD remained stable (from 15.9/100,000 to 14.9/100,000) and the incidence of UC decreased (15.4/100,000 to 10.5/100,000 (AAPC, –3.2%; P < 0.001)). In contrast, pediatric incidence of CD increased from 7.3/100,000 to 8.3/100,000 (AAPC, +1.9%; P < 0.05) and that of UC increased from 2.6 to 4.4/100,000 (AAPC, +5.8%; P < 0.05). Conclusions The IBD prevalence rate in Israel is still increasing but gradually decelerating, probably due to the decreasing overall IBD incidence. Nonetheless, incidence rate in children is still increasing. Ongoing narrowing in the rates between Jews and Arabs over time may indicate shared environmental factors.

The epidemiology of inflammatory bowel disease in Asia and Asian immigrants to Western countries

“…The incidence of CD and UC among Jewish Israelis was approximately twice that among Arab Israelis (CD: 16/100,000 Jewish persons; 9.6/100,000 Arab persons; UC: 11.4/100,000 Jewish persons; 6.2/100,000 Arab persons). 43 These findings suggest the role of genetic factors as major but environmental factors as a minor in IBD development.…”

“…Because of the geographic differences in Southeast Asia, the incidence and prevalence of IBD vary among countries. Populationbased IBD incidence data from Indonesia, Malaysia, Singapore, and Thailand during the same period have shown that the annual 43 Nationwide study IBD incidence was less than 1/100,000 persons, which is lower than that in the West and East Asia. 16,17 During 2011-2013, the pooled annual incidence of IBD was significantly lower in Southeast Asia than in East Asia (0.8 vs. 1.53/100,000 persons; p = 0.015).…”

“…In Israel, the recent nationwide Epi‐Israeli IBD Research Nucleus study reported incidence rates for CD and UC of 14.9 and 10.5/100,000 persons, respectively, in 2017, which was the highest incidence of IBD in West Asia 43 . These results were comparable to those from the Olmsted County, Minnesota, IBD cohort in 2000–2010 (CD: 10.7; UC: 12.2/100,000 person‐years) 24 .…”

Patient activation and its association with health indices among patients with inflammatory bowel disease

“…As of 2019, 54.1% had Crohn's disease (CD) and 45.9% had ulcerative colitis (UC). 2 Optimal management of IBD relies on understanding and tailoring evidence-based interventions through shared decision-making of physicians and patients. Traditional approaches to the management of IBD care, based on treating symptoms alone and managing disease flares, have not changed the natural history of the disease.…”

Progression to Anti-TNF Treatment in Very Early Onset Inflammatory Bowel Disease Patients

“…There is some conflicting data on the changes in prevalence of VEOIBD. On the one hand, some cohorts have reported a stable percentage of diagnosis of VEOIBD over time (10,11), and on the other hand, a relatively recent population based study (4) demonstrated that the prevalence in Canada has been increasing over the…”