Geographic variation in the incidence of and mortality from inflammatory bowel disease

Abstract

The geographic and temporal variations in mortality from Crohn's disease and ulcerative colitis were investigated. The validity of mortality data as indicators of morbidity was tested by comparing the death rates and incidences among different countries. Death rates from Crohn's disease and ulcerative colitis were high in England, Germany, and the Scandinavian countries, and low in the Mediterranean countries. There was a significant correlation between the incidence and mortality of both diseases among different countries. In addition, the incidence and mortality of Crohn's disease were correlated with those of ulcerative colitis. In countries with a low mortality rate from Crohn's disease, the death rates in men tended to be higher than those in women. In contrast, countries with high death rates from Crohn's disease showed female predominance. No such relationship existed for ulcerative colitis. The overall change in mortality rates during the last 20 to 30 years was characterized by a rise of Crohn's disease and a marked fall of ulcerative colitis. In countries with a high mortality rate from Crohn's disease, the death rates started to fall in recent times. The significant correlations between incidence and mortality show that the death rates from both diseases represent reliable indicators of the morbidity and that the severity of the two diseases is similar in different countries. The marked temporal and geographic variations in both incidence and mortality suggest that environmental factors play an important role in the etiology of both diseases.

Crohn's disease and the mycobacterioses: a review and comparison of two disease entities

“…The incidence is between 3.1 and 13.5 per 100,000 population in the United States and between 0.3 and 7.3 in other countries that have reported the disease (35,36). Reports are conflicting, but the incidence of Crohn's disease in the United States and in other countries has been increasing, particularly in certain regions (35,36,92,208,262 The incidence of tuberculosis in the United States has been decreasing for the last few decades, but in recent years has begun to increase. Some individuals have suggested that the apparent increase of Crohn's disease in the Western world is related to the decreasing incidence of tuberculosis, because infection or immunization with one Mycobacterium species provides protection against infection with another species.…”

Evolução da ocorrência (1980-1999) da doença de Crohn e da retocolite ulcerativa idiopática e análise das suas características clínicas em um hospital universitário do sudeste do Brasil

“…As DII ocorrem em todo o mundo e representam sério problema de saúde, pois atingem preferencialmente pessoas jovens, cursam com recidivas freqüentes e admitem formas clínicas de alta gravidade (10,11) . Importantes trabalhos retrospectivos sobre a epidemiologia da DII realizados, sobretudo, a partir de 1980 (19,20,22,25) , firmaram a noção de que está havendo, atualmente, tendência mundial para o aumento da sua incidência (4,9) . Em todos os grupos populacionais estudados, o aumento da incidência da RCUI pareceu preceder, em até 20 anos, o aumento de incidência da DC (1,2,4,18) .…”

“…A RCUI e a DC são consideradas doenças raras nos países da América do Sul (15,22) . No entanto, isto parece não ser mais verdadeiro, como sugerem estudos que mostram tendência a aumento do número de casos diagnosticados nas últimas décadas (23) .…”

Enfermedades inflamatorias intestinales: Experiencia de dos centros chilenos

“…Es difícil estimar la incidencia y prevalencia de las EII en Chile por la falta de estandarización de los criterios diagnósticos, lo que se traduce en subdiag-nóstico y falla en la derivación a centros con mayor experiencia en el diagnóstico y manejo [15][16] . Otro aspecto importante es el aumento en la incidencia de EII en todo el mundo 3,4,13,[17][18][19][20][21][22] , sobre todo en los países en vías de desarrollo. Un aspecto interesante y no claramente explicado es que en la medida que los países han mejorado sus condiciones socioeconómicas los casos de EII también han aumentado 11,17,[23][24][25] .…”