The prevalence and geographic distribution of Crohn's disease and ulcerative colitis in the United States
The prevalence and geographic distribution of Crohn's disease and ulcerative colitis in the United States
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DOI：
10.1016/j.cgh.2007.07.012
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发表时间：
2007-12-01
影响因子：
12.6
通讯作者：
Finkelstein, Jonathan A.
中科院分区：
文献类型：
--
作者：
Kappelman, Michael D.;Rifas-Shiman, Sheryl L.;Finkelstein, Jonathan A.
背景与目标：美国之前对炎症性肠病 (IBD) 患病率的研究仅对小范围、地域有限的人群进行了抽样调查，可能无法推广到整个国家。本研究旨在确定全国大样本中克罗恩病 (CD) 和溃疡性结肠炎 (UC) 的患病率，并比较不同地理区域的患病率和其他社会人口特征。方法：我们分析了 900 万美国人的健康保险索赔，汇总了 33 个州的 87 个健康计划，并使用诊断代码识别了 CD 和 UC 病例。患病率的计算方法是用病例数除以两年内登记的人数。使用逻辑回归来比较按地理区域、年龄、性别和保险类型（医疗补助与商业）的患病率估计值。结果：20 岁以下儿童中 CD 和 UC 的患病率分别为每 10 万人中 43 例（95% 置信区间 [CI]，40-45）和 28 例（95% CI，26-30）。在成人中，CD 和 UC 的患病率分别为 201 (95% CI, 197-204) 和 238 (95% CI, 234-241)。与东北部、中西部和西部相比，南方这两种疾病的患病率较低。与医疗补助保险的个人相比，IBD 在商业保险个人中似乎更常见。结论：对美国 IBD 患病率的估计应有助于量化疾病的总体负担，并为适当的临床服务规划提供信息。
Background & Aims: Previous US studies of inflammatory bowel disease (IBD) prevalence have sampled small, geographically restricted populations and may not be generalizable to the entire nation. This study sought to determine the prevalence of Crohn's disease (CD) and ulcerative colitis (UC) in a large national sample and to compare the prevalence across geographic regions and other sociodemographic characteristics. Methods: We analyzed the health insurance claims for 9 million Americans, pooled from 87 health plans in 33 states, and identified cases of CD and UC using diagnosis codes. Prevalence was determined by dividing the number of cases by the number of persons enrolled for 2 years. Logistic regression was used to compare prevalence estimates by geographic region, age, sex, and insurance type (Medicaid vs; commercial). Results: The preva lence of CD and UC in children younger than 20 years was 43 (95% confidence interval [CI], 40-45) and 28 (95% CI, 26-30) per 100,000, respectively. In adults, the prevalence of CD and UC was 201 (95% CI, 197-204) and 238 (95% CI, 234-241), respectively. The prevalence of both conditions was lower in the South, compared with the Northeast, Midwest, and West. IBD appears to be more common in commercially insured individuals, compared with those insured by Medicaid. Conclusions: This estimation of the prevalence of IBD in the US should help quantify the overall burden of disease and inform the planning of appropriate clinical services.