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Increasing Incidence of Pediatric Inflammatory Bowel Disease in Spain (1996–2009): The SPIRIT Registry

Martín-de-Carpi, Javier MD*; Rodríguez, Alejandro MD; Ramos, Esther MD; Jiménez, Santiago MD§; Martínez-Gómez, María José MD, PhD; Medina, Enrique MDon behalf of the SPIRIT-IBD Working Group of SEGHNP (Sociedad Española de Gastroenterología, Hepatología y Nutricion Pediátrica)

doi: 10.1002/ibd.22980
Original Clinical Articles

Background: Although pediatric inflammatory bowel disease (IBD) diagnosis has increased in the last decades in Spain, there are no consistent epidemiologic data. Our aim was to describe the changing pattern of pediatric IBD incidence in Spain in the last 14 years.

Methods: A retrospective survey of patients diagnosed below 18 years of age in the period 1996–2009 was performed. Patients' data were obtained from the hospitals' databases. To avoid reduced accrual of cases diagnosed by adult physicians, adult IBD units in referral centers were invited to participate. Seventy-eight centers participated in our survey. Rates of incidence were calculated using age-stratified population-based epidemiologic data. Incidence rates were compared for the last 14 years (1996–2009).

Results: In total, data from 2107 patients were obtained: 1,165 Crohn’s disease (CD, 55.3%), 788 ulcerative colitis (UC, 37.4%), and 154 IBD unclassified. The sex distribution was 56.4% male, with higher predominance for CD (59.3%) as compared to UC (52.8%) and IBD unclassified (53.2%) (P = 0.012). The median age at diagnosis was 12.3 years (p25–75 9.7–14.6) with significant differences between diseases. IBD incidence increased from 0.97 to 2.8/100,000 inhabitants <18 years/year in the study period. Although this increase is more evident for CD (from 0.53 to 1.7), UC has also risen considerably (0.39 to 0.88).

Conclusions: This is the first attempt to calculate the current incidence of pediatric IBD in Spain. A significant increase of incidence rates in the study period was observed. In the last 14 years pediatric IBD incidence has almost tripled, with a more important CD increase.

Article first published online 25 April 2012

*Unidad para el Cuidado Integral de la Enfermedad Inflamatoria Intestinal Pediátrica, Sección de Gastroenterología, Hepatología y Nutrición Pediátrica, Hospital Sant Joan de Déu, Barcelona

Hospital Virgen del Rocío, Sevilla

Hospital La Paz, Madrid

§Hospital Central de Asturias (Oviedo)

Hospital Nino Jesùs (Madrid)

Hospital Doce de Octubre, Madrid, Spain.

Reprints: Javier Martín-de-Carpi, MD, Sección de Gastroenterología, Hepatología y Nutrición Pediátrica, Hospital Sant Joan de Déu, Paseo Sant Joan de Déu, 2,08950-Barcelona, Spain (e-mail:

Received February 24, 2012

Accepted March 15, 2012

© Crohn's & Colitis Foundation of America, Inc.
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