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The Increasing Prevalence of Inflammatory Bowel Diseases Among Jewish Adolescents and the Sociodemographic Factors Associated with Diagnosis

Levi, Zohar MD*,†,‡; Shamiss, Ari MD†,§; Fraser, Gerald M. MD*,†,‡; Furman, Moshe MD*,†; Derazne, Estela MSc*; Tzur, Dorit MSc*; Gordon, Barak MD*; Welinsky, Sara MSc; Gingold Belfer, Rachel MD; Afek, Arnon MD*,‡,¶

doi: 10.1097/MIB.0b013e31828a3797
Original Clinical Articles

Background: We investigated the prevalence and sociodemographic factors associated with diagnosis of inflammatory bowel diseases (IBD) among Jewish Israeli adolescents.

Methods: A total of 953,684 Jewish Israeli adolescents (57.8% men) who underwent a general health examination at mean age 17.3 ± 0.5 years from 1998 to 2010 were included. A definite diagnosis of IBD was based on laboratory, endoscopy, and pathology reports. Covariate data included socioeconomic status (SES) as defined by the Israel Central Bureau Statistics, and origin and number of children in household.

Results: A total of 2021 patients with IBD were identified (0.21%) in 13 annual cohorts. The prevalence of IBD increased from 149.4 cases per 100,000 to 301.0 cases per 100,000 in the first and last cohort (Ptrend = 0.003). Independent factors associated with occurrence of IBD were SES (high: odds ratio [OR] = 1.84, 95% confidence interval [CI]: 1.60–2.1, P < 0.001; medium: OR = 1.47, 95% CI: 1.3–1.69, P < 0.001; low: reference), Western origin (OR = 1.71, 95% CI: 1.53–1.90, P < 0.001; Asia Africa: reference), and male gender (OR = 1.21, 95% CI: 1.10–1.33, P < 0.001; female: reference). Four or more children in the household were associated with reduced OR for IBD [N ≥ 4: OR = 0.70, 95% CI: 0.62–0.72, P < 0.001, N = 1–3: reference]. The OR among adolescents of Western origin–high SES was 2.95 times higher compared with adolescents of Asia-African origin with low SES.

Conclusions: The prevalence of IBD doubled during the 13 years of the study period. Among this large cohort of Jewish adolescents, for each origin, higher SES was associated with increased occurrence of IBD.

Article first published online 9 May 2013

*Medical Corps, Israeli Defense Force, Israel;

The Gastroenterology Department, Rabin Medical Center, Petach Tikva, Israel;

Sackler Faculty of Medicine, Tel-Aviv University, Israel;

§Sheba Medical Center, Tel Hashomer, Israel; and

Ministry of Health, Jerusalem, Israel.

Reprints: Zohar Levi, MD, The Gastroenterology Department, Rabin Medical Cancer, Petach Tikva, Israel (e-mail:

The authors have no conflicts of interest to disclose.

Z. Levi and A. Afek contributed equally to the study.

Received December 07, 2012

Accepted January 28, 2013

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